Medical ethical moral and legal aspects of Jehovah's Witnesses operations

Objective: To point out principles of blood sparing surgery. Medical ethical moral and legal aspects of operations on Jehovah’s Witnesses. Design: Retrospective clinical study. Review of articles. Setting: Dept. of Gynecology and Obstetrics, University Hospital, Olomouc; Dept. of Health Care Sciences, Faculty of Humanities, Tomas Bata University Zlín. Materials and methods: 72 Jehovah’s Witnesses patients were operated on for various benign and malignant gynecological diseases since 2007–2017. All patiens were operated according to the rules of blood sparing surgery. Results: There were no excesive blood loss at any of the operations. The estimated blood loss was between 10 to 550 ml. Conclusions: The main principles of blood sparing surgery should be applied not only for Jehovah’s Witnesses but for all patients. Even if the blood transfusion is the last resort for excessive blood loss during complicated operations it always carries some health risks. There are also the economical aspects. Blood transfusions should be therefore used only at very rare occasions. Jehovah’s Witnesses refuse blood transfusions at all even if it is the only life saving resort. Our legislation deal with this problem but there are also moral and ethical aspects. The attitude of gynecological surgeons how to solve this problem differ a great deal. © 2019, Czech Medical Association J.E. Purkyne. All rights reserved