The next October 24th will take place at the court of Napoli the first hearing of the trial involving two doctors from the hospital Cardarelli, charged with the crime of private violence for not respecting the wishes of a Jehovah's Witness patient who refused to undergo a blood transfusion in compliance with her religious beliefs.
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The reasons that convinced the Public Prosecutor to send the two health workers to trial, originate, in addition to the evident "private violence", from the fact that the episode occurred on March 14, 2018, shortly after the entry into force (January 31, 2018) of Law 22 December 2017, n. 219, which unequivocally states the duty of the doctor (and any other health professional) to respect the will of the person, when expressing consent or refusal to the proposed health treatment (or assessment).
The case. The Jehovah's Witness patient, LK, of Filipino origin, had presented herself to the Cardarelli for hematuria that had been present for three weeks, had regularly handed in the DAT (Advance Treatment Directives) and had reiterated several times, even verbally, her refusal to undergo transfusion treatment "... even - as the same indictment underlines - if it had represented a condition of danger for her life".
Even when faced with the need for an urgent “scraping” operation, and the repeated invitation of the health workers to receive a transfusion, the patient confirmed her refusal. Unfortunately, as the indictment further emphasizes, “… taking advantage in some way of the language barrier between the health workers and the patient, due to L.’s inadequate knowledge of the Italian language … the same L. (in an evident state of unconsciousness, because she was under anesthesia: ed.) was forced to undergo the transfusion of two bags of concentrated red blood cells…”. Prescribed and imposed by the two doctors who ended up on trial.
It is interesting to note that the patient – who woke up from anesthesia to find that she had been transfused against her will – was never in danger of life and that the anesthetists themselves, unlike the head physician, did not agree to proceed with the transfusion.
The expert's comment. Professor Daniel Rodriguez, a well-known medical legal expert and bioethicist, underlines the need for the doctor to respect the patient's wishes and to show particular attention to his identity as a person: "The novelty of law no. 219 / 2017 is that it has enhanced the relationship of care and trust between patient and doctor. For the doctor, accepting the refusal is an expression of availability towards the patient and the ability to share his needs, his aspirations and his values.
For a Jehovah's Witness, such a transfusion is a treatment that permanently damages his religious identity..
The transfusion that is practiced despite the person's refusal compromises various components of the person's identity: religious, physical, family, social.. For a Jehovah's Witness, such a transfusion is a treatment that permanently damages his religious identity.. Furthermore, the timeliness of the manifestation of will must be conceived in a logical and not merely chronological sense.
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Therefore, the refusal (or consent) expressed to the doctor by the person who is globally informed and aware of the consequences of his or her decisions, continues to be current and valid beyond the moment of its expression even if a state of unconsciousness occurs. Therefore, the objective is to educate the doctor in the care relationship, understood as attention to the person and taking charge of his or her health needs”.
Article published on 21 October 2022 - 08:19
