The Federal Supreme Court (STF) ruled, this Wednesday (25), that, for religious reasons, Jehovah’s Witnesses have the right to refuse medical treatments involving blood transfusions.
The faithful of this Christian denomination follow the precept of not receiving blood from other people.
They also decided that people who refuse a certain medical procedure because of religion have the right to alternative treatments that are already available in the Unified Health System (SUS), including outside their city of residence, if necessary.
The score was unanimous.
For ministers, the right to refuse blood transfusions due to religious conviction is based on the constitutional principles of human dignity and freedom of religion.
According to the STF decision, there are some conditions for a person to refuse certain treatment for religious reasons:
- The patient must be of legal age and the choice must be free, informed and expressed;
- The choice must be made before the medical procedure. The person can make their decision previously established;
- The choice only applies to the patient himself and does not extend to third parties.
This last point also applies to minor children of parents who follow the religion.
In these cases, parents can only choose alternative treatment for their children if it is effective, according to medical evaluation.
Judgment thesis
The STF’s decision was given in two cases originating from legal disputes involving Jehovah’s Witnesses. The processes have general repercussion, that is, the definition must be adopted in all similar actions in Justice.
The judgment theses — presented by the rapporteurs, Luís Roberto Barroso and Gilmar Mendes — are as follows, respectively:
“1. Jehovah’s Witnesses, when older and capable, have the right to refuse medical procedures involving blood transfusions, based on individual autonomy and religious freedom. 2. As a consequence, in respect for the right to life and health, they are entitled to alternative procedures available in the Unified Health System – SUS, and may, if necessary, resort to treatment outside their home.”
“A patient in full civil capacity is permitted to refuse to undergo health treatment for religious reasons. Refusal to health treatment for religious reasons is subject to an unequivocal, free, informed and informed decision by the patient, including when conveyed through an advance directive. It is possible to carry out a medical procedure made available to everyone by the public health system, with a prohibition on carrying out blood transfusions or other exceptional measures, if there is successful technical or scientific feasibility, the consent of the medical team to carry it out and an unequivocal, free and informed and informed information about the patient.”
The Supreme Court resumed its judgment on the matter this Wednesday (25). A.
“Legal security”
In a statement released at the end of the trial, Jehovah’s Witnesses in Brazil said that the STF’s decision gives legal certainty to patients, hospitals and doctors, and is “in line” with what has been decided in other countries.
“This decision provides legal certainty to patients, hospital administrations and doctors committed to providing the best healthcare treatment, always respecting the patient’s wishes,” said the entity.
According to Jehovah’s Witnesses, deliberations similar to those of the STF were made by courts in countries such as the United Kingdom, Italy, Canada, the United States, South Africa, Argentina, Colombia and Chile.
“In addition to being supported by international organizations, such as the European Court of Human Rights and the Inter-American Court of Human Rights”, they stated.
“Jehovah’s Witnesses love life and actively collaborate with healthcare professionals to receive the best medical care possible. They express sincere gratitude to these professionals and to the authorities who recognize and protect their right to choose medical treatments. They trust that cooperation, mutual respect and effective communication are essential for doctors and patients to successfully face healthcare challenges together.”
Why do Jehovah’s witnesses not accept blood transfusions?
The religion of Jehovah’s Witnesses is a Christian denomination that claims to have around 8.8 million adherents worldwide, preaching in 239 countries.
As shown by the CNNthe Public Information Department of Jehovah’s Witnesses defends the so-called (PBM), a medical strategy that brings together, from the pre-operative stage, measures to avoid the need for transfusion.
The refusal to transfusion, according to religion, is supported by both the New and Old Testaments. The most important reasoning is that “God commands abstention from blood because it represents life, which is something sacred”.
The justification of religious people regarding blood transfusion treatments is supported by a position from the World Health Organization (WHO), which preferably recommends an approach centered on the patient’s desire, the PBM.
During blood handling, some elements include the prevention of conditions so that blood transfusion is avoidable, through health promotion and early identification of conditions that result in the need for transfusion. This includes good surgical practices, anesthetic techniques that minimize blood loss, and the use of blood conservation methods.
The processes
The two cases being analyzed by the STF originate from legal disputes between Jehovah’s Witnesses.
After having the cost of alternative treatments rejected, they sought ways in court to perform surgeries without blood transfusions, claiming the right to protect religious freedom.
The process reported by Gilmar Mendes is that of a patient who was referred to Santa Casa de Maceió for surgery to replace the aortic valve (located in the heart).
The woman refused to sign a consent form that provided for the possibility of any blood transfusions during the procedure.
She sued the court saying she was aware of the risks of surgery without blood transfusion, and that she chose to reject this procedure out of respect for her religion.
In the lower courts, the court rejected the patient’s request. The main argument is that, although there are statements from doctors indicating that it is possible to perform the procedure without transfusion, there is no guarantee that such a method would be risk-free for the patient.
The other case, which is with Barroso, is an appeal by the Union against a decision that condemned it, together with the state of Amazonas and the municipality of Manaus, to bear surgery without blood transfusion in another state.
The conviction involved the order to pay all medical coverage for a total arthroplasty procedure (joint replacement with a prosthesis).
Amazonas did not offer this type of surgery without blood transfusion.
