Blood Transfusion and Jehovah's Witnesses. The Doctor's Posture, the Courts' View and Two Case Report

It is well known to the general population that transfusion of blood and blood products can save lives, but also that this transfusion can cause serious risks of transmitting infections. Traditionally, Jehovah's Witnesses are deeply religious people who refuse blood transfusion. The 2010 census in Brazil indicates that this year there were 1,393,208 Jehovah's Witnesses in Brazil. Most anesthesiologists consulted do not respect the wishes of Jehovah's Witness patients. Although the Brazilian Constitution guarantees religious freedom and the autonomy of life, the jurisprudence considers that people are not authorized to have their own lives for religious reasons. In the disciplinary and judicial administrative fields, there is a current scenario that makes room for the responsibility of the professional and the hospital. The two cases, a 17-year-old man and a 77-year-old woman, withstand bloodless treatment with Hb of around 4 g/dL. Multiple strategies to prevent and optimize the oxygen supply will decrease the incidence of anemia and decrease the morbidity and mortality of Jehovah's Witness patients. The medical team must respect the patients' autonomy and adhere to the principles of bioethics such as beneficence, non-maleficence and sometimes justice are also fundamental. The main objective of the chapter was to evaluate the Jurisprudence of the subject, the degree of knowledge of anesthesiologists in relation to the treatment of Jehovah's Witnesses, through a questionnaire. As a secondary objective, it was to report the experience with two patients, one young and one elderly, in surgical anesthetic management.