By Erin Talati
In the intensive care unit, almost every decision can be made into life or death. For some children whose parents are Jehovah’s Witnesses the need for a blood transfusion becomes quite literally a life or death decision. As clinicians, we struggle with maintaining a relationship with the family, while advocating for what we believe is in the best interests of a sick child. Asking a family taxed by the knowledge that their child is critically ill to step back and to choose to sin to save the life of their child or instead to choose death seems impossible; and, usually, we don’t expect families to make this decision. In many situations where a blood transfusion is required to protect a child from what is thought to be imminent death, a variety of approaches have allowed hospitals and courts to remove decision making power from the family to permit blood transfusion of a child against the family’s religious beliefs.
Decisions over transfusion of Jehovah’s Witness children are not new. A long line of cases dating to the late 1960s examines the balance between parental domain over decisions for their children and the interest of the state to protect the best interests of children. Since the 1960s, the debate has taken many forms. In life threatening situations, precedent allows doctors and hospitals to take some form of protective custody over a child in order to do what is thought to be best for the child. Early iterations of the debate focused on state intervention into the private sphere of the family only when the medical community agreed on the proposed intervention, the intervention would be the right decision for the child, and the child would face imminent death without the intervention. The justification for this approach is that while parents are generally best suited to determine what is in the best interests of their children, when the parents beliefs endanger a child’s future ability to decide for himself, the state can step in to protect the future interests of the child.
The decision to allow transfusion of children of Jehovah’s Witnesses over the wishes of their parents, however, is not universal. Read More