`There are two ethical dilemmas in the case. The first is autonomy. In clinical practice, the patients have control of their health regardless of the opinion of an expert (Palmer & Iserson, 1997) . In this case, Juana has the right to decide whether she wants blood transfusion or not. Her religion forbids blood products; hence she declined the blood transfer. This contradicts with the principle of beneficence, where care providers must do all they can to save the patient's life. In this case, Juana would have survived if she had a blood transfusion, and her child would have survived if a cesarean section was done. However, since Juana could make decisions, saving her life and that of the child was her choice.
Who should be involved in the decision-making process?
The decision-making process in Juana's case lies between Juana, her husband, and the physicians. The physician's input, in this case, is limited as they can only offer advice to her and allow her and her husband to make a decision. This is because she is conscious and able to make sound decisions. In addition, her husband, who is her next of kin, has a bigger say in this case. The final decision is Juana's, regardless of the physician's input, since the medical principle of autonomy empowers patients.
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List and evaluate alternatives in response to those ethical dilemmas.
In clinical practice, saving lives is the most important thing. In Juana's case, two lives are lost due to religious beliefs. The alternative to this should be the consideration of the Watch Tower Bible regarding the blood products. Different Bible verses could be used to change Juana's choice. For example, Luke 14:5 could be used where Jesus said that pulling an ox from a well on Sabbath is okay. In this case, saving Juana and her child was essential regardless of the means used.
Provide your final recommendation(s) along with practice implication out of this case study
Medical practitioners should be given a choice of saving the life of a patient when they make reckless decisions that may endanger their lives or that of the unborn child. Patients should also be educated regarding the importance of life regardless of their religious beliefs.
This case study shows the negative side of allowing the patient to take control of their healthcare. Although sometimes it may be for the best interest of the patient, autonomy sometimes brings unforeseen challenges, such as loss of life, which would have been saved.
References
Palmer, R. B., & Iserson, K. V. (1997). The critical patient who refuses treatment: An ethical dilemma. The Journal of Emergency Medicine , 729-733. doi:10.1016/s0736-4679(97)00157-1
