GESTIÓN EN SALUD PÚBLICA: Melbourne hospital given right to administer transfusion without consent

domingo, 9 de septiembre de 2018

Melbourne hospital given right to administer transfusion without consent

Melbourne hospital given right to administer transfusion without consent

Bioedge

Melbourne hospital given right to administer transfusion without consent

by Xavier Symons | 8 Sep 2018 | 1 comment

A court in Melbourne, Australia, has approved a hospital’s request to administer a blood transfusion to a pregnant Jehovah’s Witness teenager despite her religious objection to the procedure.

The decision was made by a supreme court authority late last month after Mercy Hospitals Victoria requested approval to perform an emergency transfusion if necessary.

The pregnant teenager had told doctors that a transfusion was against her religious beliefs. But doctors were concerned that girl’s “small stature” put her at increased risk of hemorrhaging.

Associate Professor Campbell Paul, a consultant child psychiatrist at Melbourne’s Royal Children’s Hospital, told the court that, while the girl had been clear and consistent in her refusal of a transfusion, she was significantly influenced in her decision by her family and community. “[She has] been through considerable disruption and trauma through her life” and had “transgressed a major value of her family and her community” by having pre-marital sex.

“You could imagine that she feels very frightened” and worried about “further punishment”, he said.

The girl’s mother said via a translator that to forcibly administer a transfusion would be akin to assault or rape. She said that she would always always seek medical treatment for her children when they were unwell, and that ‘‘it’s just this matter of blood transfusion that she is not able to agree with’’.

Justice Cameron Macaulay granted Mercy hospital the authority to give the girl a transfusion if necessary as “a last resort” but only if they first used all other strategies to stop the bleeding and obtained authority from two doctors.

“I’m not satisfied that [the girl] has the maturity to understand the consequences of her choice,” he said.

“I do not consider that allowing her, in effect, to choose to die ... is in her best interests”.

Sunday, September 9, 2018

John Robertson was an American scholar in law and bioethics who died last year. He is best known for making a strong case for “procreative liberty”, whether procreation takes place naturally or with the help of technology. As a tribute to his influence, the current issue of the Journal of Law and the Biosciences contains several articles about this theory.

Robertson’s theme was that reproductive choices which do not harm the interests of others should not be subject to regulation or prohibition. In his best-known book, Children of Choice, published in 1996, he discussed abortion, IVF, surrogacy and pre-natal genetic modification. But time has moved on. The principle of effectively unconstrained “procreative liberty” is being used to justify other developments, some of which are discussed in the Journal, including unisex gestation.

What I found interesting was that Robertson, in a paper written not long before his death, agreed that a male pregnancy (after a womb transplant) could be ethically justified, but only if it were necessary for genetic reproduction. Even he wanted to draw a line somewhere.

However, the author of one of tribute essays questions this restriction. Enjoying the experience of gestation is reason enough, she says. (See below). I suppose that this raises the question of whether it is possible to draw any lines, anywhere, once we agree that reproductive rights should not be limited.