Ectopic Pregnancy and the Jehovah's Witness
It is important to be aware of cultural and religious beliefs within a community, especially as a health care provider, because when dealing with patients from within that community there can be tensions that arise if the treatment violates a principle of the cultural/religious community. This would be the case were a member of Jehovah's Witness community to come into the hospital with the symptom described in the case study in which the woman has ectopic pregnancy. Because it is a tenant of the Jehovah's Witness community to reject blood transfusion, it is important that a hospital have a back-up plan for such cases so as to be able to practice "bloodless medicine" in order to save the lives of patients like the 25-year-old woman in the case scenario (Ratcliffe, 2004). This paper will discuss the impact of treating Jehovah's Witnesses when the treatment requires blood transfusion.
It is a belief of Jehovah's Witnesses that one should not ingest blood or allow blood transfusions, based on their interpretation of the Bible. This belief is based on passages within the Bible that relate to the blood and the sacredness of life. These passages include Genesis 9:4 ("But you must not eat meat that has its lifeblood still in it"), Acts 15:29 ("You are to abstain from food sacrificed to idols, from blood, from the meat of strangled animals ... "), and Leviticus 17:10 ("I will set my face against any Israelite or any foreigner residing among them who eats blood, and I will cut them off from the people"). Moreover, the official publication of the Jehovah's Witnesses, The Watchtower, elaborates on the principles on this belief and the practices that should be observed by all the faithful -- such as, abstention from the eating or transfusion of blood (even in medical emergency. Therefore, acceptance of a blood transfusion by a Jehovah's Witness who does not repent is liable to be excluded from his church and viewed as a pariah by former friends and members (Muramoto, 2001). Thus, the belief has both "spiritual" and social ramifications.
To understand the position of the Jehovah's Witness and to be able to provide a more ethical standard of care to such a patient, it is helpful to have a sense of the general beliefs as well. For instance, the general beliefs of the Jehovah's Witness regarding birth are that "life begins at conception," that life is sacred, that abortion is sinful and should never be practiced even to save the mother's life (DuBose, 2002, p. 6). Moreover, birthdays are not occasions of celebration for the Jehovah's Witness as there is no Bible basis for such celebrations and it is their belief that the Bible recommends celebrating only those days that are related to the glory of God because everything else has pagan roots (DuBose, 2002).
The general beliefs relating to death stipulate that the final days of the earth are approaching, that Armageddon as depicted in the Bible will soon be here. Yet, their views about what happens when one dies are unique: they believe that "death means only the termination of conscious existence. Hell is not eternal torment," but rather a separate existence apart from those who are called to Jehovah. Death prior to Armageddon is simply like a sleep. Nonetheless, life is still deemed as precious, since it is a gift from God, and therefore Witnesses do not support suicide, as this is a rejection of the gift of life, which no one has the right to refuse as God has obviously willed it or else it would not be. This is reconciled to the idea of refusing medical treatment such as blood transfusions that could potentially assist in saving lives because the spiritual or Biblical principle upon which that rejection is based supersedes the principle of embracing life, as it is believed that it is better to die with a pure conscience and soul than to die having defiled it through the breaking of one of God's commandments. Thus, life is to be preserved so long as it can be preserved without offending God.
Their general beliefs related to illness and disease are that disease is primarily the effect of a "degenerative process that began with Adam's fall from grace and would not be reversed until after Armageddon" -- thus, there is a certain amount of fatalism intertwined within the Jehovah's Witness
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