Content area
Full Text
Phil Wilson sets out the facts about the law as the supreme authority which directs the nurse in decision-making processes to protect the child
KEY WORDS
Children: rights
Culture and religion
Ethics
Law
Family-Centred Care is well recognised as an effective modality for assisting recovery and providing holistic, informed care for children and young people. However, when the child and family are Jehovah's Witnesses an element of difficulty commonly arises should blood transfusion be necessary.
Balancing the religious wishes of the child and family against the clinical need for a necessary blood transfusion threatens to destabilise aspects of the family-centred strategy. Being in an emergency situation in the presence of a parent who is very strongly objecting to treatment can be a harrowing experience, even for the very experienced practitioner. Clarifying the stance which the nurse must take in this complex clinical situation is vital.
This article focuses on the one authority that must always be central to the nurse's care: the law. Possible alternative treatments to blood transfusion or holistic care strategies for the Jehovah's Witness family are not discussed here (see for example Ellis 2000).
Authority to act
It can be confusing when there are many competing authorities which guide and direct nursing. Primarily, a prescribed blood transfusion obtains its authority from the Medicines Act 1968. This requires the nurse to either administer the transfusion or have valid justification for withholding it. However, the nurse is also directed by numerous other authorities; such as the NMC, NHS standards and frameworks and local service policies. Each of these authorities requires nurses to deliver care that is respectful of their patient's cultural or religious beliefs. They also stipulate that nurses must champion the child and family's choices and wishes.
It can be quite an arduous matter for the nurse to be certain of the correct course of action when consent for a life saving blood transfusion is being refused. The nurse may feel uncertain about which authority's ruling must be satisfied first. What this article will make clear is that all the authorities mentioned are secondary to UK law (Slapper and Kelly 2002).
Opposition to blood transfusion
The Watchtower and Bible Tract Society (WBTS) has historically opposed the administration of blood transfusion...