It’s not about you
Religion. Respect. Gotta respect it – religion. Religion, respect, they go together.
A young Jehovah’s Witness has died just hours after giving birth to twins. She had signed a form refusing blood transfusions, and her family would not overrule her. Couldn’t doctors have intervened? If they had, they [might] well have been charged with a criminal offence, and would not have had a legal leg to stand on in court. The UK places great emphasis on respecting the religious convictions of patients – and increasingly the doctors who treat them too. There is nothing medics can do when an adult refuses treatment on religious grounds, says Vivienne Nathanson, head of ethics at the British Medical Association.
Is there anything patients can do when an adult doctor refuses treatment on religious grounds? Sometimes. That dentist who refused treatment to a woman because she wasn’t wearing a hijab got a mild rebuke. But maybe in a few years that will be seen as insensitive – to the dentist. Or maybe not; who knows.
Jehovah’s Witness liaison committees, who advise both doctors and patients on alternative treatments, are now firmly established in many UK hospitals. “We are ever more favourably received – doctors are increasingly sympathetic to needs of the community,” says David Jones, a member of the committee for North Bristol NHS Trust. “We have drawn up detailed care plans for everything from heart surgery to giving birth, including ways to stem postpartum haemorrhage. All hospitals should have access to these.”
Isn’t that heart-warming? Doctors are increasingly sympathetic – isn’t that kind? They’re are increasingly sympathetic to the ‘needs’ of the ‘community’ – the needs of the community to adhere to a ridiculous meaningless arbitrary outmoded pettifogging bit of nonsense from Leviticus. And in order to exercise all this extra and increasing sympathy, doctors and nurses have to absorb piles of detailed care plans that wouldn’t be necessary if the ‘community’ didn’t ‘need’ to adhere to its outmoded bit of nonsense. What a pathetic waste of time and resources, which could be used in better ways. It’s revolting – that smug self-centered self-congratulation on the ability of the ‘community’ to force (by moral pressure) busy doctors and hospitals to pay lots and lots and lots of pointless extra attention to them. I might as well go drop in at the local primary school and demand that everyone there pitch in to make me a ten-course dinner but make sure it’s kosher and haram and vegan and Scientology-appropriate. I’m special, I deserve to usurp everyone’s time and attention, right?
[O]ther countries are not quite as tolerant of mothers’ religious convictions…A young woman in Dublin lost a lot of blood after giving birth to a healthy baby a year ago. A Jehovah’s Witness, she too refused a transfusion. But an emergency ruling permitted the hospital to carry out the procedure, arguing that the right of the newborn baby to have a family life overruled the mother’s right to refuse treatment.
Well, what about that? Why don’t UK hospitals take that into account? Why doesn’t the baby’s need for a mother have to be at least weighed against the mother’s ‘religious convictions’? (Yes, I know, I’m always talking about women’s autonomy, and that’s why I think women should be able to decide not to bear a child they don’t want, but I also think that if they do decide to bear the child, they take on certain responsibilities. That in fact is one reason I think they should be able to decide not to – the responsibilities are very large and potentially very intrusive. Frankly I think they make ‘religious convictions’ look horribly trivial and selfish.)
I think perhaps you are overreacting a little here. It is assault to treat an adult patient without consent in the UK for very good reason (children can be treated without their parents’ consent if it is in their best interests).
I suppose the idea that the infant has the right to a parent has some merit, but I’m not sure it overrules the parent’s right to refuse treatment. Would you limit it just to Jehovah’s Witnesses? How about mums refusing palliative chemo? How about enforcing lifestyle changes in order to reduce the risk of premature maternal death? Ought women to be allowed to risk a second pregnancy for fear they’ll leave little Johnny without a mum?
Why don’t UK hospitals take that into account? Well, that would be because of the law (Brief summary You might think that the existing legal situation is wrong, but I don’t think you can reasonably blame the hospital, on the facts. Actually, AFAIK, they were on thin ice even considering asking the family to “override” her express instructions – I’m fairly sure that the family has no legal standing in the matter whatsoever.
And just think of the difficulties of drafting statute law to allow someone (family? doctor? courts? but there would be no time in many cases, unlike the Irish one) to ignore the express wishes of someone in order to compel them to fulful their parental duties – without any accidental and undesirable side-effects.
An adult, of sound mind, should have the right to refuse whatever treatment they wish – we shouldn’t force them to make the “right” decision.
But the existence of the children does cloud the issue somewhat. Even J.S Mill argued that society should intervene in an individual’s life if they were failing to live up to their responsibilities to their family.
Personally, I agree with the doctor’s decision. It’s tragic that this woman’s religious beliefs mean that her children will never know their mother. But the idea of giving doctors the authority to over-rule my decisions about how and when I die sits too uneasily with me.
Living near San Francisco, we have to deal with a related issue: how do you deal with people unable or unwilling to take care of themselves (the mentally ill or deeply addicted homeless). One lost soul was becoming more and more bizarre in his actions. People tried calling the City to get something “done” but the police could do nothing until he actually did something illegal. Of course, he assaulted a police officer.
Mental health is a grey area as mental health services have certain powers to intervene to protect the patient or others in the UK.
Yeah, I figured it was because of the law. It was the morality (or the law, or both) I was questioning, not the hospital. I suppose at bottom I’m questioning the woman’s morality. She has the ‘right’ to do it but it’s a shitty thing to do – and it shouldn’t be hailed as sensitivity and a ‘need.’ It should be frowned on, not patted on the back.
OB: “I suppose at bottom I’m questioning the woman’s morality.”
And that, in my view, is the appropriate thing to question.
Like others, I view, with considerable horror, the idea that “others”, neither appointed or approved by me, could force (inflict?) medical treatment on me against my wishes.
Yikes this is an awkward one I am inclined to agree with O.B she has the right but it is pretty stupid,I just cant stand the thought of forced treatment,(this will come as no supprise).
“There are no ‘unborn children’; there’s no such thing as an unborn child; mawkish language-manipulation is no substitute for argument. Notice the bluntness where it serves the purpose and the triple mawkish denialism where it suits that purpose – unborn growing children are killed. No; foetuses are aborted; not the same thing as killing growing children. If it’s such a serious moral issue, then address it seriously, not with tricks.”
OB, 29 Sept. When I read this, I thought, “‘When is your foetus becoming a child?’ Yeah — I’ve noticed how people talk like that all the time. Ophelia must be onto something.”
“I think women should be able to decide not to bear a child they don’t want.”
OB, 5 Nov. Your terminology’s slipping, Ophelia. They’re not children prior to birth — they’re foetuses, remember? Of all the people to fall victim to triple mawkish denialism! It just goes to show the insidiousness of pro-life rhetoric. It’s time to address the issue seriously — not with tricks!
We had a case in Chile where a woman belonging to some New Age sect gave birth at home, began to bleed and finally bleed to death. It is not clear to what extent group pressure prevented her from seeking medical help, which could have easily saved her life. The leader of the sect was declared to be insane, suffering from messianic delusions, by the courts and will not stand trial. Some of the lesser members of the sect will be tried. Are members of a religious sect, be it New Age or a recognized religious church, really free to decide if they accept medical treatment or not? Doesn’t freedom have to do with rational decision?
I agree that the patient has the right to refuse treatment.
I think having a jehovah’s witness “committee” there to “help” the hospital implement jehovah witness friendly medical care is INSANE.
The patient not only has the right to refuse treatment, the patient has the right to demand treatment even if it violates the patient’s own religious principles. You’re allowed to do that, you know. Violate your own religious rules. And so is your family if you’re too out of it to speak up.
Patients can refuse treatment for religious reasons. Family members can refuse treatment for incapacitated relatives for religious reasons. A council of elders has no business being involved.
I too agree that the patient has the right to refuse treatment (and I too hate the idea of forced treatment) – but I also think that right can be in tension with other rights – but in a moral sense rather than a legal one. In general hospitals shouldn’t be forcing parental responsibilities on people. (But in an emergency? When there’s no time to consult anyone else? Difficult. Which is why hospitals have ethics boards.) But I really think Jehovah’s Witnesses shouldn’t be preening themselves on the amount of time and resources they’re forcing hospitals to waste, especially not in the immediate aftermath of this stupid death.
Jimmy, [putting the irony to one side] but it’s not idiomatic to say ‘bear a foetus’ is it? Once you bear it, it’s a child – at least, I think that’s the idiomatic language, thus not specially adapted for purposes of stealth argument. It wasn’t slippage, it was an attempt (probably clumsy) to acknowledge both sides of the equation. I suppose I thought that in order to do that fairly the terms had to be parallel. I did consider saying ‘have’ instead of ‘bear’ but that sounds as if I think women should be able to dispose of their children at any point – it sounded sinister. Let’s see…I think that women should be able to refuse a pregnancy, but also that if they accept it, they take on certain responsibilities.
Just for the hell of it, I’ll put it another way. I think Emma Gough should have placed much, much more weight on the likely future happiness and flourishing of her babies than on whether or not she ‘ingested’ blood. I think she should have had a better sense of priorities and a less self-centered view of the matter.
There’s some epistemic morality here too, I suppose. I don’t think people should believe in a deity who cares more about whether or not people get blood transfusions than about whether or not they survive to raise their infants.
Surely there is a fair bit to be positive about in the case of adult JW’s refusing lifesaving medical treatment.
1. Fewer such imbeciles, less of the emotional drama and interminable ethical arguments.
2.Incalculable improvement to the human genepool
3. As well as the small matter of saving a bit of money (from the treatment refused so cavalierly) to benefit other sentient lifeforms who’d actually appreciate it
4. Kid has better chance at life with only one stupid, selfish parent instead of two.
5. Kid is better placed to critically evaluate (and reject) the insane religion she’s been ‘born’ into by the totally pointless suicide of her mother.
The only disturbing aspect of the case is the apparent respect given by the medical establishment to such idiots and their faith. Hospital staff should instead give out darwin awards(make it a celebration!) and send them along with cheerful goodbyes.
It strikes me as insane and fanatical to refuse a transfusion that will save your life, especially if you’re about to be a double-parent (and also a total misreading of Leviticus). It also strikes me as insane and fanatical to call a baby, 10 minutes before birth, anything but a baby. Mawkish? What an amazing idea.
Jean, in fairness to Jimmy, I think there were levels of irony in his comment. I think the idea is that I would (in other arguments) think or claim it was mawkish.
Gosh, that’s harsh, Mirax. And on point #5, unfortunately I would expect the church to ‘support’ the raising of this child in their own ways.
I can’t even begin to understand a mother who chose to do that to her child, what horrors does her church promise to those who break their rule? A supreme being so scary and malicious that a child should never know its mother, nor the mother her child, lest It be displeased at the breaking of an arbitrary rule.
In a way it reminds me of the story I heard when I was working in Thailand, of the Thai queen who was bathing and got into difficulties. The rules surrounding who could and could not make physical contact with royalty meant that her several attendants had to watch her drown, as none were appropriate to even extend a hand. The grieving king changed the rules. Slim chance of a religious hierarchy having the same reaction.
The NHS has provision in place to allow medical staff to decline being a part of procedures which offend their religious/philosophical beliefs.
Maybe it should be extended to allow them to decline involvement with patients whose religious beliefs would require them to allow a patient to die who could have been saved. It must be traumatic for the staff, surely, to have the means to save a patient at hand, yet be forbidden to use them.
‘you are a JW? Sorry, my religious/ethical/common bloody sense standards prevent me from meeting your needs. Please find another practictioner.’
Dang, that’s a point, Don – I didn’t even think of that. Poor medical staff.
Similar to the Thai queen is the occasion when the Saudi schoolgirls burned to death in a fire because the religious police sent them back inside because they were un-Islamically dressed. And Marie-Therese tells us the same thing happened in a fire in Cavan in the ’40s. Not to mention of course the hordes of Afghan women who died because they weren’t allowed to see a male doctor (and obviously there were no female doctors).
Ophelia, the idea is not that you “would (in other arguments) think or claim it was mawkish” to “call a baby, 10 minutes before birth, anything but a baby.” The idea is that you *did* claim that “there are no ‘unborn children’; there’s no such thing as an unborn child,” and that anyone who implies the contrary is guilty of “mawkish language manipulation.” There is some unbelievably blatant “language manipulation” going on here, but it’s not mawkish, and it’s not being perpetrated by the vast majority of English speakers, of all views and none on abortion, who see nothing strange in the expression “with child” (for example). As a description of English usage your claim was clearly nonsense; as a stipulation it would be plainly ideologically self-serving. It’s a bit late to worry about “sounding sinister” at this stage. I doubt Jean K is going to be persuaded from her clearly correct view that it is “insane and fanatical to call a baby, 10 minutes before birth, anything but a baby” by the consideration that it was “in other arguments” that you insisted that ‘unborn child’ is a contradictory notion. (I’m assuming that there are unborn children if and only if there are unborn babies, but perhaps you have some innovative linguistic suggestions there, too.)
Don: “The NHS has provision in place to allow medical staff to decline being a part of procedures which offend their religious/philosophical beliefs. Maybe it should be extended to allow them to decline involvement with patients whose religious beliefs would require them to allow a patient to die who could have been saved.”
BUT the NHS should NOT have such a provision in place. The existence of such a provision potentially puts a staff member’s religious beliefs ABOVE the best interests of the patient.
Even in THIS situation, the medical staff should, I think, have an obligation to provide the best care possible, given the circumstances.
Keith:
Who gets to define “best care” ? Often it’s a matter of opinion, in which case whose opinion is to considered? It is to avoid this quagmire that the wishes of each individual are normally taken to be paramount in relation to what that individual does or has done to him or her.
I cannot see why a person should be forced to do anything against his or her conscience as a matter of course (I emphasise the last part). The idea of acceding to the wishes of a patient not to be treated in a certain way comes from the same principle that disallows forcing a medical person to perform a procedure against his/her conscience. Do a thought experiment: suppose the procedure is female genital mutilation in a country where that barbarity is legal. Do we want it also to be legal in that country to force doctors to perform that procedure?
Richard,
Would you then oblige doctors to carry out abortions if it was against their principles?
Why isn’t this viewed as assisted suicide and treated as such ?
Nick, I was thinking it came pretty close.
Once or twice per year I do have a clearly correct opinion, and I think I’m going to call this one of those occasions. Fetuses don’t magically turn into babies as their mothers give birth to them. So 10 minutes before birth, the attending physician has two patients, the mother and the baby.
That being said, sure, there’s manipulation going on when anti-abortion folks worry about “unborn children.” It’s extremely tendentious to talk about unborn children when the issue is abortion–which occurs in the first trimester most of the time, and certainly never 10 minutes before birth.
And that of course is what the issue was in the previous discussion: it was specifically about anti-abortion rhetoric.
Jean — I agree that it may be tendentious to talk about ‘children’ in early stages — although even there it’s obviously not nonsense to speak of someone ‘losing their child’ in a miscarriage. But what Ophelia said on Sept 29, without qualification, was that there is no such thing as an unborn child. The only plausible explanation for such a blatantly false claim, barring idiocy, is prior ideological commitment, of exactly the sort that she is in the business of ascribing as a matter of course, and often with far less warrant, to very many of those with whose views she disagrees. That is, the claim that there are no unborn children is clearly a “truth claim…prompted by the political, ideological and moral commitments of [its] adherent,” and a product of “the general tendency to judge the veracity of claims about the world in terms of such commitments.” (Part of this weblog’s raison d’etre is supposed to be to oppose such things, according to “About Butterflies and Wheels,” from which I have just quoted.) I am calling into question this weblog’s standing assumption that it always sails under the flag of Reason and is free of any ideological bias — an assumption manifested in its extraordinarily strident and triumphalist tone.
NOW I get it. Many layers of meaning I was missing there.
There’s some confusion here. Butterflies and Wheels is not a ‘weblog.’ Notes and Comment is, of a sort, but Butterflies and Wheels is not. ‘About Butterflies and Wheels’ is about the whole site, not Notes and Comment in particular.
It’s also true that the About page was written more than five years ago (and not by me) and that Butterflies and Wheels has changed over that time; in short, the About page needs a re-write, but it’s located in one of the places I don’t have access to. Merely an accidental by-product of the way it was first set up.
At any rate, I disavow any ‘standing assumption’ that I ‘always sail under the flag of Reason’ (if only because I wouldn’t capitalize ‘reason’), and I certainly disavow the assumption that I’m free of any ideological bias.
Jean, yeah, I missed most of the layers of meaning too; what I thought was irony was…er…something else.
Ophelia, if you “certainly disavow the assumption that [you’re] free of any ideological bias,” then “About Butterflies and Wheels” really does need a rewrite, and possibly a total rethink:
“There are two motivations for setting up the web site. The first is the common one having to do with the thought that truth is important, and that to tell the truth about the world it is necessary to put aside whatever preconceptions (ideological, political, moral, etc.) one brings to the endeavour.”
(Presumably an ideological bias is if anything even worse than an ideological preconception.)
I just said it needs a re-write.
I would also point out however that there is a difference between saying that to tell the truth about the world it is necessary to put aside whatever preconceptions one brings to the endeavour, and having a standing assumption that one is free of any ideological bias.
Oh look what I just read –
“Victoria Brescoll, a researcher at Yale, made headlines this August with her findings that while men gain stature and clout by expressing anger, women who express it are seen as being out of control, and lose stature.”
snicker
In my experience, that relates to how ‘paid up’ in the group the person is. A member who has done a lot for other people, built status fo the group and him/herself and generally an all-around top contributor is likely both to be justified in anger, and to release it in very appropriate ways. Support for that expression will be because of the persons earned status and alignement with group values.
In contrast someone who has not built status, and perhaps feels victimised by the success of others, will use anger in perhaps less appropriate ways and generate those negative perceptions in response.
This is true of males and, I imagine, of females. I would expect that this study does not control for perceived relative status within peer circles before the use of anger.
BTW, I recommend Kelley and Caplan, How Bell Labs Creates Star Performers, in Harvard Business Review. Actually developed these ideas which helped women and minorities overcome bias by the ‘network’ in a male-dominated workplace, and measured and demonstrated the success of the strategies in action.
Don no I wouldnt because it is not that unreasonable for a doctor to view a pregnant woman as 2 patients, so he or she has a duty to both mother and foetus,if the mothers life was in danger that same doctor refusing to cary out an abortion would be grossly negligent.
Richard,
I guess everyone has stopped reading this, but my point was not that medical staff should be able to exclude from treatment groups of whom they disapproved but rather that they should be able to excuse themselves from procedures they found morally abhorent.
As Nick pointed out, it is reasonable to view cases such as this as assisted suicide, without even the excuse of euthanasia.
As the case stands, once a doctor has accepted a JW as a patient then they are legally required to oversee the avoidable death of a patient, should the situation arise.
If a doctor with strong objections to abortion is approached by a patient who is considering it as an option, s/he can and should declare themselves unable to become involved and direct the patient to another provider.
Why should it be different for a doctor who has strong objections to the waste of a healthy human life when approached by a patient for whom this type of elected death is intrinsically an option?