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PHYSICIANS’ INSTITUTIONAL AND LEGAL KNOWLEDGE ON JEHOVAH´S WITNESS PATIENTS’ AUTONOMY
full name / name of organization:
Chehaibar and Grinberg / Heart Institute (InCor) of HCFMUSP
firstname.lastname@example.org / email@example.com
Bioethics was developed in the 1970’s as a structured response to the atrocities committed against human beings during the Second World War and to the human rights movement that followed (Durand, 2003) . Bioethics Committees have since been created in hospitals worldwide, aiming to discuss complex issues. They focus on human dignity and improvement in the rapport between patients and health professionals, preserving both sides’ autonomy (Gohel et al., 2005) .
Among the bioethical questions is the conflict between the patient’s or family’s will and that of the health team. This conflict is related to the autonomy principle that generally translates into respect for choices of treatments (Walker,2010) . One of such conflicts involves Jehovah’s Witness (JW) patients because their right to refuse the medical procedure of blood transfusion might go against the medical duty to use all available resources to preserve life (Rogers & Crookston 2006; Ferrer et al., 2006) .
There are over 7 million Jehovah’s Witnesses worldwide and almost 700,000 in Brazil, representing about 0.36% of the Brazilian population (Watch Tower, 2009). This population accesses the health system, public or private, and requires special care. It also requires the full awareness on the part of their physicians regarding the limitations imposed by their religious beliefs on procedures such as blood transfusion. In Brazil, these patients are immersed in a normative background including the Brazilian Code of Medical Ethics as well as the country´s Constitution and its penal code. The first states the patient’s right to decide on diagnostic and therapeutic techniques as well as to complete information about these matters and the goals of the treatments suggested (São Paulo, 1999) . The Constitution states the patient’s right to refuse a specific treatment as well the freedom of creed as provided by the Brazilian Constitution of 1998 (Brasil, 1998) .