'Under 15s must be given transfusions despite beliefs'

The Yomiuri Shimbun, Japan/June 24, 2007

A committee comprised of the country's five medical societies has compiled a draft guideline that stipulates doctors should perform a blood transfusion during surgery on patients under 15 years of age even if their parents are Jehovah's Witnesses and refuse it because of a Biblical injunction, it was learned Saturday.

The joint committee started discussing the refusal of blood transfusions by Jehovah's Witnesses in response to requests from doctors who have said they are troubled about prioritizing either religious freedom or respect for life.

The committee judged that refusing a blood donation for children under 15 who are considered to be immature in terms of their self-determination capabilities constitutes an abuse of parental rights.

The joint committee is comprised of the country's major medical societies--the Japan Society of Transfusion Medicine and Cell Therapy, Japan Surgical Society, Japan Pediatric Society, Japanese Society of Anesthesiologists and Japan Society of Obstetrics and Gynecology.

The committee said it would finalize the common guideline agreed by the five societies this year after hearing opinions from followers of the religious group and bioethicists at a symposium to be held at Tokyo Medical and Dental University on Saturday.

Medical institutions belonging to the five societies are expected to compile their own manuals in line with the guideline.

To deal with the refusal of blood transfusions by Jehovah's Witnesses, a similar guideline compiled in 1998 by the Japan Society of Transfusion Medicine and Cell Therapy--then known as the Japan Society of Blood Transfusion--stipulates that doctors should respect a patient's wishes if he or she is 18 or older. If a patient is aged under 12, however, it said doctors should prioritize saving lives, including performing a blood transfusion during surgery, even if the child's parents are against the transfusion.

The guideline, however, presents no specific rule in those cases in which a patient is aged between 12 and 17, because the committee had considered that people in this age bracket are still in their formative years and thus their decision-making ability varies.

The latest draft guideline sets 15 years of age--the age at which children finish mandatory education--as the age the committee considers children can independently make a decision about medical treatment.

In the case of patients aged from 15 to 17, the draft guideline said that a blood transfusion should not be performed if both the patient and their parents reject it. The transfusion would be conducted if the patient in this age bracket requests it, but his or her parent refuses. The transfusion also will be given if the patient rejects it but his or her parents accept it.