Blood Transfusion and Anesthesia - Literature review Example

Blood Transfusion and Anesthesia Blood Transfusion and Anesthesia Introduction Medical practitioners have an ethical dutyto ensure that their patients are comfortable during the administering of blood products. They should consider their beliefs and get consent from them in order to reduce resistance and make sure that they recover promptly. They should consider employing blood transfusion processes within the parameters of the health institution in order to avoid harm. The health providers ought to also reflect on other alternatives to administering blood related products such as carrying out acute normovolemic hemodilation, using cell-savers, making use of hypotensive anesthesia, and deliberate hyporthermia among others (Harris & Engel, n.d). Therefore, this paper identifies various ethical points that have been learned from diverse articles on blood transfusion and how they can be incorporated in the medical practice to ensure affirmative results. It is evident that medical professionals must have an informed consent before administering blood products, should uphold the principle of beneficence, mostly in cases where the patients are incompetent and do not have a consent, and they ought to ensure that there is clear communication with the parents before administering the treatment to children. They should also have proper security measures to guarantee improvement, consider alternative treatment methods such as hypotensive anesthesia, appreciate diversity by respecting the religious beliefs of persons such as Jehovah’s Witnesses, and make sure that they inform the patients on the relative benefits as well as risks of accepting or refusing blood products. Discussion/ Reflection on the Articles Various scholars have offered insights on the ethical considerations that medical professionals should follow when administering blood transfusions. This is essential in making sure that health care providers give consideration to diverse ethical values and avoid inherent related conflicts when making medical decisions. Therefore, Sacchini et al. (2013, pp. 16-17) offer numerous ethical considerations that physicians ought to follow. The authors assert that in the process of blood transfusion, experts should guarantee that the right clinical measures are upheld in order to avoid harming the subjects. This means that they should do a thorough examination on the condition of the patient as well as that of the donor. The doctors should also have an informed consent from the donor and the patient. This helps in recognizing their dignity and making sure that their right to have informed and free choices is respected. Obtaining an informed consent will mean explaining to the patient the relative risks as well as the benefits of receiving blood transfusion and other viable alternatives that they can consider. In employing this strategy in the medical practice, it will be vital to compare the main risks of obtaining the blood product with other dangers that may surround the client’s treatment. Moreover, to those patients who are incompetent, there should be a substitute consent that ought to be obtained with regard to the territorial as well as the provincial laws. In cases where the patient is unable to make decisions because of either mental impairment or a case of unconsciousness and there is no informed consent, physicians should observe beneficence principle in order to preserve the life of the patients (Sacchni et al. 2013). Sacchni et al. (2013) have also recognized the role that underage donors and patients play, arguing that they should be protected since they are mentally and physically undeveloped. This means that physicians should first communicate with the parents of the young donors on possible side effects. Parents have a responsibility to offer consent for their children and health providers should not by any chance override families or parent’s refusal. In this case, the scholars have offered a paramount basis into which ethical aspects should be reinforced in blood transfusions to avoid misunderstanding, transfusing infected blood, and maintain quality healthcare. Therefore, such strategies should be utilized in the medical practice to heighten positive outcomes. Correspondingly, numerous scholars such as Macklin (2003, pp. 275-277) claims that medical experts should uphold the principle of respecting people and comply with the competent patient’s expressed wishes even in circumstances whereby the impacts are unfavorable. However, the problem comes in when there are conflicts of principles such as that of respect and nonmaleficence that requires them to save lives and avoid harm. In such circumstances, when a patient is incompetent, and has no written or verbal consent, the principle of beneficence should override that of respect for patients, since the benefits will be maximized and the harms will be reduced. This means that in administering blood, health experts should be wary of the consequences of their actions and choose the right methods to avoid controversy. The medical principles should be applied in practice, depending on the situation and the degree of impact. According to Naunheim, Bridges and Sade (2011), the healthcare providers should also consider the individual beliefs of their patients before subjecting them to blood transfusion processes. For instance, Jehovah’s Witnesses have a firm belief that people’s life is contained in their blood; hence, accepting transfusion is viewed as a sin. Therefore, Naunheim, Bridges and Sade affirm that giving blood to such people who have already refused the process can lead to civil or criminal law suits. In that case, from an ethical perspective, if any adult who is apprised fully on the impacts of not receiving such form of treatment persists on refusing the treatment, their decision should be considered and respected. Also in cases where the patient is unconscious and has signed an informed consent on what he or she wants, doctors should respect their wishes since the patient already knows that that death is a possibility. However, in cases where there is no informed consent, there is no right or wrong answers and medical professionals should conduct their duty based on the right to respect autonomy. For that reason, it is always important for health professionals to direct patients on the consequences of refusing transfusions and allow them to make the right decisions with full certainty of what is bound to happen (Naunheim, Bridges & Sade, 2011, pp. 1563-1564; Petrini, 2014, p. 400). Similarly, Petrini (2014, pp. 395-396) just like Naunheim, Bridges and Sade (2011) argues that the right of people who have diverse religious beliefs from those of the health professionals should be considered. The author asserts that some doctors might decide to override the autonomous choices of Jehovah’s Witnesses to refute transfusions even in cases where they are highly likely to die. Nevertheless, such doctors have a responsibility to ask their patients to reflect on their fatal blood refusal and draw to their attention that it is normal for people of their faith to accept transfusions in order to save their lives. This is because the doctor’s main duty entails saving their patients from harm or death for their general optimum health. However, they should note that this is not an absolute duty that should override the rest; thus, in case the patient refuses to undergo the treatment after they have been advised appropriately, the health providers should accept their decisions. It is unfortunate that doctors face an ethical dilemma in such cases since failure to act can be interpreted as negligence and intervention can lead to criminal charges due to lack of respect to one’s privacy and trespassing against the patient’s physical integrity. For that reason, medical experts should respect their prima facie duties, respect the freedom of the patients in case there is an informed consent, and in cases where there is none, they should consider the beneficence intervention to avoid conflicts (Petrini, 2014, p. 400). Based on the views of the aforementioned scholars, medical and nursing personnel should incorporate the right of informed consent in their practice and explore other alternatives that the patients might accept such as antifibrinolytics, volume expanders, and cell savage among other pharmaceutical options (Effa-Heap, 2009, pp. 174-175). Harris and Engel (n.d) also emphasizes that medical professionals face immense challenges when treating patients who have a specific belief such as the Jehovah’s Witnesses. They have a deep rooted religious conviction against transfusion of autologous or homologous blood that is packed by platelets, white or red blood cells. Although surgeons tend to decline treating such patients due to their medical and religious stand on the utilization of blood oriented products, Harris and Engel posit that surgeons should consider other alternatives such as hypotensive anesthesia, hypothermia, the use of cell savers equipment, and the Acute normovolemic hemodilation, which have proven to be successful and ethically relevant since they are not religiously objectionable. Therefore, such methods should be used in medical practice and rather than accepting such situations as a problem, physicians should change their perception and perceive them as medical challenge that need to be overcome. In meeting such problems and dealing with diverse people, they should also develop a standard or a rule of practice for these kinds of patients that are acceptable in various medical centers across the globe. This means that both the patients and the physicians will collaborate in facing the challenge and coming up with sound strategies to avoid unforeseeable conflicts that might arise. Finally, Sacchini et al. (2013, p.14) stress that health professionals should be ethical and apply the appropriate transfusion criteria to make sure that all persons who are required to receive the blood products are able to access it in a fair manner. This will help in guaranteeing that the needs of the patients are met on time, there are increased rate of positive results, enhanced communication between the patients and the health providers, and the health facility will create a good image that will result to more referrals. This also means that there should be a systematic process in which outcomes whether positive or negative are recorded in order to come up with solid methods of improvement that will favor all persons irrespective of their cultural, religious, or gender affiliations. Conclusion It is undoubtedly evident that transfusion of blood has become a controversial issue that has challenged the health providers. This is because they are unable to balance the right to protect patient’s freedom or privacy and their need to save lives. The abovementioned scholars have given deep insights on the ethical issues and considerations that physicians should incorporate in their area of practice. They include the right to respect the informed consent, advice patients on the adverse as well as positive impacts of refusing or accepting blood products, and respecting the wishes of persons who have different religious beliefs such as Jehovah Witnesses. Other considerations that should be incorporated in medical practice entail the need to use proper transfusion methods to guarantee fairness and development of strategic methods to improve the process of blood transfusion. The health providers should also consider other alternative treatment methods such as deliberate hyporthermia to patients who refuse the blood products and should make sure that parents are notified before transfusion is administered to children. Ethically, mentally competent patients have an absolute freedom to refuse consent for administering transfusion even if it leads to their death; thus, ignoring this right can lead to grave legal and individual violation. References Effa-Heap, G. (2009). Blood Transfusion: Implications of Treating a Jehovah’s Witness Patient. British Journal of Nursing, 18(3): 174-177 Harris, A & Engel, T. (n.d). Anesthetic Challenges and Considerations Presented by the Jehovah’s Witness Patient. Retrieved from Macklin, R. (2007). Applying the Four Principles. Journal of Medical Ethics, 29: 275-280. Naunheim, K., Bridges, C & Sade, R. (2011). Should a Jehovah’s Witness Patient who faces Imminent Exsanguination be transfused? Ann Thoracic Surgery, 92: 1559-1564. Petrini, C. (2014). Ethical and Legal Aspects of Refusal of Blood Transfusions by Jehovah’s Witnesses, with Particular Reference to Italy. Blood Transfusion, 12(1): 395-401. Sacchini, D., Liumbruno, G., Bruno, G., Liumbruno, C., Rafanelli, D., Minacori, R., efolo, P & Spagnolo, A. (2013). Ethical and Deontological Issues in Transfusing Medicine. Blood Transfusion, 11(1):14-25. Read More