Chapter 9: Universal Principles? What is the Right thing to do and why?: The Influence of Culturally Imprinted Moral Values on Medical Students’ and Physicians’ Decision-Making

Jehovah’s Witnesses form a denomination of Christianity. While most nonbelievers welcome blood transfusions in life-threatening situations, Witnesses strictly refuse to receive blood transfusions, as they consider this a sin. Under extreme circumstances, withholding blood from a patient can even lead to their death. Thus if a clinician obeys their wish, they might controvert medicine’s goals to preserve and promote a patient’s life and health. The dilemma the physician finds himself in dangles between according the patient the right to make decisions for himself or herself and, on the other hand, knowing that further surgery would prolong their life, maintaining their health. Two obligations clash: respect for the patient’s right of self-determination and the duty to promote his well-being from an objective medical point of view. We call such an ethically critical situation with two conflicting moral values a “medical dilemma.” This is, of course, only one example out of the endless pool of all possible medical dilemmas.