Ethics

Summary [Remmers and Speer review some of the strategies used in the non-blood management of Jehovah’s Witness patients. They summarize Witness patients’ position on blood, blood components, blood derivatives and autologous blood options. They address, with support from the literature, approaches to managing bleeding and trauma and illustrate a proposed algorithm for the management of severe acute anemia. A brief synopsis of the surgical, anesthetic and pharmacological strategies is presented along with a table listing “oxygen therapeutics” in clinical trials.

Summary Kathleen Sazama, MD, reviews the historical development of bioethics, patient autonomy and informed choice in medicine including the impetus resulting from public outrage over medical experimentation that took place during a predominately paternalistic period of doctor-patient relationships. The author summarizes the ethical concepts of autonomy, beneficence, non-maleficence and justice and how these principles should be incorporated proactively into an ethical blood management program.