Jehovah's witnesses can refuse blood transfusions, decides the Supreme Court (STF).

 BRASIL 

Jehovah's witnesses can refuse blood transfusions, decides the Supreme Court (STF).

26/09/2024

The thesis that determines the state the cost of alternative treatments that are available from the Unified Health System (SUS) and that do not involve blood transfusion was fixed.

The Supreme Court (STF) ruled on Wednesday (25/9) that medical patients can refuse blood transfusion for religious reasons. The plenary discussed extraordinary appeals (REs) 979742 (topic of General repercussion 952) and 1212272 (topic of General repercussion 1069), which deal with the right to perform surgery without blood transfusion for patients Jehovah's witnesses, a religion that does not accept this type of treatment.

In RE 979742, the position of Rapporteur Minister Luís Roberto Barroso prevailed. In his vote, the president of the Supreme Court allowed Jehovah's witnesses to refuse blood transfusions, as long as this refusal meets requirements such as the patient being of legal age, capable and in conditions of discernment. The manifestation should also be free, unambiguous and clarified.

"Because the ban on blood transfusion is a dogma of people who profess the belief of Jehovah's witnesses, it is legitimate, in my view, to refuse,” Barroso said. According to the vote, the state must pay for alternative treatments for these patients that are available from the Unified Health System (SUS), which do not involve blood transfusion, even if they are in another city or state where the patient lives.

Minister Gilmar Mendes, rapporteur of RE 1212272, fixed in his thesis that the patient will be allowed “in the full enjoyment of his civil capacity, to refuse to undergo health treatment for religious reasons”.

"Refusal of health treatment for religious reasons is conditional on the unequivocal, free, informed and informed decision of the patient, including when conveyed through an advance directive of Will,” the minister said.

The following theses were defined:

RE 1,212,272: '1. Jehovah's witnesses, when older and able, have the right to refuse medical procedures involving blood transfusion on the basis of individual autonomy and religious freedom. 2. As a consequence, in respect of the right to life and health, they do justice to the alternative procedures available in the SUS. If necessary, you can seek treatment outside your home."

And in RE 979.742: "1. It is permissible for the patient in the full enjoyment of his civil capacity to refuse to undergo health treatment on religious grounds. Refusal of health treatment for religious reasons is conditioned on the unequivocal, free, informed and informed decision of the patient, including when conveyed through an advance directive of will. 2. It is possible to perform a medical procedure made available to all by the SUS, with the Prohibition of blood transfusion or other exceptional measure, if there is technical and scientific feasibility of success, consent of the medical team with its performance and unequivocal free and informed and informed decision of the patient".

Accompanying Barroso and Mendes were ministers Flávio Dino, Cristiano Zanin, André Mendonça, Nunes Marques, Alexandre de Moraes, Luiz Fux, Carmen Lúcia and Edson Fachin. The final score was 10-0 by the permission of the refusal. Minister Dias Toffoli remains on medical leave and did not vote.

Understand the case

Two appeals were judged, one of them is RE 979.742, in which the Union appealed against a decision that condemned it, together with the state of Amazonas and the municipality of Manaus, to pay for a total arthroplasty surgery in another state, because the procedure that does not use blood transfusion is not offered in Amazonas.

The rapporteur of the case, Minister Luís Roberto Barroso, acknowledged the general repercussion of the case still in 2017, on topic 952, and emphasized the importance of respect for the self-determination and beliefs of Jehovah's witnesses. However, he warned that the transfer of public resources, in a context of scarce funds, may compromise other constitutional principles.

The second RE judged was 1,212,272, reported by Minister Gilmar Mendes, which involves a Jehovah's witness who had aortic valve replacement surgery canceled after refusing to sign a consent form authorizing blood transfusion.

The appeal also had a recognized general repercussion, under the theme 1069, in 2019. At the time, Mendes assessed that the scope of "religious freedom should not be measured by numerical strength, nor by the social importance of a particular religious association. Freedom of belief must be guaranteed equally to all." For the minister, the refusal of proceedings is an "issue directly linked to the fundamental right to freedom of conscience and belief, as well as other constitutional principles and guarantees".

The patient's lawyer, Eliza Gomes, argued that the refusal is a “legitimate " choice from a medical-scientific point of view. "Patients no longer want to be treated like children in their medical care, they want to be treated like capable adults,” he said.