The refusal of blood transfusions by Jehovah’s Witnesses presents a significant bioethical challenge for physicians managing hematological malignancies. These situations require a careful balance between respecting patient autonomy—rooted in religious beliefs—and the physician’s professional responsibility to provide life-saving care.

Review:

This review explores the complex ethical and legal dilemmas clinicians face, including issues related to informed consent, end-of-life decision-making, and potential conflicts of interest. The refusal of blood transfusions, a cornerstone of standard treatment for hematologic cancers, compels healthcare providers to consider alternative approaches such as erythropoiesis-stimulating agents and other bloodless techniques, which may be less effective or unavailable in certain settings. End-of-life care presents additional challenges, particularly when patients also decline palliative treatments involving blood components. Furthermore, the review highlights a critical gap in medical training, emphasizing that many healthcare professionals are not adequately prepared to manage these ethically complex situations. Essential competencies—such as effective communication, ethical literacy, and cultural sensitivity—are identified as key to navigating care for Jehovah’s Witnesses.

Physicians must strive to deliver patient-centered care while honoring ethical and legal responsibilities. Respect for patient autonomy, the exploration of viable alternatives, and clear, compassionate communication are foundational to ethically appropriate care. As these cases become more prevalent, healthcare systems must prioritize training and resource allocation to support clinicians in managing such morally sensitive clinical scenarios.