Patient’s right is the heart of present medical service. Considering transfusion medicine, a branch of clinical pathology, there is an interesting aspect on patient’s right on “Jahovas witness.” According to the oaths of the Christian who believe in Jahovas witness principles, receiving blood and blood product is prohibited. Transfusion practice for these patients is an important consideration on patient’s rights [47-50]. The aspects for consideration include:
1. Medical practice for Jahovas witness: review on update medical practice [51-52]
Although there are many scientific conferences and consensus for setting up of clinical practice guideline for the Jahovas witness that bring many new alternative medical practices including artificial blood and bloodless surgery. Can we say that those new medical practices for Jahovas witness follow natural principles and sufficient medical practice?
2. Rights to accept or reject a specific therapeutic option : lesson from medical practice in Jahovas witness cases [47-50,53-54]
The rights to reject the treatment for the nearly death cases, as in the case of Buddhadasa might be well known [55-56]. However, the rights to accept or reject a specific option, selection, might be a new thing for general physicians. And this challenge the medical practice of many doctors. Although the proposed therapeutic option is the best updated and standard the patients might totally deny. Therefore, what is the role of the physician in charge? A. making an argument, B. following the patient request and saying nothing or C. or? In many countries, the management of Jahovas witness is recommended for special method. Making an argument or trying
to pursue the patient may be hopeless and usually bring confrontation. Giving the understanding and knowledge on the risk of the alternative therapy is recommended.
3. Preparation for the fought-to-select medical practice : analysis for the future [47-50]
Sometimes the medical practice is fought to select by unpredictable factor.
Sometimes, the choices are very limited such as those of Jahovas withness. Therefore analysis for alternative, preventive action plan as well as risk estimation is necessary and should be set up to increase the quality of medical service.
4. Medical practice against religious belief : conclusion [56]
Many accepted standard medical practices at present might be judged as practices that against religious belief. In addition to Jahovas witness, there are also other examples including autopsy examination and preparation for Halal drink and food for the Muslim or preparation for vegetarian food for the strict Mahayana Buddhist vegans. Physician should aware any medical practices that might against the religious belief for these patient. The system as making understanding and giving knowledge on the patient self-selected therapeutic option due to his/her rights must be followed.
R
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Chapter IX
P HOTOTHERAPY
I
NTRODUCTIONLight is a basic thing that human beings know. Light is mainly from the sun. Electricity can also provide light. Therapy by light is also a medical concept. Since light poses energy therefore it might be used for treatment. In this chapter, the author will present the topic on phototherapy. Main kinds of application, photodynamic therapy and classical phototherapy for newborn will be discussed.