RECHAZO A LA TRANSFUSIÓN DE SANGRE POR PARTE DE MUJERES EMBARAZADAS Y PUÉRPERAS TESTIGOS DE JEHOVÁ Revisão Sistemática ou Integrativa

Introduction: Obstetric hemorrhage is considered a major cause of maternal deaths all around the world. In this scenario, the Jehovah’s-Witness pregnant women constitute a unique population because they refuse total blood transfusions and its four primary components. The encounter between obstetrics and these patients has caused many legal, ethical and bioethical conflicts along the years. Objective: Discourse about legal, ethical, and bioethical issues facing blood transfusion refusal by Jehovah’s-Witness pregnant and breastfeeding women. Method: It is an integrative review study, in which 14 articles were identified to compose the sample, from MEDLINE and LILACS databases, in Portuguese, English and Spanish. Findings and Discussion: From the legal and juridical points of view, there are some disagreements related to physicians and patients’ rights. The Federal Constitution, The Civil Code and the Charter of Consumers’ Rights in Health enhance the patient’s autonomy to refuse any treatment. While both Criminal Code and Medical Ethics Codes insist on adopting a life-saving conduct even without the patient’s consent, in cases of imminent risk of death. Meanwhile, in Ethics and Bioethics, there is confrontation between the patient’s autonomy and the benefit from the medical standpoint. Conclusions: Currently we have a divided legislation, ethics and bioethics issues with opposite points of view. It is necessary to legally and bioethically rethink about these patients, understand their beliefs, to know alternative treatments and to have more qualified institutions and professionals.