An ethical assessment of the relationship between the Church and the State: A case of blood transfusion among the Jehova's witnesses of Mpika and Lusaka Districts

The Watchtower sect, just like other universal religions, makes a strong claim on its members that they refuse blood transfusion as a fundamental part of their belief that God views blood as representing life. Thus it is important to note that commitment to religious beliefs will sometimes inevitably come into conflict with the role of the State, say to provide security and welfare to its members especially vulnerable ones like children. The lives of many Witnesses in Zambia may be at risk due to their unwillingness to undergo blood transfusion on religious grounds. This state of affairs places the Zambian Government in a dilemma as it has a constitutional duty to both respect people‟s religious rights and protect people‟s right to life. The aim of this research is to ethically assess the relationship between the Church and the State on blood transfusion among the Jehovah‟s Witnesses of Mpika and Lusaka districts. The objectives of the study were : (i) to investigate the nature of the doctrinal position of the Jehovah‟s Witnesses in Mpika and Lusaka on the rejection of blood transfusion; (ii) to explore the extent to which Jehovah‟s Witnesses of Mpika and Lusaka share in the doctrinal position on the rejection of blood transfusion; (iii) to ascertain the awareness of Jehovah‟s Witnesses of Mpika and Lusaka about the benefits and burdens of rejecting blood transfusion in Zambia; and, (iv) to examine the position of the State on the rejection of blood transfusion by Jehovah‟s Witnesses. A total of 30 persons were interviewed. This number was sufficient for the study as it was supplemented by two focus group discussions among medical students at UNZA Ridgeway Campus and seven focus group discussions among Jehovah‟s Witnesses at all Kingdom Halls under study. The significance of the study highlights the ethical challenge that the Watchtower doctrine on blood transfusion presents to the relationship between the Church and the State. The research design was a case study. The study used a qualitative approach which involved an ethical assessment. The methods employed were in-depth interviews and focus group discussions. The ethical framework of the study used to collect relevant data and inform the ethical assessment of the study included Rights theory and different ethical principles which comprised the principle of beneficence, the principle of nonmaleficence, the principle of autonomy and the principle of paternalism. The study made the following recommendations: (i) the autonomy of a competent patient should be respected by medical practitioners if they refuse blood transfusion on religious grounds; (ii) the State should ensure that alternatives to blood transfusion are made available in hospitals and clinics so that patients have options to choose from ; (iii) the State should provide medical institutions with well trained personnel that minimize the possibility of blood loss; (iv) Medical practitioners should maintain frequent and close surveillance for signs and symptoms of postpartum to facilitate early intervention; (v) medical practitioners should use modern medical science as an objective basis for protecting children against being denied a life-saving medical procedure of blood transfusion by their parents on religious grounds; (vi) further research be carried out to determine the extent to which lives of children are lost as a result of religious objection of their parents to blood transfusion.