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The Office of the Public Prosecutor and the courthouse of Termini Imerese in Sicily, Italy.

AUGUST 22, 2018

Court in Sicily Reaffirms Patient Autonomy for Jehovah’s Witnesses

On April 6, 2018, the Court of Termini Imerese in Sicily, Italy, ruled that a surgeon was criminally liable for forcing a blood transfusion on a woman who is one of Jehovah’s Witnesses. The surgeon was ordered to pay her 10,000 euros ($11,605 U.S.) in damages as down payment for compensation and another 5,000 euros ($5,803 U.S.) in compensation to her husband, who is also one of Jehovah’s Witnesses. This ruling is the first time an Italian court has found a doctor criminally responsible for violating the fundamental right to have control over what is done to one’s own body in line with one’s beliefs.

The case involved a sister who, after having gallbladder surgery in December 2010, began experiencing complications. Even though she persistently refused to accept blood products, she was physically restrained and forcibly given a transfusion of red blood cells. Her surgeon falsely claimed to have authorization from a magistrate.

Subsequently, she and her husband filed a criminal complaint with the Office of the Public Prosecutor. The court decided that in “the circumstance of a Jehovah’s Witness, of legal age and fully capable, . . . the doctor must refrain from providing this treatment” if it violates the recipient’s will.

The court also declared that the Constitution of Italy prohibits doctors from administering treatments without consent even if the doctor claims that the treatment is necessary. According to the court decision, “the justification of the state of necessity . . . is not applicable in presence of a clearly expressed, free and valid dissent.”

In his medical report for the trial, Daniele Rodriguez, professor of Legal Medicine and Bioethics at Padua University and expert witness, observed that “the right to refuse a specific health treatment is protected by regulations of constitutional rank and made explicit by [article] 32 of the [Italian] Constitution stating that ‘no one may be obliged to undergo a particular health treatment except under the provisions of the law.’” Commenting on the court’s decision, Italian jurist and health law expert Luca Benci, wrote in Quotidiano Sanità (Health Daily): “There is no law that imposes a blood transfusion on dissenting patients. The refusal of treatment prevails over all other aspects.”

Marcello Rifici, a lawyer with the litigation team for Jehovah’s Witnesses, states: “We are pleased to see that this ruling is in line with established European standards, such as those codified by decisions of the European Court of Human Rights, that maintain the right to self-determination for all patients. Interestingly, in 2017 the Italian Parliament established law 219/2017, known as the ‘Living Will Law,’ which underscores the same principles as this decision.”

Lucio Marsella, also a lawyer with the litigation team, comments: “The ruling constitutes a precedent that stands as a guarantee for all the doctors who conscientiously and courageously strive to cure patients in the best way possible while respecting their dignity of choice.”