Interview With Dr. Arthur Caplan
CAROL LIN, CNN ANCHOR: We have another strange medical case to bring to you here. It involves a case of ethics and religion. South Carolina's supreme court was scheduled to hear that very unusual case today. Charlie Harvey's life may have been saved by a blood transfusion he received in 1997. But now he's suing the doctor who gave it to him. Harvey is a Jehovah's Witness, and his religion forbids blood transfusion. He says he filled out a form saying he didn't want one under any circumstances. But when Harvey lost control, or actually, consciousness, and was in danger of dying, his mother gave permission -- something Harvey says state law did not authorize her to do. Joining to talk about this case is Dr. Arthur Caplan, director of the center for bioethics at the University of Pennsylvania. Good to see you. I'm glad you could come in on this case. It's really bizarre. And it's not the first time that a Jehovah's Witness has confronted this situation before, right?</s>DR. ARTHUR CAPLAN, UNIVERSITY OF PENNSYLVANIA: Absolutely not. In fact, there really are two situations in which this comes up. One is, a competent adult, like Mr. Harvey, knows the consequences of saying, I don't want a blood transfusion. Understands he could die, and still says don't give it to me. In those situations, believe it or not, you usually go along with what that patient is telling you. The other situation we hear about is a Jehovah's Witness who is a child. In those cases, courts are very reluctant, doctors very reluctant, to go along with parental wishes. Treatment is ordered when something like a blood transfusion is needed. So an adult can say no. A child basically can't say no.</s>LIN: All right. So you're saying he has ethically more a right to say no than the doctor has an obligation to save his life, right?</s>CAPLAN: He really does. And I know it sounds counterintuitive, but if you think about it, when we get over to other cases where people say, turn off that respirator, I don't want kidney dialysis, it's the same principle. You don't have to take medical treatment. You don't even have to take live-saving medical treatment. You can say no to what the doctor or the hospital offers.</s>LIN: All right. But at the same time -- you set up that dynamic. He has the ethical right to determine his destiny there. But then, he's unconscious and his mother steps in, and she does what any mother would do. She says, you know, you get in there, you give him that blood transfusion and you save his life. Doesn't she have a right to do that?</s>CAPLAN: She had some authority. If he hadn't filled out a card, if they only had maybe some conversation, him saying I don't want blood transfusion. If the doctor didn't get such a clear directive, repeated again and again, the mom could and should be the place that you'd go. But for a 55-year-old man who says, look, "I bothered to write it down, I had discussions," even his own mother can't override that. So I think he's got a case. Although I should hasten to add, I hope they don't punish the doctor very much. Because after all, he's trying to do the right thing. I think in this case he didn't do what was the right thing to do. But you know, his motive wasn't to set out to hurt this gentleman. He tried to do what was right. So I don't think a severe penalty is in order.</s>LIN: Right. But he's not suing his mother. He's suing his doctor.</s>CAPLAN: I mean, the doctor here should not get a tough penalty. I this the Supreme Court should come down and defend that right of everyone to say no, even if their values aren't mainstream, or even if we wouldn't agree with an opportunity to have our lives saved. But I wouldn't be punishing this doctor very extensively.</s>LIN: So you're saying that blood can actually be sacred, because that's what the Jehovah's Witnesses believe.</s>CAPLAN: You know, it's interesting, Carol. You don't have to buy the metaphysics. I don't think blood is sacred. I think it's a fluid that carries oxygen. But if somebody else comes to me and says, "I can't accept this on religious grounds, I have a particular view about blood," and they're an adult and they know the consequences of trying to go into medicine without blood, and they know they could die, I think I have a duty to respect that.</s>LIN: So, what did he think was going to happen, though, when he went into the hospital? He knew that it was going to be an invasive procedure, and that blood would be needed. Did he have any other options here?</s>CAPLAN: Well, I think what he believed was that it was possible to go through this procedure without getting a transfusion. I think he'd had something like that, assurance from the doctor. Turned out it was one of those rare cases where this required a transfusion. It often doesn't, but this did. And I think he expected that he would be -- he'd take his chances and see what would happen. The doctor, of course, has got to establish this clearly before they set out on a surgical route, and I think that was done. This guy did fill in a written directive saying, no blood. Again, it sounds counterintuitive, but I think you have to respect his wishes, even when its his own life.</s>LIN: All right. Well, it's at the state supreme court level. We'll see if it gets up to Washington and the U.S. Supreme Court. Thank you very much.</s>CAPLAN: My pleasure.</s>LIN: Dr. Arthur Caplan, always good to see you, especially on these stories. TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com