On September 25, 2024, the Federal Supreme Court of Brazil issued a landmark ruling that upholds the rights of adult patients to refuse blood transfusions and to opt for medical treatment that does not include their use. The Court also ruled that the Ministry of Health must ensure that patients who refuse blood transfusions for personal or religious reasons have access to medical care that avoids them.

This ruling centers on the cases of two of Jehovah’s Witnesses in Brazil. In 2018, after Sister Malvina Silva refused to sign a consent form authorizing her doctors to administer blood transfusions during her scheduled heart surgery, the hospital canceled her procedure. It took nearly two years for Malvina to finally receive treatment that respected her personal convictions.

In 2014, Brother Heli de Souza was scheduled to have surgery. However, his local hospital was not equipped to perform the operation without a blood transfusion. The public health system denied Heli’s request for a transfer to another facility that was prepared and willing to carry out the procedure according to his beliefs and values. Heli is still awaiting surgery. Many of Jehovah’s Witnesses in Brazil have faced similar challenges, including being subjected to blood transfusions against their will.

In issuing the ruling, the Court’s president, Justice Luís Roberto Barroso, remarked: “The right to refuse a blood transfusion on religious grounds is based on the constitutional principles of human dignity and freedom of religion. Consequently, regarding the right to life and health, [Jehovah’s Witnesses] are entitled to alternative procedures [and] have the right to refuse medical procedures involving blood transfusions based on personal autonomy.”

This latest ruling requires courts throughout Brazil to respect patient autonomy regarding medical treatment. It reflects similar Supreme Court decisions in other countries, including Australia, Canada, Japan, South Africa, and the United States. This decision also parallels a September 17, 2024, ruling by the Grand Chamber of the European Court of Human Rights, which obligates 46 European lands to respect patient autonomy.

We are grateful that the Federal Supreme Court in Brazil ruled in favor of respecting the personal convictions of all its citizens and their right to make decisions regarding medical treatment.