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The pure church and the problem of confidentiality.

The Pure Church and the Problem of Confidentiality

The Jehovah's Witnesses have always been a morally interesting religious congregation for medical ethicists because of their practice of refusing life-saving blood transfusions based on the community's interpretation of Biblical injunctions against "eating blood." An article in a recent Watchtower (September 1, 1987, 12-15) indicates another religious requirement of practicing Witnesses may produce moral and legal conflict in the medical setting: Jehovah's Witnesses employed as health care workers may be obligated to violate institutional, professional, or legal requirements protecting patient confidentiality of fellow Witnesses. The "superior demands of divine law" can necessitate occasions when a Witness would "strain or even breach the requirements of confidentiality" for two related purposes: (1) To aid an "apparent" sinner, and (2) to preserve the purity and cleanliness of the congregation.

The article presents a situation that Jehovah's Witnesses face "from time to time," in which a hypothetical Witness (Mary) working as a medical records assistant discovers that "a patient, a fellow Christian, had submitted to an abortion." The dilemma posed for the assistant is whether Scripture imposes upon her a responsibility to "expose this information to elders in the congregation, even though it might lead to her losing her job, to her being sued, or to her employer's having legal problems." In making the decision, the Witness should consider (1) the situational facts and evidence of wrongdoing, (2) relevant Biblical principles, (3) legal implications, and (4) preservation of a "clear conscience."

Biblical principles that might require a violation of medical confidentiality include responsibility for disclosure of personal "serious wrongdoing," and the oaths and promises made by confessing congregants to "keep the congregation clean, both by what they do personally and by the way they help others to remain clean." Depending on the strength of the evidence of wrongdoing in the situation, such Biblical principles can override the requirements of privacy and confidentiality of medical records. Thus, citing the famous passage from Acts 5 that is so often used to justify religious exemption from legal requirements, the argument holds that when "promises required by men are in conflict with the requirement that [Witnesses] render exclusive devotion to God," the Witness must accept his or her responsibility to "obey God as ruler rather than man."

Witnesses are counseled that employers have a right to expect the observance of rules on confidentiality from their employees. As a corollary, this means that prior to accepting employment that includes confidentiality restrictions, the Witness should determine the extent to which these professional and legal requirements may conflict with scriptural mandates. One important question here, given the possibility of litigation against an employer for breaches of confidentiality, is whether the Witness would have an obligation to disclose to a prospective employer in the health (or legal) setting that situations might arise in which he or she would feel religiously bound to violate such rules.

Although it appears to be a matter of discretion whether the informing Witness should confront the "erring" individual personally or directly disclose the problem to the congregation's elders, an important question is not addressed by the article: What is to count as "serious wrongdoing"? Abortion and fornication are mentioned specifically in the discussion, and presumably, receiving a blood transfusion would also be a matter of such gravity as to warrant violating confidentiality. Some commentators have indicated that a Witness who undergoes sterilization, artificial insemination, or participates in surrogate motherhood, donates sperm or an ovum, or tests HIV positive, is susceptible to severe sanction by the congregation. These might be further instances in which the confidentiality of the participant would be violated for reasons of paternalism and ecclesiological purity.
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Title Annotation:Jehovah's Witnesses
Author:Campbell, Courtney S.
Publication:The Hastings Center Report
Date:Feb 1, 1988
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