(CN) — In a significant win for the religious rights of medical patients, Europe’s rights court found Spanish doctors guilty Tuesday of violating a woman’s beliefs when they gave her a blood transfusion even though she told them she was a Jehovah’s Witness who opposed such treatment.
In a unanimous ruling, the 17-judge Grand Chamber of the European Court of Human Rights in Strasbourg, France, blasted Spanish doctors and the country’s legal system for failing to respect the woman’s right to refuse a blood transfusion on religious grounds.
The ruling came down in favor of Rosa Edelmira Pindo Mulla, a 53-year-old Ecuadorian woman who received a blood transfusion at a Madrid hospital in June 2018 despite specifying in legal and medical documents it was against her religious beliefs.
Jehovah’s Witnesses have long abstained from taking blood, even their own, for medical procedures, saying it is against divine law as written in Biblical passages. Many followers of the religion say they are willing to risk death rather than receive blood transfusions.
Petr Muzny, the woman’s lawyer, said it was the first time for the human rights court to directly examine a Jehovah’s Witness’ request to refuse a blood transfusion. He called it a major win for patients’ rights.
“No longer can a doctor view a patient just as flesh and bones only,” he said in a telephone interview. “They have to view a person as a whole with a conscience, and for me that’s great progress.”
He said two similar cases involving Jehovah’s Witnesses refusing blood transfusions in France and Denmark are pending before the European Court of Justice, the European Union’s high court. There are about 1.5 million followers of the religion in Europe.
He accused Spanish doctors of ignoring Pindo Mulla’s demands to not receive a blood transfusion.
“My guess is that they were so determined to transfuse the lady that they forgot about the basic requirements of the law and of procedure,” he said. “There was so much focus on having a transfusion.”
In 2017, Pindo Mulla was told by doctors in her hometown of Soria, a small city northeast of Madrid, that she should undergo surgery due to a uterine fibroid, a common growth on a uterus.
She was advised to undergo a hysterectomy and removal of her fallopian tubes. She agreed with this advice and filed paperwork with the Santa Bárbara hospital in Soria saying she refused to receive a blood transfusion due to her religious beliefs.
By early June 2018, Pindo Mulla was suffering from serious bleeding and abdominal pains, prompting her to seek treatment at the Soria hospital. Doctors told her that she needed blood transfusions due to the loss of blood, but she refused.
“She got pressured, that certainly was the case,” Muzny said. “They put pressure on her throughout the night, constantly saying she needed a blood transfusion to be safe, which certainly was not true because her condition stabilized.”
On June 7, she was transferred by ambulance to the La Paz hospital in Madrid because it was better equipped to provide forms of treatment not involving blood transfusions, according to court documents.
“The applicant agreed to the transfer to La Paz, her understanding being that she could be treated there without resort to blood transfusion,” the judges wrote in the ruling.
While Pindo Mulla was driven 150 miles by ambulance to Madrid, doctors at La Paz asked for legal guidance on how they should treat Pindo Mulla from a duty judge. They informed the duty judge that she was a Jehovah’s Witness who refused blood transfusions.
The duty judge consulted a forensic doctor and a state prosecutor. The forensic doctor warned that Pindo Mulla’s life was at risk due to blood loss and that she might arrive at the hospital while not fully conscious or able to adequately consent to or refuse treatment.
However, the judges noted that during the long ambulance ride, Pindo Mulla suffered only limited bleeding and that she “was conscious, orientated and cooperative.”
Meanwhile, the duty judge determined there was “an absence of ‘any reliable evidence’ of a refusal on the applicant’s part to receive medical treatment,” according to the account of events in the ruling.
At the same time, the prosecutor was also not opposed “to the necessary medical and surgical measures” needed to save her life, the court said. The prosecutor cited the “supreme legal value of the right to life.”
In conclusion, the duty judge told the doctors at La Paz “to treat this patient with the medical and surgical measures necessary to safeguard her life and physical integrity.”
Following surgery at La Paz, Pindo Mulla was shocked to find out that doctors had given her a blood transfusion. Her arguments were dismissed by Spanish courts before she presented her case to the Strasbourg court.
Judge María Elósegui, a Spanish jurist on the panel who wrote a concurring opinion, said Pindo Mulla’s wishes were ignored.
“The applicant used all the avenues afforded to her by the law, but, having done so, her wishes as set out in the documents signed by her were nonetheless ignored as a result of various errors that are attributable to the authorities involved in her case,” the judge wrote.
She added that “the national authorities, and the doctors and judges involved, cannot hide behind mistakes made by others, much less accuse the applicant of failing to fulfil her obligations; lessons must be learned for the future.”
Muzny said Pindo Mulla remains scarred by what happened.
“Upon the delivery of the judgment, she burst into tears,” he said. “It’s still very emotional for her.”
He said Pindo Mulla was mistreated.
“Not only is she a woman, I would say she’s a little woman from Ecuador; she’s a foreigner and you add to that she’s a Jehovah’s Witness, a religious minority with lots of stereotypes against them,” he said. “She doesn’t speak the proper Spanish of Spain, so when she went to the hospital, I assume probably one of the first things doctors heard was this little lady not speaking exactly with the proper accent of Spain. So, it was much easier for them to force her into something.”
The court ordered she receive 12,000 euros (about $13,340) in damages.
Spain’s justice ministry did not respond to a message seeking comment.
Courthouse News reporter Cain Burdeau is based in the European Union.