Resolution No. 2.232/2019 of the Federal Council of Medicine and the decisions of the Federal Supreme Court regarding transfusion refusal: therapeutic refusal, conscientious objection and the work of the Public Defender's Office in defense of the affected group

Abstract

Objective: to evaluate the regulation of transfusion refusal for religious reasons, as recognized in recent decisions of the Federal Supreme Court and addressed in Resolution No. 2.232/2019 of the Federal Council of Medicine. Methodology: a critical expository analysis of the deontological norm, in light of current jurisprudence on the subject and its impact on the right to health. The study was conducted through normative, jurisprudential, and bibliographic research, based on the historical development within the ethical-professional field and its comparison with recent jurisprudential positions. It culminates in an exploratory assessment of how the decision affects access to health for individuals impacted by the aforementioned norms, which have prompted administrative action by the Public Defender’s Office in ensuring the effective protection of this group’s health. Results: Resolution No. 2.232/2019 was enacted with the aim of establishing “ethical standards for therapeutic refusal by patients and conscientious objection in the physician–patient relationship,” following the emergence of jurisprudential debate on the issue. Its content, by simultaneously addressing multiple ethical and legal aspects, raised several issues that are currently under discussion. It was found to be relevant, including for revising previous positions of the Council that had been subject to legal challenge. However, the manner in which the norm was structured gave rise to an apparent conflict between the autonomy of the physician and that of the patient. In light of the decisions rendered in Extraordinary Appeals No. 979.742 and No. 1.212,272 by the Federal Supreme Court, which upheld the right to refuse blood transfusions, proposals were advanced concerning the regulation and practice of the issue, including normative and interpretative approaches, as well as the need to ensure the availability of alternative therapeutic options. Conclusion: This study highlights the need for normative and practical harmonization regarding transfusion refusal and its implications for the exercise of autonomy, including in end-of-life decisions, within the national legal framework.

Received: September 30, 2025 | Revised: February 24, 2026 | Accepted: February 26, 2026