Brazil's Supreme Court lists 30 September to resume its judgment on transfusions given against a patient's refusal

Brazil's Supreme Federal Court, the Supremo Tribunal Federal or STF, has put two challenges about blood transfusions back on its calendar. Both are ADPFs — constitutional cases that test a rule itself rather than one person's dispute. On 28 August 2026 the court's president, Justice Edson Fachin, added ADPF 618 and ADPF 642 to the judgment calendar of the plenary, the full bench sitting together. The entry on both dockets carries the same field: Data de Julgamento: 30/09/2026 — judgment date, 30 September 2026.^[1][2] The calendar was published in the court's official electronic gazette, the Diário da Justiça Eletrônico (DJe), on 31 August, and logged on both dockets on 1 September.^[1][2]

Announcing the September list the same day, the court's own newsroom described the item like this:

The verb the court uses is prevê — anticipates, or expects. A listing is a plan, not a guarantee.

What is listed is not a fresh hearing. The merits judgment in both cases began in 2025, and has been interrupted twice, each time by one justice asking to take the file away and study it. And the two cases are not about one patient: they are abstract challenges to rules that apply across Brazil — a carve-out in the Penal Code, and binding resolutions of the doctors' own regulators. Watch Tower Bible and Tract Society of Pennsylvania and the Associação das Testemunhas Cristãs de Jeová, the Witnesses' Brazilian association, are both admitted in ADPF 618 as amici curiae — "friends of the court", outside bodies allowed to file arguments and address the bench in a case they are not parties to.^[1]

What an ADPF is, and who brought each one

ADPF stands for arguição de descumprimento de preceito fundamental — a claim that some act of the state breaches a fundamental constitutional precept. It is a tool of abstract review: the court is not deciding one person's case but testing a rule itself, and the answer binds everyone. The procedure is set by Law 9.882 of 3 December 1999, which the rapporteur has cited when admitting outside bodies into ADPF 618.^[1]

ADPF 618 was filed on 9 September 2019 by the Procuradora-Geral da República, the Prosecutor-General of the Republic — the head of Brazil's federal prosecution service. The bodies named as interested respondents are the President of the Republic, represented by the Advogado-Geral da União (the government's chief lawyer), the president of the Conselho Federal de Medicina (CFM, the national medical council, a public-law body that licenses doctors and writes rules binding on them), and the president of the Conselho Regional de Medicina do Estado do Rio de Janeiro (CREMERJ, its Rio de Janeiro state counterpart).^[1]

The case was assigned by lot on 11 September 2019 to Justice Celso de Mello, who in a decision of 19 December 2019 sent it straight to the plenary for a definitive ruling under Article 12 of Law 9.868/1999 — meaning no preliminary injunction would be examined first — and ordered the bodies whose rules were challenged to be heard within ten days. The rapporteur is now Justice Nunes Marques.^[1]

ADPF 642 reached the court in December 2019, brought by the Partido Socialismo e Liberdade (PSOL), the Socialism and Liberty Party. Its named interested party is the CFM. It went first to Justice Fachin, who in December 2023 sent it to the presidency to check whether it was tied to another case; the presidency ordered on 7 February 2024 that it be redistributed to Nunes Marques because he was already seized of the related ADPF 618 (por prevenção à ADPF nº 618), and the transfer was recorded on 14 February 2024.^[2]

The rules being challenged

The central provision is Article 146, § 3, I of the Penal Code. Article 146 defines the crime of constrangimento ilegal, unlawful coercion. Paragraph 3 lists what the crime does not cover, and item I excludes "medical or surgical intervention, without the consent of the patient or of his legal representative, if justified by imminent danger to life" (our translation). That exclusion is the text the two cases fight over.^[4]

Also challenged are CFM Resolution 2.232/2019, the national medical council's rules on a patient's refusal of treatment (Articles 2, 3, 4, 5 and its § 2, 6, 10 and 11 are variously in play); CFM Resolution 2.217/2018, the Code of Medical Ethics, Articles 22 and 31; CREMERJ Resolution 136/1999, Article 3; and item 2 of an opinion annexed to CFM Resolution 1.021/1980.^[1]

The two positions on the record

The judgment opened in a sessão virtual — a virtual session, in which justices file written votes to an electronic plenary over a set window rather than sitting together — running from 29 August to 5 September 2025.

Rapporteur Nunes Marques voted to grant the two applications in part. He would hold that ADPF 618 has lost its object in part — only as to item 2 of the opinion annexed to Resolution 1.021/1980 (in legal terms, that piece of the case is moot: there is nothing left to decide). Ratifying the legal theses already fixed in Themes 952 and 1.069 of the court's repercussão geral system — its marker for questions important enough that the answer binds every court in the country — he would (i) record the partial não recepção of Article 146, § 3, I — a finding that a pre-1988 provision was not carried over into the current Constitution — "without reduction of text," meaning no words are struck out and only one reading is excluded: the reading that doctors must transfuse against the prior or current wishes of an adult, capable patient who objects out of personal conviction; and (ii) declare partly unconstitutional, again without deleting text, Articles 5 § 2, 6, 10 and 11 of Resolution 2.232/2019, Articles 22 and 31 of the Code of Medical Ethics, and Article 3 of CREMERJ 136/1999, so as to remove any reading that authorises doctors to transfuse against such a refusal.^[1]

Justice Cristiano Zanin then asked for the file. His voto-vista — the vote a justice delivers after taking a case away to study it — was recorded in the next virtual session, from 19 December 2025 to 6 February 2026. He followed the rapporteur on the mootness point and diverged in part on method and on the hard cases. Rather than non-reception, Zanin would use interpretação conforme a Constituição, reading a text so that it fits the Constitution instead of voiding it: the Penal Code carve-out and Articles 22 and 31 of the Code of Medical Ethics would be confined to cases of presumed consent, where an emergency makes it impossible to obtain the patient's or representative's consent, excluding any reading that permits intervention against the free, express, prior or current will of a capable patient.^[1]

Zanin would also read Resolution 2.232/2019 as covering refusals in urgent and emergency settings, not only elective ones, and would set out a route for conflicts: as a rule the doctor respects the refusal; where the representative's decision may conflict with an adult patient's presumed wishes, or with the best interests of a child or adolescent, the doctor must go to court for an authorisation substituting for consent; and where harm to health or life is imminent and there is no time to wait for a judge, the doctor may act on estado de necessidade — acting without consent to avert a greater and immediate harm, the necessity defence in Article 24 of the Penal Code. He would declare Articles 5, 10 and 11 of Resolution 2.232/2019 and Article 3 of CREMERJ Resolution 136/1999 unconstitutional.^[1]

As of the STF dockets read on 2 September 2026, those are the only two justices' positions the record contains.

Suspended twice

Each of those sessions ended in a pedido de vista — a request by a justice to withdraw the file for closer study, which suspends the judgment for everyone. Zanin's was recorded on the docket on 1 September 2025, Justice Alexandre de Moraes's on 23 December 2025. The minutes of that second session were published in February 2026. Moraes returned the file on 27 April 2026, under the docket's standard wording that the justice "has finished his examination and a date may be set for the continuation of the judgment." No vote of his appears on the dockets read on 2 September 2026. That return entry tags the case for an in-person merits judgment before the full bench, where the earlier rounds ran virtually.^[1][2]

Who is taking part

Nine bodies are listed as amici curiae in ADPF 618: the doctors' union SIMEPAR of Paraná, the Associação das Testemunhas Cristãs de Jeová, the evangelical lawyers' association ANAJURE, the Instituto de Ciências Penais, the CFM, Watch Tower Bible and Tract Society of Pennsylvania, the Instituto Brasileiro de Direito e Religião (IBDR), the Sociedade Brasileira de Bioética, and the Centro Brasileiro de Estudos em Direito e Religião. On the dockets read on 2 September 2026, the only amicus in ADPF 642 is SIMEPAR.^[1][2]

The Associação das Testemunhas Cristãs de Jeová was admitted early, by Celso de Mello, in his decision of 19 December 2019, alongside ANAJURE and SIMEPAR. Watch Tower's admission came far later: Nunes Marques admitted it in one of six single-justice decisions issued on 1 October 2024 and recorded on the docket on 3 October 2024.^[1]

The docket also records who addressed the bench in the 2025 session, though not what they said. In ADPF 618: Eliza Akiyama and Luciana Cadeu for the Associação das Testemunhas Cristãs de Jeová; Maila Carla de Matos da Silva Tavares for SIMEPAR; João Paulo Simões da Silva Rocha for the CFM; Thiago Rafael Vieira for the IBDR; and Mychelli Fernandez and Laércio Ninelli for Watch Tower. In ADPF 642: Gabriela Rondon for PSOL, Rocha again for the CFM, and Beatriz Marafon Silva Spak for the amicus.^[1][2]

What the court already decided in 2024

On 25 September 2024 the STF ruled unanimously in two extraordinary appeals, REs 979742 and 1212272, with Justices Luís Roberto Barroso and Gilmar Mendes as rapporteurs. Barroso, then the court's president, said the result reaffirmed the court's position in favour of religious freedom, reconciling it with the constitutional rights to life and health.^[5]

The theses fixed there carry repercussão geral, so they bind every court in the country. In RE 979742 the court held that "Jehovah's Witnesses, when adult and capable, have the right to refuse a medical procedure involving blood transfusion, on the basis of individual autonomy and religious freedom," and that they are consequently entitled to the alternative procedures available in the SUS, Brazil's public health system, travelling outside their home area if necessary. In RE 1212272 it held that a patient in full civil capacity may refuse treatment on religious grounds, provided the decision is unequivocal, free, informed and enlightened — including where it is expressed through an advance directive.^[5]

The same ruling drew a line at minors: where the treatment of children and adolescents is at stake, their best interests prevail, and religious freedom does not permit parents to block medical treatment of under-age children.^[5]

Both 2024 cases were individual disputes. RE 979742 concerned a patient who needed a total joint replacement not available without transfusion in Amazonas, and the question of which public bodies had to pay for it elsewhere. RE 1212272 concerned a patient referred to the Santa Casa de Maceió for aortic-valve replacement surgery, which was refused after she declined to sign a consent form covering transfusion.^[5]

ADPF 618 and ADPF 642 reach past those facts to the general rules — the Penal Code carve-out and the medical councils' resolutions.

Where the cases stand

As of the STF dockets read on 2 September 2026, the two most recent entries in both cases are the presidential listing of 28 August and the publication of the calendar on 1 September.^[1][2] The Brazilian legal outlet Conjur carried the September calendar the day after it was released, reproducing the court's communications office summary.^[6]

The docket field reads: Data de Julgamento: 30/09/2026.^[1][2]