A 55-year-old man on ICU requires a transfusion of packed red cells. His religious beliefs as a Jehovah's Witness mean he refuses blood products. He h...

Question

A 55-year-old man on ICU requires a transfusion of packed red cells. His religious beliefs as a Jehovah's Witness mean he refuses blood products. He has capacity and has signed an advance refusal of blood transfusion. His haemoglobin is 45 g/L and he is haemodynamically unstable from GI bleeding. What is the correct legal and ethical response?

Accepted Answer

Respect his autonomous, capacitous refusal - a competent adult has the absolute right to refuse any treatment, including life-saving blood transfusion; optimise non-blood alternatives (IV iron, erythropoietin, cell salvage if acceptable, tranexamic acid, minimise blood sampling) and provide the best possible care within the patient's chosen limits

Answer

Transfuse against his wishes to save his life

Answer

Obtain a court order to override his wishes

Answer

Wait until he loses consciousness then transfuse

Answer

Discharge him from ICU

uk-fficm MCQ (SBA): Jehovah's Witness - Blood Refusal