To transfuse or not to transfuse...

[Satsuma]

OK, so today we had a legal issues class to go over several issues, one of which was consent. This class was given by a lawyer.

 

So I thought I would share with you the opinion received today on the topic of treating a JW in an emergency situation (so with no time to be able to contact family) with a blood transfusion if you knew this person was a JW but you had no knowledge (so no JW card or otherwise) about whether this person would accept or decline a blood transfusion (as in the case presented in the original post). The lawyer stated that in this case you have no evidence of refusal and that she would go ahead with a blood transfusion and stated that this would be supported by the courts. Obviously the situation changes if you are aware that the pt would not consent to a blood transfusion (be it from a JW card or family member etc.).

 

The discussion came out of an actual case presented where a doctor treated a JW with a blood transfusion after finding a JW card stating the pt didn`t want a blood transfusion. The card was signed but not dated. The doctor proceeded with treatment for fear that the pt would die and that the family would then pursue the doctor...since the document wasn`t dated (and so technically not valid). The pt lived and then pursued the doctor in question and it went to several levels in the courts. The courts did sympathize with the doctor and understood his perspective but in this case the pt won the case, though it was not a black & white case but was presented to us so we could gain an understanding of when the courts would support us. And that is important because this doctor really acted out of fear that if he didn`t treat the courts wouldn`t support him if he was pursued by a family member.

[illusion]

I agree with not transfusing the patient as this was their prior choice and wish and knowing that it would go against the patient's autonomy to do so. Just a thought (still catching up...so not sure if this was mentioned)... but having known that this patient did not wish to have a blood transfusion should it not have been this physician's responsibility to ASK if this patient would like to formally document this wish?