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The Jehovah's Witness Blood Refusal Card: Ethical and Medicolegal Considerations for Emergency Physicians
Author(s) -
Migden Douglas R.,
Braen G. Richard
Publication year - 1998
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.1998.tb02510.x
Subject(s) - medicine , scrutiny , witness , directive , blood transfusion , medical emergency , beneficence , informed consent , intensive care medicine , surgery , law , alternative medicine , pathology , autonomy , political science , computer science , programming language
. Jehovah's Witnesses are members of a Christian group that does not allow blood transfusion. It is a general practice for adult Witnesses to carry on their person a wallet‐sized advance directive card refusing blood. The blood refusal card directs that no blood is to be given to the owner under any circumstance, even if physicians believe transfusion will be lifesaving. Although the card claims to refuse blood on a religious basis, it also states that there are various dangers associated with blood. The possibility that in an emergency the dangers of blood may be relatively small, as compared with the likelihood of death due to exsanguination without blood, is not noted on the card. Emergency physicians should look for evidence of an informed refusal when evaluating these documents. Advance directives regarding life and death decisions should be subject to scrutiny and not be automatically accepted at face value. A good‐faith decision to transfuse the unconscious adult Jehovah's Witness, in emergent need of blood, is justified if the patient does not have a blood refusal advance directive that is informed and otherwise survives a high level of scrutiny. The ethical and medicolegal considerations upon which this thesis is based are discussed.