However, one should make sure that the patient has indeed chosen to forgo blood, and wherever possible, physicians should speak privately to a Jehovah’s Witness to ascertain his or her true wishes. Others have employed the approach of asking the patient to be guided by a court’s decision. In general, courts have resisted forcing transfusions in competent adults, holding that Jehovah’s Witnesses’ religious right to refuse blood is more compelling than the state’s interest in preserving life. On the other hand, some courts have ordered blood transfusions in children despite parental objections, or in cases in which there is a third-party at issue, such as in an advanced pregnancy with a viable fetus. It is worth noting that surgeons are increasingly adept at using relatively bloodless surgical techniques to bypass the need for transfusions. As a result, morbidity and mortality outcomes may not dramatically worsen, even for major operations such as open-heart surgery.
The right to refuse life-sustaining treatment, including artificial hydration and nutrition, will be discussed in a subsequent article.
Dr. Tan is emeritus professor of medicine at the University of Hawaii and director of the St. Francis International Center for Healthcare Ethics, both in Honolulu. This article is meant to be educational and does not constitute medical, ethical, or legal advice. It is adapted from the author’s book, "Medical Malpractice: Understanding the Law, Managing the Risk" (2006). For additional information, readers may contact the author at siang@hawaii.edu.