JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

12: Management of patients who do not accept transfusion

Essentials

  • Respect the values, beliefs and cultural backgrounds of all patients.
  • Anxiety about the risks of transfusion can be allayed by frank and sympathetic discussion with a well-informed clinician.
  • Blood Transfusion Services provide a range of quality assured information resources for patients, parents and their families.
  • Jehovah’s Witnesses decline transfusion of specific blood products, usually whole blood and primary blood components. Individuals vary in their choice and it is important to clearly establish the preference of each patient.
  • Advance Decision Documents must be respected.
  • No one can give consent on behalf of a patient with mental capacity.
  • Emergency or critically ill patients with temporary incapacity must be given life-saving transfusion unless there is clear evidence of prior refusal such as a valid Advance Decision Document.
  • Where the parents or legal guardians of a child under 16 refuse essential blood transfusion a Specific Issue Order (or national equivalent) can be rapidly obtained from a court.

Every patient has the right to be treated with respect and staff must be sensitive to their individual needs, acknowledging their values, beliefs and cultural background.

Some patients, their family members or friends are very worried about the risks of blood transfusion, especially transfusion-transmitted infection, based on reports in the media or anecdotal experience. Others decline transfusion of certain blood products based on their religious beliefs.