When a patient refuses life-saving care: issues raised when treating a Jehovah's Witness

Am J Kidney Dis. 2011 Oct;58(4):647-53. doi: 10.1053/j.ajkd.2011.05.030. Epub 2011 Sep 8.

Abstract

Patients who are Jehovah's Witnesses frequently cross the path of nephrologists when they are acutely ill in the intensive care unit and stable in the long-term setting. It is important that we as a group have a rudimentary understanding of their philosophy about blood transfusion so that we can be proactive in their management. We use a case as a launching point to discuss the origins of the faith and the decision to refuse blood, as well as potential therapeutic strategies that can be used to improve the care of these patients. Improvement in our understanding as physicians will facilitate a more productive conversation with our patients about a complex and emotional issue.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anemia / etiology
  • Anemia / prevention & control
  • Anemia / psychology
  • Anemia / therapy*
  • Anticoagulants / adverse effects
  • Attitude of Health Personnel*
  • Blood Transfusion / ethics
  • Blood Transfusion / psychology
  • Fatal Outcome
  • Female
  • Gastrointestinal Hemorrhage / complications
  • Gastrointestinal Hemorrhage / etiology
  • HIV Infections / complications
  • Hematinics / therapeutic use
  • Humans
  • Jehovah's Witnesses* / psychology
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Kidney Transplantation / ethics
  • Kidney Transplantation / psychology
  • Middle Aged
  • Multiple Organ Failure / etiology
  • Plasma
  • Platelet Transfusion / ethics
  • Platelet Transfusion / psychology
  • Professional-Patient Relations / ethics
  • Resource Allocation / ethics
  • Social Support
  • Thrombosis / complications
  • Thrombosis / drug therapy
  • Treatment Refusal* / ethics
  • Treatment Refusal* / legislation & jurisprudence
  • Treatment Refusal* / psychology

Substances

  • Anticoagulants
  • Hematinics