Refusal of a blood transfusion or blood products (adults)

Can anyone refuse a blood transfusion?

Yes. We want to be sure that we treat every patient in a way which recognises their individual choice or religious beliefs.

Your doctor will discuss with you the possible risks of treating you without using blood products. You will need to decide if you are willing to accept these risks. In extreme cases the refusal of blood can lead to harm or even death, although everything will be done to try and avoid this. The doctor will discuss with you alternatives to blood transfusions as appropriate.

The Jehovah’s Witness Hospital Liaison Committee may be able to help if you need more information.

What should I do if I have a planned admission to hospital?

Before you are admitted to hospital you will usually be invited to attend a Pre-operative Assessment Clinic where you will be seen by a nurse and/or a doctor. You should make them aware of your request for no blood or blood products to be used as part of your treatment. It is very important that you tell hospital staff as soon as possible so they can plan your treatment.

If you are a Jehovah's Witness you will probably be carrying an ‘Advance Decision to Refuse Specified Medical Treatment’ (sometimes known as a 'no blood’ form) which will outline your views regarding medical and surgical treatments.

The ‘Advance Decision to Refuse Specified Medical Treatment’ or any similar form should be seen and acknowledged by the doctor treating you. Your local ministers will be able to provide you with these documents. The hospital staff will record, in your medical records, the information you give verbally or contained in your ‘Advance Decision to Refuse Specified Medical Treatment’ form.

How will staff manage my decision to refuse a blood transfusion or blood products?

The Trust has an active programme to conserve blood and reduce the number of transfusions given for all patients.

The Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) ‘Patients who refuse Blood Components Management Plan’ is used by medical staff to plan your care.

In all cases hospital staff will respect your right, as an adult patient, to decide what will happen to you during your treatment. Some patients may wish to wear their own ‘no blood’ wristband. This would not replace the standard hospital identification wristband.

Will I be asked to sign a consent form?

Yes. Before any operation or procedure takes place you will be asked to sign a consent form. In signing the form you are agreeing only to the treatment you are willing to accept and which you have discussed with your doctor. This will be written on the consent form before you are asked to sign it.

If you decide to refuse blood you will also be asked to sign the GHNHSFT Consent Form 5 or, if unavailable, the standard NHS consent form with reference to withholding consent for blood/blood products clearly identified.

What will happen if there is an emergency during my stay?

If an emergency situation arises during your stay in hospital we will respect your wishes, whatever the risks.

What will happen if I am admitted to hospital as an emergency patient?

If you are admitted to hospital in an emergency and we know of your wishes, we will respect and follow them. The GHNHSFT ‘Patients who refuse Blood Components Management Plan’ provides guidance for medical staff dealing with these situations. This has been developed following discussions with medical professionals and the Bristol Hospital Liaison Committee for Jehovah’s Witnesses.

You can be confident that you will receive the best possible care and treatment during your time in hospital.

What if I change my mind?

If you change your mind about refusing a blood transfusion you must tell staff immediately. This change of decision will be recorded in your medical records and your treatment plan will be adapted accordingly.

What if I have other concerns?

If you have questions which are not answered in this leaflet or you are worried about any aspect of your treatment please talk to one of the doctors or nurses. If they cannot answer your questions they will find someone who can.