Problem: PATIENT REFUSES BLOOD
Mrs. Jones has gangrene of her left leg. Her hemoglobin slipped to 6.4. She has a major infection and is diabetic. There is no spouse and no living will. The patient has decided that she does not want to be resuscitated if she should go into cardiopulmonary arrest. She may need surgery. She has agreed to surgery but refuses a blood transfusion, even though she is not a Jehovah's Witness. The surgeon will not perform the surgery, which is urgent, without Jones agreeing to a blood transfusion, if it becomes necessary. The attending physician questions the patient's capacity to make decisions. Her children have donated blood. She says she is not afraid to die.
Ethical and Legal Issues
1. Should the physician refuse to treat this patient? Explain your answer.
2. Should the family have a right to override the patient's decision to refuse blood? Explain your answer.