Education And Debate

Author's views

BMJ 1994; 308 doi: (Published 28 May 1994) Cite this as: BMJ 1994;308:1425
  1. S Finfer
  1. Intensive Therapy Unit, Royal North Shore Hospital, St Leonards NSW 2065, Australia.

    Patients with life threatening haemorrhage rarely refuse blood transfusions, but when they do staff face unfamiliar legal, medical, and ethical problems. At first the legal issues seem the easiest to resolve. Those on duty are obliged to provide treatment and to withhold transfusion.

    We were fortunate that our patients were conscious and clearly understood that without blood they were likely to die. Had they arrived unconscious, as many trauma patients do, we would have had to determine their wishes. Patients may carry written instructions that they are …

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