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Consent for transfusion

BMJ 1998; 316 doi: (Published 31 January 1998) Cite this as: BMJ 1998;316:397

Leaflet on risks is available

  1. Patricia E Hewitt, Lead consultant in transfusion microbiologya,
  2. Mahes de Silva, Lead consultant red cell immunohaematologya
  1. a National Blood Service, London NW9 5BG
  2. b Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
  3. c Chinese University of Hong Kong, Cancer Centre, Prince of Wales Hospital, Shatin, NT, Hong Kong

    Editor—Williams elegantly summarised the difficult issues surrounding consent for transfusion, pointing out that true (valid) consent must be based on adequate information that the patient can understand. What information should be presented and by whom is problematical.

    Many patients, particularly in elective surgery, are unaware that their treatment will include transfusion. A considerable proportion of those who have been given a transfusion are unaware that this has occurred (unpublished data). In emergencies it may be impossible to explain that a transfusion is needed. Nevertheless, the information should be given later and included in the discharge summary. Often, neither the patient nor the general practitioner is aware that a transfusion has taken place.

    There is much misinformation about the risks of blood transfusion. Patient concerns often centre around remote risk, such as transmission of HIV. Clinical staff may also be unaware of the real, important, risks. We support Williams's proposal for nurse specialists in transfusion, who would be the source of information for patients who are about to receive, or have received, transfusion, thus reducing the number of sources of information …

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