Consent for blood transfusion

Within transfusion medicine, the question of whether separate informed consent should be obtained from patients for blood transfusion has provoked considerable debate. There has long been support for such an approach in the United States.1 A BMJ editorial in 1997 made it clear that reform was on the professional agenda in the United Kingdom, despite the established position that obtaining general consent for medical treatment included consent for blood transfusion.2 At the time, however, professional consensus proved elusive because of concerns over a range of practical problems, including who should be responsible for obtaining such consent and in what circumstances it should be obtained.3 The issue has now been brought to the fore again, highlighted by the recent stakeholder consultation launched by the UK government’s independent Advisory Committee on the Safety of Blood, Tissue and Organs.

In its consultation document, the committee acknowledged that practice on obtaining consent for transfusion of blood components is inconsistent across the UK. In addition, it highlighted several concerns including whether patients are being given information on risks, benefits, and alternatives to transfusion, as well as being informed of their right to refuse transfusion.4 We echo the committee’s concerns. Although current advice states that there is no legal requirement to obtain formal consent from the patient for transfusing blood components,5 we question the basis of such advice and its continuing legal probity.