A 50-year-old Jehovah’s Witness is admitted following a road traffic accident. He has lost a significant amount of blood and requires an urgent transfusion. His blood group card states “No blood products.” He is currently unconscious. What is the most appropriate action? A) Proceed with blood transfusion B) Withhold blood transfusion and provide alternative treatments C) Obtain consent from his family D) Seek a court order E) Assume implied consent and give blood Correct Answer: B) Withhold blood transfusion and provide alternative treatments Explanation: Jehovah’s Witnesses may refuse blood transfusions on religious grounds. If a valid written refusal exists, it must be respected even if the patient is unconscious. Alternative management: IV fluids, haemostatic agents (tranexamic acid), iron therapy. A) Proceed with blood transfusion → Incorrect. Violates patient’s autonomy. C) Obtain consent from family → Incorrect. Family cannot override written refusal. D) Seek a court order → Incorrect. No legal basis if patient made a prior valid refusal. E) Assume implied consent → Incorrect. No implied consent when a written refusal exists. Key Tips for PLAB 1: ✅ Written refusal of blood must be respected ✅ Provide alternative treatments (IV fluids, tranexamic acid) ✅ Family cannot override patient’s prior decision
