Jehovah's Witness Refusing Transfusion

Name the tension first: beneficence and the duty to preserve life pull one way, autonomy pulls the other. For a competent adult the answer is settled — a patient with capacity may refuse any treatment, including a life-saving one, and may do so for reasons that seem to you irrational or for no reason at all. Treating them anyway would be an assault.

Then show the work you would actually do. Confirm capacity for this decision at this time, and confirm the refusal is informed: that she understands what a haemorrhage means, that the refusal is specific to blood products, and that she has not been pressured by anyone else — which is why the conversation happens with her alone. Look for a signed and witnessed advance decision, which carries her prior wishes if she later loses capacity.

Show that refusing blood is not refusing care. Cell salvage, tranexamic acid, volume replacement, meticulous surgical haemostasis and early involvement of a hospital liaison committee are all still available, and offering them is what turns respect for autonomy into treatment rather than abandonment.

Finally, flag where the answer changes. A child is a different case: parental refusal of a life-saving transfusion can be overridden through the courts, because the parents' authority is exercised in the child's best interests rather than as their own autonomous choice.