Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Jehovah's Witnesses refuse blood transfusions out of obedience to the Bible's command to all Christians to abstain from blood. The Witnesses take this scriptural injunction seriously and, of their own initiative, execute advance medical directive cards to communicate their refusal to medical personnel in the event of their incapacity. ⋯ Further, not only does Migden and Braen's analysis subordinate patient values to professional preference in all cases, but the heightened scrutiny protocol they propose is useless because it cannot possibly be implemented in the hypothetical they posit. Finally, their legal analysis is not well founded and practitioners who choose to follow it will do so at their peril.
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Jehovah's Witnesses are members of a Christian group that does not allow blood transfusion. It is a general practice for adult Witnesses to carry on their person a wallet-sized advance directive card refusing blood. The blood refusal card directs that no blood is to be given to the owner under any circumstance, even if physicians believe transfusion will be lifesaving. ⋯ Advance directives regarding life and death decisions should be subject to scrutiny and not be automatically accepted at face value. A goodfaith decision to transfuse the unconscious adult Jehovah's Witness, in emergent need of blood, is justified if the patient does not have a blood refusal advance directive that is informed and otherwise survives a high level of scrutiny. The ethical and medicolegal considerations upon which this thesis is based are discussed.