A medical practitioner should inform the parent(s) of Jehovah’s Witness children that whilst he/she will try to respect their religious views, if a blood transfusion is required to save the child’s life, or prevent severe harm, it will be administered without their consent, unless they obtain a court order prohibiting this.
Where possible, such discussions should be conducted as soon as possible so that the parents of such children are offered a reasonable time to obtain legal advice or a second medical opinion, should they so wish. Given that there may be some disagreement over whether or not an alternative medical treatment to a blood transfusion is medically acceptable, it would be advisable for the practitioner to debate the acceptability of the proposed alternative treatment with a senior colleague, and record in his notes the views of the colleague consulted.
In fact, all discussions by a practitioner with a patient, a patient’s representative, proxy or the patient’s parent (whichever is appropriate) should take place well in advance of treatment/surgery (if possible). This is to afford not only the parent(s) or patient or proxy time to obtain legal advice or a second opinion, but also the practitioner an opportunity to consult a senior colleague, seek legal advice or approach the Department of Social Development, in the case of a patient who is a child.
In our experience, some Jehovah’s Witness patients may actually wish to consent to receiving blood transfusions but are reluctant to agree thereto for fear of being ostracised by their religious community. In order to ensure that patients are not acting under duress, medical practitioners would be well advised to assure the patient that the nature of any treatment administered (including blood transfusions) is confidential and will not be disclosed by the practitioner to any third parties, and that third parties cannot gain access to hospital records without the consent of the patient.
It is furthermore advisable to have all discussions about possible blood transfusions with the patient privately, to ensure patient confidentiality and to allow them to disclose their wishes without pressure from family or the community.