sheena2005
Forum Elite
Topics: 26
Posts: 257
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previousely healthy 42 years old women is brought to the emergency department after getting a femoral fracture in the right thigh, due to an accident.her Hb is 12mg/dl.surgical repair is recommended.and the patient is told about the importance of the operation.she agreees to the operation but refuses to get blood transfusion because she is a jehova's witness.which of the following is the most appropriate next step in the management?
1-obatain permission from the patient's next of kin
2-obtain a court order to transfuse the patient if necessary
3-proceed with the operation and do not transfuse when needed
4-proceed with the operation but transfuse when needed to save her life.
5-refuse to operate the patient.
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| brucella2007
Forum Junior
Topics: 9
Posts: 72
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3.
1 is definitely wrong. if teh patient herself disagrees, next of kin do not come in the picture..
of the remaining i thought 3 was suitable ...
wud lioke to know other ppl's opinion about this 
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| sheena2005
Forum Elite
Topics: 26
Posts: 257
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what do u think about 4
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| study_ing
Forum Fanatic
Topics: 180
Posts: 2,511
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its a very close tie between 3 , 4 and 5. in the end id vote for 3. in emergency situations consent is not needed pbly coz u dont heve the time etc. however the pts wishes are usually respected regarding their own life, as long as it does nat harm others, or involve active harm ( administering a lethal dose) by the physician. if we transfuse her, we will violate the pt's wishes...if it were her child involved then perhaps we wud over rule the religious binding. i m not sure if the surgery is bound to require transfusion, and whether death wud be a likely outcome in her case ( due to the refusal)....which deems 5 a close option too.
guys ure opinions will be valuable!
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| brokenhearted
Forum Senior
Topics: 5
Posts: 68
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yup, I'll go for 3 as the patient's in good condition to make her own decision just like we take consent for CPR(Cardio pul resuscitation) & if the patient signs in refusal then we don't do CPR even if the patient dies b/c of not getting CPR....what do u say guys?
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| sheena2005
Forum Elite
Topics: 26
Posts: 257
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yeah i think 4 will be more closer becuse u r bound to respect patient's wishes.even if the patient could be in danger.since she has refused in a present mind stste therefore her wish has to be respected.
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