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 One more on Ethics!  

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Unconscious patient--->Bleeding profusely--->Wife rejects blood transfusion --->Says that her husband is a firm believer of religion-So Don't transfuse!


confusedWill substituted judgement work here-Since wife has been with him always----?

Or Substituted judgement will not work in emergency situations?



in emergent situations only advanced directives or a living will work will be acceptable, not substituted judgement... and for peds group, physician must intervene i its emergent situation.


yes we transfuse


"If the individual’s substitute judgment is to refuse the treatment, that refusal must be respected except in an emergency."


It's an EMERGENCY situation... NO time to stop and think about ethics! Transfuse UNLESS the wife provides written proof that the husband doesn't want to be transfused. You can't go on word of mouth.

BUT what if the wife is the man's Power of Attorney. As we know the Power of Attorney beats a living will and the POA actually speaks as the patient's voice. In this case, what do we do?


then u follow wife's wishes


If it is not a medically necessary what should we do?


transfuse. i think women should provide power of attorney document


if it si not life threatening situation, wait till he wakes up, and ask him


yes emergency when patient is unconscious the only objective is 2 save patient

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