Week 8 Discussion Question (https://secure.flickr.com/photos/87193413@NOO 807784
ID: 248785 • Letter: W
Question
Week 8 Discussion Question (https://secure.flickr.com/photos/87193413@NOO 8077847943 Please read the passage and respond. A young mother who was severely injured in a car accident is brought into the hospital trauma center where you work. She belongs to the Jehovah's Witnesses church, and emphatically states that she refuses to have a blood transfusion. You know she risks death without a transfusion, but she believes her decision is a matter of her salvation. As a member of the patient's health care team, what will you do? The patient in the car accident scenario is an elderly Jehovah's Witness and has no family. What will you do? The female patient in the car accident scenario is unconscious, but her husband makes her wishes known regarding blood transfusions. Can you accept the husband's decision on the patient's behalf? Explain your answer.
Explanation / Answer
ANSWER 1) In the present scenario where the young mother has been brought severely injured to the trauma center, she would be triaged as most urgent. The patient has the right to decide for their treatment choices. Blood transfusion which is a crucial intervention to save her life, requires the consent of the patient or her relative if patient cannot give consent, before transfusion. The decision of not accepting blood transfusion is a part of her religious and ethical issue which has to be respected. But before that, the patient and her relative should be explained clearly that their decision may risk the life of the patient. It may cause even death. All the necessary indications for transfusion should be explained by the physician. If still the patient is not willing to get transfused, the are supposed to sign a consent which states agreement for refusal of treatment/procedure by the patient. All the event should be properly recorded in the nurses note and patient's health record.
ANSWER 2) The patient who is an elderly Jehovah's Witness has underwent a car accident which is a medico legal case. The police needs to be informed about her admission to hospital. Inspite ofthe family members being absent, all the necessary treatment needs to be given. Regarding blood transfusion, patient's consent is taken if she is conscious and can give consent. If she refuses to get transfused due to her religious norms, then after explaining all significant consequences of her decision, a refusal should be signed by her. But in case, she is not conscious and unable to take her own decision, the top priority of treatment is to save the life of the patient. The healthcare provider may not delay any interventions needed to sustain life because of the absence of the family. If the intervention is not so important then it can be delayed till the arrival of the family. In meantime, the police and the hospital authority should try to trace out the family of the patient so that uninterrupted care can be delivered.
ANSWER 3) Yes, patient's husband's decision is accepatable on patient's behalf as she is unconscious. It has been legally accepted that patient has the right to make choice of her treatment. They have the right to decide about the treatment. In the situation where patient is unconscious, cannot take decision of her own like mentally ill, memory loss or if minor, then the family member, relative or friend who is the first in close relation with the patient can make decision on behalf of the patient and make choices for their treatment. They have the legal authority to do so as they are responsible completely for their patient. On other hand, if the decision made by the patient's relative is found to be wrong medically which may risk the life of the patient, then all the possible interventions, its consequences should be explained to the relative. If patient's relative i.e the husband still refuses blood transfusion, then he is supposed to sign a refusal consent for blood transfusion. All these events should be documented clearly and accurately in patient's medical record with the consent attached to the patient file. This is to prevent any further legal implications upon health care providers that may arise in future.
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