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Capable refusal of blood transfusion — RCPSC EM MCQ

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HardEthics, medicolegal, Indigenous healthCapable refusal of blood transfusionRCPSC EM

A capable Jehovah’s Witness with exsanguinating GI hemorrhage, using a professional interpreter, refuses red cells after demonstrating understanding that death may result. Their spouse demands transfusion. What is the correct approach?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Respect the informed refusal and use acceptable blood-sparing and hemostatic measures

Explanation lettering: C = shown as A · E = shown as B · D = shown as C · B = shown as D · A = shown as E

B is correct: a capable adult’s informed refusal governs even in a life-threatening emergency. C and D override autonomy. E may delay a decision that capacity has already resolved. A misunderstands the scope of a valid refusal despite providing otherwise appropriate care.

Reference: Canadian Medical Protective Association, Medico-legal handbook for physicians in Canada: https://www.cmpa-acpm.ca/en/advice-publications/handbooks/medical-legal-handbook-for-physicians-in-canada