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Refusal of blood transfusion — RCPSC IM MCQ

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ModerateGeneral IM, Ethics, CanMEDSRefusal of blood transfusionRCPSC IM

A 45-year-old man on an internal medicine ward refuses blood transfusion for severe iron-deficiency anaemia. He is alert, explains the risk of myocardial ischemia, gives consistent religious reasons, and accepts intravenous iron. Hemoglobin is 58 g/L and he is haemodynamically stable. What is the most likely diagnosis?

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Correct answer: A — Capable refusal of recommended treatment

A capable adult may refuse recommended treatment, including transfusion, even when the clinician considers the decision risky. The decision should be documented and alternatives offered.

Reference: CanMEDS professionalism framework; Canadian consent principles