A devout Jehovah's Witness scheduled for caesarean section signs a clear written refusal of blood transfusion even if haemorrhage becomes life-threatening. She is fully oriented and understands the consequences. Massive bleeding occurs intraoperatively. The legally correct action for the surgical team is:

• A Honour the refusal, use all available bloodless alternatives and document the decision meticulously ✓
• B Transfuse after obtaining telephonic consent from her next of kin
• C Transfuse packed cells once systolic pressure falls below 90 mmHg, since saving life overrides personal belief
• D Seek permission from the hospital ethics committee to transfuse against her wishes

Explanation

C competent adult possesses an absolute right to refuse treatment, including life-saving transfusion, grounded in bodily autonomy; forcible transfusion constitutes battery and actionable assault. Neither family consent nor committee approval can override the refusal of a competent adult. The team's duties are to respect the refusal, maximise cell salvage and pharmacological alternatives, involve senior colleagues and anaesthetists, and keep contemporaneous documentation of capacity assessment and the refusal itself.

Reference: Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.