Who decides for a minor Jehovah's Witness (JW) needing a life-saving blood transfusion?

From the Guidelines

In the event of a life-threatening situation requiring blood transfusion for a minor who is a Jehovah's Witness, the court or a designated medical guardian typically makes the decision to administer blood products, as the minor's parents or guardians may refuse the treatment due to their religious beliefs 1.

Key Considerations

• The minor's right to refuse is not unlimited, and in cases where their life is at risk, the court may intervene to ensure their safety 1.
• The medical team may consider alternative treatments, such as erythropoietin (EPO) to stimulate red blood cell production, but in cases where blood transfusion is deemed medically necessary, the court's decision supersedes the family's refusal.
• In emergency situations, healthcare providers may administer blood products without consent to save the minor's life, highlighting the importance of prioritizing the minor's well-being over their family's religious beliefs.

Medical Decision-Making

• The decision to administer blood products is typically made on a case-by-case basis, taking into account the minor's medical condition, the potential risks and benefits of the treatment, and the family's religious beliefs 1.
• Ultimately, the minor's best interests are the primary consideration in making decisions about their medical care, and healthcare providers must balance the family's wishes with the need to ensure the minor's safety and well-being.

From the Research

Decision-Making for Minors

• In the case of a minor Jehovah's Witness (JW) needing a life-saving blood transfusion, the decision is not explicitly addressed in the provided studies 2, 3, 4, 5, 6.
• However, it can be inferred that the decision would typically be made by the minor's parents or legal guardians, as they are responsible for making medical decisions on behalf of their child.
• In situations where the parents or guardians are also Jehovah's Witnesses, they may refuse blood transfusions for their child due to their religious beliefs.

Medical and Ethical Considerations

• Medical professionals may face ethical challenges in respecting the parents' or guardians' decision while also ensuring the best possible outcome for the minor patient 3.
• In such cases, healthcare providers may need to explore alternative treatments and management strategies that do not involve blood transfusions, such as those described in the studies 2, 4, 5, 6.
• The use of erythropoietin-stimulating agents, intravenous iron, and other pharmaceutical options may be considered as alternatives to blood transfusions for minor JW patients with severe anemia or life-threatening conditions.

Legal Implications

• The administration of blood to a JW patient who has refused transfusion, or whose parents or guardians have refused on their behalf, may have legal implications 3.
• Healthcare providers must be aware of the legal and ethical considerations involved in treating minor JW patients and ensure that they are respecting the rights and autonomy of both the patient and their parents or guardians.