Anaes Cases · Ethics, consent & medicolegal
The Jehovah's Witness for the major cancer surgery
The long case — the JW for the major cancer surgery. The detailed consent (the specific products accepted and refused), the transfusion-free technique (the cell salvage with the continuous loop, the ANH, the erythropoietin, the iron, the tranexamic acid, the meticulous haemostasis), the MDT, the documentation, and the autonomy.
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A 54-year-old JW man, the Hb of 128 g/L, for the elective open right hemicolectomy for the colorectal cancer. He refuses all the blood products (the whole blood, the red cells, the platelets, the plasma) on the religious grounds; he has the JW advance directive. He is willing to discuss the cell salvage, the fractions, and the alternatives. Discuss the consent, the blood-management plan, and the ethical approach.
[2]References3ShowHide
- [2]Piekarski F, et al. Perioperative blood management in Jehovah's Witnesses. Die Anaesthesiologie, 2026.PMID 42081097
- [3]Bolcato M, et al. The clinical and medico-legal aspects of transfusion-free treatment. J Clin Med, 2025.PMID 40807065
- [42081098]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.