Negotiating a parental refusal of a blood transfusion — OSCE

OSCE on navigating a Jehovah's Witness family's refusal of a life-saving blood transfusion for their bleeding child, with attention to the harm-principle threshold, emergency treatment in best interests, respectful engagement and escalation.

osce communication and ethics2 min readVerification in progress

Prompt

A six-year-old child is bleeding after surgery and requires a blood transfusion to survive; the parents, who are Jehovah's Witnesses, refuse blood products on religious grounds; the child is deteriorating but conscious; a senior colleague, the ethics service and a private room are available.

Station brief (8–10 minutes)

You are called to the ward where the parents of a bleeding six-year-old refuse a life-saving blood transfusion on religious grounds. Explain the clinical situation and the ethical framework to the family, agree an immediate plan that protects the child, and arrange the appropriate escalation. Do not invent local statutory wording or specific court procedure. [2]

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References4Show ledger

[1]Diekema DS Parental refusals of medical treatment: the harm principle as threshold for state intervention Theor Med Bioeth, 2004.PMID 15637945
[2]Conti A Blood Transfusion in Children: The Refusal of Jehovah's Witness Parents' Open Med (Wars), 2018.PMID 29666843
[3]Wheeler R Children of Jehovah's witnesses: a review of judicial responses to the refusal of blood transfusion Arch Dis Child, 2026.PMID 41443962
[4]Schneiderman LJ Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial JAMA, 2003.PMID 12952998