Careful Considerations for Midcrisis Consent to and Refusal of Blood Products

(Anesth Analg. 2024;138(1):85–88)Obstetric hemorrhage is difficult in any circumstance but is especially so in cases when a patient has previously stated that they refuse blood products; this is the case for many patients who identify as Jehovah’s Witnesses (JW). A recent article examined the ethical and legal implications of revisiting previous decisions about blood transfusions midcrisis, arguing that in some cases informed consent or refusal can take place while respecting religious views, as refusal before a crisis may not accurately represent their feelings while experiencing one. This article discusses concerns with the previous argument of Holland and colleagues, mainly the 2 points on which the argument stands: first, that there is literature suggesting that individuals change their minds when faced with crisis; and second, that midcrisis discussions about decisions honor patient autonomy.