Ethical situation - Blood transfusion

[Lothric]

Hi,

FA says that during an accident and a mother and 15 year old daughter are bleeding, if the father ssays do not transfuse then the daugher should still get transfused but not the mother. After this statement, FA elaborates and says "emergent care can be refused by the healthcare proxy for an adult, particularly when patient preerences are known or reasonably inferred".

I don't understand. Is the transfusion to mother rejected solely based on what the father said, or is it rejected ONLY when the healthcare proxy is known to be the father?

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[star.buck]

This is one of those dicey ethical situations... in an emergent situation the healthcare procy can usually decide the care of the adult for whom they are legally designated. When a child comes into the EMERGENT situation, healthcare workers are primarily concerned with the well being of the child rather than the wishes of the proxy. Even this can change depending on situations, but usually it’s discussed in the context of Jehovah’s Witnesses - in which case if there is an emergent medical condition and the withholding of transfusion will result in a child’s death - as I understand it, the child is given transfusion even if the parent says no. If it wasn’t emergent... no blood is given.

This might help:
Children of Jehovah’s Witnesses and adolescent Jehovah’s Witnesses: what are their rights?

 

[Lothric]

This is one of those dicey ethical situations... in an emergent situation the healthcare procy can usually decide the care of the adult for whom they are legally designated. When a child comes into the EMERGENT situation, healthcare workers are primarily concerned with the well being of the child rather than the wishes of the proxy. Even this can change depending on situations, but usually it’s discussed in the context of Jehovah’s Witnesses - in which case if there is an emergent medical condition and the withholding of transfusion will result in a child’s death - as I understand it, the child is given transfusion even if the parent says no. If it wasn’t emergent... no blood is given.

This might help:

Thanks!

But I still don't understand the case with the mother. Why did FA tell me to not transfuse the mother just because the father said so? Am I not supposed to find out if the father is the helathcare proxy for the mother? If he is, then yeah, no transfusion for her I guess. But if he is not, I could transfuse her too right?

 

[star.buck]

Thanks!

But I still don't understand the case with the mother. Why did FA tell me to not transfuse the mother just because the father said so? Am I not supposed to find out if the father is the helathcare proxy for the mother? If he is, then yeah, no transfusion for her I guess. But if he is not, I could transfuse her too right?

HM... what page and which edition of FA are you on?

 

[deleted645092]

Thanks!

But I still don't understand the case with the mother. Why did FA tell me to not transfuse the mother just because the father said so? Am I not supposed to find out if the father is the helathcare proxy for the mother? If he is, then yeah, no transfusion for her I guess. But if he is not, I could transfuse her too right?

If a patient is incapacitated and doesn't otherwise have a designated Power of Attorney/ proxy on file, the primary decision maker is the spouse. Followed by parents > adult siblings > children > so on. I might not have the order perfect but the spouse is always #1.

Edit: If the healthcare proxy isn't known/available or there isn't anything stating otherwise on file, then all lifesaving measures are performed.

As for the child, in an emergent situation lifesaving measures trump all other decisions, even from parents. In non-emergent situations, the parents or designated primary caregiver makes the decisions.