Refusal of Treatment: Refusal of Life-Saving Blood Transfusion Bars Legal Recovery

March 24, 2014 | Healthcare Risk, Quality, & Safety Guidance

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​In a case of first impression in the state, a Michigan appellate court applied the common law doctrine of "avoidable consequences" in a case in which it decided who must bear the legal burden for the death of a patient who because of her religious convictions, refused to accept a life-saving blood transfusion in a situation in which the alleged negligence of the patient's physicians caused her to need a blood transfusion.

According to scripture in the Jehovah's Witness faith, no blood or blood products or any derivative of any kind of blood is allowed for medical treatment. Members of the faith consciously determine what he or she accepts in blood management. In this case, the plaintiff, who suffered from end-stage renal disease requiring a kidney transplant, would not accept whole blood or blood products. Less than a week after receiving the transplant, tests indicated the transplanted kidney was being rejected. A corticosteroid treatment and a plasmapheresis treatment were administered. For patients who decline to accept blood products, saline solution is typically used in plasmapheresis instead of replacement plasma. During treatment, the patient exhibited signs and symptoms that raised suspicion of internal bleeding from the transplanted kidney; a computer tomography scan showed a large mass around the kidney. Surgery revealed that the kidney was completely decapsulated. The surgeon considered the kidney to be "doomed" without a blood transfusion that the patient had declined. The transfusion was needed to replace the plasma that had been removed by plasmapheresis. The donated kidney was...

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