A recent case involving a woman who refused a blood transfusion has prompted not only legal questions, but also questions about what a court takes into consideration when making its decisions.
In Newcastle, UK, a 63-year-old woman with a history of depression and paranoid schizophrenia was admitted to hospital having been found in a confused state wandering outside her home. She had bruises on her knees possibly due to falls. This initial assessment was made on February 6th, 2014. Just a few days later on February 11th, she was diagnosed with a large bleeding duodenal ulcer, which had created a dangerously low haemoglobin level.
At this point, she was assessed by a psychiatric nurse who reported that she was “not psychiatrically unwell and was presenting appropriately.”
The next day, February 12th, the woman told the medical team that she did not want treatment with any blood products. It is reported “they felt that she had full capacity to make this decision and had an awareness of the consequences.”
They also considered “that she might not survive as long as a day in the absence of a blood transfusion and even if one was given, she might still die.”
The Newcastle upon Tyne Hospital Foundation Trust made an urgent application to the Court of Protection for a declaration that it would be lawful to withhold a blood transfusion.
Some of the issues the court considered were:
At this point, only the medical and legal structures were involved in any decisions related to the woman.
What the court then took into consideration are the views of a Jehovah’s Witness elder. The elder indicated that he had known the woman since 1975 and had seen her shortly before her admission to hospital.
This begs the question was the elder aware of her long term mental health problems?
The report by the Family Law Week notes that:
“He was clear that she had formerly been an active member of the church and subscribed to all the tenets of the Jehovah’s Witness faith (including opposition to blood transfusions).”
What “formerly” means in this context is uncertain. Was she a witness in good standing? The Family Law Week does not ask that question. Neither do other news reports. If she was a witness in good standing then, it is sad that she was found wandering around the street with bruises and in a state of mental confusion.
What is also unclear is that given that in other cases, courts have upheld the right of a person to refuse medical treatment, why was it necessary to take into consideration the views of an elder?
It is understandable that a hospital trust would want legal support to ensure there would be no repercussions for upholding the patients wishes.
What is not clear is why the court would take into consideration the views of the elder, given that the woman was deemed to be mentally competent to make her own decision to refuse treatment.
More details can be found here: