EthicsIntermediateMMI station
A Jehovah's Witness patient refuses a blood transfusion they need to survive. What do you do?
Ethical dilemma: Competing duties with no perfect answer: consent, confidentiality, fairness.
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Sample answer outline
- A competent adult can refuse even life-saving treatment. Your job is to make sure the refusal is informed, voluntary and consistent with their values.
- Talk with them privately to check for pressure from family or community.
- Explore what they will accept: bloodless surgery techniques, cell salvage, iron, medicines that boost blood production.
- Document the conversation and their decision clearly, and keep caring for them fully.
- Note how it differs for a child or for an unconscious patient without an advance directive.
What makes it work
- It respects autonomy while doing everything else possible.
- Showing the contrast with a child proves you understand the limits.
Avoid
- Trying to persuade them out of their faith.
- Treating the refusal as a reason to step back from their care.
How to approach ethical dilemma questions
- Clarify the facts and what you would want to know before acting.
- Name who is affected and the principles in tension: autonomy, doing good, avoiding harm, fairness, confidentiality.
- Walk through realistic options, starting with the least drastic.
- Choose a course of action, explain why, and say who you would involve.
What it tests
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