QuestionSBA
QuestionChoice
Doing nothing and not transfusing blood is also incorrect because it could further deteriorate the patient's condition and potentially harm or even death. If the patient is unconscious, the healthcare professional is deemed to act in the best interest of the patient's health.
62039
b
Do not transfuse blood, as there is no patient consent
QuestionChoice
Requesting the husband to sign a disclaimer is also incorrect because it does not address the patient's lack of capacity to make decisions and the need for urgent medical intervention.
62042
e
Request the husband to sign a disclaimer
QuestionChoice
Waiting for a second opinion from another consultant is an incorrect answer because time is of the essence in this situation and the patient's condition is critical.
62040
c
Wait for a second opinion from another consultant
QuestionChoice
In this case, the patient lacks the capacity to make an informed decision about blood transfusion due to her unconscious state. There is no indication that the patient has an advance directive that allows her husband to make this decision on her behalf. While most Jehovah's Witnesses may carry a blood refusal card, it is not mentioned in this case. Therefore, the appropriate course of action is to **treat the patient as you would any other unconscious patient who presents to the emergency department** until she regains the capacity to make an informed decision.
62038
a
Transfuse blood without consent
QuestionChoice
Seeking judicial review instructions and contacting the Jehovah's Witnesses council is also an incorrect answer because it would take too long, and the patient's condition is not stable enough to wait. This might have been the best choice if the patient was relatively stable and conscious in a non-emergency scenario.
62041
d
Seek judicial review instructions and contact Jehovah's witness council
Concept
Chapter
# What are Best Interests? 

If someone lacks capacity to make a specific decision, a decision may have to be made in their _best interests_. This means that a decision will be made on their behalf, having been considered from their point of view. The decision should be one that health and social care professionals believe is the right decision for _that individual patient themselves_ (and not the decision that the professionals desire without taking the patients interests into account).

# Best Interests Criteria

When making a best interests decision on behalf of someone who lacks capacity, five factors must be considered:

1. Equal consideration and non-discrimination
2. All relevant circumstances
3. Regaining Capcity
4. Participation
5. Wishes, Feelings, Beliefs and Values

# What are Equal Consideration and Non-discrimination? 

The person making the decision about what is in the patient's best interests must not make assumptions based on _age, appearance, condition or behaviour_.

# What are All Relevant Circumstances? 

In order to determine what is in the patient's best interests, all the things that the patient would take into account if they were making the decision themselves should be identified .

# Regaining Capacity 

It must be considered whether the patient is likely to regain capacity. If so, the professional(s) need to consider whether or not the decision can be delayed until then.

# Participation 

All practicable steps should be taken in order to encourage and enable participation by the patient in the decision making process.

# Wishes, Feelings, Beliefs and Values 

The wishes, feelings, beliefs and values of the patient should be found out and taken into consideration. This includes views they have expressed in the past, religious or moral opinions, or other factors that might influence the decision they would make themselves.
2033
584
Best interest decisions in patients who lack capacity
Topic
30
Ethics and Law
12469
A 28-year-old unconscious woman is brought to the Emergency Department after a road traffic accident, exhibiting signs of shock and drifting in and out of consciousness. A FAST scan reveals a large collection of free fluid in the peritoneal cavity, requiring immediate blood transfusion. However, her husband objects to the transfusion, citing their devotion to the Jehovah's Witnesses and their opposition to blood transfusion.

What is the most appropriate next step in management?
a