Consent in Jehovah's Witnesses.

Editor—Sydor and colleagues studied trainee behaviour in a crisis situation, and trainee ability to challenge a decision by a consultant anaesthetist to administer blood to a patient who is a Jehovah’s Witness. This was described as unethical, although perhaps a better term would be ‘in breach of the law’. I would like to put it to the authors that unless the notes were shown to contain the proper Advance Decision, the consultant anaesthetist’s decision could have been ethical and legal. In the UK, the legal position is that in the case of lifesustaining treatment, the advance decision must be made by an adult who has capacity, needs to be in writing, signed in the presence of awitness, and it must include aclear statement that the advance decision is to apply to the specific treatment even if the decision maker’s life is at risk. If any of the above conditions are not fulfilled, the doctor then must act in the patient’s best interests. It is not clear from the scenario whether such a form was included in the notes. ‘Consult’ done byatrainee on call overnight wasfairly brief, with no mention of Advance Decision. While it is important to respect the wishes of a Jehovah’s Witness, it is also important to establish exactly what those wishes are and whether they have a legal standing. The ethical standpoint of the doctor is thus also respected, and any future legal challenge prevented.