An alert adult patient who is a Jehovah's Witness refuses a life-saving blood transfusion; the partner requests that the client receive the blood. What is the most appropriate action by the nurse?

• A. Explain the medical necessity to the client and persuade.
• B. Honor the partner's request to proceed with transfusion.
• C. Seek a court order to override the patient's refusal.
• D. Respect the client's right to refuse the transfusion.

Answer: (D)

The main principle here is patient autonomy in medical decisions. An alert, competent adult has the right to accept or refuse any treatment, even if refusing a life-saving intervention could result in death. Jehovah’s Witness beliefs commonly lead to refusal of blood transfusions, so when the patient is clearly capable of understanding and making a voluntary decision, the nurse must honor that choice.

Before acting, confirm that the patient truly understands the consequences, that the decision is voluntary, and that capacity is intact. If so, the partner’s wishes do not override the patient’s rights. The nurse should document the refusal in the medical record, continue to provide respectful care, and discuss available alternatives (such as non-blood management options) and any supportive measures. A court order is not appropriate when the patient is competent and explicitly refuses.