Practical issues when confronting the patient who refuses blood transfusion therapy

Caring for the Jehovah's Witness patient poses unique challenges to the medical community. Understanding the patient's viewpoint regarding the refusal of blood and blood products is an essential component in treating these patients effectively. There are currently numerous alternatives to allogeneic blood products that can be used in a variety of settings. The intent of this article is to present the beliefs of Jehovah's Witnesses regarding blood transfusion and to review the use of crystalloids, colloids, hemostatic drugs, erythropoietin, hemodilution, blood salvaging, intraoperative blood-conserving strategies, and artificial blood solutions as alternative treatments for these patients.