The Jehovah’s Witness Who Refused Blood Products Mrs. Lyons was a 27-year-old woman who had recently given

The Jehovah’s Witness Who Refused Blood Products Mrs. Lyons was a 27-year-old woman who had recently given premature birth to a set of twins. The infants were doing well, but Mrs. Lyons suffered hemorrhage and required emergency surgery resulting in a hysterectomy. Severe loss of blood dropped her hemoglobin to 6.0 gm/dl. Because the patient and her husband were Jehovah’s Witnesses, they refused blood transfusions as treatment for the low hemoglobin level. Christina Moore was the nurse caring for Mrs. Lyons after her surgery. Although she did not personally believe that patients should refuse blood transfusions, especially new mothers with dependent infants, she supported the rights of others to decide their health care in accordance with their religious beliefs.Shortly after admission to Ms. Moore’s unit, Mrs. Lyons’s hemoglobin began to drop. It was suspected that the patient was hemorrhaging from an unknown site in her body. Vasoactive drug therapy was begun to help maintain adequate perfusion of her body tissues, and her cardiac output was constantly monitored. Mr. Lyons remained at his wife’s bedside and supported her repeated desire not to be transfused, even though to not do so might result in his wife’s death. Over the next 24 hours, Mrs. Lyons drifted in and out of consciousness and remained very close to death, despite a slight rise in her hemoglobin level. As Ms. Moore was leaning over the patient adjusting the intravenous tubing, she heard Mrs. Lyons whisper, “Please, I don’t want to die—please don’t let me die.” Ms. Moore quickly asked Mr. Lyons if he had heard what his wife said. He was on the other side of the room and had not heard his wife’s words. Even though the nurse believed that his wife was apparently changing her mind about receiving blood products, Mr. Lyons was reluctant to believe this and did not want to reverse her previous decisions. Ms. Moore knew that the patient’s condition required a rapid response to avert her death. 1. Should Ms. Moore, in asking for consultation, press for treating Mrs. Lyons only if she believes Mrs. Lyons was making an adequately autonomous choice when she appeared to reverse her choice? Or should she press for treatment regardless of her assessment of Mrs. Lyons’s mental status because she believes the welfare of the recently born twins is in jeopardy? 2. If you were Ms. Moore, would you notify the physician that Mrs. Lyons had changed her wishes? Why or why not? 3. If you were Ms. Moore, would you refer this case to your patient care ethics committee or ethics consult service? Why or why not?