Patient 'was persuaded to refuse transfusions'
Lord Donaldson, Master of the Rolls, and Lord Justices Butler- Sloss and Staughton also heard that when the 20-year-old woman signed refusal documents, doctors had failed to warn her of the potentially fatal consequences. She was not therefore in a position to make an informed decision.
Now unconscious, but in a 'stable' condition, the woman - who had had a stillborn child and contracted pneumonia - has been given life-saving transfusions after the intervention of her father. He does not share his former wife's religion, which says Jehovah's Witnesses must not accept blood, even if it means death.
In a case which questions for the first time the circumstances in which an adult can refuse treatment, he persuaded a High Court judge last week that his daughter, referred to only as T, would 'rather have blood than die'. Mr Justice Ward ruled that her refusal, given when she was not at risk, did not cover the unforeseen emergency which caused her condition to deteriorate to the point where she required transfusions.
But now the appeal judges are being asked to reverse that decision and rule that the wishes of T must come first and that she should have no more blood.
James Munby QC, for the Official Solicitor who is representing the woman's case, argued that T had been capable of giving a legally valid refusal. But her father and the two West Midlands health authorities responsible for her care are contesting the appeal.
Allan Levy QC, for the father, maintained that when T signed the refusal documents she was in turmoil and under the undue influence of her mother.
He also argued that doctors had failed to inform her of potential dangers and misled her as to the availability of substances other than blood for treatment.
But David Stembridge QC, for the health authorities, argued T's refusal to consent to a transfusion was 'void' only because of the influence her mother had exerted over her. It was not a hospital's duty to inquire into the validity of a refusal once it had been signed by a patient whom doctors had decided was compos mentis. He said: 'It's not for the hospital to inquire into the validity of the refusal or into the faith of that individual or into the reasons why he or she holds that particular belief.'
But Lord Donaldson said that, although it was not for a doctor to try to convert a patient to another religious faith, if questions had been asked in this case it might have been discovered 'very clearly' that T was not a Jehovah's Witness and may have been influenced by her mother. She could then have been told of the serious risks involved in refusing consent.
Lord Donaldson said the court would give its decision today with full reasons at a later date.
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