It is important to ascertain each patient’s wishes on an individual basis. Some persons,
including Jehovah’s Witnesses, carry an Advance Medical Directive/Release card, which
specifies their wishes concerning blood transfusion. Many persons may also have executed
a health care proxy form, which may indicate transfusion preferences, treatment choices,
and any end-of-life decisions. Generally, the courts have ruled that patients who are
competent adults have the right to make their own health care decisions, but pregnant
women and certain older minors present special issues. In the case of minors, hospitals
have successfully obtained court orders to appoint a guardian to make health care decisions
that may allow transfusion against the parents’ wishes.