Situations critiques peropératoires chez le témoin de Jéhovah

Physicians in charge of Jehovah witnesses who refuse blood transfusion are facing two contradictory injunctions: respect of the will of the patient on one hand and support to people in danger on the other hand. The later is the stronger provided transfusion is adapted and proportional to the haemorrhagic risk. In this setting, the transfusion threshold is lower than the one usually recommended because it corresponds to a life threatening risk. The will of the patient has to be considered and the planned treatment must be explained to the patient, clearly reported and respected. Some Jehovah witnesses accept autotransfusion and administration of certain blood products.