Blood product transfusions form a life-saving part of modern medicine, but they are not without risk. It is the responsibility of the clinician to prescribe these products appropriately and to communicate the risks, benefits and alternatives of transfusions to their patients, as stipulated in the South African National Health Act (2003). Informed consent is required when blood products are prescribed and clinicians should respect the decision of patients to refuse blood product transfusions. Common reasons for refusal include religious beliefs, previous negative reactions to a transfusion, or concern regarding the risk of transfusion transmitted disease via blood products.
What should be discussed when obtaining informed consent?
- Indications for the transfusion
- Specific products to be transfused and expected number of transfusion episodes
- Benefits and risks
- Available alternatives
- Costs involved, if relevant
When is informed consent not required?
- Emergency situations (eg. when the patient cannot consent due to a decreased level of consciousness and blood products are urgently required)
- Minors, where a parent or legal guardian can give informed consent for their transfusion
- Mental illness, where a legal guardian can give consent if the patient is unable to do so at the time
- Where a court order is obtained to permit intervention for the treatment of a patient