Perioperative care: refusal of blood by a competent patient: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Perioperative care: refusal of blood by a competent patient

Sample item

A competent adult Jehovah's Witness, who has refused blood products in writing, needs elective major surgery. What is the correct approach?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Respect the refusal and use blood-conserving strategies

A competent adult has the right to refuse treatment, including blood, even if death may follow. The team documents the decision, optimises haemoglobin beforehand and uses measures such as tranexamic acid, meticulous haemostasis and cell salvage where acceptable to the patient.

Option by option

  • A. Obtain consent from relatives to transfuse

    Relatives cannot override the informed decision of a competent adult.

  • B. Transfuse if bleeding occurs, since life is paramount

    Transfusing against a clear, informed refusal is an assault on the patient's autonomy.

  • C. Refuse to operate in all circumstances

    Refusal to operate in all circumstances is not required, as surgery can proceed with blood-conserving methods.

  • D. Respect the refusal and use blood-conserving strategies (correct)

    Correct. Autonomy of a competent adult is respected, with maximal blood conservation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Respect the refusal and use blood-conserving strategies. A competent adult has the right to refuse treatment, including blood, even if death may follow.

Why is "Obtain consent from relatives to transfuse" not the answer?

Relatives cannot override the informed decision of a competent adult.

Why is "Transfuse if bleeding occurs, since life is paramount" not the answer?

Transfusing against a clear, informed refusal is an assault on the patient's autonomy.

Why is "Refuse to operate in all circumstances" not the answer?

Refusal to operate in all circumstances is not required, as surgery can proceed with blood-conserving methods.

What concept does this question test?

It tests Perioperative care: refusal of blood by a competent patient in General Surgery. The team documents the decision, optimises haemoglobin beforehand and uses measures such as tranexamic acid, meticulous haemostasis and cell salvage where acceptable to the patient.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perioperative care: refusal of blood by a competent patient?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.