Post by Student_Nurse Eno Wellington (@eno_wellington)

Can a patient refuse a blood transfusion even when the doctor says they need it?

Imagine this: A conscious adult patient needs an urgent blood transfusion. The doctor explains why the blood is needed and what could happen if they refuse. The patient listens and says: “I understand. But I don't want blood.”

Should the doctor respect that decision?

This is where patient autonomy comes in. In Nigeria, the Supreme Court has recognised that a competent adult patient can refuse medical treatment, even when that decision may result in serious harm or death. This principle was central to Medical and Dental Practitioners Disciplinary Tribunal v. Okonkwo (2001).

And there is a real Nigerian story behind this. Mrs. Martha Okorie, a Jehovah's Witness, had severe anaemia and refused a blood transfusion because of her religious beliefs. She had signed a written directive refusing blood despite understanding the possible consequences. She later died. The case eventually reached the Supreme Court and became an important Nigerian authority on patient autonomy and informed refusal.

But “the patient refused” doesn't mean the healthcare team simply walks away. The patient's decision should be informed and voluntary. The healthcare team should explain the risks, benefits and alternatives, assess the patient's capacity, document the refusal, and continue appropriate care within the patient's wishes.

There's also a different Nigerian case involving a child, Tega Esabunor v. Dr. Tunde Faweya, where a mother refused a life-saving blood transfusion for her seriously ill infant because of her religious beliefs. The circumstances were different because the patient was a child and couldn't make the decision for themselves.

So, back to our question:

If a competent adult understands the consequences and still says, “No, I don't want blood,” should the doctor respect that decision?

What do you think? 👀

#LawAndHealth #PatientRights #NursingStudent

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