Legal considerations for allogeneic blood transfusion

Our legal system seeks to resolve conflicts while also taking societal concerns into account. In striving for conflict resolution, the court performs a balancing act that weighs legitimate but differing individual and societal needs. Accordingly, in the preoperative setting, surgery patients are afforded the opportunity to accept or reject transfusions or alternatives to transfusion. The current legal standard is that alternatives to allogeneic transfusions should be offered to and carefully considered for patients. This article reviews blood shield laws, malpractice, and informed consent considerations in allogeneic blood transfusion. It also examines issues involved in refusal of transfusions. The discussion assumes that a physician-patient relationship exists and that the patient requires a surgical procedure in which blood loss is a reasonable probability. Guidelines are offered for preoperative physician-patient discussion of transfusion issues in light of the present status of transfusion law.