What went wrong: multiple perspectives on an adolescent's decision to refuse blood transfusions

Persons with religious beliefs that conflict with mainstream medical practice create a tension for clinicians between honoring the different religious perspectives of the individual or carrying out what they believe to be their professional obligation. This is a patient presentation of an adolescent Jehovah's Witness who refuses blood transfusions. The major issue in this patient is the conflict among three values (1) respect for religious beliefs, (2) respect for a competent person's right to refuse treatment, and (3) the ability of an adolescent to make good decisions for himself. Other dilemmas presented by this patient are the lack of a coordinated plan of care, the lack of communication with the patient and family, and the lack of attention to social factors that influence the patient's situation and his resulting care.