High Court Order Obtained For Live-saving Blood Transfusion

• Published date: 26 May 2020
• Author: Ms Gemma Brannigan and Adam Dickinson
• Subject Matter: Food, Drugs, Healthcare, Life Sciences, Biotechnology & Nanotechnology
• Law Firm: Clyde & Co

NHS obtains emergency High Court Order to provide a life-saving blood transfusion to an 11-year old child.

We recently assisted an NHS Trust to obtain an emergency High Court Order to provide a blood transfusion to an 11-year old child. The parents and the child had refused to consent to the transfusion, due to their religious beliefs.

The emergency medical situation

The child presented to hospital with a new, severe anaemia. They were lethargic. Their haemoglobin (Hb) level was extremely low at 37mg/L, when the normal range for a child is between 115-155mg/L. This was the lowest Hb level that the consultant paediatrician had seen in a conscious child in 20 years. The doctors said that if the child did not receive a transfusion within the next six hours, there was a very high risk of sudden heart failure and death.

The legal situation

Although the child was articulate and could repeat their religious beliefs to refuse the transfusion, they could not voice the likely outcome of refusing blood. The doctors were of the view that the child was not Gillick competent to refuse the treatment. The parents indicated they were Jehovah's Witnesses and met with someone from the 'hospital liaison committee' from the JW community. The parents found themselves in the unimaginable position of being deeply concerned and worried for their child, but also having a deeply held religious belief that they could not consent to the blood transfusion.

The treating team had spent time trying to explore other treatment options, including in relation to bone marrow. Many Jehovah's Witnesses will accept fractions, which are derived from the primary blood components such as albumin, immunoglobulins, clotting factors etc. However, in this case the blood component that the child required was the red blood cells, which were refused.

As a result, the medical team did not have consent to provide the transfusion, and an emergency application to the High Court was required. The family understood, and appreciated the Trust taking this step.

The emergency telephone hearing

Given the emergency situation, the Court heard evidence later the same day from the family and the doctors by telephone. After a careful analysis of the child's best interests, the Order was agreed. The High Court Judge praised the way in which the family and the medical team had worked together; the family respected the Court's decision and the child received the blood transfusion that night.

Areas for learning for hospitals...