Page 107 - Registrar Orientation Manual 2016

Document reference:
1969
Effective date:
30 Mar 2010
Expiry date:
01 Jun 2013
Page:
15 of 24
Title:
Informed consent
Type:
Policy
Version:
03
Authorising initials:
7.1. Refusal of blood or blood
products
 Every patient who is a potential recipient of blood or blood products (or their legal representative) must be given a copy of the NZ Blood Service information brochure. It is important that they are:
- given time to read the brochure, and
- advised of any alternatives to transfusion of volunteer donated
blood, if any e.g. use of patient’s own blood and
- provide with the opportunity to have their queries answered.
 The patient or their legal representative must give their written consent for the administration of blood or blood products to the patient.
 Where transfusion may be needed during surgery, written consent for this should be obtained by the surgical team for blood transfusions. .
 In an emergency situation where the patient cannot give consent, blood products may be given to preserve life or prevent permanent or serious injury. When the emergency situation has passed, further treatment must not be given without the consent of the patient.
 In an emergency situation, if there is prior knowledge that the patient would not agree to blood transfusion e.g. clear and current advance directive, this must be respected unless there is good reason to believe the directive is not valid. (See also the statutory exception to the need to gain informed consent in Appendix B, 4)
 In other situations, when a competent adult patient refuses blood or blood products, this decision must be respected. The responsible health professional must ensure that:
- the person making the decision fully understands the implications this refusal may have on the clinical outcome, and
- the decision is not the result of any outside influence or coercion
- the decision is documented on the Waikato DHB Blood Consent
form.
 Where the health professional is concerned about the legal or ethical aspects of a particular situation, the advice of the Waikato DHB Legal and Risk Service should be sought.
8. Organretrievalandusefortherapeuticpurposes
 The Human Tissue Act 2008 regulates the collection and use of tissue (including organs) from cadavers.
 Prior to their death, the patient may consent to use of their tissue for organ/tissue donation or for research. The patient may also nominate a person to give or refuse consent to do so on their behalf after their death.
 In the absence of consent from a patient or their nominee, the decision can be made by the immediate family. If the immediate family is unable to reach an agreed position, there is provision for a decision to be made