Caring for Jehovah's Witness Patients

For an NP, caring for a patient who is a Jehovah's Witness is a shared decision-making problem with constraints chosen by the patient. The faith's position against transfusion of whole blood is unchanged; since September 2026, each Witness personally decides whether to accept donor red cells, white cells, plasma or platelets, and decisions about fractions and the use of the patient's own blood (including pre-operative storage, since March 2026) are also individual. The NP must elicit them individually and should expect variation — and outdated assumptions in older references, directives and colleagues. Three NP layers: 1. Elicit and document the individual decision — product by product — and make sure it is informed, voluntary and made with capacity. 2. Build the plan around the constraint. Treat anemia early, reduce blood loss, choose medications and investigations with blood conservation in mind, and refer early when the setting cannot manage hemorrhage without transfusion. 3. Know the legal decision points. Capable adults may refuse (including in advance); minors and emergencies follow different rules. Escalate, consult and document — do not improvise.