Blood transfusion and Jehovah's Witnesses: medical and legal issues in obstetrics and gynecology.

Jehovah's Witnesses are members of a religious denomination whose beliefs prohibit the use of blood or blood products. Plasma volume expanders and extracorporeal hemodilution of the patient's own blood are theologically acceptable. Acute massive hemorrhage in which only blood is lifesaving may be encountered in obstetrics and gynecology. Either withholding or administering blood in such circumstances may have legal consequences for the physician and hospital. Factors to be considered include fetal viability, the presence of dependent children, and rules of informed consent. Whenever possible, the potential for transfusion should be anticipated and clearly discussed with the patient. When appropriate, the physician and hospital should move rapidly to obtain judicial resolution.