Williams L
Colombia Presbyterian/St Luke's Medical Center, USA.
CRNA. 1997 Feb;8(1):40-4.
This article discusses some of the dilemmas the Certified Registered Nurse Anesthetist (CRNA) faces when the patient refuses potential life-saving blood products or a blood transfusion. Even if the CRNA disagrees with the patient's decision, the patient's right to refuse is taken very seriously in the legal arena. Without a court order, the patient cannot be forced to receive blood or blood products. It would be easier if there were clear guidelines; unfortunately, these do not exist. In the past, courts were more likely to agree with the anesthesia provider and order the transfusion, even if the patient were competent. Today, courts are less likely to do so in these cases. However, there are circumstances in which obtaining a court order for the transfusion is more predictable, such as if the patient is a child in a true emergency situation, or if the patient is pregnant and the fetus is viable.
本文讨论了注册护士麻醉师（CRNA）在患者拒绝潜在的救命血液制品或输血时所面临的一些困境。即使CRNA不同意患者的决定，在法律领域，患者的拒绝权也会受到非常严肃的对待。没有法院命令，患者不能被强制接受血液或血液制品。如果有明确的指导方针会更容易；不幸的是，这些并不存在。过去，即使患者有行为能力，法院也更倾向于同意麻醉提供者的意见并下令输血。如今，在这些情况下法院这样做的可能性较小。然而，在某些情况下，获得输血的法院命令更具可预测性，例如患者是处于真正紧急情况的儿童，或者患者怀孕且胎儿具有存活能力。
