QUESTION 16 OF 23

Your 21-year-old Jehovahâ€™s Witness patient suffers an abruption, threatening her life and that of her unborn baby. Your upper-level resident tells you to order a blood transfusion so she and her baby wonâ€™t die. Do you do this? If so, why? If not, why

Another trick question. Here is an adult who refuses blood by the nature of her beliefs, but she needs something written or documented (from verbal indications, e.g., in a progress note) that she would refuse blood even if it meant saving her life. If there is no such directive and there is no documentation of her beliefs, you are obligated to seek the best clinical outcome, regardless of what her family may say. If there is, you are legally forbidden to give blood, even though mother and baby will die. Beyond the ethical dilemma, giving blood would be considered malpractice, legally, which puts your program in a vulnerable position.

"I would need to know if there were an advanced directive documenting her refusal of blood. Regardless, I would have whoever is part of the hospital ethics committee join me in the decision-making on this patient. This problem is bigger than me and I shouldn't be the only one to make such a decision. I would need and seek the backing of someone delegated to navigate these issues legally. The other issue involves insubordination to my superior resident. I would urge him/her to do the same in seeking assistance from someone so designated to do this, even if it meant rolling it uphill as high as the Department Chairman."

Community answers are written by other candidates practicing this set. Reading how others frame the same question is one of the fastest ways to sharpen your own.

Anonymous Answer

I would first start by confirming with the upper-level resident if this would be ethical given that the patient is a Jehovah's Witness. Maybe the patient did not sign an advanced directive or changed her mind and expressed that to the upper-level resident. I think assumptions are dangerous and clear communication is crucial, especially in emergency situations. If the patient clearly expressed denial of blood products, then I would be ethically obligated to not order blood products out of respect for patient autonomy.

Marcie's Feedback

Excellent response. Confirming with the upper-level resident if this is ethical or not is a great first step. It appears that you looking out above all for the patient and her wishes, which the interviewer will appreciate. Emphasizing the need for clear communication is also great. Nice job!

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OBGYN Residency Mock Interview

Your 21-year-old Jehovahâ€™s Witness patient suffers an abruption, threatening her life and that of her unborn baby. Your upper-level resident tells you to order a blood transfusion so she and her baby wonâ€™t die. Do you do this? If so, why? If not, why

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23 OBGYN Residency Interview Questions & Answers