Jehovah’s Witnesses: What Anesthesiologists Need to Know
Main Article Content
Abstract
Jehovah’s Witnesses (JWs) represent a unique challenge in perioperative medicine due to their refusal of blood transfusions based on religious beliefs. This poses complex clinical, ethical, and legal dilemmas, particularly for anesthesiologists responsible for perioperative hemodynamic management and patient safety. This review summarizes JW beliefs, perioperative management strategies, ethical conflicts, legal frameworks, and global variations, including the situation in Thailand. Emphasis is placed on patient autonomy, blood conservation techniques, and medico-legal risk mitigation.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Ariga T. Refusal of blood by Jehovah’s Witnesses and the patient’s right to self-determination. Legal Med. 2009;11:S138-40.
Koomwong A. Anesthetic management in Jehovah’s Witness patient underwent acetabular fractures surgery: case report. Royal Thai Air Force Med Gaz. 2025;71:58-63.
Lawson T, Ralph C. Perioperative Jehovah’s Witnesses: a review. Br J Anaesth. 2015;115:676-87.
Murphy E, McConnell P. The perioperative care of Jehovah’s Witnesses. Anaesth Intens Care Med. 2022;23:472-6.
Klein AA, Bailey CR, Charlton A, et al. Association of Anaesthetists: anaesthesia and peri-operative care for Jehovah’s Witnesses and patients who refuse blood. Anaesthesia. 2019;74:74-82.
Lin ES, Kaye AD, Baluch AR. Preanesthetic assessment of the Jehovah’s Witness patient. Ochsner J. 2012;12:61-9.
Takaschima AKK, Sakae TM, Takaschima AK, Takaschima RST, de Lima BJSB, Benedetti RH. Ethical and legal duty of anesthesiologists regarding Jehovah’s Witness patient: care protocol. Rev Bras Anestesiol. 2016;66:637-41.
Rajewska A, Mikołajek-Bedner W, Sokołowska M, Lebdowicz J, Kwiatkowski S, Torbé A. The Jehovah’s Witness obstetric patient-a literature review. Anaesthesiol Intensive Ther. 2019;51:390-403.
Jassar AS, Ford PA, Haber HL, et al. Cardiac surgery in Jehovah’s Witness patients: ten-year experience. Ann Thorac Surg. 2012;93:19-25.
Kirsch C, Rabany R, Pon M, Shabanian J, Narayanappa A. Anesthesia approach to managing severe hemorrhagic shock and anemia with nontransfusion alternatives in a practicing Jehovah’s Witness: a case report. Cureus. 2024;16:e53301.
Wong C, Mistovich RJ, Morrison III MJ. Pediatric and adolescent Jehovah’s Witnesses: considerations for safe and ethical orthopaedic procedures. J Pediatr Ortho Soc North Am. 2022;4:534.
Migden DR, Braen GR. The Jehovah’s Witness blood refusal card: ethical and medicolegal considerations for emergency physicians. Acad Emer Med. 1998;5:815-24.
Milligan LJ, Bellamy MC. Anaesthesia and critical care of Jehovah’s Witnesses. Cont Educ Anaesth Crit Care Pain. 2004;4:35-9.