Jehovah's Witness: a management dilemma in severe maxillofacial trauma.

The fundamentalist beliefs of a Jehovah's Witness can create major clinical and medicolegal problems when blood or blood products are needed to sustain life. The continuing expansion of Jehovah's Witnesses (1/4 million in UK; 4 million worldwide) means that encounters with the sect and surgeons in clinically critical situations are likely to increase. This paper describes such a case in which a 24-year-old male died from maxillofacial injuries because transfusion was denied. The special clinical and ethical management criteria are emphasized and the legal vulnerability of the clinician is discussed. It is no longer possible for clinicians in the UK to act independently in the management of such cases without risking censure or loss of indemnity from the employing health authority.