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Malette v Shulman et al (1990), 72 O.R. (2d) 417 (ON CA)


M is a Jehovah’s Witness who was in a car accident. S was the doctor attending her. S was made aware of a card on M's person stating that she would refuse blood transfusions for religious reasons. S ignored this directive, and gave her blood. After recovery, M sued S for battery.


Did M consent to transfusion?


A doctor is not free to disregard advance instructions any more that he can disregard instructions given at the time.


Donnelly J:
** S had no reason to doubt the validity f the card (clear, concise statement of religious belief).
** Clearly, M foresaw the need for blood transfusions because she went through the exercise of preparing and keeping the No-Transfusions card.
** Her actions suggest the decision was made with a clear understanding of the risks.

Even in a case of emergency, a health care professional cannot override the limits a patient places on her consent.
** The doctrine of informed consent does not extend to informed refusal: "The right to refuse treatment is an inherent component of the supremacy of the patient’s right over his own body. That right to refuse treatment is not premised on an understanding of the risks of refusal."
** Importance of respecting the decisions made by the patient.


In favour of plaintiff M; patient did not consent to transfusion.

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