When an older patient lacks capacity to consent for a blood transfusion due to confusion, which action is appropriate to obtain consent?

When an older patient lacks capacity to consent for a blood transfusion due to confusion, which action is appropriate to obtain consent?

• A. Request the client's family member or next of kin sign the consent.
• B. Withhold the blood transfusion until the client's mental status improves.
• C. Administer the blood transfusion since a signed consent form is not necessary.
• D. Explain the transfusion, help the client sign the consent, and administer the transfusion.

Answer: (A)

When a patient lacks decision-making capacity, consent must come from a legally authorized representative who can decide in the patient’s best interests or according to known wishes. In this scenario, a family member or next of kin serves as the surrogate decision maker and should be asked to receive and sign the consent after being informed about the transfusion, its risks, benefits, and alternatives. This protects the patient’s autonomy while ensuring appropriate care. Delaying the transfusion until mental status improves isn’t appropriate if the procedure is needed to prevent harm. Administering the transfusion without consent is only appropriate in true emergencies under implied consent, which isn’t indicated here. The patient cannot sign since they lack capacity, and a staff member cannot sign as the patient’s own consent.

When a patient lacks decision-making capacity, consent must come from a legally authorized representative who can decide in the patient’s best interests or according to known wishes. In this scenario, a family member or next of kin serves as the surrogate decision maker and should be asked to receive and sign the consent after being informed about the transfusion, its risks, benefits, and alternatives. This protects the patient’s autonomy while ensuring appropriate care.

Delaying the transfusion until mental status improves isn’t appropriate if the procedure is needed to prevent harm. Administering the transfusion without consent is only appropriate in true emergencies under implied consent, which isn’t indicated here. The patient cannot sign since they lack capacity, and a staff member cannot sign as the patient’s own consent.