Instructions for Candidate:

A 34-year-old man has presented to hospital following a large upper GI bleed. He has a

history of NSAID use for chronic back pain. His initial Hb is 7.5.

Your consultant is coming in to perform an endoscopy and has asked you to consent the

patient. You have managed him according to the hospital guidelines, including prescribing

a 3-unit blood transfusion.

The nursing staff have called you, however, since the patient's wife is refusing the blood

transfusion. You are initially unaware that her and the patient are Jehovah's Witnesses.

Please discuss this with the patient's wife.

https://dai.ly/k1C3Rody4hmMFLzyLP0

https://dai.ly/k2jTVgHKpzRFamzyLP1

Instructions for Examiner:

A good candidate:

• Will acknowledge that the patient can refuse lifesaving treatment if they are alert enough to do so, but the medical team will work in his best interests without a legal document of refusal
• Will suggest involvement of consultants and the hospital legal team to ensure correct procedure is followed will be empathetic towards the beliefs of the relative and will provide reassurance to the best of their ability will summarise and provide a clear plan going forward.