Werth v. Taylor.

• Author: Griffith, Daniel B.
• Position: Medical necessity and refusal to allow blood transfusion - Michigan

HELD: Only the contemporaneous refusal of treatment by a fully informed, competent adult patient is sufficient to override evidence of medical necessity, and no action lies for battery for treating a patient without such refusal.

Two months before the birth of her twins, Cindy Werth filled out a "Refusal to Permit Blood Transfusion" form as part of her hospital preregistration. Her husband, Donald, signed another "Refusal to Permit Blood Transfusion" form upon admitting Cindy to the hospital for delivery. Id. The Werths are Jehovah's Witnesses, and their actions conformed with a deeply held tenet of their faith "that it is a sin to receive blood transfusions." Werth v. Taylor, 475 N.W.2d 426, 427 (Mich. Ct. App. 1991).

After giving birth to the twins, Cindy experienced uterine bleeding. Id. Dr. Cheryl Parsons examined Cindy and "discussed performing a dilation of the cervix and curettage of the uterine lining (D&C)." She also discussed the Werths' refusals to allow blood transfusions. Following these discussions, Cindy was placed under anesthesia, and Dr. Parsons began the D & C surgery.

Dr. Michael Taylor, an anesthesiologist, was called to assist in the surgery. Despite the physicians' efforts, Cindy continued to bleed. Dr. Taylor "observed mottling and cooling of the skin peripherally, premature ventricular activity, oozing of crystalloid material from her eyes, and fairly rapid and significant fall in blood pressure." As a result, Dr. Taylor determined that a blood transfusion was medically necessary to preserve Cindy's life. Although Dr. Parsons informed Dr. Taylor of the Werths' convictions concerning blood tranfusions, Dr. Taylor responded, '"[T]hat may be, but she needs the blood,"' and performed the blood transfusion.

The Werths filed a malpractice action, alleging that Dr. Taylor committed battery by performing the transfusion without Cindy's consent. Dr. Taylor moved for summary disposition "because Cindy's refusal was not conscious, competent, contemporaneous, and fully informed."

The trial court found that Cindy's refusals of a transfusion were made when she contemplated "merely routine elective surgery" and not life-threatening circumstances, and that "it could not be said that she made the decision to refuse a blood transfusion while in a competent state and while fully aware that death would result from such refusal." The record apparently reflected "the unexpected development of a medical emergency requiring blood...