Mrs. Hughes, a 39-year-old Jehovah’s Witness, was admitted to the hospital to undergo a hysterectomy. At the
time of her admission to the hospital, Mrs. Hughes signed forms expressing her desire not to receive any blood
or blood products. She also verbally expressed this intention to her treating physician, Dr. Ances. Unanticipated
problems arose during surgery that, in Dr. Ances’ opinion, required blood transfusions to save Mrs. Hughes’
life. Dr. Ances contacted Mr. Hughes, Mrs. Hughes’ husband, to discuss the emergency situation and his wife’s
need for blood. While on the phone, Mr. Hughes, also a Jehovah’s Witness, authorized transfusions.
On May 14, 1991, the hospital initiated an emergency hearing before a judge for the purpose of having a
temporary guardian appointed for Mrs. Hughes to allow additional transfusions after the surgery. She was
unconscious and incapable of expressing her desires at the time.
Dr. Ances testified that Mrs. Hughes, who had been his patient for 6 weeks, told him she did not want blood
products. He informed her that a time could arise when blood might be needed to save her life. He also told her
that, given the procedure and the size of the uterus, it was unlikely that she would need blood during the
surgery. Dr. Ances was aware that Mrs. Hughes had signed hospital forms refusing blood. Dr. Ances told the
judge that he assumed Mrs. Hughes was aware of the ramifications of refusing the blood and therefore did not
specifically discuss them with her. After hearing testimony from Dr. Ances and Mrs. Hughes’ family, the judge
found that the evidence was unclear as to whether she would want blood or blood products if it meant saving
her life. As a result, the judge appointed the hospital’s risk manager as temporary guardian for the limited
purpose of giving consent to the administration of blood and blood products. The order explicitly extended only
until Mrs. Hughes regained consciousness and became competent to make her own decisions.
Mrs. Hughes received blood transfusions during the time she was unconscious. She later filed a lawsuit
claiming she was administered blood transfusions contrary to her written instructions. Did the court err in
making a temporary emergency decision to appoint a medical guardian? Why or why not? Were ethics placed
above the patient’s rights and wants? Why or why not? What is the role of the Court?