A Jehovah's Witness is having a massive post-partum haemorrhage and has a valid advance directive refusing all blood products. How do you manage this?

Tips to guide your answer

- A competent adult's right to refuse treatment is absolute in UK law, including blood products, even if refusal leads to death

- A valid advance directive (advance decision) is legally binding under the Mental Capacity Act 2005

- The advance directive must be verified: is it written, signed, witnessed, and does it specifically address the circumstances including the refusal of blood products even if life is at risk?

- The patient's wishes should have been discussed antenatally and documented - verify privately that the patient made the decision freely (without coercion)

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How to approach this Obstetrics & Gynaecology interview question

This ethics question is common in Obstetrics & Gynaecology NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "A Jehovah's Witness is having a massive post-partum haemorrhage and has a valid advance..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.

What the panel is testing

A strong ethics answer makes the competing duties visible. Name the principle or legal issue, then describe the practical steps you would take in the hospital: gather facts, assess capacity where relevant, seek advice, document, and protect the patient. For obstetrics and gynaecology, show that you can balance urgency, consent, escalation, and multidisciplinary working. Labour ward, theatre, safeguarding, and communication with women and families may all be relevant.

Identify the ethical tension before jumping to a decision: capacity, consent, confidentiality, best interests, or law.
Use local policy and senior advice, and be explicit about safeguarding or immediate patient-safety concerns.
Balance respect for autonomy with professional duties, documentation, and clear communication.

How to structure your answer

For a ethics prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.

Open by naming the main issue in the question.
Give a structured response rather than a memorised script.
End with escalation, documentation, learning, or follow-up.

Common mistakes to avoid

The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.

A competent adult's right to refuse treatment is absolute in UK law, including blood products, even if refusal leads to death
A valid advance directive (advance decision) is legally binding under the Mental Capacity Act 2005
The advance directive must be verified: is it written, signed, witnessed, and does it specifically address the circumstances including the refusal of blood products even if life is at risk?