V2 · Conflict between care and personal beliefs
Actual Spiritual and values
Definition
Treatment options clash with the person's values or beliefs.- Blood transfusion refusal
- fasting
- end-of-life choices
- treatment limits
- Refuses care
- conflict with the team
- family distress
📋 Scenario
A patient refuses a blood transfusion for religious reasons.
Subjective (S): "My faith forbids a blood transfusion."
Objective (O): Refuses transfusion; family supportive; low hemoglobin.
Assessment tools for this scenario: CP-SPIRIT Spiritual & Values Check
Validated scales to consider: FICA spiritual screen
**CarePath diagnosis:** Conflict between care and personal beliefs related to blood transfusion refusal, as evidenced by refuses care and conflict with the team.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Respect values. | Respecting the patient's values upholds the right to make choices about her own body and keeps trust, which is the base for any further discussion. |
| Explain options and risks. | Clear information about benefits, risks and what may happen without treatment lets her make an informed choice, since low hemoglobin carries real danger. |
| Involve the ethics team. | An ethics team gives neutral guidance when the team and the patient disagree, helping everyone work within ethical and legal limits. |
| Document. | Careful records protect the patient's wishes and the team, and make sure all staff know her informed decision, including in an emergency. |
| Look for alternatives. | Options that fit her beliefs, such as iron, medicines that help red cell production or ways to limit blood loss, may protect her health without breaking her faith. |
**Expected outcomes**
- Informed decision documented.
- Alternatives used where possible.
- Patient feels respected.
**Linking the data to the diagnosis**
The patient says, "My faith forbids a blood transfusion." She refuses the transfusion, her family is supportive and her hemoglobin is low, with conflict with the team. This fits conflict between care and personal beliefs because a recommended treatment clashes directly with a religious value, and the clash is already causing refusal of care. It is not a knowledge problem, since the refusal comes from belief. The plan aims for an informed decision to be documented, for alternatives to be used where possible and for the patient to feel respected, using clear information, ethics support and respect for her faith.
CarePath diagnosis
Conflict between care and personal beliefs related to blood transfusion refusal, as evidenced by refuses care and conflict with the team.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Respect values. | Respecting the patient's values upholds the right to make choices about her own body and keeps trust, which is the base for any further discussion. |
| 2. Explain options and risks. | Clear information about benefits, risks and what may happen without treatment lets her make an informed choice, since low hemoglobin carries real danger. |
| 3. Involve the ethics team. | An ethics team gives neutral guidance when the team and the patient disagree, helping everyone work within ethical and legal limits. |
| 4. Document. | Careful records protect the patient's wishes and the team, and make sure all staff know her informed decision, including in an emergency. |
| 5. Look for alternatives. | Options that fit her beliefs, such as iron, medicines that help red cell production or ways to limit blood loss, may protect her health without breaking her faith. |
Expected outcomes
- Informed decision documented.
- Alternatives used where possible.
- Patient feels respected.
Linking the data to the diagnosis
The patient says, "My faith forbids a blood transfusion." She refuses the transfusion, her family is supportive and her hemoglobin is low, with conflict with the team. This fits conflict between care and personal beliefs because a recommended treatment clashes directly with a religious value, and the clash is already causing refusal of care. It is not a knowledge problem, since the refusal comes from belief. The plan aims for an informed decision to be documented, for alternatives to be used where possible and for the patient to feel respected, using clear information, ethics support and respect for her faith.