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Neonates are defined as babies up to 28 days after birth. [1] Most extremely preterm babies (less than 28 weeks) require at least one red cell transfusion; [2] this is partly due to the amount of blood removed with blood samples compared to the baby's total blood volume (iatrogenic anemia) [3] and partly due to anemia of prematurity.
Doctors sought a blood transfusion, but A.C. and her parents refused on religious grounds; child welfare officials moved to take her into care and a court ordered that she be given the transfusion. The judge said he was satisfied she was competent, but since she was under 16 the judge felt that her competence was immaterial to existing law. [6]
However, if doctor's opinions are that parents and guardians are making harmful choices about children, they can be overruled (in some jurisdictions) using legal arguments based on the harm principle; in this case if doctors believe that refusing the blood transfusion would put the child at risk of serious injury or death. [138]
Blood compatibility testing is routinely performed before a blood transfusion.The full compatibility testing process involves ABO and RhD (Rh factor) typing; screening for antibodies against other blood group systems; and crossmatching, which involves testing the recipient's blood plasma against the donor's red blood cells as a final check for incompatibility.
In children and adults red blood cell transfusion to increase the hemoglobin level to 100 g/L has been shown to decrease the risk of sickle cell-related complications. [2] However, this has not been seen in all studies, and has only been demonstrated for African haplotypes of Hemoglobin SS. [12] [13]
The mature minor doctrine is a rule of law found in the United States and Canada accepting that an unemancipated minor patient may possess the maturity to choose or reject a particular health care treatment, sometimes without the knowledge or agreement of parents, and should be permitted to do so. [1]
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