WATCH: Coroner upholds the right of informed adults to refuse blood transfusions

Anyone has the right to refuse a blood transfusion, even if it means certain death, says a Quebec coroner who studied the circumstances surrounding the deaths of two Jehovah's Witnesses who had recently given birth.  

Jehovah's Witnesses believe ingesting blood goes against their beliefs and that they should not accept transfusions or donate their own blood.
   
``Every person in Quebec has this freedom of choice,'' coroner Luc Malouin said in his report, which was made public Tuesday.
   
``This freedom has been exercised here in accordance with the rules of law. It is up to everyone to make their choices and to fully assume the consequences.''
   
Eloise Dupuis, 27, of Ste-Marguerite died on Oct. 12, 2016, of multiple organ failure resulting from hemorrhagic shock just seven days after giving birth to her first child.
   
She had been transferred to hospital in Levis from a birthing centre after complications, but had said from the start she would refuse blood products or transfusions.
   
A note in her medical file said she told medical staff she would prefer to die rather than receive blood products.
   
Malouin's report noted numerous occasions over several days when doctors tried to get Dupuis or her family to sign off on a transfusion as her health deteriorated _ and each attempt was rebuffed on the basis of religious principles.
   
``The only medical solution that existed for Ms. Dupuis in order to recover her health was to receive blood, but she always refused to do so,'' Malouin wrote.
   
Malouin said no medication or artificial blood product exists that is approved by Canadian or American authorities and that can replace natural blood.
   
``Even internationally, the research into this subject is at an experimental stage,'' Malouin wrote. ``At this time, only a blood transfusion can compensate for severe blood loss.''
   
Malouin also found there was no religious influence from Jehovah officials in Dupuis' case as had been alleged by some of her relatives.
   
The coroner also looked at the case of Mirlande Cadet, 46, of Repentigny, who died of respiratory failure on Oct. 3, 2016, at St. Mary's Hospital in Montreal.
   
She was admitted to hospital and did receive a blood transfusion when her husband eventually consented several hours after her health had begun to deteriorate following a caesarean section.
   
Cadet had noted upon her hospitalization she would refuse blood transfusions and her husband initially maintained that position until her parents convinced him she needed the transfusion.

She had underlying health issues and Malouin concluded it was unclear if a delay in the transfusion procedure led to her death just two days after her admission.

In no case was medical staff to blame, Maoulin said, adding they had no other choice but to respect a patient's wishes.

The Quebec Civil Code stipulates that an adult, who is of sound mind and well informed, can accept or refuse medical treatment.

Malouin added that everyone has the right to freedom of conscience and religion under the Charter of Human Rights and Freedoms.

The coroner recommended that hospitals and doctors draft a specific treatment plan for patients likely to refuse blood transfusions before a procedure, adding that every minute counts.    

Malouin also recommended his report be distributed to any Quebec health centre where obstetrics is practised.<