Also, a network of consultants has been organized to assist physicians and other professionals seeking alternatives to traditional blood transfusion therapy. These resources are available in the Greater Cleveland area. This stance about blood makes informed consent and patient autonomy pivotal for clinical discussions and decisions. Many Jehovah's Witnesses will allow the use of heart-lung, dialysis, or similar equipment, as well as intraoperative blood salvage when the extracorporeal circulation is uninterrupted. There is no absolute prohibition against the use of components such as albumin, immune globulins, and hemophiliac preparation, i.e., each Witness may decide individually whether to accept these.
Witnesses do accept non-blood replacement fluids, volume expanders, or blood substitutes.
Courts have upheld the right of competent adult Witnesses to refuse transfusions on religious grounds. Witnesses are willing to sign release forms relieving hospitals of liability for nonacceptance of transfusions. Many Witnesses carry a Medical Alert card instructing that no blood products be administered. Clinicians treating Jehovah's Witnesses should discuss in detail the types of blood products and the specific procedures with which the individual Witness is comfortable. The advance medical directive or release commonly used by Witnesses includes a clause naming and authorizing a surrogate decision maker.