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Talk to your doctor
Sharing your blood choices with a healthcare provider can feel awkward. Here's how to make the conversation productive.
Before the conversation
- Have your printed Directive or wallet card ready
- Know which items you refuse and which you accept — don't make the doctor guess
- Be prepared for questions — doctors may not be familiar with bloodless medicine
- Remember: this is your legal right. You're informing, not asking permission.
What to say
You:"I have an Advance Medical Directive. I'd like you to review it before we proceed."
You:"I refuse [specific items]. I accept [specific items]. For fractions, I've marked them as personal decisions — my Healthcare Agent can advise."
You:"What bloodless surgical techniques do you have available? Do you do cell salvage?"
You:"Can we discuss preoperative optimization? I'd like to explore iron therapy or EPO before the procedure."
If your doctor pushes back
- "I respect your expertise, but this is my informed decision." You have the legal right to refuse any medical treatment.
- "Are you familiar with Patient Blood Management?" The WHO endorses PBM as standard of care. Many surgeons practice it routinely.
- "I'd like a referral to a provider with bloodless surgery experience." Hundreds of hospitals have dedicated programs.
- "Please note my Directive in my medical record." This creates a legal paper trail.
Key facts to share
- The WHO endorsed Patient Blood Management in 2021
- PBM is associated with 11% lower mortality (Hofmann et al., 2013)
- Bloodless cardiac surgery outcomes are comparable to conventional approaches
- The US military invested $4.69M in bloodless techniques