Refusing treatment, including blood transfusion
- Topic
A capable adult may refuse any treatment, even a life-saving one, and the doctor must respect that.
What it is
The right to accept a treatment includes the right to refuse it. In Colombia, Statutory Law 1751 of 2015 says no one may be forced to receive health treatment against their will. The most studied case is that of Jehovah's Witnesses who refuse transfusions: the Constitutional Court has respected the refusal of a capable adult (T-659 of 2002) and, more recently, that of a mature 17-year-old (T-083 of 2021), with a duty to offer alternative treatments. With young children, the child's best interest prevails over the parents' beliefs.
Refusal of transfusion: how it changes with the patient
| Patient | Rule | Basis |
|---|---|---|
| Capable adult | The refusal is respected; alternatives are offered | Law 1751, art. 10 d; T-659 of 2002 |
| Mature adolescent | Their decision weighs according to maturity; judged case by case | T-474 of 1996 versus T-083 of 2021 |
| Young child | The child's best interest prevails over the parents' faith | Law 1098, art. 46 item 6 |
| Unconscious adult with no known wishes | The emergency is treated | Law 23, art. 14; Decree 3380, art. 3 |
In clinical practice
- Confirm the refusal is informed, voluntary (free of pressure from others) and made by a capable patient; talk with them alone.
- Explain the consequences of refusing and offer the available alternatives; record it.
- A refusal written and signed in advance (advance directive) guides care if the patient loses consciousness.
- The doctor may step aside for professional reasons but must make sure a colleague continues the care.
Legal framework in Colombia
- Law 1751 of 2015, art. 10 items d) (informed decision; no one forced to receive treatment) and f) (treatment that respects beliefs and customs).
- Decree 3380 of 1981, art. 5: the doctor respects the patient's freedom to forgo their services, provided the patient can express free will.
- Constitutional Court: T-474 of 1996 (adolescent; the parents' authorised treatment prevailed), T-659 of 2002 (capable adult; refusal respected), T-083 of 2021 (17-year-old; refusal respected and alternatives ordered).
- Law 1098 of 2006, art. 46 item 6 (minors in imminent danger).
- Official texts checked on 2026-11-05 at funcionpublica.gov.co and corteconstitucional.gov.co.
Test yourself
Think of the answer, then tap the question to see it.
May a capable adult refuse a treatment that would save their life?
Yes. If informed and deciding freely, the refusal is respected; Law 1751 of 2015 says no one may be forced to receive treatment.
What did the Constitutional Court decide in ruling T-659 of 2002?
It denied a husband's tutela seeking a transfusion for his wife, a capable adult Jehovah's Witness, and respected her decision.
What changes when the patient is a young child and the refusal comes from the parents?
The child's best interest prevails: Law 1098 of 2006 (art. 46, item 6) requires immediate action if the child's life is in danger.
What should the doctor do when a patient refuses part of a treatment?
Respect it, explain the consequences, offer alternatives and keep providing the rest of the care, recording it in the medical record.
Connections
Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.
Sources: Ley Estatutaria 1751 de 2015, que regula el derecho fundamental a la salud (Función Pública, Gestor Normativo, 2015); Decreto 3380 de 1981, por el cual se reglamenta la Ley 23 de 1981 (Función Pública, Gestor Normativo, 1981); Sentencia T-659 de 2002 (Corte Constitucional de Colombia, 2002); Sentencia T-083 de 2021 (Corte Constitucional de Colombia, 2021); Sentencia T-474 de 1996 (Corte Constitucional de Colombia, 1996); Ley 1098 de 2006, Código de la Infancia y la Adolescencia (Función Pública, Gestor Normativo, 2006); Informed Consent (University of Washington, Department of Bioethics & Humanities, 2018).
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