Abstract Imagine the following situation: you are on duty in the Accident and Emergency (A & E) department when a patient, aged 57, seriously injured in a road accident is admitted unconscious to hospital. In her purse a Jehovah's witness card is found on which is written the following: No Blood Transfusions As one of Jehovah's Witnesses with firm religious convictions, I request that no blood or blood products be administered to me under any circumstances. I fully realise the implications of this position, but I have resolutely decided to obey the Bible command: ‘Keep abstaining … from blood’. (Acts 15: 28, 29). However, I have no religious objection to use the non-blood alternatives, such as Dextran, Haemaccel, PVP, Ringer's Lactate or saline solution (translation of the original French). Do you recommend that a blood transfusion is given or do you let the patient die?