"As institutions show more respect toward parents’ faith and try harder not to use blood, Witnesses often seem eager to avoid involving child-welfare authorities to facilitate transfusions, and more accepting that Canadian case law is firmly on the doctors’ side, some hospital officials say."
David Gnam, one of the Witnesses’ lawyers who has handled many of the transfusion cases, also said there has been no official change in policy, though he is aware that some hospitals have patients sign forms.
“I’ve been involved in cases representing Jehovah’s Witnesses patients and occasionally it’s been in everybody’s best interests to come to some sort of agreement between the parties,” he said. “But that’s just individual hospitals, doctors and patients.”
Still, evidence suggests that the number of cases that end up before a judge has dropped significantly. The Canlii website, which catalogues many Canadian court decisions, includes nine separate child blood-transfusion rulings from 2000 to 2007, but just three in the five years since then.
Disputes arise when parents refuse transfusions on behalf of children below the age of consent. Hospitals in the past typically approached child-welfare authorities, who asked the courts for an order giving them temporary custody so they can ensure the transfusion is administered.
It also asks parents to sign a letter of understanding — drafted with the help of one of the church’s hospital liaison committees — that says the institution recognizes their religious objections and will try to avoid transfusions if at all possible. The letter is not a consent form, but adds that where the child is at imminent risk of serious harm or death, medical staff will press ahead with the transfusion. “What is beautiful about this [the letter of understanding] is that it’s a symbolic way of embodying respect and dignity and when we do this, we don’t need to call Children’s Aid.."
" McMaster Children’s Hospital has a similar letter of understanding...McGill Children’s Hospital in Montreal has had such a protocol for about a decade, and found that it brought about a “real, significant drop” in conflicts, said Lori Seller, a clinical ethicist at the facility. "
http://www.nationalpost.com/m/wp/blog.html?b=news.nationalpost.com/2012/12/20/without-fanfare-jehovahs-witnesses-quietly-soften-position-on-blood-transfusions