Because patients are knowledgeable and have concerns about the risks o
f proposed therapies, including transfusion, and are interested in pos
sible alternatives, they are becoming more involved in their own healt
h care. Legal decisions support the patient's interest. Since 1996, th
e Joint Commission on Accreditation of Healthcare Organizations has sp
ecifically required that institutions document informed consent for tr
ansfusion. These regulations emphasize the need to establish a practic
al approach to achieving this process so that physicians and instituti
ons appropriately inform patients and adequately document the patient'
s choice.