The Association of Anaesthetists of Great Britain and Ireland have just (1 October) published guidance on anaesthesia and peri-operative care for Jehovah’s Witnesses and patients who refuse blood. Although some of the technical and clinical, relating to the specific consequences for anaesthetists of a refusal to accept blood, its principles are of broader application. Importantly, the guidance was drafted in conjunction with Witnesses so sets the relevant decision-making in its necessary context.