What sanctions are brought to bear on Jehovah's Witnesses who?

are faced with the choice of having a blood transfusion or being disfellowshipped? What happens in the hospital when the patient is advised by the Elders? What counsel do the Elders give? What is the policy of the Watch Tower Society on blood transfusions in the UK as compared with their policy in Bulgaria, for example? Why the differences? And why the silence?