The Watchtower sent out a letter to all elders to be discussed at the elders meetings. The letter asked the elders to ensure that all Jehovah's Witnesses have a copy of the Advanced Healthcare Directive filed with the congregation secretary.
Each book study overseer has to make a list of how many in his group have completed an Advanced Healthcare Directive and each secretary has to make a list of how many copies he has. The body of elders are told to "discuss as a body how best to provide assistance for those who have not yet completed this important document." Apparently "many have evidently not filled in the document and few have submitted it for filing with the congregation secretary."
It would seem that the problem is that there are numerous occasions when an unconscious or very ill witness is in hospital and a form cannot be located. There is also a particular concern that elderly ones don't have a document or, at least, haven't completed one when they are lucid.
So even though blood transfusions are forbidden simply because the Governing Body says so, they want to keep the appearance that every Jehovah's Witnesses is deciding individually not to take a blood transfusion and what factions they will accept.
The whole thing is really a nightmare for the Governing Body. To those who want a blood transfusions with no strings attached, go to Bulgaria. The Bulgarian government would not allow the Jehovah's Witnesses in unless they agreed that their members could have a blood transfusion without consequences.