Well insofar as I recall the woman had pre-empted any medical interference by flagrantly signing a form which stated she did not want to receive blood in the event that �despite medical fact� it would be required. As far as we know, for all intents and purposes, she did this in bona mens.
Had she done this under forceful circumstances then this may be a different matter � although some may say in doing so she was clearly not of sound mind. However, in general purposes, for a doctor to ignore the written statement/authority/request of an individual would be a disregard for patient rights and mean they would be acting � albeit for the greater good - ultra vires.
None of the options covers that really. I abstain.