HARRISBURG — The state of Pennsylvania cannot force a seriously ill prison inmate to undergo a blood transfusion — even if it could save his life, a Commonwealth Court judge said in a decision released Wednesday.

Senior Judge Keith Quigley said inmate Anthony Lindsey's wishes must be respected under the First Amendment, whether they are based on religion or something else.

Lindsey, 37, an inmate at the Laurel Highlands state prison in Somerset, refuses to allow a transfusion because it violates his religious beliefs as a Jehovah's Witness.

A doctor at the prison said in court papers that Lindsey is in "imminent danger" of dying if he does not have a transfusion.

Lindsey suffers from a serious kidney ailment that requires dialysis several times a week. He also has gastrointestinal bleeding caused by other medical problems that could be corrected by surgery, but doctors are unwilling to operate unless he has transfusions to compensate for his blood loss, according to court papers.

Lindsey, who is serving a 13- to 36-year term for drug trafficking, had a kidney transplant in 2001, but that organ is no longer functional, court papers said.

In denying a preliminary injunction sought by the Corrections Department, the judge said he was satisfied that the state is prepared to "render whatever treatment is medically necessary and appropriate and to do so promptly" and, likewise, that Lindsay has carefully considered the implications of his position.

"Mr. Lindsey is sincere in his beliefs, knowledgeable in his request and entitled to have his wishes respected, be they based on religion or otherwise," Quigley wrote.

The judge said it was critical to resolve such cases deliberatively.

"We understand that any medical treatment offered, or for that matter refused, to an inmate can always be a matter of controversy," he wrote in a five-page ruling.