A teenage Jehovah's Witness who was crushed by a car as it crashed into a shop died after refusing a blood transfusion in hospital.
Joshua McAuley, 15, was airlifted to hospital from the incident in Smethwick, West Midlands, on Saturday morning, but died later that day.
The schoolboy, who received abdominal and leg injuries, is believed to have told doctors at Birmingham's Selly Oak hospital not to give him a blood transfusion because of his religious beliefs.
Clive Parker, an elder at Kingdom Hall of Jehovah's Witnesses in Smethwick, where Joshua and his family worshipped, said Joshua was conscious after the accident and "made a stand on the blood issue".
He said: "I don't want to talk about it any more than that because I don't want to add to the family's distress.
"A mother has lost her son, and Joshua had a brother. He has lost his brother, he was there in the morning and then gone by the afternoon.
"They are terribly distressed."
A spokesman for Selly Oak hospital said he could not comment on the individual case but described the issue as an "extraordinarily complex area" with no set rules.
He said: "There is not one single policy and not one single law regarding transfusions.
"There is no automatic right to override parental wishes or that of a minor. It is a very complex area that has to be approached on a case-by-case basis.
"Any decisions that have to be made are made in consultation with as many people as possible."
A postmortem is expected to be carried out by a Home Office pathologist on Thursday.
A spokesman for West Midlands police said Joshua's family, who live in Smethwick, did not wish to speak about the tragedy.
He said: "The family of Joshua has asked for privacy at this difficult time ... we ask that their privacy is respected."
Two other adults were injured in the crash, which happened in the Cape Hill area at 11.14am.
Police said a 24-year-old woman was in a serious but stable condition in hospital, and a 32-year-old man sustained a suspected broken arm and leg.
A 28-year-old man from the Winson Green area of Birmingham who was arrested after the crash was bailed pending further inquiries, police said.