In most states, if someone is arrested for DUI, DWI, OUI, OWI, drunk driving, or a related charge, they are required to provide a sample of their blood or breath for testing for alcohol content. (Where someone is suspected of driving under the influence of drugs, they must give a sample of their blood or urine.) The DMV typically advises people that as a condition of getting their driver's license, they have consented to a chemical test if they are suspected of DUI. This is called the "implied consent" law, and most states have some version of it.
If someone accused of drunk driving or DUI refuses to take a chemical test, there are several possible consequences: First, this refusal may be charged as a separate crime; next, the refusal can be used to suspend or revoke the person's driving privileges in a separate DMV action; finally, the fact of the refusal can be offered against the person at trial to show "consciousness of guilt."
If someone arrested for DUI or DWI has refused the test, it does prevent the prosecution from introducing evidence of blood alcohol level. However, the collateral consequences are potentially severe. Unfortunately, in most states, a person arrested for driving under the influence does not have the right to consult with an attorney before deciding whether to give a sample of their blood or breath, or deciding what type of sample to give.
There is no simple answer about which type of test to take. Breath test machines do not retain a portion of the breath to be independently retested. However, there are many ways to impeach the accuracy of the machines. Many people are not suitable candidates for breath testing, even if the machines are working properly. This can be the result of dental problems or persistent heartburn problems, both of which invite mouth-alcohol error by the machines.
Blood testing is generally thought to be the most accurate type of testing, but it too is subject to many challenges and problems. Contamination from an alcohol swab used to sterilize the area of the blood draw can compromise the blood sample. Failure to properly mix the preservative and anti-coagulant in the blood sample can cause the sample to ferment and literally create its own alcohol. Also, there is only one blood sample drawn (as compared with the usual two breath samples), so if there is a problem with that one sample, there are significant problems with the prosecution's case.
Urine samples, because of the wide array of problems and challenges, are generally thought of as the least reliable of the three types of chemical tests available. However, they are, in most states, only given as an option where a person is arrested for driving under the influence of drugs, not driving under the influence of alcohol.