Jehovah's Witnesses and blood transfusions
Encyclopedia
Jehovah's Witnesses
believe that the Bible
prohibits ingesting blood
and that Christians should therefore not accept blood transfusion
s or donate or store their own blood for transfusion. Watch Tower Society
publications teach that the Witnesses' refusal of transfusions of whole blood or its four primary components—red cells, white cells, platelets and plasma—is a non-negotiable religious stand and that those who respect life as a gift from God
do not try to sustain life by taking in blood, even in an emergency. Witnesses are taught that the use of fractions such as albumin
, immunoglobulin
s and hemophiliac preparations are "not absolutely prohibited" and a matter of personal choice. Although accepted by the majority of Jehovah's Witnesses, a minority does not endorse this doctrine.
The doctrine was introduced in 1945, and has undergone some changes since then. It is one of the doctrines for which Jehovah's Witnesses are most well known. Members of the religion who voluntarily accept a transfusion are regarded as having disassociated themselves from the religion by abandoning its doctrines and are subsequently shunned by members of the organization.
The Watch Tower Society has established Hospital Information Services to provide education and facilitate bloodless surgery
. This service also maintains Hospital Liaison Committees, whose function is to provide support to adherents.
Certain medical procedures involving blood are specifically prohibited by Jehovah's Witnesses' blood doctrine. This includes the use of red blood cells, white blood cells, platelets and blood plasma
. Other fractions derived from blood are not prohibited. Watch Tower
publications state that some products derived from one of the four primary components may be so similar to the function of the whole component and carry on such a life-sustaining role in the body that "most Christians would find them objectionable". For procedures where there is no specific doctrinal prohibition, individuals are to obtain details from medical personnel and then make a personal decision.
techniques have been developed for use on patients who refuse blood transfusions for reasons that include concern about AIDS
, hepatitis
, and other blood-borne infections, or immune system reactions. Thousands of physicians throughout the world have expressed a willingness to respect patients' preferences and provide bloodless treatment and about 200 hospitals offer bloodless medicine and surgery programs for adult and pediatric patients who wish to avoid or limit blood transfusions, or to avoid treatment contrary to Jehovah's Witnesses' blood doctrine. Bloodless surgery has been successfully performed in such invasive operations as open-heart surgery
and total hip replacement
s. However bloodless medical and surgical techniques have limitations, and surgeons say the use of various allogeneic blood products and/or pre-operative autologous blood transfusion is the standard of care for some patient presentations.
In cases of certain medical emergencies
when bloodless medicine is not available, blood transfusions may seem to be the only available way to save a life. Watch Tower publications suggest that in such instances, Jehovah's Witnesses request that doctors provide the best alternative care possible under the circumstances, with respect for their personal conviction. The Watch Tower Society has acknowledged that some members have died after refusing blood.
In some countries, including Canada and the UK, a parent or guardian's decision can be legally overruled by medical staff. In this case, medical staff may act without consent, by obtaining a court order
in a non-emergency situation, or without such an order in an emergency. In Japan, a doctor must respect the wish of an adult but can override the wishes of a child and its parents if the child is under 15. If a child is aged 15 to 17, a doctor will not perform a transfusion if the parents and the child refuse the transfusion. If a child aged from 15 to 17 objects to a transfusion but the parents demand the transfusion, then a doctor can override the child's wish. In the United States
, the American Academy of Pediatrics
recommends that in cases of "an imminent threat to a child's life", physicians in some cases may "intervene over parental objections".
Hospital Information Services researches medical journals to locate information on the availability and effectiveness of bloodless surgery methods. It disseminates information about treatment options to local Hospital Liaison Committees, and to doctors and hospitals.
(HIPAA).
Jehovah's Witnesses' branch offices communicate directly with congregations regarding "ways to benefit from the activities of the Hospital Liaison Committee (HLC) and the Patient Visitation Group (PVG)." A Jehovah's Witnesses publication in 2000 reported that Argentina had fewer than a hundred HLC committeemen "giving vital information to the medical community", adding that "their work is complemented by hundreds of other self-sacrificing elders who make up Patient Visitation Groups that call on Witness patients to help and encourage them". Each branch office appoints PVG committeemen, who serve as volunteers.
reported of a particular member of Jehovah's Witnesses who voluntarily accepted blood transfusion, contrary to Watchtower doctrine, alluding to the possibility that it was not an isolated event. The organization further confirms members have accepted blood transfusions despite initiation in 1961 of a communal shunning policy for willful acceptance.
Since the elaboration of the blood doctrine to the point of prohibiting transfusion, the majority of Jehovah's Witnesses have adopted the organization's position. Those Jehovah's Witnesses who accept the blood doctrine are typically fervent in their conviction. However, the blood doctrine has not attained universal acceptance among Jehovah's Witnesses; there remains a sizable minority of Jehovah's Witnesses who do not fully agree with the blood doctrine. In 1982, a peer-reviewed case study of a congregation of Jehovah's Witnesses was undertaken by Drs. Larry J. Findley and Paul M. Redstone to evaluate individual belief in respect to blood among Jehovah's Witnesses. The study showed that 12% were willing to accept transfusion therapy forbidden by Jehovah's Witness doctrine.This article presents a consensual survey of one congregation of Jehovah's Witnesses where the congregation elders provided the names and addresses of members, and the elders knew precisely the nature of the survey. 59 responses were received. Of the 59, 7 stipulated they would accept plasma transfusion (Table 1 on page 607). This result compelled Findley and Redstone to comment, “there is either some lack of understanding or refusal to follow doctrine among some members”. Whether from misunderstanding or refusal to follow doctrine, at no point did Findley and Redstone question whether these responders had honestly expressed their personal conviction. Findley and Redstone also stipulated their methodology may have skewed the results towards official Jehovah's Witness doctrine. (Local elders provided the names to be surveyed, and those surveyed knew local elders would see the results of the study.) The authors also admit that this study may not describe the beliefs of “less religious Jehovah's Witnesses.” One peer-reviewed study examining medical records indicated a similar percentage of Jehovah's Witnesses willing to accept blood transfusions for their children. Young adults also showed a willingness to accept blood transfusions. In another study, Jehovah's Witness patients presented for labor and delivery showed a willingness to accept some form of blood or blood products. Of these patients, 10 percent accepted whole blood transfusion.
In the August 1998 issue of Academic Emergency Medicine, Donald Ridley, a Jehovah's Witness and organization staff attorney, argued that carrying an up-to-date Medical Directive card issued by the organization indicates that an individual personally agrees with the established religious position of Jehovah's Witness. However, the organization has issued letters expressing serious concern regarding Jehovah's Witnesses activating and maintaining these documents. One letter cites reports that up to 50% of Jehovah's Witnesses had failed to maintain up-to-date Medical Directive cards, with the result that individual Witnesses were not protected from routine transfusions. Another letter reports that a large majority of Jehovah's Witnesses had not filled out the pre-formatted durable power of attorney document provided by the Watch Tower Society.
Watch Tower publications have noted that within religions, the personal beliefs of members often differ from official doctrine. Regarding Jehovah's Witnesses acceptance of the organization's official position on blood, Drs Cynthia Gyamfi and Richard Berkowitz state, “It is naïve to assume that all people in any religious group share the exact same beliefs, regardless of doctrine. It is well known that Muslims, Jews and Christians have significant individual variations in their beliefs. Why should that not also be true of Jehovah's Witnesses?”
Ambivalence and rejection of the blood doctrine dates back to at least the 1940s. After the Watch Tower Society established the doctrine, teaching that blood should not be eaten (circa 1927-31), Margaret Buber, who was never a member of the religion, offered a firsthand eyewitness account of Jehovah's Witnesses in Ravensbrueck concentration camp under Nazi Germany
. She relates that an overwhelming majority were willing to eat blood sausage
despite having alternate food to choose from, and specifically after considering biblical statements regarding blood.
In September 1945, representatives of the Watch Tower Society in the Netherlands
commented on blood transfusion in the Dutch
edition of Consolation
. A translation of their comments into English reads: According to sociologist Richard Singelenbreg the statement appearing in the Dutch edition of Consolation may have been published without knowledge of the doctrinal position published in the English July 1945 issue of Consolation by the Watch Tower Society's headquarters in the United States.
that the reference to abstaining from the eating of blood in the Apostolic Decree
of Acts 15:19-29 was a "suggestion" to be given to Gentile
converts. Watch Tower publications during the presidency of Joseph Franklin Rutherford
commended the commercial and emergency uses of blood. A 1925 issue of The Golden Age commended a man for donating blood 45 times without payment. In 1927, The Watchtower noted, without elaboration, that in Genesis 9, God decreed that Noah
and his offspring "must not eat the blood, because the life is in the blood". In 1940 Consolation magazine reported on a woman who accidentally shot herself with a revolver in her heart and survived a major surgical procedure during which an attending physician donated a quart of his own blood for transfusion.
In 1944, with the Watch Tower Society under the administration of president Nathan Homer Knorr
, The Watchtower asserted that the decrees contained in Genesis 9:4 and Leviticus 17:10-14 forbade the eating or drinking of blood in biblical times "whether by transfusion or by the mouth" and that this applied "in a spiritual way to the consecrated persons of good-will today, otherwise known as 'Jonadabs
' of the Lord's 'other sheep'."
In 1945, the application of the doctrine on blood was expanded to prohibit blood transfusions of whole blood, whether allogeneic or autologous. The prohibition did not specify any punitive measures for accepting a transfusion, but by January 1961—in what was later described as an application of "increased strictness"—it was ruled that it was a disfellowshipping offense to conscientiously accept a blood transfusion. Watch Tower publications warned that accepting a blood transfusion could prevent Witnesses from living eternally in God's new world, the hope held by members: "It may result in the immediate and very temporary prolongation of life, but that at the cost of eternal life for a dedicated Christian."
In September 1956, Awake! stated, "certain blood fractions ... also come under the Scriptural ban". A position against "the various blood fractions" was reiterated in September 1961. In November of the same year, the doctrine was modified to allow individual members to decide whether they could conscientiously accept fractions used from blood for purposes such as vaccination. This position has been expanded on since; the pre-formatted Durable Power of Attorney form provided by the Watch Tower Society includes an option for Jehovah's Witnesses to "accept all fractions derived from any primary component of blood."
In 1964, Jehovah's Witnesses were prohibited from obtaining transfusions for pet
s, from using fertilizer containing blood, and were even advised (if their conscience troubled them) to write to dog food manufacturers to verify that their products were blood-free. Later that year, it was stated that doctors or nurses who are Jehovah's Witness would not administer blood transfusions to fellow dedicated members. As to administering transfusions to non-members, The Watchtower stated that such a decision is "left to the Christian doctor's own conscience."
In 1982, a Watchtower article declared that it would be wrong for a Witness to allow a leech to feed on his/her blood as part of a medical procedure, due to the sacredness of blood.
In 1989 The Watchtower stated, "Each individual must decide" whether to accept hemodilution and autologous blood salvage (cell saver) procedures. In 1990, a brochure entitled How Can Blood Save Your Life? was released, outlining Jehovah's Witnesses' general doctrine on blood.
In 2000, the Watch Tower Society's stand on blood fractions was clearly stated. Members were instructed to personally decide if accepting a fraction would violate the doctrine on blood. In a later article, members were reminded that Jehovah's Witnesses do not donate blood or store their own blood prior to surgery.
In May 2001, the Watch Tower Society revised its medical directives and identity cards addressing its doctrinal position on blood; the revised materials were distributed from May 3, 2001. These revised documents specified that "allogeneic blood transfusions" were unacceptable whereas the former document (dated 1999) stated that "blood transfusions" were unacceptable. The revised 2001 documents were active until December 20, 2001. The Watch Tower Society then rescinded the revised document, stating, "After further review, it has been determined that the cards dated "md-E 6/01" and "ic-E 6/01" should not be used. Please destroy these items and make sure that they are not distributed to the publishers." Elders were instructed to revert to the older 1999 edition of the medical directives and identity cards.
Watch Tower Society publications frequently point out negative consequences of blood transfusions:
American neurologist Osamu Muramoto, who is a medical adviser to the AJWRB, has raised issues including what he claims is coercion to refuse transfusions, doctrinal inconsistency, the use of information control by the Watch Tower Society to exaggerate the dangers of transfusions and the Society's use of outdated medical beliefs.
claims the blood prohibited in Levitical laws was not human, but animal. He cites other authors who support his view that the direction at Acts 15 to abstain from blood was intended not as an everlasting covenant but a means of maintaining a peaceful relationship between Jewish and Gentile Christians. He has described as "absurd literalism" the Witnesses' use of a scriptural prohibition on eating blood to prohibit the medical transfusion of human blood.
(ECHR) found nothing in the judgments to suggest that any form of improper pressure or undue influence was applied. It noted: "On the contrary, it appears that many Jehovah’s Witnesses have made a deliberate choice to refuse blood transfusions in advance, free from time constraints of an emergency situation." The court said: "The freedom to accept or refuse specific medical treatment, or to select an alternative form of treatment, is vital to the principles of self-determination and personal autonomy. A competent adult patient is free to decide ... not to have a blood transfusion. However, for this freedom to be meaningful, patients must have the right to make choices that accord with their own views and values, regardless of how irrational, unwise or imprudent such choices may appear to others."
Muramoto has claimed the intervention of Hospital Liaison Committees can add to "organisational pressure" applied by family members, friends and congregation members on Witness patients to refuse blood-based treatment. He notes that while HLC members, who are church elders, "may give the patient 'moral support', the influence of their presence on the patient is known to be tremendous. Case reports reveal JW patients have changed their earlier decision to accept blood treatment after a visit from the elders." He claims such organizational pressure compromises the autonomy of Witness patients and interferes with their privacy and confidentiality. He has advocated a policy in which the Watch Tower organization and congregation elders would not question patients on the details of their medical care and patients would not disclose such information. He says the Society adopted such a policy in 1983 regarding details of sexual activity between married couples.
Watch Tower spokesman Donald T. Ridley says neither elders nor HLC members are instructed or encouraged to probe into the health care decisions of Witness patients and do not involve themselves in patient hospitalisations unless patients request their assistance. Yet Watchtower HLC representative David Malyon says he would respond to “sin” of Witnesses he is privy to by effectively saying “Are you going to tell them or shall I!” Nevertheless Ridley says Muramoto's suggestion that Witnesses should be free to disregard Watch Tower scriptural teachings and standards is preposterous. He says loving God means obeying commandments, not disobeying them and hiding one's disobedience from others.
Muramoto has claimed many Watch Tower publications employ exaggeration and emotionalism to emphasize the dangers of transfusions and the advantages of alternative treatments, but presents a distorted picture by failing to report any benefits of blood-based treatment. Nor does it acknowledge that in some situations, including rapid and massive haemorrhage, there are no alternatives to blood transfusions. He claims Watch Tower publications often discuss the risk of death as a result of refusing blood transfusions, but give little consideration to the prolonged suffering and disability, producing an added burden on family and society, that can result from refusal. Attorney and former Witness Kerry Louderback-Wood also claims that Witness publications exaggerate the medical risks of taking blood and the efficiency of non-blood medical therapies in critical situations.
Muramoto recommends doctors have a private meeting with patients to discuss their wishes, and that church elders and family members not be present, enabling patients to feel free of church pressure. He suggests doctors question patients on (a) whether they have considered that the Watch Tower Society might soon approve some medical practices they currently find objectionable, in the same manner that it has previously abandoned its opposition to vaccination and organ transplants; (b) whether Witness patients know which blood components are allowed and which are prohibited, and whether they acknowledge that those rulings are organizational policy rather than biblical teachings; and (c) whether they realize that although some Bible scriptures proscribe the eating of blood, eating and transfusing blood have entirely different effects on the body. English HLC representative David Malyon has responded that Muramoto's suggested questions are an affront to coerce Jehovah's Witnesses with "complicated philosophical inquisition" and, if used by doctors, would be "an abusive transformation of the medical role of succour and care into that of devil's advocate and trickster".
David Malyon, chairman of the English Hospital Liaison Committee in Luton
, England
, has claimed that Muramoto's discussion of the differences between consuming blood and alcohol is pedantic and says blood laws in the Bible are based upon the reverence for life and its association with blood, and that laws should be kept in the spirit as much as in the letter.
, to which Witnesses must adhere strictly of the premise of them being Bible-based “truth”. He has questioned why white blood cells (1 per cent of blood volume) and platelets (0.17 per cent) are forbidden, yet albumin (2.2 per cent of blood volume) is permitted. He has questioned why donating blood and storing blood for autologous transfusion is deemed wrong, but the Watch Tower Society permits the use of blood components that must be donated and stored before Witnesses use them. He has questioned why Witnesses, although viewing blood as sacred and symbolizing life, are prepared to let a person die by placing more importance on the symbol than the reality it symbolizes.
Kerry Louderback-Wood alleges that by labeling the currently acceptable blood fractions as "minute" in relation to whole blood, the Watch Tower organization causes followers to misunderstand the scope and extent of allowed fractions.
Witnesses respond that the real issue is not of the fluid per se, but of respect and obedience to God. Their principle of abstaining from blood as a display of respect is seen in the fact that members are allowed to eat meat
that still contains some blood. As soon as blood is drained from an animal, the respect has been shown to God, and then a person can eat the meat even though it may contain a small amount of blood. Jehovah's Witnesses' view of meat and blood is different to the Jewish view that goes to great lengths to remove minor traces of blood.
Jehovah's Witnesses
Jehovah's Witnesses is a millenarian restorationist Christian denomination with nontrinitarian beliefs distinct from mainstream Christianity. The religion reports worldwide membership of over 7 million adherents involved in evangelism, convention attendance of over 12 million, and annual...
believe that the Bible
Bible
The Bible refers to any one of the collections of the primary religious texts of Judaism and Christianity. There is no common version of the Bible, as the individual books , their contents and their order vary among denominations...
prohibits ingesting blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
and that Christians should therefore not accept blood transfusion
Blood transfusion
Blood transfusion is the process of receiving blood products into one's circulation intravenously. Transfusions are used in a variety of medical conditions to replace lost components of the blood...
s or donate or store their own blood for transfusion. Watch Tower Society
Watch Tower Bible and Tract Society of Pennsylvania
The Watch Tower Bible and Tract Society of Pennsylvania is a non-stock, not-for-profit organization headquartered in the New York City borough of Brooklyn, United States. It is the main legal entity used worldwide by Jehovah's Witnesses to direct, administer and develop doctrines for the religion...
publications teach that the Witnesses' refusal of transfusions of whole blood or its four primary components—red cells, white cells, platelets and plasma—is a non-negotiable religious stand and that those who respect life as a gift from God
God in Christianity
In Christianity, God is the eternal being that created and preserves the universe. God is believed by most Christians to be immanent , while others believe the plan of redemption show he will be immanent later...
do not try to sustain life by taking in blood, even in an emergency. Witnesses are taught that the use of fractions such as albumin
Albumin
Albumin refers generally to any protein that is water soluble, which is moderately soluble in concentrated salt solutions, and experiences heat denaturation. They are commonly found in blood plasma, and are unique to other blood proteins in that they are not glycosylated...
, immunoglobulin
Antibody
An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...
s and hemophiliac preparations are "not absolutely prohibited" and a matter of personal choice. Although accepted by the majority of Jehovah's Witnesses, a minority does not endorse this doctrine.
The doctrine was introduced in 1945, and has undergone some changes since then. It is one of the doctrines for which Jehovah's Witnesses are most well known. Members of the religion who voluntarily accept a transfusion are regarded as having disassociated themselves from the religion by abandoning its doctrines and are subsequently shunned by members of the organization.
The Watch Tower Society has established Hospital Information Services to provide education and facilitate bloodless surgery
Bloodless surgery
Bloodless surgery is a term that was popularized at the beginning of the 20th century by the practice of an internationally famous orthopedic surgeon, Adolf Lorenz, who was known as "the bloodless surgeon of Vienna." This expression reflected Lorenz's methods for treating patients with noninvasive...
. This service also maintains Hospital Liaison Committees, whose function is to provide support to adherents.
Doctrine
Based on various biblical texts, such as , , and , they believe:- Blood represents life and is sacred to God. It is reserved for only one special use, the atonement for sins. When a Christian abstains from blood, they are in effect expressing faith that only the shed blood of Jesus Christ can truly redeem them and save their life.
- Blood must not be eaten or transfused, even in the case of a medical emergency.
- Blood leaving the body of a human or animal must be disposed of, except for autologous blood transfusions considered part of a “current therapy”.
- A baptized Witness who unrepentantly accepts a blood transfusion is deemed to have disassociated himself from the religion by abandoning its doctrines and is subsequently subject to organized shunning by other members.
Certain medical procedures involving blood are specifically prohibited by Jehovah's Witnesses' blood doctrine. This includes the use of red blood cells, white blood cells, platelets and blood plasma
Blood plasma
Blood plasma is the straw-colored liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. It is the intravascular fluid part of extracellular fluid...
. Other fractions derived from blood are not prohibited. Watch Tower
Watch Tower Bible and Tract Society of Pennsylvania
The Watch Tower Bible and Tract Society of Pennsylvania is a non-stock, not-for-profit organization headquartered in the New York City borough of Brooklyn, United States. It is the main legal entity used worldwide by Jehovah's Witnesses to direct, administer and develop doctrines for the religion...
publications state that some products derived from one of the four primary components may be so similar to the function of the whole component and carry on such a life-sustaining role in the body that "most Christians would find them objectionable". For procedures where there is no specific doctrinal prohibition, individuals are to obtain details from medical personnel and then make a personal decision.
Prohibited procedures
The following medical procedures are prohibited:- Transfusion of allogeneic whole blood, or of its constituents of red cells, white cells, platelets or plasma.
- Transfusions of pre-operative self-donated (autologous) blood.
Permitted procedures and products
The following procedures and products are not prohibited, and are left to the decision of individual members:- Blood donation strictly for purpose of further fractionation of red cells, white cells, platelets or plasma for either allogeneic or autologous transfusion.
- Transfusions of autologous blood part of a "current therapy".
- Hemodilution, a modified technique in which equipment is arranged in a circuit that is constantly linked to the patient's circulatory system.
- Intraoperative blood salvageIntraoperative blood salvageIntraoperative blood salvage, also known as autologous blood salvage, is a medical procedure involving recovering blood lost during surgery and re-infusing it into the patient....
(autologous) or cell-saver scavenging, a method of picking up blood that has spilled from the circulatory system into an open wound, cleaning and re-infusing it. - Heart-Lung MachineLife supportLife support, in medicine is a broad term that applies to any therapy used to sustain a patient's life while they are critically ill or injured. There are many therapies and techniques that may be used by clinicians to achieve the goal of sustaining life...
, a method in which blood is diverted to an artificial heart-lung machine and directed back into the patient. - DialysisDialysisIn medicine, dialysis is a process for removing waste and excess water from the blood, and is primarily used to provide an artificial replacement for lost kidney function in people with renal failure...
, wherein blood circulates through a machine, is filtered and cleaned, then returned to the patient. - EpiduralEpiduralThe term epidural is often short for epidural analgesia, a form of regional analgesia involving injection of drugs through a catheter placed into the epidural space...
Blood Patch, consisting of a small amount of the patient's blood injected into the membrane surrounding the spinal cord. - PlasmapheresisPlasmapheresisPlasmapheresis is the removal, treatment, and return of blood plasma from blood circulation. It is thus an extracorporeal therapy...
, wherein blood is withdrawn and filtered, having the plasma removed and substituted, and returned to the patient. - Labeling or Tagging, blood is withdrawn, mixed with medicine, and then returned to the patient by transfusion.
- PlateletPlateletPlatelets, or thrombocytes , are small,irregularly shaped clear cell fragments , 2–3 µm in diameter, which are derived from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days...
Gel, blood is withdrawn and put into a solution rich in platelets and white blood cells. - Fractions from red blood cells:
- HemoglobinHemoglobinHemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of all vertebrates, with the exception of the fish family Channichthyidae, as well as the tissues of some invertebrates...
, the oxygen-carrying component of red blood cells.
- Hemoglobin
- Fractions from white blood cells:
- Interferons
- Interleukins
- Fractions from platelets:
- Platelet factor 4Platelet factor 4Platelet factor 4 is a small cytokine belonging to the CXC chemokine family that is also known as chemokine ligand 4 . This chemokine is released from alpha-granules of activated platelets during platelet aggregation, and promotes blood coagulation by moderating the effects of heparin-like...
- Platelet factor 4
- Fractions from blood plasma:
- AlbuminHuman serum albuminHuman serum albumin is the most abundant protein in human blood plasma. It is produced in the liver. Albumin constitutes about half of the blood serum protein...
- Globulins
- CryoprecipitateCryoprecipitateCryoprecipitate, also called "Cryoprecipitated Antihemophilic Factor", "Cryoprecipitated AHF", and most commonly just "cryo", is a frozen blood product prepared from plasma.It is often transfused as a four to six unit pool instead of as a single product...
- CryosupernatantCryosupernatantThe term cryosupernatant refers to plasma from which the cryoprecipitate has been removed.-Components:...
(cryo-poor plasma) - Clotting factors, including Factor VIIIFactor VIIIFactor VIII is an essential blood clotting factor also known as anti-hemophilic factor . In humans, Factor VIII is encoded by the F8 gene...
and Factor IXFactor IXFactor IX is one of the serine proteases of the coagulation system; it belongs to peptidase family S1. Deficiency of this protein causes hemophilia B. It was discovered in 1952 after a young boy named Stephen Christmas was found to be lacking this exact factor, leading to...
derived from large quantities of stored blood - Wound healing factor
- Albumin
- ErythropoietinErythropoietinErythropoietin, or its alternatives erythropoetin or erthropoyetin or EPO, is a glycoprotein hormone that controls erythropoiesis, or red blood cell production...
(EPO). - PolyHemePolyHemePolyHeme is a temporary oxygen-carrying blood substitute made from human hemoglobin that is currently in development for emergency treatment of trauma situations where large volumes of blood are lost, with emphasis on situations where fresh blood for transfusion is not readily available...
, a blood substitute solution of chemically modified human hemoglobin. - HemopureHemopureHemopure, developed by Biopure , is an hemoglobin-based oxygen carrier based on chemically stabilized bovine hemoglobin. It has been developed for potential use in humans as an oxygen delivering bridge in cases when blood is not available or is not an option...
, a blood substitute solution of chemically stabilized bovine hemoglobin derived from cow's blood.
Bloodless surgery
A variety of bloodless surgeryBloodless surgery
Bloodless surgery is a term that was popularized at the beginning of the 20th century by the practice of an internationally famous orthopedic surgeon, Adolf Lorenz, who was known as "the bloodless surgeon of Vienna." This expression reflected Lorenz's methods for treating patients with noninvasive...
techniques have been developed for use on patients who refuse blood transfusions for reasons that include concern about AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
, hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
, and other blood-borne infections, or immune system reactions. Thousands of physicians throughout the world have expressed a willingness to respect patients' preferences and provide bloodless treatment and about 200 hospitals offer bloodless medicine and surgery programs for adult and pediatric patients who wish to avoid or limit blood transfusions, or to avoid treatment contrary to Jehovah's Witnesses' blood doctrine. Bloodless surgery has been successfully performed in such invasive operations as open-heart surgery
Cardiac surgery
Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...
and total hip replacement
Hip replacement
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Hip replacement surgery can be performed as a total replacement or a hemi replacement. Such joint replacement orthopaedic surgery generally is conducted to relieve arthritis pain or fix severe...
s. However bloodless medical and surgical techniques have limitations, and surgeons say the use of various allogeneic blood products and/or pre-operative autologous blood transfusion is the standard of care for some patient presentations.
In cases of certain medical emergencies
Medical emergency
A medical emergency is an injury or illness that is acute and poses an immediate risk to a person's life or long term health. These emergencies may require assistance from another person, who should ideally be suitably qualified to do so, although some of these emergencies can be dealt with by the...
when bloodless medicine is not available, blood transfusions may seem to be the only available way to save a life. Watch Tower publications suggest that in such instances, Jehovah's Witnesses request that doctors provide the best alternative care possible under the circumstances, with respect for their personal conviction. The Watch Tower Society has acknowledged that some members have died after refusing blood.
In some countries, including Canada and the UK, a parent or guardian's decision can be legally overruled by medical staff. In this case, medical staff may act without consent, by obtaining a court order
Court order
A court order is an official proclamation by a judge that defines the legal relationships between the parties to a hearing, a trial, an appeal or other court proceedings. Such ruling requires or authorizes the carrying out of certain steps by one or more parties to a case...
in a non-emergency situation, or without such an order in an emergency. In Japan, a doctor must respect the wish of an adult but can override the wishes of a child and its parents if the child is under 15. If a child is aged 15 to 17, a doctor will not perform a transfusion if the parents and the child refuse the transfusion. If a child aged from 15 to 17 objects to a transfusion but the parents demand the transfusion, then a doctor can override the child's wish. In the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, the American Academy of Pediatrics
American Academy of Pediatrics
The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...
recommends that in cases of "an imminent threat to a child's life", physicians in some cases may "intervene over parental objections".
Hospital Liaison Committees
In 1988, the Watch Tower Society formed Hospital Information Services, a department to help locate doctors or surgical teams who are willing to perform medical procedures on Witnesses without blood transfusions. The department was given oversight of each branch office's Hospital Information Desk, and of one hundred Hospital Liaison Committees established throughout the United States. As of 2003, about 200 hospitals worldwide provide bloodless medical programs. As of 2006, there are 1,535 Hospital Liaison Committees worldwide coordinating communication between 110,000 physicians.Hospital Information Services researches medical journals to locate information on the availability and effectiveness of bloodless surgery methods. It disseminates information about treatment options to local Hospital Liaison Committees, and to doctors and hospitals.
Patient Visitation Groups
Annually since 2004, Jehovah's Witnesses in the United States have been informed that "with your consent, the law allows for the elders to learn of your admission [to hospital] and provide spiritual encouragement", but that "elders serving on a Patient Visitation Group [could] have access to your name" only if patients made their wishes known according to the Health Insurance Portability and Accountability ActHealth Insurance Portability and Accountability Act
The Health Insurance Portability and Accountability Act of 1996 was enacted by the U.S. Congress and signed by President Bill Clinton in 1996. It was originally sponsored by Sen. Edward Kennedy and Sen. Nancy Kassebaum . Title I of HIPAA protects health insurance coverage for workers and their...
(HIPAA).
Jehovah's Witnesses' branch offices communicate directly with congregations regarding "ways to benefit from the activities of the Hospital Liaison Committee (HLC) and the Patient Visitation Group (PVG)." A Jehovah's Witnesses publication in 2000 reported that Argentina had fewer than a hundred HLC committeemen "giving vital information to the medical community", adding that "their work is complemented by hundreds of other self-sacrificing elders who make up Patient Visitation Groups that call on Witness patients to help and encourage them". Each branch office appoints PVG committeemen, who serve as volunteers.
Acceptance among Jehovah's Witnesses
The Watch Tower Society acknowledges that some Jehovah's Witnesses disagree with its doctrinal position on blood, and that it has received requests from members that the doctrine be changed to sanction medical transfusion of donor blood. In 1958, The WatchtowerThe Watchtower
The Watchtower Announcing Jehovah's Kingdom is an illustrated religious magazine, published semi-monthly in 194 languages by Jehovah's Witnesses via the Watch Tower Bible and Tract Society of Pennsylvania and printed in various branch offices around the world...
reported of a particular member of Jehovah's Witnesses who voluntarily accepted blood transfusion, contrary to Watchtower doctrine, alluding to the possibility that it was not an isolated event. The organization further confirms members have accepted blood transfusions despite initiation in 1961 of a communal shunning policy for willful acceptance.
Since the elaboration of the blood doctrine to the point of prohibiting transfusion, the majority of Jehovah's Witnesses have adopted the organization's position. Those Jehovah's Witnesses who accept the blood doctrine are typically fervent in their conviction. However, the blood doctrine has not attained universal acceptance among Jehovah's Witnesses; there remains a sizable minority of Jehovah's Witnesses who do not fully agree with the blood doctrine. In 1982, a peer-reviewed case study of a congregation of Jehovah's Witnesses was undertaken by Drs. Larry J. Findley and Paul M. Redstone to evaluate individual belief in respect to blood among Jehovah's Witnesses. The study showed that 12% were willing to accept transfusion therapy forbidden by Jehovah's Witness doctrine.This article presents a consensual survey of one congregation of Jehovah's Witnesses where the congregation elders provided the names and addresses of members, and the elders knew precisely the nature of the survey. 59 responses were received. Of the 59, 7 stipulated they would accept plasma transfusion (Table 1 on page 607). This result compelled Findley and Redstone to comment, “there is either some lack of understanding or refusal to follow doctrine among some members”. Whether from misunderstanding or refusal to follow doctrine, at no point did Findley and Redstone question whether these responders had honestly expressed their personal conviction. Findley and Redstone also stipulated their methodology may have skewed the results towards official Jehovah's Witness doctrine. (Local elders provided the names to be surveyed, and those surveyed knew local elders would see the results of the study.) The authors also admit that this study may not describe the beliefs of “less religious Jehovah's Witnesses.” One peer-reviewed study examining medical records indicated a similar percentage of Jehovah's Witnesses willing to accept blood transfusions for their children. Young adults also showed a willingness to accept blood transfusions. In another study, Jehovah's Witness patients presented for labor and delivery showed a willingness to accept some form of blood or blood products. Of these patients, 10 percent accepted whole blood transfusion.
In the August 1998 issue of Academic Emergency Medicine, Donald Ridley, a Jehovah's Witness and organization staff attorney, argued that carrying an up-to-date Medical Directive card issued by the organization indicates that an individual personally agrees with the established religious position of Jehovah's Witness. However, the organization has issued letters expressing serious concern regarding Jehovah's Witnesses activating and maintaining these documents. One letter cites reports that up to 50% of Jehovah's Witnesses had failed to maintain up-to-date Medical Directive cards, with the result that individual Witnesses were not protected from routine transfusions. Another letter reports that a large majority of Jehovah's Witnesses had not filled out the pre-formatted durable power of attorney document provided by the Watch Tower Society.
Watch Tower publications have noted that within religions, the personal beliefs of members often differ from official doctrine. Regarding Jehovah's Witnesses acceptance of the organization's official position on blood, Drs Cynthia Gyamfi and Richard Berkowitz state, “It is naïve to assume that all people in any religious group share the exact same beliefs, regardless of doctrine. It is well known that Muslims, Jews and Christians have significant individual variations in their beliefs. Why should that not also be true of Jehovah's Witnesses?”
Ambivalence and rejection of the blood doctrine dates back to at least the 1940s. After the Watch Tower Society established the doctrine, teaching that blood should not be eaten (circa 1927-31), Margaret Buber, who was never a member of the religion, offered a firsthand eyewitness account of Jehovah's Witnesses in Ravensbrueck concentration camp under Nazi Germany
Nazi Germany
Nazi Germany , also known as the Third Reich , but officially called German Reich from 1933 to 1943 and Greater German Reich from 26 June 1943 onward, is the name commonly used to refer to the state of Germany from 1933 to 1945, when it was a totalitarian dictatorship ruled by...
. She relates that an overwhelming majority were willing to eat blood sausage
Blood sausage
Black pudding, blood pudding or blood sausage is a type of sausage made by cooking blood or dried blood with a filler until it is thick enough to congeal when cooled. The dish exists in various cultures from Asia to Europe...
despite having alternate food to choose from, and specifically after considering biblical statements regarding blood.
In September 1945, representatives of the Watch Tower Society in the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...
commented on blood transfusion in the Dutch
Dutch language
Dutch is a West Germanic language and the native language of the majority of the population of the Netherlands, Belgium, and Suriname, the three member states of the Dutch Language Union. Most speakers live in the European Union, where it is a first language for about 23 million and a second...
edition of Consolation
Awake!
Awake! is a monthly illustrated magazine published by Jehovah's Witnesses via the Watch Tower Bible and Tract Society of Pennsylvania and printed in various branch offices around the world. It is considered to be a companion magazine of The Watchtower, and is distributed by Jehovah's Witnesses in...
. A translation of their comments into English reads: According to sociologist Richard Singelenbreg the statement appearing in the Dutch edition of Consolation may have been published without knowledge of the doctrinal position published in the English July 1945 issue of Consolation by the Watch Tower Society's headquarters in the United States.
History of doctrine
From 1931, when the name "Jehovah's witnesses" was adopted, Watch Tower Society publications maintained the view of Society founder Charles Taze RussellCharles Taze Russell
Charles Taze Russell , or Pastor Russell, was a prominent early 20th century Christian restorationist minister from Pittsburgh, Pennsylvania, USA, and founder of what is now known as the Bible Student movement, from which Jehovah's Witnesses and numerous independent Bible Student groups emerged...
that the reference to abstaining from the eating of blood in the Apostolic Decree
Council of Jerusalem
The Council of Jerusalem is a name applied by historians and theologians to an Early Christian council that was held in Jerusalem and dated to around the year 50. It is considered by Catholics and Orthodox to be a prototype and forerunner of the later Ecumenical Councils...
of Acts 15:19-29 was a "suggestion" to be given to Gentile
Gentile
The term Gentile refers to non-Israelite peoples or nations in English translations of the Bible....
converts. Watch Tower publications during the presidency of Joseph Franklin Rutherford
Joseph Franklin Rutherford
Joseph Franklin Rutherford , also known as "Judge" Rutherford, was the second president of the incorporated Watch Tower Bible and Tract Society, and played a primary role in the organization and doctrinal development of Jehovah's Witnesses, which emerged from the Bible Student movement established...
commended the commercial and emergency uses of blood. A 1925 issue of The Golden Age commended a man for donating blood 45 times without payment. In 1927, The Watchtower noted, without elaboration, that in Genesis 9, God decreed that Noah
Noah
Noah was, according to the Hebrew Bible, the tenth and last of the antediluvian Patriarchs. The biblical story of Noah is contained in chapters 6–9 of the book of Genesis, where he saves his family and representatives of all animals from the flood by constructing an ark...
and his offspring "must not eat the blood, because the life is in the blood". In 1940 Consolation magazine reported on a woman who accidentally shot herself with a revolver in her heart and survived a major surgical procedure during which an attending physician donated a quart of his own blood for transfusion.
In 1944, with the Watch Tower Society under the administration of president Nathan Homer Knorr
Nathan Homer Knorr
Nathan Homer Knorr was the third president of the incorporated Watch Tower Bible and Tract Society, becoming so on January 13, 1942, replacing Joseph Franklin Rutherford, who had served in the position since 1916.-Life:...
, The Watchtower asserted that the decrees contained in Genesis 9:4 and Leviticus 17:10-14 forbade the eating or drinking of blood in biblical times "whether by transfusion or by the mouth" and that this applied "in a spiritual way to the consecrated persons of good-will today, otherwise known as 'Jonadabs
Jehonadab
Jehonadab was the son of Rechab. He is mentioned in the Hebrew Bible at 2 Kings 10:15-31. Though not a Jew himself, he was a supporter of Jehu, son of Nimshi, in the elimination of the house of Ahab and in suppressing worship of Baal throughout Samaria...
' of the Lord's 'other sheep'."
In 1945, the application of the doctrine on blood was expanded to prohibit blood transfusions of whole blood, whether allogeneic or autologous. The prohibition did not specify any punitive measures for accepting a transfusion, but by January 1961—in what was later described as an application of "increased strictness"—it was ruled that it was a disfellowshipping offense to conscientiously accept a blood transfusion. Watch Tower publications warned that accepting a blood transfusion could prevent Witnesses from living eternally in God's new world, the hope held by members: "It may result in the immediate and very temporary prolongation of life, but that at the cost of eternal life for a dedicated Christian."
In September 1956, Awake! stated, "certain blood fractions ... also come under the Scriptural ban". A position against "the various blood fractions" was reiterated in September 1961. In November of the same year, the doctrine was modified to allow individual members to decide whether they could conscientiously accept fractions used from blood for purposes such as vaccination. This position has been expanded on since; the pre-formatted Durable Power of Attorney form provided by the Watch Tower Society includes an option for Jehovah's Witnesses to "accept all fractions derived from any primary component of blood."
In 1964, Jehovah's Witnesses were prohibited from obtaining transfusions for pet
Pet
A pet is a household animal kept for companionship and a person's enjoyment, as opposed to wild animals or to livestock, laboratory animals, working animals or sport animals, which are kept for economic or productive reasons. The most popular pets are noted for their loyal or playful...
s, from using fertilizer containing blood, and were even advised (if their conscience troubled them) to write to dog food manufacturers to verify that their products were blood-free. Later that year, it was stated that doctors or nurses who are Jehovah's Witness would not administer blood transfusions to fellow dedicated members. As to administering transfusions to non-members, The Watchtower stated that such a decision is "left to the Christian doctor's own conscience."
In 1982, a Watchtower article declared that it would be wrong for a Witness to allow a leech to feed on his/her blood as part of a medical procedure, due to the sacredness of blood.
In 1989 The Watchtower stated, "Each individual must decide" whether to accept hemodilution and autologous blood salvage (cell saver) procedures. In 1990, a brochure entitled How Can Blood Save Your Life? was released, outlining Jehovah's Witnesses' general doctrine on blood.
In 2000, the Watch Tower Society's stand on blood fractions was clearly stated. Members were instructed to personally decide if accepting a fraction would violate the doctrine on blood. In a later article, members were reminded that Jehovah's Witnesses do not donate blood or store their own blood prior to surgery.
In May 2001, the Watch Tower Society revised its medical directives and identity cards addressing its doctrinal position on blood; the revised materials were distributed from May 3, 2001. These revised documents specified that "allogeneic blood transfusions" were unacceptable whereas the former document (dated 1999) stated that "blood transfusions" were unacceptable. The revised 2001 documents were active until December 20, 2001. The Watch Tower Society then rescinded the revised document, stating, "After further review, it has been determined that the cards dated "md-E 6/01" and "ic-E 6/01" should not be used. Please destroy these items and make sure that they are not distributed to the publishers." Elders were instructed to revert to the older 1999 edition of the medical directives and identity cards.
Watch Tower Society publications frequently point out negative consequences of blood transfusions:
- A 1951 Watchtower declared: "And let the transfusion enthusiasts with a savior-complex ponder the fact that on many occasions transfusions do harm, spread disease, and frequently cause deaths, which, of course, are not publicized."
- A 1961 Watchtower quoted Brazilian surgeon Dr Américo Valério as saying transfusions were often followed by "moral insanity, sexual perversions, repression, inferiority complexes, petty crimes" and Dr Alonzo Jay Shadman claiming that a person's blood contained all the peculiarities of the individual including hereditary taints, disease susceptibilities, poisons due to personal living, eating and drinking habits ... The poisons that produce the impulse to commit suicide, murder, or steal are in the blood."
- A 1969 Awake! reported on a man named Robert Khoury, who, after receiving a blood transfusion said, "When I recovered I found I had a terrible desire to steal."
- A 1974 Awake! cited a Center for Disease Control report that as many as 35,000 deaths and 500,000 illnesses a year might be due to the presence of serum hepatitis in blood for transfusions.
- A 2006 Awake! highlighted dangers from transfusion-related acute lung injury (TRALI), citing a New ScientistNew ScientistNew Scientist is a weekly non-peer-reviewed English-language international science magazine, which since 1996 has also run a website, covering recent developments in science and technology for a general audience. Founded in 1956, it is published by Reed Business Information Ltd, a subsidiary of...
report that suggested it was the cause of as many as 55200 reactions and 500 deaths in the United States in 2002.
Critical views
Opposition to the Watch Tower doctrines on blood transfusions has come from both inside and outside the religion. A group of dissident Witnesses known as Associated Jehovah's Witnesses for Reform on Blood (AJWRB) claims there is no biblical basis for the prohibition of blood transfusions and seek to have some policies changed. In a series of articles in the Journal of Medical EthicsJournal of Medical Ethics
The Journal of Medical Ethics is a peer-reviewed academic journal in the field of bioethics established in 1975. , its editors are Søren Holm and John Harris ....
American neurologist Osamu Muramoto, who is a medical adviser to the AJWRB, has raised issues including what he claims is coercion to refuse transfusions, doctrinal inconsistency, the use of information control by the Watch Tower Society to exaggerate the dangers of transfusions and the Society's use of outdated medical beliefs.
Scriptural interpretation
Dissident Witnesses say the Society's use of Leviticus 17:12 to support its opposition to blood transfusions conflicts with its own teachings that Christians are not under the Mosaic law. Theologian Anthony HoekemaAnthony A. Hoekema
Anthony Andrew Hoekema was a Calvinist minister and theologian who served as professor of Systematic theology at Calvin Theological Seminary, Grand Rapids, for twenty-one years.- Biography :...
claims the blood prohibited in Levitical laws was not human, but animal. He cites other authors who support his view that the direction at Acts 15 to abstain from blood was intended not as an everlasting covenant but a means of maintaining a peaceful relationship between Jewish and Gentile Christians. He has described as "absurd literalism" the Witnesses' use of a scriptural prohibition on eating blood to prohibit the medical transfusion of human blood.
Coercion
Osamu Muramoto has argued that the refusal by Jehovah's Witnesses of "life-saving" blood treatment creates serious bio-medical ethical issues. He has criticized the "controlling intervention" of the Watch Tower Society by means of what he claims is information control and its policy of penalising members who accept blood transfusions or advocate freedom to choose blood-based treatment. He says the threat of being classified as a disassociated Witness and subsequently shunned by friends and relatives who are members coerces Jehovah's Witnesses to accept and obey the prohibition on blood transfusions. In one particular case involving a Russian district court decision, however, the European Court of Human RightsEuropean Court of Human Rights
The European Court of Human Rights in Strasbourg is a supra-national court established by the European Convention on Human Rights and hears complaints that a contracting state has violated the human rights enshrined in the Convention and its protocols. Complaints can be brought by individuals or...
(ECHR) found nothing in the judgments to suggest that any form of improper pressure or undue influence was applied. It noted: "On the contrary, it appears that many Jehovah’s Witnesses have made a deliberate choice to refuse blood transfusions in advance, free from time constraints of an emergency situation." The court said: "The freedom to accept or refuse specific medical treatment, or to select an alternative form of treatment, is vital to the principles of self-determination and personal autonomy. A competent adult patient is free to decide ... not to have a blood transfusion. However, for this freedom to be meaningful, patients must have the right to make choices that accord with their own views and values, regardless of how irrational, unwise or imprudent such choices may appear to others."
Muramoto has claimed the intervention of Hospital Liaison Committees can add to "organisational pressure" applied by family members, friends and congregation members on Witness patients to refuse blood-based treatment. He notes that while HLC members, who are church elders, "may give the patient 'moral support', the influence of their presence on the patient is known to be tremendous. Case reports reveal JW patients have changed their earlier decision to accept blood treatment after a visit from the elders." He claims such organizational pressure compromises the autonomy of Witness patients and interferes with their privacy and confidentiality. He has advocated a policy in which the Watch Tower organization and congregation elders would not question patients on the details of their medical care and patients would not disclose such information. He says the Society adopted such a policy in 1983 regarding details of sexual activity between married couples.
Watch Tower spokesman Donald T. Ridley says neither elders nor HLC members are instructed or encouraged to probe into the health care decisions of Witness patients and do not involve themselves in patient hospitalisations unless patients request their assistance. Yet Watchtower HLC representative David Malyon says he would respond to “sin” of Witnesses he is privy to by effectively saying “Are you going to tell them or shall I!” Nevertheless Ridley says Muramoto's suggestion that Witnesses should be free to disregard Watch Tower scriptural teachings and standards is preposterous. He says loving God means obeying commandments, not disobeying them and hiding one's disobedience from others.
Muramoto has claimed many Watch Tower publications employ exaggeration and emotionalism to emphasize the dangers of transfusions and the advantages of alternative treatments, but presents a distorted picture by failing to report any benefits of blood-based treatment. Nor does it acknowledge that in some situations, including rapid and massive haemorrhage, there are no alternatives to blood transfusions. He claims Watch Tower publications often discuss the risk of death as a result of refusing blood transfusions, but give little consideration to the prolonged suffering and disability, producing an added burden on family and society, that can result from refusal. Attorney and former Witness Kerry Louderback-Wood also claims that Witness publications exaggerate the medical risks of taking blood and the efficiency of non-blood medical therapies in critical situations.
Muramoto recommends doctors have a private meeting with patients to discuss their wishes, and that church elders and family members not be present, enabling patients to feel free of church pressure. He suggests doctors question patients on (a) whether they have considered that the Watch Tower Society might soon approve some medical practices they currently find objectionable, in the same manner that it has previously abandoned its opposition to vaccination and organ transplants; (b) whether Witness patients know which blood components are allowed and which are prohibited, and whether they acknowledge that those rulings are organizational policy rather than biblical teachings; and (c) whether they realize that although some Bible scriptures proscribe the eating of blood, eating and transfusing blood have entirely different effects on the body. English HLC representative David Malyon has responded that Muramoto's suggested questions are an affront to coerce Jehovah's Witnesses with "complicated philosophical inquisition" and, if used by doctors, would be "an abusive transformation of the medical role of succour and care into that of devil's advocate and trickster".
Outdated medical beliefs
Osamu Muramoto says the Watch Tower Society relies on discarded, centuries-old medical beliefs to support its assertion that blood transfusions are the same as eating blood. A 1990 Watch Tower brochure on blood quoted a 17th century anatomist to support its view. Muramoto says the view that blood is nourishment—still espoused in Watch Tower publications—was abandoned by modern medicine many decades ago. He has criticized an analogy commonly used by the Society in which it states: "Consider a man who is told by the doctor that he must abstain from alcohol. Would he be obedient if he quit drinking alcohol but had it put directly into his veins?" Muramoto says the analogy is false, explaining: "Orally ingested alcohol is absorbed as alcohol and circulated as such in the blood, whereas orally eaten blood is digested and does not enter the circulation as blood. Blood introduced directly into the veins circulates and functions as blood, not as nutrition. Hence, blood transfusion is a form of cellular organ transplantation. And ... organ transplants are now permitted by the WTS." He says the objection to blood transfusions on the basis of biblical proscriptions against eating blood is similar to the refusal of a heart transplant on the basis that a doctor warned a patient to abstain from eating meat because of his high cholesterol level.David Malyon, chairman of the English Hospital Liaison Committee in Luton
Luton
Luton is a large town and unitary authority of Bedfordshire, England, 30 miles north of London. Luton and its near neighbours, Dunstable and Houghton Regis, form the Luton/Dunstable Urban Area with a population of about 250,000....
, England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
, has claimed that Muramoto's discussion of the differences between consuming blood and alcohol is pedantic and says blood laws in the Bible are based upon the reverence for life and its association with blood, and that laws should be kept in the spirit as much as in the letter.
Inconsistency
Muramoto has described as peculiar and inconsistent the Watch Tower policy of acceptance of all the individual components of blood plasma as long as they are not taken at the same time. He says the Society offers no biblical explanation for differentiating between prohibited treatments and those considered a "matter of conscience", explaining the distinction is based entirely on arbitrary decisions of the Governing BodyGoverning Body of Jehovah's Witnesses
The Governing Body of Jehovah's Witnesses is the ruling council of Jehovah's Witnesses based in Brooklyn, New York. The body assumes responsibility for formulating policy and doctrines, producing material for publications and conventions, and administering its worldwide branch office staff...
, to which Witnesses must adhere strictly of the premise of them being Bible-based “truth”. He has questioned why white blood cells (1 per cent of blood volume) and platelets (0.17 per cent) are forbidden, yet albumin (2.2 per cent of blood volume) is permitted. He has questioned why donating blood and storing blood for autologous transfusion is deemed wrong, but the Watch Tower Society permits the use of blood components that must be donated and stored before Witnesses use them. He has questioned why Witnesses, although viewing blood as sacred and symbolizing life, are prepared to let a person die by placing more importance on the symbol than the reality it symbolizes.
Kerry Louderback-Wood alleges that by labeling the currently acceptable blood fractions as "minute" in relation to whole blood, the Watch Tower organization causes followers to misunderstand the scope and extent of allowed fractions.
Witnesses respond that the real issue is not of the fluid per se, but of respect and obedience to God. Their principle of abstaining from blood as a display of respect is seen in the fact that members are allowed to eat meat
Meat
Meat is animal flesh that is used as food. Most often, this means the skeletal muscle and associated fat and other tissues, but it may also describe other edible tissues such as organs and offal...
that still contains some blood. As soon as blood is drained from an animal, the respect has been shown to God, and then a person can eat the meat even though it may contain a small amount of blood. Jehovah's Witnesses' view of meat and blood is different to the Jewish view that goes to great lengths to remove minor traces of blood.
Further reading
- Putney, Leeann J. (July-September 2007), [
- Eilers, June; Rounds, Luisa (March 2007), "Blood Transfusion or Not: A Literature Review of Bloodless Interventions to Treat Cancer Related Anemia". Oncology Nursing Forum. 34 (2):553-554
See also
- Blood transfusions
- Bloodless surgeryBloodless surgeryBloodless surgery is a term that was popularized at the beginning of the 20th century by the practice of an internationally famous orthopedic surgeon, Adolf Lorenz, who was known as "the bloodless surgeon of Vienna." This expression reflected Lorenz's methods for treating patients with noninvasive...
- Criticism of Jehovah's Witnesses
- KnockingKnocking (documentary)Knocking is a 2006 documentary film directed by Joel Engardio and Tom Shepard that focuses on the civil liberties fought for by Jehovah's Witnesses...
, a documentary on Witnesses that features bloodless medicine.
External links
- Official website of Jehovah's Witnesses
- Beliefs of Jehovah's Witnesses regarding medical treatment (JW Public Relations Website)
- Assorted articles on medical care and blood published by Watch Tower Bible and Tract Society
- How Can Blood Save Your Life? published by Watch Tower Bible and Tract Society
- Associated Jehovah's Witnesses for Reform on Blood
- BBC News - Refusing blood 'source of regret'
- Critique of Jehovah's Witnesses' blood policy by Raymond FranzRaymond FranzRaymond Victor Franz was a member of the Governing Body of Jehovah's Witnesses from 20 October 1971 until 22 May 1980, and served at the organization's world headquarters for fifteen years, from 1965 until 1980. Franz claimed the request for his resignation and his subsequent disfellowshipping...
, a former member of Jehovah' Witnesses' Governing Body - Ethical Issues in Compulsory Medical Treatment: A Study of Jehovah's Witnesses
- Jehovah's Witnesses teachings on blood from religioustolerance.org
- The Jensen Letters—correspondence between a Jehovah's Witness elder and the Watchtower Society seeking answers to critical questions about important aspects of their blood doctrine. The correspondence begins in 1998 and concludes in 2003 with the writer's resignation as an elder.