Jehovah's Witnesses and blood transfusions

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Some, but not all Jehovah's Witnesses believe that the Bible prohibits the consumption, storage and transfusion of blood, including in cases of emergency. The Watchtower introduced this view in 1945, though associated restrictions have been relaxed over time. The Watchtower’s advertised view is that Jehovah’s Witnesses agree with its doctrinal policy on blood, which gives impression that the belief is commonly held by all Jehovah’s Witnesses. However, since the teaching’s inception and until today the population of Jehovah’s Witnesses has not universally assented to it. Over this period the Watchtower has received requests from individual Jehovah’s Witnesses that the doctrine allow conscientious acceptance of donor blood for medical transfusion without organized repercussion. [1] [2] Furthermore, Jehovah’s Witnesses have accepted blood transfusions contrary to Watchtower doctrine, even when this was under threat of severe organized shunning enforced by the Watchtower.[3] [4] These facts underscore an under-advertised truth well known to medical clinicians—not all Jehovah’s Witnesses agree with and/or abide by official Watchtower teaching in respect to blood. [5][6]

In accordance with the above, the following doctrinal overview represents official Watchtower teaching but not necessarily the view of a particular Jehovah’s Witness. As the Watchtower organization also teaches “Nowadays official church dogma may bear scant resemblance to the personal beliefs of those who profess that particular religion.”[7] As is true of other religious adherents it is also true of individual Jehovah’s Witnesses—they pursue a range of objectives and not just one objective. These interests include medical, psychological, social, economic, legal, educational and spiritual pursuits. As Donald Ridley, a Watchtower representative and attorney, well expressed “Maximizing the good in one of these spheres will come at a cost in some other sphere. Rational people will trade off benefits in different spheres until the aggregate total is maximized.”[8] So it is with the population of Jehovah’s Witnesses. Undoubtedly a significant number of this population agrees completely with Watchtower doctrine on blood, but this does not make insignificant the number of Jehovah’s Witnesses who do not fully agree with the Watchtower’s blood doctrine.


Contents

[edit] Stance on blood

The Watchtower organization teaches:

  • blood is sacred to God
  • blood means life in God's eyes;
  • blood must not be eaten;
  • blood leaving the body of a human or animal must be disposed of;
  • Christians must "abstain" from blood in the sense used at Acts 15:29 (NWT);
  • blood was reserved for only one special use, the atonement for sins, which led up to Jesus' shed blood;
  • when a Christian abstains from blood, he or she is in effect expressing faith that "only the shed blood of Jesus Christ can truly redeem him and save his life.-Ephesians 1:7"; [9]
  • even in the case of an emergency, it is not permissible to sustain a life with blood; and
  • that violation of the doctrine on blood is a serious offense in which a member may be no longer considered a Witness.

These beliefs about blood affect their acceptance of products containing blood or its components and medical procedures involving the use, re-use and storage of blood. While this stance has largely remained unchanged since its introduction in 1945, the Governing Body of Jehovah's Witnesses has changed its views on which products and procedures may be considered acceptable to the conscience of each individual Jehovah's Witness.

[edit] Development of the organizational view on blood

Jehovah's Witnesses originally followed the Christian orthodox doctrine on blood, allowing it to be eaten. Charles Taze Russell, the founder of Jehovah's Witnesses, wrote that the Jewish dietary law forbidding the eating of blood was not binding for Christians,[10] and that the statement at Acts 15:29 (NWT) to "abstain" from blood applied only to first century congregations that had a mix of Jews and Gentiles.[11]

This view continued to be held after the discovery of blood types and the liberal use, into wounded soldiers, of blood transfusions during World War I. However, after Russell's death in 1916, under his successor, Joseph Franklin Rutherford, things began to change with the doctrine on blood. In 1927, The Watchtower introduced a new doctrine on blood, prohibiting members from eating blood.[12] In 1931 this was expounded by the Watchtower organization teaching “that it was not the eating of the blood that God objected to, but it was bringing the blood of the beast in contact with the blood of man.”[13] At this time the Watchtower organization was not teaching that blood as a substance was sacred. Rather it taught that human blood was sacred and that it was wrong to contaminate human blood with animal blood.[14] At this time, blood transfusions were not specifically prohibited. As early as 1944 while discussing the sacredness of blood, transfusions were mentioned. [15]

In 1945, the application of the doctrine on blood was expanded to prohibit blood transfusions of whole blood whether homologous or autologous. [16] While the prohibition didn't specify any punitive measures for accepting a transfusion, by 1961 they were warned that doing so could prevent them 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." [17]

Publications by Jehovah's Witnesses began to publish negative results from blood transfusions.

"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." [18]

In addition their publications sometimes printed news events and doctor’s opinions about the negative effects of blood transfusions. In the news article, Watching the World reference is made to a man, Robert Khoury, who after receiving a blood transfusion said, “When I recovered I found I had a terrible desire to steal.”[19]

The May 22, 1974 AWAKE! p. 18 quotes the United States Congressional Record: "'The Center for Disease Control has stated that the actual rate of hepatit[i]s may be well in excess of the official figure due to the failure of many physicians to report serum hepatit[i]s cases. The center estimates that as many as 35,000 deaths and 500,000 illnesses a year may be due to the presence of serum hepatit[i]s in blood for transfusions.'"
In a 1961 Watchtower it quoted, Dr. Américo Valério, A Brazilian doctor and surgeon for over forty years, when he said, "Moral insanity, sexual perversions, repression, inferiority complexes, petty crimes—these often follow in the wake of blood transfusion." In addition reference is made to the book, Who Is Your Doctor and Why? where Doctor Alonzo Jay Shadman says: “The blood in any person is in reality the person himself. It contains all the peculiarities of the individual from whence it comes. This includes 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.” [20]
"The heart is a marvelously designed muscular pump, but, more significantly, our emotional and motivating capacities are built within it. Love, hate, desire (good and bad), preference for one thing over another, ambition, fear--in effect, all that serves to motivate us in relationship to our affections and desires springs from the heart.... It is significant that heart-transplant patients, where the nerves connecting the heart and brain are severed, have serious emotional problems after the operation." [21] In support of such statements, references are made to the Medical World News [22], and to Dr. D. E. Schneider, a neurologist and psychiatrist of New York.
The August 2006 Awake! highlighted dangers from Transfusion-related acute lung injury. (TRALI) In 2002 this was referred to as causing around 500 deaths in the USA alone. The New Scietist magazine world's leading science & technology news service stated that "researchers now agree that TRALI occurs in about one in 5000 transfusions, which means there are at least 5300 TRALI reactions per year in the US alone, and something like 500 deaths."[1] [23]

In 1958 (around the time when blood began to be broken down into components [24]) gamma globulin, a blood fraction, was considered a “gray area” in which each Witness would decide whether to accept it or not.[25] This view was stated again in 1974 and also in 1978.[26] [27]

In 1961, Jehovah's Witnesses began to be punished with excommunication for acceptance of a blood transfusion of whole blood, or its components.[28] In 1964, Jehovah's Witnesses were prohibited from obtaining transfusions for pets, from using fertilizer containing blood, and were even encouraged to write to dog food manufacturers to verify their products were blood-free, if "troubled" over the package label.[29] Later that year, Jehovah's Witnesses doctors and nurses were instructed to withhold blood transfusions from fellow Jehovah's Witnesses. As to administering transfusions to non-members The Watchtower stated, that such a decision is "left to the Christian doctor’s own conscience."[30]

Since the 1980s restrictions on medical use of blood have been loosened, with certain blood products and medical procedures no longer prohibited. A June 1982 issue of Awake! confirmed that whole blood and its four components were not permitted for transfusion, but that this did not rule out fractions which some Witnesses would accept. [31] That same month a Watchtower article declared that it would be wrong for a Witness to allow a leech to eat upon his/her blood as part of a medical procedure, due to the sacredness of blood.[32]

In 1989 The Watchtower stated, "Each individual must decide" whether to accept hemodilution and autologous blood salvage (cell saver) procedures.[33] In 1990, a brochure entitled How Can Blood Save Your Life? was released, outlining Jehovah's Witnesses' general doctrine on blood.

In 2000, Jehovah's Witnesses stand on blood fractions was clearly stated.[34] 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 nor store their own blood prior to surgery.[35]

[edit] Current Medical Issues

[edit] Medical procedures

Certain medical procedures involving blood are specifically prohibited in Jehovah's Witnesses publications. Other procedures are not prohibited, but the decision is left to the individual to determine whether the procedure is in violation of the doctrine on blood. For procedures where there is no specific advice, individuals are to obtain details from medical personnel and then make a personal decision.[36]

Jehovah's Witnesses do not accept the following medical procedures:

  • Homologous whole blood transfusions, or transfusions using the stored blood of others.
  • Autologous whole blood transfusions, or transfusions using one's own stored blood.[37]
  • Acute normovolemic hemodilution (ANH), a method that is used to reduce or eliminate the need for blood transfusion during surgery by pre-operative collection of blood for re-infusion during or after surgery.

The following medical procedures are personal decisions for Jehovah's Witnesses, however members are instructed to refuse a procedure that they personally feel violates the doctrine on blood:

  • Closed-circuit acute normovolemic hemodilution (ANH), a modified technique in which equipment is arranged in a circuit that is constantly linked to the patient's circulatory system.
  • Intraoperative blood salvage (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 Machine, a method in which blood is diverted to an artificial heart-lung machine and directed back into the patient.
  • Dialysis, blood circulates through a machine that filters and cleans it then returns it to the patient.
  • Epidural Blood Patch, a small amount of the patient's blood is injected into the membrane surrounding the spinal cord.
  • Plasmapheresis, blood is withdrawn filtered, plasma removed, substitued added and returned to the patient.
  • Labeling or Tagging, blood is withdrawn, mixed with medicine, and then returned to the patient.
  • Platelet Gel, blood is withdrawn and put into a solution rich in platelets and white blood cells.

It is well-known in the medical community that Jehovah's Witnesses categorically refuse all blood transfusions of whole blood, and plasma. However, modern medical practise rarely uses homologous whole blood transfusions, preferring blood products.

[edit] Use of blood products

Use of four of blood's components are specifically prohibited in Jehovah's Witnesses publications. Other fractions derived from blood are not prohibited, but the decision is left to the individual to determine whether the use of the product is in violation of the doctrine on blood. However, The Watchtower stated 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".[38]

The following blood components are specifically prohibited for oral or intravenous consumption by Jehovah's Witnesses:

Products containing blood fractions other than the four listed above are not prohibited for Jehovah's Witnesses, however members are instructed to refuse use of products where they personally feel that doing so would violate the doctrine on blood:

[edit] Other medical treatments

The use of dialysis machines and cell salvage, a procedure which recycles blood during operations is considered to be a matter for personal choice.

[edit] "Bloodless surgery"

Main article: Bloodless surgery

While Jehovah's Witnesses refuse blood for religious reasons, there are non-Witness patients who also choose to avoid blood on non-religious grounds such as concern about AIDS, non-A non-B hepatitis, and immunologic reactions. As a result, bloodless surgery and transfusion alternatives are more commonplace than in the past. For example, Pennsylvania Hospital has a bloodless medicine program PennHealth - Bloodless Medicine. Worldwide there are 106 medical centers to date that provide bloodless medicine programs, with 99 in the United States alone [2].

Thousands of physicians around the world are now successfully treating patients without using blood transfusions. Many medical facilities offer bloodless medicine and surgery as a special service for adult and pediatric patients who wish to avoid blood transfusions, whatever the reasons for their choice, even in such invasive operations such as open-heart surgery and total hip replacements [3], [4], [5], [6]

For example, a major study published in both the Journal of the American Medical Association and the British Medical Journal The Lancet showed that in many cases transfusions were actually not as necessary as healthcare providers often believe. A summary of the study states:

[E]xamining the case records of nearly 2,000 adult Jehovah's Witnesses who underwent surgery without transfusions at 12 hospitals, including Robert Wood Johnson University Hospital, Dr. Carson reported that most patients did very well. In another study comparing patients who did and did not receive blood across a data base of 8,787 hip surgery patients, Dr. Carson and his colleagues reported that transfusions increased the rate of complications, but did not improve survival rates. [Emphasis added]

Jehovah's Witnesses have produced several video documentaries showing the benefits of nonblood techniques. These feature interviews with many leading surgeons and prominent physicians in this field of medicine from around the globe.[7] [39]

However, 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. Such situations are obviously very serious. However, the Jehovah's Witness patient still must not accept blood. In those instances, Witnesses ask conscientious doctors to provide the best alternative care possible under the circumstances, respecting the beliefs and consciences of their Witness patients. This has led to the death of members, as stated in the May 22, 1994 issue of Awake, p. 2: "In former times thousands of youths died for putting God first. They are still doing it, only today the drama is played out in hospitals and courtrooms, with blood transfusions the issue."

[edit] Hospital Liaison Committees

To facilitate surgery without violating their belief against transfusions, the Governing Body has set up "Hospital Liaison Committees" to enroll doctors and surgeons who will practice "bloodless surgery" for Witness patients. Currently there are some 1600 such committees in 200 different countries of the world, and over 110,000 doctors and surgeons who have agreed to treat Jehovah's Witnesses without making an issue of blood transfusions.

"Hospital Information Services", a department of the World Headquarters of Jehovah's Witnesses researches medical literature on the subject and translates medical-journal articles into dozens of languages. This department provides information to the local Hospital Liaison Committees and to doctors and hospitals seeking assistance in treatment options for Witnesses.[40]

The Watch Tower Society has published information about the medical matters in general and blood transfusion in particular in order to both provide an explanation of their view, and also promote the idea that the practice violates God's laws.

Many Witnesses carry a "Hospital Care Card" or an "Advance Medical Directive/Release card" ("No Blood" card) and, in some countries, a health-care durable power of attorney (DPA) form, outlining their wishes in case of emergencies. They also give this information to medical personnel prior to surgeries or other medical procedures that might involve the blood issue, organ transplants, or a decision whether or not to sustain their lives under any circumstances. Currently it is dubious whether these carry legal weight in Australia, but they probably do not.

Minor children have an "Identity Card" outlining the wishes of the parents or guardians, and including information on how to contact a parent, relative, or somebody responsible for the child. These are powerless under Australian law.

[edit] Critical View

Some feel there are two inconsistencies in the current policy that groups such as "Associated Jehovah's Witnesses for Reform on Blood" are attempting to have addressed. They feel that accepting blood fractions does not adhere to the principle that blood be poured out. Furthermore, they also believe that if blood fractions are accepted then Jehovah’s Witnesses should also be allowed to donate blood.

If a person has previously been disfellowshipped for accepting a blood fraction that is now permissible they are not automatically reinstated, as the disfellowshipping is considered to be a result of showing disrespect for the leadership of the Organization as much as the issue of blood.

Jehovah's Witnesses stance on blood has been controversial, particularly in the case of children. In the United States, many physicians will agree to explore and exhaust all non-blood alternatives in the treatment of children at the request of their legal guardians. However, some state laws require physicians to administer blood-based treatment to minors if it is their professional opinion that it is necessary to prevent immediate death or severe permanent damage.

An article in the Journal of Church and State states that Jehovah's Witnesses are allowed to accept whole blood provided it is in the form of blood fractions.[41] Kerry Louderback-Wood, the writer, alleges that to label the currently acceptable blood fractions as "minute" in relation to whole blood, causes followers to misunderstand the scope and extent of allowed fractions. She also claims Witness publications exaggerate the medical risks of taking blood and the efficiency of non-blood medical therapies in critical situations.[42]

Raymond Franz, a former member of the Governing Body of Jehovah's Witnesses revealed in his book Crisis of Conscience that for some years prior to 1975 hemophiliacs writing or phoning Jehovah's Witnesses headquarters were told that they would be allowed to take a clotting factor derived from blood just once as "medication", but that taking it more than once would be considered "feeding on blood", and was hence prohibited.[43] In a meeting on June 11, 1975, the Governing Body adjusted its position, deciding to allow hemophiliacs to take clotting factors repeatedly. This change of policy was privately communicated to those who had earlier enquired, but was not published publicly until 1978, when it was mentioned briefly in a Watchtower article discussing serum injections.[44] It is not known how many hemophiliac members may have survived between 1975 and 1978 had they choosen to accept this treatment, unaware of any changed in their position.

Immunoglobulin injections are another conscience matter, even though requiring 3 litres of blood to manufacture and often coming from pooled blood sources containing the blood of up to 60,000 people. [citation needed]

See also: Controversies regarding Jehovah's Witnesses#Blood

[edit] References

  1. ^ The Watchtower May 1, 1950 p. 143
  2. ^ The Jensen Letters, 1998-2003, scans of original letters at http://ajwrb.org/watchtower/index.shtml
  3. ^ The Watchtower August 1, 1958 p. 478
  4. ^ The Watchtower October 15, 1987 p. 14
  5. ^ Cynthia Gyamfi, MD, and Richard L. Berkowitz, MD, Obstet and Gynecol Vol. 104, No. 3, September 2004
  6. ^ Kaaron Benson, Cancer Control Journal, Vol. 2, No. 4, November/December 1995, available online at http://www.moffitt.org/moffittapps/ccj/v2n6/article13.html
  7. ^ Awake!' April 8, 1996 p. 4
  8. ^ 'Ridley, Donald T, Acd Emerg Med, Vol. 5 No. 8, August 1998
  9. ^ Awake! August 2006 p. 11
  10. ^ Russell, C. T. (Ed.) (November 15, 1892). "The Apostolic Council". Zion's Watch Tower and Herald of Christ's Presence, p. 1473 (Reprint) (Online edition)
  11. ^ (April 15, 1909). The Watchtower, p. 116-117
  12. ^ (December, 15, 1927). The Watchtower, p. 371
  13. ^ Golden Age February 4, 1931 p. 294
  14. ^ Golden Age February 4, 1931 p. 293-5
  15. ^ The Watch Tower December 1, 1944
  16. ^ (July 1, 1945). The Watchtower, p. 198-201
  17. ^ (1961) Blood, Medicine, and the Law of God, p. 54
  18. ^ "Question from Readers". (July 1, 1951). The Watchtower, p. 414
  19. ^ (July 8, 1969). Awake!, p. 30
  20. ^ (September 15, 1961). The Watchtower, p. 563-564
  21. ^ (March 1, 1971). The Watchtower, p. 133-139
  22. ^ Medical World News “What Does a New Heart Do to the Mind?” May 23, 1969,
  23. ^ New Scientist 25 September 2002
  24. ^ "Blood Transfusion," ‘’Microsoft® Encarta® Encyclopedia 99'’ © 1993-1998 Microsoft Corporation
  25. ^ The Watchtower September 15, 1958 p.575
  26. ^ The Watchtower June 1, 1974 p. 351-352
  27. ^ The Watchtower June 15, 1978 p.351-352
  28. ^ (January 15, 1961). The Watchtower, p. 63-64
  29. ^ (February 15, 1964). The Watchtower, p. 127-128
  30. ^ "Employment and Your Conscience". (November 15, 1964). The Watchtower, p. 680-683
  31. ^ (June 22, 1982). Awake!, p. 25
  32. ^ (June 15, 1982). The Watchtower, p. 31
  33. ^ The WatchtowerMarch 1, 1989 p. 30
  34. ^ (June 15, 2000). The Watchtower, p. 29-31
  35. ^ (October 15, 2000). The Watchtower, p. 31
  36. ^ (March 1, 1989). The Watchtower, p. 31
  37. ^ (March 15, 1989). The Watchtower, p. 30
  38. ^ The Watchtower June 15, 2004 P.24 par. 16
  39. ^ (2003) Transfusion-Alternative-Strategies Simple, Safe, Effective [Movie]. United States of America: Watchtower Bible & Tract Society.
  40. ^ January 3,2006 Letter from Christian Congregation of Jehovah’s Witnesses; To all Congregations
  41. ^ Jehovah's Witnesses, Blood Transfusions and the Tort of Misrepresentation, Journal of Church and State (2005), Volume 47, Number 4, Autumn, p. 816
  42. ^ Ibid., p. 808: "[The Watchtower Society] builds a case that other doctors wish all surgeons would become bloodless surgeons, when in fact those doctors recognize the benefits of blood transfusions for those who are in desperate need."
  43. ^ Franz, Raymond. Crisis of Conscience, p. 30-31
  44. ^ ibid., p. 30-31

[edit] See also

[edit] External links

[edit] Online articles

[edit] Websites

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