Jehovah's Witnesses believe that the Bible prohibits ingesting blood and that Christians should not accept blood transfusions or donate or store their own blood for transfusion.[1] The belief is based on an interpretation of scripture that differs from that of other Christian denominations.[2] It is one of the doctrines for which Jehovah's Witnesses are best known.[3] Jehovah's Witnesses' literature teaches that their 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,[4][5] even in an emergency.[6] Witnesses are taught that the use of fractions such as albumin, immunoglobulins and hemophiliac preparations are "not absolutely prohibited", and are instead a matter of personal choice.[5] The doctrine was introduced in 1945, and has undergone some changes since then. Members of the group who voluntarily accept a transfusion and are not deemed repentant are regarded as having disassociated themselves from the group by abandoning its doctrines[7][8][9] and are subsequently shunned by members of the organization.[10] Although accepted by the majority of Jehovah's Witnesses, a minority does not endorse this doctrine.[11][12] 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. Contents

Doctrine Edit

Bloodless surgery Edit

Acceptance among Jehovah's Witnesses Edit

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.[53][54][55] Those Jehovah's Witnesses who accept the blood doctrine typically hold strongly to their conviction.[56] 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.[57] In 1958, The Watchtower reported on a particular member of Jehovah's Witnesses who voluntarily accepted blood transfusion, contrary to Watchtower doctrine.[58] The organization confirms that members have accepted blood transfusions, despite the imposition in 1961 of a communal shunning policy for willful acceptance.[59][60] 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.[53] 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.[61] 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.[55] Watch Tower publications have noted that within religions, the personal beliefs of members often differ from official doctrine.[62] 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?"[63] 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 denomination, offered a firsthand eyewitness account of Jehovah's Witnesses in the Nazi Ravensbrück concentration camp. 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.[64]

History of doctrine Edit

From 1931, when the name "Jehovah's witnesses" was adopted, Watch Tower Society publications maintained the view of Society founder Charles Taze Russell 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.[65][66] Watch Tower publications during the presidency of Joseph Franklin Rutherford commended the commercial and emergency uses of blood.[67][68] A 1925 issue of The Golden Age commended a man for donating blood 45 times without payment.[69] 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".[70] 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.[71] 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'."[72] 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: When we lose our life because we refuse inoculations, that does not bear witness as a justification of Jehovah's name. God never issued regulations which prohibit the use of drugs, inoculations or blood transfusions. It is an invention of people, who, like the Pharisees, leave Jehovah's mercy and love aside.[73] 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.[74] In 1945, the application of the doctrine on blood was expanded to prohibit blood transfusions of whole blood, whether allogeneic or autologous.[75] 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"[76]—it was ruled that it was a disfellowshipping offense to conscientiously accept a blood transfusion.[77] 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."[78] In September 1956, Awake! stated, "certain blood fractions ... also come under the Scriptural ban".[79] A position against "the various blood fractions" was reiterated in September 1961.[80] 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.[81] 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."[82] In 1964, Jehovah's Witnesses were prohibited from obtaining transfusions for pets, 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.[83] 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."[84] 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.[85] In 1989 The Watchtower stated, "Each individual must decide" whether to accept hemodilution and autologous blood salvage (cell saver) procedures.[86] 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.[87] 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.[88] 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.[89] 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.[90] Watch Tower Society publications frequently claim 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." [91]

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 "contains 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." [92]

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 "contains 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." [93]

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 Centers 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. [94]

cited a Centers 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).[95]

Critical views Edit

Opposition to the Watch Tower doctrines on blood transfusions has come from both members and non-members. A group of dissident Witnesses known as Associated Jehovah's Witnesses for Reform on Blood (AJWRB) states that there is no biblical basis for the prohibition of blood transfusions and seeks to have some policies changed.[96] In a series of articles in the Journal of Medical Ethics US 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, selective use of information by the Watch Tower Society to exaggerate the dangers of transfusions and the use of outdated medical beliefs. Scriptural interpretation Edit Dissident Witnesses say the Society's use of Leviticus 17:12 to support its opposition to blood transfusions[97][98] conflicts with its own teachings that Christians are not under the Mosaic law.[99][100] Theologian Anthony Hoekema claims the blood prohibited in Levitical laws was not human, but animal. He cites other authors[101] 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.[102] Coercion Edit Osamu Muramoto has argued that the refusal by Jehovah's Witnesses of "life-saving" blood treatment[103] 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.[100][103] 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.[8][100][104] In one particular case involving a Russian district court decision, however, the European Court of Human Rights (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."[105] 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.[106][107][108] 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!"[109] 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.[108][110] 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.[111] 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".[109] Selective use of information Edit Muramoto has claimed many Watch Tower Society publications employ exaggeration and emotionalism to emphasize the dangers of transfusions and the advantages of alternative treatments, but present a distorted picture by failing to report any benefits of blood-based treatment. Nor do its publications acknowledge that in some situations, including rapid and massive haemorrhage, there are no alternatives to blood transfusions.[100][112] He claims Watch Tower Society 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.[113] Attorney and former Witness Kerry Louderback-Wood[114] also claims that Witness publications exaggerate the medical risks of taking blood and the efficiency of non-blood medical therapies in critical situations.[115] Douglas E. Cowan, an academic in the sociology of religion, has claimed that members of the Christian countercult movement who criticize the Watch Tower Society, make selective use of information themselves. For example, Christian apologist Richard Abanes wrote that their ban on blood transfusions, "has led to countless Witness deaths over the years, including many children."[116] Cowan wrote: "When the careful reader checks [Abanes' footnote], however, looking perhaps for some statistical substantiation, he or she finds only a statistical conjecture based on 1980 Red Cross blood use figures." Cowan also says Abanes omits "critical issues" in an attempt to "present the most negative face possible." Cowan wrote that "the reader is left with the impression that the Watchtower Society knowingly presides over a substantial number of preventable deaths each year."[117] Edit 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.[118] A 1990 Watch Tower brochure on blood quoted a 17th-century anatomist to support its view.[119] Muramoto says the view that blood is nourishment—still espoused in Watch Tower publications[120]—was abandoned by modern medicine many decades ago.[100] He has criticized an analogy commonly used by the Society[121] 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?"[118] 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."[100] 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.[122] 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.[109] Inconsistency Edit See also: Criticism of Jehovah's Witnesses § Blood 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.[100] 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 Body, to which Witnesses must adhere strictly on the premise of them being Bible-based "truth".[100] 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.[100] 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.[123] 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.[112] 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.[115] Witnesses respond that the real issue is not of the fluid per se, but of respect and obedience to God.[124][125] They say their principle of abstaining from blood as a display of respect is demonstrated by 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.[126] Jehovah's Witnesses' view of meat and blood is different from that of kosher Jewish adherents, who go to great lengths to remove minor traces of blood.[127][128]

See also Edit

References Edit