Blood Transfusion

—Why Not for Jehovah's Witnesses?

"To Aiemban oft tka Medical ftio^ettion:

Jehovah’s Witnesses appreciate that through your skillful practice of medicine you have been able to aid many persons. Blood transfusion may have been one of your principal treatment tools.

Since blood transfusions are so widely used, many in the medical field have been perplexed by Jehovah’s Witnesses’ refusal to accept blood. Logical questions arise, such as: Why do Jehovah’s Witnesses believe as they do? What does their stand respecting blood mean for you who are in the medical profession? And what can you do if you are called on to treat one of Jehovah’s Witnesses?

Some persons have mistakenly concluded that Jehovah’s Witnesses disagree with the practice of medicine or that we want to be martyrs. Both ideas are incorrect. When ill or injured we willingly seek medical help, for we desire to stay alive and enjoy good health. From our study of the Bible we have come to view life as sacred, something to treasure, not to squander or needlessly endanger.

It is not our intent here to take issue with the medical or scientific advisability of blood transfusions. You who are authorities in the field of medicine appreciate that blood transfusion is a “standard medical practice’’ in many situations. The fact is, though, that our objection to accepting blood is not primarily a medical one; it is a Biblical or religious objection.

We understand the Bible to prohibit a Christian’s taking blood, sustaining his life with blood. In a number of places the Bible pointedly forbids consuming blood. And the Bible book of Acts sets forth a command to all Christians to “abstain from . . . blood.” (Acts 15:20, 28, 29; 21:25) Abstaining from blood is therefore as important for Christians as abstaining from idolatry or fornication.

True, persons of various religions may have differing views as to the meaning of these Bible passages. But we, Jehovah’s Witnesses, understand these important texts as ruling out blood transfusions. For more details about the Biblical basis for this position, and confirmation of it from the history of early Christians, we invite you to read our booklet Jehovah’s Witnesses and the Question of Blood.

So it is for religious reasons that Jehovah’s Witnesses do not accept blood transfusions. We appreciate that this stand might seem to a doctor to be a dangerous one. And it might appear to put a reed limitation on what a physician or a hospital staff can do. But Jehovah’s Witnesses do not expect those in the medical profession to do the impossible in providing medical care. We simply ask that you do the best you can within the bounds of this religious limitation, just as you do the best you can when caring for a patient whose physical condition puts upon you certain limitations. We appeal to your conscience and your respect foi' fundamental human rights to acknowledge our right to worship without our being asked to do what is not possible for us—disobey God.

Not only may there be conflicting professional views over what is in a patient’s best interest and lasting welfare, but also there is the matter of a patient’s beliefs and wishes to consider. As was pointed out in the Canadian Medical Association Journal:

“It is an axiom of practice that nothing may be done to or for a patient without that patient’s permission. Even though a doctor thinks that without treatment a patient may come to harm, without consent he may not administer the treatment he considers necessary. A doctor is not God, nor is he a dictator, and he may not impose treatment against a patient’s wishes.”—Vol. 96, No. 2, p. 98.

This is the principle of "bodily integrity,” that each person has the right to be the final authority over what will be done to him. The courts in free lands have often upheld this right even in cases involving medical treatment where life is at stake. This principle of “bodily integrity” comes into focus when one of Jehovah’s Witnesses declines a medical recommendation that he accept blood.

Jehovah’s Witnesses are aware that in certain extreme cases our Biblebased stand on blood might seem as if it could bring fatal consequences. However, we do not want anyone in the medical profession to feel responsible for any seemingly harmful results of our determination to obey God. It is our responsibility and we accept it.

Yet, what is a doctor or nurse to do when a Witness seems to need blood? The book Blood Transfusion, edited by Dr. C. M. Ballinger, explains that sometimes a physician may thus feel that he cannot handle the case. But it also states that the doctor may choose to:

"... require the patient to sign a written refusal to permit a transfusion. This refusal is in the form of a request that no blood or derivatives be administered to the patient, notwithstanding the fact that such treatment might be necessary to preserve life or to promote recovery. Embraced within the form is a release by which the attending physician, those assisting him, the hospital and all its personnel are acquitted of any responsibility whatever for any ‘untoward results' arising from the refusal to permit the use of blood."—International Anesthesiology Clinics, Vol. 5, No. 4, p. 1052.

Jehovah’s Witnesses will cooperate with this suggestion. A form approved by the American Medical Association is set out on page 29 of our booklet on blood. By signing such a waiver we willingly relieve doctors and their associates of any responsibility or liability for possible adverse consequences of our refusing blood.

The fact is that in most instances much medical help can be given to Jehovah’s Witnesses without blood being administered. Reports bearing this out are found in numerous publications. For example, Professor W. H. Brummelkamp, a surgeon in Amsterdam, Netherlands, recently wrote:

“Every surgeon who has often operated on Jehovah's Witnesses knows that by means of calmness, extreme carefulness and a measure of skill, in addition to good communications with the anesthetist, almost all surgery on this group of patients can be done successfully.”—Plasmavervangingsmiddelen (Plasma Substitutes), edited by Drs. A. Jansz and A. van der Kuy, pp. 93, 94.

Such surgery has been accomplished successfully by employing extremely careful operative techniques and using plasma volume expanders, for example Ringer’s lactate solution and dextran. Jehovah’s Witnesses have no religious objection to the use of such nonblood solutions. Medical reports show that surgeons have thus been able to perform extensive operations on all parts of the body. In fact, in their article “Open Heart Surgery Without Blood Transfusion,” a group of surgeons reasoned:

“If these major operative procedures usually can be performed without the aid of transfusion, is this not an indication that some lesser operations may similarly be performed? Are not the hazards of blood transfusions needlessly accepted in many instances where the operation could quite safely be undertaken without the use of additional blood?”—Surgery Digest, Vol. 7, No. 5, p. 31.

From your experience and study you probably are well aware of some of the significant “hazards of blood transfusions.” In this regard we believe that you will find noteworthy the medical information about transfusions and medical ethics reviewed in our booklet. But let us emphasize that in referring to such acknowledged dangers, we do not mean that Jehovah’s Witnesses object to blood transfusions primarily for medical reasons. And we recognize that each person in the medical profession likely has his own view about the advisability of transfusions. Our point is, however, that rather than face the “hazards of blood transfusions,” we are willing to accept any seeming hazards resulting from our not receiving blood. Furthermore, we respect the good judgment of skilled, courageous surgeons as to alternative therapies.

This is an extremely serious matter for Jehovah’s Witnesses. It involves our solemn obligation to God. We are providing this brief statement of our position so that medical personnel can be aware that our refusing blood is not a rash decision made on the spur of the moment. It is a well-thought-out determination resulting from our sincere religious convictions.

We urge persons in the medical profession to display their true interest in the total welfare of patients. As you know, increasingly doctors are emphasizing the need to treat the “whole man.” With regard to Jehovah’s Witnesses, this involves recognizing that their lasting welfare would not be served by attempting to override their fundamental religious conviction about blood. For, as a group of surgeons who are experienced in treating Jehovah’s Witnesses pointed out, “who would benefit if the patient’s corporal malady is cured but the spiritual life with God, as he sees it, is compromised, which leads to a life that is meaningless and perhaps worse than death itself”?—New York State Journal of Medicine, Vol. 76, No. 5, p. 766.

We respectfully appeal to all members of the medical profession to employ their skills and experience in aiding patients who are Jehovah’s Witnesses. Our religious obligation to avoid accepting blood transfusions can be accommodated successfully. Doctors and nurses who have done so have found Jehovah’s Witnesses to be cooperative, appreciative patients. And they are patients whose Bible-based desire to live adds a vital ingredient to the skilled efforts of medical personnel.

Respectfully,

Printed in U.S.A.