Jehovah’s Witnesses are well known for their refusal to accept blood transfusions. This is based on their interpretation of biblical passages that prohibit ingesting blood. However, organ and tissue transplants involve complex medical and ethical issues that go beyond just the use of blood.
Jehovah’s Witness beliefs on blood transfusions
Jehovah’s Witnesses base their objection to blood transfusions on several bible verses:
- Genesis 9:4 “Only flesh with its life—its blood—you must not eat.”
- Leviticus 17:10 “If anyone from the house of Israel or foreigner who resides among them eats any blood, I will set my face against the one who eats the blood, and I will cut him off from among his people.”
- Acts 15:28, 29 “…abstain from blood…”
They believe these verses prohibit taking blood into the body through any means, including transfusions. This is a foundational doctrine for Jehovah’s Witnesses, and those who accept transfusions are subject to expulsion from the congregation.
Changes in organ transplant policy
In the past, Jehovah’s Witnesses were told transplants were unacceptable. This was because transplants were believed to be inseparable from blood transfusions. However, the Watchtower Society—the organization that provides spiritual guidance to Jehovah’s Witnesses—has adjusted its stance over time as medical techniques have advanced.
Key chronological changes include:
- 1967 – Organ transplants are prohibited as a form of cannibalism.
- 1980 – Transplants of individual organs or tissues permitted if blood is not transfused.
- 2012 – Publication of Jehovah’s Witness brochure “How Can Blood Save Your Life?” This provided official updated guidance on organ transplants without blood transfusions.
Thus, the current position is Jehovah’s Witnesses may accept organ transplants as long as blood is not transfused. However, individuals are left to make their own conscientious decision on the matter.
Requirements for bloodless transplants
Jehovah’s Witness patients who opt for organ transplantation face the challenge of arranging bloodless surgery. This requires:
- Finding a cooperative surgical team willing to perform a bloodless transplant.
- Meticulous planning by the surgical team to conserve blood and minimize blood loss.
- Use of blood conservation strategies, such as cell salvage and normovolemic hemodilution.
- Accepting higher surgical risks due to lack of transfusions.
Ideally, the organ donor would also be a Jehovah’s Witness. This ensures the organ itself contains little blood when transplanted.
Cell salvage
Cell salvage involves collecting blood lost during surgery, separating out the red blood cells, and then transfusing them back into the patient. This allows Jehovah’s Witnesses to accept blood that has never been disconnected from their own bodies.
Normovolemic hemodilution
This technique involves removing some of the patient’s blood before surgery and replacing it with non-blood fluids to dilute the blood. The blood can then be transfused back if needed during surgery.
What organs and tissues can be transplanted?
Jehovah’s Witnesses allow transplants of tissues considered less “living” and that contain lower amounts of blood. Therefore:
- Cornea and kidney transplants are generally accepted.
- Transplants of more “living” organs like the liver, lungs, and heart are more controversial.
- Transplants of organs with large blood supplies such as bone marrow are often not approved.
Ultimately, it is up to each individual Jehovah Witness to decide which transplant procedures align with their conscience.
Alternative treatments without transfusions
Doctors have identified various alternative treatments that can help Jehovah’s Witness patients avoid transfusions:
| Medical condition | Non-blood medical management |
|---|---|
| Blood loss anemia | Iron supplements, erythropoietin drugs |
| Clotting disorders | Clotting factors from donor plasma, desmopressin |
| Leukemia | Chemotherapy, leukapheresis, erythropoietin |
| Childbirth | Fluids, drugs to contract uterus |
Thus, while avoiding blood transfusions poses medical challenges, there are treatments that can assist Jehovah’s Witness patients.
The risks of refusing transfusions
Despite alternative treatments, refusing blood transfusions can significantly increase health risks. These include:
- Higher mortality rates for surgical procedures and childbirth.
- Increased complications during surgery and slower recovery times.
- Limitations on managing conditions like leukemia, severe anemia, and trauma.
- Possibility of cognitive impairment in babies due to neonatal anemia.
However, many Jehovah’s Witnesses accept these risks as part of faithfully upholding their biblical principles.
Ethical issues
The Jehovah’s Witness position raises ethical concerns for some doctors who feel bound to provide transfusions when a life is at risk. However, many medical ethicists believe patient autonomy should be respected, provided certain conditions are met:
- The patient is an adult capable of making an informed choice.
- There is no evidence of coercion from others.
- The choice will not create a major public health risk.
Legally, competent adult patients have the right to refuse medical treatments. However, doctors may seek court orders for transfusions when minors or pregnant women are involved.
The impact on families
Refusing transfusions can cause great distress for Jehovah’s Witness families. Despite believing they are adhering to God’s law, it can be heartbreaking to watch loved ones suffer complications and death due to lack of blood.
Jehovah’s Witness parents may be judged as failing to provide necessary medical care. But most love their children and are trying to do what they believe is right. Extended family who are not Witnesses can feel anger and frustration at the refusal of transfusions for nieces, nephews or grandchildren.
Such family divisions add further heartache at already stressful times of medical crisis and bereavement. Counseling services can assist families struggling to cope with the consequences of refusing blood.
The success of bloodless medicine programs
Many hospitals now offer specialized bloodless medicine programs. These bring together teams skilled in performing surgery without transfusions. Such programs advertise success rates comparable to other methods. However, critics argue there is selection bias, as Jehovah’s Witness patients are often relatively younger and healthier.
Nevertheless, bloodless techniques cultivated to help Jehovah’s Witnesses are now being applied to wider patient groups. The blood conservation strategies developed enable surgery on patients unable to tolerate transfusions for other reasons, such as religious objections or blood diseases.
Conclusion
Jehovah’s Witnesses believe God’s law prohibits blood transfusions. However, their position on organ and tissue transplants is more nuanced, provided blood is not transfused. While this poses medical challenges, techniques like cell salvage and hemodilution can aid bloodless transplant surgery.
Refusing transfusions significantly increases health risks. But most bioethicists and legal experts uphold patient autonomy. With skillful management, successful outcomes can be achieved without transfusions, although critical cases remain very high risk.
The Witness stance on blood continues to spark debate. But advances in blood conservation surgery pioneered to help Jehovah’s Witnesses have expanded medical options for all.
