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Jehovah's Witnesses doctrinal position about use of blood

Jehovah's Witnesses believe that the Bible prohibits Christians from accepting blood transfusions. Their literature states that, "'abstaining from blood' means not accepting blood transfusions and not donating or storing their own blood for transfusion." The belief is based on an interpretation of scripture that differs from other Christian denominations. It is one of the doctrines for which Jehovah's Witnesses are best known. 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, even in an emergency. 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. 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 and are subsequently shunned by members of the organization. Although the majority of Jehovah's Witnesses accept the doctrine, a minority do not. The Watch Tower Society has established Hospital Information Services to provide education and facilitate bloodless surgery. This service also maintains 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. Hospital Information Services researches medical journals to locate information on the availability and effectiveness of bloodless surgery methods. 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 Act (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.

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. 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. In 1958, The Watchtower reported on a particular member of Jehovah's Witnesses who voluntarily accepted blood transfusion, contrary to Watch Tower Society doctrine. The organization confirms that members have accepted blood transfusions, despite the imposition in 1961 of a communal shunning policy for willful acceptance. In 1982, a peer reviewed case study of a congregation of 59 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 researchers stated, "The members of this congregation are adamant in their refusal to accept all blood products Not one of the members stated they would receive a blood transfusion even if their refusal meant death, Almost one third of the respondents had personally refused blood transfusions". However, the study also showed that seven respondents were willing to accept plasma transplants and one member an autotransfusion, both therapies forbidden by Jehovah's Witnesses' doctrine. The researchers commented, "There is either some lack of understanding or refusal to follow doctrine among some members". The researchers noted that contact details of the respondents were provided by congregation elders, which may have influenced the responses given. Another 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. 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 (c. 1927–1931), 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.

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. conflicts with its own teachings that Christians are not under the Mosaic law. Theologian Anthony Hoekema 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.

Osamu Muramoto has argued that the refusal by Jehovah's Witnesses of "life saving" blood treatment 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." 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 Watch Tower Society 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 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. also claims that Witness publications exaggerate the medical risks of taking blood and the efficiency of non blood medical therapies in critical situations. 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." 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."

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. The Watch Tower Society's 1990 brochure How Can Blood Save Your Life? 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. 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?" 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.