Jehovahs Witnesses and the question of blood (1977)

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Jehovah’s Witnesses and the Question of Blood

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Contents

Title Page/Publishers’ Page

Table of Contents

Jehovah’s Witnesses and the Question of Blood

Title Page/Publishers’ Page

Title Page/​Publishers’ Page

Jehovah’s Witnesses and the Question of Blood

Table of Contents

Table of Contents

4 Why Do Jehovah’s Witnesses Not Accept Blood?

17 Blood As Medicine

20 Is Refusing Blood a Form of Suicide?

24 The Doctor’s Role

33 When Children Are Involved

38 Is It Medically Unreasonable to Refuse Blood?

41 Blood Transfusions​—How Dangerous?

49 Alternative Therapies

55 Major Surgery Without Blood

58 What Will You Do?

61 References

Jehovah’s Witnesses and the Question of Blood

Jehovah’s Witnesses and the Question of Blood

1. What fact about blood is being better understood?

1 BLOOD is vital to life. Though this has been recognized from ancient times, modern research is providing a greater understanding of its life-sustaining functions.

2. What is an accepted therapeutic method, but who disagree?

2 The practice of transfusing human blood holds a prominent position in modern medical care. Those in the medical field and many others regard the transfer of blood from one human to another as an accepted therapeutic method.⁠1a But there are people who do not accept blood transfusions. They are Jehovah’s Witnesses.

3, 4. What Bible view do Jehovah’s Witnesses hold regarding life, and what questions does this raise?

3 Jehovah’s Witnesses cherish and deeply respect life. This is one of the reasons why they do not smoke, use addictive drugs or seek abortions. They have learned from the Bible to view life as sacred, something to be protected and preserved both for themselves and for their children.

4 Why, then, do Jehovah’s Witnesses object to blood transfusions? Is there some rational basis for this conviction that they hold to even in the face of death? And is their position on the matter totally incompatible with modern medical knowledge and principles?

5. What is the purpose of this publication, and how will the matter be handled?

5 This topic should be of interest to everyone in the medical profession, for at any time a doctor may be confronted with the blood transfusion issue. This is quite possible, as there are more than two million of Jehovah’s Witnesses earth wide. Probably some of them are living in your community. The following is written to aid doctors to understand Jehovah’s Witnesses as patients and to consider how their view can be reasonably accommodated. First we will examine the religious basis for their position. Then, beginning on page 17, we will consider the ethics involved and some recent findings and observations by qualified doctors that may be of practical value in resolving problems regarding the use of blood.

6. To whom is this subject of interest?

6 Even persons who are not in the medical field are invited to look into this important matter. The position that Jehovah’s Witnesses take on blood actually involves rights and principles that can affect each one of us. And a knowledge of what they believe, and why, will aid a person to understand better this issue that has often been of concern to doctors, jurists, and students of the Bible. What, then, are the key factors in the issue?

The Religious Basis

7. What are some views as to the use of blood, and on what basis do Jehovah’s Witnesses take a stand on blood?

7 Most doctors view the use of blood essentially as a matter of medical judgment, much as their daily decisions about using certain medicines or surgical procedures. Other persons may view the position of Jehovah’s Witnesses as more of a moral or legal question. They may think in terms of the right to life, authority to make decisions about one’s own body, or the civil obligations of the government to protect the lives of its citizens. These aspects all bear on the matter. Yet the stand taken by Jehovah’s Witnesses is above all a religious one; it is a position based on what the Bible says.

8. In view of the position taken by Jehovah’s Witnesses, what question logically arises?

8 Many persons may wonder about the validity of the above statement. They are aware that numerous churches support the use of blood, establishing blood-bank programs and encouraging the donation of blood. Accordingly, the question logically arises:

What does the Bible say about humans taking blood into their bodies?

9, 10. What shows that the Bible has much to say about blood, and what command regarding blood did God give early in mankind’s history?

9 Even individuals who do not personally view the Bible to be the inspired word of God must acknowledge that it has much to say about blood. From the first book of the Bible through to the last, “blood” is mentioned more than four hundred times. Certain Bible verses are especially pertinent to the question of sustaining life with blood. Let us briefly examine them:

10 The Bible record shows that early in mankind’s history the Creator and Life-Giver expressed himself on the issue of blood. Right after the global flood, when God first granted humans the right to eat animal flesh, he commanded Noah and his family: “Every moving animal that is alive may serve as food for you. As in the case of green vegetation, I do give it all to you. Only flesh with its soul​—its blood—​you must not eat.”​—Genesis 9:3, 4.

11. What shows that in the killing of animals more is involved than just the matter of diet?

11 First of all, the Creator was providing a dietary regulation at a time when mankind was making a new start. (Compare Genesis 1:29.) God showed, however, that in killing animals for food more was involved than diet. That was because the blood of a creature represented its life or its soul. Thus, some Bible translations render Genesis 9:4 as: “Only you shall not eat flesh with its life, that is, its blood.”​—Revised Standard Version; Moffatt.

12, 13. What did the Creator attach to the use of blood, and how do we know that not just the blood of animals is involved?

12 So this divine regulation was not merely a restriction on diet, such as a doctor’s advising a patient to avoid salt or fat. The Creator attached a highly important moral principle to blood. In pouring out all the blood that reasonably could be drained out, Noah and his descendants would manifest their regard for the fact that life was from and depended upon the Creator. But let us examine this matter further.

13 The above-quoted scripture applies to animal blood. Would the same principle apply to human blood? Yes, with even stronger force. For God went on to say to Noah: “Besides that, your blood of your souls shall I ask back. . . . Anyone shedding man’s blood, by man will his own blood be shed, for in God’s image he made man.” (Genesis 9:5, 6) Now, if animal blood (representing animal life) was of sacred significance to God, obviously human blood had a sacred significance of even greater value. Persons complying with these divine directions would not be shedding the blood of (killing) humans, nor would they be eating either animal or human blood.

However, was this command to Noah only a limited or temporary restriction? Does it have a bearing on later generations, including ours?

14, 15. What was the nature of the command to Noah regarding blood, and what comments by a rabbi are pertinent here?

14 Many Bible scholars recognize that God here set out a regulation that applied, not merely to Noah and his immediate family, but to all mankind from that time on​—actually all those living since the Flood are from Noah’s family. (Genesis 10:32) Theologian and Reformationist John Calvin, for example, acknowledged about the prohibition on blood that “this law had been given to the whole world immediately after the flood.”⁠2 And Gerhard von Rad, professor at Heidelberg University, refers to Genesis 9:3, 4, as “an ordinance for all mankind,” because all mankind has descended from Noah.⁠3

15 Since the law on blood was linked with God’s pronouncement that emphasized a high regard for human life, we can appreciate the observations of Rabbi Benno Jacob:

“Thus the two prohibitions belong together. They are the most elementary demands of humanity in the literal sense of the word. . . . The permission to eat meat, but without its blood, and the prohibition against shedding human blood indicate the place of man within the world of the living . . . In summary: the reason for the prohibition of blood is of a moral character. . . . Later Judaism regarded this passage as establishing fundamental ethics for every human being.” (Italics added.)⁠4

In fact, later Jews drew from the early part of Genesis seven “basic laws” for mankind, and this command to Noah and his sons about blood was one of them.⁠5 Yes, despite the fact that most nations did not follow it, this was actually a law for all mankind.​—Acts 14:16; 17:30, 31.

16, 17. What law to Israel showed that God’s ban on blood still applied, and what was the only way Israelites could use blood?

16 Later in his law given to the nation of Israel, Jehovah God prohibited murder, bearing out that the mandate he had given to Noah was still in effect. (Exodus 20:13) Correspondingly, God also forbade consuming blood, saying:

“As for any man of the house of Israel or some alien resident who is residing as an alien in their midst who eats any sort of blood, I shall certainly set my face against the soul that is eating the blood, and I shall indeed cut him off from among his people.”​—Leviticus 17:10.

17 The Israelites were allowed to use animal blood only in one way. That was in offering it up as a sacrifice to God, acknowledging him as the Life-Giver to whom they were indebted. He told them: “The soul of the flesh is in the blood, and I myself have put it upon the altar for you to make atonement for your souls, because it is the blood that makes atonement by the soul [or life] in it.”​—Leviticus 17:11.

18, 19. (a) What precaution were Israelite hunters required to take when they killed animals for food, and why? (b) By heeding this command, they showed recognition of what fact?

18 How about the blood of animals killed for food, not for sacrifice? God told his worshipers that a hunter who caught a wild beast or fowl “must in that case pour its blood out and cover it with dust. For the soul of every sort of flesh is its blood by the soul in it. Consequently I said to the sons of Israel: ‘You must not eat the blood of any sort of flesh, because the soul of every sort of flesh is its blood. Anyone eating it will be cut off.’”​—Leviticus 17:13, 14; Deuteronomy 12:23-25.

19 This pouring out of the blood was not simply a religious ritual; it actually was an extension of the divine law given to Noah. When killing an animal, a person should recognize that its life comes from and belongs to God. By not eating the blood, but ‘pouring it out’ on the altar or on the ground, the Israelite was, in effect, returning the creature’s life to God.

20. (a) What penalties show that violating God’s law on blood was a serious offense? (b) Which scriptures show that eating flesh with the blood in it resulted in guilt?

20 For an Israelite to show disregard for life as represented by the blood was viewed as a most serious wrong. The person deliberately disregarding this law about blood was to be “cut off,” executed. (Leviticus 7:26, 27; Numbers 15:30, 31) A measure of guilt resulted even from eating the blood-containing flesh of an animal that died of itself or that was killed by a wild beast.​—Leviticus 17:15, 16; compare Leviticus 5:3; 11:39.

Could God’s law on blood be set aside in times of emergency?

21. Which Scriptural example shows that God’s law on blood could not be set aside in emergencies?

21 The Bible answers, No. There was no special dispensation for times of stress. We can see this from what occurred with some soldiers of Israel in the days of King Saul. Famished after a long battle, they slaughtered sheep and cattle and “fell to eating along with the blood.” They were hungry and were not deliberately eating blood, but in their haste to eat the meat they did not see to it that the animals were properly bled. Did the fact that this seemed to be an “emergency” excuse their course? On the contrary, their God-appointed king recognized their action as ‘sinning against Jehovah by eating along with the blood.’​—1 Samuel 14:31-35.

Does this proper aversion to blood apply to human blood also?

22. Why is it reasonable to conclude that God’s law regarding animal blood also applies to human blood?

22 Yes. And that is altogether understandable for God’s law prohibited consuming “any sort of blood,” “the blood of any sort of flesh.” (Leviticus 17:10, 14) We can see how the Jewish nation regarded this law by considering an incident involving some of the Jews who had followed and listened to Jesus. On one occasion he spoke figuratively about ‘drinking his blood,’ for he knew that in time his blood must be poured out in a sacrificial death and that it would result in life to those who, by faith, accepted his sacrifice. (John 6:53-58) Evidently not realizing that Jesus was speaking symbolically, some of his Jewish disciples were shocked over his words and left off following him. (John 6:60-66) Yes, the thought of taking in human blood was absolutely abhorrent to those Jewish worshipers of God.

What About Christians?

23. What effect did the Messiah’s sacrificial death have on the dietary restrictions of the Mosaic law?

23 The Mosaic law pointed to the coming and sacrificial death of the Messiah. Hence, after Jesus died, true worshipers were no longer obliged to keep the Mosaic law. (Romans 10:4; 6:14; Colossians 2:13, 14) Dietary restrictions of the Law, such as those against eating fat or the flesh of certain animals, were no longer binding.​—Leviticus 7:25; 11:2-8.

So, does the divine prohibition against blood apply to Christians?

24. When dealing with the question of circumcision for Gentile Christians, what was decided regarding blood?

24 This matter came up for discussion in 49 C.E., during a conference of the apostles and older men of Jerusalem who served as a central body of elders for all Christians. The conference was held in response to a question about circumcision. This apostolic council decided that non-Jews who accepted Christianity did not have to get circumcised. During the discussion Jesus’ half brother James brought to the council’s attention certain other essential things that he deemed important to include in their decision, namely, “to abstain from things polluted by idols and from fornication and from what is strangled and from blood.” (Acts 15:19-21) He referred back to the writings of Moses, which reveal that even before the Law was given, God had disapproved of immoral sex relations, idolatry and the eating of blood, which would include eating the flesh of strangled animals containing blood.​—Genesis 9:3, 4; 19:1-25; 34:31; 35:2-4.

25. This decision of the apostolic council became a part of what?

25 The decision of the council was sent by letter to the Christian congregations. It is now included in the Bible as part of the inspired Scriptures that are beneficial “for teaching, . . . for setting things straight.” (2 Timothy 3:16, 17) The decision was:

26, 27. What did that decision explicitly state, and how do we know that it was not merely the apostles’ opinion?

26 “The holy spirit and we ourselves have favored adding no further burden to you, except these necessary things, to keep abstaining from things sacrificed to idols and from blood and from things strangled and from fornication. If you carefully keep yourselves from these things, you will prosper.”​—Acts 15:28, 29.

27 Yes, even though Christians were not under the Mosaic law, it was “necessary” that they abstain from blood. Was that just the apostles’ personal opinion? Not at all. As they stated, that decision was made in accord with God’s holy spirit.

28. According to Professor Walther Zimmerli, what distinction did that decree make?

28 Concerning that Christian decree, Professor Walther Zimmerli, of the University of Göttingen, Germany, commented:

“The first Judeo-Christian congregation in the decision reported on in Acts 15 made a distinction between the Law given to Israel through Moses and the command given [through] Noah to all the world.”​—Zürcher Bibelkommentare.⁠6

29. What indicates that the command to abstain from blood was a moral requirement and not merely a dietary one?

29 The command to ‘abstain from blood’ was not a mere dietary restriction but was a serious moral requirement, as is seen by the fact that it was as serious to Christians as ‘abstaining from idolatry or fornication.’

The Early Christians and Blood

30, 31. What shows the binding nature of the prohibition of blood and that it was not merely a temporary requirement?

30 The Jerusalem council sent this clear-cut decision to the Christian congregations, with positive results. We read in Acts chapter 16 concerning Paul and his associates: “As they traveled on through the cities they would deliver to those there for observance the decrees that had been decided upon by the apostles and older men who were in Jerusalem. Therefore, indeed, the congregations continued to be made firm in the faith and to increase in number from day to day.”​—Acts 16:4, 5.

Was the decision recorded in Acts 15:28, 29 merely a temporary requirement, not an obligation that continued to rest on Christians?

31 Some persons have held that the apostolic decree was not a permanent obligation for Christians. But the book of Acts clearly indicates otherwise. It shows that, about ten years after the Jerusalem council issued that decree, Christians continued to comply with the “decision that they should keep themselves from what is sacrificed to idols as well as from blood and what is strangled and from fornication.” (Acts 21:25) This shows that they were aware that the requirement to abstain from blood was not limited to Gentile converts in one area nor applicable for just a brief period.

32, 33. What does Eusebius say as to the prohibition of blood being recognized in his day?

32 But what was the situation in later centuries when Christianity spread into distant places? Let us consider the evidence from the centuries following the publishing of the decree recorded in Acts 15:28, 29.

33 Eusebius, a third century writer who is considered the “father of Church history,” relates what occurred in Lyons (now in France) in the year 177 C.E. Religious enemies falsely accused Christians of eating infants. During the torture and execution of some Christians, a girl named Biblias responded to the false accusation, saying: “How can we eat infants​—we, to whom it is not lawful to eat the blood of beasts.”⁠7

34-36. What did Tertullian and Minucius Felix say as to Christians not eating blood in their day?

34 Similar false charges moved the early Latin theologian Tertullian (c. 160-230 C.E.) to point out that though Romans commonly drank blood, Christians certainly did not. He writes:

“Let your unnatural ways blush before the Christians. We do not even have the blood of animals at our meals, for these consist of ordinary food. . . . At the trials of Christians you offer them sausages filled with blood. You are convinced, of course, that the very thing with which you try to make them deviate from the right way is unlawful for them. How is it that, when you are confident that they will shudder at the blood of an animal, you believe they will pant eagerly after human blood?”⁠8

35 Also, referring to the decree of Acts 15:28, 29, he says: “The interdict upon ‘blood’ we shall understand to be [an interdict] much more upon human blood.”⁠9

36 Minucius Felix, a Roman lawyer who lived until about 250 C.E., makes the same point, writing: “So much do we shrink from human blood, that we do not use the blood even of eatable animals in our food.”⁠10b

37, 38. What statements did a bishop and a Catholic Biblical scholar make on the subject of blood?

37 The historical evidence is so abundant and clear that Bishop John Kaye (1783-1853) could state categorically: “The Primitive Christians scrupulously complied with the decree pronounced by the Apostles at Jerusalem, in abstaining from things strangled and from blood.”⁠11

But are the ‘primitive Christians’ and Jehovah’s Witnesses in modern times the only ones to have taken such a view based on the Bible?

38 Not at all. Commenting on Acts 15:29, Catholic Biblical scholar Giuseppe Ricciotti (1890-1964) refers to the incident at Lyons (described previously) as evidence that early ‘Christians could not eat blood.’ Then he adds, “but even in succeeding centuries down to the Middle Ages, we encounter unexpected echoes of this early ‘abomination’ [of blood], due unquestionably to the decree.”⁠12

39. What did the Quinisext Council state regarding blood, and what did Otto of Bamberg say to new converts regarding blood?

39 For instance, the Quinisext Council held in 692 C.E. at Constantinople stated: “The divine Scripture commands us to abstain from blood, from things strangled, and from fornication. . . . If anyone henceforth venture to eat in any way the blood of an animal, if he be a clergyman, let him be deposed; if a layman, let him be cut off.”⁠13 Similarly, Otto of Bamberg (c. 1060-1139 C.E.), a noted prelate and evangelist, explained to converts in Pomerania “that they should not eat any thing unclean, or which died of itself, or was strangled, or sacrificed to idols, or the blood of animals.”⁠14

40. What did Martin Luther write regarding Acts 15:28, 29?

40 Moving closer to our time, Martin Luther also recognized the implications of the decree of 49 C.E. In protesting Catholic practices and beliefs he was inclined to group the apostolic council with later church councils whose decrees were not part of the Bible. Still, Luther wrote regarding Acts 15:28, 29:

“Now if we want to have a church that conforms to this council (as is right, since it is the first and foremost council, and was held by the apostles themselves), we must teach and insist that henceforth no prince, lord, burgher, or peasant eat geese, doe, stag, or pork cooked in blood . . . And burghers and peasants must abstain especially from red sausage and blood sausage.”⁠15

41. What comment did a Baptist theologian make on Genesis 9:3, 4?

41 In the nineteenth century Andrew Fuller, viewed as “perhaps the most eminent and influential of Baptist theologians,” wrote concerning the Genesis 9:3, 4 prohibition on blood:

“This, being forbidden to Noah, appears also to have been forbidden to all mankind; nor ought this prohibition to be treated as belonging to the ceremonies of the Jewish dispensation. It was not only enjoined before that dispensation existed, but was enforced upon the Gentile Christians by the decrees of the apostles, Acts XV. 20. . . . Blood is the life, and God seems to claim it as sacred to himself.”⁠16

42. What answer did clergyman William Jones give to those who would ignore the Bible’s prohibition of blood?

42 Might a Christian claim that the exercise of what some call “Christian liberty” should allow him to ignore this prohibition on blood? In his book The History of the Christian Church, clergyman William Jones (1762-1846) replies:

“Nothing can be more express than the prohibition, Acts XV. 28, 29. Can those who plead their ‘Christian liberty’ in regard to this matter point us to any part of the Word of God in which this prohibition is subsequently annulled? If not, may we be allowed to ask, ‘By what authority, except his own, can any of the laws of God be repealed?’”​—P. 106.

43. What is the determination of Jehovah’s Witnesses regarding blood, based on which facts and scriptures?

43 The conclusion is plain: Under the guidance of the holy spirit the apostolic council decreed that Christians who want God’s approval must ‘abstain from blood,’ as God has required since the days of Noah. (Acts 15:28, 29; Genesis 9:3, 4) This Scriptural view was accepted and followed by the early Christians, even when doing so would cost them their lives. And down through the centuries this requirement has been recognized as “necessary” for Christians. Thus the determination of Jehovah’s Witnesses to abstain from blood is based on God’s Word the Bible and is backed up by many precedents in the history of Christianity.

Blood as Medicine

44. What three points have been established, and what is the Scriptural basis for each?

44 Up to this point we have established that the Bible requires the following: A human is not to sustain his life with the blood of another creature. (Genesis 9:3, 4) When an animal’s life is taken, the blood representing that life is to be ‘poured out,’ given back to the Life-Giver. (Leviticus 17:13, 14) And as decreed by the apostolic council, Christians are to ‘abstain from blood,’ which applies to human blood as well as to animal blood.​—Acts 15:28, 29.

Do these Biblical statements, however, apply to the acceptance of transfused blood as a life-saving medical procedure?

45, 46. What question now presents itself, and what modern medical techniques may Bible principles be said to cover?

45 Some persons contend that the Bible forbids the eating of blood as a food and that this is fundamentally different from accepting a blood transfusion, a medical procedure that was not known in Bible times. Is that position valid?

46 There is no denying that in Bible times God’s law had particular application to consuming blood as food. Intravenous administration of blood was not then practiced. But, even though the Bible did not directly discuss modern medical techniques involving blood, it did in fact anticipate and cover these in principle.

47, 48. What distinction is not made at Acts 15:29, and for what reasons?

47 Note, for example, the command that Christians “keep abstaining . . . from blood.” (Acts 15:29) Nothing is there stated that would justify making a distinction between taking blood into the mouth and taking it into the blood vessels. And, really, is there in principle any basic difference?

48 Doctors know that a person can be fed through the mouth or intravenously. Likewise, certain medicines can be administered through various routes. Some antibiotics, for instance, can be taken orally in tablet form or injected into a person’s muscles or circulatory system (intravenously). What if you had taken a certain antibiotic tablet and, because of having a dangerous allergic reaction, were warned to abstain from that drug in the future? Would it be reasonable to consider that medical warning to mean that you could not take the drug in tablet form but could safely inject it into your bloodstream? Hardly! The main point would not be the route of administration, but that you should abstain from that antibiotic altogether. Similarly, the decree that Christians must ‘abstain from blood’ clearly covers the taking of blood into the body, whether through the mouth or directly into the bloodstream.

How important is this issue to Jehovah’s Witnesses?

49. What firm position do Jehovah’s Witnesses take, and of what are they convinced?

49 Persons who recognize their dependence on the Creator and Life-Giver should be determined to obey his commands. This is the firm position that Jehovah’s Witnesses take. They are fully convinced that it is right to comply with God’s law commanding abstention from blood. In this they are not following a personal whim or some baseless fanatical view. It is out of obedience to the highest authority in the universe, the Creator of life, that they refuse to take blood into their systems either by eating or by transfusion.

50, 51. What is at stake in the issue of blood, and to what words of the psalmist do we wholeheartedly subscribe?

50 The issue of blood for Jehovah’s Witnesses, therefore, involves the most fundamental principles on which they as Christians base their lives. Their relationship with their Creator and God is at stake. Furthermore, they wholeheartedly believe the psalmist’s words: “The judicial decisions of Jehovah are true; they have proved altogether righteous. . . . In the keeping of them there is a large reward.”​—Psalm 19:9, 11.

51 Some persons who look just at the short-term effect of decisions might doubt that obeying God’s law about blood can be considered ‘rewarding.’ But Jehovah’s Witnesses are sure that obeying the directions from their Creator is for their lasting good.

52, 53. What stand did the early Christians take and at what cost to themselves?

52 The early Christians felt the same. History shows that their obedience to God was sometimes tested to the limit. In the Roman Empire they were put under pressure to perform acts of idolatry or to engage in immorality. Their refusal to give in could mean being thrown into the Roman arena to be torn apart by vicious animals. But those Christians stuck to their faith; they obeyed God.

53 Think what that involved. For the early Christians who were parents, refusal to break God’s law might even bring death upon their children. Yet we know from history that those Christians did not fearfully and faithlessly turn their back on God and the principles by which they lived. They believed Jesus’ words: “I am the resurrection and the life. He that exercises faith in me, even though he dies, will come to life.” (John 11:25) Hence, despite the immediate cost, those Christians obeyed the apostolic decree to abstain from things sacrificed to idols, from fornication and from blood. Faithfulness to God meant that much to them.

54. What responsibility do Jehovah’s Witnesses shoulder?

54 Today it means that much to Jehovah’s Witnesses also. They rightly feel a moral obligation to make decisions about worship for themselves and for their children. For that reason, Jehovah’s Witnesses are not looking for anyone else, whether a doctor, a hospital administrator or a judge, to make these moral decisions for them. They do not want someone else to try to shoulder their responsibility to God, for in reality no other person can do that. It is a personal responsibility of the Christian toward his God and Life-Giver.

Is Refusal a Form of Suicide?

55, 56. (a) What objection is raised to refusing blood transfusions? (b) Why can Witnesses not be accused of suicide, as seen by the testimony of others?

55 In the face of massive blood loss from injury, disease or surgical complications, blood transfusions have often been administered in an attempt to preserve life. Hence, when persons hear that someone refuses a blood transfusion, they may feel that he is in effect taking his own life. Is that so?

Is it “suicide” or exercising one’s “right to die” to refuse a blood transfusion?

56 Suicide is a seeking to take one’s own life. It is an attempt at self-destruction. But anyone even casually acquainted with the beliefs and practices of Jehovah’s Witnesses can see that they are not attempting self-destruction. Though they refuse blood transfusions, they welcome alternative medical assistance. An article in The American Surgeon correctly commented:

“In general, refusing medical care is not tantamount to ‘suicide.’ Jehovah’s Witnesses seek medical attention but refuse only one facet of medical care. Refusal of medical care or parts thereof is not a ‘crime’ committed on oneself by an overt act of the individual to destroy, as is suicide.” (Italics added.)⁠17

Professor Robert M. Byrn pointed out in the Fordham Law Review that ‘rejecting lifesaving therapy and attempted suicide are as different in law as apples and oranges.’⁠18 And, addressing a medical conference, Dr. David Pent of Arizona observed:

“Jehovah’s Witnesses feel that, should they die because of their refusal to receive a blood transfusion, they are dying for their beliefs in much the same way that the early religious martyrs did centuries ago. If this is passive medical suicide, there are several physicians in the audience right now who are smoking cigarettes, and that probably constitutes just as passive a suicide.”⁠19

57. Why is refusing blood transfusions not an exercising of one’s right to die?

57 What about the idea that in refusing transfusions Jehovah’s Witnesses are exercising a “right to die”? The fact is that Jehovah’s Witnesses want to stay alive. That is why they seek medical help. But they cannot and will not violate their deep-seated and Bible-based religious convictions.

58. Which rights have the courts given individuals, and why logically so?

58 Courts of justice have often upheld the principle that each individual has a right to bodily integrity, meaning that in the final analysis a person himself is responsible to decide what will be done to his body. Really, is that not how you would want it to be if you were ill or hospitalized? Since it is your life, your health and your body, should you not have the final voice about whether something will be done to you or not?

59, 60. (a) Of what is the patient the final arbiter? (b) The right and duty of a physician is limited by what freedom of man?

59 There are logical consequences of this intelligent and moral view. A booklet produced by the American Medical Association explains: “The patient must be the final arbiter as to whether he will take his chances with the treatment or operation recommended by the doctor or risk living without it. Such is the natural right of the individual, which the law recognizes.” “A patient has the right to withhold his consent to lifesaving treatment. Accordingly, he can impose such terms, conditions, and limitations as he may desire upon his consent.”⁠20

60 That is true regarding blood transfusion just as much as with any other “lifesaving treatment.” Dr. jur. H. Narr of Tübingen, Germany, stated: “The right and the duty of the physician to heal is limited by man’s basic freedom of self-determination respecting his own body. . . . The same is true for other medical intervention, hence also for refusal of blood transfusion.”⁠21

61. What is the attitude of some persons regarding the preservation of life, but what question does this raise?

61 Understandably, some persons are shocked at the thought of anyone’s refusing blood if doing so could be dangerous or even fatal. Many feel that life is the foremost thing, that life is to be preserved at all costs. True, preservation of human life is one of society’s most important interests. But should this mean that “preserving life” comes before any and all principles?

62. According to N. L. Cantor, what shows that the sanctity of life is not the supreme value, and how might this be illustrated?

62 In answer, Norman L. Cantor, Associate Professor at Rutgers Law School, pointed out:

“Human dignity is enhanced by permitting the individual to determine for himself what beliefs are worth dying for. Through the ages, a multitude of noble causes, religious and secular, have been regarded as worthy of self-sacrifice. Certainly, most governments and societies, our own included, do not consider the sanctity of life to be the supreme value.”⁠22

Mr. Cantor gave as an example the fact that during wars some men willingly faced injury and death in fighting for “freedom” or “democracy.” Did their countrymen view such sacrifices for the sake of principle to be morally wrong? Did their nations condemn this course as ignoble, since some of those who died left behind widows or orphans needing care? Do you feel that lawyers or doctors should have sought court orders to prevent these men from making sacrifices in behalf of their ideals? Hence, is it not obvious that willingness to accept dangers for the sake of principle is not unique with Jehovah’s Witnesses and the early Christians? The fact is that such allegiance to principle has been highly regarded by many persons.

63. What position of the Witnesses precludes anyone from trying to force a treatment upon them that violates their principles?

63 Also, it is worthy of reemphasis that, although Jehovah’s Witnesses do not accept blood transfusions, they welcome alternative treatments that may help to keep them alive. Why, then, should anyone else insist on and even force a certain therapy that totally violates a person’s principles and profoundest religious beliefs?

64. In one medical journal, what statement was made about doctors who try to force a certain treatment that violates the conscience of the patient?

64 Yet that has occurred. Some doctors or hospital administrators have even turned to the courts for legal authorization to force blood on an individual. Concerning those who have followed this course, Dr. D. N. Goldstein wrote in The Wisconsin Medical Journal:

“Doctors taking this position have denied the sacrifices of all the martyrs that have glorified history with their supreme devotion to principle even at the expense of their own lives. For those patients who choose certain death rather than violate a religious scruple are of the same stuff as those who paid with their lives for faith in God or who went to the stake rather than accept [forced] baptism. . . . Ours is the duty to save life but we may well question whether we do not also have a duty to safeguard integrity and preserve the few gestures of personal authenticity that continue to occur in an increasingly regimented society. . . . No doctor should seek legal assistance to save a body by destroying a soul. The patient’s life is his own.”⁠23

The Doctor’s Role

65, 66. Why might a doctor find it distressing to deal with a Witness who refuses a blood transfusion?

65 We have seen that, because of their strong religious beliefs, Jehovah’s Witnesses avoid both food that contains blood and medically administered blood. But how are others affected by this stand, such as doctors who treat Witness patients?

66 Doctors are dedicated to saving or prolonging life. That is their profession. Consequently, when a doctor schooled to view blood transfusion as standard practice is treating a patient who is seriously ill or who has lost much blood, he may find it distressing to learn that the patient refuses blood. Whereas the patient’s Bible-trained conscience may not permit a blood transfusion, the physician, too, has a conscience and follows ethics that are extremely important to him.

Should a doctor follow his own medical training and convictions if he feels that a blood transfusion, though refused by the patient, is needed to save that one’s life?

67, 68. According to what medical and legal principles may a surgeon not follow his own convictions if they violate a patient’s conscience?

67 There is no question that in such cases a delicate situation exists. But each of us can ask: If I were in a situation where there was a conflict between my conscience as a patient and the sincere conviction of an attending physician, what course would I think ought to be followed? Consider the remarks made by Dr. William P. Williamson at the First National Congress on Medical Ethics and Professionalism:

“Certainly, the physician’s first thought must be the welfare of the patient. Since life is a gift of the Creator to the individual, the primary decision rightfully belongs to the patient, because the patient is the custodian of that gift. . . . The physician should treat the patient within the dictates of the patient’s religion, and not force his own religious convictions upon the patient.” (Italics added.)⁠24

68 There is another reason, a legal one, why the patient’s conscience must not be overridden. As Professor Byrn wrote in Fordham Law Review: “ . . . I do not mean that the doctor is bound by the patient’s choice to do something contrary to the doctor’s conscience. . . . I do mean that the patient is not bound by the doctor’s conscience to do something contrary to the patient’s choice, and consequently the doctor may have the right and choice to do nothing. The law of informed consent would be rendered meaningless if patient choice were subservient to conscientious medical judgment.” (Italics added.)⁠25

69, 70. Instead of abandoning a case, what should a doctor do when faced with a patient’s refusal to accept a blood transfusion?

69 The possibility exists of a physician in this situation ‘doing nothing,’ that is, withdrawing from the case; but is that the only alternative? In his article “Emergency Surgical Procedures in Adult Jehovah’s Witnesses,” Dr. Robert D. O’Malley commented: “The patient’s refusal to accept blood transfusion should not be used as an excuse for abandonment by the medical profession.”⁠26

70 What, then, could a doctor do? Dr. J. K. Holcomb stated in a medical journal editorial:

“No doubt, we, as physicians, feel frustrated, even angered, when an obstinate patient refuses to accept what we would consider the preferred regimen of therapy. But, should we honestly feel this way when the patient cites a religious belief as the basis for his reluctance to accept specific treatment? If we are honest with ourselves, we will admit that we settle for something less than ideal treatment with many patients in our day-to-day practice. . . . If we can do this with respect to our medical convictions, shouldn’t we likewise be willing to do the best we can when a patient’s convictions, particularly religious ones, prevent our offering what we would consider the desired form of therapy. Usually, patients having religious reasons for not accepting blood transfusions, etc. are aware of the medical risks involved in their decision, but are willing to accept those risks and ask only that we do our best.”⁠27

71. What can be said about the moral obligations of both patient and doctor as regards “extraordinary” treatment?

71 There is another consideration as to the moral aspect of the matter. John J. Paris, Assistant Professor of Social Ethics, pointed out: “There is great consensus in both the medical and moral communities that an individual has no moral obligation to undergo ‘extraordinary’ medical treatment. And if the patient has no moral obligation to undergo ‘extraordinary’ treatment​—common though it might be in regular practice—​neither has the physician any moral obligation to provide it; nor the judge to order it.”⁠28 For Jehovah’s Witnesses, who direct their lives by the Bible, blood transfusions certainly are “extraordinary” treatment. In fact, they are morally forbidden.

Cooperation Between Patient and Doctor

72. What stand do Witnesses take as to medical treatment in general, but with what exception?

72 All persons concerned with this matter can rest assured that Jehovah’s Witnesses are not fanatics who oppose medical care. Recall that Luke, who wrote the Bible account of the decree against blood, was himself a physician. (Colossians 4:14) Thus, when Jehovah’s Witnesses are ill or have an accident, they do not look for some miraculous “faith healing” cure. Rather, they seek medical help. In this they do not try to dictate to doctors on how to practice medicine or even on the management of their own particular problem. The one thing that they consistently ask from doctors is that blood not be used.

73. What facts do Witnesses appreciate relative to their stand on blood?

73 The Witnesses have a high regard for the training and abilities of persons in the medical field. They sincerely appreciate doctors who use their skill to treat a patient, but doing so in accord with the patient’s conscientious beliefs. Witnesses recognize that it takes courage for a doctor to operate without being free to use blood. Also, it takes a measure of courage to go contrary to the views of one’s medical contemporaries and agree to practice medicine under conditions that may be viewed as medically less than optimum.

74. Of what fact are Witnesses aware, and what are they willing to face?

74 Naturally, Jehovah’s Witnesses are aware that some surgical procedures may involve so much blood loss that a doctor may honestly believe they cannot be undertaken on the terms the Witnesses present. Most surgery, however, can be performed without blood. True, doctors may feel that by not using blood the operation is made more dangerous. But the Witnesses are willing to face such increased risks with the courageous help of skilled doctors.

75. What conclusion was reached in an extreme case after a successful operation without blood?

75 During a panel discussion at the University of Pennsylvania, Dr. William T. Fitz related an interesting case. It involved a thirty-four-year-old patient who had bled severely from a tumor of the colon. The man, one of Jehovah’s Witnesses, told the doctors that he “would gladly undergo any surgical procedure as long as he would not be given blood.” The doctors agreed to operate, promising that blood would not be administered. During and after the operation blood loss was so great that the patient’s hemoglobin, which is normally 14 or 15 grams, fell to 2.4 grams. But he did not die. Rather, his condition stabilized and then his blood count climbed. Commenting on the doctors’ promise not to administer blood, Dr. Francis Wood, Chairman of the Department of Medicine, said: “I think you had a perfect right to promise. The man was going to die if you did not operate. He had some chance of getting well as a result of the operation without blood transfusion; therefore, I think you were perfectly justified in giving him the chance on his own terms.”⁠29

Relieving Doctors of Liability

76. Why need doctors not fear malpractice suits by Witnesses because of their stand on blood?

76 Doctors are in a difficult position in treating any serious case, for failure to use all available procedures may involve them in a malpractice suit. Jehovah’s Witnesses, however, are willing to bear the responsibility for their refusal to accept blood transfusion. They will sign legal waivers that relieve the medical staff and hospital of any concern about suits, in the event that harm be attributed to their operating without blood.

77. What is the gist of the form the AMA recommends that patients who refuse blood transfusions should sign?

77 The American Medical Association has recommended a form entitled “Refusal to Permit Blood Transfusion” for patients who will not accept blood because of religious beliefs. It reads: “I (We) request that no blood or blood derivatives be administered to ‐‐‐‐‐‐‐‐‐‐ during this hospitalization, notwithstanding that such treatment may be deemed necessary in the opinion of the attending physician or his assistants to preserve life or promote recovery. I (We) release the attending physician, his assistants, the hospital and its personnel from any responsibility whatever for any untoward results due to my (our) refusal to permit the use of blood or its derivatives.”⁠30 This document is to be dated and signed by the patient and by witnesses present. A close relative such as a mate or parent (in the case of a child) could sign the form too.

78. How do the Witnesses show they are willing to accept personal responsibility for refusing blood transfusions?

78 The willingness of Jehovah’s Witnesses to accept personal responsibility regarding their stand on blood is further shown by the fact that most of them carry a signed card requesting “No Blood Transfusion!” This document acknowledges that the signee realizes and accepts the implications of refusing blood. Thus, even if he should be unconscious when brought to a doctor or hospital, this signed statement makes clear his firm position.

Might a doctor or hospital be held liable if blood is not given?

79. What has been said as to the likelihood of a physician’s being sued for not forcing a blood transfusion on a patient?

79 An article in the University of San Francisco Law Review considered this point. It explained that Judge Warren Burger, who became Chief Justice of the United States Supreme Court, said that a malpractice proceeding “would appear unsupported” in an instance where a waiver had been signed. The article continued:

“The possibility of a criminal charge is even more remote. One commentator who surveyed the literature reported, ‘I have not been able to find any authority for the statement that the physician would incur . . . criminal . . . liability by his failure to force a transfusion on an unwilling patient.’ The risk seems more the product of a fertile legal mind than a realistic possibility.”⁠31

80. What is the position in England when a patient dies because of having refused a blood transfusion?

80 Regarding the situation in England, Emergencies in Medical Practice said: “If the position has been made clear to the patient and he dies untransfused no action can be taken against the doctor for no patient is obliged to preserve his life by the use of special or extraordinary measures.”⁠32

81, 82. What moral obligation does a doctor have, but what moral obligation does he not have?

81 A doctor contemplating surgery on a patient will naturally want to explain clearly what are the possible risks of refusing blood. But once he has done this, the doctor need feel no moral obligation to press the matter further. Certainly it would be unethical to try to “wear down” or frighten into submission a patient who has resolutely decided against accepting blood.

82 Since Jehovah’s Witnesses willingly accept responsibility for their decision, doctors are legally and in fact morally relieved of any obligation to insist on blood. And this is how many ethical and sincere physicians prefer it to be. “One cannot warn too urgently against a weakening of the human right of self-determination, including that of the patient,” wrote surgeon G. Haenisch of Hamburg, Germany. “A grant of authority for the physician to undertake a treatment that he deems right though it be against the will of the patient is to be uncompromisingly rejected.”​—Deutsche Medizinische Wochenschrift.⁠33

83. What charge could a doctor be liable for if he forced a blood transfusion upon a Witness patient?

83 In view of this human right, legal and medical publications in some lands have repeatedly warned that administering a transfusion against a patient’s wishes could make a doctor (or the hospital staff) liable to assault and battery charges or a justified malpractice suit.

What about administering blood without telling the patient, perhaps when he is unconscious?

84, 85. Which course by a doctor would be “most distasteful ethically,” and why is this so?

84 Many sincere physicians feel that in some situations, such as with terminal cancer, it is a kindness not to give a patient full information about his condition. While there may be varying opinions about the propriety of withholding details of a patient’s condition, that is quite different from a doctor’s deliberately administering a treatment that he knows the patient has forbidden. Writing in the New York State Journal of Medicine, Dr. Bernard Garner and his associates stressed this point. They acknowledged that sometimes a doctor has let a Witness patient become unconscious and then given him blood, perhaps thinking ‘What he doesn’t know won’t hurt him.’ But they concluded emphatically: “Although the motive might be altruistic, this would be most distasteful ethically.”⁠34

85 Why this is so was made clear by Marcus L. Plante, Professor of Law, University of Michigan Law School. He wrote that “the physician has a fiduciary relationship [one founded on trust] to his patient and owes an absolute obligation never to mislead the patient by words or silence as to the nature and character of the medical procedure he proposes to undertake.”⁠35

86, 87. (a) What did West Germany’s Medical Tribune have to say about giving a patient a blood transfusion while he was unconscious? (b) What ruling by a court underscored this position, leading to what conclusion?

86 Furthermore, in some localities a doctor’s promising not to give blood and then underhandedly doing so is legally wrong. For example, in West Germany’s Medical Tribune it was pointed out that “nothing is changed when the patient becomes unconscious.” This is so because ‘refusal to accept a blood transfusion, once expressly stated by a competent patient, is also valid in the event he becomes unconscious.’⁠36 Underscoring the matter more emphatically, the Supreme Court of Kansas declared:

“ . . . Each man is considered to be master of his own body, and he may, if he be of sound mind, expressly prohibit the performance of life-saving surgery, or other medical treatment. A doctor might well believe that an operation or form of treatment is desirable or necessary but the law does not permit him to substitute his own judgment for that of the patient by any form of artifice or deception.” (Italics added.)⁠37

87 Consequently, deceptively administering a blood transfusion to one of Jehovah’s Witnesses is against the professional ethics of moral physicians. It could make a doctor liable legally.

Respecting Parental Responsibility

88, 89. (a) What aspect of this subject is highly charged with emotion? (b) How do Witnesses feel about it, and why?

88 Likely the aspect of this matter that is most highly charged with emotion involves the treating of a child. All of us realize that children need care and protection. God-fearing parents particularly appreciate this. They deeply love their children and keenly feel their God-given responsibility to care for them and make decisions for their lasting welfare.​—Ephesians 6:1-4.

89 Society, too, recognizes parental responsibility, acknowledging that parents are the ones primarily authorized to provide for and decide for their children. Logically, religious beliefs in the family have a bearing on this. Children are certainly benefited if their parents’ religion stresses the need to care for them. That is so with Jehovah’s Witnesses, who in no way want to neglect their children. They recognize it as their God-given obligation to provide food, clothing, shelter and health care for them. Moreover, a genuine appreciation of the need to provide for one’s children also requires inculcating in them morality and regard for what is right. As has been mentioned, the early Christians were exemplary in this; the parents both taught their children and personally lived up to the moral teachings they enunciated. History relates that whole families sometimes were exposed to death in Roman arenas because the parents would not violate their conscientious beliefs.

90. (a) What has resulted from a lack of parental teaching? (b) In contrast, what do Witness parents do?

90 We are all aware that the lack of parental teaching and moral example has contributed to the fact that many youths today have no basic values; they think nothing of endangering their health and life, as well as the lives of others, in an unrestrained search for thrills. Is it not much better for youngsters to have parents who promote morality and respect for high principles? Parents who are Jehovah’s Witnesses show great love for their children as well as their God by using the Bible to aid their children to become moral persons. Thus, when these children are old enough to know what the Bible says about blood, they themselves support their parents’ decision to ‘abstain from blood.’​—Acts 15:29.

Need a doctor feel that he ought to administer blood to a child in spite of the resolute wishes of the parents and perhaps even of the child itself?

91, 92. Why should a doctor not feel that he must give a child a blood transfusion in spite of the resolute wishes of the parents against such?

91 Frankly, in view of the well-recognized right of parental responsibility, the moral, principled and consistent position for a doctor is to recognize the responsibility of loving, concerned parents to make decisions for their minor children.

92 In this regard, Dr. A. D. Kelly, Secretary of the Canadian Medical Association, wrote that “parents of minors and the next of kin of unconscious patients possess the right to interpret the will of the patient and that we should accept and respect their wishes. . . . I do not admire the proceedings of a moot court assembled at 2:00 a.m. to remove a child from his parent’s custody.”⁠38

93. Why is it fundamentally inconsistent to force a blood transfusion on a child of Witness parents?

93 Some persons in the medical and legal professions have recognized that a competent adult has the right to refuse a blood transfusion. But they have held that if parents refuse permission for their child, a transfusion should be forced by court order. This position, however, lacks fundamental consistency and harmony, as pointed out in the journal Forensic Science:

“Are we then to assume that the courts are willing to assign a different religion to the children than that of their parents, when statistics show that the overwhelming majority of children are reared and indeed follow the same religious denomination as their parents? Would this also not be as much an infringement of religious rights of the children by the courts as those rights which the court is trying to protect for the adults under the First Amendment [of the Constitution] by denying the transfusion over the adult’s objections? Are the courts not assigning in essence a religion to the children if they deny transfusions on religious grounds for adults and permit them for the children of the same adults?”⁠39

94. Name a gross inconsistency that prevails in some hospitals.

94 There is often another gross moral inconsistency in forcing a blood transfusion on a child whose parents have asked that other medical therapies be used. At some hospitals doctors in one room may be forcing a transfusion on an infant. Yet in a nearby room other doctors may be performing legal abortions, ending lives only a few months younger than the child on whom blood is forced ‘to save a life.’ This has led thinking persons to wonder if ‘preserving life’ is always the real issue behind forced transfusions.

95. What did a Scottish college lecturer have to say about forcing blood transfusions on adults and children?

95 Consider the implications of state-authorized medical treatment that forcibly takes away the right of parental responsibility. In Scotland, A. D. Farr, a college lecturer on blood transfusion techniques, wrote with regard to forcing transfusions on adults and children:

“The over-ruling in respect of a minority religious belief is extended to over-ruling the whole principle of an adult being allowed to accept or reject a particular form of medical treatment. . . . The State is gradually taking over the function of making decisions for the individual. It is in this way that free countries cease to be free and become totalitarian. It was indeed by the taking-over of the German children into the Hitler Youth movement that freedom and privacy were finally suppressed in Nazi Germany. This is not mere fanciful speculation. Freedom is a precious and comparatively rare possession, to be jealously guarded in those countries where it exists. Any one encroachment on individual liberty is one too many.”⁠40

96, 97. How does the principle of choice in medical treatment argue against forced blood transfusions?

96 Additionally, even if a doctor sincerely believes that a child needs a blood transfusion, does that mean that no other therapy will do? Or does it mean instead that he thinks that a transfusion offers more likelihood of success than alternative therapies? In this connection a council of judges in the United States of America wrote in “Guides to the Judge in Medical Orders Affecting Children”:

97 “If there is a choice of procedures​—if, for example, the doctor recommends a procedure which has an 80 per cent chance of success but which the parents disapprove, and the parents have no objection to a procedure which has only a 40 per cent chance of success—​the doctor must take the medically riskier but parentally unobjectionable course.”⁠41

98. What fact regarding the nature of medical knowledge further argues against forced blood transfusions?

98 These judges also said that “medical knowledge is not sufficiently advanced to enable a physician to predict with reasonable certainty that his patient will live or die or will suffer a permanent physical impairment or deformity.” Is there not much truth in that? Do not medical authorities emphasize that at best they can say only what seems likely to happen? Accordingly, many respected physicians and surgeons have cooperated with Jehovah’s Witnesses, providing fine medical treatment for young and old while respecting their Bible-based convictions about blood.

…