Jehovah's Witnesses and blood transfusions
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Jehovah's Witnesses believe that the Bible prohibits ingesting blood and that Christians should therefore not accept blood transfusions or donate or store their own blood for transfusion. The belief is based on an interpretation of scripture that differs from that of mainstream Christian denominations. It is one of the doctrines for which Jehovah's Witnesses are most well known.
Watch Tower Society publications teach that the Witnesses' 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 a matter of personal choice.
The doctrine was introduced in 1945, and has undergone some changes since then. Members of the religion who voluntarily accept a transfusion are regarded as having disassociated themselves from the religion by abandoning its doctrines and are subsequently shunned by members of the organization. Although accepted by the majority of Jehovah's Witnesses, a minority does not endorse this doctrine.
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.
- 1 Doctrine
- 2 Bloodless surgery
- 3 Acceptance among Jehovah's Witnesses
- 4 History of doctrine
- 5 Critical views
- 6 Further reading
- 7 See also
- 8 References
- 9 External links
- Blood represents life and is sacred to God. After it has been removed from a creature, the only use of blood that God has authorized is for the atonement of sins. When a Christian abstains from blood, they are in effect expressing faith that only the shed blood of Jesus Christ can truly redeem them and save their life.
- Blood must not be eaten or transfused, even in the case of a medical emergency.
- Blood leaving the body of a human or animal must be disposed of.
- Certain medical procedures involving blood fractions or that use a patient's own blood during the course of a medical procedure, such as hemodilution or cell salvage, are a matter of personal choice, according to what a person's conscience permits.
- A baptized Witness who unrepentantly accepts a blood transfusion is deemed to have disassociated himself from the religion by abandoning its doctrines and is subsequently subject to organized shunning by other members.
Certain medical procedures involving blood are specifically prohibited by Jehovah's Witnesses' blood doctrine. This includes the use of red blood cells, white blood cells, platelets and blood plasma. Other fractions derived from blood are not prohibited. Watch Tower publications state that some products derived from one of the four primary components may be so similar to the function of the whole component and carry on such a life-sustaining role in the body that "most Christians would find them objectionable". For procedures where there is no specific doctrinal prohibition, individuals are to obtain details from medical personnel and then make a personal decision.
The following medical procedures are prohibited:
- Transfusion of allogeneic whole blood, or of its constituents of red cells, white cells, platelets or plasma.
- Transfusions of pre-operative self-donated (autologous) blood.
Permitted procedures and products
The following procedures and products are not prohibited, and are left to the decision of individual members:
- Blood donation strictly for purpose of further fractionation of red cells, white cells, platelets or plasma for either allogeneic or autologous transfusion.
- Transfusions of autologous blood part of a "current therapy".
- Hemodilution, a modified technique in which equipment is arranged in a circuit that is constantly linked to the patient's circulatory system.
- Intraoperative blood salvage (autologous) or cell-saver scavenging, a method of picking up blood that has spilled from the circulatory system into an open wound, cleaning and re-infusing it.
- Heart-Lung Machine, a method in which blood is diverted to an artificial heart-lung machine and directed back into the patient.
- Dialysis, wherein blood circulates through a machine, is filtered and cleaned, then returned to the patient.
- Epidural Blood Patch, consisting of a small amount of the patient's blood injected into the membrane surrounding the spinal cord.
- Plasmapheresis, wherein blood is withdrawn and filtered, having the plasma removed and substituted, and returned to the patient.
- Labeling or Tagging, blood is withdrawn, mixed with medicine, and then returned to the patient by transfusion.
- Platelet Gel, blood is withdrawn and put into a solution rich in platelets and white blood cells.
- Fractions from red blood cells:
- Hemoglobin, the oxygen-carrying component of red blood cells.
- Fractions from white blood cells:
- Fractions from platelets:
- Fractions from blood plasma:
- Erythropoietin (EPO).
- PolyHeme, a blood substitute solution of chemically modified human hemoglobin.
- Hemopure, a blood substitute solution of chemically stabilized bovine hemoglobin derived from cow's blood.
A variety of bloodless surgical techniques have been developed for use on patients who refuse blood transfusions for reasons that include concern about AIDS, hepatitis, and other blood-borne infections, or immune system reactions. Thousands of physicians throughout the world have expressed a willingness to respect patients' preferences and provide bloodless treatment[need quotation to verify] and about 200 hospitals offer bloodless medicine and surgery programs for adult and pediatric patients who wish to avoid or limit blood transfusions, or to avoid treatment contrary to Jehovah's Witnesses' blood doctrine. Bloodless surgery has been successfully performed in such invasive operations as open-heart surgery and total hip replacements. However bloodless medical and surgical techniques have limitations, and surgeons say the use of various allogeneic blood products and/or pre-operative autologous blood transfusion is the standard of care for some patient presentations.
In cases of certain medical emergencies when bloodless medicine is not available, blood transfusions may seem to be the only available way to save a life. Watch Tower publications suggest that in such instances, Jehovah's Witnesses request that doctors provide the best alternative care possible under the circumstances, with respect for their personal conviction. The Watch Tower Society has acknowledged that some members have died after refusing blood.
In some countries, including Canada and the UK, a parent or guardian's decision can be legally overruled by medical staff. In this case, medical staff may act without consent, by obtaining a court order in a non-emergency situation, or without such an order in an emergency. In Japan, a doctor must respect the wish of an adult but can override the wishes of a child and their parents if the child is under 15. If a child is aged 15 to 17, a doctor will not perform a transfusion if the parents and the child refuse the transfusion. If a child aged from 15 to 17 objects to a transfusion but the parents demand the transfusion, then a doctor can override the child's wish. In the United States, the American Academy of Pediatrics recommends that in cases of "an imminent threat to a child's life", physicians in some cases may "intervene over parental objections".
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. As of 2006, there are 1,535 Hospital Liaison Committees worldwide coordinating communication between 110,000 physicians.
Hospital Information Services researches medical journals to locate information on the availability and effectiveness of bloodless surgery methods. It disseminates information about treatment options to local Hospital Liaison Committees, and to doctors and hospitals.
Patient Visitation Groups
Annually since 2004, Jehovah's Witnesses in the United States have been informed that "with your consent, the law allows for the elders to learn of your admission [to hospital] and provide spiritual encouragement", 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.
Acceptance among Jehovah's Witnesses
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. Those Jehovah's Witnesses who accept the blood doctrine typically hold strongly to their conviction. 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 Watchtower 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 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. 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. 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.
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 (circa 1927-31), Margaret Buber, who was never a member of the religion, 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.
History of doctrine
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. Watch Tower publications during the presidency of Joseph Franklin Rutherford commended the commercial and emergency uses of blood. A 1925 issue of The Golden Age commended a man for donating blood 45 times without payment. 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". 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.
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'."
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.
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.
In 1945, the application of the doctrine on blood was expanded to prohibit blood transfusions of whole blood, whether allogeneic or autologous. 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"—it was ruled that it was a disfellowshipping offense to conscientiously accept a blood transfusion. 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."
In September 1956, Awake! stated, "certain blood fractions ... also come under the Scriptural ban". A position against "the various blood fractions" was reiterated in September 1961. 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. 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."
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. 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."
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.
In 1989 The Watchtower stated, "Each individual must decide" whether to accept hemodilution and autologous blood salvage (cell saver) procedures. 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. 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.
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. 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.
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." 
- 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."
- 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."
- 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.
- A 2006 Awake! highlighted dangers from transfusion-related acute lung injury (TRALI), citing a New Scientist report that suggested it was the cause of as many as 55200 reactions and 500 deaths in the United States in 2002.
Opposition to the Watch Tower doctrines on blood transfusions has come from both inside and outside the religion. 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. In a series of articles in the Journal of Medical Ethics American 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.
Dissident Witnesses say the Society's use of Leviticus 17:12 to support its opposition to blood transfusions 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 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. 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. 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 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!" 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. 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".
Selective use of information
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 presents 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. 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. Attorney and former Witness Kerry Louderback-Wood 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."
Outdated medical beliefs
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. A 1990 Watch Tower brochure on blood 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. He has criticized an analogy commonly used by the Society 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?" 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." 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.
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.
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. 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 of the premise of them being Bible-based "truth". 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. 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. 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.
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.
Witnesses respond that the real issue is not of the fluid per se, but of respect and obedience to God. 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. 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.
- Sloan JM, Ballen K (May 2008). "SCT in Jehovah's Witnesses: the bloodless transplant". Bone Marrow Transplant. 41 (10): 837–44. doi:10.1038/bmt.2008.5. PMID 18246110.
- Bayam L, Tait WF, Macartney ID (2007). "Successful repair of a giant abdominal aortoiliac aneurysm in a Jehovah's Witness". Vasc Endovascular Surg 41 (5): 460–2. doi:10.1177/1538574407303172. PMID 17942864.
- Massiah N, Athimulam S, Loo C, Okolo S, Yoong W (October 2007). "Obstetric care of Jehovah's Witnesses: a 14-year observational study". Arch Gynecol Obstet. 276 (4): 339–43. doi:10.1007/s00404-007-0346-0. PMID 17522882.
- Putney, Leeann J. (July–September 2007), [Putney LJ (Jul–September 2007). "Bloodless cardiac surgery: not just possible, but preferable" (– Scholar search). Crit Care Nurs Q 30 (3): 263–70. doi:10.1097/01.CNQ.0000278927.44691.8c. PMID 17579310.[dead link]
- Eilers June, Rounds Luisa (2007). "Blood Transfusion or Not: A Literature Review of Bloodless Interventions to Treat Cancer Related Anemia". Oncology Nursing Forum 34 (2): 553–554.
- Blood transfusions
- Bloodless surgery
- Criticism of Jehovah's Witnesses
- Knocking, a documentary on Witnesses that features bloodless medicine.
- Keep Yourself in God's Love, Watch Tower Bible & Tract Society, 2008, page 77.
- Manya A. Brachear, "More doctors honor religious objections to blood transfusions", Chicago Tribune, 9 October 2012.
- Evans, Allan S.; Riley E. Moynes; Larry Martinello (1973). What man Believes: A study of the World's Great Faiths. McGraw-Hill Ryerson. p. 361. ISBN 0-07-077440-4. "Two elements of belief are probably better known than any other among non-Witnesses. One is the refusal to fight in war ... the other well-known belief is the refusal to accept blood transfusions."
- "How Can Blood Save Your Life?", Watch Tower Society website
- "Be Guided by the Living God", The Watchtower, June 15, 2004, page 22.
- "Godly Respect for Blood", The Watchtower, September 1, 1986, page 25.
- O. Muramoto, "Bioethics of the refusal of blood by Jehovah's Witnesses: Part 3. A proposal for a don't-ask-don't-tell policy", Journal of Medical Ethics, December 1999, page 464.
- Osamu Muramoto, "Bioethical aspects of the recent changes in the policy of refusal of blood by Jehovah's Witnesses," British Medical Journal, Vol. 322, January 6, 2001, pg 37.
- Jehovah's Witnesses drop transfusion ban, BBC News website, June 14, 2000. Accessed May 11, 2010.
- Jehovah's Witnesses Public Affairs Office press release, June 14, 2000.
- Lee Elder, The Associated Jehovah's Witnesses for Reform on Blood, "Why some Jehovah's Witnesses accept blood and conscientiously reject official Watchtower Society blood policy", Journal of Medical Ethics, 2000, Vol 26, pages 375-380.
- Tom Blackwell, "Without fanfare, Jehovah’s Witnesses quietly soften position on blood transfusions", National Post, 20 December 2012.
- How Can Blood Save Your Life, published by Watch Tower Bible and Tract Society, 1990 p. 24, "God told all mankind that they must not eat blood. Why? Because blood represents life."
- Awake!, August 2006 p. 11, "He also gave them his reason, equating blood with the soul, or life, of the creature. He later said: 'The soul [or life] is in the blood.' In the eyes of the Creator, blood is sacred. It represents the precious gift of life that each living soul possesses."
- The Watchtower, June 15, 2004 p. 21
- The Watchtower, February 1, 1997 p. 29
- The Watchtower, June 1, 1969 pp. 326, 327
- The Watchtower, September 1, 1986 p. 25
- October 15, 2000 Watchtower, p. 31
- The Watchtower, June 15, 2004 P.24 par. 16
- The Watchtower, March 1, 1989, p. 31
- The Watchtower, June 15, 2000 pp. 29-31
- The Watchtower, October 15, 2000 pp. 30-31
- Our Kingdom Ministry, November 2006 pages 3,4 para.1-6
- Jehovah's Witness letter to Cliff Roche, July 30, 2001 (Published in the book Three Dissertations on the Teachings of Jehovah's Witnesses, by Greg Stafford, 2002 ISBN 0-9659814-2-8)
- Instructions for Filling in The Advance Decision Document, published by Watch Tower Bible and Tract Society, 2005 p.1. This document specifically applies the term "transfusion" to a Jehovah's Witness patient having blood returned to their cardiovascular system after it was completely removed from their body.
- West, James. "Informed refusal — the Jehovah's Witness patient", Clinical Ethics in Anesthesiology: A Case-Based Textbook, Cambridge University Press, 2011 pp. 19-26.
- Farmer S, Webb D, Your Body Your Choice: The Layman's Complete Guide to Bloodless Medicine and Surgery, 2000; pages 11, 14, 75
- Ariga et al., Legal Medicine, 5 (2003) S72-S75
- , , , and  - successful cases of bloodless surgery
- Spence et al., Transfusion May 2003; Vol. 43 p. 668
- Transfusion-Free Medicine, edited by Dr Nicolas Jabbour, 2005 p. 13
- "Are You Ready to Face a Faith-Challenging Medical Situation?", Our Kingdom Ministry, November 1990.
- "Youths Who Have Power Beyond What Is Normal", Awake!, May 22, 1994, pages 9-15.
- Richards, Edward; Rathbun, Katharine (1983). "Medical Risk Management: Preventive Legal Strategies for Health Care Providers". http://biotech.law.lsu.edu/Books/aspen/Aspen.html. Chapter Nine, The Emergency Exception: Aspen Systems Corporation. Retrieved 12 July 2014.
- Hartman, Kurt; Liang, Bryan (March 1999). "Exceptions to Informed Consent in Emergency Medicine". Hospital Physician 35 (3): 53–55. Retrieved 13 July 2014.
- American Academy of Pediatrics Committee on Bioethics (1997). "Religious objections to medical care". Pediatrics 99 (2): 279–281. doi:10.1542/peds.99.2.279. PMID 9024462.
- Our Kingdom Ministry, September 1988, page 4.
- "Jehovah’s Witnesses—1998 Yearbook Report", 1998 Yearbook of Jehovah's Witnesses, ©1997 Watch Tower, page 23
- "Jehovah’s Witnesses—1996 Yearbook Report", 1996 Yearbook of Jehovah's Witnesses, ©1997 Watch Tower, page 26
- "Bridging the Gap Between Doctors and Witness Patients", Awake!, November 22, 1990, page 21
- "Are You Ready to Face a Faith-Challenging Medical Situation?", Our Kingdom Ministry, November 1990, page 3.
- September 2002 Certificate of Recognition issued by Society for the Advancement of Blood Management, available online at http://www.jw-media.org/gbl/20021118.htm
- January 3, 2006 Letter from Christian Congregation of Jehovah's Witnesses; To all Congregations
- Our Kingdom Ministry, November 1990 p. 3
- "Announcements", Our Kingdom Ministry, November 2005, page 3
- "Announcements", Our Kingdom Ministry, October 2004, page 7, emphasis added to quote
- "Service Meeting Schedule", Our Kingdom Ministry, January 2006, page 2
- "Argentina", 2001 Yearbook of Jehovah's Witnesses, ©2000 Watch Tower, page 212
- ""Follow Me Continually"", Our Kingdom Ministry, May 2006, page 1
- "No One Has Love Greater Than This", Come Be My Follower, ©2007 Watch Tower, pages 178-179
- Findley LJ, Redstone PM (March 1982). "Blood transfusion in adult Jehovah's Witnesses. A case study of one congregation". Arch Intern Med. 142 (3): 606–7. doi:10.1001/archinte.142.3.606. PMID 7065795.
This article presents a consensual survey of one congregation of Jehovah's Witnesses where the congregation elders provided the names and addresses of members, and the elders knew precisely the nature of the survey. 59 responses were received. Of the 59, 7 stipulated they would accept plasma transfusion (Table 1 on page 607). This result compelled Findley and Redstone to comment, "there is either some lack of understanding or refusal to follow doctrine among some members". Whether from misunderstanding or refusal to follow doctrine, at no point did Findley and Redstone question whether these responders had honestly expressed their personal conviction. Findley and Redstone also stipulated their methodology may have skewed the results towards official Jehovah's Witness doctrine. (Local elders provided the names to be surveyed, and those surveyed knew local elders would see the results of the study.) The authors also admit that this study may not describe the beliefs of "less religious Jehovah's Witnesses".
- Kaaron Benson, H. Lee Moffitt Cancer Center & Research Institute Cancer Control Journal, Vol. 2, No. 4, November/December 1995
- Gyamfi C, Berkowitz RL (September 2004). "Responses by pregnant Jehovah's Witnesses on health care proxies". Obstet Gynecol 104 (3): 541–4. doi:10.1097/01.AOG.0000135276.25886.8e. PMID 15339766. "This review refutes the commonly held belief that all Jehovah's Witnesses refuse to accept blood or any of its products. In this population of pregnant women, the majority were willing to accept some form of blood or blood products."
- Knuti KA, Amrein PC, Chabner BA, Lynch TJ, Penson RT (2002). "Faith, identity, and leukemia: when blood products are not an option". Oncologist 7 (4): 371–80. doi:10.1634/theoncologist.7-4-371. PMID 12185299.
"Ms. LF stated that she was a Jehovah's Witness and asserted with an advanced directive that she did not want blood product support…. The risks and benefits of continuing therapy were discussed with Ms. LF. She remained adamant in her refusal of blood products and repeated that she wanted to continue treatment and to "die fighting" her disease."
- Migden DR, Braen GR (August 1998). "The Jehovah's Witness blood refusal card: ethical and medicolegal considerations for emergency physicians". Acad Emerg Med 5 (8): 815–24. doi:10.1111/j.1553-2712.1998.tb02510.x. PMID 9715245.
Ridley DT (August 1998). "Honoring Jehovah's Witnesses' advance directives in emergencies: a response to Drs. Migden and Braen". Acad Emerg Med 5 (8): 824–35. doi:10.1111/j.1553-2712.1998.tb02511.x. PMID 9715246.
- The Watchtower August 1, 1958 p. 478
- The Watchtower January 15, 1961 p. 63
- The Watchtower October 15, 1987 p. 14, "Three areas for attention were mentioned: secretly accepting a blood transfusion, masturbation, and alcohol abuse. After considering that material, quite a number of readers wrote letters of appreciation; they admitted that they had had those faults, but they had been moved to repent and change."
- Kaaron Benson, H. Lee Moffitt Cancer Center & Research Institute Cancer Control Journal, Vol. 2, No. 4, November/December 1995, "Therefore, while most adult Jehovah's Witness patients were unwilling to accept blood for themselves, most Jehovah's Witness parents permitted transfusions for their minor children, and many of the young adult patients also were willing to accept transfusions for themselves." Available online at http://www.moffitt.org/moffittapps/ccj/v2n6/article13.html
- "Where Are the Faithful?", Awake!, April 8, 1996, p. 4, "Nowadays official church dogma may bear scant resemblance to the personal beliefs of those who profess that particular religion."
- Thomas JM (February 2005). "Responses by pregnant Jehovah's Witnesses on health care proxies". Obstet Gynecol 105 (2): 441; author reply 442–3. doi:10.1097/01.AOG.0000149842.31312.e4. PMID 15684182.
- Buber, M., Under Two Dictators, 1949 pp. 222, 235-237. Buber states the Jehovah's Witness prisoners all ate blood sausage, until around 1943. At that time she relates that 25 of the 275 Jehovah's Witness prisoners refused to eat blood sausage. She underlines the fact that this occurred in the presence of knowledge of Biblical statements regarding blood.
- The Watch Tower, November 15, 1892 p. 351, "It will be noticed that nothing is said about keeping the ten commandments, nor any part of the Jewish law. It was evidently taken for granted that having received the spirit of Christ the new law of love would be a general regulation for them. The things mentioned were merely to guard against stumbling themselves or becoming stumbling blocks to others."
- The Watch Tower, April 15, 1909 pp. 116-117, "These prohibitions had never come to the Gentiles, because they had never been under the Law Covenant; but so deeply rooted were the Jewish ideas on this subject that it was necessary to the peace of the Church that the Gentiles should observe this matter also ... these items thus superadded to the Law of Love should be observed by all spiritual Israelites as representing the Divine will."
- The Golden Age, October 15, 1919 p. 47, "A serious difficulty which has been overcome in the use of plywood for airplanes construction was the making from blood of a glue that will stand any quantity of moisture without letting go…. In this plywood, stronger than steel, we have an illustration of how the Lord can take characters, weak in themselves, and surround them with such influence and so fortify them by his promises as to make them "mighty through God to the pulling down of strong holds" of error and sin.—2 Cor. 10:4"
- The Golden Age, December 17, 1924 p. 163, "Remarkable Tale of Womanly Heroism…. Fearing the death of the child, the woman deliberately cut her arms and breast with glass from the windshield to provide blood to keep the child alive during the cold nights. The child will recover, but the heroine is expected to die."
- Golden Age, July 29, 1925 p. 683
- "One Reason for God's Vengeance", The Watchtower, December 15, 1927, p. 371.
- Consolation: 19. December 25, 1940. "one of the attending physicians in the great emergency gave a quart of his own blood for transfusion, and today the woman lives and smiles gaily over what happened to her in the busiest 23 minutes of her life."
- "The Stranger's Right Maintained", The Watchtower, December 1, 1944, p. 362
- Vertroosting (Consolation), September 1945 p. 29, "Wanneer wij ons leven verliezen, doordat wij weigeren, inspuitingen te laten maken, dient zulks niet tot een getuigenis ter rechtvaardiging van Jehova's Naam. God heeft nooit bepalingen uitgevaardigd die het gebruik van medicijnen, inspuitingen of bloedtransfusie verbiedt. Het is een ultvinding van menschen, die gelijk de Farizeën Jehova's barmhartigheid laten."
- The Blood Transfusion Taboo of Jehovah’s Witnesses: Origin, Development and Function of a Controversial Doctrine, Social Science Medicine, Singelenbreg, R., 1990, Vol. 31, No. 4, p. 516.)
- The Watchtower, July 1, 1945, p. 198-201
- "Assume Your Christian Obligations", The Watchtower, March 1, 1966, p. 142, "In the counsel from the pages of this magazine there has been a note of increased strictness with regard to pure worship, the placing of additional obligations on each one individually, strict counsel on morals, honesty, neutrality and such requirements as showing respect for the sanctity of blood."
- The Watchtower, January 15, 1961, p. 63.
- Blood, Medicine, and the Law of God, Watch Tower Bible and Tract Society, 1961, p. 54
- Awake!, September 8, 1956 p. 20
- The Watchtower, September 15, 1961, p. 558
- The Watchtower, November 1, 1961, p. 670
- Durable Power of Attorney form, published by Watch Tower Bible and Tract Society of Pennsylvania, January 2001 p. 1
- The Watchtower, February 15, 1964, p. 127-128
- The Watchtower, November 15, 1964, p. 680-683
- The Watchtower, June 15, 1982, p. 31
- The Watchtower, March 1, 1989 p. 30
- The Watchtower, June 15, 2000, p. 29-31
- The Watchtower, October 15, 2000, p. 31
- Letter to All Presiding Overseers and Secretaries in the United States, Watchtower May 3, 2001, and Enclosure
- Letter to All Presiding Overseers and Secretaries in the United States, Watchtower December 20, 2001
- The Watchtower, July 1, 1951, p. 414
- The Watchtower, September 15, 1961, p. 563-564
- Awake!, July 8, 1969, p. 30
- Awake!, May 22, 1974, page 18.
- Awake!, August 2006.
- New Scientist 25 September 2002
- Lee Elder, "Why some Jehovah's Witnesses accept blood and conscientiously reject official Watchtower Society blood policy", Journal of Medical Ethics, 2000, Vol.26, pages 375-380.
- "Rightly Value Your Gift of Life," The Watchtower, June 15, 2004, page 15.
- United in Worshop of the Only True God, Watch Tower Bible & Tract Society, 1983, page 160.
- "What Does Jehovah Ask of Us Today?" The Watchtower, September 15, 1999, page 21.
- Osamu Muramoto, "Bioethics of the refusal of blood by Jehovah's Witnesses, part 1", Journal of Medical Ethics, August 1998, Vol 24, Issue 4, page 223-230.
- F. F. Bruce, Commentary on Acts, Eerdmans, Grand Rapids, 1955, R.C.H. Lenski, The Interpretation of the Acts of the Apostles, Wartburg Press, Columbus, Ohio, 1944.
- Hoekema, Anthony A. (1963). The Four Major Cults. Grand Rapids, Michigan: William B. Eerdmans. pp. 249, 250. ISBN 0-8028-3117-6.
- O. Muramoto, "Bioethics of the refusal of blood by Jehovah's Witnesses: Part 3. A proposal for a don't-ask-don't-tell policy", Journal of Medical Ethics, December 1999, page 463.
- "Bioethics of the refusal of blood by Jehovah's Witnesses, part 2." Journal of Medical Ethics, October 1998, page 296.
- ECHR Point number 136, 139
- O. Muramoto, "Bioethics of the refusal of blood by Jehovah's Witnesses: Part 3. A proposal for a don't-ask-don't-tell policy", Journal of Medical Ethics, December 1999, page 467.
- "Honor Godly Marriage!", The Watchtower, March 15, 1983, page 31.
- "Call for new approach to transfusion refusals", The Irish Times, February 27, 2010.
- David Malyon, "Transfusion-free treatment of Jehovah's Witnesses: respecting the autonomous patient's motives", Journal of Medical Ethics, 1998, Vol 24, page 380.
- Donald T. Ridley, "Jehovah's Witnesses' refusal of blood: obedience to scripture and religious conscience", Journal of Medical Ethics, 1999, Vol. 25, page 471.
- "Bioethics of the refusal of blood by Jehovah's Witnesses, part 2." Journal of Medical Ethics, October 1998, page 298-299.
- "Bioethics of the refusal of blood by Jehovah's Witnesses, part 2." Journal of Medical Ethics, October 1998, page 301.
- "Bioethics of the refusal of blood by Jehovah's Witnesses, part 2." Journal of Medical Ethics, October 1998, page 298.
- "Religion Today", New York Times, January 6, 2006
- "Jehovah's Witnesses, Blood Transfusions and the Tort of Misrepresentation", Journal of Church and State, Autumn 2005, Volume 47, Number 4, p. 808: "[The Watchtower Society] builds a case that other doctors wish all surgeons would become bloodless surgeons, when in fact those doctors recognize the benefits of blood transfusions for those who are in desperate need."
- Cults, New Religious Movements, and Your Family: A Guide to Ten Non-Christian Groups Out to Convert Your Loved Ones p. 226
- Bearing False Witness? An Introduction to the Christian Countercult p. 146
- Reasoning From the Scriptures, Watch Tower Bible & Tract Society, 1989, page 73.
- How Can Blood Save Your Life?, Watch Tower Bible & Tract Society, 1990, page 6.
- Reasoning From the Scriptures, Watch Tower Bible & Tract Society, 1989, page 70.
- The analogy is used in The Watchtower, June 1, 1969, page 326, The Truth That Leads to Eternal Life, (1981, pg 167), Reasoning From the Scriptures (1989, pg 73), You Can Live Forever in Paradise on Earth (1989, pg 216), Yearbook (1989, pg 57), What Does the Bible Teach (2005, pg 130) and Awake!, August 2006, page 11.
- "Bioethics of the refusal of blood by Jehovah's Witnesses, part 2." Journal of Medical Ethics, October 1998, page 299.
- "Bioethics of the refusal of blood by Jehovah's Witnesses, part 2." Journal of Medical Ethics, October 1998, page 300.
- The Watchtower November 1, 1961 p. 669 Questions From Readers
- What Does The Bible Really Teach? 2005 P.128
- "Questions From Readers". The Watchtower: 669. 1 November 1961. "The important thing is that respect has been shown for the sanctity of blood, regard has been shown for the principle of the sacredness of life. What God's law requires is that the blood be drained from the animal when it is killed, not that the meat be soaked in some special preparation to draw out every trace of it."
- OK Kosher Certification — Salting of Meat
- My Jewish Learning: Making Meat Kosher
- Official website of Jehovah's Witnesses
- How Can Blood Save Your Life? published by Watch Tower Bible and Tract Society
- Why Don't Jehovah's Witnesses Accept Blood Transfusions? from the official website
- Bloodless Surgeries and Jehovah's Witnesses PBS Religion & Ethics
- Associated Jehovah's Witnesses for Reform on Blood
- BBC News - Refusing blood 'source of regret'
- Critique of Jehovah's Witnesses' blood policy by Raymond Franz, a former member of Jehovah' Witnesses' Governing Body
- Ethical Issues in Compulsory Medical Treatment: A Study of Jehovah's Witnesses
- Jehovah's Witnesses teachings on blood from religioustolerance.org
- The Jensen Letters—correspondence between a Jehovah's Witness elder and the Watchtower Society seeking answers to critical questions about important aspects of their blood doctrine. The correspondence begins in 1998 and concludes in 2003 with the writer's resignation as an elder.