Healthcare is as much about bioethics as it is about wellness. Healthcare facilities serve communities that consist of people from different backgrounds and belief systems. An individual's beliefs can greatly affect the method of care received. The beliefs of Jehovah's Witnesses and blood transfusions are an important bioethical issue to consider when using modern health practices.
Jehovah's Witnesses' Beliefs Regarding Blood Transfusions
Jehovah's Witnesses' religious beliefs do not allow them to receive blood transfusions. They assert that bloodless surgeries are just as effective and safe as those that use blood, and in many cases, they are right.
According to the Associated Jehovah's Witnesses for Reform on Blood (AJWRB) web site, New Light on Blood, the Watchtower Society changed its stance on blood in 2004, as it has many times before. While whole blood and its major components of red blood cells, white blood cells, plasma, and platelets remain unacceptable, smaller blood components may be used at the discretion of the patient. These smaller components include hemoglobin, interferons, interleukins, albumin, and other components.
What is puzzling to physicians is that the individual components of plasma may be used, but plasma cannot be transfused. According to the AJWRB, platelets cannot be used, nor can a patient provide his or her own blood for a future procedure, but cow's blood can be used as a whole.
The Watchtower Society's Inconsistent Policies
The Watchtower Society's blood doctrine is being challenged by current and former Jehovah's Witnesses. It has been argued that there really is no biblical basis for the blood doctrine and that there are major inconsistencies within the doctrine. Many within the medical community are unaware of this challenge among current and former Jehovah's Witnesses. It is important to note that the beliefs set forth by the religious leaders may not represent those of every Jehovah's Witness.
The blood doctrine is rooted in the Old Testament book of Leviticus, which dictates that blood may not be eaten. In fact, their interpretation of Leviticus was the basis for their former policy prohibiting organ transplants, but that is now a practice that is accepted by the Watchtower Society as long as they are bloodless transplants.
In the August 1998 Journal of Medical Ethics article, "Bioethics of the refusal of blood by Jehovah's Witnesses: part 1. Should bioethical deliberation consider dissidents' views," Osamu Muramoto explains that the passage states that both blood and fat may not be eaten, yet Jehovah's Witnesses may eat fat. This is an inconsistency with the Watchtower's Society's policies and their argument that they must do what the Bible says. The Watchtower Society further argues that blood transfusions are equated with eating because patients can be "fed" intravenously. Therefore, blood transfusions also nourish the body.
Muramoto is quick to point out that there is a key difference between intravenous nourishment and blood transfusions. Food is broken down into the key components of lipids, proteins, carbohydrates, and amino acids. These components are used to nourish the body's tissues. Blood transfusions, however, do not serve as nourishment. Rather, the transfused blood components remain intact and function as blood, which is essentially a transportation system.
Medical Ethics and Patient Confidentiality Jeopardized with Jehovah's Witness Healthcare Workers
Even if a Jehovah's Witness is willing to receive a transfusion, another issue of patient confidentiality may arise. Muramoto described an article from The Watchtower that emphasized reporting important medical information to church elders in spite of patient confidentiality. According to Muramoto, "Where JWs are employed as medical workers, JW patients have no assurance of doctor-patient confidentiality since, according to WTS teaching, 'the law of God' implies that the end justifies the means."
It is worth discussing the possibility of blood transfusions with Jehovah's Witnesses because not all agree with the blood doctrine, or they are willing to receive transfusions as long as it is kept in the strictest confidence. While physicians must not coerce the patient or disrespect the religion, it is worth discussing all medical options so Jehovah's Witness patients may truly make an informed decision.
Diane Ursu - Diane Ursu joined Suite101 as a contributing writer in August 2009 and became a Feature Writer in January 2010. She is a freelance writer ...
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