Here's a med student who posted something critical of religion in general and Jehovah's Witnesses in particular. He has no ax to grind (I don't think). He just reflects upon experiences he's had and reports he's heard. Why not answer his post? I did. Here's the post (with limited peripheral material edited out) entitled:
Jehovah’s Witnesses and Blood Transfusion
One of the most important aspects of science is it’s progressive nature. Our knowledge of any subject is always changing. Nowhere is this more evident than in science-based medicine. Physician guidelines change on an annual basis depending on studies and evidence supporting new treatments, therapies and procedures.
I can not imagine anything more contrasting to this than religion. Religion is structured in such a way as to prevent its beliefs from changing. Only when the most superior leaders of a religion decide that it should be changed does the doctrine itself change......
Last week, I was doing rounds in the neonatal intensive care unit (ICU) when I was introduced to a lovely little patient attached to IV lines and a nasal cannula for oxygen supplementation. This unstable newborn baby was suffering from hemolytic disease of the newborn, which occurs when maternal antibodies still present in the baby attack its red blood cells (RBCs), causing their contents to spill out into the blood stream. If it wasn’t for the concomitant jaundice that developed, this baby’s fatally low hemoglobin levels would have caused him to be almost as pale as the page these words lie on.
When a pediatrician is confronted with this scenario, the treatment is rather common sense: stabilize the patient, attempt to clear the serum of toxic levels of bilirubin (to prevent irreversible brain damage), and transfuse the patient with compatible blood. Otherwise, the baby’s blood cells will continue to be attacked until there are none left and the central organs cease to receive oxygen.
But alas, the baby’s parents are Jehovah’s Witnesses and blood transfusions are strictly against their beliefs because a nearly 2000 year-old scripture warns against eating blood. Not that eating blood and a transfusion are the same thing but according to the religions main legal entity, The Watchtower Society, it is. “The Society,” as it is often referred to colloquially by Witnesses, directs, administers and develops the doctrines for the religion and followers.
The Watchtower Society doesn’t draw the line at whole blood transfusions but rather at any components of blood. This includes platelets, RBCs, white blood cells (WBCs) and blood plasma and further discourages the use of fractions from any of these blood components, including albumin, globulins, clotting factors, erythropoietin (EPO), and hemoglobin. These restrictions have lead doctors to develop bloodless surgery techniques. Such surgery is not yet common, and very few have the luxury of utilizing it.
In the meantime, Jehovah’s Witnesses are expected to die during the desperate times requiring blood transfusions, which are more common than one might think. This is exemplified by the Jehovah’s Witness magazine Awake, which explained in its May, 1994 issue that: “In former times thousands of youths died for putting God first. They are still doing it, only today the drama is played out in hospitals and courtrooms, with blood transfusions the issue.”
If practicing Jehova’s Witnesses do receive transfusions, they are ousted from the religion in what’s known as disfellowshipping. These individuals are cut off from their families and friends who are also Jehovah’s Witnesses because the religion attempts to limit social interaction with non-Witnesses.
With increasing pressure in our technologically-advanced era, the Watchtower Society has very gradually loosened its grips on its opposition to blood transfusions and blood products. In the last few years the religion has allowed their followers to use specific blood products in special cases. For example, hemophiliacs are no longer shunned for using blood clotting factors under special circumstances. The church also seems to be heading towards the direction of allowing autologous blood donation, a process where a patient donates blood for storage that is used later in his own surgeries.
This raises the question, why not speed up the process? Why let so many people die in the past because of rules that will ultimately change in the future? Can’t Jehovah’s Witnesses just skip all the politics and allow their followers to use modern medicine like everyone else? It would certainly place the religion in a better light by removing one of its most significant criticisms. A giant weight would be lifted from the backs of so many hemophiliacs, anemics and pregnant mothers.
In the USA, the law requires doctors to overrule the wishes of families that want to deny their children procedures that would prevent long-term complications and death. This is not true around the world, however, and here in Poland, where I go to school, that is not the case. Doctors need to acquire court orders to treat children who’s parents deny them basic lif e support or treatments that would prevent end-organ damage.
As for the baby whom I saw myself in the hospital, well she did receive a court-ordered life-saving blood transfusion. If she hadn’t, there’s no doubt she might not be alive anymore. According to the resident physician, when the parents heard of this they decided to give her up for adoption. It’s still a mystery to me how religions can override our most innate emotions. To me, however, the adoption was a blessing in disguise.
Really, nothing has changed with regard to JW views on transfusion other than adjustments to keep pace with changes in transfusion therapy. In recent years, fractions have been developed that are a much tinier component of blood than the platelets, RBCs, white cells, and plasma you mention. The Bible speaks only of blood. Are these small fractions “blood” or not? Some will reason that any percentage, no matter how tiny, constitutes blood; others will think “it’s not a cake until you mix the ingredients.” I do not agree that the Watchtower Society discourages these fractions. Rather, they make clear that their use is subject to individual conscience, since the Bible doesn’t specifically say. By outlining the reasons some might decide to refuse them, you might think they are discouraging the fractions, however they also outline the reasons others might accept, making clear that it is a personal choice.
Only when the most superior leaders of a religion decide that it should be changed does the doctrine itself change.
In my opinion, it is not good to look at matters in this way. It will inevitably lead to looking down on your patient, maybe thinking them deluded, manipulated fools, given to fanaticism. Can that possibly lead to mutual respect or the trust a patient ought to be able to have in a doctor? Moreover, if you view them as slaves to “superior leaders of a religion,” that is another disconnect, since they do not view it that way. The “superior leaders” may have alerted them to what the Bible says, but having done that, it is the Bible itself that guides the Christian conscience, and not the leaders. Proceeding on an interpretation which the patient does not hold can only cause alienation.
Having said this, I can well appreciate the frustration of a doctor upon discovering his preferred method of treatment, perhaps his only method of treatment, is categorically rejected for reasons he neither understands nor agrees with. However, respect for the patient’s conscience might permit the doctor to make a mental adjustment. If a patient had a severe allergy, say, that absolutely ruled out the preferred treatment, doctors would not become angry, nor resent the patient for being uncooperative. Rather, they’d accept it as part of the big picture, and try to work with it. Every population of Jehovah’s Witnesses maintains a Hospital Liaison Committee, which serves to connect local doctors with whatever bloodless resources may exist locally, if only to arrange a transfer. (not sure what is available in Poland, as I am in the U.S., but it may be more than you are aware) Bloodless medicine is a specialty, and one can hardly expect all doctors to specialize. We simply appreciate it when doctors attempt to work with our beliefs, rather than trod over them.
The fact is that Jehovah’s Witnesses have decided to live their lives in harmony with Bible principles. In most cases, this serves them very well. The same Bible that prevents them from accepting blood transfusions also prevents them from drug abuse, from overdrinking, from smoking. If the entire population became Jehovah’s Witnesses, surely the mortality rate would plummet, since any complications arising from their view on blood is far offset by benefits from their overall healthy lifestyle. If a doctor focuses on this larger picture, he could not ask for a better patient. But regarding blood, the Bible says what it says. Witnesses don’t have the authority to change it, not even the “superior leaders.” It says it not once, but repeatedly, over many different timeframes. Moreover, Witnesses are well aware that eating blood and accepting a transfusion are not the same thing. But the Bible reasons that preclude “eating” blood apply equally to accepting it via another means.
If you are aware of the advancing nature of science-based medicine, surely you know that rethinking transfusion therapy is an area in which it is most rapidly advancing. A 2008 article in New Scientist magazine is entitled: An Act of Faith in the Operating Room. The act of faith is not withholding a transfusion. It is giving one. Says Gavin Murphy, a cardiac surgeon at the Bristol Heart Institute in the UK: “There is virtually no high-quality study in surgery, or intensive or acute care – outside of when you are bleeding to death – that shows that blood transfusion is beneficial, and many that show it is bad for you:”
The U.S. Army is now training its medical personnel in bloodless medicine, convinced that such training will save both lives and money. By eliminating the risk of foreign tissue, human error, and blood-borne diseases, these new techniques offer a safety margin that conventional blood transfusions do not. Might the day come, or is it here already, when the number of lives saved through such medicine will outnumber those lost by a few members of a relatively tiny religious group that stuck to its principles amidst much opposition?
Lastly, according to the resident physician, “when the parents heard of this they decided to give her up for adoption.” I can’t conceive of this happening. Not that I doubt your sincerity in telling the matter. But for it to be true, there have to be other factors at work. No one in the Witness community would think such an outcome a good idea. Perhaps the parents were otherwise unstable? Perhaps the state removed the child and left the parents no choice? I don’t know. But it doesn’t ring true. Jehovah’s Witnesses will strive diligently for their Bible-based view on blood to be respected. But if they are overruled (which often happens, as you point out) they don’t lose interest in the child.
There were other comments on the post besides mine. One also took issue with that parting slam at the parents: “However, the hearsay at the end – about the postulated adoption – is unsubstantiated and feels slanderous. It detracts from the otherwise well-founded observations and arguments you’ve made.” The author Matt apparently agreed: “Point taken,” he wrote. “I will try to keep this into account in my future blogs.”
I also thought it well to take a look at that May 1994 Awake quote which Matt uses to advance the notion JW youths are dropping like flies for their transfusion refusals:
“In former times thousands of youths died for putting God first. They are still doing it, only today the drama is played out in hospitals and courtrooms, with blood transfusions the issue.”
Not that I accuse Matt of anything devious. I've no doubt he used the quotation in good faith. It's likely from a web source purporting to be informative, but in reality existing only to denigrate a faith its author detests, trying to make JWs look as fanatical as possible, and doing so for philosophical reasons, rather than anything having to do with medicine or lives. So is the statement taken out of context or not?
It's a little difficult to tell, for there is no context. The quote is a one-line blurb on the magazine's table of contents designed to pique interest in the articles to follow. The articles to follow describe the cases of five Witness youngsters in North America. Each was admitted into a hospital for aggressive cancer or leukemia. Each fought battles with hospitals, courts, and child welfare agencies determined to administer blood against the patient's will. Each eventually prevailed in court, being recognized as “mature minors” with the right to decide upon their own treatment (though in two cases, a forced transfusion was given prior to that decision). Three of the children did die. Two lived. It's rather wrenching stuff, with court transcripts and statements of the children involved, and those of the participating doctors, lawyers, and judges. In no case do you get the sense that blood transfusions offered a permanent cure, only a possible prolonging of life, ideally long enough for some cure to be discovered (which has not yet happened). One of the children, who did die, was told that blood would enable her to live only three to six months longer, during which time she might “do many things,” such as “visit Disney World.” There's little here to suggest that “thousands of youths are dying for putting God first” who would otherwise live. Frankly, I think the quote is sloppily written. “They are still doing it,” says the quote. Doing what? Dying? Dying in the thousands? Or putting God first without regard for the immediate consequences?
Speaking of a respectful doctor-patient ralationship, a week after Weedsandwheat had his letter in defense of Jehovah's Witnesses published, City Newspaper published this letter:
…....In my practice years, I served three counties, which meant that I cared for children in at least six families of Jehovah's Witness faith. We worked together in a sense of communication, mutual respect, and understanding. This included ongoing discussion of therapeutic options for various conditions. I'm not sure whether today the Internet would change all of this. Hopefully my “families” might still remember me. Bernard A. Yablin MD (do a Google search, and this doctor pops up quite a bit)
It's an oddly touching letter, isn't it? Yes, hopefully they do remember him. Doctors proficient in their craft, who can also relate to the patient with “a sense of communication, mutual respect, and understanding,” are not that easy to find.