For decades the position of the organization was that blood, whether whole or in part was not permissible for Jehovah’s Witnesses to use to sustain life. The September 1961 Watchtower states:
“BLOOD TRANSFUSION
Over the centuries man’s misuses of blood have taken on many forms. Ancient Egyptian princes used human blood for rejuvenation; others drank the blood of their enemies. But not until after William Harvey’s research into the circulation of the blood, in the seventeenth century, was there any extensive effort made to transfuse blood into the circulatory system of another creature. After having suffered severe setbacks due to fatalities, blood transfusion finally came to be viewed with more favor at the beginning of this twentieth century, when research made it possible to identify certain blood types. The two world wars and the Korean war gave doctors ample opportunity to experiment with the therapeutic use of blood, and now the process has been developed to the point that doctors use not only whole blood and blood plasma, which is the nearly colorless liquid in which the blood cells are carried, but also red cells apart from the plasma, and the various plasma proteins as they feel the need.
Is God’s law violated by such medical use of blood? Is it wrong to sustain life by infusions of blood or plasma or red cells or the various blood fractions? Yes! The law that God gave to Noah and which applies to all his descendants makes it wrong for anyone to eat blood, that is, to use the blood of another creature to nourish or sustain one’s life. Even as Tertullian in his Apology showed how the early Christians reasoned on the matter, so today it is recognized that if this prohibition applies to animal blood, it applies with even more force to human blood. It includes “any blood at all.”—Lev. 3:17.
Arguments to the effect that the prohibition on the use of blood issued by the early Christian governing body did not deal with human blood, but only with animal blood, show ignorance of the facts of history. In ancient Rome, which dominated the Mediterranean world in the first century, spectators at the gladiatorial contests would rush into the arena after the fight and suck the blood streaming from the neck of the vanquished gladiator. Some from among the Scythians reportedly ate their dead relatives. Treaties were made among some peoples by mutually drinking a portion of each other’s blood; and human blood caught in the hand and eaten was used to seal initiation into the rites of the pagan goddess Bellona. So when the apostles, under direction of the Holy Spirit, said that Christians were to keep themselves from blood, they did have in mind human blood too.
It is of no consequence that the blood is taken into the body through the veins instead of the mouth. Nor does the claim by some that it is not the same as intravenous feeding carry weight. The fact is that it nourishes or sustains the life of the body. In harmony with this is a statement in the book Hemorrhage and Transfusion, by George W. Crile, A.M., M.D., who quotes a letter from Denys, French physician and early researcher in the field of transfusions. It says: “In performing transfusion it is nothing else than nourishing by a shorter road than ordinary—that is to say, placing in the veins blood all made in place of taking food which only turns to blood after several changes.” In view of the emphasis put on the use of blood in the medical world, new treatments involving its use are constantly being recommended. But regardless of whether it is whole blood or a blood fraction, whether it is blood taken from one’s own body or that taken from someone else, whether it is administered as a transfusion or as an injection, the divine law applies. God has not given man blood to use as he might use other substances; he requires respect for the sanctity of blood. (The Watchtower September 15, 1961 pp. 558-559 Respect for the Sanctity of Blood)
However a change came in 1990.
Questions From Readers
▪ Do Jehovah’s Witnesses accept injections of a blood fraction, such as immune globulin or albumin?
Some do, believing that the Scriptures do not clearly rule out accepting an injection of a small fraction, or component, taken from blood.
The Creator first laid upon all mankind the obligation to avoid taking in blood: “Every moving animal that is alive may serve as food for you . . . Only flesh with its soul—its blood—you must not eat.” (Genesis 9:3, 4) Blood was sacred and so could be used only in sacrifice. If not used in that way, it was to be disposed of on the ground.—Leviticus 17:13, 14; Deuteronomy 12:15, 16.
This was no mere temporary restriction for Jews. The need to abstain from blood was restated for Christians. (Acts 21:25) Around them in the Roman Empire, God’s law was commonly broken, since people ate food made with blood. It was also broken for “medical” reasons; Tertullian reports that some men took in blood thinking that it could cure epilepsy. ‘They quaffed with greedy thirst the blood of criminals slain in the arena.’ He added: “Blush for your vile ways before the Christians, who have not even the blood of animals at their meals.” Jehovah’s Witnesses today are just as determined not to violate God’s law, no matter how common it is for others to eat food made with blood. In the 1940’s, blood transfusions came into widespread use, and the Witnesses saw that obeying God required that they also avoid blood transfusions, even if doctors urged these.
At first, most transfusions were of whole blood. Later, researchers began to separate blood into its primary components, for doctors concluded that a certain patient might not need all major parts of blood. If they gave him only one component, it would be less risky for him, and the doctors could get more use out of the blood available.
Human blood can be separated into dark cellular material and a yellowish fluid (plasma, or serum). The cellular part (45 percent by volume) is made up of what are commonly called red cells, white cells, and platelets. The other 55 percent is the plasma. This is 90 percent water, but it carries small amounts of many proteins, hormones, salts, and enzymes. Today, much of the donated blood is separated into the primary components. One patient may be given a transfusion of plasma (perhaps FFP, fresh frozen plasma) to treat shock. But an anemic patient might be given packed red cells, that is, red cells that had been stored and then put in a fluid and transfused. Platelets and white cells are also transfused but less commonly.
In Bible times men had not devised such techniques for using these components. God simply commanded: ‘Abstain from blood.’ (Acts 15:28, 29) But why should anyone think that it would make a difference whether the blood was whole or had been separated into these components? Though some men drank blood, Christians refused even if it meant death. Do you think that they would have responded differently if someone had collected blood, allowed it to separate, and then offered them just the plasma or just the clotted part, perhaps in blood sausage? No, indeed! Hence, Jehovah’s Witnesses do not accept transfusions of whole blood or of its primary components (red cells, white cells, platelets, or plasma) used to accomplish a similar purpose.
As the question suggests, though, scientists have learned about specialized blood fractions and how to employ such. A common issue involves the plasma proteins—globulins, albumin, and fibrinogen. Likely, the most widespread therapeutic use of such is injecting immune globulin. Why is that done?
Your body can produce antibodies against certain diseases, giving you active immunity. This is the basis for advance inoculation with a vaccine (toxoid) against polio, mumps, rubella (measles), diphtheria-tetanus-pertussis, and typhoid fever. However, if someone has recently been exposed to certain serious diseases, physicians may recommend an injection of a serum (antitoxin) to give him immediate passive immunity. Until recently such injections have been made by extracting immune globulin, which contains antibodies, from a person already immune. The passive immunity gained from the injection is not permanent, for the injected antibodies pass out of his system in time.
In view of the command to ‘abstain from blood,’ some Christians have felt that they should not accept an immune globulin (protein) injection, even though it was only a blood fraction. Their stand is clear and simple—no blood component in any form or amount.
Others have felt that a serum (antitoxin), such as immune globulin, containing only a tiny fraction of a donor’s blood plasma and used to bolster their defense against disease, is not the same as a life-sustaining blood transfusion. So their consciences may not forbid them to take immune globulin or similar fractions. They may conclude that for them the decision will rest primarily on whether they are willing to accept any health risks involved in an injection made from others’ blood.
It is significant that the blood system of a pregnant woman is separate from that of the fetus in her womb; their blood types are often different. The mother does not pass her blood into the fetus. Formed elements (cells) from the mother’s blood do not cross the placental barrier into the fetus’ blood, nor does the plasma as such. In fact, if by some injury the mother’s and the fetus’ blood mingle, health problems can later develop (Rh or ABO incompatibility). However, some substances from the plasma cross into the fetus’ circulation. Do plasma proteins, such as immune globulin and albumin? Yes, some do.
A pregnant woman has an active mechanism by which some immune globulin moves from the mother’s blood to the fetus’. Because this natural movement of antibodies into the fetus occurs in all pregnancies, babies are born with a degree of normal protective immunity to certain infections.
It is similar with albumin, which doctors may prescribe as a treatment for shock or certain other conditions. Researchers have proved that albumin from the plasma is also transported, though less efficiently, across the placenta from a mother into her fetus.
That some protein fractions from the plasma do move naturally into the blood system of another individual (the fetus) may be another consideration when a Christian is deciding whether he will accept immune globulin, albumin, or similar injections of plasma fractions. One person may feel that he in good conscience can; another may conclude that he cannot. Each must resolve the matter personally before God. (The Watchtower June 1, 1990 pp. 30-31)
Since the Bible does not give specific directions on blood transfusions, would that not mean each Christian should make a conscientious decision as to whether he or she will accept or will reject the medical use of blood?
Ten years later, in June of 2000 a Questions From Readers article appeared on page 29 that made the following statement:
…Jehovah’s Witnesses refuse transfusions of both whole blood and its primary blood components. The Bible directs Christians to ‘abstain from things sacrificed to idols and from blood and from fornication.’ (Acts 15:29) Beyond that, when it comes to fractions of any of the primary components, each Christian, after careful and prayerful meditation, must conscientiously decide for himself. (The Watchtower June 15, 2000 pg. 29)
Six years later this was strengthened in an article appearing in the November 2006 issue of Our Kingdom Ministry:
Are fractions also covered by the command to abstain from blood? We cannot say. The Bible does not give specific direction on the subject of fractions. Of course, many fractions are derived from blood that has been donated for medical purposes. Each Christian should make a conscientious decision as to whether he or she will accept or will reject the medical use of these substances. (Our Kingdom Ministry November 2006)
First of all it should be noted that when the article points out early Christians refused blood even for “medical reasons” that still involved eating or drinking it. The early Christians would have likely avoided eating human organs, viewing it as cannibalistic. But the society doesn’t use this as a reason to avoid organ transplants. The article also makes the statement that first century Christians refused to eat blood even if it meant death but it provides no example. Were they offered blood and threatened with death at the refusal of it? It is difficult to imagine a Christian faced with the decision to either eat blood or starve as if that were the only food available. Furthermore it is impossible for a person to sustain his life by only eating blood.
But beginning in 1990 we see that, for an individual Christian to accept a fraction derived from blood it was now viewed as a conscience matter. See also Barbara Anderson’s article: “Deadly Theology”.
However, even with this new acceptance of blood fractions, it should be asked: if, according to God’s law, it was required to pour the blood out on the ground and cover it with dust, and if Christians are told to abstain from blood, what justification could there be for using any fractions from it? (Acts 15:20, 29) The article reasons, that would be their prerogative if they wanted to view it that way. But what scripture could they point to for support? Additionally, what Biblical basis could there be for deciding which fractions or components are approved or disapproved?
This new position is arbitrary and out of harmony with the facts. Notice again what it says in this paragraph:
“In view of the command to ‘abstain from blood,’ some Christians have felt that they should not accept an immune globulin (protein) injection, even though it was only a blood fraction. Their stand is clear and simple—no blood component in any form or amount.”
According to this, a fraction is a component. By using these terms, the Watchtower society, not the medical profession, is making a distinction without a difference. Remember, the June 1, 1990 article said: “Human blood can be separated into dark cellular material and a yellowish fluid (plasma, or serum).” Therefore, all the cells, antibodies and proteins are transported throughout the body by the plasma.
Where does the Bible clearly forbid taking in “whole blood” but that “fractions” of it is tolerable?
Consider a similar situation reported on in the Bible. Upon attacking Jericho, Joshua said:
“Shout; for Jehovah has given you the city. And the city must become a thing devoted to destruction; it with everything that is in it belongs to Jehovah… As for you people, only keep away from the thing devoted to destruction, for fear you may get a desire and you do take some of the thing devoted to destruction and do constitute the camp of Israel a thing devoted to destruction and bring ostracism upon it. But all the silver and the gold and the articles of copper and iron are something holy to Jehovah. Into the treasure of Jehovah it should go.” (Joshua 6:16-19)
With his words Joshua made God’s direction clear, everything in Jericho belonged to Jehovah, nothing was to be taken for personal consumption. Everything was to be destroyed by means of fire. After the burning, metal objects – gold, silver, copper and iron – were to be not kept by any Israelites but turned over to the treasury at God’s tabernacle. We then are told that Achan took some of the spoil of the city, resulting in his and his family’s death. Additionally, the Israelite nation suffered the death of thirty six men along with a humiliating defeat at Ai. (Joshua 7:4,5) Would it have been acceptable if Achan only stripped off the blue fringe of the Babylonian garment in order to repair his own? (Joshua 7:21) God’s direction was clear, if an Israelite were to “take some of the thing devoted to destruction” it would “bring ostracism upon” Israel. What if the leadership of Israel had tolerated individuals separating out minor components of booty for their own use?
If some Christians would be allowed to accept certain fractions by reasoning that such are transferred by means of the placenta to the unborn, why is plasma, which is 90 percent water, not permitted? Why are not white cells permitted since these are transferred naturally in breast milk? However, since the Bible does not speak of “primary components” any more than it speaks about “fractions”, reasoning on what is transferred between mother and fetus is irrelevant. It is also presumptuous to assume that because God can do something, that automatically makes it allowable for humans to do it.
Secondly, the position is internally contradictory. Since the Bible does not give specific directions on blood transfusions, would that not mean each Christian should make a conscientious decision as to whether he or she will accept or will reject the medical use of blood?
“Fractions” such as carburetor, pistons, hood, doors and drive shaft, even one identifiable screw would all be considered stolen property if he was found with them. Only if the car is not stolen would one have the right to take it apart and use or sell its parts. And if the car is not stolen, all parts, can properly be separated and used. Even the whole car! So if blood “fractions” can be tolerated, certainly the “major components” and even whole blood can!
Then the Society’s classification of “primary components” does not seem to fit what medical science says. Doctors themselves differ on what is to be considered a fraction. A footnote in the How to Remain in God’s Love book admits the following:
“Some doctors may view the four main parts of blood as fractions. Therefore, you may need to explain your personal decision not to accept transfusions of whole blood or its four main parts, namely, red cells, white cells, platelets, and plasma.”
So is it the Watchtower society that has the right to define what a fraction is? Or does that belong to medical professionals? Some medical professionals say that blood is made up of only two main components: Plasma, which is a clear extracellular fluid, and formed elements which are made up of the blood cells and platelets.[1] This definition was recognized by the society in the June 1, 1990 Question From Readers article. That is no wonder, for albumin , Factor VIII and IX etc. are complete and functioning components just as are red cells , white cells and platelets. All these components are carried in the plasma. The fact that some components (red cells, white cells and platelets) can be separated from the plasma by centrifugation and others only by different means does not actually make these latter components “fractions” of the plasma more than the others. Red cells and albumin proteins are not comparable to “uncles” and “nephews” but rather are like “siblings”!
Not surprisingly, a medical authority like Modern Blood Banking and Transfusion Practices by Denise M. Harmening (4th edition, Philadelphia 1999) includes Albumin, Immunoglobulin as well as Factor VIII and Factor IX among “the major components” of blood and no mention is made of the specific classification now made by the Society. (pp. 237-240, 246-248)
By what scriptural reasons are injections of some blood fractions allowable today but injections of others are not? Saying that Jehovah’s Witnesses abstain from blood when in fact their stance tolerates acceptance of some components of blood, physicians or anyone else can simply say, “Jehovah’s Witnesses abstain from some parts of blood but not all parts of blood.” Classifying components of blood as “major” or “minor” components is meaningless unless “major” and “minor” is effectively defined. Even if a definition were given, for a Christian it would be absolutely necessary to show that this was God’s definition and not that of men.
Is there a difference between a component and a fraction? Webster’s Universal Collegiate Dictionary defines a fraction:
2 a component in a volatile mixture whose range of boiling point temperatures allows it to be separated from other components by fractionation. 3. A part of a whole:
Two thirds is just as much a fraction of a whole as two thirty seconds. But components considered “a matter of conscience” do not make up less of blood by volume, thus no reasonable distinction can be made based upon size or amount. For example, white blood cells, which are forbidden, makes up less volume of blood than albumin, which is permitted.
There is no indication in scripture that God recognizes one component of blood as more or less important than another component. The designations of red blood cells, white blood cells, platelets and plasma are purely manmade. Modern medicine divides, recognizes and names components of blood as they discover and understand them.
We would never think to draw distinctions between major and minor aspects of porneia and say that some would be permissible because without exception the Bible says “abstain from fornication” (1 Thess. 4:3) The Bible offers no proper exceptions from abstaining from blood based upon major and minor components. In that case the phrase “abstain… from blood” is just as categorical as “abstain from fornication”. (Acts 15:20, 1 Thess. 4:3)
God has recognized from the beginning the various components of blood and the purpose for which he created them. If God’s word does not specify which medical practices regarding blood are acceptable and which are not, is it not going beyond what is written for anyone else to do so and then enforce such a definition on others?
Jehovah’s Witnesses have used the transference of antibodies and proteins via the placenta as reason that some might conscientiously accept these components of blood. However, when it comes to nourishment carried by the blood, doesn’t a fetus receive every bit of it’s nutrition – including water from the plasma – from the blood of the mother? Water makes up 90 percent of the plasma.
Osamu Muramoto, MD, PhD, a member of the ethics committee at Kaiser Permanente Northwest Division, and a neurologist at Northwest Permanente PC, Portland, Oregon raised several questions in a series of articles entitled: “Bioethics of the refusal of blood by Jehovah’s Witnesses” published in the Journal of Medical Ethics 1998.[2]
Foremost among the questions are these:
- The Bible verses against “taking in blood” refer to eating or drinking it. What scripture extends this to blood transfusion?
- If the scriptures ban blood transfusion why does the society allow transfusion/injection of all blood fractions while banning transfusion of whole blood?
- Why does the society permit witnesses to accept all the separate components of plasma, yet forbid plasma itself?
- Why are components such as platelets (0.17% of blood volume) and white cells (1% of blood volume) forbidden whereas a larger component like albumin (2.2%) is allowed?
- What sort of ethics allows witnesses to accept numerous society-permitted blood products and benefit from the donated blood of non- witnesses, yet not allow them to contribute to the blood supply?
- Since permitted haemophiliac treatments require collection and storage of massive quantities of blood (up to 2,500 units for a single treatment), why does the society forbid witnesses from storing their own blood? Why the double standard?
- Why did the society’s application to the European Commission on Human Rights (ECHR) state that there are “no controls or sanctions” against a witness who accepts blood (or non-approved blood components) when every witness knows otherwise?[3]
In their responses to Dr. Muramoto, Watchtower Society spokesmen David Malyon and Donald Ridley deny many of the criticisms levelled against the society by Muramoto. Yet the above questions were unanswered.
Other questions that have been raised are:
What is Jehovah’s Witnesses’ definition of blood?
Are all parts of blood “blood” or are there certain components of blood they do not define as “blood” as prohibited in Acts 15:29? (For example: Scripturally what makes red cells coming from whole blood different from proteins coming from whole blood, making one a matter of interest judicially and the other of no judicial interest?)
If certain components in blood are not considered “blood”, how is this determined?
Are components of blood no longer viewed as “blood” once they are of small enough proportion? If so what is the amount?
Is it the particular component that is allowable? If so what are the scriptural reasons for allowing these components to be a matter of conscience?
It seems that for one who wants to “abstain from blood” the safest position to adopt is one that rejects any and all uses of blood, whether whole or in part, which would allow for no medical use at all. Who could fault the person if that were his personal decision? But should that be mandated to all? On the other hand it would seem one could argue that the specific condemnation against blood in Bible times was in regard not to transfusing but to eating it. Also, since the blood represents a life taken which belongs to God and no life was taken in receiving a blood transfusion but freely given by the donor, then the blood would not be considered stolen property. Hence his conscience could allow him to receive blood whether whole or in fractions.
Who could fault the person if it were his personal decision out of a high regard for the sanctity of life to accept a blood transfusion to save his life or that of a child? In order to do so one could not avoid going beyond the things that have been written.
Yet even now in the midst of the COVID-19 pandemic, the Watchtower society is still enforcing its position on blood components which could lead to the unnecessary death of more of their members.[4]
Medical professionals have discovered that persons that have successfully recovered from the disease have developed antibodies in their blood. Patients suffering from the virus have been successfully treated when transfused with plasma containing the antibodies, known as convalescent plasma treatment. Normally witnesses are prohibited from receiving plasma due to the society’s arbitrary distinction of plasma as one of the four main components of blood. However, doctors are able to retrieve the antibodies from a fraction of the plasma known as cryosupernatant. Since Watchtower society policy allows for fractions of plasma, witnesses need not refuse this form of treatment.
[1] https://www.myvmc.com/anatomy/blood-function-and-composition/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1377670/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119307/
[4] See the recent JW Survey article https://jwsurvey.org/news/jehovahs-witnesses-denied-plasma-treatment-amid-coronavirus-pandemic