Jehovah’s Witnesses reject whole allogeneic blood transfusions.[54] This is based on their understanding of the biblical admonition to “keep abstaining from blood” (based on Acts 15:28, 29). Prior to 2000, the storage and use of human and animal blood products, and the commercial use of blood products were condemned as unscriptural. (Watchtower 1 February 1997 p.30)
Although Jehovah’s Witnesses do not accept transfusions of whole blood, and despite not donating blood (as they believe it must not be stored), they may according to the conscience of the particular individual, accept derivatives of blood, or even whole autologous blood so long as it is part of a “current therapy”, such as normovolemic hemodilution, a treatment that processes the individual’s own blood in a closed loop that does not interrupt the flow of blood, delivering it immediately back into the person’s body. [55] Also left to conscience are procedures where a “quantity of blood is withdrawn in order to tag it or to mix it with medicine, whereupon it is put back into the patient.” [56]
The Witnesses’ Medical Care and Blood policy changed fundamentally in the year 2000 and now accepts derivatives such as Hemopure, which consists of chemically stabilized bovine hemoglobin (derived from cows’ blood) and PolyHeme (chemically modified hemoglobin derived from human blood). The Pennsylvania Hospital in Philadelphia, PA, provides a detailed list of these specific distinctions. Witnesses interpret the prohibited use of blood to be limited to whole allogeneic blood (or any of its four main components), or stored autologous blood. Transfusion of whole autologous blood that is part of a “current therapy” and/or sufficiently fractionated constituents from donated and stored allogeneic blood are considered a “gray area” not specifically condemned and therefore permissable. [57]
Many Jehovah’s Witnesses carry carefully prepared durable power of attorney documents indicating that they will accept all fractions derived from blood. The wording of this option reads, “I accept all fractions derived from any primary component of blood.” (2003 Guide to Our Three Health Care Documents, p. 11) The conscience of some Witnesses still does not permit the use of fractions derived from blood and these will use non-blood alternatives with varying degrees of success.
The refusal of blood transfusions is a significant issue among medical professionals and others concerning Jehovah’s Witnesses, especially when it involves minor children and more so in view of the fact that children of Jehovah’s Witnesses have died as a consequence. In some countries, laws may impose limitations on physicians on the ability to withhold or withdraw blood transfusions or blood therapy from minors, particularly in life-threatening situations; parents who have prevented children under their care from receiving blood therapy in life-threatening situations may face prosecution. Courts have ordered transfusions for some children, often the very young; in other cases they have respected the declared choice of an under-age minor who is able to defend his or her own beliefs to the court in a manner that reflects a mature understanding and without undue influence from the parents.
Pursuit of medical alternatives to blood transfusion in cases involving Jehovah’s Witness patients, including the use of erythropoietin to boost the red blood cell count, has afforded opportunities for medical advancement in the field of bloodless surgery.[58]
A peer-reviewed essay entitled, “Jehovah’s Witnesses, Blood Transfusions, and the Tort of Misrepresentation,” found in the Autumn issue of Baylor University’s Journal of Church and State, published December 13, 2005, discusses the potential vulnerability of Jehovah’s Witnesses’ legal corporations to significant claims for compensation because of the religion’s possible misrepresentation of the medical risks of blood transfusions.[59]