Outrageous Omission – Blood

The following article is republished from the Blog of Marvin Shilmer and demonstrates that the Watchtower Society (WTS) is continuing to quietly back down from their once firm position on the use of blood. Sadly, individual Jehovah’s Witnesses are usually the last to know about important changes to the policy despite the WTS global publishing assets. 

Watchtower asks Jehovah’s Witnesses to treat what it says as the voice of God.[1]Watchtower asks Jehovah’s Witnesses to look to it for timely information and clarifications.[2]So why must Jehovah’s Witnesses learn important and potentially lifesaving clarifications of Watchtower’s blood doctrine fromsecularly published medical articles?What happened in 2000?

In year 2000 Watchtower presented its blood doctrine as leaving Witnesses free to accept transfusion of anything from blood so long as it is not in the form of 1) whole blood, 2) red cells, 3) white cells, 4)platelets or 5) plasma.[3]

Hemoglobin

Hemoglobin is a blood product. The year 2000 presentation of information potentially left Jehovah’s Witnesses free to accept transfusion of hemoglobin-based oxygen carriers. I say potentiallybecause hemoglobin is no minor component of blood and Witnesses have been taught for years by Watchtower that it is “minor” constituents of blood that are not forbidden under Watchtower doctrine. So was hemoglobin acceptable or unacceptable based on Watchtower’s June 15, 2000 presentation?

Answering that question was complicated in year 2004 when Watchtower pushed a reprint of the 2000 presentation before the Witness community, only this second-go-round the title had been changed.

● In year 2000 Watchtower presented its blood doctrine under the article title:

Do Jehovah’s Witnesses accept any medical products derived from blood?”[3]

● In year 2004 when Watchtower reprinted the same material, it did so under a different title reading:

Do Jehovah’s Witnesses accept any minor fractions of blood?”.[4]

Watchtower made a similar change in presentation within the healthcare power of attorney documents it provided Witnesses between years 2000 and 2004. The documents Watchtower issued in 2000 (but dated 2001) had the option to “accept all fractions derived from any primary component of blood.”[5] The same option as presented in the document Watchtower distributed in 2004 was couched with the phrase “minor fractions”.[6]

Hemoglobin is no minor blood component. So could Jehovah’s Witnesses accept transfusion of hemoglobin oxygenation agents, or not?

Secular medical writers come to the rescue

Beginning in the early 2000s doctors became aware of an internal clarification by Watchtower officials that hemoglobin agents were no longer forbidden for Jehovah’s Witnesses to accept. Essentially this information was shared with them on a need-to-know basis. The Witness community can thank these doctors for publishing what they learned so it was available on a wider basis, at least among healthcare providers who could then share it in printed form with Witness patients.[7]

It was a full six-years later before Watchtower made this clarification widely known through its internal publications to the Witness community.[8]

Cryosupernatant

Cryosupernatant is another blood product. Does Watchtower’s blood doctrine leave members of Jehovah’s Witnesses free to accept transfusion of cryosupernatant purely as a matter of personal conscience? For all the same reasons above and more, the same question has been problematic in terms of a clear answer being communicated by Watchtower to the community of Jehovah’s Witnesses.

Cryosupernatant is no “minor” fraction from blood.[9] Cryosupernatant is at or greater than 50% of the volume of whole blood and is about 99% of the volume of plasma. So is it acceptable or not?

Again secular medical writers come to the rescue

As published in 2009 Dr. Steven Hill[10] wrote the following:

(click image to enlarge)
Read the rest of this article. . .

Watchtower Position Crumbles

For those who have spent some time studying the Watchtower Society’s (WTS) position on the use of blood, one of the most troubling aspects is their allowance of all the various components of plasma. Thus Witnesses may elect to accept the various Immunoglobulins, blood serums, blood clotting factors, albumin and so forth. They may not, however take all of them at the same time.

How does the WTS justify such a position? Especially since they were once so opposed to the use of blood fractions as this quote amply demonstrates:

“Whether whole or fractional, one’s own or someone else’s, transfused or injected, it is wrong.” – The Watchtower 09/15/1961 p. 559

In the following quotation taken from the Watchtower of June 1, 1990, pages 30 & 31, you will note how they justify the use of blood fractions:

“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.”

fetus

Photo: Lennart Nilsson

The line of reasoning here used by the Society is quite apparent. The “natural movement” of these various allowed components across the placental barrier is viewed as a basis for the Christian in accepting these blood components.

Elders and Hospital Liaison Committee member’s will often make statements to the effect that the “natural movement” of these blood components is evidence that God allows the use of these blood products since it would be unimaginable for God to break his own laws on blood.

The members of the Associated Jehovah’s Witnesses for Reform on Blood agree. It would be “unimaginable” for God to break his own laws. If various components of blood actually pass through the placental barrier, either from the mother to the fetus or vice versa, than it would seem entirely reasonable that God would have no objection to our using these blood components in this way.

It is interesting to note that the medical literature contains a great deal of information on this subject. Some of it is available on the Internet, some is not. In either case, we will provide complete references so that you can research this material for yourself.

We begin by noting the presence of fetal blood within the mother’s circulatory system is an established fact demonstrated by numerous medical studies. Is this a new discovery of which the Society is not aware? That is hardly imaginable. Fetal cells were first recovered from maternal blood as reported by Walknowska et al in 1969. 1 Additionally, as early as 1961 the Society acknowledged this fact:

While there is no direct flow of blood between the mother and the fetus, yet by osmosis there is some transfer of blood between the mother and the baby through the placenta. – Blood, Medicine and the Law of God, 1961, p. 25

P.C.R. technology has facilitated additional research in this field of study, primarily for the purpose of screening for birth defects or prenatal diagnosis. This technology allows us a clear look at what is happening with respects to exchanges of blood components between the mother and the fetus. This technology and the resulting knowledge became available prior to the 6/90 WT article quoted above.

A 1993 article in the “Journal of the American Medical Association” references two studies involving P.C.R. technology reported on in 1989 and 1990, and goes on to say:

“Thus fetal DNA sequences indeed exist in maternal blood. Among the various candidate cells, the most promising appear to be fetal nucleated red blood cells. We isolated nucleated red blood cells on the basis of flow-sorting for the transferring receptor and glycophorin-A” 2(italics ours)

Here we find evidence that red blood cells do indeed pass from the fetus to the mother. The significance of this finding for the Watchtower blood doctrine can hardly be overstated. Using the reasoning and logic employed by the WTS itself, what further evidence does one need to conclude that God would not object to transfusion of red cells?

The following study comes from the Baylor College of Medicine. Please note:

“Fetal cells unequivocally exist in and can be isolated from maternal blood. Erythroblasts, trophoblasts, granulocytes and lymphocytes have all been isolated by various density gradient and flow sorting techniques.” 3 (italics ours)

Erythroblasts are immature red blood cells, and lymphocytes are white blood cells. Both are forbidden blood components by the Watchtower Society, despite the fact that they clearly are among those components that have a “natural movement” across the placental barrier.

As an interesting side point, this study notes that fetal cells can persist in the mothers blood stream for extended periods of time. In one case fetal cells were still present twenty-seven years after child-birth. How appropriate then that we think of a blood transfusion as a cellular organ transplant which becomes part of the body.

As reported in “Early Human Development,” fetal nucleated cells in maternal blood has been demonstrated by many groups. Fetal cells are detected in the mother’s circulation as early as four weeks and five days after conception, and are present during all three trimesters of pregnancy; gradually increasing as gestation progresses. Also of great significance is that the majority of cord blood samples reveal the mother’s cell’s are also present in fetal circulation. So we have a dual exchange of blood components more than 50% of the time.4

Conclusion

How can the WTS continue to ignore the facts, and insist on adherence to a policy that routinely results in avoidable death? Here we have seen how the scientific facts clearly disprove the basis upon which the Society allows some blood fractions while not allowing others. Some of the questions that remain unanswered are:

1. Did the WTS know the facts all along and make a conscious choice to misrepresent the truth?

2. Did the WTS negligently fail to do careful research when establishing a policy that millions would rely upon in choosing their medical care?

3. Will the WTS exhibit the moral courage to set matters straight? (In 2000 – likely in response to pressure from AJWRB – the WTS modified its blood policy to allow all blood fractions. Yet they still continue to prohibit red cells which as we have seen above are able to pass the placental barrier.)

4. How many more lives will slip away in the meantime?

Note: Those considering independent legal actions against the WTS will want to take note of the potential for the WTS being held liable for negligently providing inaccurate medical advice.

 

Watchtower Approves HemoPure

Watchtower Approves HemoPure (Bovine Hemoglobin) for Jehovah’s Witnesses

Jehovah’s Witnesses have long been known for their rejection of blood and blood-component transfusion, even when it is necessary to save life. In a remarkable change in policy, the Witnesses’ governing body announced in the June 15, 2000 issue of its official church publication The Watchtower, that members may now accept “fractions of any of the primary components” of blood.  (Italics added) Previously, Witnesses who accepted a transfusion of blood fractions other than those found in plasma faced possible expulsion and enforced shunning by church members.

hemopureimageThis change in policy has been particularly timely for some Jehovah’s Witnesses. According to a September 24, 2000 article in the Sacramento Bee, a patient was transfused with Hemopure®, a highly purified oxygen-carrying hemoglobin solution made from fractionated bovine (cow) blood and manufactured by Biopure Corporation.

Dorsey Griffith, a medical writer for the Bee, states that Gregory Brown, a representative from the Jehovah’s Witnesses Hospital Liaison Committee, approved the use of the oxygen-carrying solution that was transfused into the patient, Jose Orduño.  The article notes:  “When Orduño woke up from his drug-induced slumber, about a month after the ordeal began, Angelica was there …His sister told him about the accident and how he almost died, and about the drug made from cow blood that had saved his life.”

That approval of the use of hemoglobin marks a notable change in the Watchtower Society’s policy is readily seen from its own published statements:

Is it wrong to sustain life by administering a transfusion of blood or plasma or red cells or others of the component parts of the blood? Yes!…The prohibition includes “any blood at all.” (Leviticus 3:17) – Blood, Medicine and the Law of God, 1961, pp. 13, 14

“…various tonics and tablets sold by druggists show on their labels that they contain blood fractions such as hemoglobin. So it is necessary for one to be alert… if they are to keep themselves ‘without spot from the world.’—Jas. 1:27.” The Watchtower, 9/15/61, p. 557.

Early in man’s history, our Creator ruled that humans should not eat blood. (Genesis 9:3, 4) He stated that blood represents life, which is a gift from him. Blood removed from a creature could be used only in sacrifice, such as on the altar. Otherwise, blood from a creature was to be poured on the ground, in a sense giving it back to God …It would be right, of course, to avoid products that listed things such as blood, blood plasma, plasma, globin (or globulin) protein, or hemoglobin (or globin) iron.”  The Watchtower, 10/15/92 – Questions From Readers. (Italics added)

As recently as 1998 two officials from the Watchtower Society’s “Hospital Information Services” wrote that Jehovah’s Witnesses do not accept hemoglobin which is a major part of red blood cells…. Jehovah’s Witnesses do not accept a blood substitute which uses hemoglobin taken from a human or animal source.” Bailey R, Ariga T. The view of Jehovah’s Witnesses on blood substitutes. Artif Cells Blood Substit Immobil Biotechnol 1998;26:571-576.

The policy on hemoglobin and other blood fractions was changed in the June 15, 2000 issue of The Watchtower.  This latest change has created further confusion for some Jehovah’s Witnesses since products like Hemopure®  are derived from large quantities of stored animal blood.  Numerous witnesses have questioned the logic of such an internally inconsistent dogma. Some believe that the governing body of Jehovah’s Witnesses is simply changing its long-standing doctrine gradually to avoid legal problems anticipated with an overt change to a policy that has resulted in so many deaths over the years.

Hemopure® continues to be investigated and evaluated for human use. While it has been approved for human use in South African and Russia it has shown to increase the risk of death by approximately 30% and has not been able to obtain approval in other countries.

The FDA “compassionate use” program has made Hemopure® available where a life-threatening situation exists and compatible red blood cell transfusion is 1) not available, 2) not effective, or 3) not acceptable to the patient.  One such high profile case involved a Jehovah’s Witness who was severely injured in the Boston Marathon bombing. His life was apparently saved by the use of the bovine hemoglobin as reported by the Kansas City Star.

http://cjonline.com/news/2013-05-06/kansas-jehovahs-witness-saved-blood-substitute

The search for a substitute for blood has been in progress for many years and has been fraught with difficulties.1

Biopure, the company that produced Hemopure, had a very colorful history that eventually led to prison time for Howard Richman (SEC violations) and eventually bankruptcy in 2009 with its assets purchased by OPK Biotech. At the time of the most recent update of this article in 2014, Clinical Trials of Hemopure continued to be in progress.2

AJWRB welcomes the progress in blood substitute development as well as the softening of the WTS stance on hemoglobin. For Jehovah’s Witnesses who are evaluating these issues we would simply point out the kind of tortured logic the WTS is employing by taking the largest single component of blood from an animal (hemoglobin) and saying that a Christian may use it in good conscience while at the same time arguing that a tiny component of human blood like platelets are not permitted. This is certainly not something that can be substantiated with the Bible or even science for that matter. We believe the only reasonable position is to allow individual Jehovah’s Witnesses a free choice in their medical treatment.