Favorite Watchtower’s Approved Blood Transfusions

bloodchartAThe Watchtower and Jehovah’s Witnesses in general still cling to the “no blood” mantra. As you will see in this section, that claim is extraordinarily dishonest. The Watchtower has approved the use of all red cell, white cell, platelet and plasma derivatives. The list of blood products Jehovah’s Witnesses can choose to use in good conscience has grown larger and larger over the last three decades. If fact, the list has become so extensive, it’s easier to say what they don’t permit:

  • Whole Blood
  • Red Cells
  • White Cells
  • Platelets

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Watchtower “No Blood Card”

blood-transfusion-jw The “No Blood Card” that Jehovah’s Witnesses carry with them has experienced very significant changes over the years, as you will see in this article. It was simply referred to as “the blood card” for many decades, then came to be called “the Advanced Medical Directive”. The last major change occurred in 2004, when it was combined with a Durable Power of Attorney specific to each state and is at times referred to as the “DPA”.

The first example shown is one of the older versions of the blood card that Witnesses carried back in the 1960’s. You will note its clear and uncompromising statement about the use of blood. It says specifically “I demand that blood, in any way, shape or form, is NOT to be fed into my body…”

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Blood Serum – Watchtower Quotes


Blood Serum

Blood serum is the clear fluid that remains after the cellular components (red cells, white cells, platelets, clotting factors and fibrinogen are removed. It includes all proteins not used in the clotting process.

What follows is a collection of quotes from Watchtower Society literature. This information will help researchers understand the historical development of the Watchtower Society’s policy on blood serums and document the many changes in policy through the years.

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Questions for Those who Believe in the Watchtower Blood Policy


One of the most effective ways we have found in assisting other Witnesses to analyze the WTS blood doctrine is through the use of questions. The following questions have been used by AJWRB members and physicians in different parts of the world.

If you are investigating the Watchtower’s blood policy we invite you to consider these carefully. Research the publications or discuss your concerns with the elders respectfully, and ask them to help you understand what they personally believe and how they grapple with these difficult issues. You may also wish to discuss them with members of your family or friends as a way helping them to analyze the blood  policy and their commitment to it.

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Blood Transfusion: Letter of Understanding

may26-94-awThe 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 for Jehovah’s Witness minors – particularly with respects to very young children who would have no hope of being granted “mature minor” status by the courts.

I’m much pleased to make available a beautiful piece of work that’s been around since at least 2007 but with very little publicity.

It’s documentation put together by diligent medical ethicists and at the urging of Watchtower appointed Hospital Liaison Committees of Jehovah’s Witnesses.

The document used by The Hospital for Sick Kids in Toronto, Canada looks like this[1]:

Letter of Understanding, JWs blood transfusion 2007

(click image to enlarge)

This Letter of Understanding is something medical professionals treating children of Jehovah’s Witnesses have always wanted: to be left alone to do what’s in the best interest of saving a child from pain, sickness and/or death if possible.

What’s changed

Completing this document requires no knowledge that 1) a treating physician has record of good cooperation with Jehovah’s Witness patients, 2) a past record of performing a particular “bloodless” procedure along with 3) sentiment that the same procedure will be “no problem” this time. This is a change from Watchtower’s published policy dating to 1992.[2]

The Letter of Understanding document is a written and signed record that parents of a Witness child have been informed their child will be given the best medical treatment available, including transfusion of blood products forbidden under Watchtower doctrine if treating physicians deem it necessary.

Watchtower’s okay with it

The November 2012 issue of The American Journal of Bioethics reports that when Witness parents have refused consent for medically necessary blood transfusion the local Watchtower appointed Hospital Liaison Committee members have stepped forward requesting the option of having parents sign one of these letters of understanding in order to avoid involvement of child protective services.[3]

My recommendation and an observation

Every parent among Jehovah’s Witnesses worried about how local Watchtower appointed elders will respond to letting their child have blood transfusion without opposing it should download this Letter of Understanding and be ready to hand a copy to them. Then ask those elders to leave them (the parents) and doctors alone to concentrate on the child’s best interests.

Given all the time, money and publishing resources the Watchtower organization has poured into the subject of blood transfusion, individual patients, hospital administrators and treating physicians are left wondering why Watchtower has yet to advertise this option to the larger community of Jehovah’s Witnesses, and why this option is not otherwise heavily advertised by every hospital knowing of it. The document above is dated 2007 yet until now was not published anywhere known to this author, and certainly the Watchtower organization has never published this.[4-5]

Marvin Shilmer

1. Letter of Understanding, Jehovah’s Witness patients and blood transfusion, The Hospital for Sick Children, 2007.

2. Safeguarding Your Children From Misuse of Blood, Our Kingdom Ministry, published by Watchtower, September 1992, p. 3.

3. “The JW Hospital Liaison Committee members supporting this couple inquired whether an option existed for them to sign a letter of understanding (LOU) indicating their acknowledgment that their child will receive necessary transfusions, without requiring either their explicit consent or [Child Protective Services] involvement to temporarily apprehend the child.”—(Frolic et al, Opening the Black Box of Ethics Policy Work: Evaluating a Covert Practice, The American Journal of Bioethics, Vol. 12, No. 11, November 2012, pp. 3–15)

4. First hint of this document came in early 2008 after reading the article “Only flesh with its soul–its blood–you must not eat” (Dr. Christine Harrison, Paediatric Child Health, Vol. 12, No. 10, December 2007, pp. 867-868) and attempting to retrieve an unpublished referenced guideline titled Jehovah’s Witnesses and Blood Products within The Hospital for Sick Children. Success in obtaining the policy and the Letter of Understanding is recent. It turns out Dr. Harrison was the issuing authority within The Hospital for Sick Children for the policy and letter.

5. More recently talk of this document is found in a December 20, 2012 article of the National Post titled Without fanfare, Jehovah’s Witnesses quietly soften position on blood transfusions, by Tom Blackwell.

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.


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.