While the Watchtower has never published either actual statistics or estimates of the impact of their blood policy on Jehovah’s Witnesses, it is well-known in the medical community that the policy has caused or contributed to numerous premature deaths among followers who observe the policy.1 2 3
It has certainly been within the ability of Watchtower officials to collect data on the numbers of Jehovah’s Witnesses who have died prematurely because of the blood policy, as they already carefully track the activity of every member. Additionally, Watchtower HLC and HVC representatives are frequently involved in many of these cases. The likely explanation, as to why the numbers have never been released, is that such data would create a liability for the Watchtower Society in much the same way as their database of known and suspected pedophiles has done when it came to light.4
AJWRB medical adviser, Dr. Osamu Muramoto, M.D., and AJWRB Science Adviser Marvin Shilmer looked at the available medical studies and independently developed extrapolations of the impact of Watchtower’s policy in terms of estimated lives lost since the beginning of the Watchtower’s blood transfusion prohibition and a projection of lives potentially lost annually. We begin with a review of these estimates, then adjust them to bring the numbers current.
In 2001, Dr. Muramoto used a study by Kitchens CS: Are transfusions overrated? Surgical outcome of Jehovah’s Witnesses. It was published in the February 1993 issue of The American Journal of Medicine on pages 117-119. The study was based on 1404 “bloodless” surgeries performed on Jehovah’s Witnesses, and showed that 1.4% of these patients died to a lack of blood as either a primary or contributing cause of their death. Simply stated, this means that every time a JW had “bloodless surgery” their chance of death was 1.4% greater due to refusing blood.In an abundance of caution, Dr. Muramoto elected to round down this figure to 1% to allow for some who may have died anyway, so stated another way he determined that for every one hundred “bloodless” operations on Jehovah’s Witnesses, one death could be attributed to blood refusal.
At that time the American Association of Blood Banks reported that approximately 4 million patients received blood transfusions from 12.6 million units of donated blood every year. That meant that 4 million or 15 of every 1000 Americans had conditions requiring blood each year.
There were about 1,000,000 Jehovah’s Witnesses in the United States at the time, so approximately 15,000 Jehovah’s Witnesses would have had conditions that would normally require a blood transfusion. If their rate of death increased by 1% due to blood refusal, this means that about 150 Jehovah’s Witnesses died that year in the United States due to observing Watchtower’s blood prohibition.5
Since Jehovah’s Witnesses are a multi-national religious organization, we have to extend this extrapolation to account for these members in other countries, and we also have to account for the fact that the policy has been in place since 1945. However, since observing the policy was optional until 1961, we have elected to leave out the intervening years (from 1945-1961). Like Dr. Muramoto, we want to error on the side of caution, even though it can be reasonably assumed that many deaths occurred during this period due to the very limited availability of “bloodless” treatment.
We have compiled the Watchtower’s published data on Jehovah’s Witness publishers between the years of 1961-2016. Over this 56 year period, the average number of publishers per year was 3,957,868. Converting the factor determined by Dr. Muramoto this would indicate that 33,246 Jehovah’s Witnesses died during this 56 year period. On an annual basis that works out to an average of 594 deaths per year, with 1220 deaths in 2016.
It is our conclusion this represents a conservative estimate since many of the high-tech treatments and medical equipment currently in use did not exist in earlier years, and to this day does not exist in third world countries where Jehovah’s Witnesses have experienced much of their growth. While actual numbers will never be known, it is probable that the actual number of deaths among the Jehovah’s Witnesses population is higher, perhaps significantly higher.
Marvin Shilmer, AJWRB Science Adviser
In 2012 Marvin Shilmer, a former Jehovah’s Witness official, prepared a second estimate of the impact of Watchtower’s blood policy on Jehovah’s Witnesses and their children.6 In this case he was able to use a more recent study by Beliaev et al, entitled Clinical benefits and cost-effectiveness of allogeneic red-blood-cell transfusion in severe symptomatic anemia, published in VoxSanguinis in 2012.
This was a multicenter observational study pairing Jehovah’s Witness patients (excluding those under age sixteen and those with advanced cancer) who refused red blood cell products with matched patients who received red blood cell (RBC) products. Data was collected from four public hospitals in New Zealand between 1998-2007. During this period, the study found 103 JW patients who suffered severe anemia, and of these 20.4% died (21 patients). The death rate among the matching group who accepted RBC products was just 1.9%. So the net difference in mortality can be directly attributed to following Watchtower blood policy. 20.4 – 1.9 equals 18.45%.
Put another way, this means that if this group of 103 JW’s had accepted RBC products instead of having 21 deaths, there would have been just 2 deaths. Since the study covered a ten year period, and there were 19 JW’s who died unnecessarily, approximately 1.9 deaths per year occurred. Over this 10 year period, the average number of JW publishers was 12,700. 1.9 deaths per year amounts to 0.015% of the JW population. This is consistent with the factor that Dr. Muramoto arrived at in his 2001 analysis based on a separate study.
Both Dr. Muramoto and Marvin Shilmer’s calculations resulted in the same mortality factor (0.015% annually). If we apply that computation to the current population of Jehovah’s Witnesses, it is relatively straightforward to arrive at an updated mortality figure.
According to the Watchtower Society’s published annual report, the average number of publishers during the 2016 service year was 8,132,358. If we multiply that number by 0.015% (0.00015) we arrive at 1,220 Jehovah’s Witnesses worldwide that died prematurely in 2016 as a result of Watchtower’s blood policy. This is a staggering number by any measure, and amounts to more deaths on an annual basis than all of the victims of the People’s Temple massacre in Jonestown, Guyana that claimed 918 lives on November 18, 1978.7
However, the tragedy of the Jonestown Massacre was a one time occurrence. The deaths that the Watchtower’s blood prohibition has been responsible for have been occurring for over 7 decades. The Watchtower’s tragic blood policy can be traced back to its beginnings in 1945. By 1961 Watchtower leaders began to take their policy so seriously that they made failure to observe it an offense worthy of everlasting death. Not content to leave the matter is God’s hands, they began to judge, and officially disfellowship, those refusing to accept their interpretation.
The impact on the lives of Jehovah’s Witnesses forced to observe this policy has been devastating, both on an individual level, and as an organization. We compiled the Watchtower’s annual reports from 1961, the year that taking a blood transfusion became a disfellowshipping offense, up to 2016. During that 56 year period, there were average annual publishers of 3,957,868. If we multiply this figure by 56 (years) and by the annual death factor of 0.015%, there have been approximately 33,246 deaths caused by Watchtower’s policy during that period. It is not an exaggeration to think of this as a tragedy approaching genocide.
Staggering as these numbers are, it is a conservative estimate of the loss of life. As noted above, Dr. Muramoto rounded down the actual increase in mortality from 1.4% to 1%. If we use the 1.4% mortality rate (the actual conclusion reached by Kitchens) this results in casualties that are 40% higher: 1708 deaths caused by Watchtower’s blood policy in 2016, and a total of 46,544 deaths between 1961-2016.
Marvin Shilmer notes that the New Zealand study draws from the records of four hospitals in the more densely populated Northern and midland regions which contain 57% of the country’s population. New Zealand has more than eighty hospitals in less densely populated regions that account for approximately 43% of the county’s population, and they are similarly equipped. If the mortality rate is appropriately prorated for 57% of the nation’s population, it results in an increase of the annual mortality factor to .00026, and the extrapolation indicates 2,114 deaths caused by Watchtower’s blood policy in 2016, and 57,626 deaths between 1961-2016.
While actual numbers can never be known, the most likely toll probably falls somewhere between these various estimates. To offer perspective, consider there were 33,739 U.S. Service members killed in action in the Korean War,8 and 40,934 U.S. Service members killed in action in the Vietnam War.9 If we add up all of the deaths caused by terrorist attacks attributed the Taliban, Al-Qa’ida, Boko Haram, and ISIL between 2000-2013, we arrive at a total of 23,899.10
These numbers will come as a surprise to many, particularly Jehovah’s Witnesses. AJWRB has seen many examples of deaths that have occurred due to the blood ban, and we have documented many of these experiences so that others can understand what has happened and learn from it. The simple truth, however, is that the Watchtower Society is a very large organization with more than 8 million members at present. When one of these cases leads to a premature death, it is always tragic. However, it is seldom newsworthy unless a child, adolescent or pregnant JW is involved. As a result, the vast majority of these cases are not covered by the media and remain unknown.
This is particularly the case when countries like the United States have health privacy laws that restrict doctors from sharing the medical information of their patients. We typically only learn of cases where:
- AJWRB members personally report experiences.
- Non Jehovah’s Witness family members report to the media.
- Physicians or hospitals go to court to obtain a court order to treat a minor JW.
Much of the shock value of these death estimates is related to the sheer global size of the JW community. Let’s illustrate. If the average congregation has about 100 publishers, and the average circuit consists of about 20 congregations, our conservative estimate suggests there is approximately 1 death in that circuit every 3.3 years as a result of the blood policy. The typical JW would expect to see one premature death in their congregation every 66.6 years. If they meet in a Kingdom Hall that has three congregations and personally know 300 JW’s, they might expect to learn of one blood policy related death every 22.2 years. The average JW who has been a member for ten years or less is unlikely to know of a single case.
Despite this, the average Jehovah’s Witness continues to labor under the false belief that blood is not only something to be avoided for religious reasons, but for medical reasons as well. The reason is straightforward: Watchtower has consistently exaggerated the risks of blood transfusions, and stated or implied they are harmful, dangerous and unnecessary.11 Further, they have denied the impact their policy has on the Jehovah’s Witness community that is required to observe their complex policy.
What evidence does the Watchtower point to in support of this claim? Beyond some studies about bloodless surgery, none that we could find. While it is all well and good that most elective surgery can be performed without blood transfusion, these procedures are seldom the “life or death” challenge faced by physicians treating Jehovah’s Witnesses. The major issues occur with severe trauma, childbirth complications, and chronic diseases of the blood for which no effective substitutes for a blood transfusion exist.
Simply stated, the major killer of Jehovah’s Witnesses who are observing Watchtower’s blood policy is anemia. It is an inescapable fact that when the cells of the body fail to receive oxygen for more than just a few minutes, cell death begins to occur. Jehovah’s Witnesses are very misinformed about this, with most believing that blood and blood products amount to dangerous, even reckless medical treatment.
While much can be said about the potential benefits of patient blood management or blood conservation, removing the safety net of blood transfusions adds significant and unnecessary risk to any elective surgery. Additionally, in some crucial situations like trauma, childbirth, and diseases of the blood, there are no effective substitutes for blood.
While the Watchtower Society states the policy is Biblical, they offer nothing substantive to support their partial ban on blood beyond vague scriptural references to not eating blood. Members are required to support whatever the current policy is, and JW children are also taught the importance of compliance from a very young age. Even non JW family members may be compelled into following Watchtower’s policy, and indoctrination is so complete, there is often significant levels of compliance among former JW’s.
Additionally, failure to comply will result in extreme shunning by other JW members, and lifelong friends who will be prohibited from eating a meal or even speaking to the non-compliant JW who does not follow the policy, or even questions it for that matter. This intrusion into the personal lives of members amounts to coercive control or undue influence, and makes free and informed consent practically impossible. If a man holds a gun to your head, and tells you to do something, what kind of choice do you have? If you do what you are told while the gun is to your head, what role did the gunman play in whatever “choice” you make? The choice an anemic Jehovah’s Witness faces is similar to the choice a child had in Jonestown. Drink the Kool-Aid or be executed. Well meaning physicians and hospitals often fail to comprehend these complex issues, and unwittingly participate in JW’s martyring themselves, and their adolescent children.
1. Are transfusions overrated? Surgical outcome of Jehovah’s Witnesses. Kitchens CS. The American Journal of Medicine. 1993 Feb; p.117-119. http://www.amjmed.com/article/0002-9343(93)90171-K/pdf
2. Clinical benefits and cost-effectiveness of allogeneic red-blood-cell transfusion in severe symptomatic anemia. Beliaev et al. VoxSanguinis 2012 July 103(1):18-24. https://www.ncbi.nlm.nih.gov/pubmed/22150804
3. Refusal of blood transfusion by Jehovah’s Witness women: a survey of current management in obstetric and gynaecological practice in the UK. Sahana Gupta et al. Blood Transfusion 2012 Oct; 10(4): 462-470. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496240/
The risks associated with blood transfusions are real, and well understood. They are also grossly exaggerated by the Watchtower’s “pseudo science”. http://rationalwiki.org/wiki/Blood_Transfusions:_How_Safe
Conversely, the number of lives saved by avoiding complications or disease transmission associated with blood are too small to significantly impact the estimates contained in this article. http://www.bmj.com/rapid-response/2011/10/28/risk-blood-transfusion-illegal-breach-confidentiality-addendum-reply-furul