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…”


This statement is quite interesting for two reasons:

  • We seldom hear Jehovah’s Witnesses talk in terms of blood transfusions being a “feeding” on blood. This is because they now know that a transfusion is not a feeding on blood, but rather an organ transplant. The old view was based upon outdated medical views that were discarded nearly a hundred years ago. Today, Watchtower writers are forced to speak in terms of how it is wrong to “sustain one’s life” by means of blood. As we have shown, however, the Bible no where talks about blood in this way.
  • The other interesting thing about the wording in this older card is that it would clearly prohibit a Witness from taking any of the multitude of blood products that have worked their way into the Watchtower’s approved list. It accurately reflects the position taken by the Society in the following quote:

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

What follows below is the current “Advance Medical Directive” being used by Jehovah’s Witnesses:


The current blood card, or “Medical Directive” is no longer able to make the same uncompromising statement. Why? Because the Society has gradually modified its once firm position, and now allows every part of the blood to be transfused or injected if sufficiently fractionated. A doctrine that made little sense to begin with, now makes absolutely no sense whatsoever. Are you still carrying this document in your wallet? If so, why? It may well become a warrant for your untimely death. Children of Jehovah’s Witnesses, though not even baptized, are called upon to carry a similar card:

1999 blood card childb

Beginning in 2004, the Watchtower announced a major change in how the blood card was to be issued as shown below:

12-04 KM

This new policy eliminated the annual service meeting part and distribution of new blood cards that were completed and signed each year to demonstrate the individual’s continuing commitment and belief in the policy. This marked a dramatic departure from the established policy – one that medical professionals relied upon in assessing the actual wishes of an unconscious Jehovah’s Witness who showed up at the emergency room. Why was this done? Note the following:


Note the level of alarm sounded by the Watchtower Society because one card was approximately five years old and more than half were unsigned, not witnessed or out of date. The reports certainly call into question the degree of support among Jehovah’s Witnesses for the blood policy.

Under the new arrangement announced in 2004, the elders would only have to make one thorough sweep of the congregation members to insure their permanent compliance and eliminate this hugely embarrassing situation.

The obvious downside to this new arrangement is that emergency department physicians must now speculate as to the actual degree of commitment from the individual unconscious Jehovah’s Witness patient since their signed Advanced Medical Directive is now more than ten years old.

For these reasons, we believe that it is incumbent upon emergency room physicians to verbally verify the level of commitment to the current Watchtower policy. Especially in view of the fact that it is well-known a significant percentage of Jehovah’s Witness secretly oppose the policy and feel coerced into carrying the blood card or risk exposure as apostates with subsequent shunning.1,2,3,4


1-Findley LJ, Redstone PM (March 1982). “Blood transfusion in adult Jehovah’s Witnesses. A case study of one congregation”. Arch Intern Med. 142(3): 606–607. doi:10.1001/archinte. te.142.3.606.
PMID 7065795.

2-Kaaron Benson, H. Lee Moffitt Cancer Center & Research Institute Cancer Control Journal, Vol. 2, No. 4, November/December 1995, “Therefore, while most adult Jehovah’s Witness patients were unwilling to accept blood for themselves, most Jehovah’s Witness parents permitted transfusions for their minor children, and many of the young adult patients also were willing to accept transfusions for themselves.”

3-Gyamfi C, Berkowitz RL (September 2004). “Responses by pregnant Jehovah’s Witnesses on health care proxies”. Obstet Gynecol 104 (3): 541–4. doi:10.1097/01.AOG.0000135276.25886.8e. PMID 15339766. “This review refutes the commonly held belief that all Jehovah’s Witnesses refuse to accept blood or any of its products. In this population of pregnant women, the majority were willing to accept some form of blood or blood products.”

4-Empirical data suggest to us that the current level of dissent may be significantly higher. We base this upon the conversations we have had with Emergency Department Physicians and Anesthesiologists at medical conventions.


Watchtower “No Blood Card” — 16 Comments

  1. Hi, thanks for this article, very helpful indeed. I hope all the work AJWRB is doing eventually has some effect on the JWs dropping this non-sensical and deadly doctrine.
    I have 2 questions: You reference that 10-12% of JWs oppose the policy. What is your source for this? Thanks.
    Also, you talk about the latest card and the legal status of it in the USA. Do Witnesses in the UK carry a similar card, or is it called something else? Thank you! All the best. Terri

    • We have provided the full references to the article. A durable power of attorney and advance legal directive are legally valid in the United States unless revoked, altered or signed under duress or coercion. As explained in our article, the majority of these documents will now be on the order of ten years old. We advise physicians to speak directly to the patient privately to verify their wishes. To the best of our knowledge, Jehovah’s Witnesses throughout the world carry an Advance Medical Directive.

  2. Acts 15:20 clearly states “abstain from … blood.” There are numerous scriptures in the Bible that support the idea that blood is sacret and should be avoided.

    Furthermore, a plethora of studies show that blood transfusions are not only given unnecessarily, but that they actually increase morbidity and mortality in patients. In other words, blood transfusions aren’t good for you. Physicians in the US are most likely to administer blood, while European doctors have already evolved past using this old, outdated, 20th century method of treating patients and giving blood. The overall movement is towards less blood, not more, because blood is dangerous. It is dirty. It harms your immune system. I’m not a JW, but I would not want a blood transfusion either. I wash my hands after just shaking a strangers hand, why would I want to infuse a strangers blood into my body. Gross!!

    Bennett-Guerrero, E., Zhao, Y., O’Brien, S., Ferguson, T. B., Peterson, E., Gammie, J., Song. H. (2010). Variation in use of blood transfusion in coronary artery bypass graft surgery. The Journal of the American Medical Association, 304(14), 1568-1575. doi:10.1001/jama.2010.1406.
    Brice, R. (2013). Doctors trained to order “unnecessary” blood transfusions. The World Today. Retrieved from
    Ferraris, V. A., Davenport, D. L., Saha, S. P., Austin, P. C., Zwischenberger, J. B. (2012) Surgical outcomes and transfusion of minimal amounts of blood in the operating room. Archives of Surgery, 147(1), 49-55. Retrieved from
    Halabi, W. J., Jafari, M. D., Nguyen, V. Q., Carmichael, J. C., Mills, S., Pigazzi, A., Stamos, M. J. (2013). Blood transfusion in colorectal cancer surgery: incidence, outcomes, and predictive factors: an american college of surgeons national surgical quality improvement program analysis. The American Journal of Surgery, 206(6), 1024-1033. doi:
    Meredith, K. G., May, H. T., Bair, T. L., Anderson, J. L., Horne, B. D., Tandar, A., . . . Muhlestein, J. B. (2006). Abstract 3912: Blood transfusions are associated with worse outcomes compared to no transfusion in patients with similar degrees of anemia and hematocrit decline while undergoing coronary angiography. American Heart Association 114:II_841. Retrieved from
    Merrit. R, Banerjee, A., Granger, C., Newby, K., Califf, R., Harrington, R. (2005, November 23). U. S. heart patients receive more transfusions than international patients. Duke Clinical Research Institute. Retrieved from
    Rao, S., Jollins, J., Harrington, R., Granger, C., Newby, K., Linblad, L., Piper, K., . . . Moliterno, D. (2004, November 3). Blood transfusions increase mortality of hospitalized heart patients. Duke Medicine News and Communications. Retrieved from
    Religion and Ethics Newsweekly for Public Broadcasting Service (Betty Rollin). (2013, July 12). Bloodless Surgery [video]. Available from
    Rohde, J. M., Dimcheff, D. E., Blumberg, N., Saint, S., Langa, K. M., Kuhn, L., Hickner, A., Rogers, M. A. M. (2014, April 2). Health Care-associated infection after red blood cell transfusion – a system review and meta-analysis. The Journal of the American Medical Association, 311(13), 1317-1326. doi:10.1001/jama.2014.2726
    Williams, S. C. P. (2013, Spring) Against the flow – what’s behind the decline in blood transfusions? Stanford Medicine. Retrieved from

    • Whenever the Bible speaks of the misuse of blood it is always in the context of eating it as food and more specifically when the life of an animal has been taken. Transfusion of blood or blood components cannot be demonstrated to be the the equivalent of eating blood. Additionally, no life is taken to provide the blood or blood components that are transfused. Simply stated, the Bible has nothing to say about the modern medical use of blood products which are liquid tissue transplants and the equivalent of organ transplants. The obvious paradox Watchtower policy creates for Jehovah’s Witnesses is that all blood products are in fact permitted if sufficiently fractionated.

      It is true that blood products have been overused in times past and that much can be accomplished through the practice of blood conservation medicine – something AJWRB endorses. On the other hand, it is also true that in some situations there are few, or at times no, alternatives to transfusion of blood or blood components. We believe that all Jehovah’s Witnesses should have a free and informed choice in regards to their medical care without control or interference from the Watchtower Society.

  3. I gather that the yearly card dispersement, with the accompanying signing before two witnesses at the book study has been done away with? And replaced by the one-time signing of a POA and advance legal directive which is valid forever unless specifically revoked, as the article explained. I doubt that the average JW understands the legal implications of carrying this card around, and that it can mean death unless the patient is conscious and can modify or revoke the document. I don’t understand why the organization would not want to make sure yearly that everyone is on board. For your safety, don’t carry this card in your wallet! My husband and I were at that ’92 assembly, and dutifully carried our updated cards for years, even at the risk of dying with four little children who needed us.

    • There are blood alternatives that can be used instead of using blood for transfusion. Plenty of doctors use saline or ringer’s solution. Medical technology has advanced to synthetic blood and also the laser blood cauterization during surgery.

  4. They do not feel coerced into carrying the card. They can leave the organization and start going to a church, synagogue or what have you. Most witnesses have people with whom they are friendly with at the workplace and grocery stores, etc… I was disfellowshipped from the organization of Jehovah’s Witnesses and I never felt coerced nor do I feel resentment or anything else. Blood does not have oxygen for 24 hours after it has been transfused. The one thing about the Witnesses is that you cannot just join like you can at Baptist churches, you have to go through training and then meet with elders to MAKE SURE this is what you truly want to do

  5. I have a question regarding the no blood document. I have been asked by a few people who are associated with Jehovahs Wittnesses, but were told “you may not receive the no blood document unless you are baptized.” I am confused because Jehovahs law is to abstain from blood. How can non baptized people NOT receive the card when they believe in Jehovahs command? Wouldn’t that be considered a double standard? Wouldn’t that push fellow non baptized worshippers to be baptized when they feel they don’t have enough knowledge, or not ready to take the most important step in their life.
    I ask because several individuals were asking me these questions and I have never gotten a clear explanation of the answer. Two of the ones who have asked are so broken inside. I ask in all humbleness to please help me to understand and know the answer. Thank you brothers.

  6. I have medical conditions that won’t allow me to donate blood anymore. Redcross want except it nor will Lifesouth. I have lupus and RA. So I don’t feel it’s safe for others to use my blood. So where can I get some type of card with the information on it. Something legal.

  7. I have a question, since it’s called DPA instead of just medical power of attorney does this mean the agent can also make financial decisions for the person they are acting as agent for, or is it ate toy for medical purposes?

  8. Connie, you asked the right question.
    Under the common law, a power of attorney becomes ineffective if its grantor dies or becomes “incapacitated,” meaning unable to grant such a power, because of physical injury or mental illness, for example, unless the grantor (or principal) specifies that the power of attorney will continue to be effective even if the grantor becomes incapacitated. This type of power of attorney is called “power of attorney with durable provisions” in the United States or “enduring power of attorney” elsewhere. In effect, under a durable power of attorney (DPA), the authority of the attorney-in-fact to act and/or make decisions on behalf of the grantor continues until the grantor’s death.

    COMPLETE CONTROL. I guess their not going to lose another estate, i.e. Prince.

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