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.

Child Sacrifice and Jehovah’s Witnesses


Dead JW Children

Jehovah’s Witness parents and their minor children are under tremendous pressure to support the Watchtower Society’s irrational policies on blood. This is not the first time families trying to serve Jehovah God have felt compelled to offer up their children as a sacrifice. At one time, Israelites were compelled to offer their children to the false God Molech and were undoubtedly deeply touched when called upon to make their sacrifice. How did God view such child sacrifice. The Bible tells us:

And they have built the high places of To’pheth, which is in the valley of the son of Hin’nom, in order to burn their sons and their daughters in the fire, a thing that I had not commanded and that had not come up into my heart. (Jer. 7:31)

We sincerely hope that Jehovah’s Witness parents will find the courage to stand up against this ghastly policy that has claimed so many young Witnesses lives. Have you given written permission for your child to die, to be offered up upon the Watchtower Society’s alter of blood? If so, why?

Would you have ever concluded that the Bible forbade certain kinds of blood transfusions if the Watchtower Society had not taught you this? You will note that the blood card or Advance Directive states: “…as Jehovah’s Witnesses we do not accept blood transfusions.” This statement is not accurate. As Jehovah’s Witnesses, we are permitted – by the Society – to accept many types of blood transfusions as well as the use of cell salvage and hemodilution – which are autologous blood transfusions according to doctors and scientists.

The Governing Body is dead serious about Witness parents not giving their children blood transfusions. Sadly, many of the children are just plain dead.

To those who find it difficult to believe that the leadership of the Watchtower really expect such sacrifices from their members. Please consider the following comments from the Kingdom Ministry of September 1992, pages 3-5. Comments from the article are in blue. Our comments are in black: Safeguarding Your Children From Misuse of Blood

“Look! Sons are an inheritance from Jehovah.” (Ps. 127:3) If you have such a precious inheritance from Jehovah, you, as parents, have a happy, although serious, responsibility to train, care for, and protect your children. For example, have you taken every reasonable step to protect your young children from a blood transfusion? How would your children react if faced with the prospects of a transfusion? Have you discussed as a family what you might do to deal effectively with an emergency situation in which a transfusion is threatened”?

Parents are asked not only to circumvent any attempt to provide a needed transfusion, but to even be responsible for how their children react to the situation.

“What will you do if an attorney or a judge asks you why you are refusing a “lifesaving” transfusion for your child? Although your first inclination might be to explain your belief in the resurrection and express your strong faith that God will bring your child back if he dies, such an answer by itself may do no more than convince the judge, whose paramount concern is the physical welfare of the child, that you are a religious fanatic and that he must step in to protect your child.”

Parents are drilled in how they should respond if brought before a judge, and taught what to say and what not to say:

“You simply do not agree that the alleged benefits of blood outweigh its potentially lethal hazards and complications….”

Here Witness parents are instructed to repeat the Watchtower propaganda they have been taught. We can be thankful that at least in the United States most judges have the good sense to realize that doctors are in a better position to evaluate the risk benefit ratio of using blood, than are parents who have been indoctrinated by the Watchtower Society – the pioneers of quack medicine, and the bans of vaccines and organ transplants.

“When judges are called upon to issue court orders hastily, often they have not considered or been reminded of the many dangers of blood, including AIDS, hepatitis, and a host of other hazards. You can point these out to the judge…”

It never ceases to amaze how the Watchtower continually emphasizes the risks of blood transfusions, when this is supposed to be a religious issue. Sadly, most Witnesses remain unaware of how the Watchtower Society has grossly distorted these risks.

“But it should be made clear to all concerned that you, as parents, feel an obligation to continue to do all that you can to avoid a transfusion. This is your God-given responsibility.”

Here the Kingdom Ministry pulls out the big gun. Fear, guilt and intimidation.

“If a court order is issued despite your best efforts, continue to implore the physician not to transfuse…So, even after a court order has been issued, never give up, regardless! – See June 15, 1991, issue of The Watchtower, “Questions From Readers.”

Here are highlights from that WT article:

W91 6/15 31 Questions From Readers “Jesus withdrew from the area when a crowd wanted to make him king. Similarly, if a court-authorized transfusion seemed likely, a Christian might choose to avoid being accessible for such a violation of God’s law. (Matthew 10:16; John 6:15) ….If a Christian did put forth very strenuous efforts to avoid a violation of God’s law on blood, authorities might consider him a lawbreaker or make him liable to prosecution. If punishment did result, the Christian could view it as suffering for the sake of righteousness. “

Clearly, Jehovah’s Witness parents get the message they should remove their child from the hospital, even if a court order exists to transfuse the child. This is in fact what sometimes happens. If the child should die in the process, the parents must be prepared to accept punishment from the secular authorities according to the Watchtower.

Parents, make the necessary preparations in advance to protect your child from a spiritually contaminating blood transfusion. (Prov. 22:3) Children, respond to the training of your parents in making these preparations and apply them to your heart. As a family, “be firmly resolved not to eat the blood . . . that it may go well with you” because of having Jehovah’s blessing and smile of approval.-Deut. 12:23-25.

The pressure placed upon both Witness parents, and their children is formidable. Therefore, what may appear to be a Witnesses strong stand based upon conscience may in reality be nothing more than an organizational position that has been forced upon them through the Watchtower’s undue influence. One that they may have never even seriously questioned.

Consider this: Can you as one of Jehovah’s Witness offer a reasonable explanation of why the Watchtower selectively permits many types of blood transfusions but not others? When we question other H.L.C. members, or branch representatives about these contradictions they usually state: “I don’t agree with the Society’s position on blood fractions.” If the WTS can’t explain the doctrine, if it doesn’t make sense, then why should parents stand by and watch their children die when the non-blood alternatives are exhausted?

It seems that the Governing Body of the Jehovah’s Witnesses views the victims of its blood doctrine as necessary “small sacrifices” that must be made for them to keep face and not face the consequences of decades of bad policy. If you are a Jehovah’s Witness parent, we implore you to give your child the medical treatment they need. Seek non-blood alternative care if appropriate, but don’t let your child die over this misguided and tragic policy.

When you understand all of the facts – you will see this doctrine for what it truly is. Hundreds – perhaps thousands – of children have died already. This saves the Governing Body the embarrassment of having to admit that they were wrong. Will you give your child’s life as well? Will you let a friend or a relative offer their child upon the Society’s alter of blood?

Imagine this: Your child is gasping for air. His blood count is perilously low. His heart rate is at 200, and climbing. The doctors have told you that without a transfusion, he will die of respiratory distress and heart failure. Blood expanders will not help at this point, he needs more red blood cells. He is horribly pale and listless and with wide eyes, he looks at you and whispers “Help me, Daddy, help me Mommy.” What should you do?

Should you let your child die based on the word of an organization that has changed its mind about organ transplants, vaccinations, civil service, the “sheep and the goats,” the “generation of 1914”, and a practically endless list of important dates: 1799, 1874, 1878, 1881, 1914, 1918, 1920, 1925, 1975, etc., etc., etc.? Is this really what Jehovah and Jesus expect of you? How will you feel if the remaining blood component prohibition is discarded like the vaccine, organ transplant and blood fraction bans of yesteryear? Will you be able to forgive yourself? Such a scenario is not simply hypothetical. It has happened over and over again. Don’t be a victim, and don’t sit back and allow others to be victims.

Media Guide

The information below is taken directly from the written instructions provided to Hospital Liaison Committee members who take Seminar II, as provided by the Watchtower Society and shows how both the HLC and JW parents are coached to deal with the media. We have added our comments in red. Members of the media should find this information helpful when they interview representatives of the Watchtower Society or parents of Jehovah’s Witness children who are sick and having potentially lifesaving medical care withheld.

International Seminar II

Instructions for Hospital Liaison Committees



Your first responsibility is to the family, your brothers

Can aid them by preparing them for what to say

Equally important — what NOT to say: “We believe in resurrection.”

Note how Jehovah’s Witness parents are prepared to avoid saying what they have been taught to think and believe in these situations. The Watchtower wants to put the proper “spin” on what is happening. If you can get parents or Watchtower spokesman to continue talking about how they really feel, instead of just parroting these prepared speeches, you will increase the likelihood that they will say tell you the truth about what is happening. They have been prepared to let their child die, even if nonblood alternatives fail, and to put their trust in God to ressurect their child.

Petition hospital administration to discontinue unwarranted invasion of family right to privacy by disclosing to the press

Right of press not above rights of parents

Accompany family to hospital’s media representative and patient’s representative (if they have such) to point out the added trauma created for family and other negative results to family/hospital

Clearly the Watchtower does not want the press involved in these situations, and is willing to use the issue of family privacy in an attempt to keep the matter hidden. We encourage members of the medical community not to be bullied into hiding what is happening in these situations. Negative media coverage creates pressure on the Watchtower to respect the rights of individual Witnesses to make their own choices in these situations.


Maintain control of self, family, situation and during any interviews with media; don’t let yourselves be rushed by them

Reporters trained to be aggressive, to push, manipulate

Their rapid-fire questions are usually loaded

You don’t have to answer a loaded question as given; reword it to your liking so you can represent us accurately

Example:“Why would you let your baby die rather than have life-saving blood?”

Answer: “I can see you misunderstand our position. We are here at the hospital for medical treatment for our child that will not subject it to the known hazards of LIFE-THREATENING blood. We are asking for available, non-blood medical management.”

When they see you have an answer, they like to interrupt with another question as they search for your weak spot.

Don’t let them get away with that; insist on finishing your answer to the question THEY raised, but be kind about it

At the same time, don’t RAMBLE; stick to issues

Note how HLC members are instructed to control the family and avoid answering difficult questions. It is a fact that untold numbers of Witnesses have in fact chosen to die because the Watchtower Society use of “undue influence”. Instructing them that they must comply or face the consequences of being shunned by all Jehovah’s Witness friends and family members, and face eternal death at the hands of God.

Doctors, Judges, and members of the press should acquaint themselves with the actual risks of blood transfusions, and be prepared to confront the Society’s spokesmen with the facts.

IMPORTANT: Keep answers brief, pointed, QUOTABLE

Media likes short replies that make it easy to edit info

Concise replies will also likely eliminate possibility of reporter using the multitude of words in a convoluted response to locate something to use to fit his view of the story

Short answers keep interviewer on the subject, not giving him something else to pick up on that is not on the subject

If a simple “Yes” or “No” will do the job, leave it at that

Respond to one question at a time, to one reporter at a time

Members of the media should be prepared to question the Society’s representative about the gross inconsistencies in the Watchtower blood policy. Here are some examples from our section on Questions:

  • Medical experts state that there are not always alternatives to blood. Would not withholding medical treatment from your child when death is the alternative make you or the parents responsible for the death?
  • If a blood transfusion is essentially an organ transplant, how can it be viewed as “eating blood,” since no digestion or nutritional benefit accrues? Can it be an organ transplant and a meal at the same time?
  • Why does the Society have to quote doctors who lived hundreds of years ago to find support for it’s belief that a transfusion is a feeding on blood? Why don’t modern doctors acknowledge that a blood transfusion is the same as “eating blood?”
  • Why does the society exaggerate the risks of blood transfusions, and make it seem that they are always bad medicine, when nearly all of the experts disagree?
  • How does the society go about deciding which blood components are major and which are minor? For example, why are white blood cells forbidden, but albumin allowed, since albumin constitutes a larger percentage of blood volume, and milk and organ transplants are full of white blood cells?
  • Why is it that plasma is forbidden when all of its separate components, with the exception of water, are on the approved list for Witnesses to take in order to “sustain life?”
  • If Witnesses must abstain from blood completely, as the Society says, then please explain why the Society permits them to accept all the fractions of human blood? 

Witness spokesmen will not be able to provide reasonable answers to these questions.


“Are you willing to let your child die rather than accepting blood?”

“I’m not convinced that this is the choice I face for refusing blood transfusions. I am here–and came here willingly–to get the best medical treatment for my child. There are alternatives that are available. I want my child to be treated without the threat of the known hazards and complications of blood transfusions.”

“But the doctor says the baby will die without blood!”

“Well, the doctor is only telling you what he believes based on his individual experience. But we know (or are in touch with) doctors of greater experience who have assured us the child can be treated otherwise [if this is so]. So the only real issue here is not whether the child will die, but whether we have the right as parents to choose between several available medical treatments.”

This reply neutralizes the sensational mold that the reporter wishes to cast to give his slant to the story and focuses on the validity of alternative treatment and parental rights

At this point we would recommend that you ask the representative of the Society for a name of the physician so that you can verify what has been said. It is quite apparent that this is a diversionary tactic designed to imply that the physicians treating the minor child are incompetent, and that the real issue is the parent’s right to choose what they believe is best for their child.

It should be remembered that the parents are simply doing what the Society has instructed them to do. Whenever the Watchtower Society changes their mind about what is permitted and what is not permitted, the parents simply do what they are told. These frequent changes on medical policies are documented in the Historical Perspective. There really is no respect for individual conscience within the organization. You may also want to ask the spokesman what the actual risks of blood transfusions are when compared to the risks of refusing the blood.

The next step would be to point out some alternatives;

Usually inadvisable to say: “I have no comment!”

This implies we have no defense, know we are wrong!

Incorrect response: “Yes, if need be. We do believe in the resurrection and so we will see our child again.”


Again it becomes clear how concerned the Watchtower Society is about how they are portrayed in the press. The facts of the matter are that many Witnesses have been so indoctrinated by the constant demonizing of blood transfusions, they would prefer that their child die, rather than accept a blood transfusion. Thankfully, the courts usually step in in these situations.

You may want to question the representative on his medical qualifications, and why he believes that he knows better than the Doctors and the Hospital.

You may also want to ask the spokesman why the Society insists that Witness parents not allow their sick child to take a blood transfusion when the nonblood alternatives have been exhausted. Even when this results in death. 

You may have to aid the parents with information on alternatives

Here is where your notes on the case to date may be of help

“Hemoglobin count not truly dangerous yet” (Show articles)

“Know all other vital signs good?”

“Know child is playing on floor with other kids?” “Otherwise healthy?”

“Know doctor has admitted that blood not needed right now, so no real emergency; why does he want order?”

Alternatives–show “Strategies” sheets, references

“Why blood only? No other treatment really?”

“Why is doctor unwilling to try alternatives rather than let baby die?”

This last question highlights the Watchtower Society’s attempt to shift blame away from itself and onto the doctor’s involved in the situation. In effect implying that if the child dies, the real reason will be because the doctor was unwilling to treat the child without blood.

You might ask the spokesman why 61.5% of Witness patients whose hemoglobin drops to 6 or below die according to published scientific reports.

What other doctors say; offered for consultation; why is hospital/doctor unwilling to utilize available help?

“Another hospital willing to take patient; why not allowed?”

May want to discuss more about violation of right to privacy

In rare cases, may decide to say nothing to media at all, perhaps pending legal action or direction from Brooklyn


Seek Jehovah’s help in prayer for right words at right time

Self-control best ally under pressure–Galatians 5:22, 23; Proverbs 15:18

Important aspect of work, but must never overshadow primary work of looking after the spiritual and medical needs of the brothers

The Watchtower Society will try to control nearly every aspect of these situations. How the child responds, how the parents respond, how the H.L.C. members respond, and so forth. The reference to “Brooklyn” relates to the world head quarters of Jehovah’s Witnesses where the decision to let critically ill Witness children die rather than accept a potentially lifesaving blood transfusion has already been made. Now all that is left is for members to put the right spin on events.

Watchtower Commits Perjury

councilIn a shocking development, we have learned the Watchtower Society perjured itself before the European Commission on Human Rights. This is a commission that operates under authority of the World Court, and to which the Watchtower Society apparently submitted a false and misleading application regarding objections to legal recognition that were raised by the government of Bulgaria.

By reading the Press release issued by the commission, it will be readily apparent to anyone familiar with Jehovah’s Witnesses, that Watchtower officials lied.

Here is one key paragraph regarding children and the blood issue:

As regards the alleged involvement of children the applicant association submits that children cannot become members of the association but only participate, together with their parents, in the religious activities of the community. In respect of the refusal of blood transfusion, the applicant association submits that there are no religious sanctions for a Jehovah’s Witness who chooses to accept blood transfusion and that, therefore, the fact that the religious doctrine of Jehovah’s Witnesses is against blood transfusion cannot amount to a threat to “public health”. Emphasis ours

It is not unheard of for children to be baptized, and to become members of the association before reaching the age of ten, although most Jehovah’s Witness children are probably in their early teens when they officially become members of the congregation, and subject to its judicial process.
As for a Witness who accepts one of the banned blood products, or a whole blood transfusion, the Watchtower’s historical position has been quite clear:

“…the receiver of a blood transfusion must be cut off from God’s people by excommunication or disfellowshiping….if in the future he persists in accepting blood transfusions or in donating blood toward the carrying out of this medical practice upon others, he shows that he has really not repented, but is deliberately opposed to God’s requirements. As a rebellious opposer and unfaithful example to fellow members of the Christian congregation he must be cut off therefrom by disfellowshiping. – The Watchtower 01/15/1961 pp. 63, 64 Emphasis ours

Anyone can see view the press release for themselves by visiting the archive of the website for the Commission on Human Rights where the Press Release is still maintained. You can also view the friendly settlement between the Watchtower and Bulgaria where they perjured themselves which is still maintained on the commission’s web site – view document.

Is it possible that the European Commission on Human Rights is fabricating all of this as some Witnesses have suggested? No since all the Watchtower Society would have to do is produce the original application to vindicate themselves.

We invited the WTS to respond to these serious charges by contacting us and remain willing to post their official response. Sincere Jehovah’s Witnesses call to mind, and take seriously the words of the Bible. Clearly their leaders do not.

*** Rbi8 John 8:44 ***
YOU are from YOUR father the Devil, and YOU wish to do the desires of YOUR father. That one was a manslayer when he began, and he did not stand fast in the truth, because truth is not in him. When he speaks the lie, he speaks according to his own disposition, because he is a liar and the father of [the lie].

*** Rbi8 James 3:14-15 ***
…do not be bragging and lying against the truth.

*** Rbi8 Colossians 3:9 ***
Do not be lying to one another…

*** Rbi8 1 John 2:21 ***
…no lie originates with the truth.

*** Rbi8 Revelation 21:27 ***
But anything not sacred and anyone that carries on a disgusting thing and a lie will in no way enter into it; only those written in the Lamb’s scroll of life [will].

H.L.C. Elders Speak Out

A Group of Hospital Liaison Committee (HLC) Members Speak Out

HLCs are sat up in most parts of the earth by the Watchtower Society (hereafter WTS) to assist Witnesses in finding cooperative physicians who are willing to provide bloodless treatment. In their dealings with physicians, they often come face to face with the inconsistencies and discrepancies in the Watchtower Society’s blood policy. One group of HLC brothers has come forward to express themselves on the blood issue. They have asked us to publish the following information to all of Jehovah’s Witnesses, and especially “Hospital Information Services,” in Brooklyn, New York. The information should also be of interest to medical and legal professionals. 

We are a group of eight brothers working at present for the Hospital Liaison Committees in different places and countries. We have been able to communicate about our assignment and share different experiences about the work that has been done. We are very pleased that much good has been accomplished in behalf of our brothers. Many not professing to be Jehovah’s Witnesses have also benefited from the arrangement.

It is widely acknowledged, even by doctors, that blood is a dangerous medical treatment. In many of our presentations in different hospitals we often hear comments that clearly indicate that doctors usually do their utmost to avoid using treatments made from human blood. And it is noteworthy that these comments come from doctors working in the field of Hematology.

We can’t deny the fact that medical devices, procedures and medications have developed dramatically. This has contributed to, and is the main reason for reducing the need for blood products. Additionally, there are numerous company’s developing products to improve clotting capacity and maintain circulating blood volume. Hyperbaric Oxygen Therapy is another very important tool, and although many doctors resist it’s use, they do acknowledge its value in treating acute anemia.

The Society has also emphasized the use of Erythropoietin which stimulates the production of red blood cells, and together with Iron Dextran there is evidence of greater benefit and results in treating Witness patients.

Many positive things can be said regarding alternative non-blood therapies, there is no denying that. At the same time the facts are, that our work would not be necessary if medical science were to find a replacement for blood. However, in August of 1997, blood is still a valuable product for saving lives and sometimes we overlook the benefit and the importance of using it. Even among the HLC members who have many years of experience in their assignment, you can find a complete ignorance of why blood is used. These brothers have been trained through Seminar’s I and II, and the only thing that many know about blood, is that it is a dangerous medical treatment and should be avoided. Not just because of Biblical reasons, but because they believe that it is bad medicine, and that there are good alternative products available.

There exists a guideline or “rule” that developed among clinicians that stated a patient likely should be transfused if the hemoglobin level fell below 10 or the hematocrit below 30. It is called the “10/30 rule.” Many doctors today still use this guideline, and sadly, some doctors even transfuse earlier without any medical reason. Another troubling question is, how low can we go without unnecessarily exposing the life of the patient?

After the Seminars, presented by three brothers from Hospital Information Services for Jehovah’s Witnesses in Brooklyn, the custom is to go and visit some hospitals and medical institutions. Brother Major Spry, Associate Director and the principle voice in Brooklyn around the blood issue, always try to send the message that the 10/30 rule is outdated and “we want it down, much more.” Often the doctors agree that ‘it is alright to get it down, but one shouldn’t’t forget that much depends on the patients age and condition.’ A young healthy person can endure more than an anemic, undernourished or aged patient. Therefore, each patient must be considered individually, and no standard position or policy can easily be defined.

Still, the brothers in Brooklyn have achieved some very good results by their work. One example of progress is noted in “The American Journal of Surgery” Consensus Conference: Blood Management Surgical Practice Guidelines, Volume 170, No. 6A (Suppl) December 1995. In this there is a proposal of about 11 policies for surgical blood management and proposed interventions that would achieve each policy’s intended outcome. “The policies were designed to achieve four clinical outcomes: maximization of oxygen delivery, cost-effective minimization of transfusion risks, education of physicians and patients, and appropriate surgical management of special surgery subset, Jehovah’s Witness patients.”

In the same “The American Journal of Surgery”, page 14, there is a section entitled: “Blood Management Policies For Jehovah’s Witnesses.” Policy 2 states:

“In general, Jehovah’s Witnesses refuse all allogeneic blood products and any autologous blood that has been separated from the body. These prohibitions do not prevent most Witnesses from accepting the use of cardiopulmonary bypass, dialysis, intraoperative blood salvage, and reinfusion. Although the casual observer may not discern a difference between these interventions and autologous blood that has been separated from the body, Jehovah’s Witnesses distinguish acceptable therapy from unacceptable according to whether the diverted blood is still part of the circulatory system. In dialysis and cardiopulmonary bypass, blood remains part of the circulation. Autotransfusion devices can meet this test by dedicating an intravenous line from the collective device to the patient to maintain a closed circuit. Hemodilution can be similarly modified.

Jehovah’s Witnesses readily accept most drugs, such as iron dextran, aprotinin, desmopressin, and synthetic “blood substitutes,” because these agents contain no human blood products. Hemoglobin-based blood substitutes are unacceptable to Jehovah’s Witnesses if they contain either human or animal blood.

As a matter of conscience, Jehovah’s Witnesses may accept some products that contain blood products, such as immune globulin. Epoetin alfa, which contains a small amount of human albumin, is acceptable to most Jehovah’s Witnesses. Albumin will likely be refused conscientiously when used as a volume expander, but the amount contained in Epoetin alfa is small and therefore generally acceptable.”

What is blood?

This description of our position as an organization is quite accurate. However, there are a couple of problems that HLC members must address. First, and the question is often asked: What is blood? This may seem like a simple question to answer, but it is not, for there are a number of blood components that the Society permits Witnesses to take. Are these components not also blood, and how is it decided which parts of the blood are acceptable, and which are not? Since it is acceptable to introduce these “allowed components” into our bodies, it is understandable that Witnesses and medical personnel are confused by our position? Although this question has been in the minds of many brothers, no one dares to deal with the question publicly. Why?


When it comes to Hemodilution and Intraoperative autotransfusions, very few members of the HLC’s have taken the initiative to try and understand exactly how these procedures work. All of these external devices and methods should create questions as to whether or not the blood is still a part of the body. But the friends simply accept these procedures since the Society does not forbid them.

It is interesting to note how brothers who are struggling to find medical solutions react to the article, “Obstetrics and Gynecology, Volume 72, Number 6, December 1988, ‘A Simplified Device For Intraoperative Autotransfusion’.” When the article is presented, and the brothers see the device and the way blood is collected and stored into a blood bag, in a lowered position, their first and immediate reaction is generally to reject the device.

Here is how the procedure works: During the surgery doctors use Blood Aspiration with Automatic Anticoagulant Mixing, and the blood is collected into a Blood Reservoir. It is then drained by gravity into the Blood Bag, and stored in a lowered position until it is filled. When the Blood Bag is filled, it is raised to the top of the assembly, and the blood is reinfused. Although it is hard to see the blood as still being a part of the circulatory system, the brothers accept the procedure once they are told that the Society has approved of its use, and that it does not violate any scriptural principles.


Albumin is another problem. We accept albumin as a matter of conscience, although the blood contains more albumin than white blood cells, which we must reject. Many doctors are also confused by this position, but they usually are so respectful, and most of them think that there are religious principles involved although a clear contradiction exists. What doctors don’t know, and we are not permitted to explain to them, is that this position is clearly an organizational ruling for the members, and lacks any logical reason or scriptural support.


Another interesting feature about the use of Albumin that many members of the HLC’s have commented on, is that we should never decide or interfere in the conscientious decisions of our brothers. The problem here is that the Society has so greatly emphasized the benefit of Erythropoietin that HLC members often forget or don’t tell the brothers that between the two most common Erythropoietins: Eprex and Recormon, Eprex contains Albumin, but usually the HLC members don’t feel any responsibility to inform them of this. Another sad part of all this is that the brothers, even many members of the HLC’s, don’t really understand how Erythropoietin works, and hence over-estimate it’s value in treating Witnesses.

Erythropoietin (EPO) is a treatment used to raise the hematocrit, and stimulate the production of red blood cells which transports oxygen. Some members of the HLC’s feel that the Society has overemphasized the benefit of Erythropoietin. The recommended dosage in case of emergency is between 200-1000 IUnits/kg=2pounds/Daily, and when a clear response appears, 3 times a week. Some companies selling the product even recommend more IUnits. The sad part of this is that today the scientific documentation of the real benefit of Erythropoietin is vague.

The treatment is most frequently prescribed for patients with renal dysfunction’s, or patients who have predeposited their own blood some 4 weeks before an operation can receive a EPO treatment. But if the patient is in good health and no indications of any serious infections appear, they usually don’t need EPO. Even among the HLC members, there is confusion about the real benefit. Some suggest high dosages, not because a Witness patient needs it, or because an EPO treatment doesn’t bring serious contra-indications as long the hematocrit level is low, rather they feel more comfortable knowing that if something goes seriously wrong, at least it was not because EPO treatment was not used.

This lack of knowledge and lack of scientific documentation among the HLC members should be a matter of concern for the brothers. First of all, many brothers don’t know that the real benefit of an EPO treatment comes usually after 2-4 weeks. In about 3 days one can find a small reticulocyte response, within 7 days for hematocrit response, and the final and necessary benefit usually comes after 2-4 weeks. This is important to understand, particularly in a case of acute blood loss.

Another part of an EPO treatment is the Cost vs Benefit. Some doctors have recommended a small dose of EPO like 80 IUnits/kg/3 days a week. At the same time an HLC member without any scientific or medical reason, may recommend a dosage of of 600 IUnits/kg/each day the first week. In many places the patient will himself have to bear this expense. The costs may differ from one place to another, but we can conservatively estimate that the higher dosage recommended by the HLC member will drive up costs approximately $4,000.00, and this without any scientific justification, as optimal dosage regimens have not been determined for EPO.

Cord Blood

Another question that has been raised among some Jehovah’s Witnesses, as well as HLC members has to do with the issue of Umbilical Cord blood.

Today medical scientists are doing research about the use of umbilical cord blood and there are indications that it could contain and provide a vital lifesaving medical benefit. However, as in so many other cases, the Society is clearly opposed to us as Jehovah’s Witnesses accepting, or even donating umbilical cord blood (See W97, 2/1 – Questions From Readers). However, since they permit some of the components found in umbiblical cord blood to be produced and used, it is hard to see any logic or and biblical basis for their prohibition.

Problems with Alternative, Non-blood therapy

Avoiding blood is a way of searching for quality medical treatment. But offering something that can replace blood is simply not possible at this time. Doctors are well aware of the situation and the need for something to replace blood transfusions. When a good alternative to blood exists, doctors will use it. Today the only real alternatives are the surgeons skill, some medications, technical devices and procedures available in some of the hospitals, and of course the risk of operating outside the critical limits.

We as HLC members should ask ourselves if our work is simply to find cooperative doctors? A comment expressed among some brothers within the HLC’s was taken from the ‘Bloodless Coordinator’s Corner’ on the Internet.

Sometimes hospitals and doctors accept the challenge to treat us with alternatives, but that could be fatal if they are not prepared for it. Sometimes the doctors are very interested in doing an experiment with a Jehovah’s Witness. Consider the statements made in the ‘Bloodless Coordinator’s Corner’, for this is the reality for many Witnesses right now in many countries when the hospital decides to cooperate without being prepared for it. As members of the HLC’s we can confirm that from our experience. Note the following:

“Our Guest Editorial comes from Bernice Goldstien, Coordinator for Bloodless Medicine and Surgery at Kadlec Medical Center in Richland, Washington. We thank Bernice for her contribution!

… Bloodless Surgery is not actually blood free. There is shed blood. ‘Bloodless’ is a term applied to transfusion free medicine. Bloodless Surgery is being requested by an increasing number of patients who recognize there are alternatives to blood transfusions.

In the past, the most one could hope for was a physician who agreed not to use blood as part of the treatment plan. According to Dr. Estioko, Cardiovascular Surgeon and Medical Director of the Bloodless Medicine “A promise not to give blood transfusions is not enough. A cooperative doctor could kill you.” What was he talking about? If the doctor agrees to operate without blood, what does he offer in it’s place? There is more he can do! Much more!

… Clearly, an arrangement for non-blood medical management goes far beyond a promise from a physician not to give blood. It involves real commitment by the entire hospital.”

Although the WTS is doing an excellent job of providing information about alternatives, the reality is, that in many countries the doctors and hospitals are not always prepared or even willing to handle a case with alternative therapy. Many cases have ended in tragedy, cases where our brothers were attended by a cooperative doctor, who was not qualified and lacked the required experience to handle the case. Often times because the doctor was not able to offer anything to adequately replace blood therapy. The sad part is that many HLC members do not realize that Witness patients often die because of a lack of commitment and the use of alternative treatment in the hospitals. The only real cooperation is often to simply let the patient die, and that is unacceptable. The medical staff should cooperate, and realize that another hospital or doctor might be of help, but this doesn’t always happen, and tragically, many HLC members are not really qualified to evaluate these situations and know how to respond.

Minor Children

The most depressing feature of being a member of a HLC is when our children are involved. Why has the WTS completely failed to gain one legal case when it comes to minor children? It is obvious, there is nothing so effective as human blood to transport oxygen and today there is nothing to replace its use in the medical field. We must appreciate the fact that the legal system protects our children. Even for us, as members of HLC’s, we realize that it is much easier to work with the doctors knowing the rules and laws about minor children. Every Jehovah’s Witness should know, although there have been cases where Witness parents have acted against it, that parental authority is not absolute and that there can be no guarantee of bloodless treatment for Witness minors in general. They should understand that the state, has the right to provide treatment believed to be necessary to safeguard a child’s life or health.

When there are effective alternatives available, when there is a choice to be made, that choice should be made by the parent and not by some doctor, social worker, or judge. But here one needs to ask an important question: Who is qualified to make a decision about alternative nonblood management, and will that decision adequately meet or respond to the child’s needs? As members of the HLC’s we have been eye witnesses of cases where cooperative doctors have followed the parents wishes for alternative non-blood therapy, and the results have sometimes been tragic, with just one more unnecessary death being the result.

We shouldn’t be too dogmatic about the benefit and positive results of using blood products, but one thing is for sure. As long as there is nothing that can replace the blood products, they are going to be used, and many children are going to be saved by them. Judges are going to decide in favor of using blood products and protecting the child’s life and health above the religious beliefs of the parents.

A Question of conscience?

One of the arguments we use and present to the doctors has to do with the emotional damage done to a person who’s conscience is violated by forcing a medical treatment made of human blood. Every reasonable person understands that it is unacceptable to force a treatment that violates a persons conscience. With most Witnesses, however, their conscience does not really enter the picture. They are simply responding to a situation based upon how the Society has ruled on it.

When we as as Jehovah’s Witnesses look back and remember the wounded and dead brothers who did not accept vaccinations, blood serums, organ transplants or hemophiliac treatments, we must acknowledge that they took their stand largely because of an organizational policy and prohibition forced upon them. These positions have now been abandoned by the leadership, and we rarely if ever see brothers refusing vaccinations, organ transplants, or any of the blood components on the Society’s approved list. This fact alone should cause anyone involved in these situations to pause and reflect seriously about the real issues involved. Is the issue truly one of conscience, and if so, whose conscience?

In Conclusion

We are a group of eight members of the HLC’s that have been carefully considering these points, and we would like to conclude this consideration with the following thoughts. In particular, we direct our comments to the brothers in ‘Hospital Information Services for Jehovah’s Witnesses in Brooklyn.’

Quoting your own words during Seminars I and II, we are supposed to be “trained professionals” in our area of providing information about alternative nonblood management and cooperative doctors. That’s fine, we have seen many blessings and the very good results of that work. We also hope that medical science can find something to replace the present blood products used in the medical field. What a blessing, not just for us as Jehovah’s Witnesses, but for all people of the earth. Certainly all of the doctors are going to rejoice when a replacement for blood becomes available, and surely it will immediately be applied in hospital protocols and procedures for emergency care.

But, despite what is going to happen in the near future, discovering new synthetic blood products, new diseases and infections, or something else, the real questions are still going to be in our minds: Is the Society’s blood doctrine actually correct? Why do so many brothers enter into an inner conflict about the issue when they consider the biblical facts? Has the Society really provided us with the truth, and all of the Biblical facts regarding blood? Do they realize that in accepting some minor blood components they have created a tremendous contradiction in their firm stand? Where are the serious and solid arguments against stored autologous blood transfusions? Do they appreciate that their position kills many precious minor children, unless the legal system steps in to provide protection for their life and health? Should our main concern as Jehovah’s Witnesses be to look for medical alternatives, or to confront ourselves with the biblical facts about life and blood?

Your brothers,

A group of Members in Hospital Liaison Committee’s

What follows is a letter we received from an H.L.C. brother who has come face to face with the problems, and has come forward to voice his concerns:

I am a regular reader of the different material and information about blood at the Net. Also I have the special privilege to be part of a HLC (Hospital Liaison Committee). However, I understand that we are working in a very dangerous field because of so many contradictions in our blood doctrine. Personally I suffer and often work with a deep feeling of guilt, particularly when our brothers need to go through unnecessary pain and death. I can personally testify to about 4 deaths of our brothers, where they could have been saved. How? These brothers and sisters could have been saved if available alternative treatment approved by the Society had been used. But why did they not use it? The doctors could not use the treatments because the Witness patients objected on the grounds that the treatments contained fractions of human blood. These patients were not able to explain why the Society approves these treatments, but after the HLC explained to the brothers, and the doctors, the Society’s position – they agreed. Sadly, in these 4 cases I have been through, the patients died because the necessary treatment was used too late.

I have shared the pain and loss with these brothers, hugging them, talking with them, sitting together with them in cold hospital corridors just to share some fellowship, and human compassion. These poor innocent brothers are victims and they can’t understand and explain their position except for being faithful to organizational directives. First they abstain completely from all alternative blood products, but if the organization gives their approval, then in a matter of seconds they change their mind and heart.

Let me be very clear – I am ready to leave this assignment, I can’t continue to support this cruel doctrinal enforcement. Precious children and wonderful Jehovah’s Witnesses are dying for nothing. There is just one thing that keeps me in this HLC. We are three brothers in different places that are not supporting the Society’s view. If someone in Brooklyn reads this, then I want them to know that we have been very successful in our work, among doctors and brothers, as to distributing information about our internal problems. We are not pushing the matter, we respect the individuals choice in this decision. But we also hope that Society could take note of what is going on, and in the name of the truth, love and justice, do what they must do for our dear brothers.

I want to use this opportunity to thank  Lee Elder and some others out in the Net who hopefully can be a valuable tool in saving lives and changing erroneous doctrines.

Your Brother,

A Member of HLC

Control and Repression – The Ray Hemming Story

Ray Hemming

Ray Hemming
Jehovah’s Witness Elder

If there’s one thing that people identify Jehovah’s Witnesses with, it’s their refusal of blood transfusions. I know it was a doctrine that I once believed was right for me and my family. If a medical emergency had arisen, a blood transfusion would not have been an option.

I, like many Jehovah’s Witnesses, hoped that such an emergency would never happen. But if it did, I was comforted by the thought that there were alternatives to blood transfusions such as saline, dextrose, etc. These were the kind of alternatives the Watchtower Bible & Tract Society trumpeted in their literature as the preferred emergency non-blood choices.

Three years after my baptism as an ordained minister for Jehovah’s Witnesses, my daughter, who was seven-years old at the time, fell very ill with severe tonsillitis. She lost a lot of weight due to the illness and became frail and weak. Our family doctor referred us to a nearby hospital for consultation, where we were advised that her tonsils should be removed.

However, the physician would not agree to perform the operation without assurance from me that blood could be used if a complication arose in the procedure. I remember nervously asking him to review our blood booklet “Jehovah’s Witnesses and the Question of Blood.” That’s all we had in those days for medical dilemmas. There were no Hospital Liaison Committees (HLCs) at the time. The doctor said he was familiar with this booklet, but refused to discuss the matter.

My wife and I were faced with our first dilemma related to the Watchtower’s doctrine on blood. Should we consent to the doctor’s wishes and hope things turned out okay? With some dismay, we left the hospital with our daughter and began to search for help elsewhere. Eventually we were directed to a qualified professional, who specialized in alternative medicine. Because of his advice, which included dietary restrictions and some medication, our daughter was helped through that critical period. In time she regained her strength and health, although the problem has never been fully resolved, even today.

The refusal of blood transfusions was a subject that most Jehovah’s Witnesses would try to avoid when in the door-to-door ministry. This is a very emotional doctrine for non-Jehovah’s Witnesses. And there was simply no adequate response to a parent standing in front of you at their door, asking the question, “Would you let your child die?” Any response like “our child will be resurrected in the new world” or “Jehovah’s Witnesses have alternatives to blood” did not cut it, and frankly, that was of no comfort to a rational Jehovah’s Witness.

However, I never dreamed that one day I would be arguing that the Watchtower’s blood policy is very wrong. In fact, the blood transfusion issue is what finally led to me being expelled from the organization of Jehovah’s Witnesses after eighteen-years of service.

I had been an “Elder” in the congregation for many years, having teaching assignments, giving public talks and providing spiritual support to fellow Witnesses. But as time went on, I was beginning to have doubts about some of the information coming from the Watchtower.

During a particularly difficult time in my son’s life, I took some time off work. With spare time on my hand, I began reflecting on my life as a Jehovah’s Witness and browsing the internet–a big “no no” for Jehovah’s Witnesses in 1998–for information about some of the doctrines of my faith;.

On my internet journey, I found a website entitled “New Light on Blood” ( I was flabbergasted by the enormous amount of information presented, both biblical and scientific, about the experiences of people affected by the blood policy and the history of the Watchtower’s shifting position regarding its medical prohibitions. This information caused me to re-think my belief on blood.

Eventually, I overturned my strongly entrenched beliefs (2 Corinthians 10:4), because this Website provided well-researched information from medical professionals, appointed men in the congregations, former HLC members and some Elders operating within the Watchtower organization.

I presented some of this new information in a letter to my Congregational Overseer. Then I sent letters to other Elders that I knew, inviting their comment. While I received no written responses, I was visited by several of these Elders, but they would not talk about the issues. They were afraid to talk with me. The Organization had strangled their ability to comment.

However, I was asked to raise these questions on the blood issue with Elders at the Watchtower Headquarters in London. I think they suggested this in the hope of shifting some of the responsibility away from themselves. So I did as requested, and sent a letter to them. The reply I received (which can be viewed on this website) made no attempt to enter into any dialogue on my questions. Their response amounted to nothing more than a warning about apostates operating on the internet.

A few weeks later, I received another visit by a local Elder, telling me that a judicial committee had been formed and I was invited to attend. A judicial committee is made up of a group of men who act as judges to enforce Watchtower policy. In my case, the judicial committee was organized to decide if I was guilty of apostasy. I guess being an elder who was circulating material that raised questions about Watchtower policies was enough for them to charge me.

I agreed to attend the meeting in the hope of making at least one of them think about the blood transfusion doctrine differently and perhaps strike a cord in their hearts. I never expected them to agree with me on the subject, as it would have put them in the same precarious position as myself.

During the meeting, I made reference to the words of Jesus concerning worship of God. Christ said “learn what this means ‘ I want Mercy not Sacrifice’” and how he gave the story of David in the Bible while on the run from King Saul. Here a priest out of mercy is recorded of giving David and his men, who were in desperate need of food, some of the “Show bread” from the Temple, something prohibited under their law. I thought the same principle would reasonably apply today. Jesus clearly was demonstrating to the religious leaders of his day that the spirit behind the law was love. The religious leaders could not see this, that’s why they objected to Jesus disciples plucking grains of wheat on the Sabbath.

Does God want the sacrifice of so many young men, woman and children, which has occurred with Jehovah’s Witnesses over the years regarding the blood issue? Does this seem reasonable or even logical, when we reflect on those words? Jesus prefaced the expression “I want mercy not sacrifice” with the words, “learn what this means”. Jehovah’s Witnesses as an Organization have not yet learned this basic principle with regard to blood.

There were other points that I raised, such as how over time, the Watchtower had shifted its position on blood, and that now some blood components were considered acceptable in medical treatments that were once viewed as “unacceptable”. This of course became very confusing to the average Jehovah’s Witness, who is not trained in medical procedures or in the chemistry of blood. Because of this, the Watchtower organization gave birth to a new arrangement– the Hospital Liaison Committee. The HLCs were set up because the blood policy had become messy and the Watchtower was losing control over this issue.

For example, some serums with certain blood components in them became acceptable medicine to the Watchtower policy makers. There reasoning was that this was not feeding on blood. Abstaining from blood is essentially the discourse given in the bible book of Acts 15, which the Watchtower bases most of its policy on. Here, the context to those bible verses is in reference to eating blood. Interestingly, acknowledgment came through the Watchtower that a blood transfusion is essentially an Organ tissue transplant.

So the question remains, are these tissue transplants “feeding on blood”?

The Watchtower hypocritically remains resolute over their prohibition on blood in spite of their contradictions. These policy makers (Governing Body members) who reside at the Watchtower headquarters in New York, probably will at the some time, sit down to a meal and enjoy a nice steak served up rare, with its blood and think nothing of it and experience no crises of conscience.

At the end of the judicial meeting, they informed me that I was expelled/excommunicated, which meant that no Jehovah’s Witness on the face of this planet would be able to speak or socialize with me. Finally I remember saying, “Do you believe that you have carried out God’s justice here and acted with the love of Christ?” I said this because these men knew the hard work I had done in that Congregation and the sincerity in which I applied myself over many years but all this seemed irrelevant to them and the presiding overseer said coldly that I would “die at Armageddon” if I continued as I was. I left the meeting with a “goodbye”, and as I walked to my car a great relief came over me because although I knew that I would lose all the friends I had, I also knew I done the right thing.

The irony of that whole episode in my life is that the Watchtower could change its position once again regarding blood or its components and the same Elders who judged me would have to argue in favor of the changes in policy which had condemned me as an apostate.

Indeed, just two years later, the Watchtower approved the use of the largest of all blood components (hemoglobin) as well as the use of bovine (cow’s blood) to manufacture the blood product Hemopure.

Finding the real truth, good science in this case, is not the issue. Nor is it loyalty to Jesus Christ, the scriptures or even  one’s own conscience. Rather, this is about control and repression, loyalty to the Watchtower Society and its man-made directives.

Ray Hemming