To: Canadian Medical Association Journal

From: Dr. D. John Doyle, M.D., Ph.D.

November 11, 1997

"Reformed" Jehovah's Witnesses who Accept Blood Transfusions

To the Editor:

It is well-known that one tenant of the Jehovah's Witness faith is to
refuse blood transfusions, even at risk of organ injury or death [1].
This fact has contributed significantly to the development of
"bloodless" surgical techniques [2,3], as well as to successful legal
suits against clinicians who have transfused Witness patients when the
alternative would almost certainly be death [4].

The purpose of the letter is to inform CMAJ readers of a new "reform"
movement among Witnesses aimed at allowing blood transfusions. Leaders
of this movement argue that a blood transfusion is actually a form of
organ transplantation (generally allowed by the church) and thus does
not violate the Old Testament edict against "eating blood". The reform
movement Web site at http://www.visiworld.com/starter/newlight/home1.htm
offers detailed discussions from biblical, historical and theological
perspectives and may be of interest to Witness patients and their
caregivers.

Clinicians who deal with Witness patients who are severely anemic or
awaiting surgery now have a new ethical issue to consider. In the
interests of full and complete disclosure should they inform Witness
patients about the existence of a reform movement that would allow blood
transfusions, or should they remain silent to avoid any perception of
"religious interference"?

References

[1] Victorino G, Wisner DH. Jehovah's Witnesses: unique problems in a
unique trauma population. Journal of the American College of Surgeons.
184(5):458-68, 1997

[2] Rosengart TK, Helm RE, DeBois WJ, Garcia N, Krieger KH, Isom OW.
Open heart operations without transfusion using a multimodality blood
conservation strategy in 50 Jehovah's Witness patients: implications for
a "bloodless" surgical technique. Journal of the American College of
Surgeons. 184(6):618-29, 1997

[3] Mann MC, Votto J, Kambe J, McNamee MJ. Management of the severely
anemic patient who refuses transfusion: lessons learned during the care
of a Jehovah's Witness. Annals of Internal Medicine. 117(12):1042-8,
1992

[4] Brahams D. Jehovah's Witness transfused without consent: a Canadian
case. Lancet. 2(8676):1407-8, 1989