Prohibited Blood Components

bloodchart2004Whole Blood: It should come as no surprise that the Society’s prohibition against blood transfusions obviously includes whole blood. In real life, however, this prohibition has little relevance. During the 1950’s and 60’s whole blood transfusions were common. Today, practically all blood is divided into components and patients receive only the fractions they need.

It costs the Watchtower precious little, then, to uphold a prohibition against whole blood. Indeed, they could continue to keep this aspect of ban in place because most of the time a JW faces the problem of accepting or refusing a blood component.

The blood issue thus boils down to distinguishing among these components. As we will see, the Watchtower Society does this arbitrarily.

The WTS itself described how blood is separated into components [see g90 10/22]. (Note: The Awake! erroneously states that white cells comprise 0.1% of whole blood. The correct figure is about 1%.)

Plasma: Plasma is a yellowish fluid in which the blood cells described above are suspended. It contains clotting factors such as factor VIII which is used in the treatment of hemophilia, albumin used for the treatment of surgical shock or severe burns, and Immunoglobulins which protect the body against infectious diseases and are used in the treatment of immunodeficency. Considering that blood plasma is about 55 % of blood volume, it is not surprising the component is prohibited. However, it must be noted that blood plasma consists of more than 90% water. This water is not even a part of the blood stream, as the Encyclopaedia Britannica explains:

“The water of the plasma is freely exchangeable with that of the body cells and extracellular fluids and is available to maintain the normal state of hydration of all tissues.” (The New Encyclopædia Britannica, 1988, Chicago: Encyclopædia Britannica, Inc., vol. 15, p. 131, Macropædia: “Blood”)

Prohibiting transfusion of water that is even freely exchanged with the rest of the body would be unreasonable. With this in mind, note that Britannica further says of plasma that “its major solute is a heterogeneous group of proteins constituting about 7 percent of the plasma by weight. . . . Other constituents include salts, glucose, amino acids, vitamins, hormones, and waste products of metabolism.” (ibid.)

What, then, makes up the rest of this plasma? It is albumin (the major component), Immunoglobulins, fibrinogens and other components used in the coagulation process. Other components are important but the fractions are small, like lipids which amount to less than 1 gram per 100 milliliters.

Note this: the components that make up the plasma are exactly the same components we find in the permitted list. On what basis does the WTS prohibit plasma taken alone, but permit it if it is divided into its components? For understandable reasons the Governing Body has never addressed this question.

White Cells (leukocytes): The term “white blood cells” is somewhat misleading since there are more of them outside the bloodstream than in it. Only about 2-3 % are in the blood and the rest are in other parts of the body, so that a Witness who accepts an organ transplant takes in more leukocytes than he would through a blood transfusion. The prohibition against leukocyte transfusions is therefore meaningless.1

Furthermore, today we know that mother’s milk contains 5-12 times more leukocytes than a corresponding amount of blood. Therefore a newborn baby receives more leukocytes from its mother’s milk than if it took in a similar amount of whole blood. The argument against this component thus evaporates. Even more astonishing is that this also applies to cow milk, which is used extensively as food and drink in all the world. So every time a JW drinks milk, he receives more of the prohibited leukocytes than if he or she receives a blood transfusion!

In an interesting development, one Jehovah’s Witness was told that he could accept an autologous transfusion of white blood cells as a matter of conscience. This prompted the writing of a scientific article about the situation.

Red blood cells: These are among the most important prohibited components, as they carry out the vital function of transporting oxygen to the body. They constitute about 45% of the blood volume. Red cells carry oxygen and are used to treat blood loss resulting from trauma and surgical operations. Some cardiac operations can use up to 20 donations. Liver transplants would normally use 10 – 15 donations and a hip replacement 2-6 donations.2

Platelets: These play an important part in the clotting process. Platelets are widely used in the treatment of cancers like Leukemia. One patient can require the platelets from 10 or more individual donations every day for a number of weeks. Since platelets constitute a tiny percentage of blood volume (.17%), we could can only wonder why it would be that the WTS would choose to ban this particular component.3

Consider another odd prohibition. The Society does not permit a JW to store his own blood in advance of an operation. If this were permitted, the danger of infection so often mentioned in Watchtower literature would not exist. Further, it would be nonsensical to argue that a person had to abstain from his or her own blood. Yet, in effect, this is what the Watchtower does:

“Though Christians are not under the Mosaic Law, the Bible says that it is ‘necessary’ for us to ‘abstain from blood,’ viewing it as sacred. (Acts 15:28, 29) This is understandable, for the sacrifices under the Law foreshadowed Christ’s blood, God’s means by which we can gain everlasting life. – Hebrews 9:11-15, 22.

How was blood to be dealt with under the Law if it was not used in sacrifice? We read that when a hunter killed an animal for food, ‘he must in that case pour its blood out and cover it with dust.’ (Leviticus 17:13, 14; Deuteronomy 12:22-24) So the blood was not to be used for nutrition or otherwise. If taken from a creature and not used in sacrifice, it was to be disposed of on the earth, God’s footstool.-Isaiah 66:1; compare Ezekiel 24:7, 8.

This clearly rules out one common use of autologous blood-preoperative collection, storage, and later infusion of a patient’s own blood.” (The Watchtower, March 1, 1989, p. 30)

Autologous transfusions: These are prohibited despite the fact that the WTS agrees that “Christians are not under the Mosaic Law,” and that JW’s supposedly are not obliged to follow it. The mosaic law requiring the pouring out of animal blood upon the ground is the sole argument against autologous transfusions. This prohibition is entirely meaningless when we comprehend the massive blood storage that is required for many of the permitted blood fractions.

Oddly enough, the Watchtower will permit the use of induced Hemodilution (ANH). This is a process where 2-4 units of blood is removed from the body just prior to surgery, then re-infused after the surgery. The blood is stored briefly outside of the body, and the process can be set up so that a small amount of blood continues to flow back into the body. This along with cell scavenging techniques are referred to by doctors as a form of Autotransfusion. The Watchtower never refers to it in this manner because they do not want Witnesses to see the irony that they are allowing a form of “blood transfusion” after all. – See the Watchtower of June 15, 1995, p.30. We applaud these efforts to reform the blood doctrine and to make needed, but difficult changes. The reforms, however, must go further.

1-Leukocytes: “On average there are 4000 to 11,000 WBC’s per cubic millimeter and they account for about 1% of the total blood volume.” 1994 Elaine N Marieb R.N. Ph.D. Essentials of Human Anatomy and Physiology, 4th edition p. 294.

2-Red Blood Cells: “In normal adults, the red cells occupy, on the average, about 48% of the volume of blood in males and about 42% in females. The percentage of the volume of blood made up by erythrocytes is defined as the hematocrit. The red blood cell count (i.e. , the concentration of red cells in blood) normally averages about 5.2 million/micro liter in adult men and 4.8 million/micro liter in women.” – 1993 Robert M. Berne M.D. Matthew N. Levy M.D. Physiology 3rd edition p. 329

3-Platelets: “Normal blood contains between 150,000 and 350,000 platelets/micro liter.” – 1993 Robert M. Berne M.D. Matthew N. Levy M.D. Physiology 3rd edition p. 352

“Platelets are roughly disk-shaped between one-half and one-third the diameter of a red cell. However, they contain only about one-thirteenth the volume of a red cell.” – 1995 Charles D. Lawrence MPH Ph.D. The Cardiac Catheterization Laboratory – A Primer and Compendium for Technologists

Comment: If we were to take a figure of 300,000 as a “normal” platelet count, that would only equal the volume of 23,077 red blood cells This would constitute about 0.2 percent of the total blood volume based on a concentration of 5,000,000 red cells per cubic millimeter representing 45% of the total blood volume. This is slightly higher than the 0.17 figure given for platelets in the October 22, 1990 Awake! p.4

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