For Medical Professionals
Understanding Jehovah’s Witnesses and Their View of Blood Products
As medical providers, we do not treat just a disease or set of symptoms. We treat individuals, people who just like us have the right be treated with respect and dignity. As medical care providers we appreciate the need to respect the beliefs, culture, customs and religious viewpoints of our patients. But what happens when we do not personally understand the viewpoint of a certain person or group? We may feel added stress. When this stress shows, our patients may even interpret this stress as being directed against them.
Jehovah's Witnesses and Blood Products
Understanding the wishes of Jehovah’s Witnesses may present this challenge. Based on certain Bible passages, they deeply believe that blood is sacred. As such they are unwilling to accept blood transfusions. To better understand their viewpoint, consider the interactive chart of how Jehovah's Witnesses view blood and blood products.
At the top of the chart are products Jehovah’s Witnesses absolutely will not accept. These are products which they categorically define as comprising a blood transfusion. Some of Jehovah’s Witnesses may refer to these as Primary Components of Blood. These include transfusions of whole blood, red blood cells, platelet rich plasma, platelets, plasma (and FFP), and white blood cells.
Beneath that are a listing of products labeled ‘Personal Decision’. For these products each patient who is one of Jehovah’s Witnesses has to decide for himself whether or not he views them as permissible or not. Some of Jehovah’s Witnesses may refer to these as Minor Blood Fractions.
Jehovah's Witnesses
and
Procedures Involving
Their Own Blood
Another dimension to the beliefs of Jehovah’s Witnesses and blood has to do with what they will permit to be done with their own blood. One therapy which is always unacceptable is pre-autologous donation. For the patient who is one of Jehovah’s Witnesses, any procedure for which they see their blood as clearly being stored will not be acceptable.
On the other hand, procedures with your patient’s own blood—whether they be blood testing, an epidural blood patch, nuclear cell-tagging or diversion of their blood temporarily outside of their body such as in cell-salvage, hemodilution, dialysis or use of the heart-lung machine— are left up to the individual to decide.
Caring for the Needs of Each Patient
If you are treating a patient who is one of Jehovah’s Witnesses, he may present to you a legal document or other worksheet which specifically notes how he feels about accepting some or all of these products and procedures. If the patient is unclear about how he feels about some of these products from a religious point of view, he may be able to gain clarification from resources within his congregation.
For patients of Allegheny General Hospital, Bloodless Medicine Coordinators are available to discuss and document all of the issues noted above on the patient’s chart. Medical staff at Allegheny General Hospital can reach the Center for Bloodless Medicine through the hospital operator.
Understanding and documenting these items early in our relationship with the patient enables us to understand exactly what our patient wishes. Taking the time to understand these things helps the patient to understand that our motive is to respectfully care for them.
Are you unfamiliar with your patient’s beliefs? Do you want to know more about why they feel blood is sacred? Ask your patient. Most persons, not just Jehovah’s Witnesses, welcome the opportunity to explain themselves to persons with sincere questions about what they value and why. The official website for Jehovah’s Witnesses is www.watchtower.org
Beyond understanding what your patient wants, believes, or accepts is the matter of dignifying the patient. But how can you do this when your personal beliefs may not coincide with that of your patient? Many have found it helpful to consider that it is not just in refusing or accepting blood transfusions that our patients make decisions that may differ from the recommendations of their medical care givers. Whether it is deciding about pain management, refusing certain mainstream treatments or seeking alternative therapies for a host of conditions, patients make their own decisions. And each of us may one day be one of those patients!
Your patient who is one of Jehovah’s Witnesses knows that there are risks both in accepting and in refusing blood transfusions. His decision to refuse transfusions however is motivated not by a calculation of clinical risks and benefits. His decision is made in keeping with his overriding spiritual values which he values above all. He knows that you may not personally agree with all of his decisions. He does however want you to understand his decisions. Further he wants to know that you are willing to respect them. With a little information and a cultivated atmosphere of mutual respect, you can successfully and respectfully treat your patient who is one of Jehovah’s Witnesses.
