Following the March update from the governing body (autologous blood transfusions now being a matter of conscience) I thought it would be interesting to trace the history of how transfusions have been viewed, and policed, by the Watchtower Society. It is interesting, very interesting! But there are many who are quicker off the blocks than I, so I will not duplicate their work and I will turn this into a personal statement of belief, my own reaction to another screeching U turn.
The main thrust of their argument was that we are no longer under the Mosaic Law and therefore what is said regarding blood in the law is not relevant. This is stating the obvious. We do not keep Sabbath, slaughter bulls and goats at halls of worship, and stone adulterers to death (although I have a feeling that there are many elders – and sisters - who would like to!). However, the prohibition on blood both pre-dates and post-dates the law so there must be something more to consider.
In Genesis chapter nine Noah is told that he can eat animals but that he must pour out their blood onto the ground. In the letter to the Gentiles at Acts 15, they are admonished to avoid the ‘meat of strangled animals and from blood’ (v20 – BSB), repeated in v29. There are two commands here. The first refers back to Noah’s day; strangled animals will not have had their blood poured out. The second appears to refer to the ritualistic and idolatrous use of blood, which was very a much a thing in the Greco-Roman world.
Nowhere does the Bible prohibit the use of blood in medicine. That may be because the knowledge and ability to use blood in medical procedures had not been developed. It was only in the early twentieth century that blood groups were discovered (Karl Landsteiner, 1901). Prior to that, any blood transfusions would almost always have been fatal. The question then is this; if blood transfusions had been a non-fatal, or even beneficial, medical procedure in Bible times, would Jehovah have prohibited them? I cannot answer that, and neither can anyone else! It must therefore follow that if autologous blood is acceptable, assuming our conscience allows it, so are all other kinds of blood transfusion. A transfusion is a transfusion irrespective of whether it is of my blood, your blood, or anyone else’s blood. When we are flaked out unconscious on the operating table, are we in any position to verify that the blood flowing into us is actually our own blood? What if the operation takes more blood than that has been stored? What are the options? Cancel the operation halfway through? Wake us up and seek our advice? Something about the inadvisability of changing horses mid-stream comes to mind! Or more likely, top it up with someone else’s blood? How would you know? And if you suspect that is what has happened, what are you going to do about it? Launch expensive, time-consuming and deeply stressful legal action?
The option of storing up your own blood prior to an operation logically means that this is for planned surgery. Planned surgery may refer to life-threatening treatments that are not performed under emergency conditions, such as the removal of a tumour. Elective surgery refers to procedures that are not life-threatening but make life less painful or easier. Joint replacements fall into this category. Having read many secular sources about bloodless surgery over many years I understand that it is universally recognised that bloodless surgery is the gold standard. It reduces infection risk and immune reactions, lowers postoperative complications, shortens recovery time and is generally safer. This is usually due to having your own personal patient blood management (PBM) programme, better surgical techniques, improved haemostasis (stopping bleeding), and the use of pharmacological agents such as TXA and EPO: optimising haemoglobin before, minimising blood loss during, and enhancing red-cell production after surgery. PBM is now the global standard.
With all this in place, why would anyone want to store their own blood to receive a standard of treatment that may be less effective than it might otherwise? Presumably you will not be infected by someone else’s diseases or suffer organ rejection, but still, if such high-quality alternatives exist, why not make use of them?
The main issue that remains is in emergency situations – traffic accidents, uncontrolled haemorrhaging during childbirth, and the like. There are many non-blood volume expanders available: crystalloids (saline, lactated Ringer’s, Plasma-Lyte) and colloids (albumin, gelatins, dextrans hydroxyethyl starch). These can be used to keep the system up and running, to maintain pressure to prevent organ collapse. These liquids cannot carry oxygen. The body can survive with a very low haemoglobin level for a short time as long as there is sufficient volume to keep things moving. But if haemoglobin levels do not increase above a critical threshold, organ failure can occur. Volume expanders buy time.
Will you, will I accept a blood transfusion in these circumstances, which will by necessity be someone else’s blood? That is the question that is left outstanding. Is it a matter of conscience, or does the governing body really have the power to decide on our behalf what we can and cannot accept? Will this too become a matter of conscience in time?
This leads to how the change was presented. ‘The governing body has decided…’. Hang on! Who do they think they are to make such decisions on my behalf? Are they really Jehovah’s mouthpiece? Think about it! If Jehovah was right to ban blood transfusions nearly 80 years ago, why has he changed his mind now? I am Jehovah; I do not change (Mal 3:6). Jesus is the same yesterday, today and forever (Heb 13:8). If this latest statement is the true position, why has he misled us for eighty years? I wonder how many have died through obedience to a command that is now simply a matter of conscience? It was presented as a clarification, but the reality is that it is a complete U turn. How can that be a clarification? There were no apologies, no acknowledgements of harm caused. Just ‘we have decided’! What does 2 Thessalonians 2:4 say about the man of lawlessness? Why this change, now? I do not know, but my guess is that it has something to do with money. Is there a growing list of litigation cases that are proving rather expensive to settle quietly?
I will give a brief timeline here:
Prior to 1945, transfusions were encouraged and commended
1945 – transfusions declared wrong
1959 – autologous blood not even allowed for priming equipment
1961 – transfusions become a disfellowshipping offence
1964 – pet transfusions banned! Even blood-containing fertiliser frowned upon
1970s – 1990s – many rules regarding procedures and fractions become complex and inconsistent
June 2000 – receiving transfusions reclassified as disassociating oneself. This was a change of terminology to comply with a deal with ECHR regarding registration of JWs in Bulgaria in 1998. The effect is the same – shunning as an outcast.
Oct 2000 – the ban on autologous blood restated
2026 – autologous blood now a matter of conscience
Addendum - 21/05/2026
For the eagle-eyed amongst us (and I note that it has taken nine months for me to notice this, and even then I needed prompting!), the following section to the terms and conditions for using the JW Library App. I have always been discomforted by the existence of such in a Society in which everyone are, theoretically, brothers of equal standing (Matt 23:8). Jesus said ‘You received free, give free’ (Matt 10:8). The first-century brothers held all things in common (Acts 4:32). And as everything that the WTS does is funded by the brethren (at least that is the official line), then why is a necessary app, produced by the Society for the brothers, so tied up in legal speak? The thing about terms and conditions is that, in reality, nobody needs to read them. If the product or service is used as expected, then they are all irrelevant. If it is abused, there is nothing that will be of assistance to the miscreant. It is almost universal practice that unless one states that they have read and accepted them the product or service will be denied. There is no in between. This is true of JW Library. If we must serve Jehovah through the auspices of the WTS alone, and an electronic tool is the most convenient and encouraged way of accessing ‘spiritual food’, then is it the case that some carefully constructed words from a highly qualified lawyer can in some way separate us from God’s love? It is quite extraordinary.
But this is mere preamble. Have a read of this section, dated 1st Aug 2025:
6. MEDICAL INFORMATION The content of this Application that contains any medical information or references (“Medical Information”) is for informational purpose only and does not constitute medical advice, nor is it intended to be a substitute for professional medical advice, diagnosis, or treatment. The Medical Information does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned in the Medical Information. The Medical Information is not designed, intended, or authorized [sic] for use in connection with any medical or life-saving or life-sustaining decisions, systems, or procedures, or for any other application or purpose. Always seek the advice of a physician or other qualified health-care provider with any question you may have regarding a medical condition or treatment. This Application assumes no liability or responsibility for any errors or omissions in the content of any Medical Information. Reliance on any Medical Information is solely at your own risk.
So what do we make of that? Where does this leave the No Blood policy? The Application contains pretty much everything that they have published for general consumption back to 1970 and Watchtowers to 1950. The official line (at the moment) is still that any Jehovah’s Witness who accepts a blood transfusion has voluntarily disassociated himself from the congregation. In effect, this is the same as being expelled, disfellowshipped; that person will be shunned. The announcement ‘Blah is no longer one of Jehovah’s Witnesses’ is the same either way and everyone is left to jump to whatever conclusion they choose, based on a total lack of information.
In short – it is our responsibility to decide on whatever medical treatment we wish to receive. If we refuse a blood transfusion based on any past or present information from the WTS, they will not accept any responsibility whatsoever for any negative outcome. If we do accept a transfusion, we will be expelled. That’s nice! I would like to see that challenged in court. If someone does refuse a transfusion, and then suffers as a perceived result of that decision, made because the individual did not want to be cut off from his entire community of family and friends, then it seems to me that WTS very much has a responsibility! They were coerced, surely?
Where does this leave the Hospital Liaison Committee (HLC)? That exists to form a bridge between the patient and the medical team, to ensure that the patient receives treatment that is acceptable to the WTS. The individuals involved are men chosen and trained by the WTS for this purpose.
And the Advance Medical Document, the Durable Power of Attorney (DPA) that all Witnesses are expected to carry at all times? Where does that fit in? All are strongly encouraged to ‘carefully and prayerfully fill out a durable power of attorney (DPA) card’. Elders ‘can help you fill out your DPA card’ and those ‘serving on the HLC are trained to help those in the medical and legal communities understand our religious position regarding blood’ (mwb 01/23). This source then directs readers to Enjoy Life Forever, lesson 39 which explains ‘God’s View of Blood’ and how to ‘make good decisions on this matter’. Section 3 ‘Make medical decisions that please Jehovah’ says, in part, ‘Recognise that no one – not even your spouse, an elder, or your Bible teacher – should tell you what decision to make in matters of conscience - (Rom 14:12)'. 'Making this decision shows respect for life and for Jehovah’s law on blood’. Km01/09 asks ‘Have you taken a clear position on which medical treatments and procedures you are willing to accept for yourself and your children and then filled out a DPA card?’
So there we have it. It is a personal decision but there is only one option that is acceptable to the ruling body. You can have any colour as long as it is black. You can make any choice as long as it is the one we have mandated. As far as I can discover, they never have formally mandated this. It is all achieved through subtle, but very strong, pressure. It is framed as a spiritual obligation, loyalty to Jehovah, necessary, and everybody else has one so why would you want to be different? It is not technically compulsory but, in reality, it is! The moment anyone makes the ‘wrong’ decision, they will face loss of community, family, and identity.
It seems to me that these two tools work together to ensure that they are covered when it comes to legal challenges. The DPA creates the ‘voluntary’ legal commitment, and the HLC ensures social and doctrinal compliance. It is very dark and authoritarian. All very 1984; one is reminded of Orwell’s Ministry of Love, that exists to achieve total obedience through total fear, whilst forcing citizens to love Big Brother. ‘We love you all very much’!
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