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