Blood and Life, Law and Love

What is now discussed is not to imply in any way that the use of blood is not without its serious degree of risk. That there is risk is a simple fact. Nor does it in any way imply that the person who makes a personal, uncoerced choice to avoid transfusions (or any acceptance of blood components and fractions, for that matter) on purely religious grounds is acting improperly. Even acts that are proper in themselves become wrong if done in bad conscience. As the apostle puts it, “Consider the man fortunate who can make his decision without going against his conscience. . . . every act done in bad faith is a sin.”{1} Whether, in view of the evidence that will be presented, certain scruples regarding blood reflect a weak or a strong conscience, I leave to the reader to judge.

At the same time, the seriousness of an organization’s responsibility in imposing its views on an individual’s personal conscience in such critical matters should never be underestimated. What has happened with the Watch Tower Society in the field of blood illustrates forcefully how legalism can lead an organization into a morass of inconsistencies, with the possibility of its members suffering whatever unfavorable consequences result.

Starting in the late 1940s, the organization initially declared an outright ban on the acceptance of blood in any form, whole or fractional. Then, over the years, it added on new rulings that have entered into more and more technical aspects of the issue. The following chart basically presents the position of the organization on the use of blood as of the year 2001:

The organization thus categorizes the elements in blood as either “major” components or “minor” components (the effect of this division appearing in the chart presented). This categorization of itself illustrates the arbitrary nature, as well as the inconsistency, of such rulings. Where has God granted to men authority to make such division? On what basis do they divide—simply on a certain percentage of the total, and if so, what is the cutoff point in percentage separating “major” from “minor”? Or do they do it on the basis of how vital a role each component plays? If so, how do they assess and determine the relative importance of such role?

In personal conversation, even the former head of the Watch Tower headquarters’ own medical staff, a licensed physician and surgeon, acknowledged the difficulty in classifying an element as “major” or “minor” in view of the fact that if a person needs a particular blood element to save his life then that element is a “major” one for him.But the inconsistency actually goes much, much farther.

When the question is put as to why it does not forbid the use of all blood components, the Watch Tower Society often has explained its policy changes allowing use of the listed blood fractions by saying that these are used in very “small quantities” and that this places their use within the realm of personal conscience. Examined closely, however, one finds evidence indicating either ignorance of, or a covering over of, facts, facts so forceful that they expose the organization’s position as meaningless. Consider the following:

The Watch Tower’s strongly expressed statements against use of “whole blood” sound very impressive to many Witnesses. Though common in the 1950s and 1960s, such whole blood transfusions today actually are notably rare. In most cases, the patient is given the particular blood component he or she needs. {4} At the time of being donated, most blood is separated into a number of components (plasma, leukoctyes, erythrocytes [red blood cells], etc.). These are stored for future use. Most will be sent directly to medical facilities. In the great majority of cases, therefore, when a Witness is faced with the question of a transfusion the issue is not as to use of whole blood but of some blood component.

The inconsistency of the Watch Tower’s policy as to acceptable and non-acceptable components is well illustrated in its policy as to plasma. As can be seen in the chart taken from the October 22, 1990 issue of Awake!, plasma composes about 55 percent of the volume of blood. Evidently on the basis of volume, it is placed on the Watch Tower’s list of banned “major components.” Yet plasma is actually up to 93 percent simple water. What are the components of the remaining approximately 7 percent? The principal ones are albumin, globulins (of which the immunoglobulins are the most essential parts), fibrinogen and coagulation factors (used in hemophiliac preparations).{5} And these are precisely the components the organization lists as allowable to its members! The plasma is forbidden yet its principal components are permissible—provided they are introduced into the body separately. As one person observed, it is as if a person were instructed by a doctor to stop eating ham and cheese sandwiches, but told that it is acceptable to take the sandwich apart and eat the bread, the ham and the cheese separately, not as a sandwich. {6}

Leukocytes, often called “white blood cells,” are also prohibited. In reality the term “white blood cells” is rather misleading. This is because most leukocytes in a person’s body actually exist outside the blood system. One’s body contains about 2 to 3 kilos of leukocytes and only about 2-3 percent of this is in the blood system. The other 97-98 percent is spread throughout the body tissue, forming its defense (or immune) system. {7}

This means that a person receiving an organ transplant will simultaneously receive into his body more foreign leukocytes than if he had accepted a blood transfusion. Since the Watch Tower organization now allows organ transplantations, its adamant stand against leukocytes, while allowing other blood components, becomes meaningless. It could only be defended by use of convoluted reasonings, certainly not on any moral, rational or logical grounds. The arbitrary splitting of the blood into “major” and “minor” components is also seen to be without sound basis. The organization evidently prohibits plasma—though mainly water—because of its volume (55% of the blood), yet it prohibits leukocytes which, as the Awake! chart shows, compose only about 1/10 of 1 percent (.001) of the blood! {8}

The absence of either moral or logical grounds for the position is also seen in that human milk contains leukocytes, more leukocytes, in fact, than found in a comparable amount of blood. Blood contains about 4,000 to 11,000 leukocytes per cubic millimeter, while a mother’s milk during the first few months of lactation may contain up to 50,000 leukocytes per cubic millimeter. That is up to five to twelve times more than the amount in blood! {9}

This leaves erythrocytes (red blood cells) and platelets remaining on the prohibited list. What of the permitted components?

A major factor to keep in mind is that the Watch Tower organization’s argumentation seeks much of its support in provisions of the Mosaic law commanding that the blood of slaughtered animals be poured out, this being cited as though justifying the organization’s objection to any storing of human blood. {10} Remember also that it presents the blood components it allows as constituting only a negligible amount of blood. Then consider these facts with regard to the components the organization classes as permissible:

One of these is albumin. Albumins are primarily used in connection with burns and severe bleeding. A person with third degree burns over 30 to 50 percent of his body would need about 600 grams of albumin. Watch Tower policy would allow this. How much blood would be needed to extract this quantity? It would take from 10 to 15 liters (from 10.6 to 15.9 quarts) of blood to produce that quantity of albumin. {11} This is hardly a “small amount.” It is also obvious that the liters of blood from which it is derived were stored, not “poured out.”

Similarly with immunoglobulins (gamma globulins). To produce sufficient gamma globulin for one injection by syringe (a vaccination persons, including Jehovah’s Witnesses, traveling to certain southern countries may take as protection against cholera) close to 3 liters of blood are needed as the source of supply. {12} This is still more blood than is generally employed for a common blood transfusion. And again, the gamma globulin is drawn from blood that is stored, not “poured out.”

Hemophiliac preparations (Factors VIII and IX) remain. Before these preparations came into use, the average life span of a hemophiliac in the 1940s was 16.5 years. {13} Today, due to these blood-derived preparations, a hemophiliac may reach a normal life span. To produce preparations that could keep a hemophiliac alive over that period of time would require extractions from an estimated 100,000 liters of blood. {14} Even though the hemophiliac preparations themselves represent only a fraction of that total, when we consider their source we must ask how this could possibly be viewed as involving a “small amount” of blood?

The use of any of these blood components obviously implies storage of large, even massive, amounts of blood. On the one hand the Watch Tower organization decrees as allowable the use of these blood components—and thereby the storage involved in their extraction and production—while on the other they state that they are opposed to all storage of blood as Biblically condemned. This is the sole basis they give for prohibiting the use of autologous blood by a Witness (that is, the person’s having some of his own blood stored and then returned to his blood stream during or following surgery). {15} Clearly, the positions taken are arbitrary, inconsistent and contradictory. It is difficult to believe that the formulators, and also the writers of explanations and defenses, of such policy are so ignorant of the facts as to fail to see the inconsistency and arbitrariness involved. Yet that alone could save the position from also being termed dishonest.

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{1} Romans 14:22, 23, JB.

{2} These positions are spelled out in the Awake! magazine of June 22, 1982, which carries a reprint of an article published in The Journal of the American Medical Association (November 1981 issue). The article was prepared by the Watch Tower Society and sets forth Jehovah’s Witnesses’ position on blood. More recently in the Watchtower magazine of June 15, 2000, pages 29-31.

{3} Dr. Lowell Dixon nonetheless supports the Watch Tower policy and is author or co-author of various articles on the subject of blood published in Watch Tower publications.

{4} An inquiry to the Atlanta Red Cross on January 22, 1990, revealed that only about 6 percent of all blood donated there goes out to hospitals as whole blood, the other 94 percent being divided into component parts.

{5} The Encyclopdia Britannica, Vol. 3 (1969), page 795; The Encyclopedia Americana, International Edition, Vol. 4, 1989, page 91.6 Interestingly, the water, composing most of the plasma, freely “moves in and out of the bloodstream with great rapidity” and exchanges with water of the body cells and extracellular fluids. So it is never a constant component of the blood stream. (The New Encyclopdia Britannica, Macropedia, Vol. 15, 1987, pages 129, 131.)

{7} The New Encyclopedia Britannica, Macropdia, Vol. 15 (1987), page 135, points out that “Most of the leukocytes are outside of the circulation, and the few in the bloodstream are in transit from one site to another.” To categorize them as a “major blood component” is somewhat like saying that passengers riding on a train are a constituent or integral part of the railroad system personnel. Dr. C. Guyton, in The Textbook of Medical Physiology (7th ed., Saunders Company, Philadelphia), page 52, explains that the main reason leukocytes are present in the blood “is simply to be transported from the bone marrow or lymphoid tissue to the areas of the body where they are needed.”

{8} The fraction is so small that Awake! makes no attempt to show it in the chart’s test tube, and it is included with the platelets which, it may be noted, themselves constitute only about 2/10 of 1 percent of the total of the blood. They are also on the prohibited list.

{9} The New Encyclopedia Britannica, Macropedia, Vol. 15 (1987), page 135; J. H. Green, An Introduction to Human Physiology, 4th ed. (Oxford: Oxford University Press, 1976), page 16). On the amount of leukocytes in human milk, see Armond S. Goldman, Anthony J. Ham Pong, and Randall M. Goldblum, “Host Defenses: Development and Maternal Contributions,” Year Book of Pediatrics (Chicago: Year Book Medical Publishers, Inc., 1985), page 87.

{10} Genesis 9:3, 4; Leviticus 7:26, 27; 17:11-14; Deuteronomy 12:22-24..

{11} There are about 50 grams of albumin in one liter of blood. To get 600 grams of albumin, therefore, some 12 liters of blood are needed.

{12} This figure has been arrived at by dividing the amount of gamma globulin in one syringe with the amount found in one liter of blood.

{13} In 1900 it was only 11 years.

{14} This estimate is very conservative. The true figure is probably much higher in most cases. The June 15, 1985, Watchtower (page 30) states that “each batch of Factor VIII is made from plasma that is pooled from as many as 2,500 blood donors.”

{15} The organization’s position on this is spelled out, with much technical detail and reasoning, in the Watchtower of March 1, 1989, pages 30 and 31.