The Medical and Moral Issues of Treating Jehovah’s Witnesses

The Medical and Moral Issues of Treating Jehovah’s Witnesses

In 1870, Charles Taze Russell and others formed a group in Pittsburg, Pennsylvania to study the Bible. Russell disputed the traditions of mainstream Christianity and founded Zions Watchtower Tract Society which many Jehovah’s Witnesses live by to this day. In 1931 this group evolved into Jehovahs Witnesses to differentiate between the Watchtower Society and the true followers of Russell. Jehovah’s Witnesses have medical beliefs that differentiate them from other religions and are important to know when treating them as patients.

The Jehovah’s interpretation of the Bible is what makes them shun receiving blood transfusions. “In the Old Testament, Jehovah forbade as unclean, eating the blood of animals and likewise the blood of man. Blood transfusions is, in a technical sense, the ‘feeding’ of the body when disease or anemia lower the blood count and ‘starves’ the vital organs.” (Martin, 1974) The interpretation of the Bible clearly does not reference transfusions of blood, merely the eating of it. “Whatsoever soul it be that eateth any manner of blood, even that soul shall be cut off from his people” (Leviticus 7:27) According to the Watchtower the transfusion of human blood through the veins is like feeding the body through the mouth (Martin, 1974).

Jehovah Witnesses strongly believe that blood is representative of life and is sacred. One section of the Bible clearly demonstrates this belief, “Flesh with the life thereof, which is the blood thereof, shall ye not eat” (Genesis 9:4). It is through the interpretation of this scripture that makes Jehovah Witnesses value the soul of a person over a physical body. This can cause conflict and misunderstanding in a hospital where health care professionals are often trained to value the life of a physical being.

Jehovah’s Witnesses believe that when Armageddon comes that a select amount of people who have followed God’s laws will rise from the dead to spend eternity in heaven. The remainder of people who followed God’s laws but didn’t go to heaven will spend eternity in a paradise on earth. The people who have broken God’s laws will spend eternity in nothingness. This belief prevents Jehovah’s Witnesses from accepting blood transfusions because they view it as exchanging an eternity in heaven for a few years on earth.

Not only do Jehovah’s Witnesses refuse transfusions of whole blood, they also don’t accept the main four components of blood namely, red blood cells, white blood cells, platelets, or plasma. However, many individuals do make their own decisions regarding acceptance of immunoglobulin, hemoglobulin, and albumin based on their own interpretations. Preoperative blood collection or hemodilution that involve blood storage are not allowed. The majority of Jehovah’s Witnesses are against auto transfusion or predeposited blood because they believe blood removed from the body should be disposed of. Jehovah’s Witnesses don’t cite any Bible comments directly concerning organ transplants thereby, individually make decisions on whether to accept cornea, kidney, or other tissue transplants. They can have major surgery because they don’t have any objections to non-blood replacement fluids, electrocautery, or anesthesia. Also Jehovah’s Witnesses will allow use of heart, lung dialysis, or similar life sustaining equipment as long as extracorporeal circulation is uninterrupted.

It is taken for granted that parents have a voice in the care of their children, so parents need to be aware of risk-benefit potentials of surgery, radiation, or chemotherapy. Doctors and parents need to be in complete agreement concerning treatments of their ill children and that these treatments do not conflict with religious beliefs. The whole person needs to be treated without any violations of the family’s beliefs.

In treating Jehovah’s Witnesses the physicians often are faced with the challenge of treating a patient without using all of the modern medicine techniques that might go against the patients beliefs. Nontraditional treatments pose a medical challenge for physicians to develop alternate techniques in providing the best health care possible.

A recently developed fluorinated blood substitute called Fluosol-DA is in agreement with the beliefs of Jehovah’s Witnesses. Michael Debakey, MD commented “in the great majority of situations (involving Witnesses) the risk of operation without the use of blood transfusions is no greater than in those patients on whom we use blood transfusions.” This substitute is used as an alternative to blood transfusions without the use of biological blood.

When treating Jehovah’s Witnesses physicians should not fear lawsuits as Witnesses readily sign the American Medical Association form relieving them from liability. Most Jehovah’s Witnesses carry a medical alert card notifying health care providers of their religious beliefs and practices which offer protection to workers in the medical field. This document is prepared with legal and medical authorities to ensure the patient receives treatment without risk to licensure of medical professionals.

Sometimes a moral dilemma is created when it is evident treatments are necessary to preserve someone’s life and there seems to be no substitute available, how does a Hippocratic oath measure up to following someone’s religious beliefs? In many cases concerning family members of a Jehovah’s Witness there have been cases tried in court on patients rights in accordance with religious beliefs.