Jehovah's Witnesses and artificial blood
========================================

* Zenon M. Bodnaruk

In an article published in the June 15, 2000, issue of *The Watchtower*, the official journal of Jehovah's Witnesses, this Christian faith repeated its long-standing religious belief that the Biblical command to "abstain ... from blood" (Acts 15:20) rules out accepting blood transfusions.1 It also repeated the long-standing position that individual members make their own personal decisions with respect to fractions of blood components. Further, it showed that this position extended to the clinical reality of red-cell substitutes, several of which are nearing regulatory approval.

Individual Witness patients might or might not accept fractions of plasma or cellular components. Respecting the conscientious choices of their patients is an intrinsic professional duty of physicians.2 Since it is *patients* who will primarily be affected by the treatment they receive, it is rightfully *patients* who should make the value-laden decisions about their care according to their religious beliefs, personal conscience and the medical facts and uncertainties.

John Doyle's comments about saving lives are uncomplimentary to the specialist physicians worldwide who utilize life-saving blood conservation techniques. Moreover, a recent Canadian study demonstrated that a liberal blood transfusion strategy led to increased morbidity and mortality.3 Most investigators now accept that allogeneic blood impairs immune system defences and leads to higher rates of cancer recurrence and postoperative infection.4,5 The potential for transmission of disease cannot be eliminated and has been a force driving the development of red-cell substitutes and bloodless surgery programs. The Health Sciences Centre in Winnipeg announced the first such program in Canada.6

Doyle evidently relied on information from a source that purports to present the position of Jehovah's Witnesses. Information on the Internet sometimes has an aura of credibility that it does not deserve. Physicians seeking accurate and authoritative information about the position of Jehovah's Witnesses regarding medical care may refer to our Web site at www .watchtower.org or contact Hospital Information Services for Jehovah's Witnesses (Canada) at 800 265-0327.

## References

1.  1.Watch Tower Bible and Tract Society. Questions from readers. *The Watchtower* 2000 June 15;29-31.
    
    

2.  2.Post SG, Puchalski CM, Larson DB. Physicians and patient spirituality: professional boundaries, competency, and ethics. Ann Intern Med 2000;132(7):578-83.
    
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3.  3.Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999;340(6):409-17.
    
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4.  4.Klein HG. Immunomodulatory aspects of transfusion: a once and future risk? Anesthesiology 1999;91(3):861-5.
    
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5.  5.Vamvakas EC, Carven JH. Allogeneic blood transfusion, hospital charges, and length of hospitalization. Arch Pathol Lab Med 1998; 122(2):145-51.
    
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    [Web of Science](http://www.cmaj.ca/lookup/external-ref?access_num=000071926600006&link_type=ISI) 

6.  6.*Winnipeg Free Press* 2000 June 29;Sect A:1-2.