Blood As Blood or Blood As Food?

The majority in the JW community surmise that the No Blood doctrine is a biblical teaching, yet few comprehend what holding this position requires. To hold that the doctrine is biblical requires us to accept the premise that a transfusion is a form of food and nutrition as scientific fact. We must believe that God views an intravenous injection of plasma and packed RBC’s into our bloodstream the same as if we gulped down whole blood from a glass. Do you honestly believe this? If not, should you not rethink your position regarding the doctrine that relies on such an assumption?

In the previous two articles, evidence was presented confirming that blood acts as blood when injected into our bloodstream. It functions as Jehovah so designed it to. However, blood does not function as blood when ingested. Raw uncooked blood is toxic and could even be fatal, if consumed in large quantity. Whether slaughterhouse obtained or home collected, contamination with infectious coliform bacteria is far too easy, and exposure to parasites and other circulating microbes are real threats. 

It is crucial that we use our God given thinking ability and wisdom in this matter (Pr 3:13). Our survival (or that of a loved one) may someday hang in the balance. To reiterate, the kingpin of the doctrine (which has remained constant since the doctrine was enacted in 1945) is found in the following statement in the 1958 Watchtower:

“Each time the prohibition of blood is mentioned in the Scriptures it is in connection with taking it as food, and so it is as a nutrient that we are concerned with its being forbidden.” (Watchtower 1958 p. 575)

From this we discern that from 1945 to the present, leadership of Jehovah’s Witnesses has been concerned with blood being a nutrient used as food. Though published some 58 years ago, this position remains the official position of Jehovah’s Witnesses. We can make this statement because the words above have never been renounced in print. Further in this article, facts and reasoning are presented that indicate the GB maintain a very different position unofficially. Down to this day, members have hung their hats on the notion that a transfusion is a form of food and nutrition for the body, because the GB has not said otherwise. These men are viewed to be at all times directed by God’s holy spirit, so their judgment in this very serious matter must represent God’s view. Those holding such conviction are reluctant to research beyond the pages of Watchtower publications. To the vast majority, learning about a substance which God has forbidden would be somewhat a waste of time. In my own case, prior to 2005 I knew very little about blood and viewed it as a dirty subject. 

An argument making the claim that blood used as food contains a small measure of nutrition would be largely without merit. Anyone who would drink raw blood for its nutritional value would be taking great risk for virtually no benefit. Studies have shown that isolated red blood cells contain no nutritional value. Red blood cells and water constitute roughly 95% of whole blood volume. Hemoglobin (96% of the red cell dry weight) transports oxygen throughout the body. We could say definitively that the person that adheres to the No Blood doctrine views red blood cells as the most forbidden component in blood. Ironically, these blood cells contain no nutrition. So, if it was as a nutrient that leadership was concerned, the red blood cell should never have been prohibited.

How does the medical community view blood? Do they view raw blood as food? Do they use blood as a therapy to treat malnutrition? Or do they view blood as blood, with all its sustaining characteristics essential to maintaining life in cellular tissues? Modern medical science does not view blood as a nutrient, so why should we? To view it as food and a nutrient, we are endorsing a discredited centuries-old notion.

Consider someone from the Jewish community. As sensitive as they are regarding strict kosher dietary laws (which involve total abstinence from eating blood), according to Jewish belief, saving a life is one of the most important mitzvot (commandments), overriding nearly all of the others. (The exceptions are murder, certain sexual offenses, and idol-worship—these cannot be transgressed even to save a life.) Therefore, if a blood transfusion is deemed medically necessary, to the Jew it is not only permissible but obligatory.

Leadership Did Know Better

In her book Flesh and Blood: Organ Transplantation and Blood Transfusion In Twentieth-Century America (see Part 1 of this series) Dr. Lederer states that by 1945, contemporary modern medicine had long abandoned the notion that a transfusion was a form of nutrition. She stated that the current medical thinking (in 1945) did not appear to “trouble” the Jehovah’s Witnesses. This of course would refer to the leadership responsible for the doctrine. So, leadership was not troubled with rejecting modern medical science in favor of supporting a centuries-old notion? How could they have been so irresponsible and negligent?

There are two factors influencing their decision. First, leadership was paranoid over the patriotism surrounding the blood drive of the American Red Cross. In leadership’s view, donating blood would be an act of support for the war effort. If members were told they must refuse to donate their blood, how is it they could be allowed to accept donated blood? Secondly, we must remember that leadership imagined Armageddon was imminent, perhaps only a year or two in the future. Factoring these two elements into the equation, we can see how leadership could be so shortsighted and indifferent to the long range consequences. We could say that not in their worst nightmare might they have imagined that their teaching would have impacted millions of human beings. Armageddon would surely not delay. Yet here we are, seven decades later.

From the 1950’s to the end of the century, advancements in transfusion therapy and organ transplantation were highly publicized. To claim ignorance of these facts would have required that one had joined the Andaman tribe off the coast of Africa. We can be assured leadership kept themselves abreast of each and every advancement in medical science. Why can we say this? The No Blood doctrine compelled that leadership make a determination on each and every new therapy. Would they allow members to accept the new advancement, or not?

Just as we asked regarding their predecessors: How could leadership have continued to endorse an absolute myth? The fervor of patriotism (and Red Cross blood drive) surrounding WW2 was long past. Of course, Armageddon has remained imminent, but why not dictate that accepting blood is a conscience matter? Why perform such convoluted somersaults attempting to defend the premise? To name just two, recall the view that an organ transplant was akin to cannibalism? Also the view that a heart transplant could cause the recipient to take on personality traits of the donor?

The only logical conclusion is that they were in fear of the consequences; of the impact it would have on the organization if they took responsibility for such a tragic error in judgment. Fearing the consequences to the organization (and their personal situation) they chose not to upset the apple cart and instead, maintain the status quo. Loyalty to organizational interests took precedence over the interests of members.  Generations of leadership prayed fervently for Armageddon to arrive, or for the discovery of a viable blood substitute (either of which would resolve the issue), while they effectively kicked the No Blood can down the street for their successors to deal with. As organization membership has grown, the consequences have grown exponentially. For decades, members (including parents of infants and children) have taken their stand, assured that the No Blood doctrine is biblical. Refusing to accept a potentially life-saving intervention resulted in the untimely deaths of an unknown number. Only Jehovah knows how many souls have been lost prematurely and unnecessarily. [1]

A Sweeping Shift In Policy

The position as expressed in the 1958 Watchtower remained unchanged for decades. In fact, it remains the official position to this day. However, in the year 2000 the JW community (and medical professionals) witnessed dramatic reform in the No Blood policy. For decades, leadership had ruled that since blood fractions (serums) were produced from blood, they were prohibited. The year 2000 brought an about-face in this position. The GB ruled that blood fractions (though produced only from blood) were not…… “blood.” In 2004, hemoglobin was added to the list of “minor” blood fractions, so that from that year to the present, all blood ingredients have been acceptable to members.

Discerning JW’s (including this writer) saw this “new light” as a prodigious reversal of policy, given the fact that blood fractions constitute 100% of whole blood after fractionation and dissection. I asked myself: Do not the fractions themselves contain the very “nutrients” the 1958 Watchtower described as being the concern? I found myself scratching my head. To illustrate: It was as if the GB had for decades prohibited members from eating apple pie and all its ingredients, out of concern over nutritional value. Now they say the ingredients of apple pie are not apple pie. Wait, do not the ingredients of apple pie contain ALL the nutrition found in apple pie?

This is the new unofficial position of the current GB. They now acknowledge that a member can accept 100% of the ingredients of blood (including all nutritional value) transfused through intravenous injection, and they would not be breaking God’s law at Acts 15:29. So then we ask: What was prohibited in the Apostolic Decree? Drinking whole animal blood mixed with wine in an idol temple? By simply connecting the dots, one can see the position held in the 1958 Watchtower was reversed in 2004. Yet officially, what was stated in the 1958 Watchtower remains current; and members are making life-and-death decisions based upon this. How does Jehovah view the GB holding an unofficial position that contradicts the official position? Can the GB have it both ways? So far the answer is yes. But it is a race against time. Armageddon or a viable blood substitute needs to arrive before the rank and file awaken to what has happened.   

In support of the new unofficial position, the August 6, 2006 edition of Awake! magazine portrayed blood (and all its ingredients) as precious and an incredibly wonderful and unique “organ.” The timing of this article suggests the GB had an agenda. Only eight months previously, the The Tort of Misrepresentation essay was published in Baylor University’s prestigious Journal of Church and State (December 13, 2005). In response, the GB went the extra mile in explaining the complexity of blood and portraying it in a very positive light, including detailed information about HBOC’s (blood substitutes in FDA trials). The articles served to achieve two objectives: First, to defend that leadership had been diligent in educating members (not misrepresenting blood as the essay asserted). The second objective was to clear the path for the HBOC blood substitute (which at that time was assumed soon to be approved by the FDA) to be accepted in the JW community. Unfortunately, the HBOC’s failed and were pulled from FDA trials in 2009. The following are excerpts from the August 6 articles:

“Because of its amazing complexity, blood is often likened to an organ of the body. ‘Blood is one of the many organs—incredibly wonderful and unique,’ Dr. Bruce Lenes told Awake! Unique indeed! One textbook describes blood as ‘the only organ in the body that’s a fluid.’”

Some manufacturers now process hemoglobin, releasing it from human or bovine red blood cells. The extracted hemoglobin is then filtered to remove impurities, chemically modified and purified, mixed with a solution, and packaged. The end product—not yet approved for use in most lands is called a hemoglobin-based oxygen carrier, or HBOC. Since the heme is responsible for the rich red color of blood, a unit of HBOC looks just like a unit of red blood cells, the primary component from which it is taken. Unlike red blood cells, which must be refrigerated and discarded after a few weeks, the HBOC can be stored at room temperature and used months later. And since the cell membrane with its unique antigens is gone, severe reactions due to mismatched blood types pose no threat.

“Without question, blood performs functions that are essential to life. That is why the medical community has made a practice of transfusing blood into patients who have lost blood. Many doctors would say that this medical use is what makes blood so precious. However, things have been changing in the medical field. In a sense, a quiet revolution has been underway. Many doctors and surgeons are not so quick to transfuse blood as they once were. Why?”

This is an intriguing statement and question we will next address.

Why Doctors And Surgeons Can Treat Without Transfusing Blood

As mentioned previously, the JW community at large feels that adherence to the doctrine has resulted in God’s divine blessing. They point to the many advancements in bloodless surgery, perhaps noting that many lives have been spared. This would seemingly support the concept that abstaining from blood brings God’s blessing, allowing many doctors and surgeons to treat without transfusing blood. It is a fact that many are choosing to refrain from transfusion therapy. But the underlying question is, what gave them this option?

The No Blood Doctrine of Jehovah’s Witnesses can be credited for playing a pivotal role in the advancement of blood conservation techniques. JW patients have unwittingly participated in what could be considered clinical trials. Doctors and surgeons have been afforded the opportunity to practice revolutionary techniques and procedures that involve high risk. What was effectively trial and error surgery has resulted in major medical breakthroughs. So, we can say that Jehovah’s Witness patients have contributed to major advancements in bloodless surgery. But what was the price paid in exchange for such medical breakthroughs? Does the end justify the means? Do the lives of those that were lost (over decades) while complying with the No Blood doctrine offset the many that now benefit from bloodless surgery?

I am in no way suggesting that the medical profession has acted unethically or unscrupulously. They should be recognized for having done all that they possibly can to preserve life. Essentially, they were handed a lemon, so they made lemonade. Either they operate on JW patients without blood, or allow the patient to deteriorate and suffer an untimely death. This has inadvertently proved to be the silver lining of the No Blood doctrine. Doctors, surgeons, anesthesiologists, hospitals, and the medical community at large have had the opportunity to practice and perfect bloodless surgery and blood conservation without fear of malpractice in the event of major complications (even death). In fact, the No Blood directive works as a release that protects all involved from liability should the patient suffer harm during the treatment or procedure. Think of how over many decades, the JW community has provided a never-ending stream of participants willing to volunteer to be “practiced on” all over the world. My, but what a Godsend for the medical community!

Still, what about the victims?

Bloodless Surgery – A Clinical Research Trial?

A clinical trial is defined as:

“Any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes.”

The FDA typically regulates clinical trials, but in the case of bloodless surgery, a clinical trial would be highly unlikely due to the ethical challenge it presents. If preserving life underlies any medical treatment, the patient involved in bloodless surgery would receive an intervention in the event of a complication during surgery. This being said, data from case studies would be skewed. For case study history to be accurate, there could be no end-of-life intervention; no parachute. The patient (and medical team) would have to commit to non-intervention and allow one of the following to occur:

  • The patient survives the procedure or therapy and stabilizes.
  • The patient does not survive.

This writer cannot imagine the FDA participating in clinical trials that do not allow end-of-life intervention to save the patient. The phrase, “first do no harm”, is the creed of doctors and surgeons as well as officials of the FDA. Life must be preserved first, if intervention has a chance of preserving it. In my opinion, if not for JW patients acting as clinical trial volunteers (with no compensation I might add), advancements in bloodless surgery would likely be 20 years behind where they are today.

Does The End Justify The Means?

Do the lives of the many who have benefited from bloodless surgery in recent years, offset the lives of those whose chance of survival was dramatically reduced due to refusing transfusion intervention since 1945? Is it trade off; a wash? We have the utmost compassion for families who have lost a family member who refused blood. We also acknowledge the emotional and ethical challenges faced by their medical team as they stood by, helpless to intervene with a therapy that could have preserved life. Some may feel comforted knowing that Jehovah can rectify any injustice through the resurrection. Still, does the end justify the means?

If the means reflects honesty and is scriptural, then yes, we could say that the end also reflects honesty and is scriptural. But this expression is generally used as an excuse someone gives to achieve their goals by any means necessary, no matter how immoral, illegal, or unpleasant the means may be. The “end justifying the means” statement usually involves doing something wrong to achieve a positive outcome, then justifying the wrong by pointing to the positive result. Two examples come to mind:

Lying on a resume. One might rationalize that embellishing one’s resume could result in a higher paying job, thus they’ll be better able to support themselves and their family. While providing well for one’s family is morally honorable, does the end justify the means? How is lying viewed in the eyes of God?  (Pr 12:22; 13:5; 14:5) In this case the means were dishonest and unethical, therefore the end is dishonest and unethical.

Receiving an abortion. One might rationalize that the abortion can save the life of the mother. While saving the life of the mother is morally right, does the end justify the means? How is the unborn child viewed in the eyes of God?  (Psalm 139:13-16; Job 31:15) In this case the means involve murder, therefore the end is murder to save life.

Both of these examples have a positive outcome. A great job that pays well, and a mother that is saved and can live out the rest of her life. The No Blood doctrine of Jehovah’s Witnesses now has a positive outcome. But does the end justify the means?

What’s At Stake

The purpose of Part 1, 2 and 3 of this series of articles is to share secular facts and reasoning. Then each can make their own decision based upon their conscience. I hope that the information provided helps all to step back and see the forest, away from the trees. We should be aware that in an emergency situation, should we or our loved one even whisper to ambulance or ER personnel the words “Jehovah’s Witness”, or should they see our No Blood card, we will set in motion a legal and ethical protocol that could be very difficult to stop. Even should one advise that they no longer adhere to the teaching; the mere mention could cause those treating us to hesitate; to not be certain, to not act instinctively to preserve our life during the all-important “golden hour.”  

In Parts 4 and 5 we delve into scripture. We will consider Noachian law, the Mosaic law, and finally the Apostolic Decree. I examine only a few key texts with references to avoid redundancy with the excellent and comprehensive work of Apollos (See Jehovah’s Witnesses and the No Blood Doctrine) regarding the scriptural view.

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[1] It would be impossible to accurately account for the number of deaths that might have been avoidable had the medical teams caring for JW patients been permitted to intervene with a potentially life-saving intervention. Much case history is available that strongly suggests that, in the opinion of medical personnel, the percentage for patient survival would have increased dramatically had such intervention been available.