Transfusion of Whole Blood?

___

The Watchtower organization asserts a doctrinal position saying “Jehovah’s Witnesses hold that accepting whole blood or any of [its] four primary components violates God’s law.”[1]

Whole blood transfusions used by contemporary medicine?

A 2009 study of 66,369 women who gave birth at Parkland Hospital (Dallas County, Texas) between March 24, 2002, and June 12, 2006 found that of the 1,540 treated with transfusion 659 (43%) received only whole blood.[2] This demonstrates that whole blood transfusion continues to be used by contemporary medicine. The same article shows the benefit of whole blood transfusion versus component therapy under certain conditions resulting from maternity.

After WWII techniques for fractionating whole blood led to a notion that donor blood would be used more effectively if it were separated and transfused based on specific patient presentation. This resulted in far fewer whole blood transfusions. Regardless, whole blood transfusion remains as a medical treatment, and in some cases is more effective than blood component therapy.[3] Military experience treating battlefield trauma in the last decade has shown this as well as studies such as the one above (2009).

The book Perioperative Transfusion Medicine addresses a specific form of whole blood transfusion using preoperative autologous blood donation (PAD). Authors conclude by saying “We… support that continued use of PABD to increase benefit and to reduce risk for our patients.”[4]

Watchtower’s position, and outcome?

Current Watchtower doctrine tells Jehovah’s Witnesses it is wrong to accept transfusion of whole blood, including transfusion of preoperative autologous blood donation (PAD).[1, 5]

One cause of mortality among Jehovah’s Witnesses is females presenting at hospitals with maternity who abide by Watchtower’s blood doctrine. A conservative estimate of annual deaths among Jehovah’s Witnesses for this single patient presentation is 132 each year.[6]

The community of Jehovah’s Witnesses has an increased morbidity and mortality risk factor as a result of Watchtower doctrine prohibiting transfusion of whole blood.

Marvin Shilmer
______________
References

1. The Watchtower, June 15, 2004, p. 30.

2. Alexander et al, Whole Blood in the Management of Hypovolemia Due to Obstetric Hemorrhage, Obstetrics and Gynecology, June 2009, Vol. 113, No. 6, pp. 1320-1326.

3. The article Optimal use of blood in trauma patients (Holcomb et al, Biologicals, January 2010, Vol. 38, No. 1, pp. 72-77) is an excellent resource on the subject of contemporary use of whole blood transfusion. It examines current medical practice in developed and developing countries.

4. Spence et al, Preoperative Autologous Donation, in Perioperative Transfusion Medicine – 2nd Edition, edited by Bruce Spiess, Richard Spence and Aryeh Shander, (Lippincott Williams and Wilkins, Philadelphia, 2006), pp. 223 – 239.

5. The Watchtower, October 15, 2000, p. 30-31.

6. Death Statistic

___