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The
Watchtower Society redefines the guidelines for use of blood products La Sociedad Watchtower redefine los criterios para el uso de productos sanguíneos In the June
15th 2004 issue of the Watchtower, the Watchtower Bible and
Tract Society featured two articles on the use of blood products by
Jehovah's Witnesses. The first article is titled "Rightly value your
gift of life" and reiterated the long-held tradition of the scriptural
interpretation to support the religious doctrine to prohibit medical
use of blood products. The second article is titled "Be guided by the
living God", which details the rules regarding which blood products are
"unacceptable" and which are a matter of personal decision. This issue
of the magazine also included the reprint of the previous landmark
article published on June 15th 2000 titled "Questions from readers: Do
Jehovah's Witnesses accept any minor fractions of blood?", confirming
the then new policy permitting any fraction of a "primary component" of
the blood. The circumstances under which this new policy was
promulgated in 2000 clearly showed that it was the preparation for
allowing Jehovah's Witnesses to receive full benefit from the newly
developed hemoglobin-based blood substitutes.
While the two articles of June 2004 showed no substantial
changes in the policy promulgated in June 2000, there are several
interesting points which are worth discussing. First, the second
article now depicts a new chart showing a clear horizontal line
dividing the "unacceptable" and the "Christian to decide".
The latter category include fractions from red cells, from
white cells, from platelets, and from plasma. While there is nothing
new in this chart compared to the "Questions from readers" article of
June 2000, this chart now explicitly indicates the "fractions of red
cells" as an acceptable fraction. This is an important emphasis,
because until recently there have been no "fractions of red cells"
which can be used medically. With the emerging technology of
hemoglobin-based blood substitute in late 1990's, the Watchtower
Society quickly paved the wide road for Jehovah's Witnesses to receive
this "minor" fraction of the red cells, which in reality comprise 97%
of the red blood cells. The other interesting point is the explanation for the refusal
of the "primary component". After the lengthy biblical discussion and
meticulous justification for refusing to "take in" blood for medical
reasons, the article quickly concludes this: In essence, the article
states that the reason for refusing "four primary components" is that
it is "in line with medical facts" which is stated in "Emergency Care."
While everybody agrees that there is no biblical reason to define the
"four primary components" that must be refused, most readers would have
expected that such a classification is based on well-established and
sound "medical facts." Very interestingly, the book this article cites
here is not an authoritative medical textbook. It is a textbook used by
the students of the emergency medical technician courses. Why did the
Watchtower Society not cite a more authoritative medical textbook or
scientific source to base this critically important classification? The
simple reason is that such a classification is not at all scientific,
but it is simply a tradition in medicine. To use a parallel analogy,
our food is traditionally classified into "major components" such as
protein, carbohydrate, fat, minerals, etc. Is this classification the
only classification considered as a medical fact? Of course not. This
is only one of many ways to classify our food. We can also use such a
classification as grains, meat, vegetable, fish, etc. This is another
way to classify our food, which is equally valid. These classifications
are just traditional and convenient tools to understand the various
components of our food. Depending on the method of classification, what
is considered a "primary component" is different. The same is true for
the classification of the blood components. In case of the classification
of the blood components, there are many different ways to classify. It
is true that the classification that blood banks most frequently use is
the four components this Watchtower article states. However, medical
textbooks use many different classifications. Often times, the blood is
separated into "two major components", red blood cells (45%) and plasma
(55%), because other smaller components such as platelets are usually
taken as a fraction from one of those major fractions. Another
classification which is frequently used in textbooks of anatomy and
physiology is based on chemical composition. With this classification,
the major and primary components of the blood are water (80%),
hemoglobin (15%), albumin (2-3%), and globulin (1-2%). While the Watchtower Society
adopted the classification of red cells, white cells, platelet, and
plasma, as the "primary components" and specified those to be refused,
what would happen if the Society adopted a different classification
which is equally valid with "medical facts"? For example what would
happen if the classification of hemoglobin, albumin, globulin as the
primary components were adopted? This classification would have
prohibited the use of hemoglobin-based blood substitutes and albumin as
a plasma expander, which are now permitted to be used for Witnesses.
What does this difference tell us? It tells us that what is
"unacceptable" in the Watchtower doctrine has nothing to do with the
biblical doctrine cited in the article. It only depends on what
classification of the blood components the Watchtower Society adopted
among several different classifications available in medical
literature. Under one classification of the components (red, white
cells, platelets and plasma), most of the currently available
blood products in medical practice are in the category of "Christian to
decide", or the matter of conscientious decision. This is because the
current technology no longer uses those crude fractions in
pharmaceutical products. On the other hand, under the other
classification based on chemical components (hemoglobin, albumin,
globulin, besides water), most of the currently available products
become unacceptable, because this classification is more consistent
with the current biochemical technology for producing blood-based
pharmaceutical products. Under this alternative classification,
however, the use of platelets may be acceptable because it is not
considered a primary or major component under this classification. In
other words, if the Watchtower Society had adopted the chemical
classification of the primary components of the blood, which is more
consistent with the current biotechnology, hemoglobin, albumin, and
globulin, are all prohibited, but platelets and perhaps white blood
cells may have been permitted. Which classification of the
blood components the Watchtower Society adopts makes such a huge
difference in terms of what is acceptable and what is unacceptable, and
thus who can survive and who must die from catastrophic blood loss.
This difference has nothing to do with the biblical doctrine, or not
even with the current medical science. It only hinges upon the
Watchtower Society's decision regarding which classification of the
blood components they adopt. The cold reality of Jehovah's Witnesses is
that their life-and-death decisions are after all not directly based on
any of the biblical arguments these articles discuss, because such
biblical doctrines have no relevance to the classification of the blood
components. And it is this classification that determines all the
"unacceptable" components and thus the life-and-death decisions. It is
ironical that the rules promulgated in this article titled "Be guided
by the living God" are simply guided by the human decisions and old
tradition. Should they adopt an alternative classification, which is
more in line with the current medical technology, life and death of
Jehovah's Witnesses would have been totally different. Muramoto O. Recent developments in medical care of Jehovah's
Witnesses. Western Journal of Medicine 1999; 170: 297-301 [Full Text] Dr. Muramoto is a staff neurologist, lead physician, and a
member of the Regional Ethics Council, Kaiser Permanente Northwest
Division, Portland, Oregon. His views and opinions are his own and do
not reflect those of Kaiser Permanente and Northwest Permanente P.C. |