|
Medyczna
poufność i ochrona niezależnej odmowy krwi przez Świadków Jehowy.
Osamu Muramoto, Kaiser Permanente Northwest Division Portland, Oregon, USA
Journal of Medical Ethics 2000;26:381-386
Streszczenie
Pan Ridley z Towarzystwa Strażnica (WTS), które kontroluje religijną
organizację Świadków Jehowy (ŚJ) błędnie odmalował zagadnienie wolności
i poufności w odmawianiu przez ŚJ krwi przez pomieszanie ze sobą wewnętrznie
sprzecznych wytycznych organizacyjnych z faktycznymi zakazami biblijnymi. Oprócz
przerysowania i wypaczenia moich wypowiedzi, Ridley nie zdołał przedstawić
solidnych dowodów popierających jego twierdzenie, iż nie stosuje się żadnego
nacisku w kwestii dostosowania się do polityki organizacji ani ciągłego
kontrolowania wystawiającego na szwank dobro srodowiska medycznego. W
niniejszej odpowiedzi przedstawię dowody z literatury WTS - wsparte osobistymi
świadectwami ŚJ - że WTS siłą narzuca swoją politykę odmawiania krwi
przez naciski, aby się do niej dostosować oraz systematycznie gwałci prawo do
poufności lekarskiej. Brak szczerości u Ridleya w obronie opozycyjnych ŚJ chcących
wolności w osobistych i opartych na sumieniu decyzjach odnośnie krwi wskazuje
na trwające poważne naruszenie etyki w opiece medycznej nad ŚJ. Środowisko
medyczne powinno mocno się nad tym zastanowić.
(Journal of Medical Ethics 2000;26:381-386)
Słowa kluczowe: Religia; poufność; Świadkowie Jehowy; niezależność;
transfuzja krwi
Wstęp
W swojej odpowiedzi1 na mój komentarz2 odnośnie
stosowanej wśród Świadków Jehowy (ŚJ) polityki "nie pytaj, nie
dyskutuj" w kwestii osobistych decyzji medycznych co do transfuzji krwi,
pan Donald Ridley z Towarzystwa Biblijnego i Traktatowego - Strażnica (WTS)
podniósł kilka poważnych zarzutów, które wymagają dalszego komentarza.
Jednakże zanim przejdę do tych istotnych zagadnień, chciałbym zwrócić uwagę
na, że Ridley uciekł się do przesadzonej i skrajnej terminologii, by zaciemnić
sprawy podniesione w moim komentarzu. Umyślnie kładzie on nacisk na moje
wypowiedzi skłaniając się ku skrajnościom, które nie odzwierciedlają
rzeczywistości. Na przykład stwierdza: "Muramoto obstaje przy swojej
teorii, że ludzie nigdy nie działają na podstawie osobistej integralności
i zasad...", "według poglądów Muramoto ludzie są motywowani
(przymuszani) jedynie naciskiem grupy i strachem przed karą dyscyplinarną"
oraz "Muramoto najwyraźniej myśli, że żaden członek jakiejkolwiek
grupy lub społeczności nie jest prawdziwie niezależny, o ile ta grupa lub społeczność
posiada władzę do dyscyplinowania opornych członków" (podkreślenia
dodane). Nigdy nie podałem takich skrajnych stwierdzeń, które obejmowałyby
każdego członka ŚJ lub ogół członków innych organizacji. W moich artykułach3
przedstawiłem sytuację "oponentów" spośród ŚJ, którzy opierając
się na swoim sumieniu nie zgadzają się z polityką odnośnie krwi. Tworzą
oni oczywiście mniejszość w członkostwie ŚJ. Ridley przekręca całkowicie
moje argumenty, mówiąc: "Argumenty Muramoto ignorują element sumienia
danej jednostki". Trudno zrozumieć jak Ridley doszedł do takiego
zniekształconego wniosku, gdyż głównym punktem moich artykułów jest właśnie
to, by chronić wolnośc sumienia poszczególnych pacjentów będących ŚJ.
Ridley
przedstawia też fałszywie moje argumenty stwierdzając, że "nie jest też
całkowicie oczywiste w jaki sposób interpretować różnice między Muramoto a
Świadkami Jehowy w rozwijaniu rozmów o etyce medycznej". Fałszywie
przedstawia tu mój argument jako różnice pomiędzy moją interpretacją
Biblii a interpretacją ŚJ. Jednakże ja wielokrotnie wspominałem w tej serii
artykółw3, że różnice istnieją pomiędzy oponentami ŚJ, a
kontrolującym ich WTS. to nie jest chętnie oczywiste jak
exegetical różnica między Muramoto i Świadkowie Jehovah rozwijają medyczną
etyczną rozmowę". Tutaj on fałszywie przedstawia mój argument jako różnica
między moją Biblijną interpretacją i, że JWs. Jeszcze wielokrotnie wspomniałem
w tej serii articles3, którym różnica jest między dysydenckim JWs i
kontrolującym WTS. Ale to nie jest etyczny dysydent zagadnienia, którego JWs
podnosi. Zagadnienie jest kursem, za którym WTS idzie w kontrolowaniu osobistej
medycznej decyzji sądzącej o tym JWs, który ma inne widoki Biblii dotyczącej
medycznego użycia krwi. To jest właciwie wyrazisty etyczny problem, że
religijne kontrole organizacji osobowa, poufna i potencjalnie ratujacy życie
decyzja sądząca o indywidualnych członach w opiece medycznej oparty dalej
"exegetical różnica". Czy Ridley naprawdę nie może objąć tego ważnego
etycznego zagadnienia albo tylko udaje się nie zrozumieć danego sprawa żeby,
by zaciemnić prawdziwe zagadnienie jest niejasny. W którymkolwiek przypadku
zagadnienie jest "medycznej etycznej rozmowy" warty i rozrosnę się
na tym w tej odpowiedzi.
also misrepresents my arguments by stating "it is not readily
apparent how exegetical differences between Muramoto and Jehovah's Witnesses
advance medical ethical discourse". Here he misrepresents my argument as a
difference between my Biblical interpretation and that of JWs. Yet I have
repeatedly mentioned in this series of articles3 that the difference
is between dissident JWs and the controlling WTS. But that is not the ethical
issue dissident JWs are raising. The issue is the course the WTS follows in
controlling the personal medical decision making of those JWs who have other
views of the Bible regarding the medical use of blood. It is actually a
conspicuous ethical problem that a religious organisation controls personal,
confidential and potentially life-saving decision making of individual members
in medical care based on "exegetical differences". Whether Ridley
really cannot comprehend this important ethical issue or only pretends to miss
the point in order to obscure the real issue is unclear. In either case the
issue is worth "medical ethical discourse" and I will expand on it in
this response.
Personal conscience or hypocrisy?
Ridley tries to dismiss my proposal by claiming thata don't-ask-don't-tell
policy promotes hypocrisy by hiding the discrepancy between public and private
actions. Ridley wrote that "Jehovah's Witnesses believe that God sees
everything we do regardless of whether other humans are aware of our actions".
Thus, in his words, Jehovah's Witnesses' decision making is seen by God and He
is the final judge. That is precisely my point: that the matter of making a
choice about blood transfusions should rest as a matter between the conscience
of the persons needing them and their God, without the monitoring, intervention
or sanction of an organisation. It is also misleading for Ridley to speak of JWs
being encouraged by my proposal to act privately "in a manner they publicly
declare to be wrong", and to say that my proposal "trivialises the
personal religious convictions of Jehovah's Witnesses by suggesting they ignore
their belief that the love of God means that they observe his commandments".
The blood policy was not originated from the "personal religious conviction"
of each JW; the complex conglomerate of rules for medical use of blood were
elaborated by the leadership and handed to JWs for following. Some JWs
conscientiously believe that God has not, in the Bible or elsewhere, forbidden
blood transfusions, and that to accept a life-saving blood transfusion is not to
disobey God's commandments. Just as the ruling leadership has conscientiously
decreed that transfusion of certain blood products does not violate God's
commandments so these JWs conscientiously believe other blood products may be
transfused for life-saving purposes without violating God's commandments. They
do not "publicly declare" their views because of the draconian
punishments meted out by their organisation and its appointed elders.
A don't-ask-don't-tell policy is to be considered only when a person's freedom
of action conflicts with inordinate peer pressure. There is no inherent moral
judgement in such a policy. Whether it enhances moral behaviour or not depends
on how such a policy is implemented. I would ask Mr Ridley whether the WTS's
policy change in 1983 to leave oral sex between marriage partners as a personal
conscientious matter4 promoted hypocrisy. His answer should be no. If
someone in a bedroom or hospital room chooses an action that he or she believes
is not prohibited by God's commandments, whether it is engaging in oral sex or
receiving plasma (a blood component prohibited by WTS), then silently keeping
that action private is not hypocrisy. Although the oral sex issue seems trivial
compared to the blood issue, sexual immorality is prohibited in Acts 15:295 in
parallel with eating blood; whether oral sex constitutes sexual immorality was a
subject of discussion in JW literature, as much as whether transfusion of plasma
constitutes eating blood. There are many parallels between these two specific
actions that the WTS prohibits.
Freedom of choice or organisational mandate?
Ridley uses the scriptural phrase "abstain from blood" as
justification and validation of the organisational rulings, but he fails to
address how to put this injunction in a contemporary context. His argument jumps
from such religious concepts as God, the Bible and first century Christians to a
complex set of organisational rules of modern medical technology without regard
to how such complex rules are related to the religious concepts. He ignores the
argument raised by the dissident JWs who question the scriptural basis for the
complex, equivocal and arbitrary division of acceptable and unacceptable
fractions and procedures and for the entire doctrine of refusal of blood
transfusions (as distinct from eating blood). Indeed, to those dissident JWs,
the decision to accept or refuse blood is not about God, the Bible or first
century Christians, but about which blood fraction a JW patient chooses, as
compared to which blood fractions the WTS approves. As long as the WTS policy
forbids certain blood fractions and allows others, as opposed to abstention from
all blood products, it contradicts its own Bible interpretation, "abstaining
from blood means not taking it into our bodies at all".6 This
contradiction alone causes certain JWs to arrive at the conclusion that the
policy is not based on God or the Bible.
Military service
As an experienced official of the WTS, Ridley knows that when the organisation
"adjusts" any part of its policy, the majority of JWs will submit to
it regardless of their personal choice. That would be true of virtually any
addition to, or any subtraction from, the presently accepted views. Such a
change recently happened regarding the policy on "alternative service"
to military duties. Until 1995, the WTS prohibited JW men not only from joining
the military but from voluntary alternative service such as hospital work or
other civilian duties the government provided for conscientious objectors. The
WTS reasoned that, as a "substitute," such service was the equivalent
of military service and thus must be refused. While this policy was in force, it
is a documented fact that letters from the branch offices of major countries to
the governing body of JWs frankly acknowledged that, on the whole, the young men
in their countries did not understand the basis for the WTS's position in this
matter, but were willing to go to prison in order to conform to it.7
Young Witnesses by the thousands did that for about fifty years. The new policy
allows the issue to rest within the realm of personal conscience. Ridley
introduces the phrase "mind control" (a term I did not use in my
articles), but it is not necessary to label a situation when the facts speak for
themselves. Thousands of young men chose to follow the now-defunct policy and
spend time in jail. They were not overtly coerced into doing so. But the
majority clearly did not so choose because of being firmly convinced in their
own minds and hearts as to the rightness or reasonableness of the policy. The
letters from the organisationally appointed principal men in their countries
make that clear. Without employing terms such as "mind control," the
evidence is there that they felt pressure to conform.
The medical community should learn from our debate that a more serious ethical
problem than imprisonment for refusing alternative military service exists today
in the medical care of JWs. Should the medical community dismiss this as a mere
internal theological issue, as Ridley portrays it, when human lives are being
lost due to an organisational policy that most JWs do not comprehend and where
pressure to conform is backed up by threat of excommunication? Ridley compares
the controlling influence of the WTS on JWs' decision making with outside
influences such as TV, newspapers and magazines. This analogy is flawed because
the recipient of other outside influences is not pressured to accept views as
God's, sent through his divine channel, and is not punished if he or she acts
against that influence.
In reference to "mind control", Ridley also claimed that coercive
manipulation "as applied to religious movements lacked any scientific
foundations" by citing the 1987 internal memo of the American Psychological
Association (APA) 8. However, the memo, addressed from the Board of
Social and Ethical Responsibility for Psychology (BSERP) to the members of the
Task Force on Deceptive and Indirect Methods of Persuasion and Control,
expresses no official rejection of mind control theories. It simply rejects a
report prepared by the taskforce due to lack of proper methods. The memo
actually concluded that "after much consideration, BSERP does not believe
that we have sufficient information available to guide us in taking a position
on this issue". This conclusion is far from Ridley's assertion that
coercive manipulation is "a theory roundly debunked by the scientific
community over a decade ago". The board of the APA merely stated that the
information is insufficient on this issue. Admittedly, the issue of "mind
control" is quite controversial, requiring further research, but it has not
been "roundly debunked" as Ridley claims. For example, the widely used
diagnostic criteria of mental disorders from the American Psychiatric
Association (DSM-IV) lists "brainwashing, thought reform, or indoctrination
while captive" as examples of states of dissociation due to prolonged and
intense coercive persuasion.9
Shunning practice as organisational coercion
Ridley repeats David Malyon's argument10 that all JWs joined the
religion freely with full understanding of the blood policy. Here Ridley ignores
the hundreds of thousands who are members because they were raised by JW parents
and baptised as minors. They were indoctrinated from childhood into the religion
with minimal exposure, if any, to critical views. It is sufficient to point out
that the WTS strongly discouraged JW youths from seeking higher education until
1992, that they are today strongly discouraged from participating in internet
forums, and that JW children are trained to recite their position on blood to
doctors and judges. Where is the free will and full understanding of doctrine
for these next generation JW's? Ridley implies that leaving the religion has
little social cost and that disfellowshipping of members pressures no one to
conform to the blood policy. He states that it is an "indisputable fact"
that "those who wish to leave the religion or choose to become inactive
non-participants readily do so". He further claims that disfellowshipping
severs only spiritual ties and that "non-spiritual associations are not
terminated". The fact is that there are thousands of former JWs enduring
total shunning by their JW family members who believe this is the only faithful
course for JW's. Contrary to Ridley's insistence, social association is banned.
Even former governing body member Raymond Franz was disfellowshipped on the
charge of eating lunch with his employer who had disassociated himself from the
congregation, as reported in a Time magazine article.11
What are the underlying teachings about the shunning of disfellowshipped members?
Ridley used the 1981 Watchtower magazine12 I had quoted in an attempt
to show "family ties" are not terminated by disfellowshipping. A
careful reading of the Watchtower instruction shows that the "family ties"
that are not affected by disfellowshipping are merely the genetic and legal
relationships of family members. Since Ridley gives a wrong impression to
readers regarding these coercive practices, I shall clarify the official WTS
instructions. In the 1988 Watchtower article quoted by Ridley,13 the
following paragraph regarding family relationship appears:
"God certainly realises that carrying out his righteous laws about cutting
off wrongdoers often involves and affects relatives. As mentioned above, when an
Israelite wrongdoer was executed, no more family association was possible. In
fact, if a son was a drunkard and a glutton, his parents were to bring him
before the judges, and if he was unrepentant, the parents were to share in the
just executing of him, ‘to clear away what is bad from the midst of Israel'.
(Deuteronomy 21:18-21) You can appreciate that this would not have been easy for
them. Imagine, too, how the wrongdoer's brothers, sisters, or grandparents felt.
Yet, their putting loyalty to their righteous God before family affection could
be lifesaving for them."
In short, the WTS compares the current disfellowshipping practice to the
execution of wrongdoers by the Israelites. The article also states: "In
various serious matters, willful violators were executed . . . . When that
happened, others, even relatives, could no longer speak with the dead lawbreaker".
Then the reason "family ties" continue is explained thus:
"Cutting off from the Christian congregation does not involve immediate
death, so family ties continue".
In other words, the WTS teaches JWs to treat disfellowshipped relatives as if
they were dead by execution, but because they are physically alive genetic and
legal ties as a family member continue.
When an immediate family member living in the same household is disfellowshipped,
legal family relationships continue. However, the disfellowshipped member is not
permitted to participate in any religious activities such as leading Bible
studies and prayer or discussing doctrinal issues. For a Christian household,
can this be considered "normal family affections and dealings"? It is
true that the WTS does not recommend immediate divorce from disfellowshipped
mates. However, if a JW man was disfellowshipped for dissenting from the WTS's
blood policy and he tried to explain his views to his wife, what would happen?
No such intimate discussion is permitted even within the immediate family circle.
The WTS has provided a means for the wife to separate from the husband without
violating the WTS prohibition against divorce except for adultery: it is called
"absolute endangerment of spirituality" 14. Under this
policy, an orthodox JW can obtain a legal separation from the dissenting JW who
would discuss his views. This is exactly what happened to Wayne Rogers, a
California second-generation JW, who expressed his conscientious disagreement
with the blood policy in personal electronic mail. His JW wife discovered the
mail and showed it to the congregation elders. As a result, Rogers was
disfellowshipped in January 1999 and his wife obtained a separation. His
testimony about disfellowshipping and separation from family vividly illustrates
the tragedy of shunning practised by JWs.15
For relatives who are not in the immediate family circle and for JW friends, all
personal and social contacts are terminated except for necessary business
contacts. The official instruction states:
"Discussion of business matters with him or contact on the job might be
necessary, but spiritual discussions and social fellowship would be things of
the past ".16
The shunning practice of JWs involves every sort of family and social activity;
it has caused irreparable psychological trauma in many JW households. In fact,
shunning is one of the most painful traumas many former JWs have to live with
throughout their lives. For details, refer to testimonies collected on the web
site of former JWs.17
How does this shunning practice work to coerce the members to comply with the
organisational policies? The Watchtower article cited above discussed the
desirability of cutting off association because of the results it achieves.18
It quoted a JW assaying:
" ‘Cutting ourselves off completely from all association with [my
disfellowshipped sister] Margaret tested our loyalty to Jehovah's arrangement.
It gave our family opportunity to show that we really believe that Jehovah's way
is best.’-Lynette."
Later it described "Margaret's" reaction to being shunned:
" ‘If you had viewed the disfellowshipping lightly, I know that I
would not have taken steps toward reinstatement as soon as I did. Being totally
cut off from loved ones and from close contact with the congregation created a
strong desire to repent. I realised just how wrong my course was and how serious
it was to turn my back on Jehovah.' " 19
Such testimonies published in this official Watchtower magazine speak for
themselves in showing how the shunning practice works to achieve conformity to
"Jehovah's arrangement" as determined by the WTS .
In summary of this section, in response to Ridley's assertion that "Muramoto
repeatedly refers to the 'enormous' pressure to conform that, according to
Muramoto, results from the Witnesses' Bible-based practice of disfellowshipping
. . .disfellowshipping requires shunning and severance of personal ties with
family members another misrepresentation of the facts", I have presented
the facts stated in the official instructions by the WTS and the testimonies of
JW's themselves.
Indeed the facts speak for themselves that the current shunning practice of the
WTS can coerce JWs to refuse blood transfusions even at risk of their death.
Freedom of association or right of organisation? Defending the coercive practice
of disfellowshipping and shunning, Ridley justifies the restriction of freedom
of choice in the medical care of JW members. He states that John Stuart Mill's
statement on free society does not apply to the JW community because it applies
to civil government, notwithstanding the qualification I quoted in Mill's
statement, "whatever may be its form of government". What Ridley fails
to tell is that the WTS teaches that the "theocratic government"
started in the Hebrew nation in 1513 BCE and continues in the form of "modern-day
theocratic organisation" such as the WTS. 20 In its official
magazine the WTS is equated to "a separate nation" and "a
theocratic land".21 What is inescapably hypocritical is for
Malyon and Ridley to use Mill's statement to demand freedom for their
organisation in the larger human community, while they simultaneously promote
among the JW community a "government" which denies Mill's freedom to
pursue personal values.
Ridley's quotation regarding "nonconformists" who may "threaten
the common welfare" of a community would apply only if the JW community is
one requiring total conformity and not allowing for exercise of personal,
individual conscience. Furthermore the "threat" to the common welfare
is not demonstrated, simply alleged. Allowing the exercise of personal,
individual conscience in the matter of alternative military service clearly is
deemed not to threaten the common welfare of JW's. Why, then, would the exercise
of personal, individual conscience in a matter such as an autologous blood
transfusion threaten that common welfare? The only "threat" seems to
be to the absolute authority of the JW leadership and its pervasive control over
the decisions of individual JWs.
Respect for privacy or organisational monitoring?
Ridley adamantly denies the church organisation's systematic monitoring of JW
patients' private lives by saying, "Muramoto's proposals to rein in
allegedly intrusive elders and to educate individual Witnesses about their
privacy rights address nonexistent problems. Witness elders and hospital liaison
committee members are not commissioned, explicitly or otherwise, to pry into the
private affairs of individual Witnesses", "Muramoto provides no
authority for these statements". The striking fact is that Ridley, as a
lawyer himself representing the WTS, never retracts or denounces the widely
publicised policy published by the WTS in 1987 to encourage JW hospital workers
to breach medical confidentiality.22 The article used a hypothetical
but typical J W hospital worker, "Mary", who incidentally obtained
confidential medical information that a fellow JW woman received an abortion in
the hospital where Mary worked. The article encouraged Mary to breach medical
confidentiality by revealing this information to the congregation elders, even
if such an action is illegal in many jurisdictions. There has never been any WTS
publication to reverse or retract this notorious policy. Ridley is fully aware
of this policy, which I repeated in two parts of my papers, yet he provides no
evidence or documentation to support his assertion that this is one of the
"nonexistent problems" I am addressing. He reviews the issue of
medical confidentiality in his reply and has an opportunity to respond, yet he
never addresses this policy. The distinct absence of a response from the WTS
legal counsel indicates that, even if he asserts absence of patient monitoring
by peers, the policy to encourage sometimes illegal disclosure of medical
confidentiality is still in force in the JW community.
Recently I obtained a copy of an internal letter issued by the WTS and
circulated among hospital liaison committee members showing that the "hospital
visitation group" was instructed to "verify" that the patient it
visits has already talked with medical staff and told them that he or she needs
to avoid blood transfusion.23 Hospital visitation groups are also
instructed to contact the local hospitals on a regular basis to see if any JW
patients are hospitalised so that they may visit all JW patients. Although the
group's primary goal is not to monitor JW patients, but to give "pastoral
care", nonetheless, such systematic visitation and "verification"
of private medical information such as blood refusal inevitably results in
systematic monitoring and, in essence, prying into the member's private medical
decision making.
The following testimony shows this practice as a personal experience of a JW
elder.24
"In my congregation a hospitalised congregation publisher [a JW active in
preaching] received an unexpected visit from a Hospital Visitation Committee
member who observed that he was receiving a blood transfusion. This confidential
information was then reported to the presiding overseer and a judicial committee
was convened while the man was still in the hospital. The publisher was promptly
disfellowshiped. The three elders felt there was nothing he could do to
demonstrate repentance since the blood had already been transfused. About six
months later the disfellowshiped man applied for reinstatement and I served on
the committee that heard his plea. I can still recall the look on this poor
man's face as he wept and begged us to reinstate him so that he would not die
out of favor with God. We reinstated him that day and a few weeks later he lost
his fight with leukemia."
Conclusion
Mr Ridley, an official representative of the WTS, argues in his reply that
JWs cannot be accorded the liberty to make a personal and confidential medical
decision to receive a prohibited blood fraction because allowing for such a
conscientious decision is tantamount to promoting hypocrisy. He further states
that the WTS has the right to deny JWs' personal freedom to choose medical
treatment on the basis of personal conscience and to keep such decisions
confidential because this is necessary to protect the "common welfare"
of "ordered society". Since he denies the presence of coercive
practices and invasion of patient's privacy, I have presented further evidence
that serious ethical violations are currently used to enforce the blood policy.
Obviously Mr Ridley's official statement requires further scrutiny and
consideration by the medical community at large. Further wide ranging
discussions on this subject from the medical, ethics and religious communities
are vitally important. For my part I believe doctors should inform all JW
patients who refuse life-saving blood transfusions that there is internal
disagreement within the Jehovah's Witness community about whether such refusal
is required by God's commandments, and that the patient is at liberty to make a
conscientious decision to accept such a transfusion in total medical
confidentiality.
Disclaimer
Views and opinions expressed herein are personal and do not reflect those of
Kaiser Permanente and Northwest Permanente PC.
Acknowledgement
I thank many current and former Jehovah's Witnesses who provided me with
valuable documents and discussion, which formed the basis of this paper.
Unfortunately, their names cannot be disclosed publicly due to fear of
retribution by the religious organisation.
Osamu Muramoto, MD, PhD, is a member of the Regional Ethics Council at Kaiser
Permanente Northwest Division and a neurologist at Northwest Permanente PC,
Portland, Oregon, USA. Address correspondence to: Kaiser Permanente Interstate
Medical OfficeEast, 3550 N Interstate Avenue, Portland, Oregon 97227 USA. E-mail:
muramotosa@kpnw.org
References and notes
1. Ridley DT. Jehovah's Witnesses' refusal of blood: obedience to
scripture and religious conscience. Journal of Medical Ethics 1999;25:469-72.
2. Muramoto 0. Bioethics of the refusal of blood by Jehovah's Witnesses: part 3.
A proposal for a don't-ask-don't-tell policy. Journal of Medical Ethics
1999;25:463-8
3. Muramoto 0. Bioethics of the refusal of blood by Jehovah's Witnesses: part 1.
Should bioethical deliberation consider dissidents' views? Journal of Medical
Ethics 1998:24:223-30. Muramoto 0. Bioethics of the refusal of blood by
Jehovah's Witnesses: part 2. A novel approach based on rational
non-interventional paternalism. Journal of Medical Ethics 1998;24:295-301.
4. Anonymous. Honor godly marriage. The Watchtower 1983 Mar15: 30-1.
5. The Bible. Acts 15:29.Anonymous.
6. Godly respect for life and blood. The Watchtower 1969 Jun 1: 327.
7. Franz R. In search of Christian freedom. Atlanta: Commentary Press, 1991:
259-68. Franz R. Crisis of conscience [3rd ed]. Atlanta: Commentary Press,
1999:12 1-3 1. A former member of the governing body, Raymond Franz, shows
quotations from the 1978 letters sent by branch committee members of major
countries which questioned the scriptural basis for refusal of alternative
service. Note the similarity to the current internal controversy on the
scriptural basis of refusal of blood.
8. Board of Ethical and Social Responsibility for Psychology. Memo to the
members of the Task Force on Deceptive and Indirect Methods of Persuasion and
Control. Washington, DC: American Psychological Association, 1987 May 11.
9. American Psychiatric Association. Diagnostic criteria DSM-IV Washington, DC:
American Psychiatric Association, 1994: 232.
10. Malyon D. Transfusion-free treatment of Jehovah's Witnesses: respecting the
autonomous patient's motives. Journal of Medical Ethics 1998;24:376-81.
11. Ostling RN. Witness under persecution. A secretive and apocalyptic sect
shuns a former leader. Time 1982 Feb 22: 66.
12. Anonymous. If a relative is disfellowshiped . . . The Watchtower 1981 Sept
15: 26-31 at 28.
13. Anonymous. Discipline that can yield peaceable fruit. The Watchtower 1988
April 15:26-31 at 28.
14. Anonymous. When marital peace is threatened. The Watchtower 1988 Nov 1: 20-5
at 22.
15. Rogers W. The Wayne Rogers story. Available on line at: http://www.ajwrb.org/wayne.htm
16. Anonymous. Disfellowshiping-how to view it. The Watchtower 1981 Sept 15:
20-6 at 24.
17. Beacon Light for Former Jehovah's Witnesses (available on line at http://www.xjw.com)
has several articles on shunning, including a testimony of a former JW who could
never see his JW mother after disfellowshipping until her funeral (http://
www.xjw.com/ron-mom.html), and another testimony about a devout JW mother who
was disfellowshipped after decades of loyal adherence for refusing to shun her
only son (http://www.xjw.com/rawe-df.html).
18. See reference 13: 26.
19. See reference 13: 30.
20. Anonymous. Faith in Jehovah's victorious organisation. The Watchtower 1979
Mar 1: 12.
21. Anonymous. Jehovah rules-through theocracy. The Watchtower 1994 Jan 15: 14.
22. Anonymous. "A time to speak"- when? The Watchtower 1987 Sept 1:
12.
23. Watch Tower Society. Regulations of the visitation group of the patients.
This is a letter sent to the members of the hospital liaison committee in
October, 1993. A copy in Spanish can be viewed online at: http://www.ajwrb.org/visitation.htm
24. This testimony is available on line at: http://www.ajwrb.org/letest.htm
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