Between Blood and Eternity: The Choice No One Would Want to Make

Matteo Fortin
Independent writer and psychology graduate, UK

These stories are hard to tell.

They deal with blood, with life and death, and with choices that carry weight long after the moment has passed. With people who cling to belief even when the cost becomes unbearable.

They stay with me. They force us to slow down and face questions we would rather avoid.

What comes first?

Saving a life, or respecting someone else’s choice even when that means going against the oath you took to do your job properly, to save lives?

Or maybe we stop too early. Maybe we only look at the surface and miss what really pushes ordinary people to choose death over blood. What drives them to accuse and even denounce the very doctors who tried to save them because they administered a transfusion.

Where does faith end and fanaticism begin? And at what point does that conviction create the idea that reporting a doctor is justified? Reporting the person who kept you alive. The person who gave you life back.

These are not easy questions. But they deserve to be asked.

Rome, December 2025. A woman arrives at the hospital after complications from bariatric surgery performed elsewhere. Internal bleeding. Her condition is critical. The doctors prepare for emergency surgery.

Just before they begin, she makes her position clear: no blood transfusions. Not now, not ever. Even if her life depends on it.

She’s a Jehovah’s Witness. Her faith forbids it. The doctors explain the risks. She listens. She repeats her refusal.

Now the burden shifts. It’s no longer about her. It’s about the surgeon.

He contacts the public prosecutor’s office. The answer is blunt: patients can refuse treatment, but doctors must still protect life. If things spiral and a transfusion becomes medically unavoidable, he’s expected to act.

This time, it doesn’t come to that. The surgery succeeds. She survives.

But there’s one problem. Given how these cases are sometimes framed within community narratives, it’s easy to see how a transfusion could be treated as a serious spiritual violation.

How can you sue someone who just saved your life?

Outside the hospital, people tell the story in simple terms. A doctor does what doctors do under pressure. He explains the risks. He follows the law. He prepares for what could go wrong. It looks like responsibility. Nothing more.

Inside parts of the Jehovah’s Witness community, the lens shifts. The attention drifts away from what actually happened and settles on something else.

Blood no longer sits in the realm of medicine; it carries meaning. Weight. Consequences that go far beyond the body on the table.

The surgeon is stepping into something spiritual. His decisions no longer land as clinical judgments; they feel like moral pressure.

This pressure is often not abstract. Hospital Liaison Committees support Jehovah’s Witnesses to ensure medical care aligns with religious doctrine.

At the same time, the possibility of organizationally mandated shunning looms in the background.

The consequences of accepting blood can include loss of family ties, community standing, and spiritual identity. In that context, refusing blood becomes a measure of loyalty.

In the harshest interpretations, that pressure takes on a darker tone. He starts looking intentional. As if he’s testing loyalty. As if the situation itself were designed to see who obeys and who doesn’t.

From the outside, this way of thinking can feel hard to grasp. But inside the system, it holds together. It grows in an environment where trust rarely extends beyond the group, and where outside authority always carries suspicion.

And once the world starts to feel like a constant test of faith, even someone trying to help can begin to look like a threat.

This way of interpreting things is very clear in the publications of Jehovah’s Witnesses.

Take a 1994 issue of Awake! It contains photographs and stories of young people who died after refusing blood transfusions. These publications are official Watch Tower literature and were widely distributed to Jehovah’s Witness families worldwide.

Teenagers. Children. Smiling faces, names, short biographies.

These stories aren’t framed as tragedies. They’re framed as victories.

The magazine avoids the confusion of emergency medicine. It focuses on one thing: faithfulness.

These young people are praised for “putting God first.” Their deaths are described as significant. Exemplary. Spiritually successful.

So, if you refuse blood and live, you did well. If you refuse blood and die, you did even better. If you hesitate, you have failed. If you accept, you are unfaithful.

And one thing seems clear: the message is not addressed to doctors. Doctors don’t read Awake! for medical advice. The message is for those still alive.

It tells you what to expect when your turn comes. It shows you the ending you should accept. It answers the question before you even ask it.

Once this lesson is learned, the role of the doctor changes. A surgeon preparing a transfusion no longer seems careful. He seems disloyal. A surgeon insisting on blood seems incompetent. He seems willing to ignore God’s law.

From there, it’s a short step.

The doctor isn’t wrong. He’s insisting on saving a life. And that’s how suspicion takes root.

At this point, the tension matters. It tells you something important is at stake. A fair question takes shape.

Are we challenging a person’s right to decide what happens to their own body? Are we asking for individual determination to step aside for medical authority? Are we drifting toward a system that imposes rules from above and expects obedience without question?

Autonomy matters. Consent matters.

The right to refuse treatment sits at the core of modern medicine. You expect doctors to respect your decisions, even when those decisions carry serious consequences.

Jehovah’s Witnesses often point to blood derivatives as alternatives, and those options exist. At the same time, emergencies do not always allow for ideal conditions.

Sometimes alternatives are unavailable. Sometimes, time runs out. Choices never form in isolation. Stories shape them. Values shape them. Rewards and fears shape them.

When a community treats obedience as virtue and survival as secondary, personal determination starts to merge with expectation. The line between free choice and moral pressure grows thin.

At that point, the question changes. You stop wondering whether a person can refuse treatment. You start wondering how that refusal took shape long before the emergency began.

Who reinforced it? Who praised it? Who presented it as proof of worth.

A decision made under the weight of eternal consequences looks like a test. But tests have ready-made answers. And this is where doubt arises: who prepared the test questions?

But the story does not end in the operating room. It continues in homes, in families, in communities where these concepts are instilled long before there is an emergency. It continues in hospitals, where doctors find themselves caught between the penal code, science, and conscience.

When a religion holds that obedience is more important than life, the bond of trust is severed. The doctor is no longer an ally. He becomes a suspect. A possible enemy.

At that point, it no longer matters what the surgeon actually does. What matters is what he represents. Even the act of preparing to save a life can be treated as a sin.

This is the cost of turning medicine into a test of loyalty. A cost paid not only by patients. Doctors pay it. Families pay it.

It is paid by those who remain. And when death is shown as a victory, defeat has already reached everyone.