Updated September 19, 2026
The Jehovah’s Witness blood policy changed substantially in 2026. On March 20, Jehovah’s Witness leadership made the use of a patient’s own blood in medical and surgical care a matter of individual conscience.1 On September 18, the same principle was extended to donor red blood cells, white blood cells, platelets, and plasma. Whole blood from another person remains prohibited.2
This clinical guide has been revised to reflect those changes. Some official JW.org clinician materials remain inconsistent during the transition, so clinicians should confirm each patient’s current choices directly rather than relying on older documents or generalized descriptions of Jehovah’s Witness blood refusal.3,4,5
The Jehovah’s Witness blood policy has long been familiar to clinicians as a religious objection to blood transfusion. That shorthand is no longer sufficient. Under the Jehovah’s Witness blood policy 2026, a patient may accept red cells, white cells, plasma, platelets, blood fractions, and procedures involving the patient’s own blood while continuing to identify fully as a Jehovah’s Witness.6
The clinically important question is therefore no longer simply, “Is this patient a Jehovah’s Witness?” It is, “Which specific products and procedures does this patient accept or refuse?”
Clinical Bottom Line
Religious affiliation alone no longer establishes whether a Jehovah’s Witness patient will accept or refuse red cells, white cells, plasma, platelets, blood fractions, or autologous blood procedures. Treatment preferences should be established with the individual patient and documented specifically.
Two Major Policy Changes in 2026
Use of the Patient’s Own Blood
Governing Body Update #2 stated that the Bible does not comment on the use of a person’s own blood in medical and surgical care and that each individual must therefore make a personal decision. This change encompasses preoperative autologous donation and storage as well as other procedures involving a patient’s own blood.1,6
Current Policy at a Glance
Whole Blood
Whole blood from another person remains religiously prohibited.
Main Components
Red cells, white cells, plasma, and platelets are now personal decisions.
Fractions & Derivatives
Blood fractions and blood-derived products remain matters of individual conscience.
Patient’s Own Blood
Collection, storage, and other autologous procedures are personal decisions.
| Product or procedure | Current position | Clinical significance |
|---|---|---|
| Whole blood from another person | Religiously prohibited | The September 18 change did not alter the organization’s refusal of allogeneic whole-blood transfusion. |
| Red blood cells | Personal decision | Each patient decides whether to accept or refuse donor red cells. |
| White blood cells | Personal decision | Each patient decides whether to accept or refuse donor white cells. |
| Platelets | Personal decision | Each patient decides whether to accept or refuse donor platelets. |
| Plasma | Personal decision | Each patient decides whether to accept or refuse donor plasma. |
| Blood fractions and derivatives | Personal decision | Acceptance or refusal of products derived from blood remains a matter of individual conscience. |
| Patient’s own blood, including preoperative collection and storage | Personal decision | Since March 20, 2026, the use of a patient’s own blood in medical and surgical care is an individual decision. |
| Acute normovolemic hemodilution, cell salvage, and other autologous procedures | Personal decision | Clinicians should determine the patient’s specific preferences rather than assume acceptance or refusal. |
| Donation for components or fractions to be used by another person | Personal decision | Each Witness now decides whether to donate blood for the clearly expressed purpose of providing components or fractions. |
| Donation for use as whole-blood transfusion to another person | Religiously prohibited | The organization continues to reject donation when the blood will be used as whole blood. |
Red Cells, White Cells, Platelets and Plasma
Until September 18, 2026, Jehovah’s Witnesses were instructed to refuse four primary components derived from another person’s blood: red cells, white cells, platelets, and plasma. Those four categories are now matters of personal conscience.6,7
This is a major clinical change. A Jehovah’s Witness patient may now accept one, several, or all four primary components without violating the organization’s current blood policy. Another Witness may continue to refuse all four. Neither response can safely be inferred from religious affiliation alone.
For clinicians, chart labels such as “JW—no blood,” “refuses blood,” or “bloodless patient” are no longer sufficiently specific. Documentation should identify the patient’s choices regarding individual components and relevant procedures.
A patient who refuses whole blood may nevertheless accept red cells, platelets, plasma, white cells, fractions, and autologous procedures. Conversely, organizational permission does not mean that a particular patient consents to any of them.
Blood Fractions and Blood-Derived Products
Blood fractions have long occupied a separate category in Jehovah’s Witness policy. The September 2026 guidance now states more broadly that each Witness must decide whether to accept a component or fraction derived from another person’s blood.6
The following are examples of terms clinicians may encounter in discussions with Jehovah’s Witness patients. This is not an exhaustive formulary, and the biological source of a commercial product should be verified when relevant.
Under current organizational guidance, the religious classification of these products does not establish an individual patient’s choice. The treatment discussion should address the actual product being proposed, its source when material to the patient, its intended clinical use, and the consequences of acceptance or refusal.
Use of the Patient’s Own Blood
Governing Body Update #2, released March 20, 2026, changed the organization’s position on the medical use of a patient’s own blood. Jehovah’s Witnesses were told that the Bible does not comment on the use of a person’s own blood in medical and surgical care and that each individual must therefore make a personal decision.1,6
This change encompasses preoperative autologous donation and storage as well as other procedures involving a patient’s own blood. Depending on the clinical situation, these may include acute normovolemic hemodilution, intraoperative or postoperative cell salvage, cardiopulmonary bypass, dialysis, plasmapheresis, epidural blood patch, blood-cell tagging, or autologous platelet preparations.
The previous distinction under which some procedures could be accepted only if circulation was considered continuous should therefore not be assumed to represent every patient’s current religiously informed choice.
Blood Donation
The September 18 guidance also changed the organization’s position on blood donation. Each Witness must now decide whether to donate blood for the clearly expressed purpose of providing components or fractions for use by another person.6,7
The organization continues to reject donation when the donated blood would be administered to another person as whole blood. Collection and storage of a patient’s own blood for that patient’s later medical use fall under the 2026 conscience-based approach to the patient’s own blood.6
Advance Directives After the 2026 Changes
Existing Jehovah’s Witness advance directives require particular attention. Many were completed when red cells, white cells, plasma, platelets, and preoperative autologous donation were categorically prohibited.4,5 An older directive may therefore contain categorical refusals that do not necessarily reflect the patient’s present choices.
Important Transitional Issue
The September 2026 policy change does not automatically invalidate a previously executed directive. Nor does a change in religious permissibility establish that the patient now consents to treatment. Religious permission and patient consent are separate questions.
The organization has announced that an updated medical directive will be made available.6 A September 18 congregation announcement obtained by AJWRB further states that, until the revised directive is available, publishers may document their choices through forms, documents, or procedures that are legally recognized and locally accepted and may ask hospitals or healthcare providers to record their wishes in advance.8
If a capable patient presents an older Jehovah’s Witness blood directive, clinicians should clarify current treatment preferences directly with the patient and update the medical record when appropriate. For an incapacitated patient, interpretation of an existing directive should follow applicable law, the document’s wording and applicability, and reliable evidence of the patient’s own wishes. Ethics or legal consultation may be appropriate when genuine uncertainty remains.9,10
| Question | Why it matters |
|---|---|
| What exactly does the directive refuse? | Older documents may contain broad wording or specific refusals based on the former religious policy. |
| When was it completed? | A document signed before the March or September 2026 changes may reflect an organizational rule that has since changed. |
| Did the patient later express different preferences? | More recent statements or documentation may clarify the patient’s own current wishes. |
| Can a surrogate or healthcare agent clarify the patient’s values? | The goal is to identify the patient’s preferences, not substitute another person’s religious or personal choices. |
Hospital Liaison Committees and Confidentiality
Hospital Liaison Committees remain available to assist Jehovah’s Witness patients and clinicians. The September 18 guidance states that the congregation will not become involved in an individual’s decision to accept or reject components or fractions and that fellow Witnesses should not judge one another for those choices.6
The same guidance states that there is usually no need for a Witness to discuss personal medical decisions with individuals other than the healthcare agents named on the medical directive. At the patient’s request, the local Hospital Liaison Committee may provide support and help locate physicians who will respect the patient’s conscience. The organization also states that HLC representatives will keep the patient’s decisions confidential.6
HLC involvement may be useful when authorized by the patient, particularly for information about current organizational guidance or locating cooperative healthcare services. It should not replace direct, confidential communication between clinician and patient regarding the patient’s own treatment choices.11,12
JW.org Clinician Information Is Still in Transition
As of September 19, 2026, JW.org presents inconsistent clinician-facing information.3,4,5
The main Medical Information for Clinicians page now contains an “Important Adjustment Regarding Primary Blood Components” stating that each Witness personally decides whether to accept donor red cells, white cells, plasma, or platelets.3
However, the detailed JW.org page titled Religious and Ethical Position on Medical Therapy and Related Matters still states that Jehovah’s Witnesses do not accept red cells, white cells, platelets, plasma, or preoperative autologous blood donation. Its chart continues to display the former classifications.4
The separate Bioethics and Law page likewise continues to describe the four primary components and preoperative autologous donation as prohibited.5
Information-Currency Warning
During this transition, clinicians using JW.org should distinguish newly updated policy announcements from older clinician resources that have not yet been revised. When organizational information conflicts, the September 18, 2026 Governing Body announcement and the patient’s own current choices are particularly important.
Patient Blood Management Still Has an Important Role
Patient blood management, meticulous hemostasis, treatment of anemia, blood conservation, and other transfusion-sparing strategies remain valuable elements of good clinical care when medically appropriate. Their usefulness is not limited to Jehovah’s Witness patients.13
What has changed is the assumption that these strategies must replace red cells, plasma, platelets, or white cells because those products are religiously unavailable to every Jehovah’s Witness. Under the current policy, a Witness may accept those components.
Clinical decisions should therefore be individualized. Blood-conservation strategies should be offered because they are appropriate for the patient and clinical situation, not because religious affiliation is assumed to require avoidance of otherwise indicated components.
Practical Approach for Clinicians
Establish Preferences
Discuss specific components, fractions, and procedures with the patient rather than relying on a general “no blood” designation.
Protect Voluntariness
When feasible, obtain important treatment preferences in a private clinician-patient conversation, particularly when family members or organizational representatives are present.
Confirm Understanding
Explain the material risks, benefits, and alternatives of the proposed treatment and confirm that the patient understands the consequences of acceptance or refusal.
Review Documentation
Check whether an existing advance directive predates the 2026 changes and whether it still reflects the patient’s current wishes.
Document Specifically
Record acceptance or refusal of individual components and procedures rather than using only broad labels such as “JW—no blood.”
Use HLC Assistance Appropriately
Patient-authorized HLC involvement may help with current organizational information and practical support, while the patient’s individual choices remain controlling.
Escalate Genuine Uncertainty
When incapacity, conflicting documentation, or legal uncertainty creates a difficult case, consider ethics, risk-management, or legal consultation consistent with institutional policy and applicable law.
Historical Context
For decades, Jehovah’s Witness policy distinguished between whole blood and four “primary components,” which were categorically refused, and numerous blood fractions, which were matters of conscience.14,16 That structure shaped medical practice, advance directives, Hospital Liaison Committee activity, and the experiences of Jehovah’s Witness patients worldwide.
Under the former policy, preoperative collection and storage of a patient’s own blood was also rejected.15 Two changes in 2026 fundamentally altered that framework. On March 20, the organization made the use of a patient’s own blood a matter of conscience. On September 18, red cells, white cells, plasma, and platelets from another person were also reclassified as matters of personal conscience.1,2
Historical AJWRB articles describing the former policy remain part of the documentary record. They should be read in the context of the policy that existed when they were written. AJWRB is systematically reviewing its clinical and current-policy material following the September 18 change.
For a detailed account of the September 2026 development, see Jehovah’s Witness Blood Policy 2026: Major September 18 Change.
References
- Watch Tower Bible and Tract Society of Pennsylvania. 2026 Governing Body Update #2. March 20, 2026. Accessed September 19, 2026. JW.org.
- Watch Tower Bible and Tract Society of Pennsylvania. 2026 Governing Body Update #6. September 18, 2026. Accessed September 19, 2026. JW.org.
- Watch Tower Bible and Tract Society of Pennsylvania. Medical Information for Clinicians. Accessed September 19, 2026. JW.org Medical Library.
- Watch Tower Bible and Tract Society of Pennsylvania. Religious and Ethical Position on Medical Therapy and Related Matters. Accessed September 19, 2026. JW.org Medical Library.
- Watch Tower Bible and Tract Society of Pennsylvania. Bioethics and Law. Accessed September 19, 2026. JW.org Medical Library.
- Watch Tower Bible and Tract Society of Pennsylvania. How do Jehovah’s Witnesses show respect for life? Accessed September 19, 2026. JW.org.
- Jehovah’s Witnesses. Jehovah’s Witnesses: Each Witness now decides whether to accept or donate main blood components. September 18, 2026. Accessed September 19, 2026. JW.org.
- Announcement concerning Governing Body Update #6 and interim medical-directive guidance. September 18, 2026. Copy obtained by AJWRB.
- American College of Surgeons Committee on Ethics. Statement on recommendations for surgeons caring for patients who are Jehovah’s Witnesses. September 1, 2018. Accessed September 19, 2026. American College of Surgeons.
- Woolley S. Jehovah’s Witnesses in the emergency department: what are their rights? Emerg Med J. 2005;22(12):869-871. doi:10.1136/emj.2004.023382.
- Muramoto O. Medical confidentiality and the protection of Jehovah’s Witnesses’ autonomous refusal of blood. J Med Ethics. 2000;26(5):381-386. doi:10.1136/jme.26.5.381.
- Elder L. Why some Jehovah’s Witnesses accept blood and conscientiously reject official Watchtower Society blood policy. J Med Ethics. 2000;26(5):375-380. doi:10.1136/jme.26.5.375.
- Webert KE, Zeller MP. The untransfusable patient. Hematology Am Soc Hematol Educ Program. 2025;2025(1):191-198. doi:10.1182/hematology.2025000705.
- Muramoto O. Bioethical aspects of the recent changes in the policy of refusal of blood by Jehovah’s Witnesses. BMJ. 2001;322(7277):37-39. doi:10.1136/bmj.322.7277.37.
- Watch Tower Bible and Tract Society of Pennsylvania. Questions from readers: medical procedures using one’s own blood. The Watchtower. October 15, 2000. Accessed September 19, 2026. JW.org.
- Watch Tower Bible and Tract Society of Pennsylvania. Be guided by the living God. The Watchtower. June 15, 2004. Accessed September 19, 2026. JW.org.
Clinical information notice: This page is intended as an educational resource and does not provide patient-specific medical or legal advice. Treatment decisions should be based on the individual patient’s clinical condition and informed preferences, applicable law, and appropriate professional judgment.
Editorial Note: About AJWRB Patient Narratives
AJWRB publishes patient and family narratives to document the lived experience and human impact of Jehovah’s Witness medical policies and related institutional practices. These accounts are qualitative in nature and reflect the experiences, recollections, interpretations, and opinions of the individual contributors. The views expressed are their own and do not necessarily represent the views or conclusions of AJWRB. Personal narratives should not be understood as substitutes for clinical evidence, nor as independently establishing medical causation in an individual case.
We include these accounts because quantitative data and policy analysis alone cannot fully convey how medical directives are experienced by patients and families—including the effects of religious expectations, social relationships, institutional influence, and high-stakes medical decision-making. Read alongside clinical, historical, and bioethical evidence, patient narratives provide important context for understanding the real-world consequences of policy.
AJWRB remains institutionally neutral regarding an individual’s decision to remain affiliated with or separate from Jehovah’s Witnesses and advocates for every patient’s right to make medical decisions based on accurate information, free from coercion and with genuinely informed consent.
I am an ex JW for 46 years. This is one of 18 issues I argued with the body of elders about before I left. Jesus example to the religious leaders about him healing on the sabbath opened my eyes! It showed me when a life is involved, even if there is a rule, we have to look at circumstances and save that life.
An elder in California gave evidence during a preliminary hearing in 1987, that the only
tenent the Watchtower,
Bible & Tract Society has, is to “abstain from blood”. Not the 10 Commandments, not the New Commandment, etc.
Does anyone know if that was/is, true? I know of someone disfellowshipped after death, because of taking a blood transfusion. It was very hard on his young family. I have a very high allergic reaction in my blood. Pro-crit raised my blood count within 12 hours. I was down to 3.9 hemoglobin twice. The doctors in the first hospital told me it would take 2 weeks for the Pro-crit to work. Some people’s blood is just too weak to accept someone else’s blood. Don’t be afraid to push for Pro-crit, (Erythropoetin), as much as the medical staff pushes for blood transfusions. It is an excellent product. It stimulates your bone marrow to produce red blood cells, IF your bone marrow hasn’t stopped producing red blood cells.
A comprehensive review of blood use according to scripture has been posted at beroean dot study on the web.
” NO BLOOD “