By Joel P. Engardio
writer, documentary filmmaker
Blood transfusions and Jehovah’s Witnesses make dramatic stories. Life and death determined by religious faith was on trial last year in Canada where the Supreme Court ruled that blood can be forced on children of Jehovah’s Witnesses while some “mature minors” can decide their own medical fate. Russia’s high court was much less accommodating. It said the belief against blood is a danger to society that warrants a ban of the religion. In the United States, a young Jehovah’s Witness mother who refused a potentially life-saving lung transplant because it would likely require a blood transfusion was front page news in the Washington Post this week.
The twist in Maribel Perez’s story, featured in Wednesday’s editions of The Washington Post, is that she changed her mind. She is now willing to have the operation with blood because she feared leaving her two elementary school-age children motherless. Her Jehovah’s Witness congregation has reportedly shunned her.
The drama in these stories is inherent because the religious objection to blood only amplifies stakes that are high to begin with — people sick enough to need organ transplants can still die even with the blood transfusion. So Jehovah’s Witnesses are left with what appear to be impossible choices: Say no to blood and risk orphaning your children, consent to a procedure that might not work and leave family behind anyway, have a successful operation with blood but face the shame of disobeying your God and alienation from family and friends still in the faith.
Yet the issue of Jehovah’s Witnesses and blood is not always that clear-cut. I made the PBS documentary KNOCKING, which featured a 23-year-old Jehovah’s Witness who needed a liver transplant. Seth Thomas wanted to abide by his religious conviction that blood is sacred – a life force that Jesus shed to absolve humankind’s sin – and was not to be eaten, as the Bible commanded (extended to transfusions today). So Seth refused any surgery that would require blood. But Seth still wanted to live. He thought of the girlfriend he wanted to marry and a full life ahead. Seth didn’t rely on prayer alone; he also put hope in medical technology, searching for hospitals willing to give him a liver transplant without transfusing blood.
Every medical center Seth contacted in his home state of Texas turned him down, but the University of Southern California agreed to take his case (it was once said liver transplants could never be done without blood and now they are). USC has a transfusion-free surgery program that specializes in “bloodless” procedures and has been working with Jehovah’s Witness patients for years to develop better medical technology in every area from knee replacements to heart surgery and organ transplants. The hospital even applies the “bloodless” techniques to the general population for cleaner, safer operations that reduce infection risk and lower cost, saving blood transfusions only for when they are absolutely necessary. That’s the kind of treatment I would personally want, as someone who isn’t one of Jehovah’s Witnesses.
Nearly 200 hospitals in the United States have some sort of “bloodless” program, and the concept is catching on. Even the U.S. military is interested. The Department of Defense is paying Englewood Hospital and Medical Center in New Jersey nearly $5 million to train military doctors how to perform “bloodless” surgery.
Note “bloodless” is in quotes. Many of the technologies and medicines used to reduce or replace blood contain traces of blood in the manufacturing process. An organ transplant will always have residual blood.
My mother is one of Jehovah’s Witnesses and the advance medical directive she and all Jehovah’s Witnesses are asked to fill out contains a menu of choices. They can choose or decline a number of treatment options that have some sort of blood fraction but fall short of an all-out whole blood transfusion. Many Jehovah’s Witnesses, like my mom, pick options tailored to their personal conscience. Some are absolutists who won’t take anything linked to blood. And not all Jehovah’s Witnesses will accept an organ transplant, which was not allowed until 1980. But Jehovah’s Witnesses who do take transplants say their intention is to get the organ, not the residual blood that comes with it.
A doctor I interviewed for KNOCKING treats many Jehovah’s Witnesses but said he sees a “logical disconnect” with the religion’s stated beliefs and their nuanced approach to blood: whether it was a fraction of blood or a whole bag of transfused blood, it was still blood. I agree. However, where my mom is concerned, I like the idea that she doesn’t have to follow a one-size-fits-all blood policy dictated by her religion. Still, if some nuance is allowed, I wonder why the religion bothers to adhere to a no-blood theology in the first place — or at least make the leap that the Biblical ban on eating blood includes modern transfusions?
I suspect legal considerations weigh heavily on Jehovah’s Witnesses as an organized religion. While it may have been easy to “disfellowship” or excommunicate a member for taking blood years ago, the religion today would be open to devastating lawsuits if its members were forced to make certain medical decisions. High-ranking Jehovah’s Witnesses I interviewed for KNOCKING said no one is excommunicated now for taking blood, but a member who willfully chooses blood has voluntarily chosen to leave the faith. Which raises another nuance in the policy: Witness officials I interviewed said a member who takes a blood transfusion while in an “emotional state and under pressure” deserves “pastoral care and compassion.” They can remain a Witness as long as they don’t advocate that blood transfusions are good, that they would do it again and others should do it, too.
I can’t help but think about the young Jehovah’s Witness mother featured on the front page of the Washington Post. Whether through a hospital pioneering new technology or the increasingly nuanced approach Jehovah’s Witnesses take to blood, perhaps there is a way she can get her lung transplant while keeping her faith after all.