Bioethical aspects of the recent changes in the policy of refusal of blood by Jehovah's Witnesses

The medical community generally knows that Jehovah's Witnesses refuse blood transfusions. Jehovah's Witnesses reject red and white blood cells, platelets, and plasma, even at the cost of their lives, but they accept so called minor fractions such as albumin and globulin as a personal choice.1 The church organisation, the Watchtower Society, introduced the policy on refusal of blood in 1945. Since 1961 the church has enforced it by “disfellowshipping” or expelling un-repentant members who wilfully accept prohibited blood components. Other members are then instructed by the church to ostracise and shun the expelled individual. Internal dissidents have criticised this practice, which they feel coerces those who have divergent views on this issue and compromises autonomous decision making in medical care. 2 3 I analyse the recently publicised changes in this policy from a bioethical viewpoint to help understand the impact of this controversial policy on clinical practice.4 #### Summary points Under recent changes in the policy of refusal of blood by Jehovah's Witnesses, members can remain silent about the medical treatment they receive and avoid religious punishment Such freedom of conscience hinges on the integrity of medical confidentiality, which may not be adequate for Jehovah's Witnesses A broadening of options for acceptable blood products could open the way for use of various secondary blood products Such a change could also make the distinction between acceptable and unacceptable treatments further obscure and subject to personal interpretation In light of these changes it has become essential to treat members independently of the church's official policy by exploring personal conviction and preference ### Judicial proceedings In June 2000, the Watchtower Society issued a directive stating that the organisation would no longer disfellowship members who did not comply with the policy of refusal of blood. Its official statement to the media was that “if a baptized member of …