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Sharon Grant
Editorial Team

All that Jehovah's Witness patients ask is that their wishes are respected and that doctors and/or hospital administrators do not petition the courts to force a blood transfusion on them. It's as simple as that.
The reason that JW patients do not accept blood transfusions is a religious one, and as such, they have a right to make that decision without interference from anyone, including medical professionals or the government.
Needless to say, all patients have the right to accept or reject any form of treatment as they see fit, as long as they have been properly informed by their physician and they have elected to sign a liability release and express assumption of risk form.
Jehovah's Witnesses are very well educated about what alternative options to blood transfusions are available; physicians should carefully listen to their patients and proceed with a treatment plan that does not include blood transfusion.
Patients opt-out of all kinds of treatments and procedures that their doctors recommend, but it is very obvious that the only ones that get criticized for their decision are JW!

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Mario Caruso, CHT, DMT-A

Mario, it also happens to others who don't want blood. I have read articles on this site about non-witness patients who had similar treatment.

Ms. Morgan:

First it should be stated that the statements were the authors. I should think you may want to contact them for clarification.

Since I am typing and took the time to read the article I will speculate on their the meaning. Here is a copy of the statement in question:

"The second concern is the small number of red blood cell contaminants among the collected stem cells. Because the red blood cells are not the intent of the transplant and are not used for nutritive purposes, many Jehovah’s Witnesses deem their presence acceptable."

In my opinion their use of the words "the small number of red blood cell contaminants among the collected stem cells" is the real clue as to what the authors mean to say. They then go on to say; "the red blood cells are not the intent of the transplant and are not used for nutritive purposes". Taken together those statements point to intention or motive.

Gen 9:4 says; Only flesh with its soul—its blood—YOU must not eat. So, Jehovah's Witnesses do not eat blood, however some blood cells are left in some meats even after they have been thoroughly bleed before consumption. Does that mean they shouldn't eat meat just in case a "small number of red blood cell contaminants" remain? That doesn't seem to be necessary. Also in Genesis 9:3 God gives man flesh to eat (Every moving animal that is alive may serve as food for YOU. As in the case of green vegetation, I do give it all to YOU). God knows all things and so knew that hunters or those raising domestic livestock would not be able to drain every blood cell and that a "small number of red blood cell contaminants" would remain with the meat. The intent is to show respect and obedience for the Bible command not to eat blood.

You said, "The article indicates Jehovah witnesses will accept transfusions that include red blood cells as long as this component from blood is not for nutritive purposes and the transfusion of this component is not the intent of the transfusion."

"transfusions that include red blood cells" - Like they will eat meat that contain a "small number of red blood cell contaminants"? or will accept stem cells that contain a "small number of red blood cell contaminants"? I guess so. However the fact that the RBC's are small in number and are considered contaminants is telling.

Again, I am speculating on what the authors might mean. I suggest contacting the blood management program at Pennsylvania Hospital in order to ascertain their intent in writing the aforementioned phrases.

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Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email

I think your pedant positioning is poisoning your perception. You must see this from the position of the authors and the patient group they are writing about.

Since the very nature of your questions called for speculation on the part of anyone but the authors I made it clear that I was only speculating as to the meaning of the authors comments in my reply. It seemed evident to me that the authors were referring to conditions whereby some Witness patients would accept stem cells even though there was a small amount of red blood cell residue present. This brought the logical step to the reason why some might accept stem cells that contain some RBC's. Also the authors used the word 'nutrition' in connection with the acceptance or rejection of RBC's. Again, it isn't a matter of your point of view it is a matter of what Jehovah's Witnesses think and perceive. The Jehovah's Witness position on blood IS theological so that was the basis of my reply to you.

Whether you understand it or are willing to accept it they base their beliefs and decisions on scripture. The scripture I mentioned earlier mentions not eating blood. The patients in the study take this very seriously. The authors of the study referred to this by using the word nutrition in connection with the small amount of RBC contaminating the stem cells. At least that is my opinion and speculation.

It seems evident that in this case the question of why a Witness would accept the presence of some residual RBC's must be understood from their point of view...theological and scriptural, whether you agree with their reasons doesn't seem to be relevant.

__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email

Transfusion not nutrition?

Perhaps because there has been a great deal of attention focused on the presence and function of the red blood cell and its clearly vital oxygen-carrying capacity, there has been a tendency to forget what blood really is. I wish to broaden the focus and remind you that blood is composed of virtually thousands of substances that are being transported to and from body cells to provide nutrients. Oxygen is essential for energy production at the cellular level, as are many hundreds of other nutrients. However, it is quite simply a nutrient without which ALL nourishment of the body fails (without available oxygen, the Krebs cycle grinds to a halt, resulting in anaerobic metabolism, which leads rapidly to metabolic acidosis - ultimately fatal). Perhaps oxygen should be called the body's primary nutrient. As such, any transfusion of any component of blood is, first and foremost, nourishing the body in some way, at some level. Because it is not "chewed and swallowed" it is no less utilized than the juicy steak discussed above.

Of course, blood also carries away the by-products of nutrients that have been broken down, their needed portions utilized by the cell, and these remnants are metabolized in either the liver, kidneys, and spleen. The blood gets them to these recycling/eliminating organs. It also carries away undesirable organisims that are phagocytized by the immune system; carries hormones to their target organs; facilitates the immune response; and provides a mechanism for fluid balance in the body.

Because the body cannot obtain nutrients at the cellular level without blood, therefore, a transfusion of blood is absolutely analogous to eating, although by a different route. This is achieved also by IV infusion of nutrient mixtures other than blood, or by tube feeding through a surgically implanted abdominal port, in those who are physically unable to chew and swallow.

I hope this reminder is helpful to those who question whether or not blood is given as a source of nutrients.

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Jan Grossberg, RN, BSN
Editorial Team

Ms. Morgan:

So the conclusion of the matter is that you probably missed the authors meaning. When relating the fact that RBC's were not considered nutrition by the Witnesses, the authors probably meant what I said, they were referring to the Witnesses scriptural position and its effect on their clinical choices (although I am speculating).

As to your remarks to JG:

I appreciate what JG said about nutrition but I don’t think the authors were speaking to nutrition as a strictly scientific matter. Having spent the better part of two decades in hospitals working with blood management programs, I think they were relating to the issue of eating-equaling-consuming whether orally, G-tube or intraveniously RBC’s from the JW perspective. They chose not to get into a lengthy discussion of the matter in their paper. It is really an easy matter to understand. They Witnesses come to us and tell us what they will and will not accept and we follow their direction be it aspirin or jello.

Most of the professionals here are working people. We have a working understanding of what Jehovah's Witnesses believe and we work with them within those constraints. We do not find their position difficult to accommodate. For most of us that population represents a small percentage of our patient group. For you Jehovah's Witnesses seem to be a matter of eternal curiosity.

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Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email

I have read most of your posts here at NoBlood. I find it interesting that you say "Understanding perspectives and rationale aids in caring for these patients, as it does for all patient" yet you do not allow that you are growing in understanding. You have been here for many months and have been deeply involved in several threads involving the medical choices of Jehovah's Witnesses; have you learned anything? Is that your real goal? Your words and actions go contrary to your stated noble purpose of "understanding" and "caring for these patients". By contrast, I know hundreds of doctors and nurses who while not agreeing with Jehovah's Witnesses position actually understand it and care for these patients. They show kindness and willingness. Is that really your goal?

You say " My understanding from Jehovah’s Witnesses is their beliefs on blood are consistent with science.". What do you mean? Their beliefs on blood are based on their religious beliefs. They do not accept blood transfusions. You continually focus on the issue of blood fractions and whether they will accept or reject them. As science brings forth new understanding on the make up and mechanisms of blood fractions isn't it logical that Jehovah's Witnesses adjust their point of view? Their willingness to change seems to irk you.

You say, "Your remarks suggest it is inappropriate for me to have curiosity about the views of this patient population.". You misunderstand my remarks to you JulieM. If you entered the hospital and began treating Jehovah's Witness patients the way you treat them here my colleagues and I would confront you to help you see how inappropriate your actions were. We would ask you why you were so determined. We would ask you to stop. If you did not stop we would call security and have you escorted from the building.

You say, "With the exception of certain presentations involving minors, I agree these patients’ position is usually not difficult to accommodate. This is not questioned by me.". So what are you questioning and why? What is your mission? Is it simply a personal quest for ... what? What are you trying to "understand"?

As you point out I am one of Jehovah's Witnesses. I am also a professional in the field of blood management. I speak to you from this unique point of view. I try to help you "understand". I speak for myself and I do not presume to speak for the administrators here at NoBlood.

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Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email

Jan,
With the wisdom and deep thought you use on the author's "intention and motive", I was wondering if you used the same process of thought on the scripture verses?
Tony

Hi Tony,

THAT Author has made his "thoughts and intentions" clear.

Hope all is well with you and your family.

Your friend - Jan

__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email