“I will not accept whole blood products.”
This is the stand that many Jehovah’s Witnesses (JW) take even in the face of dire emergency situations. Why do they take such a stand and what specific products do they refuse versus those they potentially accept? As you continue on this short reading journey with me, you will find the answers to these questions.
Initially, Jehovah’s Witnesses believe that the Bible prohibits blood transfusions based on Acts 15:20 which states, “Abstain…from blood.” According to this belief, they maintain their stand by refusing all whole blood products including Red and White Blood Cells, Platelets and Plasma. They also refuse preoperative autologous blood collection and storage for later reinfusion.
Potentially acceptable products that the Witnesses, according to their individual conscience, may accept are those that contain fractions of red blood cells such as Hemin and Hemoglobin, fractions of white cells, platelets and fractions of plasma including albumin, clotting factors, fibrinogen and immunoglobulins. Certain procedures where the blood is salvaged during surgery or treated through dialysis are also deemed acceptable. Additionally, witnesses accept blood test, vaccines, pharmacological treatment and more.
Many active Jehovah’s Witnesses also carry with them at all times an Advance Directive document. This is a legally binding document that informs clinicians of that individual’s preferred medical treatment to be provided in case of illness and a health-care surrogate to consult in case of incapacity. Their organization also provides community-based assistants who are members forming a committee called Hospital Liaison Committee. Individuals on this committee volunteer to provide physicians with appropriate clinical information, facilitate physician to physician consultation and more.
While Witnesses are willing to do whatever is reasonably possible to prolong their life, the majority of them do not compromise on their stand to refuse whole blood products. This understandably may frustrate clinicians and other medical personnel who may not be prepared to deal with such a stand in the face of emergency situations. Some may question what can be done for these patients, especially if suffering from blood loss in labor and delivery and how can the pharmacy assist in such situations? Part 2 of this article will discuss those very pertinent questions.
