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Does God Forbid Blood Transfusions?

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Does God Forbid Blood Transfusions?

Answers to Jehovah’s Witnesses #22
Robert M. Bowman Jr.

Summary: The Watchtower Society teaches that giving or receiving blood transfusions is a violation of the biblical command not to eat blood and that God therefore condemns blood transfusions even to save a person’s life. Jehovah’s Witnesses face being ostracized from the religion and their family relationships strained if they accept a blood transfusion.

This article is one of a series of articles explaining in detail the doctrines of Jehovah’s Witnesses and showing why those teachings are not in harmony with the facts and teachings of the Bible. For an overview, see our article on what Jehovah’s Witnesses believe.

What the Watchtower Teaches

The Watchtower Society’s publications give a surprisingly great amount of attention to the subject of blood transfusion. The organization’s position on the subject is that blood transfusions are sinful acts of disrespect for the life that is in blood and violations of God’s prohibitions in Scripture against eating blood:

As Christians, we know that Jehovah is the Source of life and that all life belongs to him. We also realize that blood is sacred and represents life. So we make sure to consider Bible principles when we make any decisions about medical treatment involving the use of blood.1

The Society quotes a number of biblical proof texts to prove that all people should refuse to eat blood and that taking a blood transfusion would violate this rule. For example, God told Noah after the Flood that humans were permitted to eat meat, “But you shall not eat flesh with its life, that is, its blood” (Gen. 9:4). Since this prohibition was given prior to the time of Moses, it applies to all people, not just to Israelites under the Mosaic Law, which also prohibited eating blood (Lev. 17:10-11). The Watchtower draws attention to the account of David refusing to drink water brought to him by three of his men at the risk of their lives during the war with the Philistines: “Shall I drink the blood of the men who went at the risk of their lives?” (2 Sam. 23:17).

The Watchtower’s most important proof text on this subject is in the Book of Acts. Following a meeting of the apostles and elders of the church in Jerusalem, the leaders agreed to allow Gentiles to be full-fledged members of the Christian community without needing to submit to the Mosaic Law. In a letter, the Jerusalem leaders directed Gentile believers to observe certain restrictions, including “abstaining…from blood” (Acts 15:20, 28-29; see also 21:25). This passage is important to the Society’s case against blood transfusions in three ways.

First, Acts 15:28-29 is a directive to Gentile Christians, not to people living in Old Testament times or under the Law of Moses. Therefore, Jehovah’s Witnesses infer, this text informs us that Christians today likewise should “abstain…from blood.”

Second, the Watchtower points out that this directive to abstain from blood came alongside the directive to abstain “from sexual immorality” (Acts 15:29). The organization reasons that this means that abstaining from blood “was as important morally as abstaining from sexual immorality.”2

Third, the Watchtower argues that the broader term “abstain” indicates that the prohibition applies to such acts as blood transfusions and not only to the literal eating of blood:

Jehovah’s Witnesses understand that “abstaining from . . . blood” involves more than not eating or drinking it. It means not accepting blood transfusions, not donating blood, and not storing our own blood for transfusion.3

The Society offers the following analogy to support its claim that the biblical prohibitions about eating blood would also apply to blood transfusions:

Jehovah commanded us not to eat or drink blood. If a doctor told you not to drink alcohol, would you inject it into your body? Of course not! In the same way, the command not to eat or drink blood means that we would not accept a blood transfusion.4

Over the years, the Watchtower Society has defined its position even with regard to the parts or constituent elements of blood. After asserting that abstaining from blood means no blood transfusions, they go on to say, “It also means not accepting transfusions of any of the four main parts of blood​—red cells, white cells, platelets, and plasma.” However, the organization allows the use of blood fractions in medicine, and one may use one’s own blood in a medical procedure as long as it was not “stored” prior to the procedure:

These four main parts of blood may be broken down into smaller parts called blood fractions. Each Christian must decide whether or not he will accept blood fractions. The same applies to medical procedures that make use of a patient’s own blood. Each one must decide how his own blood will be handled in the course of a surgical procedure, medical test, or current therapy.5

Beginning in 1961, the Watchtower’s stated policy was that any Jehovah’s Witness who accepts a blood transfusion was subject to being disfellowshipped (excommunicated):

Consistent with that understanding of matters, beginning in 1961 any who ignored the divine requirement, accepted blood transfusions, and manifested an unrepentant attitude were disfellowshipped from the congregations of Jehovah’s Witnesses.6

However, in 2000 the organization instituted a new policy instructing elders not to disfellowship members who accepted blood transfusions, but instead to consider those members to have “disassociated themselves” if they were unrepentant.7 Evidently this policy change was implemented to avoid lawsuits against the Watchtower Society.8

The Watchtower’s Position on Blood Transfusion in Historical Perspective

By “blood transfusion” here we mean specifically the intravenous transfer of human blood or blood products into a human being’s circulatory system. In this sense, blood transfusion is just barely two centuries old, having been first performed by a London obstetrician in 1818 to treat women who would otherwise have bled to death after giving birth.9 In the early twentieth century, scientists working independently in Austria, Poland, and the United States discovered the distinct human blood groups, for which the standard terminology (types A, B, AB, and O) was formally adopted in 1937. Another key development during the early decades of the twentieth century was the use of anticoagulants—chemical solutions that prevented blood from clotting, thus allowing blood to be donated and stored for future use. It was also in 1937 that this practice of storing blood was initiated, at the Cook County Hospital in Chicago. Almost immediately, the use of blood transfusion increased on a vast scale in the late 1930s to save countless lives of men wounded in battle in the Second World War. The increased demands led scientists to develop the practice of fractionation—breaking down blood into smaller components or fractions that could be more practically transported to distant locations as needed. Thus, by the early 1940s the scientific basis and technologies of blood transfusion as we know it were largely in place.10

It was then that the Watchtower Society began criticizing blood transfusion. Up until this point, Watchtower publications had occasionally reported stories about people donating blood and saving lives, generally giving a positive view of the practice.11 Infamously, for two decades the Society had been condemning vaccinations,12 a stance the organization later abandoned in 1952. The Watchtower’s position objecting to blood transfusion is commonly dated to 1945, even in later Watchtower publications.13 However, an article in the Watchtower magazine in late 1944 made a passing comment indicating that transfusing blood was forbidden. Speaking of the laws governing the “stranger” in Israel under the Mosaic Law, the Society made the following assertion:

Not only as a descendant of Noah, but now also as one bound by God’s law to Israel which incorporated the everlasting covenant regarding the sanctity of life-sustaining blood, the stranger was forbidden to eat or drink blood, whether by transfusion or by the mouth. (Gen. 9:4; Lev. 17:10-14).14

The 1945 article commonly cited as initiating the policy discusses the idea of the sanctity of blood at some lengthy, but it does not attempt to explain directly how the biblical prohibitions against eating blood apply to blood transfusions. Instead, it impugns blood transfusions by indirectly comparing them to the practice of barbaric warriors drinking the blood of their slain enemies.15

The development of using blood fractions in transfusions instead of whole blood proved to be something of a conundrum for the Watchtower’s policy makers. The Society prohibited blood serums or fractions in 1954, permitted them in 1958, prohibited them again in 1963, approved them a few months later in 1964, and then allowed them as a matter of conscience (though implying some disapproval) in 1974. “Major” components of blood were prohibited but “minor” components permitted in 1982. Jehovah’s Witnesses were subjected to a similar series of multiple reversals on the subject of organ transplants: in 1949 they were admirable, in 1961 they were a matter of conscience, in 1967 they were condemned as cannibalism, and in 1980 they were once again a matter of individual conscience.16

A particularly heartbreaking and vexing example of the Watchtower’s policy on blood concerned hemophiliacs, males (mostly) whose blood does not clot normally due to a genetic disorder and who are therefore at extreme risk of bleeding to death from cuts or other injuries. Blood transfusions, and specifically the use of blood fractions, were an especially beneficial breakthrough for hemophiliacs. Yet for years the Society’s secret position was that Jehovah’s Witnesses who were hemophiliacs might receive blood fractions (which the Society decided in 1964 were acceptable) once as “medication,” but not more than once, which would be “feeding” and thus a violation of the biblical prohibition against eating blood. (Why this reasoning was not applied to all blood transfusions for the general population, most of whom would never need to undergo the procedure more than once in a lifetime, remains a mystery.) At some point, Watchtower staff receiving inquiries on the issue from hemophiliacs began informing them that they might receive the treatments as needed, but the Society did not make this change public, since the earlier position had also not been public knowledge.17 Indeed, the Watchtower periodical Awake! in February 1975 seemed to express an even harsher stance. Reporting on the use of clotting factors from blood to treat hemophilia, the article commented, “Of course, true Christians do not use this potentially dangerous treatment, heeding the Bible’s command to ‘abstain from blood.’”18 Less than four months later, the Governing Body (the ruling council of Jehovah’s Witnesses) held a session at which the secret “one time” policy for hemophiliacs was officially abandoned, but nothing was said in print on the matter until three years later, when it was buried in a statement regarding serum injections for other purposes:

What, however, about accepting serum injections to fight against disease, such as are employed for diphtheria, tetanus, viral hepatitis, rabies, hemophilia and Rh incompatibility? This seems to fall into a ‘gray area.’ …Hence, we have taken the position that this question must be resolved by each individual on a personal basis.19

An organization that claims to represent the only true religion on earth ought to have a much, much better track record.

Well-publicized deaths of Jehovah’s Witnesses in the 1980s and 1990s due to their adherence to the Watchtower’s policy concerning blood eventually brought many members to the conclusion that the policy needed to be changed. In 1997 some Witnesses formed a group called Advocates for Jehovah’s Witness Reform on Blood (AJWRB). The founder of the group, known by the pseudonym Lee Elder, was literally an elder in the religion. His own maternal grandmother, as well as several of his friends, had lost their lives due to their refusing to accept blood transfusions.20 There was a flurry of academic articles in medical periodicals discussing the ethical issues pertaining to the Jehovah’s Witnesses’ stance on blood transfusions, including an articles by a lawyer for the Watchtower defending their teaching21 and an article by Lee Elder explaining why some members conscientiously reject the Society’s position.22 The Watchtower’s arrogant dogmatism regarding blood transfusion was one of several issues on which prominent Jehovah’s Witness apologist Greg Stafford spoke out in a 2002 book, in effect disassociating himself from the organization while his basic doctrinal beliefs remained largely unchanged.23

Biblical Response

The Old Testament contains many passages forbidding the eating of blood. In every case, the passage is prohibiting people from eating meat without first draining it of blood:

“Every moving thing that lives shall be food for you. And as I gave you the green plants, I give you everything. But you shall not eat flesh with its life, that is, its blood” (Gen. 9:3-4).

“Any one also of the people of Israel, or of the strangers who sojourn among them, who takes in hunting any beast or bird that may be eaten shall pour out its blood and cover it with earth” (Lev. 17:13).

“However, you may slaughter and eat meat within any of your towns, as much as you desire, according to the blessing of the Lord your God that he has given you. The unclean and the clean may eat of it, as of the gazelle and as of the deer. Only you shall not eat the blood; you shall pour it out on the earth like water” (Deut. 12:15-16).

The people pounced on the spoil and took sheep and oxen and calves and slaughtered them on the ground. And the people ate them with the blood. Then they told Saul, “Behold, the people are sinning against the Lord by eating with the blood.” And he said, “You have dealt treacherously; roll a great stone to me here.” And Saul said, “Disperse yourselves among the people and say to them, ‘Let every man bring his ox or his sheep and slaughter them here and eat, and do not sin against the Lord by eating with the blood.’” (1 Sam. 14:32-34)

The rationale behind this rule is that the blood is the life of the animal. The Old Testament makes this equation of blood with life explicit (Gen. 9:4; Lev. 17:11). The theological point being made is that to eat the blood of an animal one has killed for food is to show disrespect for life. Old Testament scholar Gordon Wenham explains:

At a basic level this is obvious: when an animal loses its blood, it dies. Its blood, therefore, gives it life. By refraining from eating flesh with blood in it, man is honoring life. To eat blood is to despise life.24

Already we can see two reasons why this prohibition does not apply to blood transfusions. First, the blood donor is not being killed; he is voluntarily donating a relatively small amount of his blood in a medically safe procedure. Accepting blood from a living donor shows no disrespect for that donor’s life. Second, the person who receives a blood transfusion is not eating blood—and of course he is certainly not eating the meat or flesh of the donor. Now that would be cannibalism! But nothing of the sort is happening in a blood transfusion.

The Watchtower has repeatedly offered a particular analogy to argue that blood transfusion is no different essentially from eating. As quoted earlier, the Society argues that if a doctor ordered us not to drink alcohol it would be a violation of that order to inject alcohol into our veins, and likewise it would be a violation of the command not to eat blood if we were to inject blood into our veins.25 Frankly, this is a rather silly analogy. For one thing, it would always be a bad idea to inject alcoholic drinks, milk, or any other beverages into one’s veins. Injecting fluid into one’s veins is not a substitute for drinking. Osamu Muramoto, who has published several articles in academic medical journals on the subject of Jehovah’s Witnesses and blood transfusions, explains why blood transfusion is not a kind of eating or drinking:

As any medical professional knows, this argument is false. Orally ingested alcohol is absorbed as alcohol and circulated as such in the blood, whereas orally eaten blood is digested and does not enter the circulation as blood. Blood introduced directly into the veins circulates and functions as blood, not as nutrition. Hence, blood transfusion is a form of cellular organ transplantation.26

Muramoto adds that the Watchtower Society now allows organ transplantation, thereby contradicting its own policy on blood transfusions.

Notice that one cannot rationally or coherently discuss the validity of the Watchtower’s position on blood transfusion without some understanding of the biological and medical facts. Obviously, the Bible says nothing about blood transfusions per se. Therefore, in order to assess whether blood transfusions violate a biblical teaching, one must understand accurately both the biblical texts and the medical facts. The Watchtower’s doctrine misunderstands both: it fails to recognize that eating blood was a prohibition concerned with showing respect for the life of the animals whose meat people eat, and it misrepresents blood transfusions as a form of eating.

When we move forward to the New Testament, we do not find any reason to understand the prohibition concerning blood any differently. The subject came up at the meeting known as the Jerusalem Council, a gathering of the apostles and elders to consider the question of the admission of Gentiles into the community of believers in Christ. The issue before the council was whether Gentiles needed to be circumcised and keep the Law of Moses in order to be saved (Acts 15:1-2, 5). The apostles agreed that God giving the Gentiles the Holy Spirit just as he had given him to the Jewish believers showed that God made no distinction between them (15:8-14). Then James gave his judgment, to which the body of the apostles and elders agreed:

“Therefore my judgment is that we should not trouble those of the Gentiles who turn to God, but should write to them to abstain from the things polluted by idols, and from sexual immorality, and from what has been strangled, and from blood. For from ancient generations Moses has had in every city those who proclaim him, for he is read every Sabbath in the synagogues” (Acts 15:19-21).

The Watchtower argues that the word “abstain” used here (Acts 15:20; also 15:29; 21:25) has a broader meaning than just eating. Their online study Bible asserts, “With regard to abstaining from blood, the meaning of this verb is broader than simply not consuming blood. It implies avoiding all misuse of blood, showing regard for its sacredness.”27 This comment is intended to buttress the Watchtower’s application of the text to blood transfusions. However, to make such an application is to assume, rather than to show, that blood transfusion is a “misuse of blood.” What constitutes “misuse” of blood in the apostles’ cultural context was eating blood, as the Old Testament stated repeatedly. There is no basis in these references to abstaining from blood to read anything more into it.

James refers to Moses being “read every Sabbath in the synagogues” found “in every city” as the reason for proposing that the Gentiles be directed to abstain from the specific practices he mentions. (The word “For” at the beginning of verse 21, translating the Greek word gar, indicates that what he says here is the reason for the policy he has just proposed.) This explanation evidently means that the purpose of the proposed policy is to facilitate unity between Jewish and Gentile believers in Christ. F. F. Bruce explains:

In most cities Gentile believers had to live alongside Jewish believers, who had been brought up to observe the levitical food restrictions and to avoid contact with Gentiles as far as possible. If there was to be free association between these two groups, certain guidelines must be laid down, especially with regard to table fellowship.28

Most scholars agree that these “guidelines” were issued to accommodate the presence of Gentiles to Jewish sensibilities without imposing the Mosaic Law as such on them. It is interesting to note that this happens to have been the view of the founder of the Watchtower Society, Charles Taze Russell. He commented that James was concerned especially with regard to the common diets of Gentiles that “by eating such things they might become stumbling blocks to their Jewish brethren.”29 This would explain why three of the four abstentions concerned food (meats sacrificed to idols, blood, and meat from strangled animals).

James’s reference to abstaining from “immorality” (porneia) should probably be interpreted in this context. Rather than referring generally to sexual immorality of all kinds—which did not require a special decision from a council to prohibit—James was more likely referring to marriage among close relatives, common in the Gentile world but forbidden in the Mosaic Law (Lev. 18:6-18).30

That these were guidelines for the sake of fellowship among Jewish and Gentile Christians is confirmed by the apostle Paul in 1 Corinthians 8-10, where he treats eating meat sacrificed to idols in just this way. Paul himself did not consider eating such meat in and of itself sinful, but he did consider causing other believers to stumble sinful and was prepared never to eat such meat for their sake.

In any case, the council’s decision to instruct Gentile Christians to “abstain” from blood has nothing whatsoever to do with blood transfusions. Eating blood was, according to the Scriptures, an act of disrespect toward the life of the animal that was killed for food. Receiving a blood transfusion from a donor who gave it to save a life shows no disrespect for the donor’s life, nor any dishonor toward the God who gave us life. There simply is no biblical basis for thinking that God forbids blood transfusions.

 

NOTES




1. How to Remain in God’s Love (Watchtower, 2017), 92.

2. “Questions from Readers,” Watchtower, Oct. 15, 2000, 30.

3. How to Remain in God’s Love, 92.

4. What Can the Bible Teach Us? (Watchtower, 2015), 144.

5. How to Remain in God’s Love, 92.

6. Jehovah’s Witnesses—Proclaimers of God’s Kingdom (Watchtower, 1993), 183.

7. See “Jehovah’s Witnesses: Official Statement to the Media on Blood Transfusions (June 15, 2000),” posted online by CESNUR [Center for Studies on New Religions].

8. See “Blood Policy Timeline,” Advocates for Jehovah’s Witness Reform on Blood [AJWRB.org].

9. Paul L. F. Giangrande, “The History of Blood Transfusion,” British Journal of Haematology 110 (2000): 760 (758–67). Other basic historical facts regarding blood transfusion are taken from this article.

10. Giangrande, “History of Blood Transfusion,” 761–63.

11. E.g., Gives Eleven Gallons of Blood,” The Golden Age, July 29, 1925, 683; “The Mending of a Heart,” Consolation, Dec. 25, 1940, 19. This periodical, known by the two different names, was later retitled Awake! (its title to this day).

12. E.g., Charles A. Pattillo, “The Sacredness of Human Blood,” The Golden Age, Feb. 4, 1923, 293–94.

13. E.g., Jehovah’s Witnesses—Proclaimers of God’s Kingdom, 183.

14. “The Stranger’s Right Maintained,” Watchtower, Dec. 1, 1944, 362.

15. “Immovable for the Right Worship,” Watchtower, July 1, 1945, 200.

16. See “Blood Transfusion in Modern History,” AJWRB.org, with the documentation provided there.

17. For a firsthand account of the matter, see Raymond Franz, Crisis of Conscience, 5th ed. (NuLife Press, 2018), 141–42. Franz was a member of the Governing Body during this period.

18. “Hemophilia Treatment Hazard,” Watching the World, Awake!, Feb. 22, 1975, 30.

19. “Questions from Readers,” Watchtower, June 15, 1978, 30–31.

20. See the “About” section of the Facebook page for Lee Elder.

21. Notably Donald T. Ridley, “Jehovah’s Witnesses’ Refusal of Blood: Obedience to Scripture and Religious Conscience,” Journal of Medical Ethics 25.6 (Dec. 1999): 469–72.

22. Lee Elder, “Why Some Jehovah’s Witnesses Accept Blood and Conscientiously Reject Official Watchtower Society Blood Policy,” Journal of Medical Ethics 26 (2000): 375–80.

23. Greg Stafford, Three Dissertations on the Teachings of Jehovah’s Witnesses (Murietta, CA: Elihu Books, 2002). Stafford had previously written Jehovah’s Witnesses Defended: An Answer to Scholars and Critics, 3rd ed. (Huntington Beach, CA: Elihu Books, 1998, 2000, 2009).

24. Gordon J. Wenham, The Book of Leviticus, New International Commentary on the Old Testament (Grand Rapids: Eerdmans, 1979), 245.

25. What Can the Bible Teach Us? (Watchtower, 2015), 144.

26. Osamu Muramoto, “Bioethics of the Refusal of Blood by Jehovah’s Witnesses: Part 1. Should Bioethical Deliberation Consider Dissidents’ Views?” Journal of Medical Ethics 24.4 (Aug. 1998): 227 (223–30).

27. New World Translation of the Holy Scriptures (Study Edition) (Watchtower, 2020), at Acts 15:29.

28. F. F. Bruce, The Book of the Acts, New International Commentary on the New Testament (Grand Rapids: Eerdmans, 1988), 295.

29. “Studies in the Acts of the Apostles,” Zion’s Watch Tower and Herald of Christ’s Presence, Nov. 15, 1892, 350, in Reprints, 1473.

30. Bruce, Book of the Acts, 299; Joseph A. Fitzmyer, The Acts of the Apostles: A New Translation with Introduction and Commentary, Anchor Yale Bible 31 (New Haven: Yale University Press, 2008), 557–58.