Jehovah’s Witness and the Bleeding Surgical Patient

Abstract

The religion named Jehovah’s Witness was founded by Charles Russell in Allegheny, Pennsylvania, in 1869. Members of this religion do not accept blood transfusions based on passages from the Bible, such as Genesis 9:3-4, Leviticus 17:10-11, and Acts 15:28-29. “As for any man who eats any sort of blood, I shall certainly set my face against the soul that is eating the blood, and I shall in deed cut him off from among ‘his people.’” Interpreting blood transfusions as “eating the blood,” Jehovah’s Witnesses believe that hope for an eternal life would be denied if blood transfusion is allowed. Worldwide, there are approximately 6 million Jehovah’s Witnesses, with approximately 1 million residing in the USA (Ridley in J Med Ethics 25: 469–472, 1999). Many of whom do not accept homologous or autologous whole blood, packed red blood cells, white blood cells, or platelets (Singelenberg in Soc Sci Med 31:515–523, 1990). Some will agree to the use of dialysis, heart-lung, or similar technology if the extracorporeal circulation is uninterrupted. Reportedly, the religion’s belief of Jehovah’s Witnesses does not absolutely prohibit the use of all component therapies, such as hemophiliac preparations, albumin, and immune globulins. Unfortunately, a substantial percentage of bleeding surgical patients present in hemorrhagic shock and are in need of multiple transfusions (Pedowitz and Shakford in J Trauma 29:219–223, 1989). This becomes a major impediment if the patient is a Jehovah’s Witness, who abstains from receiving blood transfusions and blood product infusions based on his/her religious beliefs.