How Do I View Blood Fractions and Medical Procedures Involving My Own Blood?
The Bible commands Christians to “abstain from . . . blood.” (Acts 15:20) Thus, Jehovah’s Witnesses do not accept transfusions of whole blood or the four primary components of blood—namely, red blood cells, white blood cells, platelets, and plasma. They also do not donate or store their own blood for transfusion.—Lev. 17:13, 14; Acts 15:28, 29.
What are blood fractions, and why is their use a matter for each Christian to decide?
Blood fractions are elements from blood that are extracted through a process called fractionation. For example, plasma, one of the four major components of blood, can be divided into the following substances: water, about 91 percent; proteins, such as albumins, globulins, and fibrinogen, about 7 percent; and other substances, such as nutrients, hormones, gases, vitamins, waste products, and electrolytes, about 1.5 percent.
Are fractions also covered by the command to abstain from blood? We cannot say. The Bible does not give specific direction on the subject of fractions.* Of course, many fractions are derived from blood that has been donated for medical purposes. Each Christian should make a conscientious decision as to whether he or she will accept or will reject the medical use of these substances.
When making such decisions, consider the following questions: Am I aware that refusing all blood fractions means that I will not accept some medications, such as certain ones that fight viruses and diseases or that help blood to clot in order to stop bleeding? Could I explain to a physician why I reject or accept the use of certain blood fractions?
Why are some procedures involving the medical use of my own blood a personal decision?
Although Christians do not donate or store their own blood for transfusion purposes, some procedures or tests involving an individual’s blood are not so clearly in conflict with Bible principles. Therefore, each individual should make a conscientious decision as to whether to accept or to reject some types of medical procedures involving the use of his or her own blood.
When making such decisions, ask yourself the following questions: If some of my blood will be diverted outside my body and the flow might even be interrupted for a time, will my conscience allow me to view this blood as still part of me, thus not requiring that it be ‘poured out on the ground’? (Deut. 12:23, 24) Would my Bible-trained conscience be troubled if during a medical procedure some of my own blood was withdrawn, modified, and directed back into my body? Am I aware that refusing all medical procedures involving the use of my own blood means that I refuse treatments such as dialysis or the use of a heart-lung machine? Have I prayerfully considered this matter before making a decision?*
What are my personal decisions?
Consider the two work sheets on the following pages. Work Sheet 1 lists some of the fractions extracted from blood and how they are commonly used in medicine. Fill in your personal choice as to whether you will accept or will reject the use of each of these fractions. Work Sheet 2 lists some common medical procedures involving your own blood. Fill in your personal choice as to whether you will accept or will reject these procedures. These work sheets are not legal documents, but you may use your answers on these work sheets to help you to complete your DPA (durable power of attorney) card.
Your decisions should be your own and should not be based on someone else’s conscience. Likewise, no one should criticize another Christian’s decisions. In these matters, “each one will carry his own load” of responsibility.—Gal. 6:4, 5.
Helpful information on this subject is found in the June 15, 2004, issue of The Watchtower, pages 29-31.
Helpful information on this subject is found in the October 15, 2000, issue of The Watchtower, pages 30-1, and the Transfusion Alternatives—Documentary Series—On DVD.
[Chart on page 5]
Work Sheet 1
UNACCEPTABLE YOUR PERSONAL DECISION
WHOLE Choices You
BLOOD FRACTIONS Need to Make
PLASMA ALBUMIN—UP TO 4% OF PLASMA
A protein extracted from
plasma. Types of albumin
are found also in plants,
in foods such as milk and
eggs, and in the milk of
a nursing mother. Albumin
from blood is sometimes ․․ I accept albumin
used in volume expanders or
to treat shock and severe ․․ I refuse albumin
burns. These preparations
may contain up to
25 percent albumin. Minute
amounts are used in the
formulation of many other
medicines, including some
—UP TO 3% OF PLASMA
Protein fractions that may
be used in some medicines
that fight viruses and
diseases, such as ․․ I accept
diphtheria, tetanus, viral immunoglobulins
hepatitis, and rabies. or
They may also be used to ․․ I refuse
guard against some medical immunoglobulins
conditions that threaten
the life of a developing
baby and to counteract
the effects of snake
or spider venom.
—LESS THAN 1% OF PLASMA
There are various
proteins that help blood
to clot in order to stop ․․ I accept
bleeding. Some are given blood-derived
to patients who tend to clotting factors
bleed easily. They are or
also used in medical ․․ I refuse
glues to seal wounds blood-derived
and to stop bleeding clotting factors
after surgery. One
combination of clotting
factors is known as
Note: Some clotting
factors are now made
from nonblood sources.
RED CELLS HEMOGLOBIN—33% OF RED CELLS
A protein that transports
oxygen throughout the body
and carbon dioxide to the ․․ I accept
lungs. Products being hemoglobin
developed from human or or
animal hemoglobin could be ․․ I refuse
used to treat patients with hemoglobin
acute anemia or massive
2% OF RED CELLS
An enzyme inhibitor
derived from hemoglobin
that is used to treat a ․․ I accept hemin
group of rare genetic or
blood disorders (known ․․ I refuse hemin
as porphyria) that affect
the digestive, nervous,
and circulatory systems.
WHITE CELLS INTERFERONS—A TINY
FRACTION OF WHITE CELLS
Proteins that fight
certain viral infections ․․ I accept
and cancers. Most blood-derived
interferons are not interferons
derived from blood. or
Some are made from ․․ I refuse
fractions of human blood-derived
white blood cells. interferons
PLATELETS At present, no fractions
from platelets are being
isolated for direct use
in medical treatment.
[Chart on page 6]
WORK SHEET 2
YOUR PERSONAL DECISION
PROCEDURES INVOLVING THE MEDICAL USE OF YOUR OWN BLOOD
*Note: The methods of applying each of these medical procedures vary from physician to physician. You should have your physician explain exactly what is involved in any proposed procedure to ensure that it is in harmony with Bible principles and with your own conscientious decisions.
NAME OF WHAT IT Choices You
TREATMENT ACCOMPLISHES Need to Make
(You might want to
speak to your
refusing any of
CELL SALVAGE Reduces blood loss.
Blood is recovered
during surgery from ․․ I accept
a wound or body cavity. ․․ I might accept*
It is washed or filtered ․․ I refuse
and then, perhaps in a
returned to the patient.
HEMODILUTION Reduces blood loss.
During surgery, blood is
diverted to bags and
replaced with a nonblood
volume expander. Thus ․․ I accept
the blood remaining in ․․ I might accept*
the patient during surgery ․․ I refuse
is diluted, containing
fewer red blood cells.
During or at the end of
surgery, the diverted
blood is returned to the
HEART-LUNG Maintains circulation.
MACHINE Blood is diverted to an
artificial heart-lung ․․ I accept
machine where it is ․․ I might accept*
oxygenated and directed ․․ I refuse
back into the patient.
DIALYSIS Functions as an organ.
In hemodialysis, blood
circulates through a ․․ I accept
machine that filters and ․․ I might accept*
cleans it before returning ․․ I refuse
it to the patient.
EPIDURAL BLOOD Stops spinal fluid leakage.
PATCH A small amount of the
patient’s own blood is
injected into the ․․ I accept
membrane surrounding the ․․ I might accept*
spinal cord. It is used to ․․ I refuse
seal a puncture site
that is leaking spinal
PLASMAPHERESIS Treats illness.
Blood is withdrawn and
filtered to remove plasma.
A plasma substitute is
added, and the blood is
returned to the patient. ․․ I accept
Some physicians may want ․․ I might accept*
to use plasma from another ․․ I refuse
person to replace that
from the patient’s blood.
If so, this option would
be unacceptable to a
LABELING OR Diagnoses or treats illness.
TAGGING Some blood is withdrawn,
mixed with medicine, and ․․ I accept
returned to the patient. ․․ I might accept*
The length of time one’s ․․ I refuse
blood is outside the body
PLATELET GEL; Seals wounds, reduces
(MEANING “MADE Some blood is withdrawn
FROM YOUR OWN and concentrated into
BLOOD”) a solution rich in
platelets and white cells. ․․ I accept
This solution is applied on ․․ I might accept*
surgical sites or wounds. ․․ I refuse
Note: In some formulations,
a clotting factor taken
from cow’s blood is used.