How Do I View Blood Fractions and Medical Procedures Involving My Own Blood? [Translator: This question is intended to introduce this topic in a way that helps the reader to realize that he will have to make some decisions on what is acceptable to him. Please convey this idea in a natural way, if ne

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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; 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.a 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 bypass pump? Have I prayerfully considered this matter before making a decision?b

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 determine, in advance, what you will do if faced with a sudden and unexpected decision regarding medical treatment.

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.

[Footnotes]

a Helpful information on this subject is found in the June 15, 2004, issue of The Watchtower, pages 29-31.

b Helpful information on this subject can be found in the October 15, 2000, issue of The Watchtower, pages 30-1, and the Transfusion Alternative Strategies videos or DVD.

WORK SHEET 1

UNACCEPTABLE TO CHRISTIANS

YOUR PERSONAL DECISION

WHOLE BLOOD

FRACTIONS

Choices You 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 used in volume expanders to treat shock and severe burns. These preparations may contain up to 25 percent albumin. Minute amounts are used in the formulation of many other medicines, including some formulations of erythropoietin (EPO).

____ I accept albumin

____ I refuse albumin

IMMUNOGLOBULINS—UP TO 3% OF PLASMA

Protein fractions that may be used in some medicines that fight viruses and diseases, such as diphtheria, tetanus, viral hepatitis, and rabies. They may also be used to guard against some medical conditions that threaten the life of a developing baby and to counteract the effects of snake or spider venom.

____ I accept immunoglobulins

____ I refuse immunoglobulins

CLOTTING FACTORS—LESS THAN 1% OF PLASMA

There are various proteins that help blood to clot in order to stop bleeding. Some are given to patients who tend to bleed easily. They are also used in medical glues to seal wounds and to stop bleeding after surgery. One combination of clotting factors is known as cryoprecipitate. Note: Some clotting factors are now made from nonblood sources.

____ I accept blood-derived clotting factors

____ I refuse blood-derived clotting factors

RED CELLS

HEMOGLOBIN—33% OF RED CELLS

A protein that transports oxygen throughout the body and carbon dioxide to the lungs. Products being developed from human or animal hemoglobin could be used to treat patients with acute anemia or massive blood loss.

____ I accept hemoglobin

____ I refuse hemoglobin

HEMIN—LESS THAN 2% OF RED CELLS

An enzyme inhibitor derived from hemoglobin that is used to treat a group of rare genetic blood disorders (known as porphyria) that affect the digestive, nervous, and circulatory systems.

____ I accept hemin

____ I refuse hemin

WHITE CELLS

INTERFERONS—A TINY FRACTION OF WHITE CELLS

Proteins that fight certain viral infections and cancers. Most interferons are not derived from blood. Some are made from fractions of human white blood cells.

____ I accept blood-derived interferons

____ I refuse blood-derived interferons

PLATELETS

At present, no fractions from platelets are being isolated for direct use in medical treatment.

WORK SHEET 2

YOUR PERSONAL DECISION
PROCEDURES INVOLVING THE MEDICAL USE OF YOUR OWN BLOOD
NAME OF TREATMENT	WHAT IT ACCOMPLISHES	Choices You Need to Make (You might want to speak to your physician before accepting or refusing any of these procedures.)
CELL SALVAGE	Reduces blood loss. Blood is recovered during surgery from a wound or body cavity. It is washed or filtered and then, perhaps in a continuous process, returned to the patient.	____ I accept ____ I might acceptc ____ I refuse
HEMODILUTION	Reduces blood loss. During surgery, blood is diverted to bags and replaced with a nonblood volume expander. Thus the blood remaining in the patient during surgery is diluted, containing fewer red blood cells. During or at the end of surgery, the diverted blood is returned to the patient.	____ I accept ____ I might acceptd ____ I refuse
HEART-LUNG MACHINE	Maintains circulation. Blood is diverted to an artificial heart-lung machine where it is oxygenated and directed back into the patient.	____ I accept ____ I might accepte ____ I refuse
DIALYSIS	Functions as an organ. In hemodialysis, blood circulates through a machine that filters and cleans it before returning it to the patient.	____ I accept ____ I might acceptf ____ I refuse
EPIDURAL BLOOD PATCH	Stops spinal fluid leakage. A small amount of the patient’s own blood is injected into the membrane surrounding the spinal cord. It is used to seal a puncture site that is leaking spinal fluid.	____ I accept ____ I might acceptg ____ I refuse
PLASMAPHERESIS	Treats illness. Blood is withdrawn and filtered to remove plasma. A plasma substitute is added, and the blood is returned to the patient. Some physicians may want to use plasma from another person to replace that from the patient’s blood. If so, this option would be unacceptable to a Christian.	____ I accept ____ I might accepth ____ I refuse
LABELING OR TAGGING	Diagnoses or treats illness. Some blood is withdrawn, mixed with medicine, and returned to the patient. The length of time one’s blood is outside the body may vary.	____ I accept ____ I might accepti ____ I refuse
PLATELET GEL; AUTOLOGOUS (MEANING “MADE FROM YOUR OWN BLOOD”)	Seals wounds, reduces bleeding. Some blood is withdrawn and concentrated into a solution rich in platelets and white cells. This solution is applied on surgical sites or wounds. Note: In some formulations, a clotting factor taken from cow’s blood is used.	____ I accept ____ I might acceptj ____ I refuse

c d e f g h i j 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.