Dr. Muramoto's letter to Dr.'s on Blood Policy

One of the replies to Dr. Muramoto's letter in the British Medical Journal:

Marvin Shilmer, Elder Jehovah's Witness

I am one of Jehovah’s Witnesses (JW) and have read Dr. Muramoto’s article with much interest. Presently the Watchtower Bible and Tract Society (WTS) recognizes me as an active elder (pastor) in a congregation of Jehovah’s Witnesses.

Jehovah’s Witnesses desire to be loyal to God. Like most other people we are willing to die in defense of or loyalty to certain issues. As Christians we are willing to lay down our life in order to remain faithful to our Creator, Jehovah. This attribute is often played out in hospitals of the world by JWs as they demonstrate time and time again their willingness to die or let their children die rather than accept some sort of infusion of blood or of some portion of blood. Is this action justifiable under the pretext of loyalty to God? Without a doubt that is a question for every single parent among Jehovah’s Witnesses and it is one they must justify in absolute terms before deciding to let a child die over accepting or rejecting an infusion of blood or of some portion of blood. Aside from parents, in their own behalf each individual Jehovah’s Witnesses should have likewise performed the same mental process of absolute justification. What is the present state of that justification?

Intentionally or unintentionally Doctor Muramoto’s article highlights a critical flaw in the justification most often used by Jehovah’s Witnesses on this subject. Physicians acquainted with this topic are very familiar with the words "We [JWs] reject blood because the Bible says that Christians must abstain from blood." Those words are repeated time and again by many Witnesses because their conviction of rejecting blood stems from the Biblical tenet to "abstain from… blood." (Acts 15:28, 29) Within that simple tenet lay their perceived mental justification for facing death rather than accepting blood or portions of blood; the problem is: Intentionally JWs do not ENTIRELY abstain from blood! That discrepancy alone invalidates the perceived justification because it defies the invoked simplicity and implied encompassing nature of the tenet to "abstain from… blood." Do most JWs perceive this logical discrepancy—indeed a contradiction?

Sadly my experience is that most JWs do not understand the depth and breadth of the WTS’ actual official position regarding the use of donated blood for medical reasons. Among my fellow JWs and elders the fact that we do not entirely abstain from blood is rarely recognized as the critical contradiction that it represents. Yet physicians immediately realize the contradiction for what it is; a critical flaw in the mental task of justification. To test my assertion that most Witnesses are ignorant of this critical flaw, physicians can do something as inoffensive and simple as asking the patient "Do Jehovah’s Witnesses entirely abstain from blood?" I contend that at least 99% of JW patients will immediately answer, "Yes." Because physicians can read our official publication (The Watchtower) for themselves then they can readily know that an answer of "Yes" is incorrect, which completes the test of whether the mental justification process is accurate, complete and rational. If a JW patient THINKS that we entirely abstain from blood then they betray incomplete knowledge and therefore an incomplete process of justification. Certainly knowledge that JWs do not entirely abstain from blood is critical information when a JW patient is otherwise under an impression that our position is simple, strong and absolute and that it is based upon entirely abstaining. (And JWs must ask themselves, "If it is not based upon entirely abstaining then what is it based upon?")

Naturally physicians are careful about how far they push this issue with a patient. Because continued life depends upon more than just blood then no physician can guarantee survival based upon that one factor. That is, if a physician is asked, "Can you guarantee that I will live if I accept this blood?" he cannot do so. But the same could be said of food, oxygen, water, organs like hearts or lungs, or any other necessity of life. Life is dependent upon many necessities, but taking away only one of them causes death. For that reason, in indisputable cases a physician can do no more that guarantee that rejecting blood will cause death. Because physicians are well acquainted with life and death and because they understand the importance of respecting spiritual feelings in the process of living and dying, then they are careful not to unduly upset a patient’s state of spirituality because it can be such an important part of healthy living and healthy dying. For this reason a physician may not be too active in trying to rationalize with a patient that one of their long held spiritual justifications is critically flawed. But any reluctance on the part of a physician does not change that a critical flaw exists in the justification process, and certainly a physician’s acquiescence in no way is a justification in itself of a patient’s conviction.

Because Dr. Muramoto’s article highlights the fact that Jehovah’s Witnesses abstain from some portions of blood but do not abstain from other portions of blood then his comments highlight a critical flaw in the process of justification most often used by Jehovah’s Witnesses. Considering all that that WTS has written on the subject of blood and all the discussions held among JWs about this subject, why and how has this simple though critical flaw remained unaccounted for in the minds of most Witnesses? We can only speculate about an answer, but the fact remains that a burden rests upon those who teach, and it is the WTS that teaches JWs on the merits of this subject through the pages of The Watchtower journal, its main official publication. Therefore a high degree of responsibility rests upon our organization, the WTS, to answer the question posed about why and how such a critical flaw is left unaccounted for in the minds of so many JWs. (Why would/do so many answer "Yes" to the litmus test above?) Frankly, though sadly, language the WTS applies to our use of portions of blood is most often couched in terms that take away from the bald truth, that bald truth being that JWs do use blood that has been donated by others.

What bearing does this have for physicians on the subject of medical ethics? Since I am not a qualified physician I am not sure just how to answer that question. But a good question is, who has any responsibility to educate in plain language people holding death dealing convictions when their justification is lacking or incomplete? My untrained opinion is that physicians do not hold the most responsibility for providing that education but they do have some responsibility for providing it. At the very least physicians should be willing to ask JW patients the inoffensive and simple question, "Do Jehovah’s Witnesses entirely abstain from blood?" If the patient answers with a "Yes" then in my opinion that physician has a responsibility to the patient to explain that the WTS does not require that they entirely abstain from blood and that you can prove it if they want to see it. You can then do something as simple as showing them one of the latest WTS provided Durable Power of Attorney forms where it indicates the option of accepting applications and infusions of substances made from blood or portions of blood. Physicians should remind them that other people donated the blood necessary to make, have and apply those life saving substances. At least that action provides some clear and unambiguous thoughts for the JW patient to complete their personal process of justification on such an important subject.

On the other side of this subject is the WTS. Primarily that agency has the responsibility to better educate JWs about this subject so that the simple fact that JWs do not entirely abstain from blood is understood and can be accounted for in the justification process. The problem with that fact being highlighted in unambiguous terms is that it runs contrary to the seemingly simple idea that "we abstain from blood," and it makes people think more deeply about the very basis for the proposed justification for dying rather than accepting a particular portion of blood (or living by accepting a different portion of blood that is not prohibited by the WTS’ published position). I know that the British Medical Journal is not a platform for religious ideology, but the WTS would do well to address well-reasoned scriptural discussions of this subject, one of which can be found online at www.jwbloodreview.org < http://www.jwbloodreview.org>;. Many of my fellow JWs and elders have read the contents of such articles and realize the magnitude of what appears to be a terrible mistake on our part. If the WTS’ published views are right then no JW has anything to fear about facing up to such well written and reasoned material and either accepting it or refuting it, but we cannot just ignore it and be honest as Christians should be. We can only be honest by recognizing and responding to well reasoned information.

I thank Dr. Muramoto for taking time to write his article. Unlike another responder, I believe Dr. Muramoto must have some close contact with JWs to have so precisely represented the present state of affairs as accurately as he has. As a trained and appointed elder among JWs I can testify to the accuracy of his presentation. It is not highlighted in Dr. Muramoto’s article, but the record shows that the population of JWs did not universally agree with the WTS’ decision to have congregations of JWs begin imposing its "abstain from blood" policy back in 1961. The Watchtower journal admits that prior to that time individuals among Jehovah’s Witnesses were conscientiously accepting transfusions of blood. (See: Questions From Readers, The Watchtower of August 1, 1958, page 478) The same journal also admits that some individuals among the Witness population were, at the time, requesting that the practice of blood transfusion actually be sanctioned (authorized). (See: Letter, The Watchtower, May 1, 1950, page 143) What do those facts mean in terms of the question of autonomy and the Jehovah’s Witness patient? The presence of those admissions above says much about whether Witnesses agreed fully with the policy from the beginning.

Unfortunately I felt compelled to write this response using a pseudonym. I do not have the luxury of revealing my real name as have other JW responders to Dr. Muramoto’s article who have practically endorsed the WTS policy in full. If I did so then I would undoubtedly face some sort of tribunal for having openly presented the flaws I have above—and those flaws are just a few of many on the subject. At the very least my motives would be questioned and I would undoubtedly be stripped of any responsibilities as an elder—not that that is an important consequence. It is taught and understood that JWs can freely offer objections about a teaching directly and privately to the WTS. But, sadly, no matter how well reasoned a view or question, we are not permitted to discuss serious objections by openly insisting upon a resolution without the imminent risk of being labeled a troublemaker and probably ostracized and shunned as a result of that questioning on a sensitive issue. For this reason I expect that some of my fellow JWs will most likely question the veracity and genuineness of this response of mine. When the WTS reads this—and they will—I hope they come away with one thing, that I am interested in my brothers in faith and our individual and collective godly loyalty. Otherwise I would not work so hard as an elder in spite of the facts and views expressed above. Some of my peers at our world headquarters in Brooklyn, New York may even feel they know who I am. Please, I beg you, reconsider what we are doing on this subject.

Marvin Shilmer
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Edited by - waiting on 20 January 2001 20:52:47

Dr. Muramoto's letter to Dr.'s on Blood Policy

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