Posts by Lee Elder

And there in lies part of the WT's dilemma. Personally, I am more interested in ending the needless deaths than I am in punishing the WTS for changing a bad policy. There are many of us who have lost loved ones and family members to this policy. For me, the priority is sparing other families this senseless grief.

Lee

21

June 15th WT - AJWRB/Dr. Muramoto

by Lee Elder in

by now most have heard about or had opportunity to read the june 15, 2004 watchtower.

the article will be added to the ajwrb web site shortly.

lee elder .

Lee Elder

By now most have heard about or had opportunity to read the June 15, 2004 Watchtower. AJWRB's medical advisor, Dr. Osamu Muramoto, has written a response to this article which is posted below. The article will be added to the AJWRB web site shortly.

Lee Elder

AJWRB

The Watchtower Society redefines the guidelines for use of blood products Osamu Muramoto, M.D.

In the June 15th 2004 issue of the Watchtower, the Watchtower Bible and Tract Society featured two articles on the use of blood products by Jehovah's Witnesses. The first article is titled "Rightly value your gift of life" and reiterated the long-held tradition of the scriptural interpretation to support the religious doctrine to prohibit medical use of blood products. The second article is titled "Be guided by the living God", which details the rules regarding which blood product is "unacceptable" and which is "Christian to decide." This issue of the magazine also included the reprint of the previous landmark article published on June 15th 2000 titled "Questions from readers: Do Jehovah's Witnesses accept any minor fractions of blood?", confirming the then new policy permitting any fraction of the "primary component" of the blood. The circumstances under which this new policy was promulgated in 2000 clearly showed that it was the preparation for allowing Jehovah's Witnesses to receive full benefit from the newly developed hemoglobin-based blood substitutes.

While the two articles of June 2004 showed no substantial changes in the policy promulgated in June 2000, there are several interesting points which are worth discussing. First, the second article now depicts a new chart showing a clear horizontal line dividing the "unacceptable" and the "Christian to decide".

The latter category include fractions from red cells, from white cells, from platelets, and from plasma. While there is nothing new in this chart compared to the "Questions from readers" article of June 2000, this chart now explicitly indicates the "fractions of red cells" as an acceptable fraction. This is an important emphasis, because until recently there have been no "fractions of red cells" which can be used medically. With the emerging technology of hemoglobin-based blood substitute in late 1990's, the Watchtower Society quickly paved the wide road for Jehovah's Witnesses to receive this "minor" fraction of the red cells, which in reality comprise 97% of the red blood cells.

The other interesting point is the explanation for the refusal of the "primary component". After the lengthy biblical discussion and meticulous justification for refusing to "take in" blood for medical reasons, the article quickly concludes this:

The 2001 textbook Emergency Care under "Composition of the Blood," stated: "The blood is made up of several components: plasma, red and white blood cells, and platelets." Thus, in line with medical facts, Witnesses refuse transfusions of whole blood or of any of its four primary components. (page 22)

In essence, the article states that the reason for refusing "four primary components" is that it is "in line with medical facts" which is stated in "Emergency Care." While everybody agrees that there is no biblical reason to define the "four primary components" that must be refused, most readers would have expected that such a classification is based on well-established and sound "medical facts." Very interestingly, the book this article cites here is not an authoritative medical textbook. It is a textbook used by the students of the emergency medical technician courses. Why did the Watchtower Society not cite more authoritative medical textbook or scientific sources to base this critically important classification? The simple reason is that such a classification is not at all scientific, but it is simply a tradition in medicine. To use a parallel analogy, our food is traditionally classified into "major components" such as protein, carbohydrate, fat, minerals, etc. Is this classification the only classification considered as a medical fact? Of course not. This is only one of many ways to classify our food. We can also use such a classification as grains, meat, vegetable, fish, etc. This is another way to classify our food, which is equally valid. These classifications are just traditional and convenient tools to understand the various components of our food. Depending on the method of classification, what is considered "primary component" is different. The same is true for the classification of the blood components.

In case of the classification of the blood components, there are many different ways to classify. It is true that the classification that blood banks most frequently use is the four components this Watchtower article states. However, medical textbooks use many different classifications. Often times, the blood is separated into "two major components", red blood cells (45%) and plasma (55%), because other smaller components such as platelets are usually taken as a fraction from one of those major fractions. Another classification which is frequently used in textbooks of anatomy and physiology is based on chemical composition. With this classification, the major and primary components of the blood are water (80%), hemoglobin (15%), albumin (2-3%), and globulin (1-2%).

While the Watchtower Society adopted the classification of red cells, white cells, platelet, and plasma, as the "primary components" and specified those to be refused, what would happen if the Society adopted a different classification which is equally valid and "medical facts"? For example what would happen if the classification of hemoglobin, albumin, globulin as the primary components were adopted? This classification would have prohibited the use of hemoglobin-based blood substitutes and albumin as a plasma expander, which are now permitted to be used for Witnesses. What does this difference tell us?

It tells us that what is "unacceptable" in the Watchtower doctrine has nothing to do with the biblical doctrine cited in the article. It only depends on what classification of the blood components the Watchtower Society adopted among several different classifications available in medical literature. Under one classification of the components (red, white cells, platelets and plasma), the most of the currently available blood products in medical practice are in the category of "Christian to decide", or the matter of conscientious decision. This is because the current technology no longer uses those crude fractions in pharmaceutical products. On the other hand, under the other classification based on chemical components (hemoglobin, albumin, globulin, besides water), the most of the currently available products become unacceptable, because this classification is more consistent with the current biochemical technology for producing blood-based pharmaceutical products. Under this alternative classification, however, the use of platelets may be acceptable because it is not considered a primary or major component under this classification. In other words, if the Watchtower Society had adopted the chemical classification of the primary components of the blood, which is more consistent with the current biotechnology, hemoglobin, albumin, and globulin, are all prohibited, but platelets and perhaps white blood cells may have been permitted.

Which classification of the blood components the Watchtower Society adopts makes such a huge difference in terms of what is acceptable and what is unacceptable, and thus who can survive and who must die from catastrophic blood loss. This difference has nothing to do with the biblical doctrine, or not even with the current medical science. It only hinges upon the Watchtower Society's decision which classification of the blood components they adopt. The cold reality of Jehovah's Witnesses is that their life-and-death decisions are after all not directly based on any of the biblical arguments these articles discuss, because such biblical doctrines have no relevance to the classification of the blood components. And it is this classification that determines all the "unacceptable" components and thus the life-and-death decisions. It is ironical that the rules promulgated in this article titled "Be guided by the living God" are simply guided by the human decisions and old tradition. Should they adopt an alternative classification, which is more in line with the current medical technology, life and death of Jehovah's Witnesses would have been totally different.

References Muramoto O. Bioethical aspects of the recent changes in the policy of refusal of blood by Jehovah's Witnesses. British Medical Journal 2001; 322: 37-39 [Full Text]

Muramoto O. Recent developments in medical care of Jehovah's Witnesses. Western Journal of Medicine 1999; 170: 297-301 [Full Text]

About the author

Dr. Muramoto is a staff neurologist, lead physician, and a member of the Regional Ethics Council, Kaiser Permanente Northwest Division, Portland, Oregon. His views and opinions are his own and do not reflect those of Kaiser Permanente and Northwest Permanente P.C.

22

"Passion of the Christ", another review

by MegaDude in

jw
friends

this film is intense.

as you've read by now, the film depicts the last 12 hours in jesus' life.

everything you've heard about the graphic violence of this film is true.

Lee Elder

Hmmm - it's a bit over the top in my view. A sad testament to man's inhumanity to man. The sad truth is that untold masses were brutally murdered as was Jesus of Nazareth. I am inclined to believe that the Romans were far more responsible for Jesus death than the Gospel accounts (and the movie) would lead us to believe. The layers of historical fact have become so intertwined with conjecture and hyperbole that is very difficult to sort exactly what happened and why. Secular Biblical scholars largely take a very different view of these events than the story we saw in this movie.

I was saddened to see children as young as eight years old at this movie. If nothing else, I would have to give credit to most JWs for not taking their children to see this film.

Lee

34

The Passion of the Christ (Movie)

by Golf in

jw
friends

after hearing the pro's and con's about the movie, i went to see it this afternoon.

i know we all have differing views, but i'm interested in knowing what impression it left you.

for me, i went in with a critical eye and i was emotionally detached from the movie.

Lee Elder

I have mixed feelings about seeing this film. I am disturbed by immense interest and "passion" the fundamentalists have whipped up over the film. I don't question the historicity of Jesus of Nazareth - he is one of my heroes - but I am personally more interested in the religion of Jesus than I am in the religion about Jesus.

Lee

38

Do You Still Have Boundaries or Are You Totally Liberated Now?

by minimus in

jw
friends

jehovah's witnesses must have boundaries to be confined in.

if they want to get out of "the box", they will find themselves out of the organization.

many jws feel that they need such boundaries or else they would be either be in jail or dead.

Lee Elder

I definitely have boundaries for myself. The interesting part was taking a few years to figure out where they were rather than simply accepting boundaries that had been defined by others for me as a JW.

Lee

10

Blood issue and discipline

by lurk in

.

i'm interested in hearing if any of you have been made to leave the wts or been discipline (sp!!

) as a result of blood transfusion.. there are lots of posts on blood that im trawling through .....but im in such a hurry as this is part of a question ive been asked by an interested party ....i fear i may miss what im looking for so would greatly appreciate your help on this .. would really appreaciate anyone who can say if this has happened to them.and briefly how.

Lee Elder

Here are three documented cases:

http://www.ajwrb.org/members/wayne.shtml

http://www.ajwrb.org/members/rado.shtml

http://www.ajwrb.org/members/hemming.shtml

9

Parents Refusing Life-Saving Blood Transfusions

by kitties_and_horses_oh_my! in

i'm in a speech class in college and would like to make full use of it to expose jw's as much as possible, but in a respectable manner that won't get me in trouble with the professor.

i've decided to speak on whether or not it's okay for parents to refuse life-saving medical treatment for their children.

i was interested in what particular arguments hold the most weight with you.

Lee Elder

Approximately 2/3 of all children raised as Jehovah's Witnesses leave the religion. It follows that of those children who die as a result of the refusal of life saving treatment, approximately 2/3 would have left the religion had they simply lived long enough. Their deaths were needless.

Take a look at the resources available at www.ajwrb.org

Best regards,

Lee

6

Jehovah?s Witnesses and Hemoglobin

by Lee Elder in

jw
friends

there remains a great deal of confusion regarding whether or not a jehovah?s witness may use hemoglobin.

this is understandable since hemoglobin is the only component of the prohibited red cell.

in fact, the red cell is nothing more than a tiny doughnut shaped bag of hemoglobin.. additionally, published comments from the watchtower society give strong indication that hemoglobin is prohibited.

Lee Elder

The article is over six months old so should be available on their web site. If you email me, I will forward the a pdf of the article to you:

[email protected]

Regards,

Lee

2

Jehovah's Witnesses and Hemoglobin

by Lee Elder in

jw
friends

jehovah?s witnesses and hemoglobin

there remains a great deal of confusion regarding whether or not a jehovah?s witness may use hemoglobin.

this is understandable since hemoglobin is the only component of the prohibited red cell.

Lee Elder

Jehovah?s Witnesses and Hemoglobin

There remains a great deal of confusion regarding whether or not a Jehovah?s Witness may use hemoglobin. This is understandable since hemoglobin is the only component of the prohibited red cell. In fact, the red cell is nothing more than a tiny doughnut shaped bag of hemoglobin.

Additionally, published comments from the Watchtower Society give strong indication that hemoglobin is prohibited. For example:

"Is it wrong to sustain life by administering a transfusion of blood or plasma or red cells or others of the component parts of the blood? Yes!...The prohibition includes "any blood at all." (Leviticus 3:17) - Blood, Medicine and the Law of God, 1961, pp. 13, 14

"?various tonics and tablets sold by druggists show on their labels that they contain blood fractions such as hemoglobin. So it is necessary for one to be alert? if they are to keep themselves ?without spot from the world.??Jas. 1:27." The Watchtower, 9/15/61, p. 557.

"Early in man?s history, our Creator ruled that humans should not eat blood. (Genesis 9:3, 4) He stated that blood represents life, which is a gift from him. Blood removed from a creature could be used only in sacrifice, such as on the altar. Otherwise, blood from a creature was to be poured on the ground, in a sense giving it back to God ...It would be right, of course, to avoid products that listed things such as blood, blood plasma, plasma, globin (or globulin) protein, or hemoglobin (or globin) iron." The Watchtower, 10/15/92 - Questions From Readers. (Italics added)

As recently as 1998 two officials from the Watchtower Society?s "Hospital Information Services" wrote that Jehovah's Witnesses "do not accept hemoglobin which is a major part of red blood cells.... Jehovah?s Witnesses do not accept a blood substitute which uses hemoglobin taken from a human or animal source."

Bailey R, Ariga T. The view of Jehovah's Witnesses on blood substitutes. Artif Cells Blood Substit Immobil Biotechnol 1998;26:571-576.

All of this changed, however, in June of 2000 when the Watchtower restructured its blood policy to permit the use of all blood products fractionated from red cells, white cells, platelets and plasma. However, the Watchtower continues to obfuscate its intentions regarding hemoglobin. Sadly, to this date there has been no official notification to the average member that hemoglobin is now permitted.

http://www.ajwrb.org/basics/change.shtml

Thinking persons might question why God would change his mind on such issues but Jehovah?s Witnesses are not permitted to seriously contemplate such matters without being identified as weak, doubters, even apostates. Some have been disfellowshipped and are shunned by their Jehovah?s Witness family members for questioning the policy and pointing out the irrational aspects.

The change on the use of hemoglobin is so dramatic that many Jehovah?s Witnesses, even 3 ½ years later, either don?t believe it or are unaware of the change. How can we assist them in understanding the Watchtower?s current policy?

We are providing two tools for you in this regard. The first is an article published by the New England Journal of Medicine and is presented below. It explains how Jehovah?s Witness elders agreed to the use of PolyHeme. (As a side point, this also demonstrates how the average Jehovah?s Witness really does not make informed, conscientious choices about their health care but rather simply follow instructions from Watchtower representatives about what they may or may not accept in the way of blood products).

The second tool we are providing you at this time is a photocopy of the diagram provided to Jehovah's Witness elders who are HLC members. This diagram clearly shows that hemoglobin is now permitted. You may view the document at:

http://www.ajwrb.org/images/hlc1.jpg

http://www.ajwrb.org/images/hlc2.jpg

We hope that you will be able to make use of this information to educate others regarding this important change in Watchtower policy. Hemoglobin solutions can save lives and their use among Jehovah?s Witnesses is likely to raise even more troubling questions for the Watchtower and its representatives.

An important question to consider is this: Since a red blood cell is 97% hemoglobin (by dry weight), is it reasonable to conclude that a Jehovah?s Witness who does not have access to PolyHeme or Hemopure should have to sacrifice their life simply because they only have access to red cells? Does God really condemn them as willfully wicked and worthy of eternal destruction because they chose to accept the other 3% (red cell membrane)? Where is any of this explained in the Bible? If a Jehovah?s Witness permits their child to die rather than accept this membrane material, is it logical that God accepts such an explanation?

We hope this information will be of some assistance to you as you endeavor to educate other Jehovah?s Witnesses and the medical professionals who provide their care.

Blood Substitute and Erythropoietin Therapy in a Severely Injured Jehovah?s Witness

To the Editor:

Since a 1945 church decision, Jehovah?s Witnesses have refused blood transfusions, even in cases of life-threatening hemorrhage. As a result, physicians need to be aware of alternative therapeutic options for Jehovah?s Witnesses.

A 44-year-old Jehovah?s Witness was injured in a motor vehicle collision. She sustained a temporal subarachnoid hemorrhage; an orbital tripod fracture; facial lacerations, which were closed urgently for hemostasis; bilateral pulmonary contusions; three rib fractures; and a grade 1 splenic laceration. She was hemodynamically stable, and the initial hemoglobin level was 11 g per deciliter. When the hemoglobin

level fell to 5.4 g per deciliter, the family and church elders agreed to the use of erythropoietin and PolyHeme, a polymerized hemoglobin-based blood substitute derived from outdated human red cells (Northfield Laboratories, Evanston, Ill.). 1 The patient?s own hemoglobin level fell to 3.2 g per deciliter three days after the injury (Fig. 1). A total of five PolyHeme units (500 ml per unit, containing 50 g of hemoglobin) were transfused. These transfusions maintained the plasma hemoglobin level at 6 g per deciliter

or higher. Erythropoietin (600 units per kilogram of body weight) was administered 24 and 48 hours after the

injury, with 300 units per kilogram given on days 3, 4, and 5. Blood loss was diminished by hormonally suppressing the patient?s menstrual cycle and limiting phlebotomy with the use of pediatric-size tubes. The patient received enteral and intramuscular iron, supplemental ascorbic acid, and parenteral nutrition. She was discharged home, after surgical repair of her orbital fracture, on day 19 after the injury, with a hemoglobin level of 9.8 g per deciliter.

Few patients can survive a hemoglobin level of less than 5 g per deciliter without transfusion.

2,3 Blood substitutes are an attractive alternative to standard blood transfusion for Jehovah?s Witnesses. 1,4,5 Blood substitutes provide adequate oxygen-carrying capacity and can act as a bridge until bone marrow production compensates for the loss of red cells. Exogenous erythropoietin stimulates red-cell production. Al-

though the optimal dose of erythropoietin in a critically ill patient remains to be established, our empirically chosen high dose was associated with a rapid response. Combination therapy with erythropoietin and PolyHeme may be particularly useful in the case of a critically ill Jehovah?s Witness.

C

LAY C OTHREN , M.D.

E

RNEST E. M OORE , M.D.

P

ATRICK J. O FFNER , M.D.

J

AMES B. H AENEL , R.R.T.

J

EFFREY L. J OHNSON , M.D.

Denver Health Medical Center

Denver, CO 80204

[email protected]

1.

Gould SA, Moore EE, Hoyt DB, et al. The first randomized trial of human polymerized hemoglobin as a blood substitute in acute trauma and emergent surgery. J Am Coll Surg 1998;187:113-22.

2.

Brimacombe J, Skippen P, Talbutt P. Acute anemia to a haemoglobin of 4 g.l-1 with survival. Anesth Intensive Care 1991;19:581-3.

3.

Kale PB, Sklar GE, Wesolowicz LA, DiLisio RE. Fluosol: therapeutic failure in severe anemia. Ann Pharmacother 1993;27:1452-4.

4.

Gould S, Sehgal L, Sehgal H, Toyooka E, Moss G. Clinical experience with human polymerized hemoglobin. Transfusion 1993;33:Suppl:60S. abstract.

5.

Johnson JL, Moore EE, Offner PJ, Haenel JB, Hides GA, Tamura DY. Resuscitation of the injured patient with polymerized stroma-free hemoglobin does not produce systemic or pulmonary hypertension. Am J Surg 1998;176:612-7.

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