“I have never in my career counselled anyone so strongly about their risk of death,” Searle told the inquest. But Winchester would not receive blood. “I have had sleepless nights,” Searle said.
Winchester died four days after her initial operation, on September 27, 2019. The coronial findings into her care and medical treatment are yet to be finalised.
Former Witnesses recall being trained as children to refuse blood at all costs and to always carry a “no blood” card – a form of advanced medical care directive.
“As a nine-year-old child before having a small abdominal operation, I repeated to doctors what my parents had already told them – that I couldn’t have a blood transfusion,” Deborah said.
Hawes recalls carrying a card as a child and described being coached to refuse transfusions many times in twice-weekly congregation meetings.
“You’re in a small group setting talking about refusing blood because it’s what Jehovah wants,” she said. “There’s no option to ask questions.”
Hawes, who was regarded as a rising star of the church in her early teens and spoke at church conventions in front of thousands of people, started veering away from the Jehovah’s Witnesses because she felt it was sexist and oppressive.
“I’d learnt about first- and second-wave feminism at school,” she said. “I wasn’t just going to live out my life to serve men.”
Her parents wanted to home-school her and that was the catalyst for Hawes leaving. She was cast out and shunned by her family at 16.
“I remember walking to the street corner with my schoolbag on my back, going to the fish and chip shop and calling my friend’s mum. That was it. I worked lots of jobs, slept on couches, made my way through school. I have barely seen my family since.”
Shunning is a “weapon” that forces church members to conform, former members said. Interviewees described a consistent pattern of congregation members reporting any unorthodox behaviour to elders, and blood policy being policed by elders and the hospital liaison committees.
An elder serving on a hospital liaison committee, who spoke on the condition of anonymity, said the committee’s main role was providing emotional support to Jehovah’s Witnesses and talking with medical staff about the sect’s requirements.
“The aim is to give people information and ensure people know that there are alternatives to blood … We’re not there to spy on anyone, we aim to help.”
Former church elder John Viney served on hospital liaison committees for 15 years in Britain, which has the same church structure as Australia.
“I was a faithful and loyal JW through and through,” he said. “I saw my role as actually helping save lives of JW patients in providing information on how the medical situation could be handled to meet the patient’s viewpoint but also provide medical needs from a hospital standpoint.”
Viney’s view of the church soured after he was forced to shun his own daughters, and he now campaigns against the shunning of children.
“The shunning of people you love, completely avoiding them, is a killer as far as I am concerned. I always thought this and had trouble accepting it, but such was the cult mentality that not only did it happen to my family but as an elder, I disfellowshipped others … It’s a wicked cult control mechanism.”
The church’s spokesman said: “How each parent chooses to raise their own children is up to them and naturally many will choose to raise them in accordance with their own religious beliefs. When it comes to medical care, Witness parents seek out the best possible medical care for their children.”
It is unclear how many people may have died as a result of refusing transfusions in line with the sect’s blood policy. The Red Cross estimates one in three Australians require a blood transfusion at some point in their lives.
Since leaving the church, Sherrie D’Souza has helped run a support group, Recovering From Religion, which calls for watertight confidentiality around a patient’s medical decision-making, so church authorities cannot know if a person has agreed to a blood transfusion.
“The hospital liaison committees invade people’s privacy,” she said. “There aren’t any statistics to tell us how many people have died. Anecdotally, there are many.”
A global church whistleblower group based in the US, Advocates for Jehovah’s Witnesses for Reform on Blood, has attempted to estimate the death toll in which the refusal of blood transfusions was a major or contributing factor, basing its research on data about transfusions in the wider community. Reaching precise figures is not possible because of a lack of data due to patient privacy.
“The estimate of annual deaths in Australia would be between 10 and 18 assuming 68,000 members,” the group’s spokesman, who goes by the pseudonym Lee Elder, said.
“If we assume the ratio of members has been relatively the same with the average number of worldwide members over the past 62 years, we can extrapolate that somewhere between 632 and 1096 Australian Jehovah’s Witnesses have likely died prematurely as a result of following the Watchtower blood policy.”
The Jehovah’s Witnesses spokesman said the idea that the blood policy had led to any deaths was “completely unfounded” and said medical literature backs up the church’s view that patients have better outcomes when they avoid blood transfusions.
Many peer-reviewed studies suggest transfusions should only be used when essential, but no studies support the idea that they should be banned.
NSW Health said it “respects and upholds the wishes of any individual and will adhere to their choices regarding the administration of blood products”.
The department did not directly respond to questions about whether hospital liaison committees played a role in policing the medical care choices of church members, or what steps were taken in hospitals to make sure Jehovah’s Witness patients were not making decisions about medical care under duress.
“As established in Australian case law, all adult patients with capacity have the right to refuse any medical treatment, even in cases where that decision may lead to their death,” a NSW Health spokesperson said.
“Similar to a person giving consent to medical treatment, a refusal of treatment must be freely given, specific and informed.”
According to the elders’ handbook, if blood is administered to a patient, elders at the patient’s congregation are required to set up a committee to “determine the individual’s attitude”.
In a section of the handbook devoted to judging repentance after a member of the religion is deemed to have broken the rules, elders’ committees are given some guidelines.
“The committee must be convinced that the wrongdoer has a changed heart condition, that he has a zeal to right the wrong, and that he is absolutely determined to avoid it in the future,” the handbook says.
“Judging repentance is not simply a matter of determining whether the wrongdoer is weak or wicked. Weakness is not synonymous with repentance.”
