[21] The following medical procedures are prohibited: The following procedures and products are not prohibited and are left to the decision of individual members:[23] Many physicians have expressed a willingness to respect patients' preferences and provide bloodless treatment[27][need quotation to verify] and about 200 hospitals offer bloodless medicine and surgery programs for patients who wish to avoid or limit blood transfusions.
[28] A 2012 study in JAMA Internal Medicine concluded that "Witnesses do not appear to be at increased risk for surgical complications or long-term mortality when comparisons are properly made by transfusion status.
Thus, current extreme blood management strategies do not appear to place patients at heightened risk for reduced long-term survival."
[30][31] The Watch Tower Society states that in medical emergencies where blood transfusions seem to be the only available way to save a life, Jehovah's Witnesses request that doctors provide the best alternative care possible under the circumstances with respect for their personal conviction.
[37] In 1988, the Watch Tower Society formed Hospital Information Services, a department to help locate doctors or surgical teams who are willing to perform medical procedures on Witnesses without blood transfusions.
[43] Annually since 2004, Jehovah's Witnesses in the United States have been informed that "with your consent, the law allows for the elders to learn of your admission [to hospital] and provide spiritual encouragement",[44] but that "elders serving on a Patient Visitation Group [could] have access to your name" only if patients made their wishes known according to the Health Insurance Portability and Accountability Act (HIPAA).
[45] Jehovah's Witnesses' branch offices communicate directly with congregations regarding "ways to benefit from the activities of the Hospital Liaison Committee (HLC) and the Patient Visitation Group (PVG).
[48][49] Since the elaboration of the blood doctrine to the point of prohibiting transfusion, the majority of Jehovah's Witnesses have adopted the organization's position.
[53] In 1958, The Watchtower reported on a particular member of Jehovah's Witnesses who voluntarily accepted blood transfusion, contrary to Watch Tower Society doctrine.
However, the study also showed that seven respondents were willing to accept plasma transplants and one member an autotransfusion, both therapies forbidden by Jehovah's Witnesses' doctrine.
[57] Another peer-reviewed study examining medical records indicated a similar percentage of Jehovah's Witnesses willing to accept blood transfusions for their children.
[58] Regarding Jehovah's Witnesses' acceptance of the organization's official position on blood, Drs Cynthia Gyamfi and Richard Berkowitz state, "It is naïve to assume that all people in any religious group share the exact same beliefs, regardless of doctrine.
After the Watch Tower Society established the doctrine, teaching that blood should not be eaten (c. 1927–1931), Margaret Buber, who was never a member of the denomination, offered a firsthand eyewitness account of Jehovah's Witnesses in the Nazi Ravensbrück concentration camp.
[67] In 1940, Consolation magazine reported on a woman who accidentally shot herself with a revolver in her heart and survived a major surgical procedure during which an attending physician donated a quart of his own blood for transfusion.
[68] In 1944, with the Watch Tower Society under the administration of president Nathan Homer Knorr, The Watchtower asserted that the decrees contained in Genesis 9:4 and Leviticus 17:10–14 forbade the eating or drinking of blood in biblical times "whether by transfusion or by the mouth" and that this applied "in a spiritual way to the consecrated persons of good-will today, otherwise known as 'Jonadabs' of the Lord's 'other sheep'.
[76] In November of the same year, the doctrine was modified to allow individual members to decide whether they could conscientiously accept fractions used from blood for purposes such as vaccination.
[77] This position has been expanded on since; the pre-formatted Durable Power of Attorney form provided by the Watch Tower Society includes an option for Jehovah's Witnesses to "accept all fractions derived from any primary component of blood.
"[78] In 1964, Jehovah's Witnesses were prohibited from obtaining transfusions for pets, from using fertilizer containing blood, and were even advised (if their conscience troubled them) to write to dog food manufacturers to verify that their products were blood-free.
The Watch Tower Society then rescinded the revised document, stating, "After further review, it has been determined that the cards dated "md-E 6/01" and "ic-E 6/01" should not be used.
[89][90][9] Dissident Witnesses say the Society's use of Leviticus 17:12 to support its opposition to blood transfusions[91][92] conflicts with its own teachings that Christians are not under the Mosaic law.
He cites other authors who support his view that the direction in Acts 15 to abstain from blood was intended not as an everlasting covenant but a means of maintaining a peaceful relationship between Jewish and Gentile Christians.
[96] Osamu Muramoto has argued that the refusal by Jehovah's Witnesses of "life-saving" blood treatment[9] creates serious bio-medical ethical issues.
It noted: "On the contrary, it appears that many Jehovah's Witnesses have made a deliberate choice to refuse blood transfusions in advance, free from time constraints of an emergency situation."
Case reports reveal JW patients have changed their earlier decision to accept blood treatment after a visit from the elders."
[90] HLC representative David Malyon has responded that Muramoto's suggested questions are an affront to coerce Jehovah's Witnesses with a "complicated philosophical inquisition" and, if used by doctors, would be "an abusive transformation of the medical role of succour and care into that of devil's advocate and trickster".
[103] Douglas E. Cowan, an academic in the sociology of religion, has claimed that members of the Christian countercult movement who criticize the Watch Tower Society make selective use of information themselves.
For example, Christian apologist Richard Abanes wrote that their ban on blood transfusions "has led to countless Witness deaths over the years, including many children.
Cowan wrote that "the reader is left with the impression that the Watchtower Society knowingly presides over a substantial number of preventable deaths each year.
[100] Muramoto has described as peculiar and inconsistent the Watch Tower policy of acceptance of all the individual components of blood plasma as long as they are not taken at the same time.
[89] He says the Society offers no biblical explanation for differentiating between prohibited treatments and those considered a "matter of conscience", explaining the distinction is based entirely on arbitrary decisions of the Governing Body, to which Witnesses must adhere strictly on the premise of them being Bible-based truth.