Jehovah’s Witness Patient

More than 8 million members worldwide

Headquarters in Brooklyn, New York; new world headquarters under construction in Warwick, New York

Possible morbidity and/or mortality from massive hemorrhage secondary to religious dogma banning members from accepting blood transfusions.

Appropriate blood conservation measures (i.e., autologous blood salvage, normovolemic hemodilution, reduction of intraoperative and iatrogenic blood loss) in pts who do not accept autologous blood transfusions results in similar or better outcomes compared with the population that does receive autologous blood transfusion.

Understanding the rights and desires of pt versus duty of physician in regard to blood or blood product administration.

Trauma and emergency situations in which little time is available to discuss blood product transfusion.

Competent adults are those who know the nature and consequences of their actions and such adults have the right to refuse specific therapies.

Parens patriae (“parent of the nation”) refers to the public policy power of the state and represents the duty and interest of the state to preserve the health of minors. Medicolegally, when a child’s right to live and parental religious beliefs collide, the courts have consistently ruled that the child’s welfare is paramount.

Began as Bible study group in 1869 and adopted the name Jehovah’s Witnesses (based on Isaiah 43:10–12) in 1931.

Strict interpretation and adherence to Biblical passages, which forbid eating of blood. This is interpreted as prohibition of acceptance of blood products to sustain life because this may compromise their soul.

Other medical restrictions were established over time, such as prohibition of organ transplants in 1967. However, vaccinations are deemed acceptable.

In 1942 the Watchtower Society, the governing body of Jehovah’s Witnesses, introduced the blood ban, which forbids members from accepting allogeneic blood products, including whole blood, RBCs, WBCs, platelets, and plasma.

There is variability among members to the interpretation of the prohibition regarding blood. Jehovah’s Witnesses may consider the use of one’s own blood in the course of a medical procedure or therapy provided there is no advanced storage. They may accept fractions of plasma, such as albumin, rHuEpo, immunoglobulin, or factor concentrates.