here is some info from freeminds
http://www.freeminds.org/doctrine/medicine/jehovahs-witness-accept-blood-–-a-little-known-fact.html
Consent and the Jehovah’s Witness
Consent must be freely given, and not coerced. In every life threatening situation there is thought of the afterlife. The thought of hell fire or pearly gates is clearly not coercion. Coercion refers to the consequences that would happen in the present life. Jehovah’s Witnesses carry a blood card and some even have a detailed blood directive which goes through their choices of blood treatments. The signing of the cards is a yearly event done at an open church meeting officiated by an elder with other Jehovah’s Witnesses in the room. Jehovah’s Witnesses, especially those who are elderly or have no other family members in the religion, are encouraged to sign an extra copy for the elders to keep and to give an elder a healthcare power of attorney. Refusal to sign a blood card has consequences. The consequence is disfellowshipping from the religion and shunning by all followers as a marked “apostate.” Disfellowshipping happens when a follower willingly and unrepentantly accepts a blood transfusion for himself or for a family member (including a child). However, no sin is committed if a court of government authority requires the transfusion. Then, the follower’s hands are clean. I oftentimes hear from doctors that a parent “seemed relieved” when the doctor threatened to obtain a judge’s order to administer blood to the child. If a patient accepts a blood transfusion in a deathbed circumstance, he has automatically “disassociated” himself from the church. This change was made because Bulgaria’s government demanded that there be no disfellowshipping for accepting blood.
http://www.ajwrb.org/basics/perjury.shtml. The truth is that a disassociated person is also shunned, and will only be allowed back into the church if he repents. If he agrees with his decision to take blood (i.e. would do it all over again), he is then disfellowshipped. Either disassociated or disfellowshiped, he is shunned by other Jehovah’s Witnesses. Jehovah’s Witnesses strictly shun the disfellowshipped and disassociated. Shunning means loss of family relationships and contact, loss of friends, and sometimes, loss of employment. Jehovah’s Witnesses can be disfellowshipped for not following the shunning rules. Parents are to shun adult children. No contact other than legal matters, no opening mail, no phone calls, no money sent, no participating in the child’s wedding or birth of grandchildren, nothing. Parents of minor children are to provide for the apostate child, but it is expected that all ties will cease upon reaching 18 years old. All other relatives are free to shun the minor child. Spouses are to not have any spiritual conversations with apostate spouses, and the church gives an understanding nod if the two decide to divorce. Children of apostate parents have very strained relations with their sinful parents and are encouraged to write the parent letters pleading for the parent to rejoin Jehovah’s Organization. Doctors and hospitals need to know that Jehovah’s Witnesses are highly encouraged to report on other Jehovah’s Witnesses who break a medical tenant. Jehovah’s Witnesses will do this to attain status with both Jehovah and with peers. They will tattle-tail even if it breaks medical or legal confidentiality laws. The Watchtower article, “A Time to Speak-When?” illustrates how Jehovah's Witness followers, including lawyers and doctors, are told that Jehovah's law is supreme over man's confidentiality rules. This theme is repeated throughout Watchtower literature.
http://www.jwfiles.com/report-members.htm I can not emphasize enough the importance of protecting patient’s medical records and putting those records on a “need to know” basis. Medical records need to be protected, as any Jehovah’s Witness who can get access (including even a Janitor) may try to peek at the patient’s records. Hospitals and doctors will often see a deluge of visitors to the patient’s bedside, including a Hospital Liaison Committee Elder. Even if the visitors are banned from the room, they are often lurking outside in the hallways and other public places near the patient’s room. This is oftentimes an attempt to make sure there is no blood going into the room. I have heard countless stories from doctors that a Jehovah’s Witness will accept blood if there are no other Jehovah’s Witnesses in the hospital room or outside.
I can not emphasize enough the need to discuss the blood issue with the patient while he is alone and to assure the patient of his confidentiality.
This will help ensure the patient is making an autonomous decision. A sick follower has a lot to think about, much more than the afterlife. He is under extreme pressure to not accept a blood transfusion. This pressure starts with the signing of his blood card. If he accepts blood to save his life, he will likely lose his family life, his friends, and his job (if Witness operated). The patient knows that other Jehovah’s Witnesses will report, even if they are under a confidentiality oath, if blood is taken. He knows the consequences in this life if he is caught.
Recommendations For Treating a Jehovah's Witness
I believe that adult Jehovah’s Witnesses can not give informed consent without information from their treating medical team. I recommend doctors consider the following: Talk in complete privacy with the Jehovah’s Witness patient. Ensure the patient you will use bloodless and blood conservation and, if agreed, any Watchtower permitted blood fractions and blood therapies. Discuss the actual risks of blood transfusions and abstaining from blood or bloodless surgery. Address both the patient’s fears and expectations. Give concrete facts as much as possible. (i.e. a “1 in 3,000,000” chance of getting AIDS verses a “1 in 3” chance of dying or organ failure). Test the patient’s conviction of his medical knowledge. Ask him if he can explain:
The difference between Watchtower allowed “current therapy” verses autologous or whole blood transfusions.
The Watchtower allowance of all blood fractions including hemoglobin, albumin, clotting factors, immunoglobulins. Explain that each of these fractions can be made from thousands of units of whole blood, and if added together, would equal a whole unit of blood.
The Watchtower’s changing blood doctrine. See http://www.ajwrb.org/watchtower/data1.shtml
The Watchtower’s changing doctrine on vaccinations and organ transplants. See http://www.ajwrb.org/watchtower/quotes.shtml
Why he’s willing to die for a belief that the Watchtower might change tomorrow.
If asked by patient, agree to speak with the minister on blood with the patient present. Ask the minister the same questions as above. He will have no meaningful response and this may help the patient to further think his position. Assure the patient that strict confidentiality of their medical records will be observed. Brief all treating medical staff and set up records on “need to know” basis to keep non-treating medical staff out of records. Offer to give blood in the operating room or secluded location; away from family, friends, and Watchtower Hospital Liaison Elders. Before leaving the operating room, disconnect all blood administering equipment from the patient. In briefing family and friends, be careful to not mention blood or blood products administered. I believe that medical doctors should be the chief decision maker on whether children, teenagers, and people with reduced decision making ability need a blood transfusion. The minor patient may need to be sedated, as he has been taught from an early age to pull out the blood transfusion lines and physically resist with all strength the blood transfusion. The parent should not be present when the blood transfusions are administered, as the parent may try to remove the lines and cause the child mental anguish. Both the child and parents need to be informed of the danger to the child from such actions. The doctors should question the parents with the above questions to ascertain their conviction. In court, the child should be represented by State appointed, independent, non-Watchtower attorney. The Watchtower Society should stop ousting and shunning followers who willingly agree to have a blood transfusion. Only if given free will, can any person make a true attestation to his faith. Further, the Watchtower Society needs to apologize and correct the misquotes in its medical literature. The Watchtower Society needs to provide an honest argument to its followers, and not base their beliefs on trickery and illogic. The Watchtower Society needs to explain to its followers the vast allowance of blood fractions and their relation to whole blood as a unit. The Watchtower Society needs to explain to its followers the difference, if any, between “current therapy” and autologous blood storage. In short, the Watchtower needs to stop its own hypocrisy.
