Two Questions—Plasma and Serum

by Marvin Shilmer 20 Replies latest jw friends

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  wasblind

  "Straining the gnat from the soup while swallowing the camel somehow comes to mind "

  JWoods, i get a kick out of your posts
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  TD

  Hi Marvin,

  I see were you're going with this now. I don't think they meant to say that serum was forbidden. My impression is that they've been inaccurate and sloppy with their terminology.
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  Marvin Shilmer

  TD,

  Thanks for your comments. Now the big question: If your conclusion is true then how do we prove it true based on Watchtower’s published statements?

  That is, if Watchtower doctrine does not forbid serum then how is this proven true in the face of Watchtower’s explicit statement in year 2000 and repeated in year 2004[1]?

  Marvin Shilmer

  _____________

  References:

  1. “Today, most transfusions are not of whole blood but of one of its primary components: (1) red cells; (2) white cells; (3) platelets; (4) plasma (serum), the fluid part. Depending on the condition of the patient, physicians might prescribe red cells, white cells, platelets, or plasma. Transfusing these major components allows a single unit of blood to be divided among more patients. Jehovah’s Witnesses hold that accepting whole blood or any of those four primary components violates God’s law.”—(Watchtower, June 15, 2004 pp. 29-30)
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  Scully

  Marvin

  I believe it was in that very same QFR where the WTS declared that fractions were a Conscience Matter™, particularly with regard to Anti-D (RhoGam or WinRho) and clotting factors.

  Is that statement a mistaken notion, a deliberate attempt to mislead, or is it saying that both serum and plasma are forbidden?

  I somehow doubt that it is a mistaken notion, they must have at least one physician on staff who could act as a consultant on these matters. Is it a deliberate attempt to mislead? I also doubt that, given the overall limited understanding of medical terms among JWs. Giving them the benefit of the doubt, I would speculate that it is an attempt to "simplify" the material, i.e., Here are the four components from which you must abstain: red cells, white cells, platelets and plasma. I am just guessing here, but I think the comparison to the production of blood sausage indicates an attempt to mislead, because they apparently have no idea how blood sausage is made (as do most JWs) and therefore present the analogy in the most repulsive manner possible.

  The context of the article goes on to explain how sera are derived and clearly indicates that some JWs understand the scripture in Acts 15:28, 29 to mean that they should abstain from all blood products, while other JWs feel that their conscience does not forbid them from taking "tiny" fractions of a donor's blood such as immune globulins which are not "life-sustaining" (the "tiny" aspect goes back to my previous comment regarding the WTS's beloved metaphor relating blood transfusions to sexual violations).

  Questions from Readers

  • Do Jehovah’s Witnesses accept injections of a blood fraction, such as immune globulin or albumin?

  Some do, believing that the Scriptures do not clearly rule out accepting an injection of a small fraction, or component, taken from blood.

  The Creator first laid upon all mankind the obligation to avoid taking in blood: "Every moving animal that is alive may serve as food for you . . . Only flesh with its soul—its blood—you must not eat." (Genesis 9:3, 4) Blood was sacred and so could be used only in sacrifice. If not used in that way, it was to be disposed of on the ground.—Leviticus 17:13, 14; Deuteronomy 12:15, 16.

  This was no mere temporary restriction for Jews. The need to abstain from blood was restated for Christians. (Acts 21:25) Around them in the Roman Empire, God’s law was commonly broken, since people ate food made with blood. It was also broken for "medical" reasons; Tertullian reports that some men took in blood thinking that it could cure epilepsy. ‘They quaffed with greedy thirst the blood of criminals slain in the arena.’ He added: "Blush for your vile ways before the Christians, who have not even the blood of animals at their meals." Jehovah’s Witnesses today are just as determined not to violate God’s law, no matter how common it is for others to eat food made with blood. In the 1940’s, blood transfusions came into widespread use, and the Witnesses saw that obeying God required that they also avoid blood transfusions, even if doctors urged these.

  At first, most transfusions were of whole blood. Later, researchers began to separate blood into its primary components, for doctors concluded that a certain patient might not need all major parts of blood. If they gave him only one component, it would be less risky for him, and the doctors could get more use out of the blood available.

  Human blood can be separated into dark cellular material and a yellowish fluid (plasma, or serum). The cellular part (45 percent by volume) is made up of what are commonly called red cells, white cells, and platelets. The other 55 percent is the plasma. This is 90 percent water, but it carries small amounts of many proteins, hormones, salts, and enzymes. Today, much of the donated blood is separated into the primary components. One patient may be given a transfusion of plasma (perhaps FFP, fresh frozen plasma) to treat shock. But an anemic patient might be given packed red cells, that is, red cells that had been stored and then put in a fluid and transfused. Platelets and white cells are also transfused but less commonly.

  In Bible times men had not devised such techniques for using these components. God simply commanded: ‘Abstain from blood.’ (Acts 15:28, 29) But why should anyone think that it would make a difference whether the blood was whole or had been separated into these components? Though some men drank blood, Christians refused even if it meant death. Do you think that they would have responded differently if someone had collected blood, allowed it to separate, and then offered them just the plasma or just the clotted part, perhaps in blood sausage? No, indeed! Hence, Jehovah’s Witnesses do not accept transfusions of whole blood or of its primary components (red cells, white cells, platelets, or plasma) used to accomplish a similar purpose.

  As the question suggests, though, scientists have learned about specialized blood fractions and how to employ such. A common issue involves the plasma proteins—globulins, albumin, and fibrinogen. Likely, the most widespread therapeutic use of such is injecting immune globulin. Why is that done?

  Your body can produce antibodies against certain diseases, giving you active immunity. This is the basis for advance inoculation with a vaccine (toxoid) against polio, mumps, rubella (measles), diphtheria-tetanus-pertussis, and typhoid fever. However, if someone has recently been exposed to certain serious diseases, physicians may recommend an injection of a serum (antitoxin) to give him immediate passive immunity. Until recently such injections have been made by extracting immune globulin, which contains antibodies, from a person already immune. The passive immunity gained from the injection is not permanent, for the injected antibodies pass out of his system in time.

  In view of the command to ‘abstain from blood,’ some Christians have felt that they should not accept an immune globulin (protein) injection, even though it was only a blood fraction. Their stand is clear and simple—no blood component in any form or amount.

  Others have felt that a serum (antitoxin), such as immune globulin, containing only a tiny fraction of a donor’s blood plasma and used to bolster their defense against disease, is not the same as a life-sustaining blood transfusion. So their consciences may not forbid them to take immune globulin or similar fractions. They may conclude that for them the decision will rest primarily on whether they are willing to accept any health risks involved in an injection made from others’ blood.

  It is significant that the blood system of a pregnant woman is separate from that of the fetus in her womb; their blood types are often different. The mother does not pass her blood into the fetus. Formed elements (cells) from the mother’s blood do not cross the placental barrier into the fetus’ blood, nor does the plasma as such. In fact, if by some injury the mother’s and the fetus’ blood mingle, health problems can later develop (Rh or ABO incompatibility). However, some substances from the plasma cross into the fetus’ circulation. Do plasma proteins, such as immune globulin and albumin? Yes, some do.

  A pregnant woman has an active mechanism by which some immune globulin moves from the mother’s blood to the fetus’. Because this natural movement of antibodies into the fetus occurs in all pregnancies, babies are born with a degree of normal protective immunity to certain infections.

  It is similar with albumin, which doctors may prescribe as a treatment for shock or certain other conditions. Researchers have proved that albumin from the plasma is also transported, though less efficiently, across the placenta from a mother into her fetus.

  That some protein fractions from the plasma do move naturally into the blood system of another individual (the fetus) may be another consideration when a Christian is deciding whether he will accept immune globulin, albumin, or similar injections of plasma fractions. One person may feel that he in good conscience can; another may conclude that he cannot. Each must resolve the matter personally before God.[Footnotes]

  With recombinant DNA, or genetic-engineering, techniques, scientists are developing similar products that are not made from blood.

  One example is Rh immune globulin, which doctors may recommend when there is Rh incompatibility between a woman and her fetus. Another is Factor VIII, which is given to hemophiliacs.

  Evidence shows that nonblood volume replacement fluids (such as hetastarch [HES]) can be used effectively to treat shock and other conditions for which an albumin solution might have been used previously.
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  Marvin Shilmer

  TD,

  Perhaps this helps answer my question:

  “The injection of antibodies into the blood in a vehicle of blood serum or the use of blood fractions to create such antibodies is not the same as taking blood, either by mouth or by transfusion, as a nutrient to build up the body’s vital forces.”—(Watchtower, Sept. 15, 1958 p. 575)

  This Watchtower statement does not speak of “a serum” but rather it speaks to serum as a component of blood. But we still have the 2000 and 2004 statements.

  Marvin Shilmer
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  Marvin Shilmer

  Scully,

  Thanks for your observations and comments.

  If you are correct then how do we prove your conclusion true based purely on Watchtower’s published statements?

  Marvin Shilmer
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  Scully

  Marvin,

  I think the WTS's focus on the "life sustaining" (playing on the food = sustenance, therefore blood = sustenance analogy) aspect of a blood component / fraction is the qualifier in deciding which treatments are forbidden and which are Conscience Matters™.

  All of the major components - the ones that would most likely be transfused in a life-threatening (non-life-sustaining) emergency - are prohibited. A JW, therefore, must be prepared to face death if he or she is to please Jehovah. Someone who has lost enormous volumes of blood in an accident must refuse transfusions of red blood cells. A woman whose pregnancy induced hypertension has spiralled into HELLP Syndrome and DIC cannot survive without massive infusions of platelets.

  The fractions are things that enable people to improve their quality of life, but are not necessarily life sustaining, in and of themselves. A haemophiliac does not require injections of clotting factor to sustain their life, but those injections do improve their quality of life. A woman with Rh-negative blood does not require injections of RhoGam or WinRho to sustain her life, but it improves the quality of life for her fetus/newborn child and any subsequent children she delivers. Children who receive routine vaccinations do not require the passive immunity that they gain from the vaccines - they could very well develop active immunity by contracting the disease itself. However, the vaccine improves the child's quality of life by way of preventing a potentially life-threatening case of measles, mumps, chicken pox, diptheria, polio, meningitis, etc.
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  TD

  Thanks for your comments. Now the big question: If your conclusion is true then how do we prove it true based on Watchtower’s published statements?

  If you follow the rule that newer publications always supersede older ones, I don't think the idea can be proven. Intentionally or unintentionally, I think they've set up a contradiction.

  I think part of the problem is the term, "serum" can have a specific technical meaning, but it can also be a loose reference to any circulatory compound in an aqueous suspension. "Serum cholesterol", "Serum magnesium" and "Maternal serum alpha fetoprotein" are common examples. Sometimes it seems clear how the term is being used in JW literature and other times, it's not clear at all.
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  Marvin Shilmer

  TD and Scully,

  Regarding our subject, take a look at the following presentation found in a position paper published by Watchtower and distributed to healthcare providers via HLC members:

  “Blood Transfusion: Jehovah’s Witnesses believe that blood transfusion is prohibited by biblical passages such as: “Only flesh with its soul—its blood—you must not eat” (Genesis 9:3, 4); “[You] must in that cast pour its blood out and cover it with dust” (Leviticus 17:13, 14); and “Abstain… from fornication and from what is strangled and from blood.” (Acts 15:19, 20) While these verses are not stated in medical terms, Witnesses view them as ruling out transfusion of whole blood, red blood cells, white blood cells, platelets, and plasma. However, refusing a blood transfusion does not make Jehovah’s Witnesses antimedicine. There are many effective medical alternatives to blood transfusion. Moreover, the religious understanding of Jehovah’s Witnesses does not absolutely prohibit the use of blood fractions, such as clotting factors, interferons, and platelet-derived wound-healing factor.—See “Alternatives to Blood Transfusion,” “Immunoglobulins and Serums.”—(Jehovah’s Witnesses—Religions and Ethical Position on Medical Therapy, Child Care, and Related Matters, published by Watchtower, 2004 p. 2)

  “Immunoglobulins and Serums: The religious understanding of Jehovah’s Witnesses does not absolutely prohibit the use of blood fractions. Each Witness must decide whether he can accept immune globulins or serums made with a blood fraction.”—(Jehovah’s Witnesses—Religions and Ethical Position on Medical Therapy, Child Care, and Related Matters, published by Watchtower, 2004 p. 3)

  What do you make of this, if anything?

  Marvin Shilmer
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  Scully

  Marvin,

  I find the following quote to be quite interesting:

  While these verses are not stated in medical terms, Witnesses view them as ruling out transfusion of whole blood, red blood cells, white blood cells, platelets, and plasma.

  I find it absolutely mind-boggling that they claim "[Jehovah's] Witnesses view them [scriptures at Genesis 9:3, 4; Leviticus 17:13, 14 and Acts 15:19, 20] as ruling out transfusion of whole blood, red blood cells, white blood cells, platelets and plasma."

  Clearly without the WTS printing such instructions in its publications and requiring acceptance of these instructions to remain 'approved associates', Witnesses would not necessarily collectively come to that view. They aren't even permitted to independently study the Bible without WTS publications as guidance, unless they want to risk being identified as an Apostate™.

  Approved association with Jehovah’s Witnesses requires accepting the entire range of the true teachings of the Bible, including those Scriptural beliefs that are unique to Jehovah’s Witnesses. ~ Watchtower, April 1, 1986, p. 31.

  That, in itself, is extremely misleading.