I've posted this a few times but what the heck, let's get it out again...
BLOOD
REFERENCES
(EA) The Encyclopaedia Americana (International Edition) Volume 4 1981
(NEB) The New Encyclopaedia Britannica 1998 Edition
(ECT) Encyclopaedia of Chemical Technology Volume 4 Fourth Edition 1992
(CE) Colliers Encyclopaedia Volume 4 1997 Edition
(EE) Everyman’s Encyclopaedia Volume 2 Sixth Edition 1978
(Publications listed above are available from the Reference Section of most libraries.)
From the HEALTH-CARE ADVANCE DIRECTIVE:
(2) I am one of Jehovah's Witnesses. On the basis of my firmly held religious convictions (see Acts 15:28,29) and on the basis of my desire to avoid the numerous hazards and complications of blood transfusions, I absolutely REFUSE allogenic blood (another persons blood); stored autologous blood (my own stored blood); the blood components red cells, white cells, platelets and blood plasma; and blood-derived haemoglobin preparations (human or animal) under any and all circumstances, no matter what the consequences. This refusal is not to be overridden by a purported consent of a spouse, relative or other person or body.
(3) With respect to minor blood fractions or blood products containing minor blood fractions, according to my conscience I ACCEPT: [Initial one of the three choices below.]
(a) NONE.
(b) ALL.
(c) SOME. That is, I ACCEPT: [initial choice(s) below]
Products that may have been processed with or contain small amounts of albumin (e.g., streptikonase, and some recombinant products [such as erythropoietin (EPO, epoetin-a) and synthesised clotting factors], and some radionuclide scan preparations may contain albumin).
Immunoglobulins (e.g., Rhesus immune globulin [Anti-D], gammaglobulin, horse serum, snake bite anti-venoms).
Clotting factors (e.g., fibrinogen, Factors VII, VIII, IX, XII).
Other:
White Cells (Leukocytes)
In the Awake! 22/10/1990 page 4 there is an illustration detailing 'The Main Components of Blood'.
White Cells are noted as making up only 1/10th of 1 percent (0.1) of the volume of blood*.
Why isn't this classed as a minor fraction?
Also, The Encyclopaedia Americana (International Edition, 1981) states,
"white blood cells are capable of moving about independently and are not merely carried by the bloodstream. They can also move out of the bloodstream".
The New Encyclopaedia Britannica (1998 Edition) states that,
"Most of the leukocytes are outside the circulation, and the few in the bloodstream are in transit from one site to another".
This means that if a brother accepts an organ transplant (which is permitted), he will receive into his body many times more white cells than if he had them as a transfusion (which is not permitted).
Consider also that fractions like albumin have been deemed a matter of conscience on the consideration that such pass naturally from mother to child in the womb. However leukocytes also pass naturally from mother to child during breastfeeding, particularly in the first few days when colostrum is produced. On this matter, La Leche League International state,
"Colostrum also contains high concentrations of leukocytes, protective white cells which can destroy disease-causing bacteria and viruses".
The highly respected British Medical Association in their Complete Family Health Encyclopaedia state on page 291 under the heading 'COLOSTRUM',
"It has a high content of lymphocytes (white blood cells) and immunoglobulins, which help protect the baby from infection".
Why then are white cells not approved of by the Society for transfusion?
Platelets (Thrombocytes)
Again, NEB states,
"The blood platelets are the smallest cells of the blood, averaging two to four micrometres in diameter. Although much more numerous (150,000 - 400,000 per cubic millimetre) than the white cells, they occupy a much smaller fraction of the volume of the blood because of their relatively minute size".
EA puts platelet size smaller still at just "1 to 2 microns in diameter".
Why then aren't platelets classed as a minor fractions?
In the Questions from Readers article in the 10/1/94 issue of The Watchtower, the question raised was,
"Would it be proper to accept a vaccination or some other medical injection containing albumin derived from human blood"?
The first line of the response was, "Frankly, each Christian must personally decide on this". (The article then discussed the matter in detail and made the following observation,) "Currently a small amount of albumin is also used in injections of the synthetic hormone EPO (erythropoietin). Some Witnesses have accepted injections of EPO because it can hasten red blood cell production and so may relieve a physician of the feeling that a blood transfusion might be needed".
Why then are platelets prohibited?
The New Encyclopaedia Brittanica states that,
"The effect of the platelet response is to stop the bleeding and to form the site of the developing blood clot, or thrombus. If platelets are absent, this important defense reaction cannot occur, and protracted bleeding from small wounds (prolonged bleeding time) results".
Surely efficient clotting and reduced bleeding time would 'relieve a physician of a feeling that a transfusion might be needed'.
Blood Plasma
The Awake! article mentioned above states that,
"Plasma [makes up] about 55 percent of the blood. It is 92 percent water; the rest is made up of complex proteins, such as globulins [includes immunoglobulins], fibrinogens, and albumin".
NEB agrees with this and fills in some of the details. It states,
"The liquid portion of the blood, the plasma, is a complex solution containing more than 90 percent water. The water of the plasma is freely exchangeable with that of body cells and other extra cellular fluids and is available to maintain the normal state of hydration of all tissues. The major solute of plasma is a heterogeneous group of proteins constituting about 7 percent of the plasma by weight".
EA defines this portion of the plasma as 8 percent and states,
"The three principal plasma proteins are albumin, globulin and fibrinogen".
Whether 7 or 8 percent, this portion of the plasma (about 3.7 percent of the volume of blood), is comprised entirely of elements, which are approved of by the Society for transfusion.
The plasma is prohibited but its ingredients are approved!
TABLE 1. THE CONSTITUENTS OF PLASMA (in milligrams per 100 millilitres)
(Taken from Colliers Encyclopaedia, Volume 4, 1997 page 263)
The chart below details every component contained within the water that makes up human plasma. Not ONE component is forbidden from use by the Society. Even the water is permitted as ‘saline’.
Sodium 310 - 340
Potassium 14 - 20
Calcium 9 - 11
Phosphorus 3 - 4.5
Chloride 350 - 375
Glucose 60 - 100
Urea 10 - 20
Uric Acid 3 - 6
Cholesterol 150 - 280
IF EVERY COMPONENT OF PLASMA CAN BE TAKEN WITHOUT SANCTION, WHY IS THE PLASMA ITSELF FORBIDDEN?
PLASMA PROTEINS 6000 – 8000
Albumin 3500 – 4500
Globulin 1500 – 3000
Fibrinogen 200 – 600
Carbon Dioxide 55 – 65
(Volume in millilitres, corrected for temperature and pressure, per 100 millilitres plasma)
Storage
In respect of albumin and immunoglobulins, very many litres of stored blood are needed to produce the small amounts of approved products. For example, to produce enough globulin for a single vaccination jab almost 3 litres of stored blood are needed. (See Encyclopaedia of Chemical Technology, Volume 4, Fourth Edition 1992)
This is more blood than a patient would normally get from a transfusion and remember that the globulins have been taken from FFP (fresh frozen plasma), which is stored blood.
The Society has also approved Factors VIII and IX.
But to produce enough of these products to keep just one haemophiliac alive would mean taking components from thousands of litres of stored blood.
How do we reconcile this? Why is it that we are allowed to make use of the stored blood of an anonymous donor, but aren't allowed to use our own stored blood?
If we can make use of stored donated blood in this way, why, as stated in the ‘Advance Medical Directive’, are we required to "absolutely REFUSE-stored autologous blood"?
It has been noted by the Society with respect to albumin, that as Jehovah's creation allows for this component to pass naturally from mother to child, it could be considered appropriate to duplicate this transfer via an injection or other means for medical purposes.
What of Jehovah's creation with respect to blood and its storage outside of the circulatory system?
Please note the following quote from 'Biology, a Functional Approach' 4th Edition 1998 page 208,
"(11) Storing blood. The veins in the liver have great powers of expansion and contraction, to such an extent that the total volume of blood in the liver can vary from 300 cm3 to 1500 cm3. This enables the liver to serve as a blood reservoir. Along with the spleen, it can regulate the amount of blood in the general circulation".
If Jehovah's creation allows for the removal and storage of blood outside of the circulatory system could it not be considered appropriate to duplicate this for medical purposes?
Notes:
The Society may be mistaken in assigning to white cells such a low value for volume (0.1%).
Colliers Encyclopaedia, Volume 4, 1997 Edition, states that white cells "make up 0.5 to 1.0 percent of total blood volume".
Compton's Interactive Encyclopaedia 1997 Edition, states; "There are far fewer white cells, or leukocytes, than there are red cells. In the bloodstream there is approximately only one white cell for every 700 red cells".
NEB states that white cells and platelets together constitute "less than one percent of the volume of blood".
Even at 1 percent, this is still a smaller amount than both of the permitted fractions, albumin and globulins. (EA page 91)
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nicolaou
http://www.do-not-call.org
