I can remember when the 1992 KM article came out. It was apparent that parents and elders were not "preparing" minor jws and they were unable to express their "beliefs" to the doctors in a way that was convincing. Pretty much the same when it came to brithdays and holidays, "because the Society says so" or "my parents won't let me."
Then in 2005, the WTS updated the information with the "mature minor" legal concept because of several cases in the US and Canada.
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*** km 9/92 pp. 3-6 Safeguarding Your Children From Misuse of Blood ***
1 "Look! Sons are an inheritance from Jehovah." (Ps. 127:3) If you have such a precious inheritance from Jehovah, you, as parents, have a happy, although serious, responsibility to train, care for, and protect your children. For example, have you taken every reasonable step to protect your young children from a blood transfusion? How would your children react if faced with the prospects of a transfusion? Have you discussed as a family what you might do to deal effectively with an emergency situation in which a transfusion is threatened?
2 Preparing your family for such situations need not be a cause for anxiety or undue stress. You cannot anticipate and prepare for every eventuality in life, but there are many things you, as parents, can do in advance to protect your children from a transfusion. Neglecting these responsibilities could result in your child being transfused when getting medical care. What can be done?
3 Firm Conviction Important: Serious thought should be given to how firm your own convictions are regarding God’s law on blood. Are you teaching your children to obey Jehovah on this matter, just as you teach them his law on honesty, morality, neutrality, and other aspects of life? Do we really feel as God’s law commanded at Deuteronomy 12:23: "Be firmly resolved not to eat the blood"? Verse 25 adds: "You must not eat it, in order that it may go well with you and your sons after you, because you will do what is right in Jehovah’s eyes." A doctor may claim that blood will ‘make things go well’ for your sick child, but you must be firmly resolved before any emergency comes up to refuse blood for yourself and your children, valuing your relationship with Jehovah as higher than any alleged extension of life that would involve breaking his divine law. Favor with God now and everlasting life in the future are involved!
4 Yes, Jehovah’s Witnesses are life-oriented. They have no desire to die. They want to live so they can praise Jehovah and do his will. That is one reason why they go to hospitals and take their children there for treatment. They ask physicians to treat them, and when they are told blood is the standard or medically indicated course of treatment, they ask for alternative nonblood medical management. There are many alternatives to blood. Experienced physicians are using them. Such alternative management is not quack medicine but consists of medically sound treatments and procedures that are documented in leading medical journals. Thousands of physicians around the world are cooperating with us in providing good medical care without the use of blood, although it is still a problem at times to locate physicians who will treat Witness children without using blood.
5 Finding a Cooperative Doctor: Physicians have many concerns in treating patients, and when you ask them to treat your child without blood, this increases the challenge. Some physicians will agree to treat adults while respecting their wishes on blood as long as an acceptable release is filled out. Some may similarly agree to treat minors who have demonstrated they are mature minors, since some courts have recognized that mature minors have the right to make their own medical choices. (See The Watchtower, June 15, 1991, pages 16-17, for discussion of what constitutes a mature minor.) However, physicians may refuse to treat young children, especially infants, unless they have permission to give blood. In fact, very few physicians will give 100-percent assurance that they will not use blood under any circumstances when treating a child. For medical and legal reasons, most doctors feel that they cannot give such a guarantee. Nevertheless, an increasing number want to provide care for the children of Jehovah’s Witnesses while going as far as they feel they can in respecting our wishes on blood.
6 In view of this, what if, in your search for a suitable doctor for your child, you find one with a record of good cooperation with Jehovah’s Witnesses and who had in the past performed the same bloodless procedure for other Witnesses, yet he feels that the law does not allow him to give you an absolute guarantee that blood would not be used? However, he assures you that he feels there will be no problem this time as well. You may decide this is your best option. Under these circumstances you might conclude that you could grant permission to proceed. Make it quite clear, however, that in giving permission for medical treatment for your child you are not giving permission for blood transfusions. Taking this course would be a responsibility you would have to bear without your decision being viewed as a compromise.
7 Of course, if you could find a reasonable alternative treatment option that would further reduce or possibly eliminate the problem of blood being used, then you likely would take the less risky course. It would be expected that you would make a diligent effort to find the physician or surgeon who would go further than any other in agreeing not to give blood. The best defense is to anticipate problems. Make every effort to find a cooperative doctor in advance. Try to stay away from uncooperative doctors and hospitals where possible.
8 In some lands another factor that can make a difference in whether a blood transfusion is given is how hospital care will be paid for. Where parents have health insurance or other security that permits searching out a doctor of their choice, the children can more easily be kept out of the hands of uncooperative physicians or hospital personnel. Sufficient financial coverage often determines the type of service and cooperation a family receives from doctors and hospitals. Also, whether a hospital or physician is willing to accept transfer of a child will often depend on the parents’ ability to pay for care. And prospective mothers, it is important that you look after your health during pregnancy! This will do much to prevent premature births and the associated complications, since the standard treatment for premature babies and their problems many times involves blood.
9 At times physicians complain that Jehovah’s Witnesses do not discuss their objections to blood until the last minute. This should never be the case. One of the first things Witness parents should do when going to the hospital or when engaging the services of a physician is to discuss their position on blood. If surgery is involved, request an early meeting with the anesthesiologist. The surgeon may be able to assist you in doing this. The admittance forms should be checked carefully. You have a right to cross out anything objectionable. To remove any doubt, write on the admittance form clearly that blood, for religious and medical reasons, is not wanted or permitted under any circumstances.
10 Help From Jehovah’s Organization: What provisions has Jehovah’s organization made to help you in protecting your children from blood? There are many. The Society has published much to educate us on blood and nonblood alternative management. You have studied the brochure How Can Blood Save Your Life? and other publications on this subject. And you have your brothers and sisters in the local congregation who can give you much help and support. When there is a crisis, elders may consider it advisable to arrange a 24-hour watch at the hospital, preferably by an elder with the patient’s parent or another close family member. Blood transfusions often are given when all relatives and friends have gone home for the night.
11 In the United States, there are over a hundred Hospital Liaison Committees located in major cities. All congregations are assigned to a committee made up of trained brothers who are available to assist. Call on them, through your elders, when they are needed. They should not be called about minor problems, but do not wait too long to call if it is perceived that a serious problem may be developing. They often can supply the names of cooperative physicians and suggestions on alternatives. Where necessary and possible, these brothers arrange to be on the scene and help to manage the problem.
12 Anticipating and Dealing With Court Involvement: What if a doctor or a hospital intends to get a court order to transfuse your child? Is this the time to quit, assuming that there is nothing more that can be done? By no means! It may still be possible to avert a transfusion. Preparation for such a possibility should be made ahead of time. What can be done?
13 Understanding some of the legal principles that guide or influence hospitals and judges in these matters will help you greatly in making a defense. One such principle of fundamental importance is the fact that the law does not give parents unlimited authority to accept or refuse medical treatment for their children. Although adults generally have the right to accept or refuse medical treatment as they wish, parents are not free to refuse treatment considered necessary for their child’s welfare even when their refusal is based on sincerely held religious beliefs.
14 This basic principle was reflected in the 1944 U.S. Supreme Court decision that said: "Parents may be free to become martyrs themselves. But it does not follow they are free, in identical circumstances, to make martyrs of their children before they have reached the age of full and legal discretion when they can make that choice for themselves." This same primary concern for the child’s physical health and welfare is embodied in child-welfare laws today. These laws, which are aimed at child abuse, are also designed to protect children from medical neglect.
15 Protecting children from parental abuse and neglect certainly is not objectionable to Christian parents. But child-neglect laws and the Supreme Court statement quoted above often are inappropriately applied to cases involving children of Jehovah’s Witnesses. Why? For one thing, Witness parents have no intention of "martyring" their children. If they did, why would they take their children to the hospital in the first place? On the contrary, Witness parents willingly seek medical treatment for their children. They love their children and want them to have good health. But they believe they have a God-given duty to choose responsibly the kind of medical treatment that is best for their children. They want their children’s health problems managed without blood. Not only is such alternative nonblood care better and safer than blood but, most important, it keeps their children in the favor of the great Life-Giver, Jehovah God.
16 Despite the benefits of nonblood medical management, many doctors and child-welfare officials view transfusion therapy as standard medical practice that may be necessary or even lifesaving in certain circumstances. Thus, when Witness parents refuse recommended transfusions, problems can arise. Generally speaking, doctors cannot lawfully treat children without the parents’ consent. To overcome the lack of parental consent to use blood, doctors or other hospital personnel may seek consent from a judge in the form of a court order. Such court-authorized consent may be obtained through child-welfare officials or by doctors or by hospital officials acting to protect the child from alleged medical neglect.
17 Many times court orders authorizing the use of blood are obtained very quickly with little or no notice to the parents. Doctors, hospital administrators, or child-welfare officials try to justify such expedited orders by claiming there is a medical emergency that does not allow time for the parents to be fully informed of what is going on. Often under questioning, however, doctors have admitted that a real emergency does not exist and that they want a court order "just in case" a transfusion might, in their opinion, become necessary in the future. As the natural guardians of your child, you have a fundamental right to know what doctors, hospital administrators, or child-welfare officials are doing with respect to your child at all times. The law requires that, if at all possible, you should be informed of efforts to obtain a court order and should be allowed to present your side of the dispute before the court.
18 These legal realities highlight the value of finding a cooperative doctor. Work with him, and with assistance from members of your Hospital Liaison Committee, help him pursue nonblood management of your child’s medical problem or have your child transferred to a doctor or hospital that will provide such treatment. But if there are signs that the doctor, hospital administrator, or child-welfare worker is contemplating obtaining a court order, you should be alert to ask if this is what is being planned. Sometimes this is done secretly by telephone. If there is a plan to go to court, emphasize that you want to know about it so that you can present your side to the judge also. (Prov. 18:17) If there is time, it often is advisable to seek the help of an attorney. On some occasions attorneys have been appointed by the court. If you have your own or a court-appointed attorney, the Society’s Legal Department can share information with him that will help him make the best defense possible under the circumstances.
19 If your refusal of blood is taken to court, the doctor’s opinion that blood is necessary to preserve your child’s life or health can be very persuasive. The judge, as a medical layman, will usually defer to the doctor’s medical expertise. This is especially true when parents are given little or no opportunity to present their side of the case and the doctor, without challenge, is allowed to express his claims about the "urgent" need for blood. Such one-sided proceedings are not conducive to determining the truth. The fact is, when and why doctors feel blood is needed is highly subjective and uncertain. Often, when one doctor says blood is absolutely necessary to save a child’s life, another doctor, experienced in managing the same medical problem without blood, will say blood is not necessary to treat the patient.
20 What will you do if an attorney or a judge asks you why you are refusing a "lifesaving" transfusion for your child? Although your first inclination might be to explain your belief in the resurrection and express your strong faith that God will bring your child back if he dies, such an answer by itself may do no more than convince the judge, whose paramount concern is the physical welfare of the child, that you are a religious fanatic and that he must step in to protect your child.
21 What the court needs to know is that, although you are refusing blood on deeply held religious grounds, you are not refusing medical care. The judge needs to see that you are not neglectful or abusive parents but, rather, loving parents who want their child treated. You simply do not agree that the alleged benefits of blood outweigh its potentially lethal hazards and complications, especially when medical alternatives that do not carry these risks are available.
22 Depending on the situation, you might make known to the judge that it is the opinion of one doctor that blood is needed, but doctors differ in their approaches, and you would like the opportunity to find a doctor who will care for your child with widely available methods of nonblood management. With the help of the Hospital Liaison Committee, you may have already found such a doctor who will treat your child without blood and who may give helpful testimony in court, perhaps by telephone. Likely the liaison committee will be able to share with the judge—even the doctor pressing for the court order—medical articles that show how your child’s medical problem can be effectively managed without the use of blood.
23 When judges are called upon to issue court orders hastily, often they have not considered or been reminded of the many dangers of blood, including AIDS, hepatitis, and a host of other hazards. You can point these out to the judge, and you can also make known to him that you, as a Christian parent, would view the use of another person’s blood in an effort to sustain life as a serious violation of God’s law and that forcing blood upon your child would be viewed as tantamount to rape. You and your child (if old enough to have his own convictions) can explain your abhorrence for such bodily invasion and can appeal to the judge not to grant an order but to permit you to pursue alternative medical management for your child.
24 When a proper defense is made, judges are able to see more clearly the other side—your side—as parents. Then they are not so quick to authorize a transfusion. In some cases judges have severely restricted the doctor’s freedom to use blood, even requiring that alternatives be considered first, or have given parents the opportunity to find doctors who will treat without blood.
25 In dealing with those seeking to force a transfusion, it is essential that you never give any evidence of wavering in your convictions. Judges (and doctors) sometimes ask if parents would have any difficulty "transferring" to them the responsibility for the decision to transfuse, feeling that this would make it easier for the parents to live with their conscience. But it should be made clear to all concerned that you, as parents, feel an obligation to continue to do all that you can to avoid a transfusion. This is your God-given responsibility. It is not transferable.
26 Hence, in speaking with doctors and judges, you need to be prepared to state your position clearly and convincingly. If a court order is issued despite your best efforts, continue to implore the physician not to transfuse and urge alternative treatment. Continue to seek his willingness to consider medical articles and the advice of any doctors who are willing to be consulted on the medical problem so as to avoid blood. On more than one occasion, an apparently unyielding doctor has come from the operating room and proudly announced that he did not use blood. So, even after a court order has been issued, never give up, regardless!—See June 15, 1991, issue of The Watchtower, "Questions From Readers."
27 Remember, Jesus said: "Be on your guard against men; for they will deliver you up to local courts . . . You will be haled before governors and kings for my sake, for a witness to them and the nations." For our comfort under such circumstances, Jesus added that the holy spirit would help us recall what would be appropriate and beneficial to say on such occasions.—Matt. 10:16-20.
28 "He that is showing insight in a matter will find good, and happy is he that is trusting in Jehovah." (Prov. 16:20) Parents, make the necessary preparations in advance to protect your child from a spiritually contaminating blood transfusion. (Prov. 22:3) Children, respond to the training of your parents in making these preparations and apply them to your heart. As a family, "be firmly resolved not to eat the blood . . . that it may go well with you" because of having Jehovah’s blessing and smile of approval.—Deut. 12:23-25.
[Footnotes]
Only when there is a present, ongoing emergency which, in the doctor’s opinion, requires immediate attention may treatments deemed necessary to the child’s life or health (including blood transfusions) be lawfully provided without either parental or judicial consent. Of course, a physician must be accountable when he relies on this emergency power in the law.
*** km 12/05 p. 6 Could Your Child Make a Mature Decision? ***?
1 A mature decision about what? Blood transfusions. As shown in the article entitled "Walk as Instructed by Jehovah" in the June 15, 1991, issue of The Watchtower, children of Jehovah’s Witnesses have had to take a mature stand to prove that their desire to obey God’s law on blood is as important to them as it is to their parents. Could that also be required of your minor child?
2 What Does the Law Say? In the United States, the highest court that has ruled on a mature minor’s right to refuse blood transfusions is the Illinois Supreme Court. In reviewing the case of a 17-year-old sister, the court decreed: "If the evidence is clear and convincing that the minor is mature enough to appreciate the consequences of her actions [and] to exercise the judgment of an adult, then the mature minor doctrine affords her the common law right to consent to or refuse medical treatment." Thus, in assessing whether a child is mature enough to make his own decision, doctors or officials may interview the patient to hear him express his personal objection to taking blood. The youth would need to understand reasonably the gravity of his medical condition and the consequences of his options for treatment and clearly and firmly express his own religious belief about God’s law on blood.
3 What Would Your Child Say? Are your children able to express themselves on this issue? Do they believe with all their heart that it is a divine command to ‘abstain from blood’? (Acts 15:29; 21:25) Can they explain their belief from the Scriptures? Would they courageously defend their firm decision about blood if doctors believed that their life was in jeopardy, even if their parents were not present? Since "time and unforeseen occurrence befall [us] all," how can you prepare your children for any unexpected challenge to their integrity?—Eccl. 9:11; Eph. 6:4.
4 Parents, What Can You Do? You have the responsibility to teach your children God’s view of blood. (2 Tim. 3:14, 15) A clear explanation is found in the Reasoning book, pages 70-4. Study it carefully with your family. Using the feature "If Someone Says—" on pages 74-6, conduct practice sessions with your children to help them gain experience in explaining what they believe and why. (1 Pet. 3:15) Other provisions for educating us about the blood issue include the brochure How Can Blood Save Your Life? and The Watchtower of June 15, 2004, pages 14-24. In addition, the video programs Transfusion-Alternative Health Care—Meeting Patient Needs and Rights and No Blood—Medicine Meets the Challenge, which are currently available on the DVD entitled Transfusion Alternatives—Documentary Series, give convincing information about the reasonableness and effectiveness of bloodless medicine and surgery. Has your family watched and discussed these presentations recently?
5 Help your children ‘prove to themselves what the good, acceptable, and perfect will of God’ is regarding blood. Then they can make a mature decision that has Jehovah’s blessing.—Rom. 12:2.
