Blood transfusion: Letter of Understanding

by Marvin Shilmer 37 Replies latest jw friends

  • BluesBrother

    I have to say that I do not understand this. It says that the parent understands that the hospital can give blood in an emergency and signs to that effect. It also says that "This is not consent to a blood transfusion" Then what is it?

    Perhaps by including the second sentence the parents can say that they never consented, but they have.

    As it stands, in the congregation, if a child is made a ward of court and transfused that is o k judicially. If the parents wilted under extreme pressure and consented, they can plead their case and almost certainly get off with a reproof. But if they sign "consent" in advance it is pre meditated before the emergency arose . I would think the elders could well see a case for calling a disassociation !

    What happened to the "good reasons" for refusing? i.e. safety and more importantly "Gods Law"? Does that not matter now?

  • NVR2L8

    In the early 60's I almost lost my dad because he refused transfusions following a car accident and for decades I believed his survival was the proof Jehovah knows what's good for us better than any human. I was resolved to never make a compromise on the blood issue regardless of the possibility that I could lose my life in obedience to God. That's what the WTS expected of all JWs and there was no wiggle room for compromise. My father's fight with the doctors to avoid a transfusion was deemed heroic and that would also be even more so the case if he had died. In more recent cases parents took their gravely child out of the hospital and went into hiding often under the direction of a WTS lawyer to prevent the doctors to force a transfusion. Some of the cases went to court and delayed treatment until it was too late for the patient. Their argument was that God's law supersedes the law of the land. The letter allowing doctors to treat a child using treatment not approved by God (aka the WTS) is a huge compromise that most JWs would not accept without guidance from a WTS lawyer or the HLC. Even the new light on acceptable fractions hasn't changed the resolved of many to totally abstain from blood. I would be curious to see their reaction in finding out the HLC let's parents sign a letter allowing doctors to use blood as part of their treatment. Although I believe such a letter should not be necessary to allow doctors to treat JW children, that letter is written proof the blood doctrine is hogwash and no longer has a moral of scriptural leg to stand on.

  • Justitia Themis
    Justitia Themis

    Don’t overlook this significant point: what’s okay for Jehovah’s Witnesses in Canada is, from Watchtower’s doctrinal perspective, okay for Jehovah’s Witnesses everywhere. Right?

    Personally, I would reason as you stated above, Mr. Shilmer, but I doubt the WTBTS does.

    It seems that, in the past, the WTBTS has applied different rules to different people. This reminds me of the issue concerning treatment for hemophilia addressed in Louderback-Wood’s article, Jehovah’s Witnesses and the Tort of Misrepresentation. (At least I think that’s the title). I believe she documented that the WTBTS allowed those who called headquarters to obtain certain treatments that were previously prohibited, but they did not announce these changes to the congregations for a significant amount of time. This was a case where different rules applied to different people, despite having the same medical condition.

    In addition, I see at least two ‘wiggle’ arguments it could make. I could see it arguing that this was just an exercise at conciliation for those provinces controlled by AC v. Manitoba,and that outside the covered provinces, the rules remain the same.

    Also, as you noted, nothing in this document prohibits them from seeking judicial intervention, so they relinquished no rights. I do not know the circumstances of this particular case, but it seems the minor recovered without blood. Therefore, I do not know if this is a case of they did not want to pursue the isssue in the courts, or a case wherein they did not need to pursue the issue in the courts. If the minor recovered without blood, the HLC could claim that it was merely working within the system, but had a blood transfusion been ordered, it would have asked for judicial review.

  • wallsofjericho

    my personal experience leads me to beleive this is real and "indirectly" supported by the liason committee for use where children are so young they cannot make a stand for themself.

    If a parent or guardian is a JW, the courts position is that the child is NOT a JW since they have not made that decision for themself. Hence the court will provide treatment exactly as outlined in the letter.

    If a newborn infant is in critical care, the parents will NEVER "win" a battle against blood, a judge will come right to the hospital and allow the hospital to provide any medically necessary treatment allowable by law. After the treatment is complete they will return guardianship to the parent.

    I spoke personally with doctors who agreed personally with me to act in a manner exactly as this LOU directs. Respect the JW stance on blood until you absolutely can't anymore, then, do whatever you need. They knew I would not fight blood if it came to that and the dr's were fantastic about this. they allowed RBC counts to go right to the limit and never needed to transfuse, but I am certain if I were a believing JW with intention to fight they would have brought in the judge to be prepared and RBC would have been transfused. I am certain of it!

    The fact is the dr's are going to give your child blood if it needs it, this letter actually helps JW's since the dr's know they won't have a fight on their hands and tie up 6 hours waiting for a juge to order care, the dr's know they can wait until absolutely necessary to pull the trigger on blood instead of padding the decision based on needing court intervention.

    the WTS benefits as they do not need to tie up lawyers in a fight they know they cannot win, and they remove the burden of guilt from the parents since they have maintained the no blood stance but have accepted/acknowledged that the hospital will take custody of the child so why bother fighting.

    The WTS will never put their letter head on this, but for sure, the HLC will reveiw this letter that the "worldly hospital" printed and give the parents the needed warm fuzzy hug from Jehovah they need to sign it and save the society the legal battle and potential liabilty

  • Marvin Shilmer
    Marvin Shilmer


    “I have to say that I do not understand this. It says that the parent understands that the hospital can give blood in an emergency and signs to that effect. It also says that "This is not consent to a blood transfusion" Then what is it?... Perhaps by including the second sentence the parents can say that they never consented, but they have.”


    With this form the parents can consent to treatment at a medical facility by physicians who’ve gone on record they are going to transfuse the patient if need be, and the parent can say lay claim to having never consented to blood transfusion.

    The whole thing is pregnant with dissonance from the JW side of the table. But it’s a tool Watchtower has endorsed via its appointed Hospital Liaison Committee members. In the end it’s a mechanism for rationalization.

    In effect, the JW parent has consented to blood transfusion rationalizing they have not consented to blood transfusion because the document includes the phrase “not an agreement for blood transfusion”.

    From the ethicists' side of the table, they’re happy if everyone else is happy. The doctor is happy because he/she can proceed unhindered and treat a sick child. The JW is happy because Watchtower has told them you won’t be disfellowshipped if you do this thing because ‘it’s a conscience matter'.

    Marvin Shilmer

  • Doubting Bro
    Doubting Bro

    I had a conversation with someone I know on the local HLC a few years ago. His remarks go along the same line in terms of what to do with minors. He told me that there's basically no chance of winning when it comes to refusing blood for minors and the society is simply not interested in getting involved to the degree they once were (his words summarizing the stance). He told me that they will recommend to parents to tell the drs they don't consent to such treatment but won't contest.

    I've also see a consent form similar but along the lines of "we do not wish for our child to have a BT but recognize that the hospital/physician may do so if there is a medical emergency". I don't have a copy of what I saw but remember thinking it must have been drafted in conjunction with WT legal.

  • Chaserious

    Are they using this or anything similar in the U.S.?

  • Marvin Shilmer
    Marvin Shilmer


    “I had a conversation with someone I know on the local HLC a few years ago. His remarks go along the same line in terms of what to do with minors.”

    In 1998 a Watchtower appointed Hospital Liaison Committee member by the name of David Malyon authored an article published by Journal of Medical Ethics (Oct, 1998 issue). He said this:

    The parents are not asked to consent to the use of blood, but are encouraged to recognise the situation in law.”--(Malyon, 1998)

    You can imagine how awkward it was for JWs like Malyon to nurture a JW parent to rationalize they could consent to letting doctors treat their child knowing perfectly well the treatment will include blood transfusion, but this is not actually consenting to use blood.

    It’s not as awkward with the document sliding from the facility side of the table.

    The HLC guy needs only to glance at the document and respond to the parent saying “Other JWs have signed these forms and the Governing Body has ruled that it’s completely your option without congregational repercussion. You need not even mention this to anyone in the congregation since it’s purely a matter of personal conscience.”

    Marvin Shilmer

  • Justitia Themis
    Justitia Themis

    As I stated earlier, I do not think these Letters of Understanding reflect any change on the part of the WTBTS. It appears that they have been used for a while now to meet the legal and ethical demands of full disclosure to the parents. I suspect the HLCs are merely seeking a seat at the table to impact drafting and make themselves appear useful.

    The following seems to document the usage of a similar document in a 2006 or 2007 North Carolina case:

    "Hospitals have an ethical obligation to delineate expressly to guardians of minors the parameters of the law and how medical care will be administered. The institution operating the “blood conservation program” in the above case routinely utilizes acknowledgement statements in circumstances involving the medical care of minors whose parents seek to refuse blood transfusions. These statements serve as a tool ensuring and documenting that clear and complete disclosure of the hospital’s intentions are conveyed to the patient’s guardians . . .Failure of the parents to sign such a document would not alter the care administered to the minor under North Carolina law in the event a life saving [sic] transfusion is required. From a legal and ethical standpoint, the statement serves to document formally that a clear dialogue was conducted between the hospital and the parents regarding the emergent administration of blood products.”

    Paul R. Brezina & John C. Moskop, Urgent Medical Decision Making Regarding a Jehovah’s Witness Minor: A Case Report and Discussion, 68 NC MED J 312, 314 (2007).

  • blondie

    So if a minor does not contest or their parents, is that like not resisting rape?

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