Background: Jehovah’s Witnesses and Blood Products
Jehovah’s Witnesses represent a global, religious Christian group with more than 9 million members. Some of the practices and beliefs that set them apart from other Christian groups include:
- Religious leaders don’t have titles that put them above others in the group;
- Jesus is the Son of God rather than part of a Trinity;
- Birthdays aren’t celebrated because it is believed these celebrations have pagan roots; and
- Blood products cannot be accepted in a medical situation because the Bible discusses abstaining from blood (JW, n.d.).
Jehovah’s Witnesses’ refusal of blood products has been widely portrayed in popular culture, including in medically focused television shows like Scrubs and Grey’s Anatomy. Episodes in both series depict patients who are Jehovah’s Witnesses and require a blood transfusion; through the refusal of this treatment, the episodes explore alternative options and the intersections of patient autonomy, religion, and medical practice.
A Patient Experience
A patient presents with thrombotic thrombocytopenic purpura, or TTP, a rare but life-threatening disorder that results in the formation of blood clots throughout the body. The physician proposes plasma exchange as a life-saving treatment, which involves replacing the patient’s plasma with donor plasma to remove harmful antibodies and to replace a critical protein called ADAMTS13 (NIH, n.d.). After the physician recommends the plasma exchange, however, the patient discloses that they are a Jehovah’s Witness and cannot accept blood products.
Reflection
- How should the physician in this situation respond? What might you say to a patient who has shared this information? How might you balance the need for swift treatment with compassionate and empathetic care?
- Research indicates that while Jehovah’s Witnesses usually refuse white and red cells, plasma, and platelets, they might be open to albumin, clotting factor concentrates, intravenous immune globulin, hemoglobin-based oxygen carriers, and recombinant proteins (Tran, 2023, p. 1). How might this impact your approach, if at all?
- Ultimately, how would you develop a treatment plan for this patient that considers both their spiritual and physical wellbeing?
References
- Jehovah’s Witnesses (JW.org). (n.d.). About us: Who are Jehovah’s Witnesses?
- National Institute of Health (NIH). (n.d.). Platelet disorders: Thrombotic thrombocytopenic purpura. https://www.nhlbi.nih.gov/health/thrombotic-thrombocytopenic-purpura
- Tran, M.H. (2023). Therapeutic modalities in thrombotic thrombocytopenic purpura management among Jehovah’s Witness patients: A review of reported cases. Transfusion and Apheresis Science, 62(4), 1-6. https://doi.org/10.1016/j.transci.2023.103706