Watchtower Blood Transfusion Doctrine

This article shows the inconsistent history surrounding Watchtower rules concerning blood. Blood transfusions are shown to be Scripturally acceptable at Blood Doctrine.

Jehovah’s Witnesses come under tremendous criticism for applying their stand on blood to blood transfusions. The Bible never mentions blood transfusions, as this practice has only become common in the 20th century. The Watchtower reasons that if the Mosaic Law said blood cannot be eaten, then it must follow that it would be equally disrespectful to transfuse it. As will be shown, much of the reasoning the Watchtower has used in regards to transfusions is inaccurate, with the result being an inconsistent stance on how blood may or may not be used.

The reasoning originally given for why blood transfusions were banned was that it was thought to be a nutrient in the same way that food is.

“Each time the prohibition of blood is mentioned in the Scriptures it is in connection with taking it as food, and so it is as a nutrient that we are concerned with in its being forbidden.” Watchtower 1958 Sep 15 p.575

Blood is not a nutrient, blood transfusions do not nourish the body and this is not the reason a patient is given a transfusion. Blood is used as a volume expander and to carry oxygen. The Watchtower now understands this and no longer uses this incorrect reasoning. However, rather than change the prohibition on blood a new line of reasoning started to be used. To link blood transfusions with eating blood the Watchtower now uses the following illustration.

“Consider a man who is told by his doctor that he must abstain from alcohol. Would he be obedient if he quit drinking alcohol but had it put directly into his veins?” Reasoning from the Scriptures p.73

Medical professionals find this argument illogical. Although an alcoholic is advised not to drink alcohol, it would not prevent a doctor administering alcohol based medicine in case of a medical emergency. Furthermore, when blood is introduced directly into the veins as a transfusion it circulates and functions as blood. Similarly, when a person orally ingests alcohol it is absorbed as alcohol into the bloodstream. The alcohol is not broken down by the stomach and for this reason it is the same as injecting it directly. On the other hand, orally eaten blood when digested does not enter the circulation as blood, but is broken down into simple components.

A more important line of reasoning against blood transfusions is that the Bible says blood was not to be stored but poured out onto the ground. For this reason even using ones own stored blood for a transfusion is said to be wrong. (Watchtower 1959 Oct 15 p.640, Watchtower 2000 Oct 15 p.31) Though this reasoning is partially sound, it highlights how grossly inconsistent the Watchtower standard has become. This reasoning is used to prevent a Jehovah’s Witness:

  • donating blood
  • transfusing blood
  • transfusing four of bloods fractions (red blood cells, white blood cells, platelets and plasma)

However, a Jehovah’s Witness is able to have blood taken and stored for blood tests. Vaccines cultivated in stored blood are allowed. Many types of blood fractions, manufactured from stored blood, are allowed and medical treatments derived from large quantities of stored blood are permitted.

To indicate just how illogical this standard is, it is worth considering immunoglobulin injections, which are now allowed to be used by Witnesses. (Awake! of Dec. 8, 1994) Immunoglobulin injections are used as replacement therapy in people whose body does not produce enough immune globulin or to treat people who have not been immunized against certain viral infections such as hepatitis A and measles. It takes about 3 litres of blood to get enough gamma globulin for one injection. The blood is taken from a pooled blood supply, as antibodies to these diseases are likely to be in the pool if enough samples have been added together. According to the IDF Patient/Family Handbook p.76;

“Blood is collected from as many as 60,000 people, and then pooled together. The first step in gamma globulin pro-duction is to spin the blood to remove all red and white blood cells. Then, the gamma globulins are chemically purified from the liquid plasma in a series of steps involving treatment with alcohol.”

It is very difficult to understand the double standard that the Watchtower has created here. On the one hand, blood is said to be so sacred that it must not be stored, but poured onto the ground. Even someone’s own blood must not be stored for just a few hours and then transfused back during the operation. Certain blood components are also not allowed to be used, such as white blood cells which make up less than 1% of the volume of blood. On the other hand the Watchtower sees nothing wrong with using medication made from mixing and storing the blood of 60,000 people together. If blood is so sacred that it cannot be stored for a transfusion, then the storing of blood and processing it into fractions should also be disallowed.

An illustration on stealing explains the inconsistency of the blood standard. If stealing and reselling a car is a crime, would it be any less of a crime if the thief took the car apart and sold only components of it?

This double standard has led to Jehovah’s Witnesses taking from society something that they are not prepared to give back. Jehovah’s Witnesses refuse to donate blood for the benefit of other people, but they partake of the medical benefits that arise from the donated blood supply freely for themselves.

With a lack of consistent reasoning on which to base its blood transfusion doctrine, the Watchtower consistently relies on fear as a motivator to abstain from blood. A number of Watchtower articles instil fear of blood into the average Witness. A look at the Watchtower Index shows a preoccupation with topics relating to the danger of blood transfusions, blood being contaminated with AIDS, fungus and hepatitis and blood being big business. Consider the following statements;

“The blood in any person is in reality the person himself. … poisons due to personal living, eating and drinking habits … The poisons that produce the impulse to commit suicide, murder, or steal are in the blood. Moral insanity, sexual perversions, repression, inferiority complexes, petty crimes – these often follow in the wake of blood transfusion.” Watchtower 1961 Sep 1 p.564

“Frequently, in connection with attempts to force transfusions on the children of Jehovah’s Witnesses, great public hostility has been whipped up by the press. In some instances, even without a legal hearing at which the parents could speak, judges have ordered that their children be transfused. In more than 40 cases in Canada, however, the transfused children were returned dead to their parents.” Jehovah’s Witnesses-Proclaimers of God’s Kingdom p.184

“But Jehovah’s Witnesses believe that to be transfused . . . [may] result in eternal damnation.” How Blood Can Save Your Life p.31

Changing Standard

Jehovah’s Witnesses believe that the Governing Body of Jehovah’s Witnesses are directed by God’s holy spirit and since they have stated that blood transfusions are wrong, then it is Gods will to reject it. An examination of the ongoing history of this teaching gives little evidence of holy direction.

Originally, Jehovah’s Witnesses were allowed vaccinations, transplants and blood. At various points in time during the 1900’s Jehovah’s Witnesses were forbidden all of the above. Now all of these are allowed once again in some shape or form. Though full blood transfusions and major blood fractions are still forbidden, technically 100% of the blood components are now allowed to be transfused in their broken down parts.

Until 1927, the Watchtower Society understood that Biblical laws against blood were not binding on Christians. Russell accepted the generally agreed theological understanding on this matter, including that the prohibition at Acts was not binding on Christians and was only observed in the first century to keep peace between Jews and Gentiles.

“He further suggested writing to them merely that they abstain from pollutions of idols, i.e., from meats offered to idols (verse 29), and from things strangled and from blood – as by eating such things they might become stumbling blocks to their Jewish brethren (See 1 Cor. 8:4-13)- and from fornication. … It will be noticed that nothing is said about keeping the Ten Commandments, nor any part of the Jewish law. It was evidently taken for granted that having received the spirit of Christ the new law of love would be a general regulation for them. The things mentioned were merely to guard against stumbling themselves or becoming-stumbling blocks to others.” Watch Tower 1892 Nov 15 pp.350-351

“These prohibitions had never come to the Gentiles, because they had never been under the Law Covenant; but so deeply rooted were the Jewish ideas on this subject that it was necessary to the peace of the church that the Gentiles should observe this matter also.

(1) Abstain from sacrifices to idols;
(2) and from blood,
(3) and from things strangled:
It is our opinion, therefore that these items thus superadded to law of love should be observed by all spiritual Israelites as representing the divine will.” Watch Tower 1909 Apr 15 pp.116-117

Eating blood was not banned until 1927, under the guidance of Rutherford. (Watchtower 1927 Dec p.371) How seriously should a person take the medical teachings of the Watchtower from the 1920’s and 30’s? This was the period of time when the editor of the Golden Age, Woodworth, made the claims that “Medicine originated in demonology” and condemned vaccinations, women cutting their hair, chewing gum, using aluminium pots and eating breakfast.

Blood transfusions have been conducted for hundreds of years, and were successfully used to treat humans in the early 1800’s. ABO blood types were identified in 1930 and the first Blood Bank was established in 1932. ( Oct 2008) By “the 1940’s, scientists began to separate blood into its components.” (Awake 90 Oct 22 p.4) Yet, it was not until 1945 that the Watchtower extended its blood censorship to transfusions, over 70 years after the commencement of the Watchtower Society. If this is such a critical doctrine, one must wonder why God would wait so many decades before revealing it to the Governing Body.

In 1951 it was clarified in great detail that a Witness must not use blood in any form, but it remained a conscience matter and was not a disfellowshipping offence.

“However, congregations have never been instructed to disfellowship those who voluntarily take blood transfusions or approve them. We let the judgment of such violators of God’s law concerning the sacredness of blood remain with Jehovah, the Supreme Judge.” Watchtower 1958 Aug 1 p.478

Beginning with the Watchtower 1961 Jan 15 pp.63-64, blood transfusions became a disfellowshipping offence, highlighting the importance this doctrine had become to the Watchtower Society.

“Beginning in 1961 any who ignored the divine requirement, accepted blood transfusions, and manifested an unrepentant attitude were disfellowshipped from the congregations of Jehovah’s Witnesses.” Jehovah’s Witnesses-Proclaimers of God’s Kingdom pp.183-184

This applies to a Jehovah’s Witness that consumes or transfuses blood or a parent that allows their children to have a blood transfusion. This is despite the New Testament never listing consumption of blood as a reason for expulsion from the congregation.


Vaccinations were originally acceptable.

1921 – In 1921 Witnesses were forbidden vaccinations (Golden Age 1921 Oct 12 p.17)

1952 – After 30 years the Watchtower Society returned to its original position, once again allowing vaccinations. (Watchtower 1952 Dec 15 p.764)

Organ transplants

Organ transplants were originally considered “wonders of modern surgery.” (Awake! 1949 Dec 22)

1967 – Transplants forbidden to Witnesses as cannibalism. This continued to be the case through the 1970’s. (Watchtower 1967 Nov 15 pp.702-704)

1980 – The Society overturned the decision and transplants became acceptable once again. (Watchtower 1980 Mar 15 p.31)

Eating Blood

Initially blood could be eaten. (Watchtower 1892 November 15 pp.349-352, Watchtower 1909 Apr 15 pp.116-117)

1927 – Blood was no longer to be eaten (Watchtower 1927 Dec p.371)

Blood Serum

1954 – Unacceptable.

“We are told that it takes one and a third pints of whole blood to get enough of the blood protein or “fraction” known as gamma globulin for one injection… its being made of whole blood places it in the same category as blood transfusions as far as Jehovah’s prohibition of taking blood into the system is concerned.” Awake! 1954 Jan 8 p.24

1958 – Acceptable (Watchtower 1958 Sep 15 p.575)

1963 – Unacceptable (Watchtower 1963 Feb 15 p.124)

1965 – Acceptable (Watchtower 1964 Nov 15 pp.680-3)

1974 – Conscience matter (Watchtower 1974 Jun 1 p.352)


1972 – Unacceptable.

“The Journal of the American Medical Association, dated November 15, 1971, described a procedure for open-heart surgery that employs “sever hemodilution.” Early in the operation a large quantity of blood is drawn off into a plastic blood bag. Though the bag is left connected to the patient by a tube, the removed and stored blood is no longer circulating in the patient’s system. It is replaced with a plasma volume expander, which dilutes the blood remaining in the veins and which gradually dissipates during the operative procedure. Near the conclusion of the operation the blood storage bag is elevated, and the stored blood is reinfused into the patient. The New York Times of November 9, 1971, reported on a somewhat similar procedure whereby some days before one undergoes surgery as much as four pints of blood are removed and stored. During the operation the person’s own stored blood is transfused back into him, thus avoiding the danger of disease and mismatched blood. These techniques are noteworthy to Christians, since they run counter to God’s Word. The Bible shows that blood is not to be taken out of a body, stored and then later reused.” Awake! 1972 Apr 8 p.30

1982 – Objectionable.

“Techniques for intraoperative collection or hemodilution that involve blood storage are objectionable to them.” Awake! 1982 Jun 22 p.25

1983 – Acceptable.

“It is with this in mind, and not just to honor the requests of Jehovah’s Witnesses, that Denton Cooley [of Houston, Texas] has performed open-heart operations now for over seven years, limiting transfusions wherever possible by substituting hemodilution, diluting the patient’s blood with a glucose and heparin solution.” Awake! 1983 Mar 22 p.16

Blood transfusions

Originally Allowed. Blood transfusions and donating blood for transfusion is commended (Golden Age 1925 Jul 29 p.683, Golden Age 1929 May 1 p.502, Consolation 1940 Dec 25 p.19)

1945 – Forbidden. Blood transfusions first stated as wrong (Watchtower 1945 Jul 1 p.198-201)

1961 – Became a disfellowshipping offence (Watchtower 1961 Jan 15 pp.63-64)

In 1961 it was clearly specified that blood law applies to both whole blood and components of blood such as blood fractions and haemoglobin.

“If you have reason to believe that a certain product contains blood or a blood fraction if the label says that certain tablets contain hemoglobin this is from blood…a Christian knows, without asking, that he should avoid such a preparation. Watchtower 1961 Nov 1 p.669

Gradually becoming allowed again

1982 – Blood components are listed with some minor components allowed. Major components and hemodilution are forbidden. (Awake! 1982 Jun 22 p.25)

1995 – Acute Normovolemic Hemodilution (ANH) and autologous blood salvage procedure (Cell Saver) are acceptable despite being briefly stored outside the blood. (Watchtower 1995 Aug 1 p.30)

2000 – Major change to blood policy, with all of blood now being allowed when converted to minor fractions.

“…when it comes to fractions of any of the primary components, each Christian, after careful and prayerful meditation, must conscientiously decide for himself.” Watchtower 2000 Jun 15 pp.29-31

2004 – Hemoglobin, a major component of blood by weight is specifically permitted – In the Watchtower 2004 June 15 it is shown graphically that transfusions of whole blood and transfusions of the ‘major’ components of blood are forbidden. ‘Major’ components are stated to be red cells, white cells, plasma and platelets. However, fractions of these four components may be used. In other words, when blood is broken down into small enough components 100% of it can be transfused by a Jehovah’s Witness.

Determining Which Components to allow

In 1958 the criteria for determining what is acceptable related to whether the components ‘nourished’ the body, leading to serums being allowed.

“While God did not intend for man to contaminate his blood stream by vaccines, serums or blood fractions, doing so does not seem to be included in God’s expressed will forbidding blood as food. It would therefore be a matter of individual judgment whether one accepted such types of medication or not.” Watchtower 1958 Sep 15 p.575

In 1982 the concept of ‘nourishment’ was replaced with a consideration of whether a fraction was a ‘major’ component. Major components are forbidden but certain minor components are allowed.

“While these verses are not stated in medical terms, Witnesses view them as ruling out transfusion of whole blood, packed RBCs, and plasma, as well as WBC and platelet administration. However, Witnesses’ religious understanding does not absolutely prohibit the use of components such as albumin, immune globulins, and hemophiliac preparations; each Witness must decide individually if he can accept these.” Awake! 1982 Jun 22 p.25

In 1990 the consideration for which minor components can be use was related to placenta transfer.

“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.” Watchtower 1990 Jun 1 p.31

In 2000, the rule was greatly simplified. A “major” component cannot be used but a “minor” one can, though the following section will show there is no basis or logic behind such reasoning. This distinction is identified in the 2008 book Keep Yourself in God’s Love.

Current Standard

The Apostles had no physiology manuals and made no distinction between blood components. Blood referred to just that; blood. No distinction was made to allow for the separation of blood into fractions, allowing the consumption of one blood component and not another.

The current Watchtower position to allow blood fractions is unscriptural and inaccurate. To justify what these major components are, the 2004 Watchtower article contains the following quote;

“The 2001 textbook Emergency Care, under “Composition of the Blood,” stated: “The blood is made up of several components: plasma, red and white blood cells, and platelets.” Thus, in line with medical facts, Witnesses refuse transfusions of whole blood or of any of its four primary components.”

The book the Society chose to use as a reference is not a medical textbook and is a simplification of the major components of blood. As shown in Medical textbooks such as Modern Blood Banking and Transfusion Practices by Denise M. Harmening, Ph.D., the major components of blood can be considered to include;

“Red blood cells, RBC Aliquots, Leukocyte-reduced red blood cells, frozen – deglycerolized red blood cells, platelet concentrate, single donor plasma, cryoprecipitated antihemophilic factor, granulocyte concentrates, factor VIII concentrate, porcine factor VIII, factor IX concentrate (Prothrombin Complex), immune serum globulin, normal serum albumin, plasma protein fraction, Rho(D) immunoglobulin, antithrombin III concentrate.”

Since 2000, Jehovah’s Witnesses have been allowed to transfuse many of these blood factors. For instance, whereas white blood cells compose less than 1% of the volume of blood allowed serum proteins compose 6%. Hemoglobin is an allowed component makes up over 15% of the volume of blood. Quite startling, once broken down into fractions a Witness can transfuse 100% of blood.

The Watchtower attempts to create a semblance of logic to its allowance of blood fractions by presenting the concept that blood consists of four primary “components”. Use of these components is unchristian but when these components are broken into “fractions” their use is acceptable. (w04 6/15 p. 21)

This Watchtower distinction of fractions from components is used to make it appear that a component is somehow different and hence more of a violation when used than a fraction. This is flawed reasoning because a component is a fraction, these are interchangeable terms. Many medical texts refer to red and white blood cells as fractions. Likewise, text books discuss the breakdown of plasma into components.

The classification the Watchtower uses of blood being composed of the four primary fractions of plasma, red cells, white cells and platelets is a common one. It is accurate, albeit a basic simplification that has arisen from what results when blood is processed through a centrifuge. The result is:

  • plasma
  • buffy coat (white cells and platelets)
  • red cells.

This classification is only one of many ways to describe blood. Blood is alternatively classified as being made of four major components of plasma, fat globules, chemicals and gas – with red and white cells being considered fractions of plasma. ( 28 Feb 2006)

Alternatively, “blood consist of cellular material (99% red blood cells, with white blood cells and platelets making up the remainder), water, amino acids, proteins, carbohydrates, lipids, hormones, vitamins, electrolytes, dissolved gases, and cellular wastes.” 28 Feb 2006)

Simply put, blood plasma is a liquid made up of water, water red cell, white cells, platelets, proteins, glucose, mineral ions, hormones, carbon dioxide, immunoglobulins, growth factors, albumin, plus a host of other substances.

Watchtower discussion that blood comprises four components is deceptive; as their use of this definition is to make it appear breaking a component into a fraction becomes acceptable. In reality, many of the allowed “fractions” are suspended in the plasma in much the same manner “components” such as red cells are suspended in plasma.

For example, the hierarchal system the Watchtower presents is intended for it to appear that a platelet is more offensive to God than Immunoglobulin. However, in reality these are both components suspended in the plasma, and whilst “acceptable” immunoglobulin composes 1.7%, platelets compose only 0.5% of the volume of blood.

The 4 major components used is an arbitrary measure. Some medical books list just 2 major components, Red blood cells and Plasma. If the Watchtower chose the definition of 2 major components it could then allow White Blood cells and platelets. Other sources list 16 major components; if chosen this would then disallow several fractions now allowed. Other sources divide blood by chemical composition which would totally change again what is allowed.

The Watchtower has used an arbitrary definition, resulting in an arbitrary result. The only way to have a coherent doctrine is to have an all or nothing policy. Bible writers were unaware of any of these definitions. Blood was not separated by a centrifuge. Blood was simply regarded as blood. To contain some semblance of logic, the Watchtower should either allow the use of blood use, or not allow it in any form.

The Watchtower blood issue supposedly centres on the sacredness of blood. The Watchtower 1961 Sep 15 p.559 stated that “Whether whole or fractional, one’s own or someone else’s, transfused or injected, it is wrong.” Blood was not be eaten or transfused but poured on the ground out of respect for God and his gift of life. If this is so, how can the Watchtower now consider the use of blood fractions and blood substitutes such as Hemopure as acceptable? The taking of large quantities of blood and processing it into components for later use shows less sanctity for blood than a blood transfusion.

View of the Medical Fraternity

In general, doctors are encouraged to follow the wishes of their patients, and many will respect the stand that a Jehovah’s Witness will make for their convictions. Doctors act in the best interests of their patients and recognise that blood carries risks and will avoid it where considered possible.

“Because the blood transfusions carry risks and because the blood supply is limited, doctors try not to transfuse when possible. In some cases, alternatives to blood product transfusions may be available.” ( 28 Feb 2006)

However, blood is at times deemed essential for survival and though the Watchtower questions the ethics of the Medical fraternity, they should not ignore that a doctor has financial incentive to act in a manner that gives patients their best chance for survival. Increasing litigation insurance costs ensure doctors recommend blood because they believe it increases a person’s chance of survival. As of 2010, there are no alternatives for red blood cells; this is still the only known way for the body to successfully carry oxygen. states that “Human blood substitutes have been in the pipeline since the 1980s. But, for a combination of scientific and political reasons, there are none currently on the market in either Europe or the US.”

Many physicians understand that the Watchtower rules on blood related procedures are inconsistent;

“Many physicians are surprised by the complexities involved in distinguishing between acceptable and unacceptable treatments for JW patients. Muramoto notes: [Muramoto O. Recent developments in medical care of Jehovah’s Witnesses. West J Med 1999]”For physicians who treat JWs, one of the most puzzling aspects is that they are, in fact, accepting many blood-based treatments despite their belief in absolute abstinence from blood. Since this biblical law is said to be absolute, it is unclear why the WTS does not teach its members to simply refuse all medical use of blood.”


The Bible emphasises respect for life. At Matthew 12:11 Jesus showed that it was more important to save the life of an animal than to follow the Mosaic Law. How much more important it is to save the life of a human than follow the law on blood transfusions; legislation that the Watchtower organization did not establish until 1945.

Christian scholars understand that the Mosaic Law was done away with at Jesus death and that Acts 15 only applied to congregations with a mix of Judaizers and Gentiles. Russell and the original Jehovah’s Witnesses recognised this for almost half the history of the Watchtower Society. Jehovah’s Witnesses currently misuse Acts to claim modern day Christians must not have blood and then erringly revert to the Mosaic Law for formulating the strict details on their blood doctrine.

Due to the variety of standards that the Watchtower Society has had over the years in regards to blood, vaccinations, transplants and other medical procedures a person is entitled to ask:

“Is Jehovah directing the Watchtower Society in issuing medical directives?”

Can it be said that God’s holy spirit has directed the Watchtower Society to this controversial position on blood transfusions? An examination of the history of this doctrine shows that this can not be considered the case.

Witness lives have been lost following laws on blood, vaccinations and organ transplants that were later superseded. A gross injustice has been done to members and it is unfortunate that Jehovah’s Witnesses are willing to die for a doctrine without knowing its history or alternate Scriptural viewpoints. These deaths are the ultimate sacrifice for an Organization, placing blood on the hands of Watchtower leaders.

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