blood. But if you did, it is very likely that skilled doctors could manage your care without using blood transfusions, which have so many risks.

SURGERY, YES—BUT WITHOUT TRANSFUSIONS

Many people today will not accept blood. For health reasons, they are requesting what Witnesses seek primarily on religious grounds: quality medical care employing alternative nonblood management. As we have noted, major surgery is still possible. If you have any lingering doubts, some other evidence from medical literature may dispel them.

The article “Quadruple Major Joint Replacement in Member of Jehovah’s Witnesses” (Orthopaedic Review, August 1986) told of an anemic patient with “advanced destruction in both knees and hips.” Iron dextran was employed before and after the staged surgery, which was successful. The British Journal of Anaesthesia (1982) reported on a 52-year-old Witness with a hemoglobin level under 10. With the use of hypotensive anesthesia to minimize blood loss, she had a total hip and shoulder replacement. A surgical team at the University of Arkansas (U.S.A.) also used this method in a hundred hip replacements on Witnesses, and all the patients recovered. The professor heading the department comments: “What we have learned from those (Witness) patients, we now apply to all our patients that we do total hips on.”

The conscience of some Witnesses permits them to accept organ transplants if done without blood. A report of 13 kidney transplants concluded: “The overall results suggest that renal transplantation can be safely and efficaciously applied to most Jehovah’s Witnesses.” (Transplantation, June 1988) Likewise, refusal of blood has not stood in the way even of successful heart transplants.

‘What about bloodless surgery of other types?’ you may wonder. Medical Hotline (April/May 1983) told of surgery on “Jehovah’s Witnesses who underwent major gynecological and obstetric operations [at Wayne State University, U.S.A.] without blood transfusions.” The newsletter reported: “There were no more deaths and complications than in women who had undergone similar operations with blood transfusions.” The newsletter then commented: “The results of this study may warrant a fresh look at the use of blood for all women undergoing obstetric and gynecological operations.”

At the hospital of Göttingen University (Germany), 30 patients who declined blood underwent general surgery. “No complications arose that could not also have arisen with patients who accept blood transfusions. . . . That recourse to a transfusion is not possible should not be overrated, and thus should not lead to refraining from an operation that is necessary and surgically justifiable.”—Risiko in der Chirurgie, 1987.

Even brain surgery without using blood has been done on numerous adults and children, for instance, at New York University Medical Center. In 1989 Dr. Joseph Ransohoff, head of neurosurgery, wrote: “It is very clear that in most instances avoidance of blood products can be achieved with minimal risk in patients who have religious tenets against the use of these products, particularly if surgery can be carried out expeditiously and with a relatively short operative period. Of considerable interest is the fact that I often forget that the patient is a Witness until at the time of discharge when they thank me for having respected their religious beliefs.”

Finally, can intricate heart and vascular surgery without blood be performed on adults and children? Dr. Denton A. Cooley was a pioneer in doing just that. As you can see in the medical article reprinted in the Appendix, on pages 27-9, based on an earlier analysis, Dr. Cooley’s conclusion was “that the risk of surgery in patients of the Jehovah’s Witness group has not been substantially higher than for others.” Now, after performing 1,106 of these operations, he writes: “In every instance my agreement or contract with the patient is maintained,” that is, to use no blood.

Surgeons have observed that good attitude is another factor with Jehovah’s Witnesses. “The attitude of these patients has been exemplary,” wrote Dr. Cooley in October 1989. “They do not have the fear of complications or even death that most patients have. They have a deep and abiding faith in their belief and in their God.”

This does not mean that they assert a right to die. They actively pursue quality care because they want to get well. They are convinced that obeying God’s law on blood is wise, which view has a positive influence in nonblood surgery.

Professor Dr. V. Schlosser, of the surgical hospital at the University of Freiburg (Germany), noted: “Among this group of patients, the incidence of bleeding during the perioperative period was not higher; the complications were, if anything, fewer. The special view of illness, typical of Jehovah’s Witnesses, had a positive influence in the perioperative process.”—Herz Kreislauf, August 1987.

You Have the Right to Choose

A current medical approach (called risk/benefit analysis) is making it easier for doctors and patients to cooperate in avoiding blood therapy. Doctors weigh factors such as the risks of a certain drug or surgery and the probable benefits. Patients too can share in such an analysis.

Let us use one example that people in many places can relate to—chronic tonsillitis. If you had this problem, likely you would go to a doctor. In fact, you might consult two, since health experts often recommend getting a second opinion. One might recommend surgery. He outlines what that means: length of hospital stay, amount of pain, and cost. As to risks, he says that severe bleeding is not common and death from such an operation is very rare. But