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AAWA raising the blood issue AGAIN?

The following article appeared on the Good Man Project online edition on the 23rd of January 2024:

Lee Elder is the founder and acting director of AJWRB (Advocates for Jehovah’s Witness Reforms on Blood). AJWRB is a non-profit educational association operating under the umbrella of AAWA (Advocates for Awareness of Watchtower Abuses).

Born and raised as a Jehovah’s Witness, Lee is part of the fourth generation in his family to follow this faith. He was baptized at the age of nine and started serving as a regular pioneer at fifteen. After completing college, he continued his service as a ministerial servant, and regular pioneer. He was later appointed as an elder where he held various responsibilities within the congregation, such as Book study conductor, Congregation Secretary, and Watchtower Study Conductor.

Lee’s interest in the Watchtower’s blood policies was heightened following a significant exchange with his primary care doctor in the early 1990’s. This, coupled with the distressing experiences he witnessed among Jehovah’s Witnesses, led to numerous unanswered questions.

After an extensive period of study, Lee concluded the Watchtower’s blood policy was flawed from its inception. Sharing this conclusion with other Jehovah’s Witnesses risked charges of apostasy and expulsion, with even the closest family members being required to shun. This was the mechanism Watchtower had used to suppress dissent for many decades. The advent of the internet, however, enabled a remarkable change.

In February of 1997, having been rebuffed by a member of the Governing Body, Lee opened a website titled “New Light on Blood” to expose the various irrational and unscriptural aspects of the policy. Soon, he was contacted by numerous Jehovah’s Witnesses who were struggling to deal with Watchtower’s policy. Many of these were other elders, as well as HLC (Hospital Liaison Committee) members, and various organization officials. Over the following year this group reformed as AJWRB and set out on a mission to reform the Watchtower’s blood policies.

Although no longer active as a Jehovah’s Witness, Lee continues to advocate for Jehovah’s Witnesses, and educates both patients and the medical community about the irrational aspects of Watchtower’s blood policy. He envisions a future where all members will have the opportunity to make fully informed choices about their healthcare without the constraints of coercion and mandated shunning.

“Lee Elder” is a pseudonym Lee adopted while still an active Jehovah’s Witness elder in the mid 1990’s. This alias enabled him to retain his standing within the Jehovah’s Witness community while spearheading an initiative from within the Watchtower Society to reform its blood policy. His dedication for seeking reform of the Watchtower’s blood policy is driven by his concern for fellow Jehovah’s Witnesses and their families. Lee contributions have been acknowledged through publications in the British Journal of Medical Ethics and interviews with the BBC. Frequently cited in medical journals, Lee currently serves as the Vice President at AAWA.

Here, we talk about the issues AJWRB tackles.

Scott Douglas Jacobsen: Now, to the main focus of Advocates for Jehovah’s Witness Reform on Blood (AJWRB), the issue of blood transfusions. Not for the life-and-death medical emergencies, but, rather, for the issues around the blood issues requiring ongoing care and medical treatment. What has been the position for decades of the Jehovah’s Witnesses on blood transfusions?

Lee Elder: Elements of the Watchtower’s blood policy have been stable for many decades. Namely, that whole blood transfusion is prohibited, along with the primary components: red cells, white cells, platelets, and plasma. However, their position on the use of the 200 plus plasma proteins has been in a near-constant state of flux beginning in the 1950’s. While there were numerous reversals in the 1950’s, the trend was unmistakable, and by the 1980’s they were permitting 100% of blood plasma fractions.

Numerous members of AJWRB pressed the Watchtower for an explanation as to why these blood products were acceptable when some of them, like albumin, are much larger by volume than platelets – which are not allowed.

In response to the rising criticism leveled by AJWRB, physicians, and medical ethicists, in 2000 the Watchtower responded by changing their policy to permit the use of all blood fractions from not only plasma, but the remaining blood components (red & white cells, and platelets).

Additionally, unreleased Watchtower documents showed the Watchtower leadership was on the cusp of permitting Jehovah’s Witnesses to predonate their own blood, and had printed and shipped advance directives to this effect, but suddenly changed their minds and withdrew them in late 2001. The policy has been static since that time, so as it stands, Jehovah’s Witnesses may technically use 100% of blood as long as it is fractionated.

This includes the largest of all blood proteins – hemoglobin which transports oxygen. If a stable and FDA approved hemoglobin-based oxygen carrier (HBOC) is developed, it would likely solve many of the problems their policies have created. Jehovah’s Witnesses have been using Hemopure (an HBOC developed from bovine hemoglobin) on a compassionate use basis for about 20 years, and it is approved for use in South Africa. However, the dream of artificial blood has proved elusive for Jehovah’s Witnesses, as well as the military.

Jacobsen: What was the position of the Jehovah’s Witnesses on this stuff before the change in the 1960s on the policy?

Elder: Answered above. If you want more detail look here:

Jacobsen: There’s more than one elephant in the room. Here’s one, if we did not have the scientific and secular revolutions, and medical technological and technique advancements, we would not know about this – nor would the Jehovah’s Witnesses. In that, this only became an issue in the light of the advancements of modern science, medical technology, and secular society, not Jehovah’s Witnesses culture. Obviously, the justifications for the Jehovah’s Witnesses come from the Bible. My bias aligns with the analysis of the brilliant and articulate Professor of Hebrew Bible and Ancient Religion at the University of Exeter, Francesca Stavrakopoulou (who I absolutely adore as an intellectual), i.e., the Bible is a collection of storybooks or a collection of opinions reified into some divine or transcendental truth status. It is an analysis of fellow traveler humanists, by and large. What is the mixed status of the Jehovah’s Witnesses towards science and medicine in general terms?

Lee Elder: Jehovah’s Witnesses, in general terms, embrace this revolution right up to the point where it conflicts with their beliefs. For example, they welcome all aspects of modern medicine as long as they can be practiced without whole blood, red blood cells, white blood cells, or platelets. Now bear in mind, the Bible has nothing to say about blood components or even the modern practice of blood transfusion for that matter. These are policies developed by the Watchtower organization which is seen as a divine channel of communication between God and the average Jehovah’s Witness.

In other areas of technological revolution we see Jehovah’s Witnesses largely willing to embrace change and advancement. Like other large modern organizations, they have embraced information technology and have moved largely to a digital format.

However, they bristle at the thought that creation was accomplished by anything other than direct and purposeful intervention, and thus completely reject modern scientific theories like evolution. Other examples come to mind, like a single Jehovah’s Witness choosing to become impregnated through artificial insemination.

Jacobsen: Following from the previous question, if we look at the Jehovah’s Witnesses sources themselves, or some emails sent to me, there is the assertion of the Jehovah’s Witnesses acceptance of all medical treatments, as in not rejecting any medicine. While, at the same time, if I look at the rejection of some orientations around blood transfusions, there is a rejection of some medical treatments and, thus, acts as a defeater for the assertion of accepting all medical treatments, simply as a matter of logical reasoning. On the issue of the mixed stature of the Jehovah’s Witnesses to blood transfusions, what types of blood transfusions will the Jehovah’s Witnesses accept? What type will they reject?

Lee Elder: Answered above. For more detail look here:

I would add that the blood prohibition does indeed result, albeit indirectly, in Jehovah’s Witnesses rejecting some medical treatments. This happens when those treatments have the side effect of blood loss or deterioration of the blood. A good example would be chemotherapy treatments for cancer which can cause severe anemia in which case a faithful Jehovah’s Witness would have to stop their chemotherapy. Other examples could be given, but they would all involve the blood issue.

Jacobsen: There is an idea of quoting scripture as a form of reasoning within the community of the faithful. Some term the Jehovah’s Witnesses as a cult. Others as a fringe religious group. Others as the chosen group, and so on. What is the general theological orientation of the Jehovah’s Witnesses?

Elder: I would describe the Jehovah’s Witnesses as a “high control” fundamentalist Christian group. They practice a primitive form of Christianity that emphasizes the old testament. They see themselves as set apart from the rest of the world and hence as alien residents.

Jacobsen: Following from the previous question, how does this compare to the mainstream of Christianity around much of the world, especially the societies with better educational systems and healthcare infrastructure?

Elder: The thing that comes to mind is the disparity in education. Their members have the lowest level of education among the various Christian groups. This is because they discourage their children from pursuing higher education. I believe this is because experience has taught them that members who are better educated are more likely to become critical thinkers, and this tends to create difficulty in a high control group like the Witnesses where compliance and submission are expected.

Jacobsen: Wikipedia gives some names of former or ex-Jehovah’s Witnesses: Francisco José Alcaraz, Peter Andre, David Bercot, Gary Botting, Heather Botting, Danielle Colb,y Daniel Allen Cox, Patrisse Cullors, DMX, Luke Evans, Rakin Fetuga, Deborah Frances-White, Raymond Franz, Jesse Garcia, Jan Groenveld, Gary Gygax, Barbara Grizzuti Harrison, Ja Rule, Janet Jackson, Jermaine Jackson, La Toya Jackson, John-Paul Langbroek, Norma McCorvey, Kurt Metzger, Olin R. Moyle, Dave Mustaine, Gloria Naylor, Kylie Padilla, Oliver Pocher, Nate Quarry, Michelle Rodriguez, Amber Scorah, Sherri Shepherd, Patti Smith, Carol M. Swain, TomSka, and Yahir. What happens to individuals who leave the faith? Is this likely the things happening to individuals leaving today? Did this probably happen to the aforementioned listed individuals above?

Elder: Every situation is a bit different, but ultimately the circumstances under which a person leaves will determine how they are viewed and treated. If they openly defy the leadership or choose to break the organization’s rules they may be disfellowshipped. In that case, they will experience extreme shunning with former JW friends and family members required to abstain from seeing or speaking to them. However, if they simply choose to quit attending they will be viewed as inactive and spiritually weak. Other JW’s may choose to shun them but they are not required to do so.

Jacobsen: Back to Advocates for Jehovah’s Witness Reform on Blood (AJWRB), the website states:

AJWRB is an international educational organization composed of volunteers, with the following goals:

To assist physicians, and hospital administrators in actively seeking ways to stop compliance monitoring of JW patients by WT representatives who are required to report any deviation from WT policy.

To provide physicians with the knowledge, and necessary tools to equip them to have meaningful interactions with their JW patients, and promote “non-interventional paternalism”.

To better inform JWs in the hope they will make life saving choices for themselves and their families.

To promote meaningful change to WTS policy that enforces compliance through coercion, and misinformation.

To support those who have been traumatized by WTS policies on blood transfusion and shunning, with special emphasis on those who were born to JW parents, and/or raised in the religion.

Let’s cover this point by point and take as much space as you need, what are the theoretical and practical manifestations of these goals for AJWRB?

Elder: I would say that over the past twenty five years we have been pretty effective in conveying to the medical community the need to have private conversations with their JW patients regarding their medical care. Particularly when it comes to the topic of blood products. Physicians are now largely aware that their JW patients face potential duress and coercion to follow whatever the current Watchtower policy happens to be. As a result, many doctors have developed strategies to provide needed blood products in private settings like an operating room, or during the middle of the night so that Watchtower representatives are not easily able to monitor what is being done.

Of course there are many challenges. In emergency situations, things develop so quickly that it can be difficult to make a difference. This is why education is really the key but that too has been problematic. The Watchtower, as previously stated, is a “high control” group with cult-like characteristics. One of the manifestations of this is that members are told in clear terms not to read anything critical of the organization. So theoretically, a Jehovah’s Witness could simply go to and come to understand the Watchtower policy, but practically many will not. This is why it’s so important that we continue to reach out to medical professionals who are in a very good position to assist their patients with just a little effort on their part. In my own case, it was my personal physician who got me questioning the Watchtower policy simply by saying, “I don’t understand why they have changed their position so many times”.

As for the Jehovah’s Witnesses who have been adversely affected by the policy we are able to offer them some support and understanding. Most of us have also been affected adversely. One thing that some find cathartic is simply being able to tell their story. Either directly to us by email, phone or Skype, or in some cases by relating their experience in the hope that it will help others:

Jacobsen: In the past, what have been invalid critiques of AJWRB?

Elder: Watchtower leaders tend to dismiss AJWRB as hateful apostates. Disaffected former members, and tools of the devil. What seems to be missed is that AJWRB grew out of a core group of faithful JW elders and HLC members that were confused by the many contradictions of the policy, and distressed by the devastation caused by the policy.

It was pretty clear to us back in 1997 that given the entire story, most Jehovah’s Witnesses would conclude that the Watchtower’s blood policy was in serious need of an overhaul. If speaking truth to power makes us “evil” in their view simply because we want members to make free and informed choices, then so be it.

Jacobsen: In the past, what have been valid critiques of the AJWRB?

Elder: The only valid criticism of AJWRB that I have personally read is some disappointment of former Jehovah’s Witnesses that we have not accomplished more in the way of reform of the organization’s policies. I think that is valid, and I share that view. This has been a long uphill slog, and I’ve come to think about it more in terms of “reforming” the thinking of the medical community, and individual Jehovah’s Witnesses. In that context, we’ve done a great deal of good.

If you go to Google Scholar and type in: AJWRB and this is what popped up:

Fairly impressive considering all that’s happened over the years. And, Google Scholar does not pick up the lion’s share of academic works out there.

Jacobsen: Based on a listing from the University of Calgary and some others, great resources on destructive cults have been Robert Jay Lifton, Rick Alan Ross, Jeffrey K. Hadden, Eileen Barker, Catherine Wessinger, James T. Richardson, Irving Hexham, Karla Poewe, George Chryssides, Hubert Seiwert, Lynne Hume, Richard Poll, John Morehead, Anton Hein, and Steven Hassan, and then Margaret Singer. Who else comes to mind for you?

Elder: Jon Atack comes to mind as well as Bonnie Zieman, and Lee Marsh.

Jacobsen: As you note through AJWRB, the Watchtower’s blood policy is a religious based belief. To independent journalists outside of the Jehovah’s Witnesses and coming from the perspective of scientific skepticism, any quotation of sacred scripture to bolster scientific and medical claims does not strengthen the medical or scientific claim. However, it does make the claimant less reliable and valid to the scientific skeptic perspective. If one quotes the Book of Mormon, the Bible, the Quran, the Bhagavad Gita, etc., and if the quotations are intended to support a medical or scientific claim in an overall explicit or implicit argument, then this doesn’t make the position any more firmly established. Same with moral acts based on ethical theoretical positions and then application of these to some transcendent object. Neither makes the positions or the ethics more firmly established and, therefore, become, more or less, useless steps in medicine and science, and in ethics. What other positions of the Watchtower amount to more religious-based beliefs than scientific or medical beliefs primarily? In that, the religious ground is drawn out, and then the scientific and medical evidence and claims are warped, ignored, or falsified in order to support the positions?

Elder: I’m afraid I’m a one trick pony, and limit myself to the blood issue. I can refer you to others on different topics.

Jacobsen: Let’s cover some of the core experts helping AJWRB, who are the medical experts and scientists who are part of AJWRB? Who are the ones not a part of AJWRB while helping the organization?

Elder: AJWRB is now in its 25th year of advocacy, so as you can imagine, we’ve had quite a few different medical advisors over that period of time including anesthesiologists, neurologists, hematologists, medical ethicists, etc. Without question, however, Dr. Osamu (Sam) Muramoto was the most influential. We owe him a great debt, as do Jehovah’s Witnesses in general – whether they realize it or not.

Jacobsen: Are the Jehovah’s Witnesses a destructive cult or not? If so, why? If not, why not?

Elder: At least for the time being the answer to this question continues to be yes. There is simply no rational reason or scriptural basis for a religion to require members to refuse life saving medical care. They have abandoned previous bans on vaccines and organ transplants, and they need to walk away from their blood ban as well.

Jacobsen: AJWRB, fundamentally, wants reform on blood within the Jehovah’s Witnesses. If we take some of the research of AJWRB, what have been the mortality statistics based on expert analysis, even if we ignore all of the other concerns?

Elder: Formulating mortality estimates has been difficult. However, it is becoming easier with recent studies of anemia among Jehovah’s Witnesses by several researchers. Our most recent published estimates can be found here:

While I cannot go into further detail at this time, I am privy to recent research and analysis that strongly suggests our estimates have been entirely too conservative.

The death toll is likely much higher than what we have suggested, and Watchtower

officials and former officials seem to have acknowledged as much. I will give you an example.

Here is a fairly recent interview with a former WT official in WT HID (Hospital Information Department) for the U.S:

At minute marker 9:15 he talks about he and his wife first entering Bethel. She was a nurse and went straight away to work in the infirmary.

At minute marker 11:30 he talks about his entrance to HID.

At minute marker 24:50 he begins answering questions about the number of deaths due to the blood policy. He ends up saying over a 3-1/2 year period there were thousands of deaths in the US Branch alone.

Jacobsen: What other complications have arisen for Jehovah’s Witnesses due to the Watchtower policies and religious prescriptions on blood transfusions and blood in medical treatments?

Elder: Beyond premature death and all of the family trauma that goes with it, I’d have to say the consequences of severe anemia. While the Watchtower likes to address the miracles of JW’s surviving massive blood loss with very low hemoglobin counts, you will seldom, if ever, here them talk about the consequences. There is frequently a very high price to be paid for starving your brain and other organs of oxygen. I knew one JW woman with diverticulitis who rejected blood and survived only to learn that she suffered brain shrinkage and dementia. Damage to the heart is not uncommon either.

Jacobsen: What have been the deaths attributable to the policy?

Elder: See above.

Jacobsen: What are the Jehovah’s Witnesses or the Watchtower claiming themselves? Have they put out any statistics?

Elder: They deny there is a problem and point to the marvels of bloodless surgery.

Jacobsen: How have these policies over decades, put them in a knot or a pickle with the modern scientific and medical world and the issues of religious-based beliefs and policies?

Elder: The medical and legal community are still coming to terms with the policy and we see quite a bit of variation with how it is handled in different countries. In the U.S. there is great accommodation for the JW’s due to the high regard for freedom of religion. I personally think it goes too far – particularly with regard to children and minors. Most have been indoctrinated from the cradle to support the policy and have not developed enough mentally to even question it. Furthermore, they have been meticulously trained to answer questions from doctors, hospital administrators, and judges to make it appear as though they are mature enough to make life-and-death decisions. It amounts to brain washing in my opinion. There are a number of doctors who are far too accommodating when it comes to providing no-blood treatments that amount to “second best” care or worse. When this care involves minors it clearly crosses the line in my view.

Jacobsen: What do you consider the strongest arguments against the policies of the Watchtower in regards to some of the subject matter discussed today?

Elder: This is the 64,000 question and the answer is straightforward. “Where in the Bible does it explain which parts of blood are permissible and which parts are not?” This is the question every doctor should be asking his JW patients. Once the patient grasps the fact that 100% of blood is acceptable in fractionated form they generally conclude the entire policy is deeply flawed.

Jacobsen: Where can people get more information and become involved with AJWRB? What are other important resources and voices in this work?

Elder: Individuals can find information at various websites on blood around the internet but it is limited. Generally it is associated with sites that are widely critical of the Watchtower. AJWRB is different. We started in 1997 as a movement from within Jehovah’s Witnesses advocating for reform of the blood policy. The original materials, still largely intact, were written by current Jehovah’s Witness elders and Hospital Liaison Committee members. One of our brochures was written with the assistance of a former member of the Governing Body of Jehovah’s Witnesses.

AJWRB offers comprehensive educational resources for Jehovah’s Witnesses and the medical professionals who treat them, and we do it on a strictly voluntary basis and without any expectation or agenda. Our goal is simply to help individuals make informed choices about the medical care they choose for themselves and their children. While seeing the Watchtower finally walk away from this tragic policy is something we yearn for, that remains entirely up to the leadership of the organization. If and when that finally happens, it is a change we would welcome. It is not something we would criticize.

About Scott Douglas Jacobsen

Scott Douglas Jacobsen is the Founder of In-Sight Publishing and Editor-in-Chief of "In-Sight: Independent Interview-Based Journal" (ISSN 2369–6885). Jacobsen is a Tobis Fellow (Research Associate) at the University of California, Irvine for 2023-2024. He is a "Freelance, Independent Journalist" and "in good standing" with the Canadian Association of Journalists. He considers the contemporary scientific method as the pragmatic, functional source of understanding the world and universal human rights as the moral frame leading substantive ethical discourse, internationally. You can email: Scott.Douglas.Jacobsen@Gmail.Com.

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