One of the most important aspects of science is it’s progressive nature. Our knowledge of any subject is always changing. Nowhere is this more evident than in science-based medicine. Physician guidelines change on an annual basis depending on studies and evidence supporting new treatments, therapies and procedures.
Even seemingly well-established techniques like Cardiopulmonary Resuscitation (CPR), are under constant debate. Chest compression-to-ventilation ratios were changed in 2005 from 15:2 to 30:2, and now are challenged altogether with a compression-only technique. Such changes in medical procedure are not only common, but are expected to occur in the face of new studies and evidence. This fundamental component of science-based medicine allows patients to be assured that they receive the most current and up-to-date healthcare.
I can not imagine anything more contrasting to this than religion. Religion is structured in such a way as to prevent its beliefs from changing. Only when the most superior leaders of a religion decide that it should be changed does the doctrine itself change. It took almost 300 years for the church to accept heliocentrism, and only last year did the Vatican accept evolution, exactly 150 years after Darwin’s seminal work On the Origin of Species. Even such central understandings of the universe and biology are difficult for religions to accept.
Last week, I was doing rounds in the neonatal intensive care unit (ICU) when I was introduced to a lovely little patient attached to IV lines and a nasal cannula for oxygen supplementation. This unstable newborn baby was suffering from hemolytic disease of the newborn, which occurs when maternal antibodies still present in the baby attack its red blood cells (RBCs), causing their contents to spill out into the blood stream. If it wasn’t for the concomitant jaundice that developed, this baby’s fatally low hemoglobin levels would have caused him to be almost as pale as the page these words lie on.
When a pediatrician is confronted with this scenario, the treatment is rather common sense: stabilize the patient, attempt to clear the serum of toxic levels of bilirubin (to prevent irreversible brain damage), and transfuse the patient with compatible blood. Otherwise, the baby’s blood cells will continue to be attacked until there are none left and the central organs cease to receive oxygen.
But alas, the baby’s parents are Jehovah’s Witnesses and blood transfusions are strictly against their beliefs because a nearly 2000 year-old scripture warns against eating blood. Not that eating blood and a transfusion are the same thing but according to the religions main legal entity, The Watchtower Society, it is. “The Society,” as it is often referred to colloquially by Witnesses, directs, administers and develops the doctrines for the religion and followers.
The Watchtower Society doesn’t draw the line at whole blood transfusions but rather at any components of blood. This includes platelets, RBCs, white blood cells (WBCs) and blood plasma and further discourages the use of fractions from any of these blood components, including albumin, globulins, clotting factors, erythropoietin (EPO), and hemoglobin. These restrictions have lead doctors to develop bloodless surgery techniques. Such surgery is not yet common, and very few have the luxury of utilizing it.
In the meantime, Jehovah’s Witnesses are expected to die during the desperate times requiring blood transfusions, which are more common than one might think. This is exemplified by the Jehovah’s Witness magazine Awake, which explained in its May, 1994 issue that:
“In former times thousands of youths died for putting God first. They are still doing it, only today the drama is played out in hospitals and courtrooms, with blood transfusions the issue.”
If practicing Jehova’s Witnesses do receive transfusions, they are ousted from the religion in what’s known as disfellowshipping. These individuals are cut off from their families and friends who are also Jehovah’s Witnesses because the religion attempts to limit social interaction with non-Witnesses.
With increasing pressure in our technologically-advanced era, the Watchtower Society has very gradually loosened its grips on its opposition to blood transfusions and blood products. In the last few years the religion has allowed their followers to use specific blood products in special cases. For example, hemophiliacs are no longer shunned for using blood clotting factors under special circumstances. The church also seems to be heading towards the direction of allowing autologous blood donation, a process where a patient donates blood for storage that is used later in his own surgeries.
This raises the question, why not speed up the process? Why let so many people die in the past because of rules that will ultimately change in the future? Can’t Jehovah’s Witnesses just skip all the politics and allow their followers to use modern medicine like everyone else? It would certainly place the religion in a better light by removing one of its most significant criticisms. A giant weight would be lifted from the backs of so many hemophiliacs, anemics and pregnant mothers.
In the USA, the law requires doctors to overrule the wishes of families that want to deny their children procedures that would prevent long-term complications and death. This is not true around the world, however, and here in Poland, where I go to school, that is not the case. Doctors need to acquire court orders to treat children who’s parents deny them basic lif e support or treatments that would prevent end-organ damage.
As for the baby whom I saw myself in the hospital, well she did receive a court-ordered life-saving blood transfusion. If she hadn’t, there’s no doubt she might not be alive anymore. According to the resident physician, when the parents heard of this they decided to give her up for adoption. It’s still a mystery to me how religions can override our most innate emotions. To me, however, the adoption was a blessing in disguise.