Why Is Evolution Still Debated?

May 9, 2010

It always baffles me that to this day many people don’t believe in evolution. Even from my early days in grade school it seemed so obvious to me that human beings came from earlier species of animals. Other people don’t seem to grasp such fairly simple scientific concepts, especially in the U.S. where polls have shown that only 45% of Americans agreed with the statement, “Human beings, as we know them today, developed from earlier species of animals.” That’s significantly less than the figure in Europe, which was 65%. Still shabby.

Last year I had a knock on my door and when I answered it there was two Catholic’s awaiting me to preach the good word of the Bible. They asked me if I was willing to speak to them about Jesus and the Bible, and I replied that I would be very grateful to discuss with them but that I was an atheist. After hearing this response, the considerably older one of the two was shocked. “You don’t believe in a God!?”, he asked. “No. Not at all.” The other member of the Biblical task force was a young guy that looked eager to confront a challenge.

He said to me, “But you must know that the evolution of feathers has never been proven and this is a major obstacle for the theory of evolution!” Every now and again, someone will use an argument that is so demonstrably false that you worry that if there was even a hint of truth to it your beliefs about something would dissolve. The more you learn, the harder it is for this to happen, and that poor kid had no idea who he was dealing with. He was like a sheep outside of a lions den, trying to convince the lion himself to become a vegetarian. I debunked his claim in about 3 sentences. But could anyone who doesn’t read general science articles and listen to science podcasts have done the same? Definitely not.

We bid each other adieu and went on our merry way. Who knows how many people will be led to believe his moronic assumptions? The nonsense will just keep on spreading.

Of note is the detail of his argument. The evolution of feathers? Comeon! That’s just going to make you sound like you know what you’re talking about. More importantly, it’s going to decrease the amount of people able to argue against the claim.

As someone who supports evolution, I find it so easy to come up with much more common sense arguments. Yesterday I thought about how humans lactate after delivery to feed their young, and how mice do the same exact thing. Is that a coincidence? Is it a coincidence that salamanders have hearts in their chests and that bacteria use oxygen with the same molecular mechanisms as us? Or that viruses use DNA just like we do?

According to polls, less than half of Americans that read this post will agree with my views. At what point will the evidence be so overwhelming that those numbers will rise? I guess since evolution has already been proven in just about every way possible, and nothing has come close to challenging it, evidence alone will never change people’s opinions on the subject.

Long-term Evolution Depiction

Do Antidepressants Really Work?

April 26, 2010

As you can see from my previous post, I rely on evidence for all of my beliefs. Currently I’m doing a clinical round in a psychiatry department and one of the most commonly prescribed drugs are antidepressants. A recent study in the New England Journal of Medicine (bow down to the almighty one) has exposed the Food and Drug Administration‘s (FDA) bias towards positive studies of antidepressants.

Not only was the FDA choosing to publicize mostly positive results, but studies with negative outcomes that showed no significant benefits to using antidepressants were presented in such a manner as if they showed benefit. One of the leading authors was a previous employee of the FDA and it was not until he left that he decided to publish a meta-analysis about it and reveal to the public what was going on.

This is a good example of the difference between evidence-based medicine and science-based medicine. Before this article was published, the evidence was there. The antidepressants were being prescribed in an evidence-based manner, but not a science-based one. Science incorporates in it a process by which evidence is examined, valued and scrutinized. Here we see that antidepressants had the evidence, but the evidence was being cherry-picked and studies that lacked a beneficial outcome to antidepressants were being discarded in a bias manner. That is not a scientific approach.

I’ll be interested to see how this pans out. There will have to be many new studies done to determine the true benefit of taking antidepressants. This is gonna be a lot uglier than we might expect. There are many different types of antidepressants (tricyclics, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, etc.)  and each category has lots of different antidepressants within it. Furthermore, antidepressants are used for things other than depression as well, such as obsessive compulsive disorder (OCD) and panic disorder, to name a few.

It’s going to take scientists (especially those working for pharmaceutical companies) a long time to flesh out the exact benefits of many drugs on different psychiatric disorders. Nevertheless, my personal stance on antidepressants is that they are better than placebo (as stated in the NEJM study itself), but that they don’t work on everyone and probably not on the majority of people. They have definite effects in the body and there is no denying that. Which people benefit enough to outweigh the side effects and risks of the drugs is still yet to be determined in a conclusive manner.

And of course, whenever something like this occurs there are quacks out there like Dr. Mark Hyman who use these exposed faults of government organizations and pharmaceutical company-related advances to advertise their alternative mdicine techniques. In his Huffington Post article (95% of people’s articles on there are bunk), he uses the seemingly ineffective benefit of antidepressants to promote Omega 3 fatty acids, and mercury toxicity checks (a common theme in the anti-vaccination movement), along with vitamin D and organic food.

His logical fallacy is as follows: The evidence of antidepressants seems to be less than originally believed, therefore use products without much evidence for helping depression instead! This is the logical fallacy of inconsistency, because he is expecting sound evidence and science for pharmaceuticals but not for his own alternative methods.

The bottom line is that antidepressants probably are not as helpful for treating depression as we previously thought, but they do show some benefits. We need to use sound science-based techniques to review them as thoroughly as possible over the next few years. This does not mean that we should start treating ourselves with other “natural” and alternative medicine instead.

About Science

April 18, 2010

This blog mostly covers scientific subjects. It is my understanding from my own experiences that most people don’t grasp what science is and why it is so important. For example, people don’t realize the differences between acupuncture, or herbal medicine or chiropractic as anything different from science-based medicine. The fundumental difference between these modalities of therapy and, say, aspirin is that they don’t use science to support their claims and, if they do, it is lacking, flawed and never corrected.

Let’s start off discussing how stupid we are. We see ourselves as these incredible beings much greater than other animals. We are more intelligent but not by much. Primates (and birds) use tools, just like us. They can speak with sign language and use spears to hunt. Our brains are better adapted to these skills but we broke off evolutionarily not that long ago. A new discovery shows that at one point,three species of humans coexisted with one another around 40,000 years ago and a fourth lived on an island in the phillipines. Only our species remains, but it is closely linked with others. We only began to use metal tools 6,000 years ago and we were hunter gatherers until 10,000 years ago. It took a long time for us to create a society vastly different from how animals live.

We continue to believe that we are something extra special and smart. The problem with this is that we fail to realize how much our minds affect our observed reality. Time and time again, studies show that our memories are terrible at remembering facts, we observe what we believe (rather than vice versa) and we have natural tendencies to believe certain things. Even our most basic choices and behaviors are affected by our surroundings and circumstances.

Such facts are a thorn in our methods of science. Experiments are bombarded with biases and confounders that we often fail to realize. One of the most obvious examples of this is the placebo effect. Take some ginkgo and go study. Surely you’ll think your memory is better when in fact it doesn’t do jack to help your thinking.

But the reason science is so great is that it incorporates this knowledge of our inherent biases and the ways that data can be affected through non objective influences and it controls for these factors. One of the greatest ways to help do this in drug experiments is by doing a double blinded study where neither the experimenter nor the subject knows whether he is receiving a true therapy or not. This prevents both sides from biasing the outcomes of the experiment.

Another way to help filter out bias is through the replication of experiments. There are many published experiments and studies that show benefits of medical therapies whose results have never been replicated by independent researchers. This implies that the experiments are flawed in some way. Supporters of sham therapies use these outlying studies to support their treatments. That’s why (and this is key) truth is based not on any single study but on the entire scientific literature.

Another important way of filtering out flawed studies is by subjecting them to a peer review before they are published. Anonymous experts on any specific topic are chosen to read and criticize every detail of a study before it is published. This makes it much more difficult for scientists with an agenda to publish a biased report after such rigorous inspection.

Furthermore, all published data is made available to the public, allowing for ongoing review and repeated experiments and observations by multiple researchers operating independently of one another. This is because science, unlike most everything else, is open to falsification if new evidence is presented. Want to know if something is based on proper science? Ask yourself this, “How much has this therapy changed over time?” If it is stagnant, like chiropractic or accupuncture, chances are it does not abide to science very rigorously and therefore doesn’t rely on actual proof of its benefit. Science-based medicine, on the other hand is always being re-examined and changed depending on proper objective data that has been acquired in ways that prevent bias and people’s beliefs from affecting it as best as possible.

One of my favorite ways of figuring out whether something is true is not by attempting to prove it but instead attempting to disprove it. There is a hypothesis and, more importantly, there is a null hypothesis that says something does not work. Before saying something has benefit, true science attempts to prove the null hypothesis (that it does not) as best as possible many times over. Only if experiments can not prove the null hypothesis is something considered to be valid. Homeopaths can cherry-pick some studies implying that homeopathy works but scientist sure as hell can prove that it doesn’t work more concretely. Thus it is labeled as pseudoscience.

Finally, I’d like to mention Occam’s razor as an important principle in science. Always expect the most simple reason for anything first. If there is a study that sounds too good to be true, like one that shows that accupuncture helps cure cancer, don’t believe it right away (like the media often does) but instead believe the more simple and obvious reason for this conclusion: the study was flawed! I recommend cutting away the nonsense and believing the more logical and scientifically-proven conclusions in life.

All of these things I am discussing can be shown in the general trends that pseudoscientific theories undergo in the published literature. Most adamantly-supported beliefs have small, poorly conducted studies demonstrating that they work early on. Then, as more proper and larger studies are conducted, the positive data starts to disappear. Finally, as the largest and most expensive studies are performed the pseudoscientific theories are shown to be false. Unfortunately, supporters of pseudoscience continue to cherry-pick the early studies to support their beliefs.

A current example of this is the anti-vaccination movement’s strong adherence to the principle that vaccines cause autism. Their hero, Andrew Wakefield, published a study showing that the MMR vaccine causes autism. Subsequent investigations showed no link and eventually the study itself was removed from the published literature because it was found that Wakefield was bribed by lawyers involved in vaccine-caused-autism lawsuits to change his data. Yet anti-vaxers continue to support him and refuse to change their stance on vaccines despite a mountain of evidence disproving their claims.

This sort of behavior is common in all aspects of society. Conspiracy theorists believe that the government caused 9/11, herbalists believe herbs can cure a plethora of diseases, politicians think Obama isn’t a US citizen, ghost hunters communicate with spirits, religious leaders claim their authority comes from a supernatural source, and so forth. What ties all these together is the lack of adherence to a scientific method before making their claims and forming their beliefs. That is why I love science so much: if conducted correctly, it is almost impenetrable to human bias.

Let’s Get Sirius!

April 14, 2010

Last week, Klara and I went for a nice walk around the Kazimierz district of Cracow and ate a delicious zapiekanka for 6 zloty (about 2 dollars). On our way home, we decided to stop by the Wisla river, which I live practically next to, and we took the remaining few bites of our meal while watching the last sliver of sun that remained disappear as we rotated away from it.

Obama will be here on Sunday!

It was at that very moment when I recalled a blog post by astronomer Phil Plait, in which he said that in the subsequent few days it would be possible to see both Venus and Mercury next to one another after sun set. This was a perfect opportunity for us to see if that was true and we stuck around for a little bit to see the nearby planets.

Low and behold, not long after sunset appeared a bright “star” in the sky above where the sun had just been. I figured that it had to be Venus, since Venus is almost twice as close to us as Mercury and a lot bigger. Interestingly, Mercury is only 0.055 earth masses and is actually smaller than the moon Ganymede, which revolves around Jupiter. We waited for Mercury to show its hot little self, but couldn’t see it.

Screen shot from Stellarium depicting exactly what we were looking at and location of Sirius, Venus and Mercury.

That’s when Klara pointed at another star in the southwest direction (we were looking west) and asked if that was it. I looked at the twinkling and bright star and told Klara I didn’t think that it was Mercury since I assumed that it would be closer to Venus in the sky. Realizing that I didn’t know much at all about astronomy, I decided to educate myself a bit about the stars I was looking at, especially this bright southwestern star because I recall always seeing it throughout my life as one of the brightest in the sky.

So the next day I downloaded a free program called Stellarium. It is basically a planetarium on your computer that allows you to manipulate visuals and settings at a whim. After plugging in your coordinates (find them on google maps) you can see which stars are visible from where you are, at any time you choose. It’s even possible to turn off the visibility of the ground to look ‘down’ through the earth and see what’s visible from the southern hemisphere.

Of course one of the first things I did using Stellarium was to see what the southwestern star was. It was Sirius, the brightest star in the sky. A quick wikipedia search (yes, I use wikipedia all the time for everything) explained that it is almost twice as bright as the next brightest star. It’s still not as bright as Venus and Jupiter, but they don’t count as stars.

There are other cool things about Sirius, besides it’s luminosity. For one, it’s a local neighbor of ours. It’s about 8.5 light years away making it the fifth closest star. There are no planets around Sirius, but that’s OK because it makes up for it by being a binary star system composed of two suns revolving close to one another.

Sirius A on left and Sirius B on right.

One of the suns, Sirius A, is a lot larger than the other and its surface is almost twice as hot as our own sun’s: a steamy 10,000 degrees Kelvin. That’s three times the temperature required to boil iron.

Sirius B, on the other hand, is a lot smaller but used to be even larger than its brother. Around 120 million years ago (the Cretaceous period), when dinosaurs walked the planet, it collapsed from a red giant into a white dwarf. That means that some dinosaurs would see Sirius as nearly twice as bright as we do. Nowadays, Sirius B is much smaller, with a volume of earth’s but a mass of our own sun’s (astronomy is so freakin’ cool!).  Its surface is 25,000 degrees Kelvin, yet its small volume makes it thousands of times less bright than its counterpart.

Next time you’re out, see if you can spot Sirius to the left of where the sun set (at least in the northern hemisphere). It’s visible from pretty much everywhere in the world and bright enough to be seen during the day from some places so it shouldn’t be hard to spot. It will stay near the horizon for most of the time and it sets after the sun and rises before it. I’m glad I know now at least one star by name and I hope some of my readers will as well.

Coolest Bird Ever? Terror Birds

April 4, 2010

When birds evolved from dinosaurs in the Jurassic period (about 150 million years ago), they were tiny creatures like the ones we see on a regular basis. Many of these smaller birds evolved into beautiful parrots, others into waterbirds, and some would become aggressive predators. In every ecosystem there are always apex predators that find a niche at the top of the food chain. Behold Phorusrhacidae, commonly known as the Terror Birds.

These monstrosities were up to 3 meters high and could swallow a dog in a gulp. Their heads were the size of a horses. One of the largest, Phorusrhacidae titanis, was the only one to travel into North America when the bridge between South and North America had formed. This migration and intermixing of species was called the Great American Interchange and P. titanis’ habitat reached form Texas to Florida according to fossil specimens.

Some terror birds, specifically Mesembriornis, could run at over 60 miles per hour, comparable to that of a cheetah. And since they were flightless, their bones were found to be dense enough to be used to shatter the bones of their prey to reach the delicious marrow inside. Yummy!

It fascinates me how dinosaur-like these birds had become. Even though they existed only 2 million years ago, they demonstrate similar characteristics to theropod dinosaurs that went extinct around 65 million years ago. This sort of convergent evolution occurs if animals are put under similar stressors from their environment. In this case, a predatory lifestyle selected characteristics very similar to those of theropod dinosaurs, which held a similar position at the top of the food chain.

Take for example the “ostrich dinosaurs”, Ornithomimosauria. These dinosaurs had similar body shapes and even evolved beaks.  Of course, their arms had not passed through an evolutionary flying adaptation, so they were more handy at grasping.

But what the Terror Birds’ upper limbs lacked in weaponry, their beaks made up for. I know myself the strength of a beak. I once owned an African Grey parrot (named Albert) whose beak had evolved to crush nuts. That thing could bite through my finger if it wanted to. Now imagine a bird towering over you whose beak hadn’t evolved to crush nuts, but rather evolved to crush your skull. Researcher working for the Discovery Channel reconstructed the neck muscles and skull of a Terror Bird and found that it was easily capable of driving its beak into a skull like a sledge hammer. Especially while running as fast as a car….

So if you’re ever asked what your favorite bird is, answer whatever you please but remember that there were birds on this planet a hell of a lot cooler than a bald eagle.

CAM in the Health Care Reform Bill

March 27, 2010

This week President Obama will sign the final piece of health reform legislation, concluding an epic battle that ultimately lead to the passage of the Patient Protection and Affordable Care Act (PPACA). The bill enforces the largest change to US healthcare for decades and has provided an opportunity for Complementary and Alternative Medicine (CAM) advocates to be federally endorsed in our future healthcare system.

CAM proponents tout a few sections in the PPACA as a victory for their cause. One of these sections is 3502, entitled Establishing Community Health Teams To Support The Patient-Centered Medical Home, which endorses government grantsto establish community health teams,” which are defined as “community-based interdisciplinary, interprofessional teams.” It goes on to say that such a ‘team’ may include, “doctors of chiropractic, [and] licensed complementary and alternative medicine practitioners[1].

The requirements of such a health team are listed and one of them ultimately reads, “to provide support necessary for local primary care providers… to provide coordination of the appropriate use of complementary and alternative (CAM) services to those who request such services.” What this entails, is that there will be an influx of federal spending into CAM services with the enactment of the new bill.

Fortunately, the section provides other requirements for ‘health teams’ such as,

to support patient-centered medical homes, defined as a mode of care that includes… safe and high-quality care through evidence-informed medicine, appropriate use of health information technology, and continuous quality improvements.

Health teams will also be required to (bare with me here),

“provide support necessary for local primary care providers to… provide quality-driven, cost-effective, culturally appropriate and patient- and family-oriented healthcare… [and]collect and report data that permits evaluation of the success of the collaborative effort on patient outcomes, including collection of data of patient experience of care and identification of areas for improvement.”

This could mean that even though CAM will be supported by our government plan there will be some restrictions in place requiring CAM therapy to adhere more to an ‘evidence-informed’, ‘quality-driven’ and ‘cost-effective’ form of medicine. Guidelines may be implemented to track the progress and efficacy of health teams using CAM therapies. If this was true, I would suspect an initial rise in CAM from the increase in government funding but an ultimate demise in the long-term as an enormous surge of government-sponsored data separates cost-effective treatments from sham.

Unfortunately, this hasn’t been shown to be true in relation to The National Center for Complementary and Alternative Medicine (NCCAM), which has been criticized for spending hundreds of millions of tax dollars on studies of CAM and never confirming the efficacy of a single therapy nor declaring any as ineffective. This shows that data gathered from CAM due to the healthcare reform bill might never actually lead to any meaningful conclusions or changes in healthcare.

Another section of the PPACA, supported by herbalists, is number 4206: Demonstration Project Concerning Individualized Wellness Plan[2]. The section describes the establishment of “a pilot program to test the impact of providing at risk populations… an individualized wellness plan that is designed to reduce risk factors for preventable conditions.” The program will include nutritional counseling and will provide dietary supplements that have health claims approved by the FDA. Examples include calcium supplementation for those at risk of osteoporosis and prenatal folic acid to decrease the incidence of neural tube defects. Seeing as this is guided by the FDA’s recommendations I can only join in the approval of such a “wellness plan”, and expect it to be a big hit in the new healthcare system.

Chiropractic has found a niche in the soon-to-be National Healthcare Workforce Commission as described in section 5101[3] of the PPACA. “The Commission,” as it is referred to, will be responsible for analyzing and disseminating information to the government, state and local agencies, Congress, healthcare organizations, and professional societies about the US healthcare workforce. It will be responsible for developing and commissioning “evaluations of education and training activities to determine whether the demand for healthcare workers is being met.”

In so doing, it will recommend to the government which institutions deserve grants for the government in order to “develop a fiscally sustainable integrative workforce that supports a high-quality, readily accessible healthcare delivery system that meets the needs of patients and populations.” It will also “study effective mechanisms for financing education and training for careers in healthcare.” Basically, the Commission will be channeling tax dollars to different healthcare institutions based on their analysis of demand in our healthcare system.

The Comptroller General, Gene L. Dodaro, will appoint the members of the Commission no later than September 30th of this year. It will consist of 15 members representative of the healthcare workforce, employers, third-party payers, representatives of consumers, State or local workforce investment boards, and educational institutions. It seems like there will be a host of different viewpoints and interests influencing the recommendations that this commission will be making.

Therein lies the problem. The section about the Commission specifically defines the ‘healthcare workforce’ as, “all healthcare providers with direct patient and support responsibilities,” and specifically includes licensed CAM practitioners and chiropractors in the definition. If proponents of such CAM therapies infiltrate the Commission, taxpayers could end up funding disproportionate amounts of money to medical therapies unsupported by science.

Another section of the PPACA that has been hailed as a victory by CAM proponents, especially chiropractors, is section 2706 in the Senate-approved H.R. 3590 bill, which prohibits “discrimination” against any health care provider. Chiropractors who feel they are being ‘discriminated’ against in the medical community see this as an end to their problems. Interestingly, this section is colloquially dubbed the “Harkin amendment”, after the Iowa Senator’s introduction of the section into the new healthcare reform bill. David Gorski has written about him on a number of occasions. Tom Harkin is the man most responsible for the creation of the aforementioned NCCAM and also the Dietary Supplement Health and Education Act (DSHEA) of 1994, which allows “herbal supplement” manufacturers to make dubious health claims with little or no regulation.

Fortunately, I couldn’t find any sign of section 2706 in my ‘quick’ look-through of the 2,407 page PPACA (my web browser crashed every time I tried searching the document) but it may crop up somewhere in the overwhelmingly lengthy and technical health reform bills so let’s keep a look out for it. The American Chiropractic Association (ACA) is saying, however, that the amendment did pass and will become law once Obama signs the bill this week.

On a positive note, the PPACA bill has in it a section on immunization[4] and describes a new program that will come into effect to maximize vaccinations throughout the country. This is a huge blow to the anti-vaccine movement, which has been surprisingly quiet about this.

In summary, we should be prepared for an infiltration of CAM therapies into the new healthcare system that will come into effect starting this year. The PPACA healthcare bill is not a disaster for science-based medicine by any means, but it is not bullet proof. The bill specifically mentions it’s endorsement of CAM and the more it acts on this, the more difficult it will be to eradicate passionately advocated therapies with no evidence supporting them in the years to come. Now is the time, more than ever, to ensure that the US health care system does not begin to excessively promote sham therapies. Otherwise, we will risk developing a foundation to the new healthcare system that incorporates scientifically unsound medicine.

[1] Page 1049 of the PPACA

[2] p1215 of the PPACA

[3] p1255 of the PPACA

[4] p1199 of the PPACA

Jehovah’s Witnesses and Blood Transfusion

March 14, 2010


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.