JEHOVAH'S WITNESSES PRESENTATION


On October 17 the Chaplaincy hosted three representatives of the Jehovah's Witnesses Hospital Liaison Committee in a talk on the policy/beliefs about receiving blood products.

James Lang, James Donaher and Anthony Gilmer began by stating there are about 25,000 baptized Jehovah's Witnesses within the 128 belt. The Hospital Liaison Committee is designed to support Jehovah's Witness patients in their decision-making and hospital staff in respecting the patient's wishes, and, where possible, to find appropriate alternatives to transfusion. They also visit Jehovah's Witness patients who may be far from their local community and need other types of support. They can also provide more concrete types of support such as temporary lodging for family members. They can be reached through the national office in New York (718) 560-4300. The chaplaincy and the CRC also have phone numbers for the members of the committee.

Baptism occurs for Witnesses when one reaches the age to understand the requirements of the religion. Commonly this is around age 18. Jehovah's Witnesses do believe in western medical care, and not in faith healing, though they feel faith plays an important role in the healing process.

One strongly held principle is that of following a scriptural prohibition against ingesting blood, which is interpreted as applying to transfusion of any whole blood or blood components. "We feel so strongly we do not compromise." There is a specific health care proxy form that Witnesses are encouraged to carry that lists acceptable and unacceptable treatments (the CRC is expecting a supply of these forms). This spells out that the Witness patient does not want whole blood, platelets, red cells or plasma under any circumstances. Once the blood has left the body it can not be returned, so autologous transfusion is not an option. It is left up to the individual to determine if she/he will accept fractions of blood such as albumin (which may also be present in vaccines and certain medications such as immunoglobulins). Some feel the use of a heart/lung machine or a cell-saver is OK because the blood is continuously recirculating through the body.

The Massachusetts General Laws recognize an adult's right to refuse care. Jehovah's Witnesses also recognize and credit the conscience of health care providers and will assist in finding other providers who can provide care within these guidelines if the current provider cannot. In cases where the patient is a minor, their parents generally will not consent to receiving blood, but recognize that the law protects minors. The speakers requested that in situations where there are no alternatives to going to court, that the parents be informed and be allowed to be present. They will ask the court to write the order in a limited way that only applies to this specific situation. The parents also will likely ask the medical team to refrain from carrying out the court order. Where time allows they will appeal the court decision. Jehovah's Witnesses recognize that in emergency situations medical care providers do not have to obtain a court order to treat. They stated that in general they are not looking to file suit.

The presenters told of a court case in which a Witness was forced to have a transfusion against her will and described it as a violation that felt like she was raped. They used this analogy several times to describe the spiritual and psychosocial impact of forced transfusion. Our speakers stated that the stance of the community towards those who've been forced is one of support and not to chastise or reprimand. If someone consented to the transfusion and regrets it, they will get spiritual help to return to the tenets of the faith. If there is no regret this would be a sign of self-excommunication as they are indicating by their actions that they no longer accept the tenets of the faith. The speakers did not discuss the process in detail, but in response to questioning said that whether or not one is viewed as "repentant" is determined by elders from the person's local community. The Hospital Liaison Committee is not involved in this process.

Upon questioning about the article that came out this summer in the London Times about a change in policy that we discussed in this newsletter in July, they denied there was any change in policy.*

Other Beliefs And Practices
Although the intent of this meeting was to address the blood policy issue, understandably there were many questions from the audience about the general tenets and practices of this religion. Jehovah's Witnesses are against abortion, unless the mother's life is at risk at which point it is a fam-ily decision. Organ donation and transplantation are a matter of personal conscience. Consistent with their belief in the sanctity of life, Jehovah's Witnesses do not condone carrying guns and are anti-capital punishment. As a result they do not serve in the military or as police officers. Though they will call the police for protection and can work in law enforcement support positions that do not require carrying firearms. They believe that the ultimate power is in God, not the state, so they do not become involved in politics. They do not vote nor run for political office. They do not observe national holidays, birthdays nor any of the traditional Christian holidays, though they consider themselves Christians. The only holiday they observe is the Memorial of Christ's Death which falls in the spring and is a very important day for them. In their belief system it is important to commemorate that Christ died for the sins of those on earth, which means their salvation. They don't focus on giving gifts on any particular day, they try to do this throughout the year, especially parents towards their children. Similarly there is no Sabbath day.

Other principles include that Jehovah/Yahweh is God. Jesus is his son, not the same as God. In this faith there is recognition of "the trinity", but the three aspects are not equal. They do not believe in an immediate life after death; they literally interpret "ashes to ashes, dust to dust" as Adam was created from dust, so shall he return to it in death. The Our Father prayer is highly revered and it is an article of faith that when the Kingdom comes the vast majority of believers will live again forever in a paradise on earth. A certain few, chosen over the centuries from varied religious backgrounds will rule in heaven with Christ. Burial practices are very simple. Scriptures are read, generally Witnesses have a favorite scripture that they may specify or those close to him/her will know is appropriate to read. If someone is sitting with a Witness at the end of life asking questions about this, or reading from a Bible (the New World translation is preferable, but not necessary) together may be helpful to the patient.

For more information visit the web-site www.watchtower.org.

Additional comments from Reverend Mary Martha Thiel, Director of Chaplaincy
MGH clinicians may contact members of the Hospital Liaison Committee directly for consultation, or, as with all religious traditions, through the Chaplaincy at 6-2220. Mary Martha Thiel, Director of Chaplaincy, urges clinicians to contact Witness resource persons directly only if the patient/family has given permission for you to speak with the elders. (This guideline applies to linking up patients and outside clergy of any religious tradition). Witness patients/families who go against the guidelines of their tradition by consenting to blood transfusions are almost always clear that they do not want elders from their community to know anything about it. To make the contact at that point would be unethical and add to patients' spiritual and psychological distress. The Chaplaincy can serve as a useful buffer at this point: seeking out "theoretical" information to assist in a patient/family's decision-making process, thereby protecting the patient/family's confidentiality. On the other hand, when a patient/family does wish to be connected to the Witness community, the group is poised and ready to provide exemplary continuity of supportive care. The very tightness of the Witness community which brings threat at times, also brings strength and support at others.

In the presentation, the members of the Hospital Liaison committee mentioned that they look at our census and visit patients who declare their religious affiliation as Jehovah's Witness. This writer asked Rev. Thiel to comment.

Currently, we allow only those clergy who are formally designated by their religious tradition to have access to the list of patients from their faith group, and from their faith group only. So, the rabbi gets a list of only Jewish patients. The JW rep gets the list of only Witness patients, etc. Of all the religious traditions, the Witnesses are the most faithful in visiting their folks. This means that if a patient on admission declares him/herself JW, the JW representative may well come visit. If the patient declares his/her religious preference as "unreligious" or "Protestant," say, his/her name will not appear on the JW list, so the JW visitor will have no way of knowing that person is here. We in Chaplaincy can also change a patient's religious designation in the PATCOM system, so it's possible to have someone's name "disappear" from a denominational list during their hospitalization. If making such a change is appropriate, just call the Chaplain's office. So, going "off-screen" denominationally can happen by the pt's choice at preadmission/admission, or by requesting a chaplain to make the change in designation during the hospitalization. It's not a perfect system, but it does take into account both sides of what may be diametrically opposed dynamics in a patient's decision-making process.

For the record, I have also banned a denominational visitor from MGH on the basis of patient complaints about his visits communicated to me through social workers. When/if social workers hear complaints about outside religious visitors, I'd like to be notified. With a pattern of complaints, I can dismiss outside people appropriately, in protection of our patients.

Comments on the above are welcome and can be directed to Rev. Thiel.

The MGH Community News thanks Rev. Thiel for her helpful comments.


* Editor's Note: The MGH Community News in July 2000 quoted from a statement entitled "Jehovah's Witnesses: Official Statement to the Media on Blood Transfusions (June 15, 2000)" that "If a baptized member of the faith willfully and without regret accepts blood transfusions he indicates by his own actions that he no longer wishes to be one of Jehovah's Witnesses..(and) revokes his own membership by his own actions rather than the congregation initiating this step. This represents a procedural change instituted in April 2000 in which the congregation no longer initiates the action to revoke membership in such cases." Italics added. This statement was found on the CESNUR Center For Studies on New Religions web-site (www.censur.org). Prior to the publication of the July Community News article this writer called the Watchtower public relations office which confirmed this was an official Jehovah's Witnesses statement.


10/00