The recent tragic deaths of two Jehovah’s Witnesses in Canada, Eloise Dupuis and Mirlande Cadet, have focused media and political attention on the issue of coercion in refusing medical treatment. Specifically the question being asked by the media and Government and investigated by the coroner is: Did these women make their choice to refuse a blood transfusion of their own free will, or was there an element of coercion from their religious community leaders?

For example, does the very presence of the Jehovah’s Witness Hospital Liaison Committee generate a coercive atmosphere for a Witness in such a situation? Do Witnesses personally sign the Watchtower-produced Advanced Medical Directive that Watchtower requires them to carry on their persons at all times, stating they desire to refuse blood? Are they free of coercion when they do so?

Editors note: For informational purposes, the Hospital Liaison Committee (HLC) normally interact with doctors and Witness patients only when there is a medical condition which may require a blood transfusion. A separate group, called the Patient Visitation Group (PVG) does not interfere with medical treatment of Witnesses, but usually consists of Witness elders who offer pastoral support and prayer.

I want to state at the outset that I support the right of a mature adult to make an informed decision, free of coercion, to refuse any and all medical treatment, even if doing so represents a threat to their life. However, the key words here are informed and free of coercion.

In this article I intend to demonstrate that it is simply not possible to state that any Jehovah’s Witness is free from coercion when they make these choices. Additionally, I will demonstrate that, even if a Witness genuinely desires to reject blood and is prepared to die as a result, it is highly unlikely that their decision is genuinely informed; rather it is highly dependent on misleading information and a social atmosphere that stifles any genuine attempt to gather unbiased medical or scriptural data on the subject.

There are three areas to consider:

Jehovah’s Witness culture Jehovah’s Witness policy of shunning How these two factors produce a coerced medical choice

1: Jehovah’s Witness culture: Information lockdown

Jehovah’s Witnesses live in a religious culture which is very different from what many in the modern Western world might be used to. It is strongly frowned upon for them to make close friends or associates with those outside of the faith. Such ones are viewed as “worldly” and “tools of Satan.” This culture of suspicion extends to the authorities and experts outside of the religion as well.

The Australian Royal Commission into Institutional Responses to Child Sexual Abuse, after in-depth study of Watchtower literature and culture in Case Study 29 concluded:

F1: The Jehovah’s Witness organisation presents its members with conflicting and ambiguous teachings regarding their relationship with secular authorities, thereby fostering a distrust of such authorities.

The reality is that for a Jehovah’s Witness, any government, institute of learning, NGO, charity, any person or group at all that is not under the direct control of the Watchtower Organization is viewed as being less reliable and trustworthy than Watchtower. If there is a conflict between the teachings and statements of Watchtower, and the teachings or statements of a medical institute, government or court system, a witness is expected to accept Watchtower’s side of matters unquestioningly. This includes any conflict about various medical or scriptural issues.

Therefore, whilst Jehovah’s Witnesses might appear on the surface to be normal members of society, the reality is that they live in a very socially and intellectually insular world. They are strongly discouraged from attending higher education, and any research into matters of faith and religion outside of the publications of Watchtower is strongly discouraged, and can even result in punishment. Intellectual curiosity or critical evaluation of an argument from both sides is not something Watchtower encourages.

Thus, when making their choice as to whether to refuse a blood transfusion or not, it is highly unlikely that a Jehovah’s Witness will have access to unbiased or accurate medical information. Most of their information will come from Watchtower, and the information Watchtower provides on medical treatments using blood is highly suspect to say the least.

Consider a small sample of statements that Watchtower has made on the subject throughout the decades, and decide for yourself if they represent an accurate, unbiased reflection of scientific knowledge and medical practice. Also try to imagine what decades of constant exposure to such statements from a source one views as the mouthpiece of God would to do your opinion.

“The blood in any person is in reality the person himself. … poisons due to personal living, eating and drinking habits … The poisons that produce the impulse to commit suicide, murder, or steal are in the blood. Moral insanity, sexual perversions, repression, inferiority complexes, petty crimes – these often follow in the wake of blood transfusion.” – Watchtower 1961 Sep 1 p.564 “Selling blood is big business. Well, what makes many people uneasy about big business in general? It is greed. The greed shows, for example, when big business persuades people to purchase things they don’t really need; or worse, when it continues to foist on the public some products known to be dangerous, or when it refuses to spend money to make its products safer. If the blood business is tainted with that kind of greed, the lives of millions of people the world over are in great danger.” – Awake 1990 Oct 22 p.7

You can find a very detailed analysis of this matter on JWfacts.com, along with a detailed scriptural discussion showing that the Witnesses’ stance on blood is arguably not even truly scriptural, but rather comes from a profound misunderstanding of the relevant scriptures on the part of earlier Watchtower leaders.

However, the main point here is that such a discussion cannot happen in Witness culture. Any Witness who openly admitted that they had visited JWfacts.com, or consulted other Biblical scholars outside Watchtower to get their view on blood transfusions would find themselves subject to extreme social stigma, and even worse.

They could find themselves completely shunned; their family and friends forbidden to even make eye contact on the street.

2: Jehovah’s Witness Enforcement: Obey or be shunned

Jehovah’s Witnesses are not free to find their own path in life. In more or less every aspect of their existence, from the smallest matter such as the choice to have facial hair, right through to matters of life and death, Jehovah’s Witnesses are required to follow a vast tapestry of rules and regulations imposed from the top down by the Watchtower Bible and Tract Society.

And compliance is ruthlessly enforced.

Watchtower has a long list of what it considers to be “serious sins.” This list includes everything from sex outside of marriage, to voting in an election, to celebrating a birthday, to openly and unrepentantly disagreeing with Watchtower teachings – and much more.

And yes, accepting a blood transfusion is on that list.

If someone is thought to have committed a serious sin, a religious court known as a “Judicial Committee” is formed. Consisting of three elders (the JW term for religious congregation leaders), the committee is essentially a closed-off “star chamber” style affair, where the accused has no form of representation and very little in the way of rights or assistance that we have come to expect from a modern judicial system. To cut a long story short, the accused basically has to throw themselves on the mercy of the three elders and beg for forgiveness, hoping that they can convince the committee that they are genuinely repentant for their sinful act. This is by no means a certain thing. Judicial Committees are notoriously fickle; if the elders are on the kinder or more moderate end of the scale, you may escape with a reproof. However, if the elders are strict, authoritarian, or simply don’t like you, you can find yourself disfellowshipped.

Disfellowshipping is the JW term for being excommunicated. That means that no Jehovah’s Witness is allowed to even speak to you.* And since JWs are forbidden from making close friends outside of the faith or marrying outside of the faith, it means you lose everyone you know and love.

The goal of this shunning is obvious; to inflict so much emotional trauma on the dissenting person that they fall back into line in order to regain their loved ones. (And according to Watchtower, their relationship with God). Watchtower has explicitly acknowledged this is the case, albeit whilst attempting to paint it in the most glowing terms possible, as per the following extract from one Watchtower publication:

Consider just one example of the good that can come when a family loyally upholds Jehovah’s decree not to associate with disfellowshipped relatives. A young man had been disfellowshipped for over ten years, during which time his father, mother, and four brothers “quit mixing in company” with him. At times, he tried to involve himself in their activities, but to their credit, each member of the family was steadfast in not having any contact with him. After he was reinstated, he said that he always missed the association with his family, especially at night when he was alone. But, he admitted, had the family associated with him even a little, that small dose would have satisfied him. However, because he did not receive even the slightest communication from any of his family, the burning desire to be with them became one motivating factor in his restoring his relationship with Jehovah.” – Watchtower 2012 Apr 15 p.12

Such punishment also prevents obedient Witnesses from hearing viewpoints or facts that may conflict with Watchtower’s teachings. Please see this jwfacts.com article for further information about this practice, as well as a discussion of the way Watchtower frequently lies to the media and the courts as to it’s existence. You can find further such articles on this site as well

From 1961 until recently, taking blood was officially a disfellowshipping offense. However, Watchtower has intentionally altered its official title for the offense. It no longer gets you disfellowshipped. It now renders you as “Disassociated“. What’s the difference? Well, Disfellowshipping is when you are thrown out; Disassociating carries the implication that you have made a choice to leave the organization. However, the punishments are exactly the same. In addition, the elders can deem you “disassociated” without your consent, thus rendering any supposed difference meaningless in real terms.

This is how the Elders Handbook Shepherd the Flock of God, the field manual for Elders to use in regulating their congregations, discusses blood transfusions:

Willingly and unrepentantly taking blood. If someone willingly takes blood, perhaps because of being under extreme pressure, the committee should obtain the facts and determine the individual’s attitude. If he is repentant, the committee would provide spiritual assistance in the spirit of Galatians 6:1 and Jude 22, 23. Since he is spiritually weak, he would not qualify for special privileges for a period of time, and it may be necessary to remove certain basic privileges. Depending on the circumstances, the committee may also need to arrange for an announcement to the congregation: “The elders have handled a matter having to do with [name of person]. You will be glad to know that spiritual shepherds are endeavoring to render assistance.” On the other hand, if the elders on the committee determine that he is unrepentant, they should announce his disassociation.

Now, it sounds as if all you have to do is say you are sorry and you’re home free, right? Wrong. For one thing, Elders are instructed not to forgive anyone they suspect as showing “worldly sadness” (i.e sorry for getting caught) as opposed to genuine repentance. So you’re going to have to convince them you are sad to have taken blood and lived, and that you’d rather have died, and you’d better be convincing. Also, elders are notoriously fickle; many former and current Witnesses relate horror stories of unaccountable, unkind, super-strict elders making the lives of their congregants a misery. Additionally, elders are instructed to take previous violations into account, so if you require more than one transfusion to live, or have a condition that requires regular transfusions, you will only get to play the repentance card once. It is entirely possible that you could be a weeping wreck, begging forgiveness and swearing that you’d rather have died on the operating table, and find yourself disassociated regardless.

Witnesses live their lives in a cloistered intellectual environment, forbidden from searching out alternative views when it comes to the issue of blood transfusions, and knowing full well that they live under the threat of total shunning, should they transgress upon any of Watchtower’s “red lines.”

Now, how does this impact what takes place when a Witness is taken into a hospital and is faced with the choice of obeying Watchtower and refusing blood, or accepting medical advice that a transfusion is essential to save their life?

3: Jehovah’s Witnesses and blood: A choice that is no choice.

Firstly there is the question as to whether a witnesses voluntarily signs their medical documentation, and whether they fully understand the implications and the true facts surrounding the treatments they are rejecting.

To this, I say: No.

I have no doubt that they put pen to paper themselves. But as we have seen, none will have made these choices in an environment where all the facts were available, or where unbiased inquiry was encouraged. Rather, they will have been presented all their lives with highly questionable, distorted versions of the medical data, in a social environment that strongly discouraged any dissent, then placed them under extreme social pressure to sign the Watchtower’s Advanced Medical Directive. (Editors Note: The name for the directive and the legal contents does vary from country to country. We are using the name Advanced Medical Directive in a general sense). Whilst refusing to sign the directives will not in itself trigger a Judicial Committee, it will certainly result in lower level ostracizing. The JW will be viewed as a bad influence; weak in the faith. Social invites will fall away, potential marriage mates will be warned off by the elders, and those same elders will be watching like hawks for the moment the “weak” one makes a critical error, and can be officially sanctioned.

Additionally, a copy of their medical directives will be kept by the congregation Secretary (an elder responsible for all congregation documents) thus limiting the options of a JW to pretend they’ve signed the documents but deliver slightly modified or completely different instructions to their doctor. Again, a JW cannot opt out of giving the Secretary the documents without drawing attention and scrutiny from the enforcement-minded Body of Elders.

Next there is the question as to whether the presence of the elders of the Hospital Liaison Committee at the hospital bedside of a Jehovah’s Witness represents a coercive element.

To this, I say: Yes. A significant one.

According to Watchtower, the presence of these Elders serves to “support” the Witness in their decision to refuse blood. What Watchtower does not like to address, but what we have discussed in this article, is that if the Witness changes their mind and decides to accept blood, the elders standing by their bedside will not “support” this choice. They will rather draw up preparations to assemble a committee, with a view to disassociating that Witness. Such Witnesses lie there, potentially in horrible pain and distress, facing death on the one hand if they refuse blood, but a life without their family and friends if they accept. They cannot even arrange to have a transfusion in secret, as the HLC’s continual presence in the hospital renders discovery extremely likely.

Thus, we can say that at best these Witnesses are making a choice that is significantly uninformed and results from a lifetime of undue influence and information control by the religion governing every aspect of their lives. At worst, these Witnesses are making a reluctant choice to risk death via refusal of treatment rather than risk a life without the ones they love, under the watchful eyes of religious enforcers standing next to their bedside- ready to enact religiously mandated shunning if the Witness makes the “wrong” choice.

If Watchtower truly wishes to allow Witnesses to make a free choice, without coercion in this matter, it will remove the punishment sanctions from the act of taking blood, and allow Witnesses the freedom to do their own research and make their own choices in this matter. Until such time, once cannot seriously claim that Witnesses refusing a blood transfusion are doing so in an informed matter, with genuine consent

It is my hope that the legal entities, government groups, and media organizations investigating this matter come to understand these facts as soon as possible. Human life is at stake.

*As of the time of writing, 1st November 2016, it was permissible for a disfellowshipped family member to be contacted to deal with significant family events; i.e a family death. It was also permissible for a disfellowshipped minor child to remain in the family home, albeit with restrictions as to anything viewed as religious participation. However, the 2016 Watchtower Convention made it clear that once such a child is old enough to survive on their own, JW parents are expected to throw their child out. Please see this article for further details, including a discussion of what happens when disfellowshipping of a parent or spouse occurs.