Jehovah's Witness patients within the German medical landscape

Abstract

Blood transfusions belong to standard and commonly utilised biomedical procedures. Jehovah's Witnesses' transfusion refusals are often referred to in bioethical and medical textbooks. Members of this globally active religious organisation do not, however, challenge biomedical diagnosis and treatment as such. A result of both their trust in and their interpretation of the Bible, they question only this medical treatment. In spite of the global presence of this religious community and its uniformly practised teachings, including those pertaining to blood, experiences and choices of Jehovah's Witness patients have been understudied. Drawing on a nine-month fieldwork with Jehovah's Witnesses and physicians in Germany (mainly in Berlin) between 2010 and 2012, the paper addresses treatment choices made by Witness patients and their relationship with physicians. In light of the long tradition of 'medical heterodoxy' established in German culture and society, Germany constitutes an ideal point of departure for such a study. By utilising the concept of 'medical landscape' it is argued that Jehovah's Witnesses in my field site find themselves at the intersection of different medical landscapes: in the 'immediate' surroundings of the German healthcare system that is open to different 'treatment modalities', and that of the United States, which favours biomedicine. The paper also argues that Jehovah's Witnesses' position towards blood transfusions can further be used as a lens to shed light on the German (bio)medical landscape itself.

Characteristics and outcomes of pediatric oncology patients at risk for guardians declining transfusion of blood components

“…13 , 14 In the JW faith, interpretation of biblical verse prohibits autologous or allogenic transfusions but leaves the decision regarding use of cryoprecipitate and immunoglobulins to the individual, as they are considered minor blood fractions. 2 , 15 , 16 , 17 , 18 Our data in children is consistent with prior literature in adult patients indicating that under anonymity, 10%–12% of people identifying as JW are willing to accept blood products for themselves. 7 In children, the requirements for parent/legal guardian consent and many hospital system's requirement for written consent at each transfusion encounter could contribute to parental distress in cases where there is a faith‐based tenet to not receive blood products.…”

“…JW number over 300 000 within the United States and 8.6 million worldwide 13,14 . In the JW faith, interpretation of biblical verse prohibits autologous or allogenic transfusions but leaves the decision regarding use of cryoprecipitate and immunoglobulins to the individual, as they are considered minor blood fractions 2,15–18 . Our data in children is consistent with prior literature in adult patients indicating that under anonymity, 10%–12% of people identifying as JW are willing to accept blood products for themselves 7 .…”

Religiosity and Attitudes towards Health, Disease, Death and the Use of Stimulants among Jehovah’s Witnesses

“…(a) The author’s research tool measuring attitudes towards health and disease. The instrument was developed during two stages: an analysis of the literature on the beliefs of Jehovah’s Witnesses and research into health behaviours and the impact of religion on health [ 2 , 10 , 27 , 28 , 32 , 33 , 34 ]; and consultation with two Jehovah’s Witnesses regarding their views on health, disease and medical care issues. The questionnaire consists of 65 questions in total and is divided into the following sections: sociodemographic characteristics; the attitudes of Jehovah’s Witnesses to health, disease and death; the use of stimulants; the attitudes of Jehovah’s Witnesses on selected medical procedures; the expectations of Jehovah’s Witnesses towards medical personnel.…”

“…To our best knowledge, none of the published scientific studies involving Jehovah’s Witnesses included any measurements of religiosity in the context of health, disease, death and the use of stimulants. It is worth noting that the available literature mainly employed analyses of medical records or case descriptions, and there is scarce research through direct contact with Jehovah’s Witnesses using a survey questionnaire [ 26 , 27 , 28 ]. Additionally, the use of stimulants, mostly alcohol consumption and cigarette smoking among adolescents and young adults in Poland, is reported as high, which is a basis for the recommendation of different prophylactics programs [ 29 ].…”

Cardiopulmonary bypass management and acute kidney injury in 118 Jehovah’s Witness patients: a retrospective propensity-matched multicentre cohort from 30,942 patients

“…There is a single meta-analysis of 6 studies comparing outcomes of 564 JWs with 903 matched controls 5 with the majority of reports of cardiac surgery in JW patients refusing blood transfusions being single-centre studies with relatively small patient numbers. [6][7][8][9][10][11][12] In part, this is a reflection of the very small proportion of JWs in the population (USA: 0.6%, Canada and Australia/New Zealand: 0.3%, Britain: 0.2%). 13 These studies reveal no accurate detail of the modifiable factors of the conduct of cardiopulmonary bypass (CPB), including blood flow and pressure, nadir haemoglobin (Hb), oxygen delivery (DO 2 ) and blood conservation measures, that are known to influence patient outcome.…”