The article by Van Wolfswinkel et al. concerning elevated risk of maternal mortality and morbidity in some of Jehovah’s witnesses concludes by suggesting that care for such women be centralised and that an obstetrics protocol be developed. We suggest that the protocol include strategies to permit informed and free choice.
The mini-commentary by Watchtower Society worker, P. Wade, incorrectly implies that all of Jehovah’s witnesses agree with the Watchtower Society policy on blood transfusion. This is as likely to be true as the claim that all Catholics agree with the Vatican’s statements on condom use. Not all Jehovah’s witnesses refuse blood transfusion.1
We recommend that physicians, and particularly those whose patients are at risk from blood loss, familiarise themselves with the website created by ‘Associated Jehovah’s Witnesses for Reform on Blood’. This group of Jehovah’s witnesses provides questions that a physician might helpfully ask a patient at risk of morbidity or mortality http://www.ajwrb.org/physicians/index.shtml
Further, we note that patients under the influence of the Watchtower Society tend to have very poor information about the safety and efficacy of blood2 and that they are subject to coercion: choosing blood transfusion can subject them to shunning, a severe form of social ostracism that can lead to suicide.3 One survivor of postpartum haemorrhage without transfusion told us that her real choice was between the living death of losing her family and friends if she chose blood transfusion, or actual death caused by blood loss. The latter seemed preferable. Developers of protocols to manage Jehovah’s witnesses obstetric and gynaecological patients ought to invite dissident adherents to participate. They have insight into, among other things, the role of the Hospital Liaison Committees which monitor patient choice. Non-orthodox Jehovah’s witnesses can assist hospitals in making it safe for patients to choose religiously unauthorised medical treatment.