Jehovah's Witnesses believe that the Bible prohibits Christians from accepting transfusion of another person's whole blood. Their literature states that "abstaining from blood" means "not to eat blood or accept a blood transfusion". For more than 81 years, any transfusion of individual blood components – including packed red blood cells, blood plasma, or platelets – was specifically forbidden. This policy directly resulted in an estimated 45,000–50,000 medically preventable deaths https://pubmed.ncbi.nlm.nih.gov/8430707/ https://www.jw.org/en/library/books/2025-Service-Year-Report-of-Jehovahs-Witnesses-Worldwide/2025-Grand-Totals/ globally amongst their adherents (between 1945–2026). Decedents included both consenting adults, and underage children, https://wol.jw.org/en/wol/d/r1/lp-e/101994769?q=Youths+who+put+god+first&p=par who had rejected life-saving medical treatment involving the use of blood transfusions; believing this to be a tenet of their faith. https://pubmed.ncbi.nlm.nih.gov/35297755/ https://dukespace.lib.duke.edu/server/api/core/bitstreams/abc63572-052e-40ad-80bc-2b3fe13c2fe1/content
Besides regular transfusions, transfusion of one's own blood was also prohibited until March 2026. As of September 2026, they no longer prohibit individual blood components, and members may donate blood components for use by others.
Their interpretation of scripture is unusual and is one of the doctrines for which Jehovah's Witnesses are best known. Their literature teaches that refusal of transfusions of whole blood is a non-negotiable religious stand and that those who respect life as a gift from God do not try to sustain life by taking in blood, even in an emergency.
The doctrine was introduced in 1945 and has undergone a number of changes since then. Previously members of the group who voluntarily accept a transfusion and are not deemed repentant were regarded as having disassociated themselves from the group by abandoning its doctrines and were subsequently formally excommunicated and shunned by members of the organization.Jehovah's Witnesses Public Affairs Office press release, June 14, 2000.
Prior to its 2026 doctrinal change, the Watch Tower Society had established Hospital Information Services to provide education and facilitate bloodless surgery. This service also maintains Hospital Liaison Committees.
Doctrine On the basis of various biblical texts, including , , and , Jehovah's Witnesses believe:
Blood represents life and is sacred to God. After it has been removed from a creature, the only use of blood that God has authorized is for the atonement of sins. When a Christian abstains from blood, they are in effect expressing faith that only the shed blood of Jesus Christ can truly redeem them and save their life. Blood must not be eaten or transfused, even in the case of a medical emergency. Blood leaving the body of a human or animal must be disposed of. Certain medical procedures involving blood fractions or that use a patient's own blood during the course of a medical procedure, such as hemodilution or cell salvage, are a matter of personal choice, according to what a person's conscience permits. A baptized Witness who unrepentantly accepts a blood transfusion is deemed to have disassociated himself from the group by abandoning its doctrines and is subsequently subject to organized shunning by other members.
For many years, certain medical procedures involving blood were specifically prohibited by Jehovah's Witnesses' blood doctrine, including the use of red blood cells, white blood cells, platelets, and blood plasma. However, as of September 2026, only the transfusion of allogeneic whole blood is specifically prohibited, and the use of the components is considered a matter of conscience for individual members. Watch Tower Society publications state that some products derived from one of the four primary components may be so similar to the function of the whole component and carry on such a life-sustaining role in the body that "most Christians would find them objectionable". Where no specific instructions are provided by the Watch Tower Society, members are told to obtain details from medical personnel about specific procedures and then make a personal decision.
Prohibited procedures
The majority of procedures and products are left to the decision of individual members:
Treatment / ProcedurePre-19451945–19611961–20002000–2025April–September 2026Sept 2026–presentTransfusion of donated whole blood.⚪🔴🔴🔴🔴🔴Primary components (red blood cells, white blood cells, platelets, plasma)⚪🔴🔴🔴🔴🟢Blood fractions (albumin, immunoglobulins, clotting factors)⚪🔴🟢 (1990)🟢🟢🟢Interferons, interleukins⚪⚪🟢 (1989)🟢🟢🟢Erythropoietin⚪⚪🟢 (1994)🟢🟢🟢 Cryosupernatant⚪⚪⚪🟢 (2011)🟢🟢Blood donation⚪🔴🔴🟢 (for further fractionation only)Jehovah's Witness letter to Cliff Roche, July 30, 2001 (Published in the book Three Dissertations on the Teachings of Jehovah's Witnesses, by Greg Stafford, 2002 )🟢🟢 (for use of separate main components)Autologous blood transfusion⚪🔴🟢 (1989, intra-operative only)🟢🟢 (including pre-operative storage)🟢Hemodilution, intraoperative blood salvage, plasmapheresis⚪⚪🟢 (1989)🟢🟢🟢Bone marrow transplant⚪⚪🟢 (1984)🟢🟢🟢Cardiopulmonary bypass, dialysis⚪⚪🟢 (1978)🟢🟢🟢Organ transplants⚪⚪🔴 (1967–1980)🟢🟢🟢 🔴 = Explicitly prohibited 🟢 = Conscience-based (officially permitted) ⚪ = Not clearly defined
Bloodless surgery
108,000 physicians have expressed their willingness to respect the wishes of Jehovah's Witnesses and provide bloodless treatmentAriga et al., Legal Medicine, 5 (2003) S72-S75. and about 200 hospitals offer bloodless medicine and surgery programs for patients who wish to avoid or limit blood transfusions. Bloodless surgery has been successfully performed in significant procedures including open-heart surgery and total hip replacements., , —successful cases of bloodless surgery. A 2012 study in JAMA Internal Medicine concluded that "Witnesses do not appear to be at increased risk for surgical complications or long-term mortality when comparisons are properly made by transfusion status. Thus, current extreme blood management strategies do not appear to place patients at heightened risk for reduced long-term survival." The study also stated that "Survival estimates of Witnesses were 86%, 69%, 51%, and 34% at 5, 10, 15, and 20 years after surgery, respectively, vs 74%, 53%, 35%, and 23% among non-Witnesses who received transfusions."
Bloodless medical and surgical techniques have limitations, and surgeons say the use of various allogeneic blood products and pre-operative autologous blood transfusion are appropriate standards of care for certain patient presentations. The Watch Tower Society has historically stated that in medical emergencies where blood transfusions seem to be the only available way to save a life, Jehovah's Witnesses request that doctors provide the best alternative care possible under the circumstances with respect for their personal conviction. The Watch Tower Society has acknowledged that some members have died after refusing blood.
In some countries, including Canada and the United Kingdom, a parent or guardian's decision can be legally overruled by medical staff; in such cases, medical staff may act without parental consent by obtaining a court order in a non-emergency situation, or without such in an emergency. In Japan, children under 15 can be administered blood transfusions against their and their parents' wishes, and children between the ages of 15 and 18 can be similarly treated provided they, or at least one of their legal guardians, consent to the procedure. In the United States, the American Academy of Pediatrics recommends that in cases of "an imminent threat to a child's life", physicians in some cases may "intervene over parental objections". The Michigan Court of Appeals, in deciding Werth v. Taylor, refused to hold a doctor liable for giving a Witness a lifesaving transfusion in an emergency.
Hospital Liaison Committees In 1988, the Watch Tower Society formed Hospital Information Services, a department to help locate doctors or surgical teams who are willing to perform medical procedures on Witnesses without blood transfusions. They advocate for bloodless surgery methods. The department was given oversight of each branch office's Hospital Information Desk, and of one hundred Hospital Liaison Committees established throughout the United States. As of 2003, about 200 hospitals worldwide provided bloodless medical programs. As of 2006, there were 1,535 Hospital Liaison Committees worldwide coordinating communication between 110,000 physicians.January 3, 2006 Letter from Christian Congregation of Jehovah's Witnesses; To all Congregations Patients who accept certain blood products in the committee's presence were deemed to have disassociated and were shunned. It disseminates information about treatment options to local Hospital Liaison Committees, and to doctors and hospitals. The National Secular Society advocates against hospitals partnering with hospital liaison committees due to medical coercion.
Patient Visitation Groups Annually since 2004, Jehovah's Witnesses in the United States have been informed that "with your consent, the law allows for the elders to learn of your admission [to hospital] and provide spiritual encouragement", but that "elders serving on a Patient Visitation Group [could] have access to your name" only if patients have made their wishes known according to the Health Insurance Portability and Accountability Act (HIPAA).
Jehovah's Witnesses' branch offices communicate with congregations regarding "ways to benefit from the activities of the Hospital Liaison Committee (HLC) and the Patient Visitation Group (PVG)." A Jehovah's Witnesses publication in 2000 reported that HLC committee members provide "vital information to the medical community", adding that "their work is complemented by hundreds of other self-sacrificing elders who make up Patient Visitation Groups that call on Witness patients to help and encourage them". Each branch office appoints PVG committee members, who serve as volunteers.
Acceptance among Jehovah's Witnesses The majority of Jehovah's Witnesses accept the organization's position regarding the medical use of blood, and members who accept the blood doctrine typically hold strongly to their convictions. In the August 1998 issue of Academic Emergency Medicine, Donald Ridley, a Jehovah's Witness and organization staff attorney, argued that carrying an up-to-date Medical Directive card issued by the organization indicates that an individual personally agrees with the established religious position of Jehovah's Witnesses.
In 1958, The Watchtower reported about a member who voluntarily accepted blood transfusion, contrary to Watch Tower Society doctrine. The organization confirms that members have accepted blood transfusions, despite the imposition in 1961 of a communal shunning policy for willful acceptance.