The fundamental answer is that Jehovah’s Witnesses do not accept blood. We firmly believe that God’s law on blood is not open to reform to fit shifting opinions. Still, new issues arise because blood can now be processed into four primary components and fractions of those components. In deciding whether to accept such, a Christian should look beyond possible medical benefits and risks. His concern should be what the Bible says and the potential effect on his relationship with Almighty God.

The key issues are quite simple. As an aid to seeing why that is so, consider some Biblical, historical, and medical background.

Jehovah God told our common ancestor Noah that blood must be treated as something special. (Genesis 9:3, 4) Later, God’s laws to Israel reflected the sacredness of blood: “As for any man of the house of Israel or some alien resident . . . who eats any sort of blood, I shall certainly set my face against the soul that is eating the blood.” By rejecting God’s law, an Israelite could contaminate others; thus, God added: “I shall indeed cut him off from among his people.” (Leviticus 17:10) Later, at a meeting in Jerusalem, the apostles and older men decreed that we must ‘abstain from blood.’ Doing so is as vital as abstaining from sexual immorality and idolatry.​—Acts 15:28, 29.

What would “abstaining” have meant back then? Christians did not consume blood, whether fresh or coagulated; nor did they eat meat from an unbled animal. Also ruled out would be foods to which blood was added, such as blood sausage. Taking in blood in any of those ways would violate God’s law.​—1 Samuel 14:32, 33.

Most people in ancient times would not have been troubled over the consuming of blood, as we can see from the writings of Tertullian (second and third centuries C.E.). Responding to false charges that Christians consumed blood, Tertullian mentioned tribes that sealed treaties by tasting blood. He also noted that “when a show is given in the arena, [some] with greedy thirst have caught the fresh blood of the guilty . . . as a cure for their epilepsy.”

Those practices (even if some Romans did them for health reasons) were wrong for Christians: “We do not include even animals’ blood in our natural diet,” wrote Tertullian. The Romans used food containing blood as a test of the integrity of real Christians. Tertullian added: “Now, I ask you, what sort of a thing is it, that when you are confident [that Christians] will turn with horror from animals’ blood, you should suppose them greedy for human blood?”

Today, few people would think that the laws of Almighty God are at issue if a physician suggested their taking blood. While Jehovah’s Witnesses certainly want to keep living, we are committed to obey Jehovah’s law on blood. What does this mean in the light of current medical practice?

As transfusions of whole blood became common after World War II, Jehovah’s Witnesses saw that this was contrary to God’s law​—and we still believe that. Yet, medicine has changed over time. Today, most transfusions are not of whole blood but of one of its primary components: (1) red cells; (2) white cells; (3) platelets; (4) plasma (serum), the fluid part. Depending on the condition of the patient, physicians might prescribe red cells, white cells, platelets, or plasma. Transfusing these major components allows a single unit of blood to be divided among more patients. Jehovah’s Witnesses hold that accepting whole blood or any of those four primary components violates God’s law. Significantly, keeping to this Bible-based position has protected them from many risks, including such diseases as hepatitis and AIDS that can be contracted from blood.

However, since blood can be processed beyond those primary components, questions arise about fractions derived from the primary blood components. How are such fractions used, and what should a Christian consider when deciding on them?

Blood is complex. Even the plasma​—which is 90 percent water—​carries scores of hormones, inorganic salts, enzymes, and nutrients, including minerals and sugar. Plasma also carries such proteins as albumin, clotting factors, and antibodies to fight diseases. Technicians isolate and use many plasma proteins. For example, clotting factor VIII has been given to hemophiliacs, who bleed easily. Or if someone is exposed to certain diseases, doctors might prescribe injections of gamma globulin, extracted from the blood plasma of people who already had immunity. Other plasma proteins are used medically, but the above mentioned illustrate how a primary blood component (plasma) may be processed to obtain fractions. *

Just as blood plasma can be a source of various fractions, the other primary components (red cells, white cells, platelets) can be processed to isolate smaller parts. For example, white blood cells may be a source of interferons and interleukins, used to treat some viral infections and cancers. Platelets can be processed to extract a wound-healing factor. And other medicines are coming along that involve (at least initially) extracts from blood components. Such therapies are not transfusions of those primary components; they usually involve parts or fractions thereof. Should Christians accept these fractions in medical treatment? We cannot say. The Bible does not give details, so a Christian must make his own conscientious decision before God.

Some would refuse anything derived from blood (even fractions intended to provide temporary passive immunity). That is how they understand God’s command to ‘abstain from blood.’ They reason that his law to Israel required that blood removed from a creature be ‘poured out on the ground.’ (Deuteronomy 12:22-24) Why is that relevant? Well, to prepare gamma globulin, blood-based clotting factors, and so on, requires that blood be collected and processed. Hence, some Christians reject such products, just as they reject transfusions of whole blood or of its four primary components. Their sincere, conscientious stand should be respected.

Other Christians decide differently. They too refuse transfusions of whole blood, red cells, white cells, platelets, or plasma. Yet, they might allow a physician to treat them with a fraction extracted from the primary components. Even here there may be differences. One Christian may accept a gamma globulin injection, but he may or may not agree to an injection containing something extracted from red or white cells. Overall, though, what might lead some Christians to conclude that they could accept blood fractions?

“Questions From Readers” in The Watchtower of June 1, 1990, noted that plasma proteins (fractions) move from a pregnant woman’s blood to the separate blood system of her fetus. Thus a mother passes immunoglobulins to her child, providing valuable immunity. Separately, as a fetus’ red cells complete their normal life span, their oxygen-carrying portion is processed. Some of it becomes bilirubin, which crosses the placenta to the mother and is eliminated with her body wastes. Some Christians may conclude that since blood fractions can pass to another person in this natural setting, they could accept a blood fraction derived from blood plasma or cells.

Does the fact that opinions and conscientious decisions may differ mean that the issue is inconsequential? No. It is serious. Yet, there is a basic simplicity. The above material shows that Jehovah’s Witnesses refuse transfusions of both whole blood and its primary blood components. The Bible directs Christians to ‘abstain from things sacrificed to idols and from blood and from fornication.’ (Acts 15:29) Beyond that, when it comes to fractions of any of the primary components, each Christian, after careful and prayerful meditation, must conscientiously decide for himself.

Many people would be willing to accept any therapy that seems to offer immediate benefit, even a therapy having known health risks, as is true of blood products. The sincere Christian endeavors to have a broader, more balanced view that involves more than just the physical aspects. Jehovah’s Witnesses appreciate efforts to provide quality medical care, and they weigh the risk/benefit ratio of any treatment. However, when it comes to products derived from blood, they carefully weigh what God says and their personal relationship with our Life-Giver.​—Psalm 36:9.

What a blessing for a Christian to have such confidence as the psalmist who wrote: “Jehovah God is a sun and a shield; favor and glory are what he gives. Jehovah himself will not hold back anything good from those walking in faultlessness. O Jehovah . . . , happy is the man that is trusting in you”!​—Psalm 84:11, 12.