Email Rolf J. Furuli:
Dear Dr Muramoto,
You end your letter by the words "all the loyal Witnesses who wrote their opinions here never returned
and followed up their comments, nor did they answer any of my questions. I sincerely hope that Furuli
does not follow in the footsteps of those fellow Witnesses whose communication is only one-way
traffic."(1) D. Malyon, a member of the HLC of Luton, Bedfordshire has written an article with a
thorough discussion of a previous article that you wrote.(2) If a Witness has not answered your
previous questions, I can understand his or her reasons, because your letter is not an inquiry to get
answers but rather an attempt to change the faith of the addressee and all other Jehovah's
Witnesses. At least this is the case with your letter to me.
According to yourself, you are a "'third party"' because you are not a Witness. I do not consider it
appropriate to discuss internal questions with an outsider who is very critical of our brotherhood of
believers. However, you have by your article directed the attention of the readers of BMJ to the
Witnesses in a way which can create unwarranted suspicion on the part of doctors, and this may
result in an extra burden on an ill Witness patient. I therefore would like to correct some of your
inaccurate claims and make comments on others.
CONFIDENTIALITY OF JEHOVAH'S WITNESSES PATIENTS
If you as a physician had an HIV-positive patient who dated your daughter, and they wanted to get
married, and you knew that your daughter was unaware of his sickness, would you tell her? This
would be an extremely problematic situation - your professional confidentiality versus the health of
your daughter - so I shall not advise you. For Witnesses as well, confidentiality is an extremely
important issue. Confidential matters should not be revealed to others and promises made to one
another should be kept.
Although an outsider may not understand it, the Witnesses learn to cultivate a love so strong for God
and for fellow Witnesses that they are willing to die for one another and for God. So if a Witness
definitely is on the point of destroying his or her relationship with God, another Witness will offer to
help. In practically all instances, a Witness can be given spiritual help without revealing confidential
matters. But in extremely rare situations there can be a serious case where a Witness faces a
situation like that with the HIV-positive patient. Another person cannot give advice to the Witness, but it
can happen that he or she views the situation as 'jus nessisitatis' as you might do with the HIV-positive
patient. Such a situation occurs so rarely that to use the possibility of it as proof that
Jehovah's Witnesses are willing to break their professional confidentiality is not honest. I am quite
sure that among medical personnel who belong to the 15.000 Witnesses of Norway there is not a
single example of this situation within the last ten years.
IS THERE A DIVERSITY OF VIEWS REGARDING BLOOD AMONG JEHOVAH'S WITNESSES?
In a letter you write: "Mr. Elder testifies how diverse the views are on the issue among Jehovah's
Witnesses."(3) In your letter to me you write: "I have personally seen several Witnesses who altered
their advance directive to select different blood products from what the Watchtower Society permits"
and, that according to L. Elder "some anesthesiologists revealed that up to half of their Jehovah's
Witness patients had been willing to reevaluate their position on blood when a private conference
was held with them." I accept your words regarding what you have seen, but am doubtful regarding
the information you have gotten from opposers. I do not think that the statistics of persons who
pretend to be something they are not, namely, loyal and cooperative brothers in the congregation,
should be trusted, particularly not when their words are so dramatically different from what I know
about Jehovah's Witnesses through 40 years, and from the information I get from doctors.
In Norway, we have a very good relationship with doctors. We give lectures and participate in
discussions at hospitals; in addition, we have personal conversations with doctors. At the yearly
meetings of anesthesiologists and surgeons, we are present for several days with our information
stand, and we exchange information with individual doctors. At these occasions, some doctors are
skeptical. They ask sweeping questions, and relate different cases to us (without revealing
confidential information). If there were such cases where Witnesses reevaluated their stand, this
would have proved to be a good argument for the skeptical doctors. However, we do not hear of such
cases. In my first letter I quoted a professor, the head of a team of surgeons, who has operated on
Jehovah's Witnesses for more than 30 years. His statistics show that one Witness out of every
hundred accepts blood or its major components. This is about the same statistic we get from all the
country and it is a figure that is very far from your figures.
DO" THIRD PARTY" JEHOVAH'S WITNESSES EXERCISE PRESSURE ON PATIENTS AND
PHYSICIANS?
In a stressful situation, persons may behave differently than normal. Because they do not want blood,
some Witnesses may not always do all things in a reasonable way, in spite of the fact that
congregation members are advised time and again to be balanced, polite and respectful toward
doctors. However, your description of hospitalized Witnesses is extreme, and differs significantly
from my experience. You write: "Most physicians have experienced enormous pressure applied by the
local Witness community, mainly family, friends and elders who belong to the same congregation.
They insist on bloodless surgery even before the patient himself expresses his own understanding
and wishes . . . It is well known to the medical community that the congregation members even
maintain an overnight vigil in the hospital to prevent the patient from receiving blood."
It stands to reason that you cannot know what "most physicians" who treat Jehovah's Witnesses in
the UK or in the US experience, and you cannot know the degree of pressure those who feel
pressure experience. So the expressions "most physicians" and "enormous pressure" has nothing
to do with reality, but are extreme exaggerations. The same is true with the claim of "overnight vigils"
which is "well known." I am sure that such a situation has not happened in Norway in the last ten
years, and that such precautions are extremely rare, if they happen at all, in other countries.
As to the feelings of doctors I will relate the following experience. Ten years ago, a young man who
was badly injured called for assistance. Another elder and myself went to the hospital. With the help
of the Hospital Information desk at the Watchtower Society in Brooklyn we contacted a professor in
the US who had experience regarding the situation. We got his advice and several medical articles
which we conveyed to the responsible doctors. We asked about a treatment found in these articles
which was not used in Norway.
"Would you like to try this on the patient?" we asked the medical team. "Well . . . " "Will it harm the
patient?" we asked. "No," the doctors answered. "So why don't you try it?" we queried.
In the end, the medical team did try the treatment, but the patient died. However, he died, not because
of the lack of blood, but because he was badly injured.
Five years later, at a meeting of doctors and nurses regarding treatment of Jehovah's Witnesses,
(and after an unfavorable article in a Norwegian medical journal) a doctor from the team spoke about
two members of the hospital liaison committee who had exercised "improper pressure" in the
mentioned situation. The truth was that we had not spoken with the young man because he was
unconscious, and the only contact between us and the doctors had been to convey medical
information and ask questions about the treatment. The father who lost his son was not a Witness,
but he was so impressed by the love and kindness he saw - not pressure - that after the incident he
became a Witness. Doctors are also humans, and it is easy to interpret the behavior of other
persons in the way that you expect this behavior to be. This is the reason why articles similar to the
one you have written may stir up suspicion, and therefore harm the good relation between doctor and
patient. The family and congregation friends of a patient are not a dangerous "third party" but those
who give wrong information about Jehovah's Witnesses and create suspicion certainly are.
WHO IS IT WHO DO NOT RESPECT THE CONSCIENCE OF OTHERS - JEHOVAH'S WITNESSES OR
THE OPPOSERS?
As you will not reveal the epicrises of your patients to others, I will not discuss internal congregational
matters with you or others. I will, however, make the general remark that I would respect a position
based on the sincere conscience of another Witness, whether or not it is different from mine. To
respect the conscience of another person, however, does not mean that I admit that everything goes
or that two diametrically different viewpoints are both correct. If the conscience of a person, for
instance, says that it is right for a Christian to steal, it is time for him or her to adjust the conscience,
as the Bible says (Romans 10:2,3; Hebrews 13:19.
As to those "Witnesses" to whom you give advice, and for whose sake you want me to write letters to
the Watchtower Society, the question about conscience plays just a minor part. Their situation is not
like a person who comes to his fellow Christians and says that because of his special illness he
needs a solution including neutrophil leucocytes. He states that his conscience allows him to accept
that and he asks that his conscience be respected. (4) No, those persons whom you represent and
who have written letters in connection with your article actively oppose Jehovah's Witnesses and
express false accusations. One of them wrote: "My question to you, sir, is this: is the sacrifice of
hundreds, perhaps thousands of JW children a justifiable price for 'greater peace, inner contentment,
and life meaning."(5)
This is a serious accusation, but where is the proof behind it? Hundreds, perhaps thousands of
children killed by Jehovah's Witnesses? The article in Awake! May 22, 1994, to which the writer refers,
does not speak about children in general, but about youngsters with leukemia and similar deadly
diseases. The lack of blood did not kill the youngsters mentioned in the article; their disease killed
them. If a young person who already knows that he or she is going to die, does not want to try to
prolong life for a short time with the use of blood but seeks alternative treatment, how can it be said
that Jehovah's Witnesses sacrificed ("killed") this person?
In an editorial, C.D. Kitchens refers to 16 studies with 1404 Witness patients, and reports that the
authors "... implicated a lack of blood as the primary cause of death in 8 patients (0.6%) and
contributing to death in another 12 patients, yielding a total of 20 deaths (1.4%)." The author
continues, "Other complications were not increased in Jehovah's Witness patients". Then he draws
the interesting conclusion: "Less clear is how much morbidity and mortality are avoided by this
practice [refusal of blood], but they probably exceed the risk of being transfused."(6) Because it can be
more dangerous to accept a transfusion than to refuse one, a person who refuses one and dies for
this reason or another, cannot rightly be accused for suicide, and it is even more illogical to accuse
his or her fellow believers for killing the person.
JW respect the consciences of the opposers when they disagree, but what you and they ask for is not
just that, but you ask for an acceptance of the correctness of your viewpoints, and that we cannot do.
You, on the other hand, appear not to respect the consciences of the Witnesses when they abstain
from blood, but claiming that many Witnesses do not really mean what they say in their own signed
statements, you suggest that doctors should try to persuade sick Witnesses to change their minds. If
you respect our consciences, why don't you not follow your own decision but leave us alone?
ARE JEHOVAH'S WITNESSES BRAINWASHED OR DO THEY FOLLOW THE BIBLE?
You write: "The Scriptures alone have little authority for JWs"(7) and "The most important external
factor is not physicians "ruthlessly defending a cherished belief/dogma of modern medicine," but the
inconsistent and mutating policy of the controlling organization, the Watchtower society (WTS)."(8)
It is a bold and utterly false claim to say that the Watchtower Society is the authority for Jehovah's
Witnesses and not the Bible. This is something which is the very opposite of what the Witnesses
themselves say and believe. I have a mag. art. degree in Semitic linguistics, which is about the same
as an American Ph.D.; in addition, I am currently doing research for the higher Norwegian doctoral
degree. I teach the biblical languages Hebrew and Aramaic on the university level, and I have
mastered the third Biblical language, Greek. I continually study the Bible in its original languages.
Should I not know the basis for my faith and the faith of other Jehovah's Witnesses? Should I be
brainwashed? My basis for being a Witness I find in the Bible and in the Bible alone, and this is the
same for my fellow Witnesses. You have completely misunderstood the theocratic arrangement
among Jehovah's Witnesses and misinterpret it as some form of spiritual dictatorship. However, the
truth is that responsible persons function as teachers and not as prophets.
RESPECTING AUTONOMY AND PERSONAL DECISIONS
Your assertions that "In biblical times 'blood' only meant whole blood, not any blood fractions or
components, major or minor. In biblical times 'abstain from blood' meant from eating blood, not from
using it to treat medical conditions" are not true. The medical condition which caused the death of
Jesus Christ, could have been that his heart burst. This can explain the words of John 18:34 that
"blood (haima) and water came out" when the soldiers jabbed his side with a spear. If a volume of
blood is allowed to stand undisturbed for a time, the red cells sink to the bottom. Evidently the red
cells are called 'blood' in the quote, and the plasma, perhaps mixed with lymph is called 'water'.(9) A
Biblical law can cover practices which are new and did not occur in the past; the law against 'porneia'
can, for instance, be applied to to a situation where a woman artificially is fertilized by semen from a
man with whom she is not married.
When a Witness needs surgery, it is his or her conscience that matters, so the ethical question is
whether the will of the Witness shall be respected or not. Whether you, who is not a Witness, or
another person who claims to be a Witness, agrees with the beliefs of the patient is beyond the point.
So all your words about 'Witnesses' who disagree just cloud the issue and shows that you have an
agenda, namely to try to change the mind of as many Witnesses as possible so they accept those
blood components which you think they should accept. You have the right to work for your own
interests, the reason why I react, is that you paint a picture which does not represent reality, where
extreme possibilites which almost never occur is portrayed as normal among the Witnesses. This
also includes the claim that "many" Witnesses, in one context "up to half of the Witnesses" will
change their mind regarding blood if the right questions are asked. I do not doubt that practically all
Witnesses stick to their decision also in a situation of stress or when someone tries to persuade
them to change their mind. My concern is that doctors get a false picture of the Witnesses and that a
good relationship therefore can be hampered from the start. This is the reason for my present
comments.
(1) Muramoto, O. http://www.bmj.com/cgi/eletters/322/7277/37, 26 February 2001. All quotes from
Muramoto without special reference is from this article.
(2) Malyon, D., "Transfusion-free treatment of Jehovah's Witnesses: respecting the autonomous
patient's right", Journal of Medical Ethics, 1998, vol 24, No 5. pp. 302-307.
(3) Muramoto, O. http://www.bmj.com/cgi/eletters/322/7277/37, 19 January 2001.
(4) I am using this as an example of different attitudes and not as a 'case'.
(5) Pseudonym, Elder, L. http://www.bmj.com/cgi/eletters/322/7277/37, 7 February 2001
(6) Kitchens, C. D., "Are transfusions overrated? ", American Journal of Medicine, 1993, 94:117-119.
(7) Muramoto, O. http://www.bmj.com/cgi/eletters/322/7277/37, 4 February 2001.
(8) Muramoto, O. http://www.bmj.com/cgi/eletters/322/7277/37, 21 January 2001
(9) The Hebrew word mayim and the Greek word hydor are generic terms which can refer to liquids
such as juice and urin. That the red cells were specified as 'blood' in this verse, would not
necessarily, according to Semitic thought, rule out that the hydor (water) or a part of it could be called
'blood' in other contexts. Regarding the Hebrew word nephesh ("soul", "life") Leveticus 17:11 says
that the soul is 'in' the blood while verse 14 says that the blood 'is' the soul. This does not mean that
the rest of the creature is not 'soul', because verse 15 shows that men 'are' souls, and 19:28 speaks
of a 'deceased soul', a creature which had been a soul. So in John 18:34 the red cells are specified
as 'blood', without excluding that other parts could be specified as 'blood' in other contexts.