Jehovah's Witnesses (JW) belong to the religious organization, the Watch Tower Bible and Tract Society. They number an estimated 6 million world-wide, of whom 145 000 live in the UK1. In Australia, a 2001 population survey showed that the 81 000 JW represented 0.4% of the population2. JW refuse blood transfusion with the 'primary components' of blood (see below for definition) and are prepared to die rather than be transfused. Until 2000, the church would have expelled any member who had been transfused with any prohibited component of blood. Such an individual would have been ostracized and shunned by the members of the church and their family, leading to social isolation. In 2000, rejection by the church was abandoned and it was left to the individual to revoke his own membership from the Society. Although this change in policy was seen as a relaxation of the JW policy on blood transfusion, the JW Society felt that no JW would wish to dissociate them-selves3. In practical terms, this change may mean that some JW may, in absolute medical confidentiality, accept transfusion under certain circumstances. Regardless, under British law, any competent adult has an absolute right to refuse transfusion. Readers are directed to previously published works on this area of ethics (discussed in reference 4), whereas issues of consent in adult JW are discussed later in this review. Transfusion in children of JW is not discussed in this review. Instead, the reader is referred to recent summaries4,5 based on guidelines from the Association of Anaesthetists of Great Britain and Ireland (2005)6
and the Royal College of Surgeons Code of Practice (2002)7.
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