Recognizable questions
- According to the current blood policy, what may and may not Jehovah’s Witnesses accept?
- Are red blood cells, white blood cells, plasma, and platelets still forbidden?
- Why is whole blood still forbidden while the four main components are each a personal decision?
- What changed in March and September 2026?
- Who nowadays decides whether a Witness accepts a certain blood product?
- May an elder or congregation interfere with a personal decision about blood components?
- What exactly does a Hospital Liaison Committee do?
- Does every congregation have its own Hospital Liaison Committee?
- Why did Jehovah’s Witnesses carry a blood card or medical directive for years?
- Why were minor children also given a special Identity Card?
- What happens if a Jehovah’s Witness nowadays does accept red blood cells or plasma?
- What should you do if you once filled out a ‘no blood’ directive but now want to accept blood?
- Can parents in the Netherlands refuse a necessary blood transfusion for their child?
- Has the policy changed because medical science now offers more options?
- Why did such a major change happen דווקא in 2026?
- Did lawsuits in Japan have anything to do with the policy change?
What is the blood policy?
Jehovah’s Witnesses believe that the Bible’s command to ‘abstain from blood’ applies not only to eating blood, but also to certain medical uses of blood.
The main Bible texts the organization relies on include Genesis 9:4, Leviticus 17:10-14, and Acts 15:20, 28, 29.
The application of these texts to blood transfusions is a religious interpretation.
Jehovah’s Witnesses have always stressed that their refusal of blood is primarily based on their Bible-based belief, and not simply on the possible medical risks of transfusions.
BIBLE
“abstain from blood”
↓
INTERPRETATION
this also applies to
medical use of blood
↓
ORGANIZATIONAL POLICY
which uses are
forbidden and which are
personal choices?That last boundary, in particular, has changed over the years.
1945 – blood transfusion is placed under the Bible-based prohibition
Jehovah’s Witnesses date their explicit stance against blood transfusions from 1945.
From that point on, the organization also applied the Bible’s command to abstain from blood to medical blood transfusions.
This made refusing blood not just a personal medical choice, but a religious standard within the faith community.
1961 – accepting blood could have consequences
From 1961 onward, a baptized Jehovah’s Witness who knowingly accepted blood was treated as having committed a serious religious offense.
If someone knowingly accepted a transfusion and, under the rules at the time, did not show repentance, consequences could be attached to their standing in the congregation.
ACCEPTING BLOOD
against the rule in force
↓
religious offense
↓
possible consequences
for standing in the congregationSo the blood policy was not just a matter between patient and doctor.
Later, a distinction arose between blood and blood fractions
As transfusion medicine developed, blood could be broken down into increasingly smaller parts.
The organization therefore spent years making a distinction between:
whole blood;
the four so-called main components;
smaller fractions derived from those main components.
The four main components were:red blood cells;
white blood cells;
platelets;
plasma.
Until September 2026, both whole blood and these four main components were religiously not allowed.
Many smaller fractions, however, were a matter of personal conscience.
WHOLE BLOOD
forbidden
↓
four main components
red blood cells
white blood cells
platelets
plasma
all four forbidden
↓
smaller fractions
personal choice20 March 2026 – a change regarding one’s own blood
On 20 March 2026, the Governing Body announced an important change regarding the use of a person’s own blood in medical treatment and surgery.
The new reasoning was that the Bible does not specifically address different medical uses of a person’s own blood, and that therefore the individual Christian must make a conscience-based decision.
This represented a clear shift from older publications, in which certain forms of storing one’s own blood in advance and later having it returned were judged much more strictly.
BEFORE
certain uses
of one’s own stored blood:
not allowed
2026
more uses
of one’s own blood:
personal choiceThis reasoning was expanded much further a few months later.
September 18, 2026 — the biggest change
On September 18, 2026, the Governing Body announced that four blood products that had been religiously forbidden for decades are now personal conscience matters:
red blood cells;
white blood cells;
platelets;
plasma.
Donating blood with the aim of obtaining components or fractions for use by others also became, under certain conditions, a personal conscience matter.
Whole blood remains religiously unacceptable.
What is the current policy?
Blood or treatmentCurrent policyWhole bloodnot acceptableRed blood cellspersonal conscience matterWhite blood cellspersonal conscience matterPlateletspersonal conscience matterPlasmapersonal conscience matterFractions from these productspersonal conscience matterVarious uses of one’s own bloodpersonal conscience matterDonating for components or fractionspersonal conscience matterDonating to be transfused as whole bloodnot acceptable
The current official explanation also says that the congregation should not interfere with the personal choice regarding the four main components and that other Christians should not judge someone for that decision.
A simple comparison: hussar salad
The current religious boundary can be illustrated simply with hussar salad.
potatoes → allowed
carrots → allowed
peas → allowed
mayonnaise → allowed
but:
HUSSAR SALAD → not allowedWith blood:
red blood cells → personal choice
white blood cells → personal choice
platelets → personal choice
plasma → personal choice
but:
WHOLE BLOOD → forbiddenMedically, this comparison is not literal. Blood components processed separately are not simply four ingredients that are then put back together to form exactly the same medical product.
But as a comparison of the religious policy boundary, it does make a clear question visible:
why does the whole remain categorically forbidden when the four main components are left to personal conscience individually?
What has actually changed from a policy standpoint?
Until September 18, 2026, a medical situation might have looked like this:
DOCTOR:
“You need red
blood cells.”
↓
RELIGIOUS POLICY:
not acceptedNow:
DOCTOR:
“You need red
blood cells.”
↓
INDIVIDUAL WITNESS:
decide for yourselfThe medical product has remained the same.
What has changed is who makes the religious decision.
The current official explanation states that the Bible does not specifically speak about the individual products that can be obtained from blood and that the Governing Body therefore does not want to go beyond what is written.
That naturally raises a historical question:
why, then, was that same decision not left to personal conscience for decades?
Has medical science made this change possible?
Medical science has advanced enormously.
But the explanation “in the past hospitals still could not give red blood cells, plasma, and platelets separately” is not correct.
Component therapy has existed for many decades.
Red blood cells, plasma, and platelets were already being used separately in the twentieth century.
Jehovah’s Witnesses themselves had long distinguished in their own publications between these four main components and smaller fractions.
TRUE:
medicine has
advanced greatly
ALSO TRUE:
the main blood
components have been
administered separately
for decades
THEREFORE NOT TRUE:
“these products could not
formerly be used separately”The newest official JW explanation does cite medical developments as a reason for new questions, but the eventual policy change is mainly justified biblically: according to the Governing Body, the Bible gives no specific instructions about these separate medical products.
The Bible text did not change — the policy did
Acts 15 has not changed.
Neither has the composition of blood.
Red blood cells, plasma, and platelets were also not invented in 2026.
What changed is the official application of the Bible text to medical products.
BIBLE TEXT
the same
MEDICAL PRODUCTS
have existed for decades
POLICY
changedAn active Jehovah’s Witness may see this as further clarified Bible understanding.
A former Witness may view the same change more critically.
But in fact, the religious application has changed.
Older JW publications may now contain outdated rules
Because the change was not announced until September 18, 2026, there are still older JW publications stating that red blood cells, white blood cells, platelets, and plasma may not be accepted.
For information on the current policy, the most recent publications should therefore always be used.
An older article may be historically valuable, but no longer give an accurate description of what a Witness may choose today according to the current policy.
Who now decides about the four main components?
According to the current policy:
the individual Jehovah’s Witness.
The organization now says that:
every Christian decides for themselves;
the congregation does not interfere with that decision;
other Christians may not judge the person for the choice;
in principle, the decision may remain private.
BEFORE
organization policy
↓
“no” to four
main components
NOW
personal conscience
↓
“yes” or “no”
is an individual choiceOrganizationally, that is a fundamental shift.
Can a Witness nowadays accept red blood cells without congregation consequences?
According to the current official arrangement: yes.
If someone, after weighing their own conscience, accepts red blood cells, plasma, platelets, or white blood cells, that is no longer automatically a violation of the blood policy.
According to the current explanation, the congregation is not to make that choice for the person or judge him or her for it.
That is a major departure from the previous policy.
What is a Hospital Liaison Committee?
Jehovah’s Witnesses have a worldwide network of Hospital Liaison Committees, usually abbreviated HLC.
It is not one committee per congregation.
These are regional committees that can support hospitals, doctors, and individual Witnesses with medical issues involving blood.
According to the organization, the network consists of about 2,000 Hospital Liaison Committees in more than 110 countries.
What does an HLC do?
A Hospital Liaison Committee can, among other things:
provide information about bloodless treatments;
make medical literature available;
put doctors in touch with specialists experienced in treatment without certain blood products;
help with a possible transfer;
explain the patient’s religious position.
Historically, the committees were strongly focused on helping Witnesses avoid blood transfusions.
Due to the 2026 policy change, that position has changed in important respects.
The HLC no longer determines whether someone may accept a main component
If a Witness nowadays wants to accept red blood cells, for example, a Hospital Liaison Committee should respect that choice according to the current official policy.
The organization also says that the HLC must treat personal medical decisions confidentially.
So for the four main components, the committee should no longer say:
“A good Jehovah’s Witness may not accept this.”
The decision lies with the patient.
The blood card and medical advance directive
For decades, the blood policy was organizationally supported by medical documents.
For example, Jehovah’s Witnesses carried a Medical Document, later various forms of medical advance directives.
Historical instructions showed that these documents were regularly renewed, and in certain periods annually.
The documents made clear that the patient did not want to receive blood if he or she could no longer communicate.
RELIGIOUS POLICY
↓
medical advance directive
↓
signature
↓
carried with you
↓
in an emergency:
doctor knows the wishesChildren were also given an ID card
Minor children were also given a special Identity Card.
In Dutch JW publications, parents were instructed to ensure that their children carried this card with them.
A historical instruction even said that parents had to check daily whether their children took the card with them when they went to:
school;
a playground;
a recreation area
.
CHILD
↓
Identity card
about blood policy
↓
taken to school
and other placesFor many children, the blood position therefore became part of everyday life from an early age.
‘No blood’ at school
Some former Jehovah’s Witnesses also remember that in medical records at school, on forms, or in a school diary, ‘no blood’ was written.
What is officially documented is that children could be issued an Identity Card and that parents had to check whether they took that card to school.
A general worldwide instruction that every child had to literally write ‘no blood’ in their school diary has not been found.
So it is better to make a distinction:
Identity card
to school
= officially documented
“no blood”
written in school diary
= may have been a family or
local practiceWhat if an old advance directive no longer matches your current choice?
If someone used to be one of Jehovah’s Witnesses and at the time filled out a ‘no blood’ directive, but now thinks differently about transfusion, it is wise to clearly record that change.
In the Netherlands, a patient may revoke a previous medical consent or refusal.
Therefore, it can be wise to:
inform your general practitioner and any specialist;
have it noted that the old refusal no longer applies;
no longer carry old documents;
inform authorized representatives and family members who have a copy;
if necessary, draw up a new medical advance directive.
For that, no permission from elders, the congregation, or the Hospital Liaison Committee is needed.
Rights of an adult patient in the Netherlands
According to article 7:450 of the Civil Code, consent from the patient is generally required for medical treatment.
An adult patient who is competent therefore has the right to accept or refuse treatment, even if a doctor strongly recommends that treatment.
A patient may also reverse a previous decision.
An adult Jehovah’s Witness can therefore legally decide for themselves:
to refuse whole blood;
to refuse certain blood components;
or to consent to red blood cells, plasma, platelets, or other medical products.
Dutch law does not determine which religious choice someone must make.
How does this work for children in the Netherlands?
The Dutch rules differ by age.
UNDER 12 YEARS OLD
parents/guardian
normally decide
12 TO 15 YEARS OLD
child + parents/guardian
normally decide together
16 AND 17 YEARS OLD
young person decides
in principle for themselves16- and 17-year-olds: an important nuance
A young person of 16 or 17 in principle decides independently about medical treatment, provided that he or she is competent to make that specific decision.
Competent means that someone is sufficiently able to understand the relevant information, assess the consequences, and make a reasonable judgment.
If a young person is not competent for that specific decision, the legal representatives may play a role.
16 OR 17 YEARS OLD
competent
↓
decides for themselves
not competent
for this decision
↓
representation12- to 15-year-olds
For young people aged 12 to 15, consent is normally required from both the young person and the parents or guardian.
There are exceptions to that.
A doctor may, under certain conditions, treat if treatment is necessary to prevent serious harm to the child or if the treatment reflects the child’s well-considered wish, despite a differing opinion from the parents.
The situation is therefore more nuanced than:
‘The parents always decide.’
What if parents refuse a necessary transfusion for their child?
In the case of minor children, the best interests of the child carry great weight.
When parents refuse medically necessary treatment and the child is thereby placed in serious danger, doctors can take legal action.
Through the children’s judge, for example, substitute consent or a child protection measure can be arranged.
In doing so, factors such as the following are considered:
the urgency;
the child’s age;
competence;
possible alternatives;
the child’s opinion;
the seriousness of the risk if treatment is not given.
Religious belief therefore does not simply give parents the right to permanently block any medically necessary life-saving treatment for their child.
Why was the policy regarding children so far-reaching?
For adults, it ultimately concerns their own medical autonomy.
For children, it is different.
The combination of:
a religious rule;
special Identity Cards;
instructions to carry the card every day;
parents refusing blood on behalf of their child;
doctors sometimes finding a transfusion necessary;
and possible intervention by a judge
makes the blood policy concerning children particularly far-reaching.
Bloodless medicine and blood transfusion are not simple opposites
The subject is sometimes presented in too black-and-white a way.
It is not correct to say:
‘A major surgery can only be safe with a transfusion.’
There are many treatments in which blood loss can be greatly reduced and transfusions can be avoided.
Patient blood management has also received a great deal of medical attention outside Jehovah’s Witnesses.
But the opposite is just as untrue:
‘Blood components are never needed.’
In severe bleeding, very severe anemia, and certain other medical situations, blood components can expand treatment options and sometimes be life-saving.
BLOOD CONSERVATION
where possible
can be good medicine
AND
BLOOD COMPONENTS
can in certain
situations be important
or life-savingHas the old policy cost lives?
We do not know the exact worldwide number.
There is no reliable international registry in which it has been established for every deceased Jehovah’s Witness:
which blood product was refused;
whether that product was medically necessary;
whether refusal caused the death;
and whether the person would probably have survived with a transfusion.
Estimates of around a thousand or more deaths per year are circulating, but those are estimates and extrapolations, not globally recorded numbers.
Therefore:
‘It has been proven that a thousand Witnesses die every year because of the blood policy’
is too categorical.
But the reverse:
‘Refusing blood has never caused any excess mortality’
is not medically sustainable either.
What does the change mean for people from the past?
Suppose someone was seriously ill twenty years ago.
Doctors advised red blood cells.
The patient refused because he or she was convinced:
‘Jehovah forbids me this treatment.’
In September 2026, the same organization says:
‘This is a personal conscience decision.’
Then relatives can understandably ask:
What would my family member have chosen if that freedom had existed then?
Why wasn’t he or she allowed to decide that for themselves at the time?
Could the treatment have increased the chance of survival?
Why was something then treated as a religious prohibition and now as a personal choice?
One important distinction must remain clear here:
“the treatment
might have helped”
≠
“the person would
certainly have survived”The latter can only be assessed in each individual medical situation.
Why דווקא in 2026?
The official explanation is that, after further study, prayer, and consideration, the Governing Body concluded that the Bible does not specifically address these separate medical applications.
Therefore, the decision should rest with the individual Christian.
At the same time, there are international medical, social, and legal discussions about refusing blood.
That context makes it logical to ask whether external developments may have played a role.
But a possible influence is something different from a proven cause.
What is happening in Japan?
In Japan, various legal proceedings are underway concerning refusal of blood.
In Tokyo, the Japanese legal entity of Jehovah’s Witnesses and believers have sued the Japanese government over guidelines concerning religion-related child abuse.
Under those guidelines, refusing a medically necessary blood transfusion for a child may under circumstances be regarded as possible neglect.
In addition, in Okinawa five Jehovah’s Witnesses have sued the prefecture, stating that public hospitals refused their treatment when they would not agree to possible blood transfusions.
What happened on 16 September 2026 in Okinawa?
On 16 September 2026, the first oral hearing in the Okinawa case took place.
No judgment against Jehovah’s Witnesses was handed down that day.
Two days later, on 18 September, the major worldwide change to the blood policy was announced.
16 September
first hearing Okinawa
↓
18 September
worldwide change
blood policyThat timing is striking.
But:
STRIKING TIMING
≠
PROOF OF CAUSATIONThere is no public internal document or official statement showing that the Japanese legal cases were the reason for the policy change.
Can the change reduce legal conflicts?
Yes, in certain situations that can be a logical consequence.
A patient who previously, according to the religious rule, could not accept red blood cells, plasma, or platelets, may now personally allow these products.
As a result, some conflicts between patient and hospital may disappear.
But:
THE CHANGE CAN
reduce legal
problems
≠
LEGAL PRESSURE
WAS PROVEN TO BE THE REASON
FOR THE CHANGEAre there billion-dollar claims or criminal prosecutions?
As far as is currently reliably known publicly, there is no demonstrated worldwide billion-dollar mass claim against Watch Tower because of historical deaths from refusing blood.
Nor has it been shown that members of the Governing Body are currently being criminally prosecuted over such deaths.
There are legal proceedings concerning:
hospital policy;
medical autonomy;
children's rights;
religious freedom;
blood transfusions.
But that is something different from an existing worldwide damage claim based on the historical blood policy.
Policy versus personal choice
The development of the policy can ultimately be summed up very simply:
BEFORE
whole blood ORGANIZATION: no
red blood cells ORGANIZATION: no
white blood cells ORGANIZATION: no
platelets ORGANIZATION: no
plasma ORGANIZATION: no
fractions INDIVIDUAL: decide
NOW
whole blood ORGANIZATION: no
red blood cells INDIVIDUAL: decide
white blood cells INDIVIDUAL: decide
platelets INDIVIDUAL: decide
plasma INDIVIDUAL: decide
fractions INDIVIDUAL: decideSo the biggest change is not that everything is now allowed.
The major policy change is that the organization no longer prescribes a universal no for the four major blood components, but leaves the decision to the individual Witness.
Questions to think about
Which parts of the current blood policy are still determined by the organization, and which are determined by the individual Witness?
Why were red blood cells, white blood cells, plasma, and platelets forbidden for decades when those same products are now a matter of personal choice?
What does the current statement that the Governing Body does not want to go beyond what is written mean for the former policy?
What makes whole blood, according to current doctrine, religiously different from the four main components separately?
Do I find the comparison with Russian salad helpful in making that boundary visible?
How much of the policy change can really be explained by medical progress if component therapy has existed for decades?
What does the current policy mean for people who made other medical decisions under the old rule?
How would I feel if a family member had previously refused a blood component that is now permitted?
Do I think it is important that, under the current policy, the congregation may not interfere with that choice?
What does it mean that an HLC must handle personal decisions confidentially?
Does an old 'no blood' advance directive still fit my current wishes?
How do I view the historical instruction that children had to take their ID card to school?
Do I distinguish between the official reason for the policy change and possible external factors for which there is no evidence?
Do I distinguish between striking timing and evidence of a causal connection?
Do I use the same standard of proof for information from Jehovah's Witnesses and for critical information?
Sources and further reading
Jehovah’s Witnesses – Acceptance of blood components will now be a matter of personal choice, 18 September 2026. Official announcement stating that red and white blood cells, plasma, and platelets become matters of personal conscience, while whole blood remains unacceptable.
Jehovah’s Witnesses – How do Jehovah’s Witnesses show respect for life? Current explanation of the blood policy, personal conscience, medical choices, and the role of the Hospital Liaison Committee.
Governing Body update 2026 no. 2 – 20 March 2026. Clarification on the use of a person’s own blood in medical treatment and surgery.
Jehovah’s Witnesses – Proclaimers of God’s Kingdom. Historical account of the development of the blood stance from 1945 onward and the organizational consequences from 1961 onward.
The Watchtower – Accept the Guidance of the Living God, 15 June 2004. Documents the former distinction between whole blood, the four prohibited major components, and personal decisions regarding fractions.
Jehovah’s Witnesses – Hospital Liaison Committees. Current official description of the international HLC network and the support it provides to patients and medical professionals.
Our Kingdom Ministry – historical instructions on medical documents and Identity Cards. Documents the use of advance medical directives and cards for minor children.
Our Kingdom Ministry – 1990. Historical instruction to parents to ensure that minor children carried their Identity Card, among other places, to school.
Civil Code, article 7:450. Dutch legal basis for consent to medical treatment.
Central Government – Rights in medical treatment. About consent, refusal of treatment, and changing a previous decision.
KNMG – Guide to consent and information in the treatment of minors. About capacity to consent, permission, and decision-making in children and young people.
Child Care and Protection Board – Medical treatment of minor Jehovah’s Witnesses. About necessary medical treatment, substitute consent, and the child’s position.
The Japan Times/Jiji – reporting on the Tokyo proceedings, 2025-2026. About the lawsuit by the Japanese JW organization and believers against government guidelines on religion-related child abuse.
Ryukyu Shimpo – reporting on the Okinawa proceedings, 2026. About the case of five Jehovah’s Witnesses against the prefecture concerning hospital policy and transfusions.
