Jehovah's Witnesses and blood transfusion

Updated international guidance issued by the Governing Body of Jehovah’s Witnesses allows individual members to decide as a matter of personal conscience whether to accept or donate separate blood components (1):

• longstanding religious refusal of whole blood transfusions remains unchanged (1, 2)
• patients who choose to accept or donate individual blood components no longer face the risk of excommunication (1)

Blood Component and Preoperative Autologous Donation (PAD) Guidance

• blood components: receiving or donating separate components (red blood cells, white blood cells, plasma, or platelets) is now a matter of individual conscience (1)
• whole blood: total refusal of whole blood transfusions remains mandatory under religious doctrine (1, 2)
• preoperative autologous donation (PAD): updated guidance permits the collection and storage of a patient’s own blood prior to elective procedures for autologous reinfusion during medical or surgical care (3)
• clinical significance: because UK transfusions almost exclusively use separated components rather than whole blood, this position allows Witness patients to receive the vast majority of routine transfusion products (1)

Clinical Guidance and Consent Protocols when caring for Jehovah’s Witness patients in primary or secondary care settings, clinicians should (1):

• avoid assuming a blanket refusal of all blood products and autologous procedures (1)
• ascertain directly from the patient which specific blood components or autologous techniques they accept or refuse (1)
• ensure patients are aware of the updated governing body guidance and fully informed of the clinical implications of their decisions (1)
• document accepted and refused components clearly in medical records, re-verifying consent if clinical circumstances change (1)
• adhere to standard principles of informed consent, respecting the autonomous decision of the individual patient regardless of organizational policy (1)

Reference:

1. BMJ. Jehovah’s Witnesses can now decide themselves whether to accept or donate blood components, without risk of excommunication. Published Sep 2026.
2. Petrini C. Ethical and legal aspects of refusal of blood transfusions by Jehovah’s Witnesses, with particular reference to Italy. Blood Transfus. 2014;12(suppl 1):s395-401.
3. Jehovah’s Witnesses Governing Body. 2026 Governing Body update #2. Published Mar 2026.