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Blood, medical ethics, and the Bible

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In a 2010 survey on ethics, 10,000 doctors were asked, ‘What was your biggest ethical dilemma?’ The top five were:

  • Reporting an incompetent or impaired colleague
  • Owning up after making a medical error
  • Patient confidentiality, when one half of a couple is HIV positive and the other half doesn't know
  • Prolonging futile care for a dying patient
  • Denying care to a nonpaying patient

None mentioned pressuring a patient to accept a treatment that was against the patient’s wishes. None listed glossing over the dangers of a particular treatment.

Perhaps that is because doctors inhabit a world where they are god-like, where their word is law and no one dares questions them. Perhaps some of them begin to believe in their own infallibility.

Last week, an African news headline read: ‘Woman dies after refusing blood transfusion.’ However the article said the woman had shown up at the hospital, so clearly she wasn’t refusing to be treated. And the story said she died of ‘anemia,’ for which there are myriad treatments:

  • EPO
  • iron supplements
  • vitamin K
  • TXA
  • nitric oxide
  • Hemopure
  • hyperbaric treatment
  • rectal oxygen insufflation
  • Perflubron

Perhaps the headline should have read: ‘Woman dies after pigheaded doctors refuse to treat her anemia with anything other than blood.’ Why not blood? Had they been keeping abreast of medical progress, her doctors would have known that, as the AMA correctly put it, blood causes more problems than it cures.

Ann Noble, a grandmother from Canada, is currently being treated at Southwest Oncology Center in Scottsdale, Arizona, for a life-threatening liver condition after her Canadian doctors sent her home to die. She contracted the liver problem years ago from a blood transfusion.

60 years ago, in the aftermath of WWII, every doctor on the planet was hailing blood transfusion as the newest “life saving” technique.

Today, when blood transfusion makes headlines – at least in the civilized world – most of the real medical stories are about efforts to reduce, avoid, or eliminate blood use, like these headlines:

Now, here’s something odd: 60 years ago, when everyone else was jumping on the blood transfusion bandwagon, Jehovah’s Witnesses were telling anyone who would listen that blood transfusions were wrong.

“If blood transfusion is approved of God and is Christlike, why should [a transfusion of the wrong type of blood kill you?] Of what type was Christ’s blood? And does his blood benefit only people with a certain kind of blood? Or does it benefit all? Why… should medical doctors have to exercise such care about the types and other features of the blood of certain individuals? If God, the great Physician, approves of blood transfusion… why should not blood transfusion be outright beneficial and applicable without all the precautions? And think of all the harm that blood transfusions did before the doctors discovered the harmful features about this practice that must be guarded against! Do you think God justified all the harm that was thus done during the experimental stage and that is still being done despite greatest care, on the assumption that the doctors are working toward the perfecting of the practice for the greater health benefit of all mankind?” – The Watchtower, May 1, 1950

It has been over 60 years, and the "experimental stage" in which doctors were supposed to perfect the practice, is still going on. People are still dying from blood transfusion.

Did the Witnesses have some special, insider medical knowledge that doctors hadn’t yet figured out? No. They had the Bible.

Medically, it must seem odd to include the Bible in a discussion on blood. But like it or not, if you work in medicine, at some point in your career you are going to have a Christian quoting the Bible to you. What light could such an ancient book possibly shed on such a modern practice?

"Blood” shows up very early in the Bible, in the account of Cain killing Abel. Confronting Cain, God said: “Your brother’s blood is crying out to me from the ground.” (Genesis 4:10) God could have said, ‘Your brother’s brain/heart/toenails/hair is crying out,’ but He didn’t. It was God who decided that blood would be a SYMBOL of life. It was not some Jewish priest thousands of years later worrying about kosher food who made up the idea of blood being sacred.

1600 years after Cain and Abel, after the Flood, God gave Noah’s offspring permission to eat meat. (People may have eaten meat before the Flood, but they did so without God’s permission.) But at the same time God was very specific that blood was to be avoided. Genesis 9:4 (NKJV) says: "You shall not eat flesh with its life, that is, its blood.” Again, this was 800 years before the Jewish laws about treating blood as sacred.

Nearly 200 years ago, a century before modern blood transfusion was invented, Bible scholar Adam Clarke commented on this scripture:

“Blood was most solemnly forbidden, because it was the life of the beast, and this life was to be offered to God as an atonement for sin. Hence the blood was ever held sacred… That the prohibition has been renewed under the Christian dispensation, can admit of little doubt by any man who dispassionately reads Acts 15:20, 29 where even the Gentile converts are charged to abstain from it on the authority not only of the apostles but of the Holy Ghost… No blood was eaten under the law, because it pointed out the blood that was to be shed for the sin of the world; and under the Gospel it should not be eaten, because it should ever be considered as representing the blood which has been shed for the remission of sins.”

On the night before his death, Jesus filled a cup with wine and said: "This cup is the New Covenant made by my blood which is being poured out on your behalf.” (Lu 22:20)

Did Jesus mean that the cup, that plain piece of earthenware, was a covenant or contract? No. Jesus used the word ‘cup’ as a SYMBOL of what was inside it – the wine. And the wine was a SYMBOL of his blood, and his blood was a SYMBOL of his life, given as a sacrifice exactly like a slaughtered animal, as a ransom or redemption price paid to cover the sinful state of, well, of any humans who wished to take advantage of it, to get back into the proper relationship with God that Adam had forfeited.

We understand SYMBOLS. A bit of gold dug from the earth can become a filling in your tooth, or a tennis bracelet on Serena Williams’ wrist. But if it is fashioned into a ring and worn on the third finger of the left hand, it is a SYMBOL that a person is married, with all that marriage implies. God did not invent that symbol; man did. Still, most of us respect its meaning. If you were out at some nightspot and caught a man slipping his wedding band off as he talks to a young lady, would you reason that, well, it’s really only a gold tooth in a different shape? Or would you be disgusted at his disrespect for the marriage arrangement?

Suppose I need a rag to wash the car. I go buy a square of fabric at the 99 Cent Store. If that fabric happens to consist of alternating red and white stripes, and a blue corner sporting white stars, how are you going to feel about my washing the car with it? Most Americans would be appalled if I treated the flag in such a manner.

But wait, Bill: medically, scientifically, blood is simply a collection of fluids, lipids and proteins, many of which are very similar to other lipids and proteins serving other functions in the body. True.

What if I separated the fabric, cutting apart the red stripes from the white stripes, carefully cutting the white stars out of the blue field? For most Americans the pile of fabric would still be identifiable as a flag.

Only if I were to actually separate it into a pile of threads would it be far enough removed from the similarity to the nation’s SYMBOL to put these fractions of what used to be a flag to some other use. Perhaps I could use some of the white ones to mend my shirt or some of the blue ones to fix my jeans without anyone being offended.

Similarly, a scientist can take the protein molecule from cow hemoglobin, sterilize it, break it apart, turn half of it around and perform some other scientific magic on it, and I might be persuaded that Hemopure is far enough removed from the SYMBOL of blood that I can use it without violating God’s command to keep blood sacred.

Respecting the SYMBOL of blood protected those who take the Bible seriously, even back when there was very little medical evidence to counter all those who were praising blood transfusions as “life-saving.”

So, if you’re a medical practitioner, don’t roll your eyes when someone mentions the Bible to you. All through your medical career, you’re going to be dealing with ethical questions: When does life begin? When does it end? Does God approve or disapprove of abortion, or does he even care? What about the effect of lifestyle on health: anxiety, overeating, tobacco, too much alcohol, recreational drug use? What about stem cells? Genetic modification? Assisted suicide? Frozen embroyos?

Bible students have principles to guide them through each one of these ethical areas. Furthermore, we who rely on the Bible know that, whatever ethical question comes up tomorrow from some scientific advancement that hasn’t even been thought of yet, we will be able to find a God-given Bible principle to guide us.

Who or what will guide you?

To read previous columns, click here.

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Email me at bill.underwood@mail.com, or find me on Facebook, Google+, LinkedIn, or Twitter.

Read a free sample of my novel about the apostle Paul’s arrest, The Minotaur Medallion at smashwords.com.

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