Challenging encounters

How does Jehovah's Witnesses relate to death, and what do they learn about medical blood transfusion?

Fakta: 

Jehovah's Witnesses
In Norway Jehovah's Witnesses is a religious minority and counts appoximately15 000 members, with 180 congregations.
 

How does Jehovah's Witnesses relate to death, and what do they learn about blood transfusion? Hege Kristin Ringnes and Harald Hegstad went to New York to find answers.

Every year, about 1,000 members of Jehovah's Witnesses die because of their views on blood transfusion. Jehovah's Witnesses says no to blood transfusions because of their own biblical conviction. PhD student Hege Kristin Ringnes and Professor Harald Hegstad have recently analysed texts and conducted observational studies and interviews among Jehovah's Witnesses in Norway and in the USA. They have looked more closely on what is communicated about blood transfusions among Jehovah's Witnesses, and how members respond to doctrine and medical and psychological strategies used.

To the headquarters
Ringnes has for many years been doing research on Jehovah's Witnesses in Norway. First through her work on her master's thesis, then through the role as editor of the book
Jehovah's Witnesses. A multidisciplinary study and now as part her PhD studies.

-You've interviewed both leaders and parishioners at the headquarters in Brooklyn, New York. How did you get in contact with them?
-Jehovah's Witnesses in Norway acted as "door-openers" for contacts with the headquarters, Ringnes says.

Theology and psychology of religion
- How have you benefited from interaction with each other's unique expertise?
- Religious teachings have psychological implications on individual- and group levels. Therefore, it is highly relevant to have a theologian as part of a  psychology of religion-project. You cannot study a religious group psychologically without understanding what the members believe, Ringnes says.
Harald Hegstad, professor of systematic theology, says it has been very interesting to get more insight when it comes to the doctrinal system of Jehovah's Witnesses.
- It's quite interesting to see how religious teaching both give psychological conditions and have consequences, and it has also given new insights for work with doctrinal issues in other contexts, Hegstad says.

A sacrifice
With Jehovah's Witnesses refusal of life-saving medical blood transfusion there is a discord between saving lives and sacrificing lives. In Ringnes's and Hegstad's blood-study this has been identified as a life-death cognitive dissonance. That means a conflict between both being willing to sacrifice their lives, but at the same time denying that this becomes necessary. Cognitive dissonance can be seen as an undesirable condition, which creates negative emotions.
- Through the congregation Jehovah's Witnesses receive access to strategies for managing emotions. This is called Emotion-Regulation strategies, Ringnes ​says.

Underestimated risk
Dissonance was handled by under-communicating separate risk factors. Medical blood transfusion was also articulated as dangerous.
- It was a selective focus on survival and that alternative treatments would be an option. Our research shows that there is a strong tendency of using bio-medical arguments as part of the religious explanation, says Ringnes. 

Distrust to the health professionals
Some of the informants in the "blood-study" believe that healthcare professionals have an agenda regarding the use of blood. Many are uncertain or convinced that they cannot trust health professionals. Jehovah's Witnesses prioritise the development of local leaders. After training they can provide support to members who come in demanding placement at hospitals. Ringnes's and Hegstad's research findings draw a complex and often difficult image of the relationship between Jehovah's Witnesses, hospitals, the medical environment and society in general in this highly emotional field involving life and death.

Is there anything that surprised you during the collection of data?
– Jehovah's Witnesses make major life choices based on their membership. It is an interesting finding, and perhaps surprising at first. A membership can result in the following choices: to not have children, deselect education and career, cutting contact with family members who are excluded and being willing to die earlier by saying no to medical blood transfusions, Ringnes says.
She compares Jehovahs's Witnesses with extreme athletes.
– They go all in. But it happens at a religious venue. And they are few. They are investing everything to protect themselves from the outside world. They say: "We are not part of this world."
In that statement, it is the non-members who are "world". Jehovah's Witnesses are carrying out their member identity hundred percent in everything they do and are. The research of Ringnes and Hegstad shows that members of Jehovah's Witnesses receives much social support. Members get clear answers. A hope for the future is communicated - members will, in the future, get to live in an earthly paradise.

Obedience is important
Among Jehovah's Witnesses, obedience to God and the hope of a paradise on earth has a higher value than current, life-prolonging treatment. The findings of studies by Ringnes and Hegstad  show that obedience is still considered superior.
- If one receives a medical blood transfusion against one's will, the general consensus is that this will not lead to any sanctions from Jehovah or the religious community, Ringes explains.
The researchers say that it made a huge impression to meet people who were willing to sacrifice their lives rather than getting a blood transfusion.

Do you want to read more about the informants' stories? The article about the blood-study is published in Journal of Religion and Health, "Refusals of Medical Blood Transfusions Among Jehovah's Witnesses: Emotion Regulation of the Dissonance of saving and sacrificing Life."

A challenging experience
- Based on the knowledge of theology and doctrine, we were expecting attitudes about being willing to offer ones life. However, it still makes a very strong impression talking with people who are willing to do just that. We heard many concrete experiences, says Ringnes.
Even if the doctrine dictates that the community members should not accept medical blood transfusion, there is an increasing tendency of members making individual choices. This is because of the medical developments that entail more use of blood fractions and blood substitutes. For some treatments Jehovah's Witnesses will say yes or no on the basis of personal conscience. For instance, the Headquarters in New York reported that many younger Jehovah's Witnesses  would often accept such treatment. Ringnes also designates this as surprising. 

- The doctrine exists because one says no to blood transfusions, while there are more hidden changes that occur as part of the medical development. The real possibility of premature death, however, is still present.

Would you like to read more?

The article on the blood-study, can be read here.

In addition, a new article entitled "Emotion Regulation Strategies Among Members of End-Time Focused Jehovah's Witnesses' will be published in 2016/2017. Ringnes and Hegstad has prepared the article in collaboration with Associate Professor Gry Stålsett and Professor Lars Johan Danbolt.

Recently Hilde Sjo Førre wrote her master's thesis on Jehovah's Witnesses. We recommend it and it is possible to read here.