Consequences within the community
How accepting blood has affected congregation membership and relationships, and what the September 2026 policy says about personal decisions. Updated .
The announcement’s own wording is excerpted on the doctrine page and is not repeated here. The 22 May 1994 Awake! feature has its own entry in the archive.
Congregation rules over time
The Society’s text first at every stage. Where no wording could be read, the citation says so rather than paraphrasing the Society into quotation marks.
Accepting a transfusion becomes grounds for expulsion
From 15 January 1961The Watchtower, 15 January 1961, pages 63–64; compare 1 August 1958, page 478.
The 1958 article ruled out disfellowshipping but allowed restrictions on congregation assignments. From 1961, a baptised member who accepted a transfusion and was not judged repentant was expelled from the congregation and shunned by it.
What expulsion means, in the Society's own words
Earlier handbook wording; see the August 2024 guidance below“We do not have spiritual or social fellowship with disfellowshipped ones.”
“How to Treat a Disfellowshipped Person”, appendix to “Keep Yourselves in God's Love”, jw.org The same appendix states that contact with a removed relative who does not live in the household “should be kept to a minimum”, and that members should not “look for excuses to have dealings” with one.
What the Society told a European human rights body
Friendly settlement, March 1998“…members should have free choice in the matter for themselves and their children, without any control or sanction on the part of the association.”
Blood clause of the friendly settlement in Khristiansko Sdruzhenie “Svideteli na Iehova” v. Bulgaria, European Commission of Human Rights, Application no. 28626/95, reported March 1998. Quoted here from jwfacts.com, which reproduces it; the Commission's own report could not be reached from a stable public URL. — not read on jw.org or wol.jw.org; treated as unverified here The Society's own press statement of 27 April 1998, as quoted by Watchman Fellowship, described the agreement as including “an acknowledgment that each individual has the freedom to choose the type of medical treatment he receives”. Two years later the June 2000 statement below set out what happens to a member who exercises that freedom in favour of blood.
The sanction reworded: “deemed to have disassociated”
From June 2000“If a baptized member of the faith willfully and without regret accepts blood transfusions, he indicates by his own actions that he no longer wishes to be one of Jehovah's Witnesses. … The individual revokes his own membership by his own actions, rather than the congregation initiating this step.”
Watch Tower Society press statement, June 2000, as quoted in Watchman Fellowship, “New Watchtower Blood Transfusion Policy”. Not read on jw.org or wol.jw.org. — not read on jw.org or wol.jw.org; treated as unverified here The congregation no longer convened a judicial committee to expel the person; the person was treated as having expelled themselves. Loss of membership and shunning were unchanged.
The instruction elders actually work from
October 2023 edition of the elders' handbook“If someone willingly accepts a blood transfusion, perhaps because of being under extreme pressure, a committee (not judicial) should obtain the facts and determine the individual's attitude. … Since he is spiritually weak, he would not qualify for special privileges for a period of time. … On the other hand, if the elders on the committee determine that he is unrepentant, they should announce his disassociation.”
“Shepherd the Flock of God”, October 2023 edition, chapter 18 (“Disassociations”), paragraph 3(3). The Society does not publish the handbook for general circulation and this site does not link to a copy, so the wording is marked unverified. — not read on jw.org or wol.jw.org; treated as unverified here The handbook also directs that, where the person is judged repentant, an announcement may still be read to the congregation: “The elders have handled a matter having to do with [name of person].”
- "Shepherd the Flock of God" — 1 Peter 5:2 (elders' handbook, October 2023 edition)
The word changes: “removed from the congregation”
From August 2024“We will no longer refer to such ones as being disfellowshipped. In harmony with Paul's words recorded at 1 Corinthians 5:13, we will now refer to them as being removed from the congregation.”
“Help for Those Who Are Removed From the Congregation”, The Watchtower (Study Edition), August 2024, footnote The same article restates the treatment: the congregation “stop[s] keeping company” with the person, “not even eating with such a man”.
What contact the 2024 article permits
From August 2024“Some may feel comfortable with greeting or welcoming the person to the meeting. However, we would not have an extended conversation or socialize with the individual.”
“Help for Those Who Are Removed From the Congregation”, The Watchtower (Study Edition), August 2024, paragraph 14 The public FAQ puts the same position as: “We do not socialize with someone who has been removed. However, we do not ignore him completely. We treat him with respect.” The article permits a brief greeting at a meeting, while continuing to restrict socialising and extended conversation.
September 2026: components become personal decisions
From 18 September 2026Announcement to bodies of elders, 18 September 2026 (9/18/26-E), and “Questions From Readers”, jw.org, 18 September 2026. Extracts appear on the doctrine page. The internal announcement was supplied as a scan and has not been independently authenticated. — not independently verified
The public article says congregations will not intervene in decisions about components or fractions. The supplied internal announcement describes elder involvement after a whole-blood transfusion; that document’s authenticity remains unverified here.
What the published evidence finds
Interview studies describe participants’ experiences. They do not measure how common those experiences are across all members or former members.
“Narratives suggest that experiences of ostracism following religious exit can be associated with diminished mental health, while having a sense of agency and establishing new (online) social connections may help mitigate adverse consequences.”
Ransom, Monk and Heim, “Grieving the Living: The Social Death of Former Jehovah's Witnesses”, Journal of Religion and Health 61(3), 2458–2480. Semi-structured interviews with six former Witnesses, analysed by interpretive phenomenological analysis. Six people is a qualitative sample, not a measurement of how common anything is; the abstract was corrected in 2025.
Twenty-one shunned former Witnesses describe a fixed sequence: a judicial committee of elders determines culpability and repentance, and a public announcement is then read to the congregation. The authors report themes that “shed light on the events and behaviour which led to the public announcement of the participants' formal shunning and on the controlling environment the religious community has created by endorsing a culture based on fear, guilt, and shame.”
Grendele, Bapir-Tardy and Flax, “Experiencing Religious Shunning”, Pastoral Psychology (2023). Twenty-one semi-structured interviews, reflexive thematic analysis. Participants were recruited as people who had been shunned, so the sample is not representative of members generally.
From the same twenty-one participants: “Being shunned from a tight-knit religious community, such as the Jehovah's Witnesses, may be a traumatic event.” Two themes are reported — “losses due to shunning” and “rebuilding of self post-shunning”.
Grendele, Flax and Bapir-Tardy, “‘You're Going to Go into Some Really Dark, Dark Places in Your Mind.’”, International Journal of Coercion, Abuse, and Manipulation (2023).
The authors connect congregation penalties with blood refusal: “the fear of exclusion from the JW group is often greater than the potential negative health consequences in real life.” The same paper records that a member who accepts blood “would no longer be regarded as one of JWs”.
Pavlikova and van Dijk, “Jehovah's Witnesses and Their Compliance with Regulations on Smoking and Blood Treatment”, International Journal of Environmental Research and Public Health 19(1): 387 (2021). A documentary analysis of the rules and the literature, not a survey of members.
The bioethics objection built on that link: “The usual physician assumption that JWs are acting autonomously and uniformly in refusing blood is seriously questioned.”
Muramoto, “Bioethics of the refusal of blood by Jehovah's Witnesses, Part 1”, Journal of Medical Ethics 24(4), 223–230 (1998). Argument from the dissident literature, quoted here from the published abstract; it is a contested position and the Society and sympathetic clinicians have answered it in the same journals.
Hospital Liaison Committees and Patient Visitation Groups
“Worldwide, some 2,000 Hospital Liaison Committees form an international network operating in over 110 countries. They are made up of community-based ministers who knowledgeably interact with physicians and hospital personnel.”
“Hospital Liaison Committees (HLC) play a vital role in helping medical and legal communities understand our religious position regarding blood transfusions. HLCs coordinate the activities of Patient Visitation Groups (PVG) in key cities to provide spiritual support for hospitalized Witness patients from outside the local area.”
“With the publisher's permission, Hospital Liaison Committee members or others may discuss the publisher's case with medical personnel. … However, it is the responsibility of the patient or his health-care agents to make health-care decisions.”
As the Society describes them
On jw.org the committees are presented to clinicians as a service: they supply papers from peer-reviewed journals, arrange physician-to-physician consultations, help with transfer to another hospital, and “clarify ethical issues for Witness patients or clinicians”. The elders' handbook adds the internal side. Elders are told to encourage a member to seek HLC help “as early as possible in any situation that requires a hospital stay, surgery, or a therapy such as cancer treatment, even if it seems that the situation might not involve the blood issue”, and, when making the referral, to tell the committee “the spiritual standing of the publisher and his family and whether unbelieving family members are involved”.
As clinicians, ethicists and coroners have
Muramoto's objection in the Journal of Medical Ethics is that a clinician cannot read a refusal as a purely private decision when the people at the bedside also hold the member's standing in the congregation. Coroners have looked at the question twice with opposite results. In Quebec, relatives of Éloïse Dupuis complained to police that a hospital liaison committee had pressed her not to accept blood; coroner Luc Malouin's 2017 reports found she had made a free and informed choice, and found no religious influence of the kind alleged. In New South Wales, the 2025 inquest into Heather Winchester's death criticised the Society's own blood worksheets rather than the committee, and recommended both that hospitals tell Jehovah's Witness patients the committee is available and that regular meetings between the committee and directors of medical services be resumed.
- Hospital Liaison Committees for Jehovah's Witnesses
- "Shepherd the Flock of God" — 1 Peter 5:2 (elders' handbook, October 2023 edition)
- Bioethics of the refusal of blood by Jehovah's Witnesses, Part 1: should bioethical deliberation consider dissidents' views?
- Jehovah's Witnesses had right to refuse blood transfusions: Quebec coroner
- Jehovah's Witness who died after childbirth remembered in Laval
- Inquest into the death of Heather Winchester — findings
Named cases
Published cases are labelled by source: a court finding, a press report, an organisational account or personal testimony.
Heather Winchester
Court or coroner's record2019 · Maitland and John Hunter Hospital, Newcastle, New South Wales
Mrs Winchester, 75, died on 27 September 2019 of multiple organ failure due to severe anaemia after an elective hysterectomy. The Deputy State Coroner found that “when Mrs Winchester entered surgery, the anaesthetic and surgical teams had differing understandings of whether she would accept a transfusion of packed red blood cells”, and that she was not transfused. The Christian Congregation of Jehovah's Witnesses (Australasia) appeared at the inquest. The coroner held it “completely inappropriate” that the Society's Worksheets 1 and 2 — which offer “I accept haemoglobin or I refuse haemoglobin” — were available for her to complete in 2018 when no haemoglobin product existed in New South Wales, and recommended the Society tell congregants the worksheets are no longer to be relied upon.
Éloïse Dupuis
Press report2016 · Hôtel-Dieu de Lévis, Quebec
Dupuis died on 12 October 2016 of multiple organ failure resulting from haemorrhagic shock after giving birth. Her aunt complained to police that a Jehovah's Witness hospital liaison committee at the hospital had pressured her not to accept blood, and non-Witness relatives were left out of the funeral. Coroner Luc Malouin reported in November 2017 that “the only medical solution that existed for Ms. Dupuis in order to recover her health was to receive blood, but she always refused to do so”, and concluded that the choice was free and informed and that the alleged religious influence was not made out. The finding did not support the relatives’ allegation of pressure.
Mirlande Cadet
Press report2016 · St Mary's Hospital, Montreal, Quebec
Cadet, 46, died on 3 October 2016 of respiratory failure following a caesarean section, two days after admission. Coroner Malouin reported on her death alongside Dupuis's; on this one he found it unclear whether a delay in the transfusion procedure contributed to her death. The two cases were examined together because both were Witnesses who had declined blood after childbirth.
Randy Wall
Court or coroner's record2014 · Calgary, Alberta
This was a membership dispute, not a blood case. Wall was disfellowshipped by the Highwood Congregation's judicial committee in 2014 after admitting conduct he was judged insufficiently repentant about, and said the decision cost him money because Witness clients left his estate agency. The Supreme Court of Canada held unanimously in 2018 that the decision was not reviewable by a court. The Society's own statement on the ruling is that “religious groups are free to determine their own membership and rules”. The judgment concerns Canadian judicial review of a religious membership decision; it does not establish a rule for every blood-related dispute.
Denise Nicoleau
Published by the Watch Tower Society1988 · New York State
The Society's own telling, published in the July 2020 Watchtower as part of the life story of its long-serving lawyer Donald Ridley: “On December 29, 1988, Sister Denise Nicoleau suffered severe hemorrhaging after giving birth to her son. Her hemoglobin dropped below 5.0, and her physician asked for her consent to transfuse blood. Sister Nicoleau refused.” A judge authorised transfusion without a hearing. “On Friday, December 30, the hospital staff transfused Sister Nicoleau despite the objections of her husband and other family members who were at her bedside. That evening, several family members and one or two elders were arrested for allegedly forming a human wall around Sister Nicoleau's bed to prevent the transfusions.” The events precede 1994; the account is the Society's and was published in 2020.
Evelyn De L'Ombre
Personal testimony1992 · United States
First-person testimony published by AJWRB in 2018 under the writer's own name. She was injured in a motorcycle accident about two months after leaving her parents' home and ceasing to attend meetings, and was transfused: “My surgeon visited me and said they had needed six pints of blood and without it I would have died.” Of what would have followed had she still been a member: “I would have been disfellowshipped and shunned by all my friends and family for at least six months to a year, and obligated to attend all their meetings.” That second sentence is her expectation, not an event that happened; nothing in the account has been checked against an independent source.
What September 2026 changes here, and what it does not
The announcement is excerpted on /doctrine.
- Changed
The public article leaves components and fractions to personal conscience. It says the congregation will not intervene and members should not judge one another.
The article’s footnote says personal medical decisions usually need be discussed only with the health-care agents named on the member’s directive. Hospital Liaison Committee help is available on request.
- Unchanged
Donated whole blood remains prohibited. Claims about the new internal instructions to elders depend on a supplied scan that has not been independently authenticated here.
The public blood-policy article does not set out a general revision of congregation removal or social-contact rules, or discuss past removals for accepting blood.
Commentary
This site’s assessment of the sources above.
The history of removal and shunning matters when assessing whether members feel free to choose treatment. The interview studies describe serious consequences for some former members, but their small samples do not establish how common those experiences are.
Pressure should not be assumed in every case. The Quebec coroner’s finding that Éloïse Dupuis made a free and informed choice is relevant evidence, even though relatives alleged otherwise.
The September change expressly limits congregation involvement in decisions about components and fractions. Whether members experience that freedom in practice will require further reporting. The public announcement does not address people removed under the earlier policy.