Blood Transfusions: How Safe

The following is a side-by-side rebuttal to the JW.org (the official Jehovah's Witnesses website) document "Blood Transfusions: How Safe?",https://www.jw.org/en/publications/books/blood/blood-transfusions-how-safe/ which exists to provide a health-based defence for the Witnesses' disavowal of blood transfusions. "How Safe" alleges that blood transfusions pose several serious health risks, but uses many outdated publications that are no longer relevant in the slightest. Moreover, the article presents many "scary" truths in order to frighten people from transfusions - without even mentioning the comparable risks of refusing blood transfusions.
Although the document was originally published in the 1990s, JW.org keeps the publication online and presents it without noting that its contents are hopelessly out-of-date. This becomes unmistakably obvious when the actual text keeps using a present tense (and tone) when citing studies from the years 1987-1990. "Radically tubular!", as the kids of today would put it. And just in case you've repressed how much of life's journey you've already zoned out through, please realise that 1987 was years ago. These aren't exactly studies from yesterday; the spring-chicken college sophomores who conducted said studies are likely retired by now.
Overall, the document is a pseudoscientific defense of a religious dogma. On the positive side, it does mean that the Jehovah's Witnesses serve as a useful set of test subjects for synthetic blood substitutes. 
==RationalWiki Introduction==
According to JW.org, Jehovah's Witnesses (JW) cannot get without violating the tenets of their official church doctrine.Why Don’t Jehovah’s Witnesses Accept Blood Transfusions?, JW.orgOne of the reasons that JW are asserted to be the true faith is that Jehovah's Witnesses refuse to get blood transfusions. In a 1968 publication, "Is Your Religion the True One?", Watchtower (an official JW publication) asks: (Watchtower 1968 July 1. Is Your Religion the True One? p.391.) This doctrine has resulted in unnecessary injury and death.
How can the harms of this belief be quantified? First, we must examine the harms of blood transfusion.
===Federal data===
Fortunately for comparative health purposes, federal law requires that blood-related fatalities be reported (bold added):http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/default.htm
The HHS does note that "[t]he actual rate of adverse reactions is likely to be more than what was reported to the transfusion service." However, these numbers includes both fatalities where "transfusion could not be ruled out as the cause" and where "while there was a temporal link, there was no evidence to support a causal relationship". In other words, these estimates are essentially the maximum possible fatality rate that we know about:http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm391574.htm
Year 	FDA: Transfusion fatalities	FDA: Post-donation fatalities	FDA: Total fatalities 	HHS: Total transfusions 	Fatality rate (FDA / HHS):
deaths per million transfusions
2014 	56 	7 	63http://www.fda.gov/downloads/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/UCM459461.pdf	(assumed to bethe same as 2011) 	3.0096https://www.google.com/search?q=((56%2B7)%2F20%2C933%2C000)*1%2C000%2C000
2013 	59 	5 	64 	(assumed to bethe same as 2011) 	3.0574https://www.google.com/search?q=((59%2B5)%2F20%2C933%2C000)*1%2C000%2C000
2012 	65 	11 	76http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm346639.htm 	(assumed to bethe same as 2011) 	3.6306https://www.google.com/search?q=((65%2B11)%2F20%2C933%2C000)*1%2C000%2C000
2011 	58 	8 	66http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm302847.htm 	20,933,000http://www.hhs.gov/ash/bloodsafety/2011-nbcus.pdf 	3.1529https://www.google.com/search?q=((58%2B8)%2F20%2C933%2C000)*1%2C000%2C000
2010 	64 	4 	68http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm254802.htm 	(assumed to bethe same as 2008) 	2.8731https://www.google.com/search?q=((64%2B4)%2F23%2C668%2C000)*1%2C000%2C000
2009 	66 	4 	70http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm204763.htm 	(assumed to bethe same as 2008) 	2.9576https://www.google.com/search?q=((66%2B4)%2F23%2C668%2C000)*1%2C000%2C000
2008 	54 	10 	64http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm113649.htm 	23,668,000https://wayback.archive-it.org/3919/20140402175927/http:/www.hhs.gov/ash/bloodsafety/2009nbcus.pdf 	2.7041https://www.google.com/search?q=((54%2B10)%2F23%2C668%2C000)*1%2C000%2C000
2007 	63 	15 	78http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm118316.htm 	(assumed to bethe same as 2006) 	2.5962https://www.google.com/search?q=((63%2B15)%2F30%2C044%2C000)*1%2C000%2C000
2006 	73 	14 	87http://www.fda.gov/downloads/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/UCM129521.pdf	30,044,000https://wayback.archive-it.org/3919/20140402175908/http://www.hhs.gov/ash/bloodsafety/2007nbcus_survey.pdfBetween 2006 and 2008, HHS changed how they count platelets. In 2008 and on, their estimates were "[b]ased on the use of an apherisis platelet as the basis for counting platelets instead of the platelet concentrate equivalent used for 2006 and previous reports."	2.8958https://www.google.com/search?q=((73%2B14)%2F30%2C044%2C000)*1%2C000%2C000
2005 	76 	8 	84 	(assumed to bethe same as 2004) 	2.8928https://www.google.com/search?q=((76%2B8)%2F29%2C038%2C000)*1%2C000%2C000
2004 	n/a 	n/a 	n/a 	29,038,000https://wayback.archive-it.org/3919/20140402175910/http://www.hhs.gov/ash/bloodsafety/2005nbcus.pdf 	n/a
Average	63.4 	8.6 	72 	24386200Yearly estimates are weighted by the number of years for which they are used. (Meaning 20,933,000 (2011) is multiplied by 4, 23668000 (2008) by 3, 30044000 (2006) by 2, and 29,038,000 (2004) by just 1.) 	2.9525https://www.google.com/search?q=%28%2863.4%2B8.6%29%2F24386200%29*1%2C000%2C000
If we assume that the average death rate for blood transfusions is 8 per million (which is far beyond any upper reported estimate), then if every single one of the (upper estimate) 8.2 million Jehovah's Witnesseses had a blood transfusion, then at most about 66 people' would die. (Realistically, only about 1.5% of people need a blood transfusion, and the true death rate is less than half of the above, making this estimate at least orders of magnitude too high.)
===Data on harms on lack of blood transfusions===
In comparison, the May 1994 cover (see above) of Jehovah's Witness publication Awake! lists 26 children (children! no adults!) who died rather than get a blood transfusion.
One (pro-blood-transfusion) Jehovah's Witness source puts the annual death toll from lack of blood transfusions during surgery alone at 900 deaths per year,http://www.krev.info/library/pocetumrti.pdf based on the results of Kitchens 93.Kitchens CS: “Are transfusions overrated? Surgical outcome of Jehovah's Witnesses.” Am J Med 1993;94:117-119.
===Rates comparison===
To summarize:
Let's assume that every single infection of Hepatitis B and C and HIV are fatal. Even in this worst-case scenario, only 0.0014005% of blood transfusions recipients die. In other words, even in the best possible light, Jehovah's Witnesses face perhaps 700 times as much risk as non-JWs do.
Jehovah's Witnesses also face vastly increased risks during childbirthhttp://www.medicalnewstoday.com/releases/153743.php -- on the order of 70 times greater.http://www.religioustolerance.org/witness11.htm However, the increased deaths from surgery alone are sufficient to prove that refusing blood is far, far more dangerous than accepting it.
==Side-by-side rebuttal==
===Intro===
==="Magical quality"===
===General problems===
===Hemolytic Transfusion Reactions===
500px|center|thumb|Fatal incidents of Hemolytic Transfusion Reactions (HTR) are low and have been going down. Remember, that number on the left is the actual number -- 0-30 people, not percent or thousand or million.
===Immune system===
===Cancer===
==="Fingerprints"===
===Infection===
====Lyme disease====
====Migrant blood====
====Hepatitis====
====Previously considered non-infectious====
====AIDS====
==Video summary==
Goes through the 1994 Awake magazine:
==External links==
*Keeping Blood Transfusions Safe: FDA's Multi-layered Protections for Donated Blood, FDA.gov
==Notes==
==Calculations==
==References==
Category:Side-by-side articles