Image source: Valdez Family
In August of this year, 26-year-old Isaac Valdez had an epileptic seizure while browsing through books in a local library, convulsed and hit his head on the floor.
Ishaq lost consciousness, and it was later discovered in the hospital that the impact to his head was so severe that it caused a brain hemorrhage.
His treatment was further complicated by the fact that, as a follower of the Jehovah’s Witnesses group, he carried a card that read “No to blood,” indicating his refusal of any treatment that included blood transfusion, based on his religious beliefs.
As a result, he was not given medical intervention to drain the fluid from his brain.
But his family, residing in Waxahachie, Texas, was happy that he regained consciousness and began speaking again. He was able to confirm his adherence to his belief that he refuses to receive blood.
The family's relief regarding what seemed to be an improvement in his condition did not last long, after Ishaq fell into a coma, and his condition quickly deteriorated.
A neurosurgeon informed his family that the only way to save his life was to perform an emergency operation requiring a blood transfusion.
The family decided to respect the wish of Isaac, who had been a follower of Jehovah's Witnesses all his life, to reject such a procedure.
Ishaq died on August 26, 2026, after doctors stopped his life support.
His twin brother, Jacob Valdez, describes him as an intelligent man who loved volunteering and helping the elderly.
Just 23 days later, the governing body of Jehovah's Witnesses announced a radical change in its teachings that would have effectively given Isaac religious permission to receive the treatment he had refused that could have saved his life.
This sudden change means that the vast majority of medical procedures that use donated blood are no longer prohibited for the group’s followers, as the decision to accept these treatments is now up to each individual.
This angered Jacob, who was still trying to come to terms with the death of his twin, at the leadership of Jehovah's Witnesses for not coming to this decision sooner.
He told the BBC he believed Isaac might still be alive if she had done so.
The original rule on blood transfusion dates back to 1945, towards the end of a war that saw its use increasingly expand. At the time, leaders of Jehovah's Witnesses declared that their followers may not accept blood transfusions.
This was based on their interpretation of verses from the Old and New Testaments that prohibit the consumption of blood, including a verse in the Book of Acts that commands believers to abstain from consuming blood, from food offered to idols, and from eating strangled animals.
So why did the governing body of Jehovah's Witnesses, based in New York State, decide to change the rules now, 81 years after they were approved?
The decision came after years of pressure from inside and outside the group, but its leaders do not describe it that way.
“The change is essentially an application of biblical principles to modern medicine and its methods,” says international spokesman for Jehovah's Witnesses, Paul Gillies.
He describes it as a new reading of sacred texts and medical progress.
Gillies meets with the BBC at the headquarters of Jehovah's Witnesses in the United Kingdom, located on 85 acres in rural Essex. It is a large, modern complex where hundreds of volunteers from the group’s followers live and work without pay.
Gillies stresses that the basic teachings have not changed, and that whole blood transfusion is still prohibited. But most blood transfusions, for decades, do not use whole blood, but rather the specific components that the patient needs.
The justification for the change is based on allowing blood components, such as plasma, red blood cells and platelets, to be used in a huge number of medical procedures that were previously prohibited.
Gillies says that the Bible refers to “abstaining from blood,” but it does not talk about “the various components that can be extracted from blood.”
He adds that the governing body saw it as its duty to avoid “going beyond” what the sacred texts stipulate, and to be content with applying what was explicitly stated in the Holy Book.
But this explanation astonished many people, and prompted them to wonder whether the ban on blood transfusion in the first place, 81 years ago, was also a major transgression, since the Bible does not explicitly mention blood transfusions.
Others also wonder why it took so long to reach such a pivotal decision, when transfusions of blood components, rather than whole blood, have been the standard practice for decades.
These are the questions Jacob asked immediately after the ban was lifted, just days after Isaac's memorial service was held.
Jacob had already left the Jehovah's Witnesses group in which he grew up. After Isaac's death, he sent text messages to prominent figures in the local religious group to which his brother belonged in Texas. These are messages filled with pain and difficult to read.
He asked them to think about “the role you played in encouraging so many people to sacrifice their lives for something that was never God’s will.”
Most of them didn't answer, but one of the adults did, saying that he couldn't understand why Jacob was so angry and so focused on changing the rules.
All of this increased Jacob's anger, who especially wanted the group's decision-makers to be held accountable for all the lives that were lost.
He says: "I want to ask them if they can offer a direct apology. I do not want an evasive answer, but rather a clear and frank apology."
It is very difficult to determine the number of Jehovah's Witnesses who die each year after refusing treatment that includes blood transfusions, out of an estimated nine million people estimated to belong to the group around the world. But research published in 2016 in the medical journal “Obstetrical and Gynecological Survey” estimated the number at about 1,100 people.
“We sympathize with their feelings, and if there are people who have lost family members and are bothered by some of these questions, they deserve to be listened to with compassion,” Gillis says.
But the reasons for not adopting the change sooner remain largely unclear.
"Why did it take so long? Well, I think it's because things take time, and it doesn't necessarily mean that some magical change has happened," Gillies says.
When asked about calls for the group's leadership to apologize, Gillies did not respond, saying that many lives had already been saved because committed followers of Jehovah's Witnesses were not exposed to the tainted blood scandal.
He also stresses that some followers of Jehovah's Witnesses may decide, even after the issuance of the new directive, to refuse blood transfusions, and that they may have made the same decision had the directive been issued years ago.
Indeed, the BBC spoke with Alex Paul, 58 years old, a follower of Jehovah’s Witnesses who resides in West Sussex. He says a doctor told him in 2012 that he would not survive the chemotherapy he needed to treat his leukemia unless he also underwent a blood transfusion.
He says: “When I was sick, I wanted to adhere to the sacred texts as much as possible, and I think I succeeded in that.”
With the help of what is known as the Hospital Liaison Committee of Jehovah's Witnesses, Alex found an American consultant doctor who could provide a treatment that would increase his blood cell count, without the need for any derivatives of someone else's blood. His consultant doctor in the United Kingdom agreed to treat him with the new method, and it worked.
More than a decade later, Alex says he would make the same decision again, despite a change in the rules about blood, which would have allowed him the transfusions he was told he needed.
The issue was not limited to receiving blood.
Elisha Cummings, 50, a Jehovah's Witness in Trinidad and Tobago, was unable to donate blood to her aunt, who died, because of these rules.
Image source: Cummings family
These rules also cost her her marriage, as her husband, after ten years of marriage, left the community and divorced her, after it was discovered that he had undergone a blood transfusion in his childhood, something that her local community viewed with disapproval.
“Since the rules about blood changed, I haven’t been myself anymore,” she says. “It has put me into a state of depression.”
Elisha adds: “How many houses have I knocked on doors trying to convince people of the doctrine related to blood? And now you come with something completely different.”
Elisha says that her beliefs as a whole have been shaken, but she hesitates to leave the group, partly because it provides her with a social environment, and partly because she fears isolation.
Previously, those who opposed the “blood doctrine” were ostracized, or felt they had to leave the group. Will they now be able to return?
“Anyone who wants to return to the group is warmly welcomed,” says Gillies, speaking of those who have left the group because they accepted a blood transfusion for themselves or a relative.
He adds, "If they want to become Jehovah's Witnesses again...we welcome that."
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