Marshnee Pillay recounts leaving Jehovah’s Witnesses after her baby needed a transfusion

Almost five years ago, Port Shepstone mother Marshnee Pillay walked away from Jehovah’s Witnesses to save her baby’s life.

Her 11-month-old daughter had been diagnosed with thalassemia major and needed regular red blood cell transfusions.

But for Pillay, who had been taught that accepting blood was against her faith, allowing her daughter to receive the treatment meant making a choice that would change her life forever.

She chose her daughter.

Today, the six-year-old still travels to a Durban hospital every three weeks for a pint of red blood cells that keep her alive.

But the Jehovah’s Witnesses’ recent announcement that individual members can now decide whether to accept donor red blood cells, white blood cells, plasma and platelets has left Pillay heartbroken and angry.

“The announcement that receiving blood is now a matter of personal choice is incredibly painful for me. It takes me back to the uncertainty, fear and sense of rejection we experienced when our child was first diagnosed. I am angry. I cannot help asking, ‘Why did this change not come sooner? Why did it not happen when my child needed it?’”

Pillay said she could not stand by and watch her child go without the treatment doctors said she needed when she was diagnosed in 2021.

“Suddenly, everything I knew and believed no longer made sense to me. It was terrifying because at that point in my life I needed my faith.”

Pillay and her husband sought guidance from within the organisation but claim the advice they received remained consistent with the position against blood transfusions.

“We had to make a personal decision as her parents. To give my child the treatment that could save her life, we had to leave the faith. No one shunned us. We were just no longer following the teachings.

“Would the change make us want to return? No. I made my decision based on the circumstances my family faced at the time. I have no regret about that decision,” said Pillay.

She declined to name the branch of the organisation she had belonged to.

After reaching out to several Jehovah’s Witnesses branches; we were referred to the organisation’s head office, which did not respond to calls.

On its official website, Jehovah’s Witnesses in South Africa said it continued to regard life and blood as sacred gifts from God.

“Decisions involving primary blood components are matters of individual conscience for each witness patient. This adjustment extends the principle of personal decision-making, which has already been applied to plasma-derived therapies and autologous blood management, to the use of primary blood components.

“Clinicians should therefore consult each Witness patient directly and ensure that the patient’s individual decisions are clearly documented and respected,” it said.

Over the years, the Department of Health has been forced to approach the courts to compel parents to consent to life-saving blood transfusions for their critically ill children.

Suhayfa Bhamjee, senior lecturer and discipline head of Public Law at the University of KwaZulu-Natal’s School of Law, said the change was significant, but did not change the constitutional law governing medical consent.

“It does not alter the constitutional framework governing medical decision-making in South Africa. Nor does it expand the power of doctors, hospitals or courts to compel treatment. Rather, its principal significance lies in the relationship between the individual believer and the religious organisation.”

She said the Constitution protected freedom of religion while simultaneously recognising an individual’s right to make decisions about their own body.

“Accordingly, a court cannot ordinarily force a competent adult Jehovah’s Witness to undergo a blood transfusion against their will simply because the treatment may save their life. Respect for personal autonomy requires that competent adults be permitted to make decisions that others may regard as irrational, dangerous or contrary to their own interests.”

“Against that backdrop, the recent doctrinal development within the Jehovah’s Witness faith does not really change the legal relationship between the adult patient and the state. What it changes is the religious dynamic within the faith community itself. If acceptance of red blood cells, white blood cells, plasma and platelets is now regarded as a matter of personal conscience, an adult believer who wishes to accept such treatment need not view themselves as defying a mandatory religious prohibition. The decision rests with the individual.”

The position is different when parents make medical decisions for their children.

“South African law draws a clear distinction between a person exercising rights over their own body and a parent making decisions on behalf of a child. Parents undoubtedly have important rights and responsibilities concerning their children, including the right to raise them according to their religious convictions. However, parental authority is not absolute.

“Where there is a conflict between parental religious beliefs and a child's need for life-saving medical treatment, South African courts have consistently placed decisive weight on the child's welfare and best interests.”

Bhamjee said the change may reduce conflict between religious beliefs and medical treatment, but does not alter the constitutional principles governing medical consent.

The South African Medical Association said the change should prompt doctors to have more individual conversations with Jehovah’s Witnesses patients rather than relying on assumptions about what they would or would not accept.

“SAMA views the change as a significant development for patients and healthcare professionals. Doctors should not assume that a Jehovah’s Witness patient will accept blood components. Instead, the change reinforces the importance of an open, respectful and individualised discussion with every patient.

“Healthcare professionals should establish the patient’s wishes, explain the benefits, risks and available alternatives, and support an informed decision based on the individual’s circumstances and beliefs. 

“Where possible, particularly in emergency situations, treatment preferences should be established early, clearly documented and communicated to the treating team. Patients should also review any existing advance directives to ensure these reflect their current wishes,” SAMA CEO Dr Mzulungile Nodikida said.

Nodikida said the association recognised that decisions involving blood and blood products could be deeply personal and, for some patients, involved important religious and ethical considerations.

“These decisions must be approached with sensitivity, respect and without judgement. From a medical perspective, the priority remains ensuring that patients receive safe, appropriate and evidence-based care while their autonomy and legally and ethically valid treatment choices are respected.”