February 22

Page Two

Many babies, often called preemies, are born prematurely. Why? Are there ways to prevent this? How early are some babies born, and how small are they? How does this pose a dilemma? What is the prognosis for infants born early? What are their special needs? What can family and friends do to assist? In this issue, “Awake!” will examine these and related questions.

Born Early, Born Small

MILLIONS of couples the world over are expecting a certain precious “package.” Most of them know the approximate date that their baby is due to arrive. Some, however, are quite surprised when theirs is delivered early and is much smaller than anticipated.

On March 22, 1980, a baby was born to a couple near Middletown, New York, more than three months sooner than expected. She weighed 1 pound 12 ounces [794 g] and was a mere 13 3/4 inches [35 cm] long, about the span of these two pages.

The parents named their little one Kelly. She was born early, born small. Kelly arrived after only 26 weeks of gestation, instead of after the normal 40 weeks. Gestation is counted from the first day of the mother’s last normal menstrual period.

Premature and Underweight Babies

An infant is premature if born more than three weeks early, or prior to the 37th week of pregnancy. Previously, a baby was called a preemie if it weighed less than 5 1/2 pounds [2,500 g]. But the definition was changed, since some full-term babies also weigh less than 5 1/2 pounds [2,500 g]. Significantly, the epidemic of births among teenagers, and even preteens, has resulted in more and more underweight babies.

In the United States, about 10 percent of all live births are premature. Indeed, up to 300,000 of such babies are born in the United States each year! These are thrust from the womb into an environment for which they are not yet fully suited. They can be compared to Arctic explorers who have been deprived of their tents and sleeping bags.

True, these premature babies have all the organs of the body, although these are in an immature state. In fact, by the 15th week of pregnancy, a baby’s heart, brain, kidneys, and digestive system are formed and recognizable. Why, at three weeks the partly developed heart even starts beating!

But, of course, a baby cannot survive outside its mother’s womb during the very early weeks of pregnancy. Yet, because of advances in medical science, even preemies born during the 22nd week of gestation are now being saved. This, however, has resulted in a dilemma, and a very costly one at that. Consider how this has come about.

Recent Medical Developments

In the early 1960’s, more than half of all preemies weighing from about two to three pounds [900 to 1,400 g] died. In 1963 the nation’s finest doctors could not save Patrick, the three-pound [1,400 g] newborn son of U.S. president John F. Kennedy.

The fact is, until very recently there was a hands-off approach in the treatment of preemies. Those who were too underdeveloped or sick were allowed to die naturally. Of course, they were fed and cared for, but no aggressive treatment was initiated. Then, zealous medical personnel decided to make a career of trying to save these newborns.

In 1975 the new medical specialty called neonatology (a branch of medicine concerned with the care, development, and diseases of newborn infants) was formed by the American Academy of Pediatrics. Modern NICUs (neonatal intensive care units) were created to simulate some of the functions of the womb. Now about 90 percent of the infants weighing from about two to three pounds [900 to 1,400 g] survive!

The treatment, however, is neither pleasant nor pretty. A preemie may have half a dozen tubes inserted into his body, and his skin may be mottled purple from being stuck with needles. The science magazine Discover describes a modern NICU:

“Most of the infants lie naked on padded, electrically warmed tables, hooked up to an array of bottles and machines. Each one usually has his or her own nurse. . . . Their chests heave tremendously; their ribs and breastbones are so soft that they bow inward with each breath. According to their monitoring devices, most of their hearts beat 150 times a minute, and they take anywhere from 30 to 90 breaths in that time.”

A Real Dilemma

According to a survey, some 17,000 preemies weighing less than about two pounds [900 g] are annually admitted to the hundreds of special infant care units now operating in the United States. Now, even these very tiny ones are said to have about a 70-percent chance of survival! But at what price?

The estimates for severe mental and physical handicaps for preemies range from 5 to 20 percent, which is much higher than for full-term babies. And, of course, the smaller the baby, the greater the risks. The major risks include mental retardation, visual and hearing problems, and cerebral palsy. But that is not all. The author of The Premature Baby Book says: “I’ve seen a lot of kids born under 1500 grams [3 pounds 5 ounces] who have dyslexia, behavior problems, eye problems, or other problems the doctors call ‘minor.’”

Even preemies that doctors say are normal have difficulties. Dr. Forest C. Bennett, director of the high-risk infant follow-up program at the University of Washington in Seattle, observes: “Our tests of premature babies were all coming up normal. But parents kept telling us these babies were different from their brothers and sisters. They tended to smile less, to communicate with their mothers less, to pay less attention to light or sounds, and to be more fussy than other children. And when they grew up and went off to school, they didn’t do very well.”

In addition, it is very hard on families to have a preemie in an NICU perhaps many miles away and to make frequent trips to visit​—only to see the baby suffering so. And when the little one is finally taken home, it can be especially trialsome. Sandy E. Garrand, president of a network known as Parent Care, notes:

“It’s unbelievable that hospitals will spend $300,000 to keep a baby in intensive care for two or three months, but when the baby goes home, the parents are left totally on their own without even knowing if the child will be disabled. That creates a tremendous feeling of isolation. Families are stressed. Marriages are stressed.”

One father of a tiny preemie was moved to say: “There was a time when we were afraid she would die. Now there are times when we’re afraid she’ll live. Without this technology, she would have died naturally, and we wouldn’t have had to ask ourselves these questions. Maybe that would have been better.”

Dr. Constance Battle, as medical director of the Hospital for Sick Children in Washington, D.C., says she is “immersed in the tragic outcomes of well-intentioned treatment.” Her advice to neonatologists? “I say give it some thought when you whip something into life you never see again. You don’t understand the limbo the child lives in.”

With the physical and mental outcome for many preemies so uncertain and the cost of care so high, you can understand why one magazine calls preemies “A $2 Billion Dilemma.”

Another Facet of the Dilemma

When is a baby considered a person? Some babies are legally aborted at up to 24 weeks of gestation, about the same age at which others are being saved. Thus, Omni magazine says: “The line between abortion and lifesaving care is becoming increasingly slim​—so slim that many hospitals abort fetuses in one wing while saving preemies just a couple of weeks older in another.”

The magazine pointed to what would heighten the dilemma, noting: “Lungs are the only organs unable to function in preemies 16 to 20 weeks of age. Thus, with either high-pressure chambers or ECMO [extra corporeal membrane oxygenation], the plateau of viability would take another step down,” so that even younger babies would be saved. Indeed, on July 27, 1985, a 12-ounce [340 g] baby was delivered to a mother 22 weeks pregnant, and it is still alive!

When the heart of an aborted baby continues to beat for more than a few minutes, in some hospitals the baby is taken over to the NICU, where it is kept warm and comfortable until it dies. Yet, Dr. Elizabeth Brown of Boston City Hospital explains that one such aborted baby survived and was later adopted. Dr. Brown said regarding the mother who gave birth: “She was very happy that the child lived.”

Indeed, life is precious. And nothing is so heartwarming, especially to a mother and a father, as seeing their baby live and become a happy, healthy child. This is true whether the baby is full-term or premature. But what happened in the case of Kelly, mentioned in the introduction? How can parents of preemies be helped to cope? Is there anything a prospective mother can do so that she does not give birth prematurely? What is the source of the problem of premature births, and is there a truly satisfactory solution?

[Box on page 5]

Saving the Very Premature

“Parents didn’t cry out saying they wanted this. Physicians, I among them, were the ones who wanted to go ahead. Doctors have their own agendas, their own academic ladders to climb. If you talk to parents, you find they’re much more fearful of having malformed, handicapped children than they are of stillbirths.”​—Dr. William Silverman, retired professor of pediatrics at the College of Physicians and Surgeons at Columbia University.

Premature Babies​—Meeting the Challenge

KELLY is eight years old now, and the accompanying picture shows that she is a happy, healthy child. Truly, this is remarkable when you consider that she was born 14 weeks premature and weighed only 1 pound 12 ounces [794 g]! Prior to the mid-1960’s, rarely, if ever, did an infant born so early and so small survive.

But in what ways does a premature baby differ from a full-term infant? The tiny size is the most obvious difference. Also, the baby’s delicate skin may appear pink and sort of thin; minute veins may even be visible. And depending on how early this little one came, it may have some very fine hair on its face or body. This will soon disappear.

Further, the baby’s head may seem a trifle large in proportion to the rest of the body, but this is nothing to be alarmed about. As the baby approaches its full-term-delivery date, it will acquire more fat and begin manifesting the more symmetrical appearance of a full-term babe.

As to any special needs that the tiny tot may have, these range from few to many. Each case is different. But milestones have been reached. Modern technology along with devoted hospital personnel and a superabundance of TLC from parents have resulted in a remarkable survival rate.

What Parents Can Do

Parents, you especially can do much for your premature newborn. Naming the child soon after birth is encouraged, as this draws parents and infant close together in a relationship that actually enhances the progress of the “earlycomer.” After the baby’s condition is stabilized, a foremost concern is to establish physical contact with the infant.

Caressing, gently stroking, and lightly massaging the baby’s skin may be appropriate, particularly if the baby cannot be held as yet. And what could be more reassuring to the little one than to hear mom and dad’s voices expressed in soft humming, sweet lullabies, or whispered words of endearment? On the other hand, when the baby is very premature, there is reason for caution. “They’re easily overwhelmed, and they crash,” says Dr. Peter A. Gorski, who spent two years recording preemie behavior. “I’ve had babies so overtaxed by the social interaction of eye contact that they go limp. What seems kindly to us may not always be best.”

Visiting the baby as often as possible will certainly help to strengthen your relationship with him. If, because of circumstances, you are not able to visit your little one physically, tape recordings of family members talking and other home sounds can be sent to the hospital for your baby to hear. An article of clothing from mother, which even though laundered still retains her unique scent, might be placed in the incubator, or isolette. Some have set a picture of mom, dad, or brothers and sisters about ten inches [25 cm] from the baby.

Consider the situation of Elise, who, in 1971, arrived ten weeks earlier than had been expected. She weighed 3 pounds 5 ounces [1,500 g]. Her parents were permitted to visit her only twice a week. Her mother, Betty, observes: “I did not have the closeness with Elise that I had with my first baby and the three children born after her.” Yet, Betty explains: “Through the years we have grown close, and Elise has turned out to be one of the most helpful and pleasant of the children.”

Mother can provide the perfect food for the premature baby, her breast milk. Canadian scientists in Toronto found that milk of mothers of preemies is different in composition from milk of mothers of full-term infants, and prematures fare better with it. According to The Journal of the American Medical Association, “the premature infant [is] better able to use the protein and other nutrients of breast milk for growth.”

What Others Can Do

Are you a friend or a relative of a preemie’s parents? If so, there is much you can do. There are groceries to be bought, meals to be cooked, housework to be done, clothing to be laundered, and perhaps other children to be cared for. Your support in these mundane matters can be most helpful to parents who must make frequent and often long trips to visit their baby in a neonatal intensive care unit.

Christy, the mother of an infant born over five weeks early, said that her Christian brothers and sisters supplied all of the above. “They were a constant source of joy and strength to us in those first few weeks,” she said.

Support can also be given by sending cards and gifts. The gifts may include anything you would obtain for a full-term infant. The size of the infant must be taken into consideration, of course. Preemie-size disposable or cloth diapers are available, as well as preemie patterns and clothing.

Emotional support cannot be overemphasized. Be positive and optimistic. Kelly’s mom, Mary, said: “I needed people to be encouraging and say upbuilding things. I hated it when some would say, ‘Don’t get too attached.’ I thrived on hope.” One Scriptural thought that sustained her is found at Isaiah 41:13: “For I, Jehovah your God, am grasping your right hand, the One saying to you, ‘Do not be afraid. I myself will help you.’”

Visits by Christian elders from Mary’s congregation were most uplifting. Both mothers, Christy and Mary, said that the support they received from their husbands was immeasurable and that the experience drew them closer together.

Prevention​—The Wise Course

There is wisdom in expending more effort in trying to prevent premature births rather than in simply caring for preemies afterward. According to one study made in the United States, for every hour a pregnancy between 24 and 28 weeks is prolonged, $150 is saved in hospital care. So it would be beneficial to include information on premature births in your “prenatal library” and to have a plan of action ready in case a premature birth occurs. But more importantly, a prospective mother should try to prevent having a premature birth.

First, a pregnant woman should not smoke. Smoking during pregnancy evidently damages fetal arteries, according to a report in Medical World News. A Cornell University professor commented: “That fetal vessels are injured, I think, goes along with what we know about the low birthweights and high incidence of congenital malformations and premature separations among babies of women who smoke.”

Second, if you are pregnant, you should steer clear of overly strenuous activities, such as heavy lifting. Third, avoid situations that may cause physical or emotional trauma. The Bible tells how a physical injury or devastating news can precipitate a birth.​—Exodus 21:22; 1 Samuel 4:19.

If you are at high risk of delivering a preemie, you should consult with a person, such as an obstetrician, who has had experience in caring for pregnant women. Women at high risk include those who previously have given birth to a premature child, those who are carrying more than one child, those who are over 40 years of age or are teenagers, and those who use alcoholic beverages immoderately. Among other things that put a woman in the high-risk category are high blood pressure, diabetes, and abnormalities of the placenta. Such women need to have their pregnancy monitored more closely. Be sure to observe a proper prenatal diet to ensure the best possible health for you and your baby.

Yet, even though a prospective mother does everything possible to ensure a normal delivery, there are no guarantees. Premature births are all too common, and they appear to be increasing in number. But what about the future? Is there any prospect for correcting this defect in the human reproductive system?

Premature Babies Need Tender Loving Care

IT WAS three o’clock Sunday morning. As to what triggered a premature labor, I don’t know. But I suspect I may have been doing too much entertaining. Whatever the reason, my little son was on his way a month too early.

The labor was long and erratic. All day Sunday and all Sunday night, I labored without delivering. Many times the baby’s head would be visible to the midwife on one contraction (crowning, it is called) only to disappear completely out of reach on the next one. At four o’clock Monday morning, 25 hours from the start of labor, the midwife determined from listening to the baby’s heartbeat that the baby was in distress. She gave me oxygen and brought me to the hospital at once. Three hours later, Danny was born.

My husband, Bill, and I could see he was having a hard time breathing, since his lungs were not working well. They let us hold him for a few seconds, and during that time, Bill and I noticed that his breathing came easier as we held him and talked to him. When the hospital staff said he had to be put into the incubator, I was in no frame of mind to argue after such a long, confusing labor.

At 9:30 a.m. the pediatrician came to see me. He said that he had checked the baby and he seemed to be doing all right; the doctor would have him brought in so I could nurse him. But the baby didn’t come. Ten o’clock, 11 o’clock, 12 o’clock, and still no Danny. Finally, just past noon, a nurse came from the nursery and made the startling announcement: “Your baby is retracting and flaring, and he had to be moved to an isolette!” On that note and with no further explanation, she left.

You can imagine what that did to my already shaky emotional state. Since I didn’t know what “retracting and flaring” meant, I called the midwife and asked her if it was serious. “Yes,” she said, “it’s very serious. That’s what they worry about with premature babies.”

“What do you mean?” I asked: “Could he die?”

“It’s possible,” she said. She told me I should insist on seeing him.

The nurses told me I couldn’t see him until the doctor had checked him out. At that point I started crying hysterically and caused quite a commotion. “He’s my baby and he’s going to die and I can’t even hold him!” They responded quickly by bringing me down to him. Even though I couldn’t hold him, there was a small opening on the side of the isolette, or incubator, where I could put my hand through and touch him.

Danny was a sad sight. His stomach muscles were still heaving from trying to breathe the wrong way and his nostrils were spread wide open because he just wasn’t getting enough oxygen. (Hence the expression retracting of the sternum and flaring of the nostrils.) His hands and feet were dark from lack of oxygen.

I put my hand in and started to massage him gently from head to toe and to tell him how much I loved him. I told him all about his daddy and his brother, Timmy, and his whole family and how much we all loved him and wanted him to come home. He was very intent on listening to my voice, and the massage helped calm him. No one has to convince me that love works wonders. I saw it for myself that very day. Within a half hour, his breathing was completely normal, and his hands and feet were rosy pink.

The nurse on duty said: “I can’t believe it! Look at him! He’s breathing so well, and look at his hands and feet!” She took him out and gave him to me without waiting for the doctor’s permission.

The crisis was over. Danny was safe. That was more than seven years ago. To this day, Danny loves to hear the story of his experience, and he likes for me to tell others about it.​—As told by Mary Jane Triggs.

When All Infants Will Be Healthy

IT WOULD be a crime to drive a person from his tent and sleeping bag on a cold Arctic night, making him endure the elements in his skimpy underwear. Similarly, it is a crime that an infant is prematurely thrust from his warm, protective place in the womb before he is ready to face the outside world. But who or what is responsible for this heinous crime?

The parents surely would not intentionally work such a hardship on their young one. Actually, the mother is unable to stop her labor when it begins, whether it occurs at a baby’s full term or before. Even medical experts do not understand exactly what starts labor, whether prematurely or at full term. What is known, however, is that something goes terribly wrong on occasion, and a baby is thrust out into a world in which it is not equipped to live.

Why this occurs is explained in the Bible. The inspired psalmist wrote: “Look! With error I was brought forth with birth pains, and in sin my mother conceived me.” (Psalm 51:5) A rebellious spirit creature induced the first human pair to rebel against God, and they thereby became sinners. They missed the mark of proper obedience to their Creator. Thus, all their offspring were conceived in sin, or imperfection. (Romans 5:12) The consequences are sickness and death, as well as various malfunctions of the body, including a reproductive system that sometimes thrusts its precious fruitage out prematurely.

A World Without Preemies

If humans had maintained their perfection, no infants would have been born before their time to face the calamities that confront so many preemies today. And the time will soon come when a mother never again will give birth prematurely. The inspired prophet Isaiah wrote about that time, providing us the promise of our loving Creator: “I create new heavens and a new earth, and the past will not be remembered, and will come no more to men’s minds.”​—Isaiah 65:17, The Jerusalem Bible.

The Bible prophecy in Isaiah goes on to tell of the heartwarming conditions that will prevail in God’s new world, saying: “No more will the sound of weeping or the sound of cries be heard in her; in her, no more will be found the infant living a few days only . . . They will not toil in vain or beget children to their own ruin, for they will be a race blessed by Yahweh, and their children with them.”​—Isaiah 65:19-24, JB.

How grand that will be when all human suffering and distress will be a distant memory, when there will never again be the need for extreme medical measures and intensive care units to try to keep alive infants born prematurely! Because human imperfection will then be eliminated by means of the grand ransom provision of our great God, never again will an infant be thrust from the womb before it is perfectly equipped to enjoy life to its fullest.​—Revelation 21:3, 4.

[Box on page 11]

You Can Realize True Comfort

◆ If your child dies, try to accept help and encouragement from friends and relatives. Perhaps those who have lost children can help comfort you.

◆ You may believe in the hope of the resurrection, but do not be alarmed if that belief does not bring you immediate comfort. As time begins to heal those wounds, you will, no doubt, come to appreciate the hope of seeing your loved one again.​—Isaiah 25:8; 65:23; John 5:28, 29; 1 Corinthians 15:25, 26.

◆ Try to rely on Jehovah, “the God of all comfort.” (2 Corinthians 1:3) He is the One who has provided a way to “bring to nothing the one having the means to cause death, that is, the Devil.”​—Hebrews 2:14.

◆ If you are a friend of the grieving parents, it might be best not to say that they can have another child. At the moment, nothing could replace that baby. It would be best in this case to “weep with people who weep.” (Romans 12:15) Your acknowledging the parents’ loss and grieving with them can bring comfort to them, as sharing grief can lessen it.

◆ It is proper and helpful to express grief, so give yourself time to resolve feelings of grief and loss. (See “Awake!” of April 22, 1985, “When Someone You Love Dies,” and of August 8, 1987, “Facing the Loss of a Child.”)

I Found ‘One in a Million’

THE New York Woodstock Music Festival in 1969 was the most thrilling moment of my musical career. A sea of humanity stretched as far as the eye could see. It was awe-inspiring!

I was the bass guitarist and singer with Sly and the Family Stone, one of the best-known music groups of the time. A tremendous roar of approval came from the throats of half a million people as they called for an encore of our performance.

That was indeed a thrilling moment, but it is now far from the most memorable event of my life. I have found a rare treasure, a ‘one in a million’ find. However, before describing it, let me explain things that shaped my life.

Becoming a Musician

In 1946 I was born into a musical family in Beaumont, Texas, my mother’s only son. She was a pianist with the church choir, and my father was a jazz guitarist. Soon afterward my family moved to Oakland, California, where I started tap dancing at the age of five. Two years later, I learned the piano under the guidance of my grandmother, who cared for me in those early years.

When I was 11, my father gave me his guitar and amplifier, and I eagerly set about learning this new instrument. Later, I learned to play the drums, the clarinet, and the saxophone. By the time I was 13, I had my own professional rock ’n’ roll band called The Five Riffs. At the age of 15, I began playing in nightclubs as part of the Dell Graham Trio, which was made up of my mother on piano, me on lead guitar, and a drummer.

My mother and I later formed a duo. To make up for the lack of a drummer, I thumped and plucked the bass strings of my guitar to accentuate the rhythm. In this way I developed my own distinctive thumping-and-plucking style of bass playing. A regular patron was so impressed that she telephoned a disc jockey, Sly Stone, and urged him to listen to me. The result was that, in 1966, I was offered the role of bass guitarist in a seven-piece group that became known as Sly and the Family Stone.

Our record “Dance to the Music” became an international hit, and we became the most popular black group of the time. Other hits quickly followed, including “Hot Fun in the Summertime,” “Everyday People,” and “Thank You for Letting Me Be Myself Again.” Then came the Woodstock Music Festival, where we played alongside other internationally famous musicians. Later, we played for 300,000 people on the Isle of Wight in Britain and for 350,000 at a music festival in West Germany.

In 1971 I received a threat against my life. I was told that during a performance in the Los Angeles Coliseum, I would be shot as the sound of the music and the roar of the crowd reached a crescendo. I was terrified. However, the electronic equipment malfunctioned, and the concert promoter came out and canceled the performance. I felt that God had somehow intervened to save my life. I ran in panic from the stadium back to my hotel room, where I hurriedly packed and left the city.

This terrifying experience preoccupied me, even when I formed my own musical group called Graham Central Station. My second record album with this group has printed on its cover the words “Produced by God.” I did not intend to be blasphemous, but the words reflected my feeling that I had been saved by God.

A Turning Point in My Life

In 1973 I met Tina, an international airline stewardess. While she braided my hair in preparation for performances, I would often talk to her about my belief in God. About this time, Tina’s mother began studying the Bible with Jehovah’s Witnesses.

One day Tina found her mother in tears. She was crying because none of her children would be present for her baptism at the district convention of Jehovah’s Witnesses in the Oakland Coliseum. Tina promised that if it meant so much to have her family present, she would attend the baptism on Friday.

Tina was so impressed by what she saw and heard that July day in 1974 that afterward she telephoned me and tried to persuade me to attend Saturday’s session. But I was too tired from recording the night before. On Sunday, Tina again telephoned and urged me to attend. I was curious to see what had impressed Tina, so I went.

A policeman said that since I didn’t have a convention parking ticket, I couldn’t go into the parking lot. He added: “You don’t want to listen to that stuff anyway!” I was temporarily put off and drove away. But later I thought better of it, turned around, and headed back. By the time I got into the Coliseum, there were only a few minutes of the final address remaining.

Having been a performer for most of my life, I have a feeling for crowds. I had been in the Oakland Coliseum many times for other events, but this was unlike anything I had ever seen​—60,000 people of different races and social backgrounds all mingling together peacefully. Just the “feel” of the crowd convinced me that this was something important, indeed, a ‘one in a million’ find!

As I left the Coliseum, a young teenage girl, who because of my appearance had no difficulty in seeing I was not a Witness, came up and pressed a copy of the book Is This Life All There Is? into my hand. It was just what I needed! On reaching my car, I opened to page 24 and saw an illustration of a swan, a tortoise, a tree, and some people. Observing that a swan may live 80 years, a tortoise 150 years, and a tree thousands of years, the book asked: “Does man’s short life-span make sense?” The message of this illustration had an immediate impact on me.

Later, I asked Tina many questions, but she knew no more about the Bible than I did. So we decided to visit the woman who had studied with Tina’s mother. As we left her house, I turned to Tina and said: “That woman is a phony! Nobody can be that nice! You watch, next week she will be different!” But week after week, she remained exactly the same, answering all our questions by calmly turning to the Bible.

Tina and I began a regular Bible study in the book The Truth That Leads to Eternal Life. Shortly, however, it came time for me to tour with my group. I was encouraged to telephone the local congregations in each of the many cities I would be visiting across the United States and ask for someone to study the succeeding chapters of the Truth book with me.

I visited congregations from the west coast to the east coast and from the north and midwest down to Texas and the southern states. Those who conducted the Bible study with me came from a variety of races and socioeconomic backgrounds. But everywhere I went, the message was the same. It impressed me greatly that I had found not just a local phenomenon in the Oakland Bay area but a countrywide organization that was truly united in spiritual harmony.

A Complete Change of Life

When I toured Europe after completing our U.S. tour, I continued my studies with Witnesses there. Reaching Paris, I telephoned Tina and proposed marriage. A few weeks later, in February 1975, we were married in Nevada. After only five days of marriage, I began another tour of the United States, but Tina joined me this time.

In Brooklyn, New York, we visited the international headquarters of Jehovah’s Witnesses. We were outlandishly dressed, wearing black matching outfits with glittering red and silver dragons on the trouser legs and on the backs of our jackets, which still embarrasses us when we think about it. But we were kindly treated, and no one made remarks about our dress.

Tina and I were baptized at the district convention in Oakland in July 1975, exactly one year from when we had walked into our first convention at the same site. What made the occasion even more joyous was the fact that Tina’s two sisters, Denise and Shelia, and my own mother, all of whom began studying soon after we did, were baptized at the same time. A few years later, my grandmother, at the tender age of 82, also got baptized.

The things I was learning are apparent from the record covers of some of the albums my group produced. The 1976 album entitled Mirror showed on the cover photographs of me and other band members. On one side we appeared with long hair, sunglasses, and faddish clothing, while on the other a mirror-image depicted us as clean-cut, with shorter hair, and modest styles of dress.

The songs included one entitled “Forever.” It was dedicated to my hope of seeing my father in the resurrection, when life forever will be in front of us. The words of one song reflected my feelings as a newly baptized Witness.

Helping Others

We have had many opportunities to share our faith. An organist and a drummer responded and dedicated their lives to Jehovah. That drummer is now an elder and a regular pioneer in the West Hollywood Congregation.

During a tour in 1975, I took our organist witnessing for his first time in a wealthy, all-white area of Atlanta, Georgia. As we were going from house to house, police cars suddenly screeched to a halt, and policemen jumped out demanding to know what we were doing there. At the same time, a police helicopter appeared overhead and hovered just a few feet above us. Apparently the police had received reports of “suspicious characters” in the neighborhood, but when our mission as witnesses of Jehovah was explained, the police left us alone. It was quite an introduction to the witnessing work for our organist!

On this tour, following our baptism, we made a giant audiovisual display with 15-foot [4.6 m] screens. This was the feature of the show. It required the use of two large semitrailer trucks and two tour buses. The audiovisual show depicted the horrors of world conditions and then pointed to the solution through God’s Kingdom. The slides included photographs of the Oakland Coliseum convention and our own baptism. This was set to music, and I gave a commentary between the songs.

During one tour, I was out in the field service in Hollywood, Florida, and we were being assigned to work from door to door by the one conducting the group. Suddenly, I heard one of my records being played at a house nearby. I knocked on the door, and the three young men there getting high on drugs were dumbfounded suddenly to see standing at their door the singer of the song they were listening to! I have since learned that two of these men have become Witnesses.

In 1979 we moved to Los Angeles into a large house with a swimming pool and landscaped gardens overlooking the city. I set up my own 24-track recording studio next to it. The first record that I recorded there was entitled “One in a Million You,” which sold over a million copies. Shortly afterward I was privileged to serve as a ministerial servant, and in 1982, just one week before our daughter, Latia, was born, I was appointed an elder.

One Sunday I was conducting the Watchtower Study when a young Hawaiian man entered the Kingdom Hall and stared at me in amazement. He had seen me in Hawaii in 1975 when I was a long-haired pop performer, so he was now shocked to see me modestly dressed and conducting the Watchtower Study. Although he had moved to Los Angeles with the intention of making it big in the music field, he agreed to study with me. He now serves with our congregation as a regular pioneer.

Simplifying Our Life-Style

Tina and I can truthfully say that we have been the happiest since entering the full-time ministry as pioneers in 1982. A further refinement in our spiritual advancement has been the simplifying of our life-style. We were spending 90 percent of our time at home in only two rooms of a large house that required the services of gardeners and maids to operate effectively. We could not fully utilize the Lincoln Town Car, the 1955 Thunderbird, the Cord, the Mercedes-Benz, the 25-foot [7.6 m] motor home, a van, and several motorcycles. So after the district convention in 1985, we sold our house and most of the vehicles.

We now live in a modest townhouse, which Tina finds easier to keep while pioneering. Although I still do limited work as a musician, my real happiness now comes from serving as a pioneer and seeing our little daughter advance spiritually. She has set firm goals despite her young years and constantly talks about the time when she can symbolize her dedication to Jehovah.

Another blessing I long for is to see my mother again in the resurrection and to tell her about the events that have transpired since she died faithful as a regular pioneer in April 1987. Yes, instead of being thrilled by entertaining hundreds of thousands of music fans, I now get true satisfaction by doing my best to obey the words of the psalmist: “Praise Jah, you people! Sing to Jehovah a new song, his praise in the congregation of loyal ones.” (Psalm 149:1)​—As told by Larry Graham.

[Picture on page 13]

Here at the Woodstock festival, I played before half a million people

[Credit Line]

John Dominis, LIFE MAGAZINE © Time Inc.

[Picture on page 15]

With my wife and child

Religion’s Future in View of Its Past

Part 4​—1513-607 B.C.E.​—A Nation Set Apart, Unlike All Others

ACCOMPANIED by thunder and lightning, it was an auspicious birth. The time was 1513 B.C.E., and the place was Mount Sinai, in what at that time was Arabia but today is Egypt. Rather than the birth of a human, it was the birth of a nation!

Less than a year before, they had been a patriarchal society of perhaps three million people, enslaved to the world power Egypt. Now they were a free people, one their God had determined to organize into a nation​—but not just any kind of nation. They were to be a nation set apart, unlike any that had existed before or would exist again.

‘Church and State’​—But With a Difference

Nimrod’s attempt at merging religion with government had ended in disaster. What was now taking place at Mount Sinai was in some respects a similar merger. Would it fare any better?

A nation needs laws. The Israelites were therefore given ten basic laws, commonly known as the Ten Commandments, as well as an additional 600 or so regulations. (Exodus 20:1-17) It was a law code based upon fundamental truths that have always applied to true religion, and still do, even in our 20th century.

Were these laws based upon the already existent Code of Hammurabi? Some people might think so, since Hammurabi, king of Babylon’s first dynasty, ruled well over a century and a half before Israel became a nation. In 1902 his law code was found copied on a stela that had originally been in the temple of Marduk in Babylon. The book Documents From Old Testament Times concludes, however: “Despite many resemblances, there is no ground for assuming any direct borrowing by the Hebrew from the Babylonian. Even where the two sets of laws differ little in the letter, they differ much in the spirit.”

That was only one way in which the nation was to differ. In addition, originally it was to have no human ruler. It was to be directed by an invisible King in the heavens, thus making this nation truly different, unlike all others. Not until almost 400 years later was a dynasty of human kings introduced. But even then, the nation was unique. Its king did not claim to be God or a descendant of God as, for example, the Pharaohs of Egypt did. Israel’s kings simply sat upon “Jehovah’s throne” in a representative way.​—1 Chronicles 29:23.

Israel’s governmental functions, involving legislative, judicial, and executive processes, may remind us of certain governments today. But once again, there was a profound difference. Isaiah 33:22 explains: “For Jehovah is our Judge [judicial agency], Jehovah is our Statute-giver [legislative power], Jehovah is our King [executive officer].” All three functions of government were unified in Israel’s God. Neither the nation’s king, nor its judges, nor its priests were to be absolute monarchs. All were bound by the laws and directives of the God they represented, quite unlike the dictatorships of political and religious men today.

Thus, whereas the merging of Church and State in Nimrod’s day had been a merging of human government with false religion, what occurred at Mount Sinai was a uniting of divine government with true religion. This ensured better results.

Interfaith Movements Ruled Out

Lack of faith resulted in the Israelites’ having to wander 40 years in the wilderness. Now, in 1473 B.C.E., finally about to enter Canaan, the land their God had promised them, they were reminded of their obligation to reflect his glory as a nation set apart for his service. There was to be no fraternizing with the Canaanites. That accounts for what a reference work calls “their hostility toward their non-Yahvistic neighbors, and the insistence on the uniqueness of Yahveh.”

‘But just a minute,’ someone may object, ‘why this intolerance? The Canaanites may have been quite sincere. Besides, are not all religions just different ways of approach to the same one God?’ Before agreeing, recall the negative effects suffered by certain people in the violence-filled earth before the Flood, in the ziggurat-building days of Nimrod, and in the polytheistic atmosphere of Egypt. Some of these people also were probably sincere, but this did not save them from reaping the consequences of having practiced religions obviously unacceptable to their Creator. Was the Canaanite religion as bad as these others had been? Ponder the facts revealed in the box “Religion in Canaan​—True or False?” on page 20 and then judge for yourself.

Limping Upon Two Opinions

After entering the Promised Land, Joshua, Moses’ successor, took the lead in battling false religion. But after his death, the Israelites neglected to push on, taking possession of the land. They embarked upon a tolerant policy of coexistence. This was not to their advantage. The Canaanites became like thorns in their sides, continually harassing them, repeatedly causing them to deviate from true religion.​—Numbers 33:55; Judges 2:20-22.

For some 300 years thereafter, 12 divinely appointed judges periodically appeared on the scene to deliver the backsliding Israelites from the bondage of false religion. These included such well-known men as Barak, Gideon, Jephthah, and Samson.

Then, in 1117 B.C.E., a major change in governmental structure occurred when Saul was enthroned as Israel’s first human king. He was followed on the throne by David, who finally subdued all of Israel’s enemies within the Promised Land, expanding the nation to its divinely set boundaries. During the reign of his son Solomon, Israel reached its pinnacle of glory, enjoying a prosperity that set it apart from all its neighbors.

But at Solomon’s death, in either 998 B.C.E. or 997 B.C.E., disaster struck. The nation broke apart. Ten tribes to the north were thereafter known as Israel, the two southern tribes of Judah and Benjamin as Judah. Although claiming to represent the true God, none of the northern kingdom’s ensuing 19 kings, not counting Tibni, practiced true religion. (1 Kings 16:21, 22) They were limping, as it were, on two opinions, a situation that led to serious consequences in the days of King Ahab. (See 1 Kings 18:19-40.) Even more serious were the consequences in 740 B.C.E., when Israel was overthrown by the Assyrians.

Meanwhile, of Judah’s 19 kings beginning with Solomon’s son Rehoboam, only a handful practiced true worship. As the nation fluctuated between good and bad kings, so also its people vacillated between true and false religion. The false religious doctrines and degrading practices of neighboring nations, including Baal worship, became increasingly evident in the homes of its people. As these elements “became further entrenched in the Israelite faith,” says The New Encyclopædia Britannica, “the people began to lose the concept of their exclusiveness and their mission to be a witness to the nations.” This brought about the nation’s ruin.

Obviously, the command to stay separate from the Canaanites had been designed to protect the Israelites and to maintain the purity of their worship. As a nation practicing true religion, they were to stand out in clear contrast with those that did not. But they wavered all too often. Finally, in 607 B.C.E., Jerusalem was destroyed by the Babylonians, and its surviving inhabitants were carried into captivity. For 70 years they suffered the sad consequences of having forsaken true religion. Babylon, birthplace of post-Flood false religion, had triumphed over a nation set apart, unlike all others.

Needed​—An Effective Ruler

As long as the Israelites practiced true religion, they enjoyed peace and security. The uniting of divine government with true religion brought them benefits of every kind. Yet success was limited. If the peace and security experienced for a limited time by one nation was to be achieved in full for every nation, something more was needed. A ruler​—someone capable of providing righteous government and true religion to achieve full success—​was sorely needed. What, or who, would it be?

Some 250 years after Jerusalem’s fall, a man was born who, though having a short life, would make a name for both himself and his nation. His foot would touch down in Babylon and also in Egypt, where he would be hailed as a great deliverer. Of him The New Encyclopædia Britannica, with the benefit of hindsight, would say some 23 centuries later: “It is not untrue to say that the Roman Empire, [and] the spread of Christianity as a world religion . . . were all in some degree the fruits of [his] achievement.”

Would this prominent world ruler prove to be what was needed? Our next installment, “Mythical Gods Without Merit,” will answer.

[Box on page 19]

“The ruin of a nation begins in the homes of its people.”​—Ashanti (Ghanaian) proverb

[Box on page 20]

Religion in Canaan​—True or False?

“Excavations in Palestine have brought to light a multitude of A[starte] figures in all forms; . . . most of them are small, crude figures, an indication that this deity was chiefly used in home worship, perhaps worn by women on their person or placed in an alcove in the house. . . . The sensual nature religions of A[starte] and Baal appealed to the common folk. Of course, serious injury was inevitable; sexual perversions in honor of the deity, voluptuous lust, and impassioned exuberance became a part of worship and later moved into the home.”​—Calwer Bibellexikon (Calwer Bible Lexicon).

“Religious festivities became a degraded celebration of the animal side of human nature. Even Greek and Roman writers were shocked by the things the Canaanites did in the name of religion.”​—The Lion Encyclopedia of the Bible.

“Of Canaanite religious practices, mention will only be made here of the sacrificing of children, for excavations have directly verified this. In Gezer as well as in Megiddo, the way corpses of children are immured . . . speaks conclusively . . . for this practice.”​—Die Alttestamentliche Wissenschaft (Science of the Old Testament).

“In no country has so relatively great a number of figurines of the naked goddess of fertility, some distinctly obscene, been found. Nowhere does the cult of serpents appear so strongly. . . . Sacred courtesans and eunuch priests were excessively common. Human sacrifice was well known . . . The aversion felt by followers of YHWH-God when confronted by Canaanite idolatry, is accordingly, very easy to understand.”​—Recent Discoveries in Bible Lands.

[Picture on page 18]

A representation of the god Baal, the adoration of whom caused the Israelites to deviate from true worship

[Credit Line]

Louvre Museum, Paris

Young People Ask . . .

A Successful Courtship​—Just How Important?

WHETHER a marriage will be happy or not is often determined during the first few years. In 1979, 52,000 couples in the United States were divorced before completing their first year of marriage. And in each of the next several years of marriage, a much greater number of couples got divorced.

How is it possible for two people to contemplate building a lifelong relationship and then, in just a few months or in two or three years, determine that their marriage is a failure?

“Most marriage failures are courtship failures,” explains Paul H. Landis, a respected researcher on family life. “This point cannot too often be repeated.” In lands where individuals customarily choose their marriage mates, courtship is the period of time wherein a couple get to know each other better with the possibility of marriage in view. Why is this period so critical?

A Time for Examination

A happy marriage requires painstaking effort. After counseling many unhappily married couples, author Nancy Van Pelt, in her book The Compleat Courtship, asked: “Why do so many marriages fail? There are many reasons, but the main reason is a lack of preparation. . . . I feel anger because of their ignorance regarding the complexity of the task.”

A husband and wife make a sacred vow before God to be faithful to each other for the rest of their lives. The Bible warns that making a vow is a serious matter, saying: “It is a snare when earthling man has rashly cried out, ‘Holy!’ and after vows he is disposed to make examination.” (Proverbs 20:25) On an impulse a person may make a solemn promise but later realize that more is involved than was bargained for. But the time “to make examination” is before making the vow, not afterward.

Courtship gives a couple the opportunity to make such an examination or investigation. When utilized properly, courtship not only can help a couple determine whether they are really suited for each other but can also prime them for the challenges of married life.

Courtship is a time for a person to search his own heart, to sort out just what his important emotional needs are. When Steve began to court Barbara, she began to reflect on her background and concluded: “I would need a man that would be very patient with me.” She added: “Steve was so patient, putting up with so many things I did to him, and he was very considerate. He always listened to me regardless of what I said. Because of this, my interest in him kept increasing and deepening.” Because each satisfied the other’s emotional needs, their courtship led to a happy marriage.

So during courtship, ask yourself: What kind of person am I? What are my important emotional needs? Also, what are the personality strengths and weaknesses of me and my partner? For instance, one young man said of his girlfriend: “She has a certain stability that I need. I’m restless and flighty. I feel that she has a steadying, calming influence.”

A landmark study of a thousand engaged couples, many of whom were questioned further after several years of marriage, found that the fulfillment of such emotional needs “appears to be of primary importance in today’s marriage.” (Courtship, Engagement and Marriage, by Burgess, Wallin, and Shultz) While love is important, having similar goals and the ability to satisfy each other’s emotional needs are essential for a lasting relationship.

Take Your Time!

What is said at Proverbs 21:5 can appropriately be applied to courtship: “Everyone that is hasty surely heads for want.” You can end up being tragically hurt​—emotionally, spiritually, and physically.

For example, Evelyn confessed: “I hate to admit it, but I hastily married a man I didn’t know very well. I was in such a hurry to get married, I thought that things would work out. I left him after three months.”

One study of 51 wives who had been married for many years compared the length of their courtship with how happy they were at present. The result? Those having a long courtship reported greater “marital satisfaction.” When asked, “How often do you regret that you are married?” and, “How often do you and your spouse ‘get on each other’s nerves’?” the short-term daters were “much less happy with their marriages,” reported the team of researchers in the journal Family Relations (1985). What was the reason?

“Short periods of dating may mean that individuals do not get much chance to experience troublesome differences, and thus when differences inevitably arise afterwards, they cause greater problems to the marriage,” explained the Kansas State University researchers. “By contrast, couples who have had such experience before marriage may see them as part of life, nothing to get terribly upset about.” Once initiated, courtship can become simply a best-foot-forward time when the man and woman go all out to win each other’s love. But if given enough time, unpleasant habits and tendencies have a way of revealing themselves. A couple who take their time with a courtship will likely find an easier adjustment after marriage, with fewer disappointing surprises.

So a successful courtship should be long enough for a couple to get well acquainted. The really important concern is not always how many months or years the courtship takes but what is accomplished during the period.

However, what if the courtship seems to take too much time?

The Time for Mature Thinking

Some persons, while wanting to keep the relationship cozy, avoid discussing the possibility of marriage. They reason: “Why can’t we just keep things the way they are now?” In some respects this is like a person who goes to a restaurant and is seated at a table. The waiter, after bringing water, bread, and a menu, waits expectantly to take the order. But the customer keeps saying, “No, I’m just fine like this. I don’t want to order anything yet.” Why enter a restaurant if you don’t want to eat a meal? So with a courtship, why enter such a relationship if you don’t want to get married?

Mature thinking will move a couple to consider and discuss the future of a relationship. It is not fair or loving to raise another’s expectations if the intention is not to follow through and get married. “Expectation postponed is making the heart sick,” states Proverbs 13:12. Of course, intimacy and commitment deepen gradually and cannot be rushed. Yet, during courtship especially, a person should ‘let his love be without hypocrisy’ so that his partner, who may be expecting the relationship to lead to marriage, is not unnecessarily hurt.​—Romans 12:9.

As the couple seriously consider marriage, courtship provides time for them to talk frankly about their values and goals. Courtship also gives them time to get better acquainted with their partner’s family and discuss how they will relate to in-laws.

Courtship often leads to engagement, when a couple make a formal promise to marry. The previously mentioned study of a thousand engaged couples found that a successful engagement was the best indicator of a satisfying marriage. But a successful engagement does not always mean an entirely smooth one. As the couple spend more time together, formality is set aside. The upcoming wedding may also put the couple under strain. Thus, disagreements, and even quarrels, may occur. Solving such differences demonstrates a couple’s ability to work out matters.

Regardless of the length of the engagement, a Christian couple must refrain from becoming overly intimate with expressions of affection. (1 Thessalonians 4:3-8) In this way, they will maintain a good conscience before God. They will also avoid the trap of allowing sexual attraction to cause them to ignore important issues.

A couple planning for marriage will often find it beneficial to seek out the advice of a Christian minister or an older happily married couple. Such premarital counseling can help them avoid some of the frustrations after marriage.​—Proverbs 15:22.

A successful courtship yields many pleasant memories and lays a good foundation for a happy marriage. How to carry on such a courtship will be discussed in a later article.

[Blurb on page 22]

Research has shown that a longer courtship often leads to good adjustment to marriage

[Picture on page 23]

It is beneficial for those planning marriage to seek the advice of a happily married older couple

Japan Bridges Its Inland Sea

By Awake! correspondent in Japan

CROSSING Japan’s Seto Inland Sea by ferry used to take an hour. But on April 10 of last year, the Seto Ohashi Bridge was opened, linking two of Japan’s main islands, Honshu and Shikoku. Driving across the Inland Sea now takes less than ten minutes.

This convenience, however, does not come cheap. The toll is 5,500 yen (about $45) each way. But that is little when compared to the total cost: 1,130 billion yen (8.7 billion dollars) and 17 lives. Also, its construction required about ten years, or nine million man-days, of work. There had to be good reasons for such a costly feat.

For one thing, transportation between the two islands is no longer at the mercy of unpredictable weather. In 1955 a ferry sank, and 168 lives were lost. Furthermore, the bridge is deemed an economic boon to agricultural Shikoku Island now that it is linked to Honshu, the principal island of Japan. At 380 yen (about $3) per person, the train is decidedly an economical way to cross.

Although referred to as one bridge, it is actually a 5.8-mile-long [9.4 km] series of bridges and skyways over five islands across the Seto Inland Sea. It is made up of three suspension bridges, two cable-stayed bridges, a truss bridge, and the viaducts linking them. One of the suspension bridges, the Minami Bisan-Seto Ohashi, is the world’s longest double-decked suspension bridge that carries both railway and highway traffic.

Mr. Tetsuo Yamane of the Honshu-Shikoku Bridge Authority in Tokyo provided some interesting insights into the construction. He worked on the bridge project for 13 years and was a construction overseer for the substructure of the bridge.

“Most difficult of all,” explained Mr. Yamane, “was laying the undersea foundations. By undersea blasting we shattered the rock bed and excavated the bed with a grab dredger. Then, caissons, or frame forms, as big as ten-story buildings were built at a shipyard, towed to the construction site, and sunk into the water. We stuffed stones into the caissons and poured mortar into them, using a newly developed mortar-plant barge called Century.”

Workers had to labor under the most adverse conditions. “The foundations were laid deep under the water, about 50 meters [160 ft] down,” continued Mr. Yamane. “In addition to that, the tide around the construction site was very strong, at a speed of five knots. It is equivalent to working in a 250 kilometers-per-hour [160 mi/​hr] wind. The excavations and the sunken caissons had to be inspected while the tide was still. But visibility in the water was virtually nil. Just 10 or 20 meters [30-70 ft] underwater, you can see practically nothing. With lights taken underwater to spotlight places requiring inspection, we took pictures and videos from a distance of 50 centimeters [20 in.].”

Since the bridge is in the Seto-Inland Sea National Park, the overall harmony of the bridge with the surrounding scenery had to be considered. The motif of “the whole landscaping is a Japanese garden with an arrangement of stepping-stones,” said Professor Toshiaki Ohta, who worked on designing the bridge.

Harmony of another sort was also achieved. Last March the undersea Seikan Tunnel was opened, connecting Hokkaido, Japan’s northernmost island, to Honshu. Now, with the opening of the Seto Ohashi Bridge, the last link in joining together Japan’s four main islands, Hokkaido, Honshu, Shikoku, and Kyushu, has been forged. Thus is fulfilled a long cherished dream of the Japanese people.

Blood: Whose Choice and Whose Conscience?

Reprinted by permission of the New York State Journal of Medicine, 1988; 88:463-464, copyright by the Medical Society of the State of New York.

Physicians are committed to applying their knowledge, skills, and experience in fighting disease and death. Yet, what if a patient refuses a recommended treatment? This will likely occur if the patient is a Jehovah’s Witness and the treatment is whole blood, packed red blood cells, plasma, or platelets.

When it comes to the use of blood, a physician may feel that a patient’s choice of nonblood treatment will tie the hands of dedicated medical personnel. Still, one must not forget that patients other than Jehovah’s Witnesses often choose not to follow their doctor’s recommendations. According to Appelbaum and Roth,⁠¹ 19% of patients at teaching hospitals refused at least one treatment or procedure, even though 15% of such refusals “were potentially life endangering.”

The general view that “the doctor knows best” causes most patients to defer to their doctor’s skill and knowledge. But how subtly dangerous it would be for a physician to proceed as if this phrase were a scientific fact and to treat patients accordingly. True, our medical training, licensing, and experience give us noteworthy privileges in the medical arena. Our patients, though, have rights. And, as we are likely aware, the law (even the Constitution) gives greater weight to rights.

On the walls of most hospitals, one sees displayed the “Patient’s Bill of Rights.” One of these rights is informed consent, which might more accurately be called informed choice. After the patient is informed of the potential results of various treatments (or of nontreatment), it is his choice what he will submit to. At Albert Einstein Hospital in the Bronx, New York, a draft policy on blood transfusion and Jehovah’s Witnesses stated: “Any adult patient who is not incapacitated has the right to refuse treatment no matter how detrimental such a refusal may be to his health.”⁠²

While physicians may voice concerns about ethics or liability, courts have stressed the supremacy of patient choice.⁠³ The New York Court of Appeals stated that “the patient’s right to determine the course of his own treatment [is] paramount . . . [A] doctor cannot be held to have violated his legal or professional responsibilities when he honors the right of a competent adult patient to decline medical treatment.”⁠⁴ That court has also observed that “the ethical integrity of the medical profession, while important, cannot outweigh the fundamental individual rights here asserted. It is the needs and desires of the individual, not the requirements of the institution, that are paramount.”⁠⁵

When a Witness refuses blood, physicians may feel pangs of conscience at the prospect of doing what seems to be less than the maximum. What the Witness is asking conscientious doctors to do, though, is to provide the best alternative care possible under the circumstances. We often must alter our therapy to accommodate circumstances, such as hypertension, severe allergy to antibiotics, or the unavailability of certain costly equipment. With the Witness patient, physicians are being asked to manage the medical or surgical problem in harmony with the patient’s choice and conscience, his moral/​religious decision to abstain from blood.

Numerous reports of major surgery on Witness patients show that many physicians can, in good conscience and with success, accommodate the request not to employ blood. For example, in 1981, Cooley reviewed 1,026 cardiovascular operations, 22% on minors. He determined “that the risk of surgery in patients of the Jehovah’s Witness group has not been substantially higher than for others.”⁠⁶ Kambouris⁠⁷ reported on major operations on Witnesses, some of whom had been “denied urgently needed surgical treatment because of their refusal to accept blood.” He said: “All patients received pretreatment assurances that their religious beliefs would be respected, regardless of the circumstances in the operating room. There were no untoward effects of this policy.”

When a patient is a Jehovah’s Witness, beyond the matter of choice, conscience comes into the picture. One cannot think only of the physician’s conscience. What of the patient’s? Jehovah’s Witnesses view life as God’s gift represented by blood. They believe the Bible’s command that Christians must “abstain from blood” (Acts 15:28, 29).⁠⁸ Hence, if a physician paternalistically violated such patients’ deep and long-held religious convictions, the result could be tragic. Pope John Paul II has observed that forcing someone to violate his conscience “is the most painful blow inflicted to human dignity. In a certain sense, it is worse than inflicting physical death, or killing.”⁠⁹

While Jehovah’s Witnesses refuse blood for religious reasons, more and more non-Witness patients are choosing to avoid blood because of risks such as AIDS, non-A non-B hepatitis, and immunologic reactions. We may present to them our views as to whether such risks seem minor compared to the benefits. But, as the American Medical Association points out, the patient is “the final arbiter as to whether he will take his chances with the treatment or operation recommended by the doctor or risk living without it. Such is the natural right of the individual, which the law recognizes.”⁠¹⁰

Related to this, Macklin⁠¹¹ brought up the risk/​benefit issue regarding a Witness “who risked bleeding to death without a transfusion.” A medical student said: “His thought processes were intact. What do you do when religious beliefs are against the only source of treatment?” Macklin reasoned: “We may believe very strongly this man is making a mistake. But Jehovah’s Witnesses believe that to be transfused . . . [may] result in eternal damnation. We are trained to do risk-benefit analyses in medicine but if you weigh eternal damnation against remaining life on earth, the analysis assumes a different angle.”⁠¹¹

Vercillo and DuPrey⁠¹² in this issue of the Journal refer to In re Osborne to highlight the interest in ensuring the security of dependents, but how was that case resolved? It concerned a severely injured father of two minor children. The court determined that if he died, relatives would materially and spiritually care for his children. So, as in other recent cases,⁠¹³ the court found no compelling state interest to justify overriding the patient’s choice of treatment; judicial intervention to authorize treatment deeply objectionable to him was unwarranted.⁠¹⁴ With alternative treatment the patient recovered and continued to care for his family.

Is it not true that the vast majority of cases physicians have confronted, or likely will, can be managed without blood? What we studied and know best has to do with medical problems, yet patients are human beings whose individual values and goals cannot be ignored. They know best about their own priorities, their own morals and conscience, which give life meaning for them.

Respecting the religious consciences of Witness patients may challenge our skills. But as we meet this challenge, we underscore valuable liberties that all of us cherish. As John Stuart Mill aptly wrote: “No society in which these liberties are not, on the whole, respected, is free, whatever may be its form of government . . . Each is the proper guardian of his own health, whether bodily, or mental and spiritual. Mankind are greater gainers by suffering each other to live as seems good to themselves, than by compelling each to live as seems good to the rest.”⁠¹⁵

[References]

1. Appelbaum PS, Roth LH: Patients who refuse treatment in medical hospitals. JAMA 1983; 250:1296-1301.

2. Macklin R: The inner workings of an ethics committee: Latest battle over Jehovah’s Witnesses. Hastings Cent Rep 1988; 18(1):15-20.

3. Bouvia v Superior Court, 179 Cal App 3d 1127, 225 Cal Rptr 297 (1986); In re Brown, 478 So 2d 1033 (Miss 1985).

4. In re Storar, 438 NYS 2d 266, 273, 420 NE 2d 64, 71 (NY 1981).

5. Rivers v Katz, 504 NYS 2d 74, 80 n 6, 495 NE 2d 337, 343 n 6 (NY 1986).

6. Dixon JL, Smalley MG: Jehovah’s Witnesses. The surgical/​ethical challenge. JAMA 1981; 246:2471-2472.

7. Kambouris AA: Major abdominal operations on Jehovah’s Witnesses. Am Surg 1987; 53:350-356.

8. Jehovah’s Witnesses and the Question of Blood. Brooklyn, NY, Watchtower Bible and Tract Society, 1977, pp. 1-64.

9. Pope denounces Polish crackdown. NY Times, January 11, 1982, p A9.

10. Office of the General Counsel: Medicolegal Forms with Legal Analysis. Chicago, American Medical Association, 1973, p 24.

11. Kleiman D: Hospital philosopher confronts decisions of life. NY Times, January 23, 1984, pp B1, B3.

12. Vercillo AP, Duprey SV: Jehovah’s Witnesses and the transfusion of blood products. NY State J Med 1988; 88:000-000.

13. Wons v Public Health Trust, 500 So 2d 679 (Fla Dist Ct App) (1987); Randolph v City of New York, 117 AD 2d 44, 501 NYS 2d 837 (1986); Taft v Taft, 383 Mass 331, 446 NE 2d 395 (1983).

14. In re Osborne, 294 A 2d 372 (DC Ct App 1972).

15. Mill JS: On liberty, in Adler MJ (ed): Great Books of the Western World. Chicago, Encyclopædia Britannica, Inc, 1952, vol 43, p 273.

From Our Readers

Cleanliness

Reading “Meeting the Challenge of Cleanliness” (September 22, 1988) made me reflect on how I myself was brought up. To tell you the truth, it was in an unhygienic and unsanitary condition, all because of ignorance and lack of knowledge. After reading this issue, I just wonder how I was able to stay alive in those unhealthy conditions. Also, thank you for the helpful checklist on pages 10 and 11. It helped me to stop putting things off. I right away cleaned up the cupboards, etc. I fought a war and gained the victory over the cockroaches.

S. M., St. Lucia, West Indies

Children Dying

As a doctor, I would like to express my reaction to “Millions of Children Are Dying​—What Could Save Them?” (September 22, 1988). I appreciate the measures mentioned in order to check this slaughter: better nutrition (primacy given to breast-feeding) and better hygiene. However, you cite vaccinations as one of the measures intended to save lives. You avoid “getting your feet wet” by stating that Awake! does not recommend one type of medical treatment over another. In my opinion, the fact that you publish this information amounts to taking sides. Is it not dangerous to put community interests ahead of individual interests? The number of morbid, even mortal, complications prove that man has been polluted by vaccinations.

D. G., M.D., France

I always find your articles interesting, and I appreciate your review. However, in your September 22 issue, you appear to be badly informed about the effectiveness and dangers of vaccinations.

J. V., France

Many things people do in seeking improved health are less than desirable. Some take medicines that have undesirable side effects, believing that the benefits outweigh the risks. Many view vaccines similarly. We consider vaccination to be a personal matter, though one must accept any legal consequence of his or her decision.​—ED.

Parents’ Homework

When we visited schools with the magazine “Parents​—You Have Homework Too!” (September 8, 1988), we were told that it must first be presented to the Superintendent of Schools. When I returned after having left a copy with his secretary, I suggested leaving a few issues in the teachers’ lounges. But he said: “Better yet, I have read the information, so why don’t you bring about a hundred copies to my office, and we will distribute them to all the teachers.”

K. A., United States

I am an assistant principal in an elementary school of 655 students. After I left a copy of Awake! with the principal, he decided to do a series of letters to the parents based on this fine issue. At first he was concerned that the publisher might not wish him to quote from Awake!, but I assured him that this would be no problem. However, you may wish to assure him of this also.

S. S., United States

We have no objection to information in “Awake!” being used for such purposes as long as “Awake!” is credited as its source.​—ED.

Watching the World

Bishops Resent Curbs

Roman Catholic bishops in the United States continue to struggle for greater freedom to interpret church teachings for American Catholics. In the latest round, the National Conference of Catholic Bishops voted 205 to 59 to reject a proposed Vatican policy paper that would undermine their authority to act as a group. They resolved that “it should be replaced with another draft.” One bishop compared the Vatican proposal to “a used car that could not be fixed, regardless of how much money you pour into it.”

Quake Killer

After almost 20 years, Chinese officials have publicly revealed that an earthquake measuring 7.7 on the Richter scale shook southern Yunnan Province in 1970 and killed about ten thousand people. The information was revealed when they corrected the death count for an earthquake in that same area last November 6, which injured 4,015 people and left 300,000 homeless. The revised death toll for the 1988 quake stands at 730 people, down from 938.

Bloodless Transplants

A recent study found that kidney transplant recipients who did not receive blood transfusions prior to surgery had survival and organ function rates similar to those of kidney patients who did receive transfusions. Researchers at the University of Minnesota compared Jehovah’s Witnesses, who refused blood transfusions for religious reasons, to a control group of non-Jehovah’s Witnesses who received kidneys along with transfusions. Their findings were published in the June 1988 issue of Transplantation.

Hitchhiking Risky

While hitchhikers may travel cheaply in a monetary sense, there is a hidden cost they may not count on​—their lives! According to German police, 57 hitchhikers, male and female, were murdered in the Federal Republic of Germany between 1980 and 1987. Another 40 “narrowly escaped a murder attempt,” comments the German newspaper Frankfurter Allgemeine Zeitung. Hitchhiking is a risky business.

Violent Entertainment

One week’s television programming in France yielded a crop of 670 murders, 15 rapes, 27 tortures, and 20 scenes of sex. “Each day they [televiewers] witnessed more murders and aggressions than are committed in a city like Paris in a year,” reports the French weekly Le Point. What are the consequences of viewing such violence? One police officer commented: “When questioned, rapists are often surprised that rape is prohibited by law. In some ways television is opening the way to considering such things as everyday features of life.”

Computerized ‘Lord of Hades’

Statues of Enma, the Japanese deity who rules Hades and judges whether humans have been good or bad, are not frightening Japanese children into obedience the way they used to. Therefore, one priest in Tokyo plans to use computerization to make the Enma at Hojoin Temple more terrifying. The Enma, 11 1/2 feet [3.5 m] tall, will now be activated when a coin is inserted and one of 12 prayers is selected. His angry red face will suddenly light up, and he will thunder out such questions as, “Can you say that you have never told a lie? Have you never borne a nasty thought toward others . . . ?” The priest hopes Enma’s questions will motivate people to improve their personality.

Train Surfing

Youths in Rio de Janeiro, Brazil, have taken up a deadly new sport: train surfing. Too poor for ocean surfing, they seek thrills by standing on top of speeding commuter trains. The stunt often amounts to suicide. As the electric-powered trains barrel along at speeds of up to 75 miles per hour [120 km/​hr], surfers are often swept off or electrocuted on the power cables. In one 18-month period, some 200 were killed, with another 500 injured. A State prosecutor blames inflation and social problems for the youths’ indifference to the danger of their “sport.” Agrees a bereaved father: “Brazilian youth is suffering so much, they see no reason to live.”

Preventable Deaths

The main causes of preventable deaths in Britain are tobacco and alcohol, says the chief medical officer for the British government, Sir Donald Acheson. His recently released report, On the State of the Public Health for the Year 1987, also calls attention to innocent victims of these two dangers​—the unborn in the womb, nonsmokers who inhale other people’s smoke, and victims of drunk driving.

Zero Growth

While many Third World countries are grappling with a population explosion, “Australia’s birth rate slipped 11 per cent below zero population growth last year,” reports The Sydney Morning Herald. What does that mean? It means that “Australia’s population would rapidly age and decline” were it not for immigration, notes the Herald. According to the report, statistics for the past 12 years have shown Australia’s birthrate to be well below the rate of replacement. The increasing trend among women to postpone childbearing so they can work longer for material assets is cited as contributing to the decline of the birthrate.

Indoor Pollution

Energy-efficient homes are posing a major health problem. The reason? They trap indoor pollutants, says a Canadian building designer and environmental researcher. He claims that “cleansers, perfumes, air fresheners, disinfectants, polishes, waxes and glues can cause skin irritations,” reports The Toronto Star. Dr. William Chodirker, chief of immunology and allergy service at the University Hospital in London, Ontario, says that about 15 percent of the population suffer from allergic reactions to items inside their homes. He points to asthma as the most common medical problem triggered by household items. In airtight, energy-efficient homes, heating and cooling systems recirculate pollutants and intensify the problem.

Rabies Advancing

Only seven countries in the world remain rabies-free, reports The Independent of London. Five are in the Northern Hemisphere (Britain, the Republic of Ireland, Sweden, Iceland, and mainland Norway) and two (Australia and New Zealand) are in the Southern Hemisphere. However, recent outbreaks of the disease have prompted Scandinavian authorities to put their counties above the Arctic Circle on full alert to prevent the disease from spreading further. Rabies is already endemic across the Arctic regions, including Greenland, Siberia, and Alaska. Although domestic animals and reindeer have apparently been unaffected thus far, red foxes, polar foxes, mink, and wolverines are victims of this advancing killer disease.

Marauding Locusts

“The world’s worst locust plague” in a quarter century is making its way through northern Africa, damaging whatever crops are in its path, reports The Economist of England. Originating three years ago in Ethiopia, the locust outbreak is now threatening 65 countries. The UN Food and Agriculture Organization estimates that the plague will continue for another two years before it is brought under control. Because of its voracious appetite, a migrating desert locust is able to consume daily the equivalent of its own weight. Thus, a one-third-square-mile [1 sq km] section of a swarm, containing about 50 million locusts, “can devour as much food in a day as a village of 500 people will eat in a year,” says The Economist.

Goliath​—A Giant With Culture?

WHO has not heard the historical account of young David’s encounter with the Philistine giant Goliath? (1 Samuel 17:23-51) According to Bible chronology, this fight occurred about the year 1100 B.C.E. But what can be said of Philistine culture in those days?

During the past seven years, excavations of what is believed to be ancient Ekron, a major Philistine city in David’s day, have revealed that the Philistines were master builders with advanced notions of city planning. Last summer, for example, a 2,300-square-foot [210 sq m] complex was unearthed. It is the largest building known from the period of Philistine prominence (from the 12th to the 10th century B.C.E.). Excavation of the 50-acre [20 ha] site revealed a method of terracing the city in a stepped-down fashion to utilize natural water runoff. Archaeologist Seymour Gitin marveled: “It was a highly sophisticated way of building.”

Excavations also produced large quantities of exquisite pottery decorated with birds, fish, and geometric designs. Also discovered were four-horned religious altars, storage jars possibly for olive oil, and metal implements. All these items demonstrate the skill and the advanced culture of the ancient Philistines. Gitin noted: “The Philistines . . . introduced a new culture in this part of the world. Eventually they became a great trading power and a powerful industrial nation.”

[Picture on page 31]

Philistine pottery of this type was recently found at the site of ancient Ekron

The Mysterious Beasts of Revelation

Do you know the significance of this grotesque beast? What is the meaning of the other beasts of the Bible book of Revelation?

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