Consensus of 25 evangelical scholars who participated inA PROTESTANT SYMPOSIUM ON THE CONTROL OF HUMAN REPRODUCTION, Aug. 27–31, 1968.
Theological Basis
Prologue. We affirm that ultimate values come from God through divine revelation rather than from the “human situation” alone. For some questions the Scriptures provide specific answers as concerning the sacredness of marriage and the wrongness of sexual intercourse outside that relationship. In other situations the Bible speaks primarily through principles such as the sacredness and value of human life, the need to act in love for God and man. Where specific counsel is lacking, Christians acting under the authority of Scripture may differ from each other in the conclusions they reach because different weight may be given to different principles.
The Christian whose mind is committed to God is obligated to understand as fully as possible the problems that confront him and to enunciate with clarity the biblical principles underlying his decision. He recognizes that the will of God may become known to him more fully through discussion and interaction with men of like faith. Even so, while a symposium can provide information and direction it cannot speak with binding authority where the Bible is unclear. Each man is ultimately responsible before God for his own actions, and he cannot relinquish this responsibility to others no matter how qualified they may appear to be.
The Character of Sexual Intercourse as a Means of Procreation and as an Expression of Fellowship and Married Love. Sexual intercourse is the gift of God and shall be expressed and experienced only through the marriage relationship. In this act, husband and wife become one flesh; for Christians this union is ennobled by God and is likened in Scripture to the union between Christ and his Church. Coitus was intended by God to include the purposes of companionship and fulfillment, as well as procreation. Any marriage which does not seek to fulfill both of these sexual functions constitutes a deformed relationship. The Bible asserts that procreation is one purpose of marriage and considers children to be an evidence of God’s blessing. The divine ideal is for all of nature, including man, to be fertile. It is not merely the notion of a static balance but of a dynamic and abundant society. Procreation, however, is not the sole purpose of the sexual relationship even as sex is not the sole component of the marriage relationship.
God intended sexual intercourse to be continued and to be enjoyed even when or after procreation is impossible. Therefore procreation need not be the immediate intention of husband and wife in the sex act, which may be simply the expression of love and of a desire for the mutual fulfillment of normal human needs.
The Prevention of Conception. Because of the Christian’s high view of the sexual relationship, contraception often presents complicated ethical questions. This is true whether the individual employs so-called natural means (coitus interruptus and rhythm), or medicine, mechanical devices, and other methods.
The Bible does not expressly prohibit either contraception or abortion but it does set forth certain governing principles such as the sanctity of life, the command to multiply, and the apostolic injunction for husband and wife to satisfy each other’s sexual needs.
The prevention of conception is not in itself forbidden or sinful providing the reasons for it are in harmony with the total revelation of God for the individual life. Disease, psychological debility, the number of children already in the family, and other factors such as financial capability are among those that determine whether pregnancy should be prevented. The method of preventing pregnancy is not so much a religious as a scientific and medical question to be determined in consultation with the physician. Of all the methods of contraception that of sterilization presents the most difficult decision because it impairs God’s creative activity in man and is usually irreversible. Yet there may be times when a Christian may allow himself (or herself) to be sterilized for compelling reasons which appear to be the lesser of two evils.
Induced Abortion, the Fetus, and Human Responsibility.1Unless otherwise specified, when the word “abortion” without modifiers is used in the text, the writer means induced abortion and not spontaneous abortion. In addition, unless otherwise specified, the word fetus is used in reference to the offspring from the time of wnception until birth. We are left with the most perplexing questions of all: Is induced abortion permissible and if so, under what conditions? If it is permissible in some instances does this mean that the act of intervention is sinful? Can abortion then be justified by the principle of tragic moral choice in which one evil is chosen to avoid a greater evil? Whether or not the performance of an induced abortion is sinful we are not agreed, but about the necessity and permissibility for it under certain circumstances we are in accord.
The Christian physician who is asked to perform an abortion will seek to discover the will of God in this as in every other area of his life. He needs divine guidance for himself in his practice and for the counsel of his patients. The physician in making decisions should take into account the following principles:
—The human fetus is not merely a mass of cells or an organic growth. At the most, it is an actual human life or at the least, a potential and developing human life. For this reason the physician with a regard for the value and sacredness of human life will exercise great caution in prescribing an abortion.
—The Christian physician will advise induced abortion only to safeguard greater values sanctioned by Scripture. These values may be individual, familial, or societal.
—From the moment of birth, the infant is a human being with all the rights which Holy Scripture accords to all human beings; therefore infanticide under any name should be condemned.
Christian Conscience, Natural Law, and Legal Authority. The Scriptures clearly inform us that all men are bound by God’s moral law. Because of sin, men are severely limited in their ability to perceive the content of this law. Apart from the guidance of Scripture, too easily do they equate it with the mores of their particular culture. Nor do we believe that ethical judgments can be based on the situation alone. While the physician must consider the individual circumstances present in each situation, his evaluation must be controlled by biblical laws and principles.
The fallenness of human nature requires the guidance of laws and regulations prescribed for the benefit of society and administered in recognition of the ultimate authority of God who is the supreme law giver. Harmful pressures easily result from the codification of law in a way that is either too authoritarian or too permissive. The Christian maintains that in avoiding legalism on the one hand and license on the other, the prescriptions of the legal code should not be permitted to usurp the authority of the Christian conscience as informed by Scripture.
Principles Of The Christian Physician In The Control Of Human Reproduction
The rendering of guidance is basic to a physician’s concern and effective work. This may well result in the confession of his view of life as a Christian. In the realm of the control of human reproduction, his view of Christian life is reflected in the following biblical principles:
Sanctity of Family Life
—Marriage is sanctified as a God-given institution. It is life-long and secure in love. Husband and wife live for each other and in God’s service.
—Children are God’s gift, born into the love and security of family for nurture and training.
Responsibility, Fulfillment, Self-discipline, and Divine Grace in Sexual Relationship
—Sexual relationship is a good and perfect gift from God to mankind, but this, like all of God’s good gifts, has been marred by the effects of sin on human thought, will, and action. The forgiveness and the grace of God are a constant human need.
—Sexual intercourse is rightly confined to marriage. Therefore, fornication, adultery, and prostitution with or without contraception are not a Christian option.
—Sexual intercourse is to be undertaken with understanding and consideration.
Preservation of God-Given Life
—It is the duty of physicians to preserve human life and the integrity of the human body.
—Physicians are called upon to maintain and restore the health of the whole man.
Mitigation of the Effects of Evil. We live in a world pervaded by evil. Human relationships become distorted; unwanted children are born into the world; genetic defects are not uncommon and harmful social conditions abound. Therefore, it is the duty of Christians to be compassionate to individuals and to seek responsibly to mitigate the effects of evil when possible, in accordance with the above principles.
Guidelines For Professional Practice*
The Prevention of Conception. This Symposium on the Control of Human Reproduction affirms the role of the physician in the support of the integrity of the family. The partners in marriage should have the privilege of deciding the number of children to have in their family. The physician should cooperate by providing counseling, taking into consideration both medical and moral factors. It is recognized that at times permanent sterilization, of either male or female, may be indicated. If contraception is indicated, the physician should assist in selecting the best available method for this purpose. In some countries in the foreseeable future, the intra-uterine device (I.U.D.) is expected to be the preferred contraceptive method.
The single person seeking contraceptive advice requires concerned counseling by the physician. If he provides contraceptive agents, he participates in the intent of their use.
Induced (Therapeutic) Abortion. The sanctity of life must be considered when the question of abortion is raised. Regardless of what stage of gestation—including birth—at which one considers the developing embryo or fetus to be equivalent to an adult human, the potential of the developing intrauterine life cannot be denied. There could, however, be compelling reasons why abortion must be considered under certain circumstances. Each case should be considered individually, taking into account the various factors involved and using Christian principles of ethics. Suitable cases for abortion would fall within the scope of the American College of Obstetricians and Gynecologists Statement on Therapeutic Abortion. However, we believe that isolated sociological pressures that justify abortion rarely occur. We do not construe the A.C.O.G. Statement as an endorsement of abortion on demand or for convenience only.
THE AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS STATEMENT ON THERAPEUTIC ABORTION
Termination of pregnancy by therapeutic abortion is a medical procedure. It must be performed only in a hospital accredited by the Joint Commission on Accreditation of Hospitals and by a licensed physician qualified to perform such operations.
Therapeutic abortion is permitted only with the informed consent of the patient and her husband, or herself if unmarried, or of her nearest relative if she is under the age of consent. No patient should be compelled to undergo, or a physician to perform, a therapeutic abortion if either has ethical, religious, or any other objections to it.
A consultative opinion must be obtained from at least two licensed physicians other than the one who is to perform the procedure. This opinion should state that the procedure is medically indicated. The consultants may act separately or as a special committee. One consultant should be a qualified obstetrician-gynecologist and one should have special competence in the medical area in which the medical indications for the procedure reside.
Therapeutic abortion may be performed for the following established medical indications:
1. When continuation of the pregnancy may threaten the life of the woman or seriously impair her health. In determining whether or not there is such risk to health, account may be taken of the patient’s total environment, actual or reasonably foreseeable. 2. When pregnancy has resulted from rape or incest: in this case the same medical criteria should be employed in the evaluation of the patient. 3. When continuation of the pregnancy is likely to result in the birth of a child with grave physical deformities or mental retardation.
Changes in the state laws on therapeutic abortion that will permit honesty in the application of established criteria and the principles supported in this statement should be encouraged. Provisions should be included to protect the physician from legal action or medical liability should he refuse to perform the operation because he finds a particular abortion to be against his moral standard.
Fetal Indications for Prevention of Conception and for Therapeutic Abortion with Specific Reference to Genetic Considerations. Much human suffering can be alleviated by preventing the birth of children where there is a predictable high risk of genetic disease or abnormality. This appears to be a reasonable Christian objective.
An accurate diagnosis of genetic defect and statement of risk for subsequent pregnancies often can be based on examination of a single affected child. (Multiple abnormalities in a family are not essential to establish indications for intervention.) In some conditions a significant risk can be determined prior to the production of any children, through evaluation of the family history and laboratory tests. The assistance of a consultant who is a specialist in human genetics may be required.
When a genetic problem is encountered the physician should point out the implications for subsequent pregnancies. The parents should be helped to understand the medical, emotional, and financial problems involved in rearing a child with a congenital disease. The shortterm consequences of contraception and sterilization should be explored. The family may wish to consider other factors, but the decision concerning additional pregnancies should be left to them. If contraception is attempted but fails, the risk of severe defect in the child should constitute a fetal indication for abortion. On the other hand, the couple may prefer voluntary sterilization for husband or wife (the choice depending on the specific case). The preceding accepted precepts of sound clinical genetics accord with the principles of care for the individual and society on which we have agreed.
When an affected individual is not mentally competent to make decisions for himself, the genetic problems should be made clear to the guardian(s). In such circumstances, involuntary sterilization could be considered upon the request and express permission of the guardian(s).
The Christian in an Over-Populated World. The control of human reproduction demands the attention of Christians from the standpoint of the desperate needs not only of individuals and families but also of nations and peoples, including our own. This Symposium acknowledges the need for Christians’ involvement in programs of population control at home and abroad.
It is emphasized, however, that participation in programs of population control should be in response to requests for help from the states or communities involved, and that the services or counsel rendered should conform both professionally and ethically with the principles embodied in this Statement.
