Abortion: the Adventist dilemma
In the early 1980s the refugee camp at Sangkhla in southern Thailand received large numbers of Vietnamese who had crossed the Gulf of Thailand. Many of the refugee women had been raped by marauding fishermen. On arrival at Sangkhla, a significant number of the refugees were found to be pregnant and suffering from venereal dis ease. For reasons of conscience the Catholic physicians in the camp refused to perform abortions. Adventist doctors there were faced with requests to terminate such pregnancies, which, after careful deliberation, they agreed to do.1
This is one example of Adventist practice with regard to abortion in exceptional circumstances. The contrast between Adventist and Catholic responses in less extreme situations would not, however, be so marked. Indeed many Adventists would be sympathetic to the peaceful pro-life campaigns waged by Catholics.
The above case highlights the predicament in which Adventists find them selves over abortion. On the one hand, their theology inclines them toward a conservative, anti-abortion stance. On the other, they operate an extensive net work of hospitals around the world, to which many women have turned at a time of personal crisis no less deep, in their opinion, than that of the Vietnamese women.
The Adventists' dilemma is compounded by the fact that the major sources to which they normally turn for direction in matters of faith and practice the Scriptures and the writings of Ellen White are silent, or at least less than unequivocal about abortion. Some have argued cogently that there is an anti-abortion ethic implicit in Scripture. A recent MINISTRY article, containing a careful interpretation of Exodus 21:22, 23, was a persuasive example of this viewpoint.2
Others believe that even though abortion is offensive to them personally, it is impossible to derive an imperative on the matter from Scripture. They argue that those passages commonly used to support the anti-abortion stance (e.g., Jer. 1:4,5; Ps. 139:13-16; Eccl. 11:5) do not directly address the issue. Even the sixth commandment has to be reconciled with the scriptural claim that there is "a time to kill" (Eccl. 3:3).
Ellen White's writings are equally in conclusive. It is not difficult to select quotations from her writings to support the view that abortion violates the purpose of God, and as such is a sinful act. The following is but one example: "Life is mysterious and sacred. It is the manifestation of God Himself, the source of all life. Precious are its opportunities, and earnestly should they be improved. Once lost, they are gone forever. . . .
"God looks into the tiny seed that He Himself has formed, and sees wrapped within it the beautiful flower, the shrub, or the lofty, wide-spreading tree. So does He see the possibilities in every human being." 3
It is safe to conjecture that Ellen White found abortion a deeply repugnant act. It is interesting, however, that she refrained from condemning it, even though it was of widespread concern in society in her day.4 While there are, no doubt, perfectly adequate reasons that she omitted any reference to abortion in her work, the point here is simply that at no time did Ellen White directly address the issue in a way that could supply a norm for Adventists.
Thus an editorial writer in the Adventist Review was prompted to observe that "our church leaders have noted that neither the Bible nor Ellen White say any thing definite about elective abortion. They have felt that where Inspiration is silent, we should not legislate."5
Since church leadership has not taken a clear stand against abortion, it is not surprising that church members hold widely divergent views. The issue arouses strong emotions whenever it is discussed, and a number of tensions have developed in Adventism concerning it.
Institutional v. individual norms
In 1971 MINISTRY magazine published a set of guidelines recommended by the General Conference officers to be fol lowed by Adventist medical institutions on the matter of abortion.6 That same year a study committee amended and considerably liberalized these guidelines (see "Abortion guidelines for Adventist medical institutions" in this issue of MINISTRY). The recommendations closely resemble the model code created by the American Law Institute and the provisions that were later enshrined in law by the Supreme Court ruling of 1973. It was a relatively liberal provision and very much in the spirit of the age. It stated that therapeutic abortions could be performed when the following indications were established:
"1. When continuation of the pregnancy may threaten the life of the woman or impair her health.
"2. When continuation of the pregnancy is likely to result in the birth of a child with physical deformities or mental retardation.
"3. When conception has occurred as a result of rape or incest.
"4. When the case involves an unwed child under 15 years of age.
"5. When for some reason the requirements of functional human life demand the sacrifice of the lesser potential human value.
"When indicated interruptions of pregnancy are done, they should be per formed as early as possible, preferably during the first trimester of pregnancy."
It is not difficult to understand why the church should have adopted a relatively permissive policy for abortion practice in its hospitals. First, it could be argued that the church administration felt a responsibility to give physicians the right to per form procedures they considered necessary for meeting patients' needs. The administrators left it up to individual physicians and hospital ethics commit tees to apply the highest professional and Christian standards in formulating policies and making decisions.
But the fact that many of the physicians employed in obstetric and gynecological facilities were not Adventists complicated the issue, diluting the distinctive ethos of denominational hospitals. The same sort of process was observed in Roman Catholic hospitals in Belgium. Furthermore, Adventist hospitals have to function as facilities for the wider community, and face the pressure of a demand that derives from a secular source. The prospect of a growing secularization in Adventist hospitals is only heightened when the network of denominational health-care facilities grows significantly, as it has done recently.
Rightly or wrongly, some Adventist hospitals are perceived to have a relatively permissive attitude toward abortion. This contrasts sharply with the recommendations for personal behavior that have been carried regularly by Adventist periodicals over the past 15 years. Following the publication of the General Conference guidelines, the Review and Herald published an article that implicitly opposed them. Articles printed subsequently in the Review, MINISTRY, Insight, Spectrum, and denominational family magazines, have consistently defended an anti-abortion stance.
So we face a situation in which recommendations for personal behavior appear to conflict with standards for institutional practice. It should not surprise us if members, discerning what they take to be an ambivalence in standards, some times use abortion as a way out of personal crisis.
Difference in Adventist practice
This ambivalence in Adventist attitudes is reflected in the way in which practice varies with location. A survey of practice in Adventist hospitals in the United States showed considerable regional variation. 10
Some hospitals in the East and South apparently approve or provide no abortion services whatever. One facility re corded only three abortions among 5,000 admissions to the Ob-gyn department, but another institution, farther west, had one abortion in every nine admissions to the Ob-gyn facility.
A similar piece of research carried out in Adventist hospitals outside the United States offered an instructive comparison. 11 Most such hospitals were situated in the Third World and followed strict policies. Some were located in countries where abortion was illegal and merely complied with the law. Even those located in countries where the law was more permissive performed abortions only when there were pressing medical indications, particularly when the life of the mother was threatened. Some hospitals refused to perform an abortion on the ground that it was an immoral act.
Explanations of the incongruity be tween Adventist attitudes in the western United States and in the Third World may be sought in several directions. It may be that believers in the Third World perceive behavioral and doctrinal matters in more clear-cut terms. Or the attitudes of physicians who are attracted to mission service may tend toward the conservative end of the spectrum. It would also be inevitable that practice would vary somewhat in accordance with the general social expectations in a given culture.
Development of public opinion
The publication of the General Conference guidelines antedated the U.S. Supreme Court ruling by almost two years. But that ruling was only the culmination of a process of evolution in public opinion that had begun a decade before with the distressing realities brought about by the thalidomide tragedy and several severe epidemics of rubella. Thus, though the denominational guide lines undoubtedly reflected the spirit of the age, they were, in part, borne of a genuine humanitarian concern to meet the needs of women whose pregnancies brought them deep distress.
Since the Supreme Court ruling, more than 20 million pregnancies have been terminated in the United States, many for rather flimsy reasons. At the same time there has been a general shift to the right in American public opinion. With its 1971 guidelines still in place, the Adventist Church now finds itself to the left of center in the spectrum of opinion on this issue. The church is uncomfortable with the resulting perception that it has struck a liberal pose. It may also be uncomfortable with the fact that individual members may understand the permission granted in denominational policy to be moral legitimation of abortion.
Abortion and the Adventist ethos There is some disagreement over the extent to which religious affiliation affects readiness to terminate an unwanted pregnancy. Some have argued that the evidence demonstrates that, in an emergency, churchgoers seek abortion regard less of their own religious convictions or the official position of their church and that the main effect of religious affiliation is not to stop abortion but to create problems of conscience. 12 On the other hand, some observers find evidence to suggest that the more religiously active a woman is, the more likely she is to op pose abortion as a personal option.
Others contend that what may appear to be a religious dimension to the issue is in fact a function of socioeconomic factors. In other words, denominations tend to attract their members from a particular part of the socioeconomic spectrum, with its own characteristic norms, expectations, and strategies for solving problems. Variations in attitudes to abortion and in actual resort to it will basically reflect social differences rather than religious principles. 13 If this is the case, what socioeconomic influences at work within Adventism may affect the resort to abortion?
Adventists are, as a group, occupationally ambitious. Obtaining a good education has high priority among them. An unplanned pregnancy might seriously disrupt the plans of a young Adventist couple who had high vocational aspirations. Similarly, an Adventist couple in a higher age category who wished to provide a denominational education for their children might find that goal jeopardized by an unplanned pregnancy.
Moreover, there is considerable evidence to show that those who use birth control techniques efficiently are more likely to resort to abortion in the event of contraceptive failure than those who do not. 14 It is also clear that Adventists em ploy contraceptive techniques carefully and efficiently. Purely according to the criterion of socioeconomic status, then, Adventist women seem to figure strongly as candidates for abortion in the event of an unwanted pregnancy.
Bernard Haring, the eminent Catholic moral theologian, has observed that in the United States, legality is often taken to confer moral Tightness on behavior. 15 Adventists have generally been careful in performing their civic responsibilities and in maintaining solidarity with the surrounding society where possible. It is conceivable therefore that legalization of abortion has shaped Adventist perceptions of its morality.
On the other hand, certain attitudes inherent in Adventism are likely to have an influence against abortion. Advent ism encourages its members to cultivate great moral sensitivity, so many members undoubtedly regard abortion as a sinful act. For them the dominant reaction after abortion is likely to be guilt rather than relief. The anticipation of postabortal-guilt probably encourages some to carry their pregnancy to term. The strong emphasis in Adventism on the maintenance of good physical health might also incline a woman to carry an unwanted pregnancy to term rather than submit her body temple to an unnatural procedure and its possible complications.
Plausible though such explanations may be, we prefer to believe that our decisions are rational and derive from a spiritually sensitive conscience. What elements in Adventist theology might figure in the abortion decision? The doctrine of conditional mortality is clearly relevant to the debate, though surprisingly little has been said about it in Adventist publications. The Catholic view that a soul is infused into the embryo at conception, and that it, as an inheritor of original sin, must not be allowed to perish without baptism, clearly dictates a certain course of action. In contrast, Adventists believe neither that there exists a separate entity called a soul, nor that baptism is essential to salvation. They prefer to say that man "becomes a soul" rather than that he "possesses a soul." Soul is therefore understood to mean both "life" and "individuality." 16 This then allows them to say that "a new soul comes into existence every time a child is born." 17 which might seem to permit some concession to the abortion option.
On the other hand, this view of humanity means that a soul cannot exist without a body. Possessing a body material entity is part of what it means to be a soul. Thus it could be argued that since a material entity with a unique genetic inheritance is formed at conception, a soul exists from that point and absolute value should be attached to it.
Adventist doctrine overlaps with the abortion issue at several other points, and we as a church can only acknowledge our delinquency in failing to chart the area more adequately.
Strong belief in an imminent Second Advent might, for example, lead some to ignore one common justification for abortion—the spiralling world population. Adventists might argue that no humanly contrived strategy could avert the march to ecological disaster and thus that no embryos should be sacrificed to this lost cause.
The strong Adventist attachment to the Decalogue might encourage some members to avoid abortion for fear of transgressing the sixth commandment.
A common argument in favor of termination is that in the evolutionary process the body has developed a mechanism for aborting abnormal fetuses. It is then asserted that induced abortion is, in cases of abnormal development, only an extension of that process. Adventists are more likely to believe that it is the prerogative of a personal, interventionist God to dispose of human life.
Much remains to be done in grounding our ethics securely in our doctrine.
It cannot be denied that the Adventist approach to the question of abortion has been pragmatic. The absence of any sustained debate within the denomination has averted a debilitating internal dispute and prevented the church from be coming involved in a wider and highly politicized debate. It has had the further virtue of allowing church medical institutions to respond in a flexible way to the kind of need experienced at the Thai refugee camp. The major disservice of such an approach has been that the church has failed to demand of its leaders and its scholars a careful investigation of ethical concerns. The danger is that Adventist moral action may sometimes lack consistency and may gradually become merely an ethic of self-interest.
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1. Roy Branson, "Massacre at Sea," Spectrum, vol. 12, No. 3, pp. 22-24.
2. Richard Miiller, "Abortion: a Moral Issue?" MINISTRY, January 1985, pp. 18-20, 31.
3. The Ministry of Healing, p. 397. Other statements can be found in Patriarchs and Prophets, p. 516; manuscript 43, 1900; Counsels on Health, p. 41; Testimonies, vol. 2, p. 378; letter 16a, 1861.
4. See A Solemn Appeal to the Church, pp. 100, 101. This volume, published by James White, and to which Ellen White was the major contributor, contained a couple of pages of anti-abortion sentiment by a non-Adventist. Furthermore, the Whites' protege, John H. Kellogg was very much alive to the issue and wrote vehemently against the practice.
5. EugeneF. Durand, "About Abortion,"Adventist Review, Sept. 1, 1983, pp. 13, 14.
6. MINISTRY, March 1971, p. 11.
7. Survey of abortion practice in Adventist hospitals in the United States completed for "Seventh-day Adventist Responses to Some Contemporary Ethical Issues" (Ph.D. thesis by Michael Pearson submitted to the University of Oxford, 1986).
8. Karel Dobbelaere, "Professionalization and Secularization in the Belgian Catholic Pillar," Japanese Journal of Religious Studies 6, Nos. 1, 2 (March-June 1979): 39-64.
9. W. G. Dick, "A Look at Abortion," Review and Herald, May 13, 1971, p. 11.
10. Pearson, pp. 120-122.
11. lbid.,p. 123.
12. Malcolm Potts, Peter Diggory, and John Peel, Abortion (Cambridge: Cambridge University Press, 1977), p. 119.
13. D. Callahan, Abortion: Law, Choice, and Morality (New York: Macmillan, 1970), p. 298; N. B. Ryder and C. F. Westoff, Reproduction in the United States: 1965 (Princeton, N.J.: Princeton University Press, 1971), p. 279.
14. Potts, Diggory, and Peel, pp. 454-504.
15. B. Haring, "A Theological Evaluation," by J. T. Noonan, ed., Morality of Abortion: Legal and Historical Perspectives (Cambridge, Mass.: Harvard University Press, 1970), pp. 142, 143.
16. Seventh-day Adventists Answer Questions on Doctrine, pp. 511-519.
17. Ibid., p. 512.