COVID-19: A sign of the last days?

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“State Public Health Laboratory in Exton Tests for COVID-19”

 by Governor Tom Wolfe (CC BY)

The entire world is shut down in various forms. Never since Noah’s flood has the whole globe at one time endured the same catastrophe. So, publishers are seeing a spike in sales of books about the end times. And people are asking: Does COVID-19 signal the end is near?  

As it turns out, before all eyes turned to Wuhan, LifeWay Research already had questions in mind about the last days. So, they surveyed 1,000 people from two groups: evangelical pastors and historically Black denominational pastors. Between January 24 and February 11, 2020, Lifeway asked some questions about these pastors’ perceptions. And the results revealed that even before everyone’s least favorite pandemic, a lot of pastors in the USA felt that current events indicate Jesus’s return is imminent.

• 88 percent saw at least some current events matching those Jesus said would occur shortly before He returns

• 70 percent saw the modern rebirth of the state of Israel and the regathering of millions of Jewish people as fulfilling biblical prophecies

•  39 percent saw the establishment of the United States embassy in Jerusalem as a sign of the End Times 

My colleague, theologian Darrell Bock, said this in response: “When we look at pestilences and plagues and how they function in Scripture, what we see is that God doesn’t always use them with a specific signature to explain why He is doing it. Rather, He uses them as a reminder to us of our need for Him, our dependence upon Him, the fact that we are mortal and don’t control what is going on around us, that we need to pursue a relationship with Him and be aware of what He asks of us as human beings made in His image.” Bock added that he thinks if Lifeway were to redo the survey today, the numbers would be even higher. And a Youtube search supports his hunch. A video of pastor David Jeremiah talking about Covid-19 and the end times has garnered 1.8 million views. 

The Bible does not say specifically that in the last days we will have a global pandemic. It does, however, in 2 Timothy 3, list the following as being among the signs:

People will …

• Love their own selves. 

  • Might that include fighting for the right to keep our faces unmasked vs. showing deference in love?

  • Might that include fighting for the right to gather with more than “two or more” in His name when such actions are at the very least perceived to put others at risk? 

  • Be covetous.

    • Might that include hoarding rather than sharing toilet paper, meat, and cleaning supplies? 

    • Boast and be proud, be false accusers.

      • Might that include asserting we know more than all the experts? And/or posting and forwarding conspiracy theories, thereby adding to the slander of people at the center of them when we have no way to verify their guilt or innocence—and even if doing so makes people wonder if our belief in the resurrection is equally lacking in investigative rigor?  

      • Might that include slandering “the media,” as if all journalist are liars? 

      • Be unthankful.

        • Might that include “I know I have a full pantry and a job, but…” 

        • Having a form of godliness, but denying the power thereof. 

          • Might that include worship of a god in our own image whom we believe is always on America’s side? 

Events in our world are prompting people to reflect on their mortality. Surveys show it. Book sales show it. Youtube shows it. The trauma of COVID-19 is making many consider their lives in light of eternity. Yet many who name the name of Christ, rather than seeing in this pandemic the need to stay laser-focused on the gospel—reaching out across the world in word and deed—are sacrificing our credibility on less-important conversations, some of which call into question our commitment to love and/or sound thinking. If our insistence on our rights is louder than our commitment to self-sacrifice for the sake of love, maybe our beliefs are more rooted in the U.S. Constitution than in scripture.

Perhaps, based on what we find in 2 Timothy, we are indeed seeing indications that the end is near. But those indications don’t actually include the virus.  

The Table Podcast: Infertility & Pregnancy Loss

Dr. Julie Fuller and I talk with Dr. Darrell Bock about the marital, ethical, spiritual, and emotional challenges of infertility and pregnancy loss.

Thinking about Freezing Your Eggs?

In this video, WFAA-Dallas explores the emotional and technical process of women freezing their eggs to ensure future fertility. What do you think?

"The Student Body": Do Students’ BMI Tests Do More Harm Than Good?

When Bailey Webber interviewed people for her new documentary, The Student Body, she took a set of bathroom scales with her. And every person with whom she spoke, she asked, “Would you be willing to step on the scales so we can get your BMI?” To a person, they balked. Most ultimately refused, though some reluctantly agreed.A lot of kids in our schools don’t get the choice to decline. And then a letter arrives notifying them that they are too skinny or too fat.In the ground-breaking and excellently produced film she made with her dad, Bailey, a young journalist, tackles the heated topic of childhood obesity and misguided efforts to solve our national childhood obesity epidemic.And just what are those misguided efforts? Lawmakers in dozens of states have passed mandates requiring schools to perform body mass index (BMI) tests on students and then send letters stating their results. Coined the “Fat Letters” by students, these notifications go to kids whose bodies fall outside a narrowly acceptable range, essentially notifying children, even as young as kindergarten age, that they are abnormal. Sometimes the results are devastating.When a determined sixth grader in Ohio voiced her protest against the mandatory weigh-ins and the embarrassing letters, Bailey took up the girl's fight. Bailey's investigation is chronicled in The Student Body, the story of how she and a friend took on law-makers for their fat-shaming. But in it she also explores the broader complexities of childhood obesity.Hosted by The National Eating Disorders Association, the award-winning father/daughter team who made this film have been honored by the National Association of University Women. Michael Webber is a motion-picture producer and renowned documentary filmmaker whose film, The Elephant in the Living Room, I reviewed here in 2011.Although makers of The Student Body acknowledge that obesity is a real national crisis, the Webbers’ stance is that requiring kids to reveal their weight at school in addition to receiving impersonal notifications is cruel and bully-like behavior. Good intentions, perhaps, but horrible execution.Webber does interview those who support the BMI screenings/notifications. But the film is definitely weighted toward those who believe the notifications cause damage.The film has excellent production values, a bit of humor, and it'll inspire your faith in the next generation of journalists. Watch it with a young person and have a great discussion. Look for screenings near you this fall (and in video next year) and check out The Student Body web site. 

My latest novel: Lethal Harvest Remix

Sixteen years ago, a couple of wannabe novelists saw stem cell research on the horizon and launched our first narrative that explored the ethical side of such complex medical issues. Completely apart from our planning, the book launch happened the same week leaders at the Human Genome Project announced they had a rough draft of the human genome. And that announcement thrust our subject into the headlines, so books flew off the shelves.The characters in our story used landlines. And they could receive email only when using desktop computers. No smartphones, no texting. And acting according to what is now outdated medical procedure.So this month, Lethal Harvest re-released with a makeover. In the 15+ years since we wrote the story, I've grown as a writer and spinner of yarns. So when Kregel asked for an update, I jumped at the chance to improve on the dialogue, characterization, and general storyline—while, of course, updating the tech. My beloved coauthor passed suddenly three years ago, so the new book also includes a preface I wrote about him.So now...voila! The new and improved Lethal Harvest about a rogue doc at an IVF clinic.

On Beauty, The Senses, and Science

On Saturday, I organized some stacks of papers started before I got my PhD. The deadline has passed for blaming it on the busyness of school (I graduated in 2013!). In the stack I found some quotes I had saved that are worth sharing. . . .C. S. Lewis in Mere Christianity:There is no need to be worried by facetious people who try to make the hope of “Heaven” ridiculous by saying they do not want “to spend eternity playing harps.” All the scriptural imagery (harps, crowns, gold, etc.) is, of course, a merely symbolical attempt to express the inexpressible. People who take these symbols literally might as well think that when Christ told us to be like doves, he meant that we were to lay eggs.C. S. Lewis in Transposition and Other Addresses:How far the life of the risen [human] will be sensory, we do not now. But I surmise that it will differ from the sensory life we know here . . . as a flower differs from the bulb or a cathedral from an architect’s drawing.We do not want merely to see beauty. We want something else which can hardly be put into words—to be united with the beauty we see, to pass into it, to receive it into ourselves, to bathe in it, to become a part of it. If we take the imagery of Scripture seriously . . . we believe that God will one day give us the Morning Star and cause us to put on the splendour of the sun. We cannot mingle [now] with the splendours we see. But all the leaves of the New Testament are rustling with the rumour that it will not always be so.C. S. Lewis in God in the Dock:The angels…have no senses; their experience is purely intellectual and spiritual. That is why we know something about God which they don’t. There are particular aspects of His love and joy which can be communicated to a created being only by sensuous experience. Something of God which the Seraphim can never quite understand flows into us from the blue of the sky, the taste of honey, the delicious embrace of water whether cold or hot, and even from sleep itself.David Sayre in Something There Is:Many who have devoted their lives to science testify to their sense of awe at the great beauty that lies at the heart of nature. . . . The experiences of order, of symmetry, of finding deep and hidden relationships, of consistent metaphors and analogies—all are deeply scientific, as well as beautiful.

When Mother's Day Never Comes

Often the worst day of the year for an infertile woman is Mother’s Day. On this holiday going to a house of worship can feel more like going to the house of mourning.During the decade when my husband and I experienced infertility treatment, lost multiple pregnancies, and endured three failed adoptions, I found it difficult enough to see all the corsages on M-Day. But then the pastor asked mothers  to stand, and I remained conspicuously seated. Some years the worship leader would even call for the youngest mother to stand, and then he smiled awkwardly as a sixteen- or seventeen-year-old unmarried teen got to her feet. On such occasions I would sit wondering about God’s mysterious ways of supply and demand. Following most such services, each mother would receive a carnation as she headed out the door. But to exit she first had to answer “yes” to the question, “Are you a mother?”On a number of occasions, however, I experienced Mothers’ Day as a day of grace. On the one following my first miscarriage, a message in the church bulletin said, “The altar flowers today are given with love and acknowledgement of all the babies of this church who were conceived on earth but born in heaven and for all who have experienced this loss.” The couple who dedicated these flowers had six children, and through their validation of our pain, we caught a glimpse of the one who is acquainted with grief. The husband crossed the aisle and stood by my husband during the music. And with tears streaming down our faces, we found new strength to bring our sacrifice of praise.On several Mother’s Days, a pastoral prayer has included requests that on this special day God would bless the motherless children, those bereft of mothers, mothers estranged from their children, infertile women, and those who wish to become mothers but must wait on God’s timing. Apparently someone figured out that about half the church was mourning along with the celebration. On such occasions I felt like I belonged.One year during Mothers’ Day, I was with a mission team in Culiacán, Sinaloa, Mexico. A man stood at the door after the service handing out carnations to all the mothers. Having heard that my husband and I had just experienced another pregnancy loss, he looked at me through misty eyes and thrust his entire bouquet in my hands.My niece, who is married without children, calls the holiday “mothering day.” In this way she broadens the meaning, making it inclusive enough to include all who nurture. And this seems a fitting practice for the church. We are family. The one without a mother finds mothers in Christ. The parent without children finds children in Christ. Families of one and of twenty all find a broader family in Christ.My mourning on M-Day was not because I wished in any way to diminish our practice of honoring mothers for the thankless work they do. (I myself have one of the best moms on the planet, and it is a joy to honor her.) I wished only for the Body of Christ to find ways to acknowledge our mothers’ sacrifices without inflicting unnecessary pain on those who mourn.This Sunday, we have the opportunity once again to minister grace both to the one in six couples who experience infertility and to the rest of those who experience Mother’s Day as a day of grief. May we rise to the occasion. Because while the preacher in Ecclesiastes tells us it is better to go to the house of mourning than to the house of feasting (Eccl. 7:2), it is also better if that house of mourning is full of empathic family members. As they reach out with the arms and tear ducts of Christ, we remember what will always be true about us: We are not alone.

Bioethics in the News

New Test Can Predict Cancer More Than a Decade Before DiagnosisThe Telegraph reported that scientists at Harvard and Northwestern University have devised a test that can predict with 100% accuracy whether a person will develop cancer up to 13 years in the future, as changes are already taking place on chromosomes more than a decade prior to diagnosis.New Drug Info Made PublicThe New York Times reports that Medicare has released detailed data on prescription drug use in the USA.  The data was the most detailed breakdown ever provided by government officials about the prescription claims of Medicare beneficiaries.Couple Fighting Over Frozen Embryos(New York Times) “Our frozen embryos have a right to live,” says Sofia Vergara’s ex-fiancé. Last August he filed a complaint in Santa Monica, Calif., using pseudonyms, to protect two frozen embryos the couple created.NIH Reiterates Ban on Editing Human Embryo DNA(Nature) – The US National Institutes of Health (NIH) has reaffirmed its ban on research that involves gene editing of human embryos. In a statement released on 29 April, NIH director Francis Collins, a Christian, spelled out the agency’s long-standing policy against the practice. 

Bioethics in the News

IVF NUTRIENTS MAY DICTATE IF THE BABY’S A BOY OR GIRL(New Scientist) Will it be a boy or a girl? For people undergoing in vitro fertilization (IVF), the nutrient-rich liquid their embryos grow in could tip the balance. The finding adds to mounting evidence that the culture medium is playing a role in determining the baby’s sex. The scales seem tipped toward males.ETHICS OF EMBRYO EDITING DIVIDES SCIENTISTS(Nature) Research that uses powerful gene-editing techniques on human embryos needs to be restricted, scientists agree but they are split over why."I personally think we are just not smart enough—and won't be for a very long time—to feel comfortable about the consequences of changing heredity, even in a single individual." —DAVID BALTIMORE, a former president of the California Institute of Technology, on a call for a moratorium on using a gene editing technique to change human DNA. As quoted in The New York Times.

Bioethics in the News

Thanks to the Center for Bioethics and Human Dignity for combing through the news and bringing these to the attention of readers:

CHINA OFFICIAL’S MANDATORY ‘TWO CHILDREN’ PROPOSAL DRAWS REBUKE
(Medical Xpress) – China should roll back its one-child policy and instead mandate that all couples have two children, a family planning official has said, drawing criticism Friday from a ruling Communist Party newspaper.   Read More

STEM-CELL TREATMENT BEATS MEDICINE IN SEVERE MULTIPLE SCLEROSIS
(Bloomberg) – Stem-cell transplants were more effective than the standard medicine used to treat people with severe multiple sclerosis, a trial found.   Read More

DYING DUTCH: EUTHANASIA SPREADS ACROSS EUROPE
(Newsweek) – In 2013, according to the latest data, 4,829 people across the country chose to have a doctor end their lives. That’s one in every 28 deaths in the Netherlands.  Read More

CANCER PATIENTS, DOCTOR SUE TO ALLOW PHYSICIAN-ASSISTED DEATH FOR TERMINALLY ILL
(Los Angeles Times) – A group of cancer patients and physicians filed a lawsuit Wednesday to clarify the ability of mentally competent, terminally ill patients in California to obtain prescription drugs from their physician to hasten their death.   Read More

WORLD HAILS UK VOTE ON THREE-PERSON EMBRYOS
(Nature) – Following a February vote in the UK House of Commons, the world may once again look to Britain to push the envelope in fertility treatments, 37 years after IVF was pioneered there.   Read More

Frozen Embryos: Ethical Considerations

What can we do about all the frozen embryos slated for destruction?

Avoid cryopreservation of embryos. First, we need to avoid the waste of more embryos by counseling couples pursuing assisted reproductive technologies to limit the number of eggs fertilized to the number they’re committed to carry to term. With in vitro fertilization procedures, each mature egg is placed in a separate dish. So in the case of abundant eggs, embryologists can limit the number of eggs exposed to sperm. Generally when couples request this, clinics honor their ethical desires.

Perfect the egg-freezing process so that gametes—sperm and eggs—are frozen instead of embryos. Currently freezing sperm is commonly done, but scientists are still working to improve the egg-freezing process.

Encourage embryo adoption. At the moment, such a service costs about $6,000. However, some Internet services charge less than $100 to connect couples and let them work out the details.”

—William Cutrer, M.D., and Sandra Glahn, “Of Ethics and Embryos,” Light, (Fall 2000), page 5

Pre-Conception Genetics Testing

By Sandra Glahn

Robin’s brother has hemophilia. She and Kelvin want children, but they wonder, “What are our odds of having a baby with the same problem?”

Bill and Liz have lost four pregnancies. Before Liz conceives again, they want to know if chromosomal abnormalities could be causing their losses and whether to keep trying.

Ben and Sarah’s first child has Tay-Sachs. They are thinking about having another child, but they want to know how much of a gamble they would be taking.

Between two and three percent of children have some major abnormality caused by one of the nearly four thousand disorders linked to genetic causes. Half of these are apparent by birth; the rest will show up later. While good health and fitness do little if anything to prevent hereditary diseases, pre-pregnancy genetic counseling can help couples determine the probability of passing on some of these problems.

Although most couples don’t need it, experts estimate that nearly 15 million Americans could benefit from screening. Those at risk meet one or more of the following criteria:

The husband, wife or one of their relatives has a genetic disorder.
They have a history of three or more miscarriages.
They have experienced stillbirth.
They both belong to an “at risk” ethnic group.

“Genetic counseling” brings to mind an avalanche of vocabulary words from the molecular biologist’s lab. Yet words like odds, risk, gamble and chance are also common terms in the process of testing genes and chromosomes.

Chromosomes are microscopic structures located inside cells. An individual chromosome carries hundreds of thousands of genes, the basic units of heredity that determine everything about a person from eye color to blood type. Each parent contributes randomly to half of the child’s total make-up, except sex determination, which always comes from the father. Abnormalities in the number or structure of chromosomes, or negative factors in the genes they carry, can lead to problems.

Medical personnel with special training in genetics offer consultation. They start by taking detailed family health histories. They then chart a family tree which includes the couple, their immediate family, nieces, nephews, aunts, uncles, first cousins, and grandparents.

In the case of recurrent miscarriage, stillbirth, and a small number of other problems, blood is drawn from both partners and checked for chromosomal abnormalities. When a testable genetic disorder like sickle cell anemia is suspected, blood is sent to a laboratory which specializes in investigating that particular disease.

Based on results of their investigations, experts calculate risk. Walter Taylor, MD, a genetics specialist, says, “`Genetic counselor’ can be a misleading title; our job is not to give advice. We let couples make their own decisions after we provide them with clear, accurate information about the likelihood of something happening. Yet it’s important for couples to realize that even though we check everything, problems can still occur.”

Many problems occur randomly at conception, as with most cases of Down syndrome. Age is also a factor. For this reason, couples who conceive earlier in their childbearing years have better odds of having healthy babies than older couples. Environment may play a small part, too. “We recommend refraining from smoking, drinking and illicit drugs,” says Gail Brookshire, a genetics counselor at Children’s Medical Center, “but it’s doubtful that these actually have an impact before conception. It’s good to be cautious, but we don’t want to create guilt if something goes wrong.”

Most insurance policies cover consultation and lab costs, and results take between one and six weeks, depending on the test. Then, if a couple finds the odds stacked against them, they can decide to try anyway, live without children, adopt, or conceive with donor eggs and/or sperm.

Sometimes, despite favorable odds, something goes wrong. Joe McIlhaney, Jr., MD, author of Dear God, Why Can’t We Have A Baby, says, “I would hate to see the day when we judge everyone by some arbitrary degree of ‘normality.’ Just because children are born with limitations does not mean that they are ‘nonpersons’ or worthless. These children do have limitations, but then so do you and I.”

This article first appeared in Dallas Child.

Ethics of the Body: Wellness

By William Cutrer, M.D.

Beloved, I pray that in all respects you may prosper and be in good health, just as your soul prospers. 3 John 2, NASB

“But I buffet (discipline) my body and make it my slave, so that after I have preached to others, I myself will not be disqualified.” 1 Cor. 9:27

Our physical health has spiritual significance in that God has entrusted us with the gift of humanity. Indeed, humans are made in God’s image, yet embodied. And when Christ came to identify perfectly with our humanity, He took on not just human form, but a human body—complete with the physical needs of nutrition, hydration, rest, and recovery. The very lifestyle of Christ may best exemplify a “wellness” lifestyle, evidenced as it was by regular exercise (walking), nutrition (broiled fish, whole grain breads) active ministry in community, and powerful devotion in solitude. Each of these represents a key element to our anthropology—wellness of mind, body, and soul.

As Paul told the Corinthians, humans need both physical and spiritual discipline. To illustrate his points he incorporated many athletic metaphors, including those of runners and boxers. Clearly when he used the word “buffet” (1 Cor. 9:27, quoted above), he meant the word we pronounce with stress on the first syllable. Yet most who read this word now envision a long table filled with delectable foods at an “all you can eat buffet” where we harm our bodies for lack of self control.

That lack of self control represents the absence of one of the key elements of a healthy lifestyle – responsibility. Each of us is responsible for the choices we make, whether it is the food we choose to nourish our bodies, the activities we pursue to keep ourselves fit, or the decisions we make to follow Christ moment by moment. To create a wellness lifestyle is to accept responsibility for the choices we make and to continue to grow and learn how to better care for this magnificent, Christ-like, human body we have been given.

What is Wellness?

Wellness is a proactive choice to create a lifestyle that enables an individual to live fully—integrating spirit, mind, and body for a life of meaning and purpose. Consider how most people in their youth envision their lives at age forty or beyond. Few would answer, “I plan to be overweight, under-fit, addicted to caffeine, stuck in a job that I hate, in a career going nowhere, and married to a couch potato.” Yet while this vision is not what anyone aspires to, a glance at the American public indicates many have arrived at this very state.

The proactive nature of wellness requires action be taken before such a dismal outcome. The individual bears responsibility for making informed, intelligent decisions about health and well-being. The impetus for choosing a wellness lifestyle should be to live a life of purpose and meaning, obedient to the teaching of Scripture, fulfilling God’s calling. Contrary to the popular bumper sticker, the one who dies with the most toys does not win. “Winning” comes from a life well lived, a life of service to the Lord and others, a life of sharing and caring for the world and those around us. We enter this life crying, while those around us are smiling. Perhaps when we leave this earth, we do so with the roles reverse—those we leave behind shed tears of joy for a life well lived while we smile when we hear the Lord say, “Well done good and faithful servant, enter into the joy of my kingdom” (Matt. 25:21).

Wellness encompasses all that we are and expands beyond the absence of illness into every sphere of our existence. This article will focus on a narrow segment of our complex humanity—our physicality. Though made in the very image of God, we inhabit flesh. Unfortunately, humanity’s fall into sin corrupted every cell, every strand of DNA from the first couple down through the succeeding generations. Thus illness, disease, deterioration and ultimately death await all of Adam and Eve’s descendants until the return of Christ.

The late comedian Bob Hope spoke wisely when he said, “The key to living is to die young—at an old age.” While our physical capabilities gradually diminish, our spirits can remain vibrant as we grow in intimacy with our Lord each day. Yes, we age and fail, yet we can glorify God with and through our bodies until that day when we meet the Lord and later receive resurrection bodies, equipped anew for eternity.

As we pursue wellness, we can either live in obedience, worship, and gratitude, or we can be self-focused, making even good health an idol. Our relationship with God should supersede attention to our physical wellbeing. The apostle Peter listed many virtues of the Christian life: faith, moral excellence, knowledge, self-control, perseverance, godliness, brotherly kindness and love. And he concluded with, “For if these qualities are yours and are increasing, they render you neither useless nor unfruitful in the true knowledge of our Lord Jesus Christ” (2 Peter 1:5 –8). Thus even if aging or physical limitations greatly hamper our abilities, we can still be useful and fruitful as we grow in the Lord’s grace.

Fitness

On the other hand discipline yourself for the purpose of godliness; for bodily discipline is only of little profit, but godliness is profitable for all things, since it holds promise for the present life and also for the life to come. 1 Timothy 4:7b – 8

As seen in the overview diagram, aspects of body “wellness” include fitness, nutrition, and stress awareness and management. Begin with an honest evaluation of where you currently stand. Prayerfully consider your physical conditioning, which includes weight for height (BMI)[1], cardiovascular condition, strength, flexibility, and balance. Some abilities reflect genetics, others age, nutrition and activity schedule. With the guidance of your physician, set personal goals. Reasonable target weight, fitness level and appropriate exercise regimens are available in books, magazines, online, and with the assistance of a personal trainer available at our fine health and fitness center here on SBTS campus.

A simple formula for fitness regardless of your current activity level would be “4 x 30 x Comfortable x Large.”

· The 4 represents 4 days per week, the minimum number of days of activity to begin achieving fitness. This allows more days of activity than inactivity, helps develop the habit of fitness, and still allows for days of rest and the always unplanned occurrences that make life so unpredictable and enjoyable. Are more than 4 days per week better? Absolutely! Going from no days of activity to 4 days of activity is the big challenge, though. Adding additional days beyond the first 4 should be a joyful experience clearly demonstrating that fitness is becoming a part of a lifestyle and not just something that has to be done.

· 30 minutes at a time. Longer is better, but building up to longer periods should be done slowly and gradually. A thirty-minute routine gives the heart time to work at elevated workloads, strengthening cardiac muscle. That thirty-minute timeframe allows the metabolism to increase, thereby burning more calories. This sustained elevated heart rate and metabolic rate also combine to continue the higher rate of caloric burn long after the actual activity is completed, a post-exercise benefit.

· “Comfortable” refers to a comfortable pace, the intensity of the activity. The talk test is the simplest way to measure this. You should be working harder than you are at rest, but not so hard that you cannot talk to someone next to you. You may or may not be able to engage in deep, philosophical discussions, but you should always be able to communicate with those nearby.

· Large muscles are the ones to involve in any fitness program. Large muscles include legs, hips, core muscles of the abdomen, and lower back. While including upper-body muscle groups would be ideal, getting the body moving is the first step, literally and figuratively. A fitness routine can include any number of available activities that are highly beneficial to body, mind, and spirit. The best plan incorporates a variety of activities—not only to avoid boredom but to enable cross-training, that is, using multiple activities to avoid overuse injuries and reach fitness goals. Such activity can include walking, jogging, biking, swimming—any activity that engages the large muscle groups over a period of time. Variety can be very helpful as any exercise targets specific muscle groups and not others, so just jogging, for example, can lead to overuse injuries if not coupled with flexibility and balance work. Weight-independent exercise (biking, swimming) has an advantage of being less stressful to joints and enjoyable even during pregnancy. Having a fitness partner can provide essential encouragement on those days when you’d rather do anything but exercise.

Resistance exercise, using free weights, weight machines, elastic bands or other devices develop muscular strength and bulk depending on how the exercise is conducted. Free weights help develop balance when used with proper technique, but having a partner to spot your lifts can help you avoid injury when moving large weights. The machines are safer than free weights in this regard.

As with cardiovascular work, regular resistance exercise is important, but rest and muscle recovery are important too. In general don’t exercise the same muscle group two days in a row. Allow at least a 24-hour rest, recovery, and rebuild time. Also as with cardiovascular exercise, a resistance exercise routine can quickly bore or discourage, so select activities you enjoy and vary them.

Flexibility work is important in protecting the joints, thereby allowing maximal range of motion and superior performance in athletic endeavors and physical exertion. Whether you enjoy stretching activities alone or Yoga programs, you can find a variety of such exercises to incorporate into your cardiovascular and/or resistance work. In fact beginning serious weight work without a warm up with stretching, flexibility movements, and balance moves could easily lead to injury. As for balance, most of the yoga poses and some of the stretching exercises will allow some balance development. Again, making flexibility work a priority can prevent injury, enhance performance, and make your workout time more enjoyable.

As we age, the joints tend to stiffen, range of motion becomes more limited, and the propensity to lose balance and fall increases. So gentle stretching, flexibility/balance poses can improve the quality of life.

Choose activities that you will enjoy. No one stays with an exercise program if it’s too hard, too boring, too stressful, or too “un-fun.” Here are some suggestions for making your “bodily discipline” more pleasant so you can achieve that “little profit.”

• Find support. Many people find the friendship and camaraderie of their chosen activity itself to be the most motivating factor in staying involved with fitness. Having a partner or a group tends to support your commitment and provides you someone to depend on—as well as someone who depends on you.
• There are always opportunities to exercise independently, and for some such times become another bonus of their fitness program—time alone to think, reflect, ponder, pray.
• Take time to “smell the roses.” If training becomes solely training, just a matter of time and distance, miles and minutes, then the great gifts of our bodies and our world are being lost in the narrow pursuit of better fitness. Walks, runs, bikes, and hikes provide opportunities both to enjoy the wonders of the human body and also the wonders of the world around us.
• Slower, gentler activities such as yoga, Tai Chi, and Qi Gong provide excellent opportunities not only to stretch and strengthen the body but also allow for quiet meditation and reflection, perhaps time to consider the integration of spirit, mind, and body.
• The best advice from the marketing world is Nike’s slogan: Just do it!

Nutritional Awareness

Whether then you eat or drink or whatever you do, do all to the glory of God. 1 Cor 10:31 (NASB)

An essential facet of overall wellness relates to the intake of calories: what we eat and drink. America as a nation has been richly blessed, yet the statistics covering recent decades show a remarkable downward spiral in wellness mirroring a steep rise in obesity. Though the normal range for body weight is quite broad, one third of all Americans—72 million people—have broken through the limits into “overweight” and even beyond that to the “obesity” category. This includes 16% of all U.S. children.[2] Looking beyond our borders, one billion people in the world are now overweight, 300 million of whom are obese. And obesity brings with it associated medical issues.

Being obese “confers physical stress on multiple biologic processes and is associated with an increased risk of developing cardiovascular disease, Type 2 Diabetes, hypertension, osteoarthritis, and certain forms of cancer, not to mention sleep apnea, asthma, and fatty liver disease.” Remarkably “a reduction of only 5 to10% of body weight improves lipid profiles, insulin sensitivity and endothelial function (reducing clotting risk and inflammation).” [3]

Most of us understand the balance between energy expenditure and calories consumed, but perhaps a simple review buttressed by the newest research in weight loss can be instructive. Our bodies are the temples of the Holy Spirit… and we should glorify God in our bodies. That includes choosing to eat wisely.

We can estimate how many calories each person needs based on his or her height and current weight. Using this information, we can also determine whether weight gain or loss are needed and what the neutral nutrition needs are. Basic truths include the fact that fat contains twice the calories that protein and carbohydrate carry for the same basic weight of food. A calorie (more technically a Kilocalorie) represents the energy available to be burned in a given amount of food. For example, one gram of protein contains four calories, and one gram of fat contains nine calories. To burn up one pound of fat, a person would need to expend about 3,500 calories! Or put another way, each extra 3,500 calories consumed generates one pound of fat if not burned by exercise or the normal activities. Clearly, weight gained is acquired slowly, and wisdom requires for long term success at weight loss that it be burned off gradually. Fad diets, crash diets, and diets that involve only one food group or type are generally bad for one’s health and contrary to an overall goal of wellness. In addition the rebound weight gain after these dramatic programs often exceeds the starting weight.

The simplest formula for weight management is, ‘Calories In = Calories Out.’

‘Calories In’ represents your daily caloric intake, what you eat and drink on any given day.’Calories Out’ are the calories you burn during exercise and normal daily activities. If you burn off as much as you eat each day your weight will remain the same. If you wish to lose weight, rather than making drastic adjustments to your diet or over-exercising, a healthier choice would be to slightly reduce caloric intake and slightly increase activity levels. This pattern allows for responsible choices and changes to be made slowly and gradually, making them easier to adopt and incorporate into your lifestyle. No one gains 50 pounds overnight – they gain it one pound at a time! Weight loss follows the same pattern, although it comes off much slower than it goes on!

A healthy diet includes a wide variety of foods that include a balance of protein, carbohydrates, and some fats, all of which are prepared in healthy ways. That is, bake it, broil it, roast it, but don’t fry it. Also, beware of rich sauces and heavily buttered dishes (butter is basically fat). By wisely selecting food and preparing it with good health in mind, you can eat well, feel satisfied, and still be moving toward your ideal body weight and percentage body fat. (Underwater weighing is the best measure, but skin fold calipers and some of the newer electrical impedence devices for measuring body fat are quite useful.)

Most foods now come with package labeling clearly providing the number of calories, carbohydrates, fat grams, and protein, but the information may be so detailed that it confuses. Can “low fat,” diet, fat-free items really be worse that the more fat-filled items? Absolutely, if the fat grams have been replaced by more sugar. In such cases, if you consume many such products, you may wind up gaining weight. Sugar is a simple carbohydrate that the body absorbs quickly. Sugar shoots the blood glucose higher causing the release of insulin, which drives the blood sugar back down, perhaps lower than when you started, resulting in lightheadedness and hunger. So even snacks can be detrimental.

A diet plan of three “square meals” daily will virtually guarantee failure. The 4- or 5-hour time span between the three big meals triggers some bodily responses that actually cause it to slow the metabolism, and cling to the “fatty stores” to protect against anticipated famine. Thus wisdom means eating more frequent, smaller meals that still total the proper number of calories. Snacks between meals would be planned for, and they might include fruits, and definitely include protein, as protein does not have the wild impact on the blood sugar and insulin system.

Many programs are available for creating an appropriate nutritional program. Weight Watchers® with its point system can be very helpful and far more “doable” than tracking calories. Monitoring “fat grams” can be useful as well. Many calorie-restricted balance meals are available.

Still, constant vigilance, awareness, and commitment to wellness over time has been shown to bring the best results. A recent study of more than 800 dieters assigned different diet plans demonstrated that no diet was superior. The determining factor was consistency and accountability with counselor visits.[4]

Eating Disorders

Most articles on nutrition focus on obesity because of the sheer volume of statistics, but a discussion of wellness must also include mention of increasing numbers of those struggling with eating disorders. For such people the flood of information about obesity and wellness can make them feel unacceptable or worthless if their body image doesn’t match the “norm.” As mentioned, more than half of adult Americans are overweight, with one-third exceeding 20% of their normal, healthy weight. And such information can motivate some to abuse their bodies in efforts to conform either to the norm or to what they perceive as the norm.

Eating disorders are potentially fatal problems affecting an enormous number of our young people. Data collected by the American Anorexia and Bulimia Association (AABA) suggests that 1% of all female adolescents suffer with anorexia, while 4% of college-aged women suffer from bulimia.

Anorexia

Anorexia (also called anorexia nervosa) is characterized by a preoccupation with dieting as well as thinness as a body image. While our society exalts the super-slender model build, anorexics go way beyond even this to excessive weight loss. They experience a genuine fear of fat and gaining weight. When they look into a mirror, even when they are emaciated with almost zero body fat, they still see their body shape as obese. The sufferer does not recognize the problem!

Twenty percent of anorexics die without treatment! And even with treatment, the death rate approaches 3%. With the best available treatment, roughly sixty percent fully recover and another twenty percent experience some improvement.

The lives of these individuals revolve around food and weight concerns. Refusing to eat is all about control. Early symptoms include depression, loneliness, helplessness, and hopelessness. Telltale symptoms include hair loss, cold hands and feet, fainting spells and compulsive, excessive exercise. Such exercise can be hidden, often done in middle of the night, taken to the extreme. Anorexics lie about their food intake, lie about the exercise, and often cover up the fainting spells and irregular heart rhythms that characterize a metabolism that’s totally out of balance.

In addition medically, when the menstrual cycle fails because of significantly depressed estrogen levels, calcium is lost from the bone, just like in an aging woman. Key organs in the body shrink and lose functionality. Blood sugar and blood pressure often fall below normal levels.

Bulimia

Bulimia is an eating disorder characterized by binge eating (rapid and massive consumption of food at one sitting) followed by purging (induced vomiting, laxative abuse, diuretics). Some estimate that as many as 5% of college women are bulimic. Though they may not be severely underweight, the process of binging and purging leads to intense guilt and shame.

As with anorexia, those suffering from bulimia have a preoccupation with body weight and shape. The purging can trigger depression and mood swings, Rather than being in control, the person suffering from bulimia may often feel out of control.

Forced vomiting can cause dental problems as well as throat and stomach issues. Heartburn, bloating, and swollen lymph glands can indicate bulimia. Once again, in young women, because the nutritional status is poor, the menstrual cycle disappears. Dehydration can result, as well as permanent injury to the intestines, liver, and kidneys. Also, the imbalance in blood chemistry can lead to abnormal and potentially fatal cardiac rhythms. Obviously, eating disorders deserve prompt attention.

Fluid Intake

What you drink may affect the weight and nutrition equation. Your body needs plenty of water, which perfectly satisfies thirst and bodily requirements and has zero calories. I would recommend you gradually shift to water as your primary beverage and squeezed fruit or vegetable juices when you need flavor. Common soft drinks are loaded with sugar giving a calorie boost and triggering the insulin reaction leading to more hunger. Sports drinks can be reasonable if used as an exercise recovery drink, but they may contain too much sugar and excessive salt. What about the carbonated waters and diet drinks? Wisdom would be to avoid these. The carbonation can trigger the insulin response according to some new research, and the long-term effects of the artificial sweeteners are uncertain. Caffeine, so popular to lace drinks with now, is indeed a stimulant. Caffeine will accelerate heart rate, increase blood pressure, and draw fluid from the body, possibly causing dehydration. God designed us to need water and to thrive on it. So drink up!

In summary…

Avoid extremes and “gimmicky diets”

Balance your caloric intake
Prepare your food properly from a wellness standpoint
Drink plenty of water
And here’s another—Follow the 80% Rule. That is, if 80% of the time you eat healthy, enjoy the other 20%! Of course you can still have pizza. You just can’t eat the whole thing in one sitting. Desserts are fine, as long as you understand the caloric impact and factor that into your dietary plan.

Stress Awareness

Be anxious for nothing, but in everything with prayer and supplication with thanksgiving let your requests be made known to God and the peace of God which surpasses all comprehension will guard your hearts and mind in Christ Jesus.. Phil 4:6,7.

Casting all your anxiety on Him because He cares for you. I Peter 5:7

Having considered the impact of nutrition and exercise, both essential to overall wellness and life in the body, we now turn to consider stress. Stress has both negative and positive consequences and has enormous impact on successfully walking worthy of God’s high calling for each believer.

First of all, there is “normal stress.” Only the dead are stress-free, and that would apply only to the believing dead. Stress is an inevitable, inescapable part of the human experience, and in proper amounts, it’s essential to living maximally.

Stress is defined as the normal internal physiological mechanism that adapts us to change. For example cold temperatures are an external stress. The body responds to it in the ways designed within our humanity to preserve heat (constricting blood vessels) and ultimately preserving life (sacrificing non-essentials—fingers and toes) to shunt life saving blood to the essential organs (brain, heart, lungs). The body has a remarkable ability to respond to external stress through internal mechanisms, but some basic pathways follow virtually all forms of significant physical, emotional, and even intellectual stress (remember the stress of the last unannounced quiz?).

When your body interprets environmental factors as stressful, the stress response is initiated. Pulse becomes more rapid, as does breathing rate; blood pressure elevates; and the body is prepared for a fight-or-flight response. Key hormonal mediators of this response are adrenaline (also called epinephrine, made in part from the adrenal gland) and a surge of corticosteroid hormones including a powerful one called cortisol. Focus is heightened, but fine motor control is lost (remember that near miss car collision and how your hands and feet felt like cement?). Thus, if athletic performance or quick thinking are needed, the stress response enables one to run faster, farther, or quickly assess the stressor as real or imagined. These are “good stress” responses.

Yet if you live under the constant impact of stressors, the cumulative effects of adrenaline and cortisol will lead to “distress” and the breakdown of the human body. Symptoms would be headaches, backaches, irritable bowel symptoms, migraines, fatigue and ultimately physical collapse or emotional meltdown.

Easily identified current stressors in the lives of the minister and those preparing to serve include not only the educational process itself but financial, relational, grief, even church-related issues and a host of other incidental surprises. Everyone living will face stress, but will the level of stress become overwhelming or remain manageable?

The danger for the minister is recognizing the difference between handling stress appropriately (while growing deeper in one’s personal spiritual walk) and burnout, defined by a noted Christian counselor as “compassion fatigue.” Compounding stressors lead to physical fatigue whereas crossing over the “manageable” line leads to emotional fatigue, depression, and a loss of interest in your calling to serve.

How does one identify and overcome the cumulative effects of abundant stressors?

When physical exhaustion from over-engagement leads to flattened emotions and lack of motivation, be on alert. When you feel anxious, hostile, frustrated and resentful of the demands of your calling, your stressors may be overwhelming your capacity to respond.

Practically speaking, how can we walk in the Spirit with the enormity of demands facing each that would serve the Lord?

· Respect your body: You won’t get another until the Lord returns, and this one suffers the effects of fallenness.

· Care for your body: Apply what you learned in the fitness and nutrition sections.

· Eat Right: Be careful of everything you put into your body.

· Exercise: Do so regularly and responsibly. Fitness is for everyone, not just the elite athlete.

· Practice the disciplines: Even as exercise and nutrition are everyday essentials, so too are prayer, Bible study and reflection, worship, fasting, giving, solitude, and silence.

· Practice community: The church body needs your body! We are interdependent. Learn to be comfortable both in community and in solitude.

· Sleep: This one’s really not optional. Cumulative sleeplessness depresses the immune system and ages you faster. Skipping proper sleep will catch up to you.

· Learn to say no: Your yes is meaningless if you cannot appropriately say no. Give others in the community of faith an opportunity to serve.

· Play: Allow time to enjoy God’s creation, those you love, and those who love you.

· Create margin: Allow sufficient space in your schedule to be interruptible so God can use you to minister to people and needs that are unplanned.

· Laugh more: It releases endorphins in the brain making your joy a neurochemical reality.

· Remember Christ: He’s our immovable anchor beyond the veil, our Savior, Redeemer, Brother and Friend.

Or do you not know that your body is a temple of the Holy Spirit who is in you, whom you have from God, and that you are not your own? For you have
been bought with a price: therefore glorify God in your body. 1 Cor. 6:19

· In a country in which more than half of adults are either overweight or obese, in a place where diabetes kills 220,000 Americans annually, we must engage in the countercultural practice of caring for our bodies, because they belong to God, purchased by the blood of Christ and indwelt by the Holy Spirit.

· Consider a quote that very powerfully and eloquently expresses the integration of spirit, mind, and body;

· We are not human beings having a spiritual experience.

· We are eternal spiritual beings having a temporal human experience.

And part of the human experience that we are meant to enjoy is the care and respect we give this marvelous body we have been given—or perhaps better said, loaned to us for our time here on earth. God’s design of our bodies is flawless. It is our responsibility to care for and use them to the best of our abilities, each of us with a wide and varying range of talents and gifts. With that thought in mind, it is neither selfish nor narcissistic to make time for the care of the body. We are all better at whatever we do when we feel healthy, confident, and whole. With proper nutrition, exercise, and attention to the stresses of life, we place ourselves in the best condition to deal positively with whatever demands life presents. We are whole when God is the center of our lives and we are using His vessel (our body) in His service.

Pursuing wellness is not something we can do completely on our own, however. It has been said “You alone can be well, but you can’t be well alone.”

None of us knows all there is to know about being well, but in today’s rapidly expanding, information-exploding world, the possibilities for learning are endless. We need to learn more and more from others but, perhaps more importantly, also be there to share and care for those who are fellow pilgrims on the journey of faith. Wellness is a part of the human experience, a part in which we have the responsibility to create our lifestyles. It is within every one of us to be well. What choices will you make? How will you respond to this gift of another day?

This is the day the Lord has made, I will rejoice and be glad in it. Psalm 118:24

[1] BMI = weight (kilograms) / height(meters squared) CDC.Gov accessed 2/28/09
[2] CDC.Gov accessed 2/28/2009
[3] Overweight and Obesity: Key Components of Cardiometabolic Risk, Clinical Cornerstone, Vol. 8, Issue 3, Dec.2007.

[4] Comparison of Weight-Loss Diets with Different Compositions; New England Journal of Medicine, Vol 360:859-873, Feb 26, 2009.

End of Life Issues: Part Two

When Is It Okay to Withdraw Treatment?

by William Cutrer, MD, and Sandra Glahn, ThM

One of the most sensitive, complex issues or our day concerns the end of life and how to die well. Most of us would like to live to a ripe old age, call our families together, give them each an ample inheritance, and then die peacefully in our sleep. Unfortunately, it doesn’t always work that way and both the terminally ill and their families face difficult decisions. Is it ever right to withhold treatment? Is it okay to withdraw treatment once it has been initiated? Christians have struggled with these dilemmas, wondering if “revering life” must mean “prolonging life at all cost.” Or might we sometimes “prolong death”? In such cases, might cessation of medical intervention be the right course?

Death entered the world when sin did. And as believers in Christ die, we continue our new, eternal life without the stain of sin. From the Christian perspective, physical death isn’t the worst thing imaginable—in fact, to be absent from the body is to be present with the Lord (2 Cor. 5:8).

In past columns, we’ve set out the four principles of ethics. So let’s consider an actual “end of life” case through the grid of these four principles:

A Case Study

Leonard, an 88-year-old Christian man is hospitalized following a serious stroke. He is able to open his eyes and recognize loved ones, but cannot speak or swallow. Because of the stroke, he has been placed on a ventilator and is dependent on it for sufficient oxygen. The medical team has asked the family to answer a question: If Leonard has another stroke and a cardiac arrest, should he be resuscitated?

Autonomy. When the patient is unable to communicate, the principle of autonomy becomes hazy, unless the patient has documented personal desires with a living will. This document outlines what the patient does and does not want done in the event of his inability, which can be of enormous value to the family. Another option is a “durable power of attorney for health care. This document names a person who may make the choices in the event of a patient’s inability. Almost no one wants to live dependent on a ventilator with no hope of recovering consciousness.

Does the patient have the right to refuse care? Yes he does, if he can. Only in a few rare cases can a physician treat a patient against his or her will.

Beneficence. This requires that we “do good” or seek the good for the patient. Yet in this case, exactly what would that be?

Doctors make decisions based on the answers to two questions:

(1) Is the condition reversible or recoverable? Certainly aging cannot be reversed, but the effects of a stroke often decrease over time. However, a patient with metastatic, recurrent cancer that has not responded to any available means of therapy would pose a different set of considerations.

(2) Does a respect for the sanctity of life require the initiation and maintenance of all conceivable therapies in the face of no reasonable hope for recovery?

Justice. We must give the patient his or her right or due. In this case—in the absence of the expressed desire of the patient—what exactly is his “right”? And what is the “right thing” for the patient?

Nonmaleficence. We must commit to doing no harm. But is withholding or withdrawing treatment “doing harm” when the likely result will be the death of the patient?

Having posed the usual questions, recognizing the sensitivity of an issue such as the impending death of a loved one, how can we determine what is right? How can we help those we care about to make these decisions or how do we make decisions for them if they are unable?

Several helpful decisions can be made once we’ve answered a few more questions. Is curative therapy—or only comfort care—available? We must never withdraw “care” that seeks to make the patient more comfortable. But sometimes the “treatment” or curative therapy is neither helpful nor comfortable. Generally, supportive care, such as food and water are appropriate. However, as the patient nears death, even providing food and water can worsen his or her condition.

In our test case, Leonard has not reached the stage of absent brain function, and supplemental nutrition would seem appropriate and a comfort-care issue. The greater question is this: Should he be resuscitated in the event of another stroke and placed on a ventilator for support? This is more complex. In fact, Leonard will never be any younger, but eighty-eight may not be his full complement of years. Yet, if the medical team resuscitates him after a stroke that has irreversibly damaged his conscious capacity, he is left fully dependent on machinery.

Let’s suppose that Leonard does arrest, and because there has been no DNR (Do Not Resuscitate) order, he gets the “full code.” His heart rhythm is restored; he is on a breathing machine. Further evaluation shows that this stroke indeed has done vast and irreversible damage to his brain function. He will never wake up. Can the family, in good conscience, make the decision to remove the ventilator, to “unplug” the machine that is keeping him alive?

Again, we have no documented expression of the patient’s desires, so the decision will fall upon the family at the bedside. In this instance, what does it mean to “do good and not harm”? Is withdrawing life support the same as “killing” the patient? Is the “good thing” to keep him alive as long as possible using the breathing machine and the feeding tube?

No Easy Answers

There is room for disagreement among godly people here. The family—after prayerful consideration—may in fact, discontinue life support. We have now reached an irreversible condition for which there are no known therapies. In fact without the medical advances, which include ventilators, Leonard would already be with Christ.

Intent: Life or Death?

The “intent” of the action, not just the result, has considerable importance. As you will read in the upcoming column on “active euthanasia,” in which the doctor injects a lethal dose of medication, the intent is to kill the patient. In the case at hand, the withdrawal of “life support,” while likely to result in the death of the patient, actually allows for voluntary, unaided breathing if the patient is able to do so. There is still plenty of oxygen in the room so that if Leonard could sustain his own life without artificial support, he would live, not die.

End of Life Issues: Part One

A Time to Give Birth, and a Time to Die (Eccl. 3:2)

by William Cutrer, M.D., and Sandra Glahn, Th.M.

During the fall of 2000, PBS sponsored a six-hour series that took a highly favorable view of physician-assisted suicide (PAS). Included in the human drama were a woman in Oregon who could legally commit suicide, though she got too sick to swallow the prescribed medications and died naturally soon thereafter. Another patient, a man in Louisiana with Lou Gehrig’s Disease, could not legally take part in PAS, but he was a veterinarian. That gave him access to the medications, but he too, by the time he was ready to take his life, was too sick to take the drugs. He died shortly thereafter.

Do these people have a right to take their own lives? Do they have a right to ask physicians to help them? How do we reason ethically? How can we best honor God with our lives and deaths? This sort of question has become more common, probably due in part to shifting demographics:

More than half the people in history who have reached age sixty-five are alive today.

Seventy thousand Americans are one hundred years old or older. That number is projected to reach more than 834,000 by 2050, according to the U.S. Census Bureau.

The National Hospice Foundation found that half of Americans want their families to carry out their final wishes, but 75% haven’t explained what their desires are.

Our population is aging and living longer, so we are seeing some changes in the emphasis on end of life issues. In 1993 for the first time one state (Oregon) passed legislation that enabled terminally ill patients or family members to receive as many painkilling drugs as needed to relieve illness-related suffering. The bill stopped short of legalizing PAS, but that same year, Oregon Right to Die was founded to back a PAS initiative. By the end of the following year, Oregonians had approved Measure 16, making the Death With Dignity Act the nation’s first law permitting PAS. (For a complete listing of state and Supreme Court rulings go to www.religioustolerance.org.)

In our next few columns we will consider some of the difficult issues involved when a patient is suffering with a terminal illness. But in order to engage in the discussion, we must first define some key terms, recognizing that these may vary slightly depending on what sources you read:

Withdrawal of Treatment – The decision to stop prolonging death. This involves continuing to provide care, but withholding or withdrawing curative therapies and aggressive efforts to cure disease or sustain life.

Euthanasia – The act of ending the life of a suffering patient; taken from a similar Greek word meaning “easy or good death.”

Active Euthanasia – Intentional administration of medications or other interventions to cause the patient’s death.

Indirect Euthanasia – sometimes referred to as inadvertant death and not euthanasia, because the death results from a “dual effect.” Administering narcotics or other pharmaceuticals to relieve pain, shortness of breath, nausea, or other symptoms in a terminal patient with the unintended or incidental consequence of causing death.

Voluntary Euthanasia – Done at the patient’s persistent request.

Involuntary Euthanasia – The patient has refused euthanasia, but is killed.

Nonvoluntary Euthanasia – Result of a therapeutic decision to terminate the life of the patient, such as when a patient in a coma has not expressed wishes, but the patient’s life is terminated as a result of a family or physician decision.

Physician Assisted Suicide (PAS) – Providing medications or other interventions with the understanding that the patient intends to use them to commit suicide.

So what’s the key difference between euthanasia and PAS? During euthanasia, when death itself occurs, it’s carried out by the doctor or his agents; in physician-assisted suicide, the patient fulfills the final step of terminating his/her own life. Dr. Jack Kevorkian, the outspoken advocate for euthanasia and PAS, describes the difference between the two in his own words: “It’s like giving someone a loaded gun. The patient pulls the trigger, not the doctor. If the doctor sets up the needle and syringe but lets the patient pull the plunger, that’s assisted suicide. If the doctor pushed the plunger, it would be euthanasia.”

Attitudes about euthanasia in general vary significantly, depending on whether the euthanasia is voluntary or involuntary. Views on PAS are more clearly defined. A survey of Americans about their attitudes toward PAS reveals the following:

1/3 support it under variety of circumstances
1/3 oppose it under any circumstances
1/3 support it in selected cases but oppose it under most circumstances

In this series, we will consider some end-of-life scenarios through our principles of ethics: Beneficence, Nonmaleficence, Autonomy, and Justice (refer to first column for definitions)

We will also explore other key related considerations:

Sanctity of Life
Confidentiality
Medical Futility
Resource allocation

Often when we think of Proverbs 31, we think of the noble wife. But earlier in that chapter we find some verses that give us some guidance in the end of life debate: Give beer to those who are perishing, wine to those who are in anguish; Speak up for those who cannot speak for themselves…(Pro 31:6-7).

So what are the ethical considerations in helping the suffering patient? How far is too far? What can be done to provide comfort care to alleviate suffering? Join us next time as we consider these and other key considerations.

After the “Choice”

For Those Facing Post Abortion Syndrome

by Sandra Glahn, Th.M. and William Cutrer, M.D.

Having reviewed the medical and ethical aspects of abortion, we must also consider its personal impact. Statistics suggest that in a year’s time, more than one and a half million U.S. women will have abortions. Where are all these women and how do they feel after “the choice” has been made?

Despite the risk of hemorrhage, infection, and future problems with pregnancy or fertility, it’s remarkable that most women who have abortions recover with no physical problems. Yet what about the emotional and spiritual issues? Are there any long-term effects? Can a woman take the life of her own unborn child and suffer no emotional or spiritual pain?

Many women—and the men involved, too—do, in fact, suffer with what has been labeled PAS (Post Abortion Syndrome) or PASS (Post Abortion Stress Syndrome). (We will use PASS hereafter, as in future columns we will use PAS to refer to Physician-Assisted Suicide.)

The pro-life community has been quicker than the pro-choice community to acknowledge the existence of PASS and provide support for those affected by it. Many in the pro-choice community have denied its existence.

A 1997 study reported that “Despite a concerted effort to convince the public of the existence of widespread and severe postabortion trauma, there is no scientific evidence for the existence of such trauma.” The study received widespread media attention.

There are several problems with studies such as this that rely heavily on testimony from the women themselves:

The subjects are not trained to diagnose their own conditions.

Most studies are affected by reporting bias. In 1989, then-Surgeon General C. Everett Koop wrote in a government report that only about 50% of women who have had abortions will admit it when asked directly.

Poor measurement of trauma is used. In the above-cited study women were asked about their self-esteem. The method was not set up to measure trauma.

More recent research has provided evidence that contradicts the 1997 study:

A July 2002 study, the results of which were reported in the American Journal of Orthopsychiatry (written by Priscilla Coleman, Vincent Rue, David Reardon, and Jesse Cougle) demonstrates that abortion can cause mental health problems, both early and delayed. The new study, “State-Funded Abortions Versus Deliveries: A Comparison of Outpatient Mental Health Claims Over 4 Years,” avoids the problems cited for the report listed above. Using records kept by the California Medicaid program, researchers looked at rates of first-time outpatient mental health treatment following abortion or a live birth from 1989-1992. All women who had made claims prior to pregnancy were eliminated from the study. Here are some of the results:

After controlling for age, months of eligibility, and the number of pregnancies, the mental health claims of the 54,419 women in the study were analyzed for 90 days, 180 days, one year, two years, three years, and four years following the pregnancy event.

The overall rate of mental health claims was 17% higher for the abortion group in comparison with the group who delivered.

Within the first ninety days after the pregnancy, the abortion group had 63% more claims than the birth group.

The aborting women had significantly higher rates of treatment within the categories of adjustment reaction, bipolar disorder, neurotic depression, and schizophrenic disorders. Higher rates of treatment for the abortion group approached significance for the categories of anxiety states and alcohol and drug abuse.

In subsequent time periods, the abortion group also had a higher percentage of claims compared to the birth group:

42% at 180 days; 30% at one year; 16% at two years

Rates were not significantly different after three and four years.

Conclusion: The abortion group had a greater need for mental health care than the childbirth group, which persisted for two years following pregnancy outcome.

An unpublished, in-house study performed by the Virginia Department of Medical Assistance Services yielded similar results: Of 325 women who had state-funded abortions, 73% had more health claims (85% higher costs) for reproductive health problems compared with a matched sample of women who carried their babies to term. They also found that women who had state-funded abortions had 62% more mental health claims post-dating the procedures (43% higher costs) compared with a matched sample of women covered by Medicaid who had not had state-funded abortions.*

A special issue of the Journal of Social Issues dedicated to research on the psychological effects of elective abortion, the journal’s editor concluded: “There is now virtually no disagreement among researchers that some women experience negative psychological reactions post abortion. Instead the disagreement concerns the following: (1) The prevalence of women who have these experiences… (2) The severity of these negative reactions… (3) The definition of what severity of negative reactions constitutes a public health or mental health problem…and (4) The classification of severe reactions.

What are the symptoms of PASS? They include denial, depression, anger, despair, anxiety, feelings of worthlessness, mild to severe depression, guilt, isolation, and particularly in the faith community, the “murderer syndrome.” In addition, some report that these symptoms further present themselves in sleep or eating disorders. Someone with PASS may not experience all of these, and the symptoms may first present themselves at varying times in the post abortion period, including as much as a decade later. The hormonal changes involved in the sudden cessation of pregnancy may further aggravate symptoms.

Is There a Solution?

If you have had an abortion, the first place to begin is repentance. Recognizing the destruction of a life created in God’s image, begin by confessing your sin to God (1 John 1:9) and asking His forgiveness through Christ. The Bible promises that God is faithful and just to forgive such confessed sin—it is part of His character. In offering your prayers of repentance and confession, you take the most important step toward finding inner peace. You might also admit your sin to another trusted individual (James 5:16), who can encourage you that it is impossible to fall outside of God’s love.

In addition…

Meditate on scriptures that speak to your unique situation. King David committed adultery and murder. Yet David, who is called “a man after God’s own heart,” went on to pen prayers of repentance in Psalm 51 and Psalm 32. For centuries these verses have blessed those seeking reconciliation with God and encouraged souls troubled by guilt. David prayed for God’s forgiveness and indicated that if God would restore him, “…then I will teach sinners your ways.” Look for opportunities to use your past mistakes to bring glory to God by helping others avoid the same mistakes you’ve made.

Think about stories in scripture that remind you of God’s forgiveness. Consider the Prodigal Son (Luke 15), Jesus’ restoration of Peter after who denied his Lord three times (John 21), and Jesus’ words, “Neither do I condemn you—go and sin no more” (John 8:11).

If you find yourself feeling hopeless or suicidal, seek professional help immediately from someone who understands your needs.

Visit Internet sites where you can find encouragement and support for people facing PASS. Having a chance to talk and interact with others who understand what you are going through can help a lot.

Encourage other believers and churches to reach out in forgiveness and reconciliation. Work to make your faith community a “safe” place to be “imperfect.” Heather Jamison in her forthcoming book titled Reclaiming Intimacy points out that Jesus did not say to the woman caught in adultery, “Let the one who is without sexual sin cast the first stone.” He said, “Let the one who is without sin…”

Contact your local Pregnancy Resource Centers and ask about their PASS support groups.

Know that some who suffer with PASS feel better if they can be involved—such as volunteering at a Pregnancy Resource Center or donating clothing to those experiencing crisis pregnancies.

Whether or not you are touched by the tragedy of abortion, with 1.5 millions abortions performed annually in the U.S., you must know that the pain of abortion has touched many around you. So be quick to offer a word of grace and hope in a desperately hurting world. As the Lord reached out to the woman caught in adultery, we must be quick to offer the grace of, “Neither do I condemn you…go and sin no more.”

*Source: Wanda Franz, PhD. National Right to Life News, “Abortion Associated with Higher Levels of Psychiatric Problems than Carrying Pregnancy to Term,” p. 22-23.

Abortion As Birth Control?

by William Cutrer, M.D., and Sandra Glahn, Th.M.

In some countries today where contraceptive methods are unavailable or too expensive, first trimester elective abortion is the technique of choice. On mission trips to Russia, we’ve seen young women who’d had five or more abortions.

Consider the growing percentage of repeat abortions in the U.S.:

1973 – 20% of abortions
1987 – 44% of abortions
1995 – 45% of abortions

Sadly, we seem to be so desensitized to the taking of human life or so convinced that the embryo is something other than human life that our society is apparently growing more lax in the use of contraception. Many reason that if an “unwanted pregnancy” occurs, abortion is an easy, available option.

Birth control as abortion?

But what about the possibility that birth control pills actually cause abortion? This is currently the hot topic in family planning for Christians, and some well-meaning scholars have spoken dogmatically on this subject before we really know all the facts.

Birth control pills, or oral contraceptive pills (OCPs) are designed primarily to prevent ovulation or egg release. Most pills are a combination of an estrogen and a progesterone derivative that cycle a woman artificially without allowing ovulation. OCPs are effective at preventing pregnancy, with rates of effectiveness reported at less than one pregnancy per one hundred women years of use. Their effectiveness is greatly dependent on correct usage, and taking other medications at the same time can also decrease pill absorption and effectiveness.

In addition to preventing ovulation, OCPs thicken cervical mucus, making sperm penetration more difficult. OCPs also change the motion of the cilia (tiny hair-like structures) within the fallopian tubes, altering egg transport. And they thin the uterine lining, making it less favorable to implantation should fertilization occur. While each of these “side effects” actually increases the effectiveness of the pill in preventing pregnancy, the latter could, in fact, have an abortive effect if breakthrough ovulation were to actually occur. The potential risk described would seem to be very low, but the possibility does exist. However, this scenario remains extremely difficult to quantify because of the many variables. Thus, to avoid these potential concerns, OCP users should carefully weigh the available information and certainly be vigilant in taking their pills as prescribed.

Another type of OCP contains only the progesterone type of hormone. This pill clearly has a higher rate of breakthrough ovulation, increasing the risk of a fertilized egg reaching a hostile uterine environment. For this reason, in my practice I never prescribed the “progesterone only” pill, though the clear evidence that abortions are caused is not impressive even here.

Some Christians criticize pill users, arguing with, “I would never want to do anything that would endanger a single human life.” Yet because there is—tragically— a one-in-three chance of any pregnancy miscarrying, in truth the only way to avoid any risk is to be celibate, which is certainly not scriptural for married couples. Simply put, as a result of the fall (Gen. 3), humans are bad at reproducing.

“But,” they may say, “it isn’t my intent to cause an abortion. Does intent matter? Yes, from a strictly ethical point of view, intent is important. From a legal standpoint, there is an enormous difference between first degree/premeditated murder, involuntary manslaughter, and accidental death. The thousands of Christians taking OCPs now do not intend to cause miscarriage. In fact, they intend to prevent pregnancy.

What should we do? Know the medical risks as they are currently understood. Be willing to be teachable if new data reveals different risk. Then prayerfully decide if you can use pills until the question is more fully resolved. If you take them, do so carefully as we know that will diminish the risk. And be gentle with others who make choices that differ from yours.

Educate yourself. If your doctor won’t talk to you about it, find another physician. It’s important to base medical decisions on solid information, not conjecture. When microwaves, sonograms, computer monitors, and cell phones first came out, all were accused of causing miscarriage. Later studies confirmed that none of them actually did.

The ongoing debate

As those who hold to the Bible as our authority, we are used to having absolute answers on many topics. Thus we can feel great discomfort with issues for which answers are unclear. Solid Christian physicians stand on both sides of this issue. Some say birth control pills can cause abortion and thus shouldn’t be used. Others argue that if breakthrough ovulation takes place, the ovary immediately begins producing increased amounts of progesterone that will prepare the uterus for implantation, changing the effect of the pill.

In my own practice, I (Dr. Bill) delivered some babies conceived on the pill. So I know from personal experience that if there is an abortive effect of the pill, it certainly cannot be 100 percent, but the answer at this writing is unclear. If you need absolutes, stay away from the pill, but stay informed and consult your own physician. For now taking them appears to be an ethical option, but there are some unknowns for which we are awaiting further research.

Is Abortion Ever Justified?

by William Cutrer, M.D., and Sandra Glahn, Th.M.

Are you against abortion in any circumstance? What about these:

If a sonogram reveals the growing baby has anything from Down syndrome to cleft palate?
If the pregnancy occurred due to rape or incest?
If the physical life of the mother is at risk?
If the mother is on death row, scheduled for execution before delivery?
As we established in our last column, abortion takes the life of a human being, a person, uniquely created in God’s image. Is there ever justification?

Physical “abnormality”

How do we define normal? What type of “abnormality” would be of sufficient magnitude to be worthy of death?

Dr. Robert Pyne, who teaches theology at Dallas Theological Seminary, writes in his book Humanity and Sin, “People have inherent dignity and unique value because they have all been made in the image of God. Since every person has been created according to the divine image, every human life becomes sacred…so we should not murder (or even curse) those who have been made in the image of God (Gen. 9:6; James 3:9). Our oldest son, Steve, had open heart surgery when he was just eight months old. Unfortunately, some countries, doctors, and even some parents would not have allowed him to have that operation, even though it was necessary to save his life. Steve has Down syndrome, and too many people think that lives like his are not worth saving. [Yet] his life was worth saving because he has inherent dignity as a human being in the image of God.”

Case of rape and incest

Pregnancies due to rape and incest require special consideration. Is the life of the mother at stake in these cases? No. Does killing the infant “unrape” the mother—a victim of a horrible crime? No. Is the child conceived in these cases still fully human? Yes. So an abortion would make the mother complicit in the murder of her unborn child. She changes from being guilt-free victim of crime to being guilty of taking the life of her own, innocent child. This baby will have just as much of her genetic material as any child she will ever have. Rape or incest are terrible tragedies, and the church can and has stepped up to specially assist women in these situations, both through the pregnancy and in helping her decide either to raise the child or to make an adoption plan for him or her.

The life of the mother

Can the life of the mother be truly at stake in an ongoing pregnancy—not just her emotional health, or the inconvenient disruption of her life circumstances, but her physical life? In other words, can a woman die, or substantially increase her risk of dying by continuing a pregnancy? Yes, though admittedly this is rare, representing only a tiny fraction of the abortions performed.

These are rare circumstances, indeed, but it is the foolish or inexperienced physician that would suggest this can never happen. In my own practice, I (Dr. Bill) have seen cases of artificial heart valve failure, liver failure, and systemic immune failure that clearly jeopardized the mother’s life such that abortion was a consideration.

Abortion was never a requirement, because a woman can choose to put her own life at extreme risk in attempt to carry a pregnancy to viability. Yet I’m not certain that such heroism—one life for another—is required. In cases where the mother chooses to give her life for that of the child, both lives may be sacrificed. In life and death cases—when the physical life of the mother is at stake—perhaps it would be ethical to sacrifice the life of the one to save the life of the other, particularly in the instance where not doing the abortion would likely cost both lives. Here there is full recognition of the dignity and value of both lives, and in reverence one life is given to preserve the life of another.

If we define humanity as being made in God’s imagine and thus having the “rights of personhood from the one-cell stage,” we have a compass that helps us find our way through the forest filled with such difficult paths. Once we have established human personhood as “being” rather than “function,” we can see more clearly to make wise decisions even in the most difficult of cases.

However, once we understand the need to value life from the one-celled stage, we must ask ourselves a tough question: “What am I doing to help those choosing to do right in these painful circumstances?”

Here are some suggestions for how we can each make a difference:

Pray. Ask God to help you help others. And pray for them, too.
Give of your time and resources. Consider volunteering your time, money, maternity clothes, diapers, or baby items to Pregnancy Resource Centers or other pro-life ministries.
Volunteer. If you have time to volunteer, become involved…with an adoption agency, as a foster parent…anything that will support the defenseless members of society.
If you are uniquely gifted to provide legal or medical advice, donate some of your professional skills to aid others.
James 2:16 warns against merely praying for someone in need without doing what we can to help. It is not enough to be “against” abortion…we must also show in tangible ways that we stand “for” life.

The Foundational Consideration in Abortion

When Does Personhood Begin?

by William Cutrer, M.D. and Sandra Glahn, Th.M.

Say the word “abortion,” and you’ve guaranteed a lively discussion. In our last column, we raised some questions—is it a right? A therapy? Murder? What about mothers on death row?

The most basic question in the abortion debate is this: What is the legal, moral status, if any, of the entity being aborted? If it is not a tiny, human individual—if it is only a mass of “living tissue,” not a living being—then we need no justification for abortion. However, if it truly is a unique human person, taking a life requires some justification—for example, if it is done to save another life. So the key issue emerges: When does personhood begin?

Personhood as function

Even semi-scientific minds will grant that from the first cell onward, the union of sperm and egg makes a “human.” However, what makes someone a “person,” entitled to rights and civil protection? Those who advocate choice—putting maternal “rights” above any potential rights of the unborn—often argue a functional definition for personhood. That is, they define personhood as the ability to do or function in some way. Thus, they would say we have personhood only when we are able to think, feel, reason, or respond to stimuli in the environment. While human in origin and potentiality, the “developing mass,” they would say, is not really a human person, and therefore the rights of the mother clearly take precedence.

It’s a clever argument, as is used to justify more than ninety-eight percent of all elective first trimester abortions, which number approximately 1.2 million per year in the U.S. alone.

However, before that tiny embryo is developed enough to feel or reason, he or she has brainwaves and a heartbeat.

At three weeks, the heart begins to beat.
At seven weeks, pain receptors in the brain.
At twelve weeks, the baby’s sex is evident.
Babies born at approximately twenty weeks have survived.

These facts would suggest “personhood” before the time outlined by those holding to “functional personhood.”

Peter Singer, a philosophy professor at Princeton, carries the “personhood as function” view to its logical extreme and states that parental rights take precedence over those of the infant who, by virtue of being not yet fully mature, is unable to “function.” He teaches that it would be ethical for a parent to take the life of the baby, since it isn’t a person—as it lacks conscious awareness of self, which is, in his view, essential to personhood.

Whatever functional criteria one comes up with, be it self-awareness, ability to create, feel, love etc., some other species (dolphins, chimps) can match them in some ways. This clouds the personhood definition—especially since some chimps have learned some sign language and can now “communicate.”

Clearly function is not what defines us as human.

Personhood as being

We advocate defining personhood not on the basis of function, but of “being”—thus, the phrase, “human being.” This view is fully compatible with the statement in Genesis about humanity “being made in the image of God” (Gen. 1:27). It is also consistent with the biblical texts that say that our origins as believers began in the mind of God as his “workmanship” before the creation of the world (Eph. 1:4), with the intention that we would perform good works in Christ (2:10). The New Testament word “workmanship” is the word from which we get the English word for “poem.” We are God’s unique and beautiful artwork, designed in his mind before the foundation of the world.

Thus we are persons worthy of respect by virtue of the fact that we are human, not because of anything we do, or can do. So the aged, the mentally handicapped, and the comatose, do not lose their humanity when they have diminished or absent function.

Simply by being human, we have innate dignity.

Scientific support

At what point do we begin “being”? Consider the news we have recently received from the Human Genome Project. We now know for sure that from the first cell following fertilization, the 3.2 billion nucleotide pairs that will direct and inhabit every one of the trillions of cells that follow are distinct, unique—and human.

Truly we are “fearfully and wonderfully made” (Psa. 139:14). Fearfully—because an error in just a few of those nucleotide pairs would cause the human possessing them to be extremely handicapped, or unable to survive. Wonderfully—because all of our diversity and complexity is housed in the genome of the very first cell.

The strength of any argument against abortion lies in demonstrating that the pre-embryo, the embryo, the unborn “fetus,” the ball of cells—whatever point you choose along this continuum of human growth—possesses not only “life” but is a unique, individual, being. We have not another species, but a human life.

The most foundational argument in the abortion debate relates to when personhood begins, and the scriptures would suggest human personhood begins not at the stage at which a human “functions,” but at the stage where there is a “being,” even if it has only one cell.

Introduction to a Biblical Look at Abortion

by William Cutrer, M.D., and Sandra Glahn, Th.M.

An October 2002 report released by the Alan Guttmacher Institute showed that the overall abortion rate in the United States declined throughout the 1990s but “rose sharply” for low-income women. The U.S. abortion rate among women of childbearing age fell from 24 abortions per 1,000 women in 1994 to 21 abortions per 1,000 women in 2000–an 11% decrease. However, the abortion rate among women earning less than the federal poverty level rose by 25% during this period, and the abortion rate for women earning less than two times the poverty level–or $34,000 for a family of four–rose by 23%. The study was based on data from more than 10,000 women who sought abortions. The following are among the report’s other findings:

• The abortion rate among teens between the ages of 15 and 17 fell by 40% from 24 abortions per 1,000 girls in 1994 to 15 per 1,000 girls in 2000. The decline does not necessarily mean that more teens are carrying pregnancies to term, as the teen pregnancy rate and teen birth rate also decreased throughout the 1990s.

• Black and Hispanic women continue to have disproportionately high abortion rates, with blacks and Hispanics accounting for 32% and 20% of abortions, respectively, even though they represent only 14% and 13% of women of childbearing age.

• Most women who have abortions (56%) are in their 20s. Two-thirds of women undergoing an abortion have never been married, and 61% have one or more children.

• About 88% of women who obtain abortions live in metropolitan areas, and 57% are “economically disadvantaged,” meaning they make less than 200% of the federal poverty level.

• More than three-quarters of women undergoing an abortion reported having a religious affiliation–43% of all women identified themselves as Protestant, 27% as Catholic and 8% reported affiliation with other religions.*

• Doctors used pills such as RU-486 to perform about 6 percent of abortions in the first several months after the controversial drug was approved in the United State.

In other abortion news, we read the following:

• The Washington Times reported that the number of “partial-birth” abortions has tripled in the past four years.

• According to the Atlanta Journal-Constitution, most states experienced a decrease in abortion providers. There are reportedly one-fourth fewer clinics, hospitals and doctors offering the procedure, according to a national survey. The decline in providers nationally coincided with a similar drop in the rate of abortions–a 17 percent decrease between 1992 and 2000.

• The Washington Times reported that nearly 70 percent of Americans say they favor “restoring legal protection for unborn children.”

The debate about abortion is ongoing. Is it a right? A treatment? A last resort? Murder? In our next few columns, we will explore this complex debate. Abortion has divided many groups across the world, in Christendom, and even recently in the U.S. political arena in which party platforms are debated and placed to “win over” the confused electorate.

How can a Christian understand and articulate a consistent Christ-honoring position in a volatile arena in which we hear so much verbiage, see protests, and watch TV reports of abortion providers being killed. Before exploring the issues within the abortion debate itself, we must first address a more fundamental issue: Can we “know” what’s right or wrong, moral or immoral, ethical or not? Clearly people of various faith systems and those with no religious convictions differ in their conclusions about elective abortion. What is our standard of absolute truth—or does such a standard even exist?

The source of absolute truth

The very suggestion that something can be right or wrong goes against post-modern thinking. Today “truth” is an elusive target and many of the brightest, most articulate young men and women have abandoned the concept of absolute truth, having been taught that truth is relative. They believe, “What is true for you is your truth; what is true for me is mine and to think there exists an “absolute truth” is naïve. In the abortion debate, this translates into, “I respect your view that abortion is wrong, but please allow me to differ with you—I think it’s okay.” Can both be right?

This is a remarkable departure from the concept that absolute truth exists and if we can discover it, we can agree to believe it. For the Christian, God is the source of absolute truth, and he has communicated with us through the clear teaching of Scripture. And in the areas of life where the Bible remains silent, scriptural principles guide our understanding. If we cannot agree on the fundamental that there is a right and wrong—a true and false, a good and an evil— then issues such as abortion and the status of the unborn will remain out of reach.

Yet for those who consider the biblical record authoritative, we can establish some foundational moral principles and move consistently to formulate a view on abortion. In the columns to follow we will use the Bible as our guide, assuming absolute truth exists—while also considering the supporting scientific evidence and.

In this series on abortion we’ll look first at when personhood begins. Then we’ll explore cases involving “the life of the mother,” rape and incest. We’ll consider medicines—the abortion pill (RU-486) and even whether there’s a link between the birth control pill and abortion. Finally, we’ll look at post abortion syndrome and encourage a compassionate approach to those who suffer from the emotional pain associated with abortion–pain that is often ignored.

*Source: kaisernetwork.org

Other stats about abortion:

The following highlights the results of a USA Today/CNN/Gallup poll of 1,002 adults on issues impacting the abortion debate:

• 88% of respondents support laws requiring doctors to inform patients of alternatives to abortion before performing the procedure.

• 78% support a 24-hour waiting period before a woman can undergo an abortion

• 73% support parental notification laws for women under age 18.

• 72% support laws requiring women to notify their husbands if they are going to have an abortion.

• 70% support banning so-called “partial-birth” abortion except in cases to save a woman’s life.

• 38% favor a constitutional amendment banning abortions in all cases expect to save the life of a woman (Kiely, USA Today, 1/16).

• Nearly 70% of Americans support “restoring legal protection for unborn children,” according to a poll conducted last month by Wirthlin Worldwide, the Washington Times reports. In the poll, approximately 1,000 adults were asked, “Are you in favor of restoring legal protection for unborn children,” in light of recent medical advances making it possible to see the body and facial features of the fetus, according to the Times. Approximately 68% of the “randomly surveyed” respondents said that they were “in favor” of such legal protection, while 44% said that they were in “strong agreement,” the Times reports. In addition, 66% said that they were in favor of the appointment of Supreme Court justices “who would uphold laws that restore legal protection to unborn children.”

• More than 60% of respondents to a poll conducted by the Pew Research for the People and the Press said they would oppose the Supreme Court completely overturning Roe v. Wade (Associated Press, 1/21/03).