Presbyterian Church USA

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Official Denominational Website: https://www.pcusa.org/


Beginning of Life

Abortion

Official Statement: from "Abortion/Reproductive Choice Issues" (2016) See also Problem Pregnancies and Abortion[1]; Problem Pregnancies: Toward a Responsible Decision[2]; and "Abortion: ACSWP Introduction"[3]

"When an individual woman faces the decision whether to terminate a pregnancy, the issue is intensely personal, and may manifest itself in ways that do not reflect public rhetoric, or do not fit neatly into medical, legal, or policy guidelines. Humans are empowered by the spirit prayerfully to make significant moral choices, including the choice to continue or end a pregnancy. Human choices should not be made in a moral vacuum, but must be based on Scripture, faith, and Christian ethics. For any choice, we are accountable to God; however, even when we err, God offers to forgive us.
The church has a responsibility to provide public witness and to offer guidance, counsel, and support to those who make or interpret laws and public policies about abortion and problem pregnancies. Pastors have a duty to counsel with and pray for those who face decisions about problem pregnancies. Congregations have a duty to pray for and support those who face these choices, to offer support for women and families to help make unwanted pregnancies less likely to occur, and to provide practical support for those facing the birth of a child with medical anomalies, birth after rape or incest, or those who face health, economic, or other stresses.
The church also affirms the value of children and the importance of nurturing, protecting, and advocating their well-being. The church, therefore, appreciates the challenge each woman and family face when issues of personal well-being arise in the later stages of a pregnancy.
Life is a gift from God. We may not know exactly when human life begins, and have but an imperfect understanding of God as the giver of life and of our own human existence, yet we recognize that life is precious to God, and we should preserve and protect it. We derive our understanding of human life from Scripture and the Reformed Tradition in light of science, human experience, and reason guided by the Holy Spirit. Because we are made in the image of God, human beings are moral agents, endowed by the Creator with the capacity to make choices. Our Reformed Tradition recognizes that people do not always make moral choices, and forgiveness is central to our faith. In the Reformed Tradition, we affirm that God is the only Lord of conscience-not the state or the church. As a community, the church challenges the faithful to exercise their moral agency responsibly.
We affirm that the lives of viable unborn babies—those well-developed enough to survive outside the womb if delivered — ought to be preserved and cared for and not aborted. In cases where problems of life or health of the mother arise in a pregnancy, the church supports efforts to protect the life and health of both the mother and the baby. When late-term pregnancies must be terminated, we urge decisions intended to deliver the baby alive. We look to our churches to provide pastoral and tangible support to women in problem pregnancies and to surround these families with a community of care. We affirm adoption as a provision for women who deliver children they are not able to care for, and ask our churches to assist in seeking loving, Christian, adoptive families.
There is [both] agreement and disagreement on the basic issue of abortion. The committee [on problem pregnancies and abortion] agreed that there are no biblical texts that speak expressly to the topic of abortion, but that taken in their totality the Holy Scriptures are filled with messages that advocate respect for the woman and child before and after birth. Therefore the Presbyterian Church (U.S.A.) encourages an atmosphere of open debate and mutual respect for a variety of opinions concerning the issues related to problem pregnancies and abortion.
We are disturbed by abortions that seem to be elected only as a convenience or ease embarrassment. We affirm that abortion should not be used as a method of birth control.
Abortion is not morally acceptable for gender selection only or solely to obtain fetal parts for transplantation.
"We reject the use of violence and/or abusive language either in protest of or in support of abortion . . ."
The strong Christian presumption is that since all life is precious to God, we are to preserve and protect it. Abortion ought to be an option of last resort. . .
The Christian community must be concerned about and address the circumstances that bring a woman to consider abortion as the best available option. Poverty, unjust societal realities, sexism, racism, and inadequate supportive relationships may render a woman virtually powerless to choose freely." ("Abortion/Reproductive Choice Issues")[4]

Contraception

Official Statement: from "Abortion/Reproductive Choice Issues" (2016)

"We affirm that abortion should not be used as a method of birth control." ("Abortion/Reproductive Choice Issues")[5]

Official Statement: from "Birth Control and Family Planning: ACSWP Introduction"

"Since the PCUS Assembly of 1960, the General Assemblies have held that access to the means of birth control is a right and its provision is a societal responsibility (PCUS, 1960, p. 43). The 1959 and 1962 UPCUSA Assemblies called for the repeal of all laws forbidding the sale of contraceptives (UPCUSA, 1959, p. 385; UPCUSA, 1962, p. 275). The 1965 UPCUSA Assembly encouraged ". . . endeavors by appropriate agencies in both private and public sectors to develop methods of birth control which will be acceptable to people of all religious faiths . . ." out of an awareness that religious objections to birth control methods were standing in the way of effective practice of birth control by persons needing it (UPCUSA, 1965, p. 422). In 1970, the UPCUSA Assembly addressed birth control questions in the light of sexuality, while the 1971 PCUS Assembly saw birth control as population stewardship.
In the 1980's, the federal government, under pressure from some religious and anti-abortion groups, began to limit its role in population planning, withholding support for international population programs. At the same time, research and development into means of birth control slowed, and virtually stopped in the United States. Both developments attracted the attention of the church. The 1981 UPCUSA Assembly stressed the need for poor persons to have real access to means of birth control. The 1983 PC(USA) Assembly urged ". . . that informed consent be required from all participants in contraceptive and fertility drug experimentation," and stated emphatically ". . . that racial-ethnic, poor, and Third World women should not be used as guinea pigs . . ." (PC(USA), 1983, pp 363-369). The Assembly also affirmed ". . . the church's commitment to minimize the incidence of abortion and encourage[s] sexuality education and the use of contraception . . ." (PC(USA), 1983, pp. 363-369). In 1984, the Assembly adopted a statement on the world population situation which called for population planning in all countries and defended the sanctity of life and the ". . . rights of individuals to be, to belong, to share, to act. . . ." (PC(USA), 1984, p. 333). In 1987, concerned over reports that pharmaceutical companies were discontinuing research and development on contraceptive technologies because of liability concerns, the General Assembly called for efforts ensuring the availability of insurance at reasonable costs to such companies and the development of effective contraceptives worldwide, for men and women (PC(USA), 1987, p. 580).
The 205th General Assembly (1993) adopted a commissioners' resolution on comprehensive family planning that supported new governmental initiatives on contraception research, family planning education, outreach, and financial assistance for those in need (PC(USA), 1993, p. 935). The Assembly also sent Overture 93-61. On Conveying to All Major Ecclesiastical Bodies Concerns Regarding the Population Explosion Crisis, to the Task Force on Sustainable Development with comment: ". . . it is time to recognize . . . that education on availability, acceptability, and use of methods of birth control has been seriously restricted or denied by custom or religious dogma in many countries including the United States. . . ." (PC(USA), 1993, p. 85). ("Birth Control and Family Planning: ACSWP Introduction")[6]


Infertility & Reproduction

Reproductive Technologies

Official Statement: See "The Covenant of Life and the Caring Community"[7]


Healthcare & Medicine

Access to Healthcare

Official Statement: from "Health Care: ACSWP Introduction" See also "Christian Responsibility And A National Medical Plan" (1991)[8] and "Life Abundant: Values, Choices and Health Care" (1988)[9]

"The Presbyterian General Assemblies have evidenced strong concern over the years for the health of persons. The policy statements of the General Assemblies on the subject range from the 1960 UPCUSA statement challenging the church to overcome rather than increase the ill-health of the society, to the 1980 UPCUSA Assembly's specific suggestions for ". . . more immediate short-range solutions to the acute problems of the nation's health care services . . ." (UPCUSA, 1980, p. 219). It should be noted that while the UPCUSA policy statements endorse a system of national health care in principle, the 1976 PCUS statement affirms ". . . that maximum freedom of choice should be respected for both those who provide and those who receive health care. . . ." (PCUS, 1976, p. 207). Nonetheless, throughout the statements abstracted below there rings a common note of hope that the provision of health care services in American society can be made both equitable and rational.
In 1987, the General Assembly expressed its concern for the problem of serious mental illness and followed this action by adopting a policy statement on the issue the next year which appears in part below (PC(USA), 1987, p. 760). In 1988, the General Assembly adopted a major policy statement on the Presbyterian role in health entitled "Life Abundant: Values, Choices, and Health Care." Two years later, in 1990, the Committee on Social Witness Policy presented Toward Universal Access to Health Care: An Emerging Issue Paper (PC(USA), 1990, p.635-646). This was to prepare the church for a resolution on the subject at the 1991 Assembly.
In 1991, the General Assembly adopted a resolution, Christian Responsibility and a National Medical Plan, which developed the themes of "Life Abundant" into a list of Christian values which define a universally accessible medical plan and focus the attention of the church on political advocacy. The values of caring, doing justice, preventing illness, curing, stewardship, and building community -- confirm to the church a unique roll in the political process. The church has the capability to challenge the nation's ". . . prevailing values and offer an alternative vision of its own. . . ." This vision is detailed in ten ". . . elements and principles of a National Medical Plan . . ." (PC(USA), 1991, pp. 105, 810-820).
The 205th General Assembly (1993) adopted an overture that ". . . [r]eiterate[d] and reinforce[d] the positions adopted by previous General Assemblies . . . and endorse[d] in principle a universal health-care plan giving priority to a single payer system . . ." (PC(USA), 1993, p. 895).
The 206th General Assembly (1994) adopted a resolution which urged " . . . members of congregations and governing body committees to act [to] advocate for guaranteed universal coverage, regardless of income, race or ethnicity, geography, age, gender, or health status." The assembly also urged "Congress to assure a basic benefits package that includes the needs of the historically underserved, [and] to strengthen and expand the community-based health care infrastructure. Further, the Assembly "petitions legislators formulation health care proposals to include both consumers and providers from historically underserved areas to serve on national boards that assess quality of care and outcomes." (PC(USA), 1994, p. 574)
In 2002, the 214th General Assembly approved the Resolution on Behalf of the Uninsured. ("Health Care: ACSWP Introduction")[10]

Organ Donation & Transplantation

Official Statement: from PCUS, "Biomedical Ethics: 1970 Statement," 80.

"We recommend that the General Assembly state that, in the spirit of Jesus Christ who gave himself for us all, Christians should feel free, insofar as medically and legally feasible, to make gifts of their bodies or parts thereof for the purposes of transplantation into those who have need of them." ("Biomedical Ethics: 1970 Statement")[11]

Official Statement: from PC(USA), "Biomedical Ethics: 1983 Statement," 97 and 846.

"Be it resolved, that the Presbyterian Church (U.S.A.) recognize the life-giving benefits of organ and tissue donation, and thereby encourage all Christians to become organ and tissue donors as a part of the ministry to others in the name of Christ, who gave his life that we might have life in its fullness." ("Biomedical Ethics: 1983 Statement")[12]


Science & Technology

Stem Cell Research

Official Statement: from PC(USA), "Biomedical Ethics: 2001 Statement," 461-464.

"Therefore, the 213th General Assembly (2001) of the Presbyterian Church (U.S.A.) affirms the use of fetal tissue and embryonic tissue for vital research. Our respect for life includes respect for the embryo and fetus, and we affirm that decisions about embryos and fetuses need to be made with responsibility. Therefore, we believe that the Presbyterian Church (U.S.A.) and other faith groups should educate their members in making these very difficult ethical decisions. With careful regulation, we affirm the use of human stem cell tissue for research that may result in the restoring of health to those suffering from serious illness. We affirm our support for stem cell research, recognizing that this research moves to a new and challenging frontier. We recognize the need for continuing, informed public dialogue and equitable sharing of information of the results of stem cell research. It is only with such public dialogue and information sharing that our diverse society can build a foundation for responsible movement toward this frontier that offers enormous hope and challenge." ("Biomedical Ethics: 2001 Statement")[13]

Genetic Ethics

Gender Selection

Official Statement: from "Abortion/Reproductive Choice Issues" (2016)

"Abortion is not morally acceptable for gender selection only or solely to obtain fetal parts for transplantation." ("Abortion/Reproductive Choice Issues")[14]

Gene Therapy/Genetic Engineering

Official Statement: from PC(USA), "Biomedical Ethics: 1990 Statement," 776.

"Resolved that the 202nd General Assembly (1990) commit itself to:
Engage in prophetic inquiry with the genetic research and development community in order to better understand the theological and ethical issues involved in such research and development;
Draw upon the members of its own body who are also members of the genetic research and development community to facilitate such inquiry;
Seek the insights of sister communions who are also seeking to engage in such inquiry;
Support the discovery of new genetic knowledge that can improve the treatment and eradication of disease and increase the quantity and quality of food supplies.
Distribute throughout its body information about the Human Genome Project (mapping the human gene structure) and its potential benefits and possible costs. . . ." ("Biomedical Ethics: 1990 Statement")[15]


End of Life

See In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues (1995)[16]

Definition of Death

Official Statement: from In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues (1995), 64.

" While not technically part of our consideration of euthanasia, the matter of determining when death occurs is an important related issue. There are circumstances in which taking life or allowing to die can be confused with acknowledging death, as when the use of a respirator for a comatose patient is discontinued. The act could constitute taking life, allowing to die, or acknowledging death depending upon the condition of the patient. If it were either of the first two possibilities, it would be subject to analysis in terms already provided. Here we need to indicate what is involved if the third possibility, acknowledging death obtains.
To determine when death occurs is a subtle admixture of medical and philosophical or theological judgment. On the basis of our earlier discussion of the relational character of human life, our theological judgment is that death occurs where the capacity for such relationships is irretrievably lost. The related medical judgment is that such capacity is lost when cerebral function is lost. Traditionally, the most readily evident signs of lost cerebral function have been lost heart and lung function. Modern medical technology complicates the picture, however, since heart and lung function can sometimes be supported by the use of a respirator. In such a situation, the question is whether any determination can be made about cerebral function. Through the use of electroencephalogram and possibly other tests of responsiveness and reflexes, judgments about whether cerebral function is present or not can be made. If judged to have been irretrievably lost, the individual is properly determined to be dead." (In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues)[17]

Extraordinary Measures

Official Statement: from In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues (1995), 63-64.

"Entailed in this commitment to accompany dying patients is a readiness to undertake medical treatment that will prolong dying if requested by patients, assuming their competence. Perhaps most often in the situation of dying, the person will be unable to make judgments or requests of this sort. Here, where doctors and guardians are necessarily entrusted with the decision, no moral obligation to treat the dying patient exists. However, if a patient is able to and does make a request for so-called heroic medical measures, even against

the best medical judgment, it would be a failure of readiness to support and accompany to refuse such a request.

Obviously this response assumes that the requested treatment does not portend a more harmful result for the patient than already experienced; nor does responsiveness to such a request preclude careful review with the patient of the medical judgment and even the theological implications to enable the patient to better grasp the rationale for not prolonging dying. Nevertheless, the medical judgments involved are human and therefore fallible. With due explanation and discussion, it would not be appropriate to refuse request for treatment from the patient.
"It should go without saying that should the medical indications suggest that the person is not in a condition of dying, then the obligation to protect includes the obligation to treat medically to the maximum extent possible. Such a severe, even terminal, but non-dying medical condition does not change the normal implication of out obligation to protect from harm. Here not to intervene medically constitutes a clear violation of the obligation to protect." (In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues)[18]

Physician-Assisted Suicide/Euthanasia

Official Statement: from In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues (1995), 61-62, 65.

"The topic of euthanasia is complicated by the fact that one term is often applied to quite different kinds of circumstances. Therefore it is important at the outset to make a fundamental distinction between taking life (sometimes referred to as active euthanasia) and allowing to die (sometimes referred to as passive euthanasia). Our consideration of each of these matters will be carried out in terms of the framework utilized in the discussion of abortions.
"Active euthanasia is a question that arises in situations of medical extremity where it is thought that an individual is beyond the reach of medical care. Some have at least posed the question of whether the most humane treatment might be to terminate life. However, the dominant value of respect for human life and its accompanying obligations to do no harm and to protect from harm establish a clear prejudice against such direct taking of life. The only relevant question for us is whether there is a conceivable conflict between these obligations. Once again it is also necessary to formulate a judgment about which obligation is more expressive of respect for life if conflict is seen to exist"
"Active euthanasia is extremely difficult to defend morally. There are, however, extreme circumstances in which we may have to at least raise the question of a fundamental conflict of obligations. There is an analogy between such cases of active euthanasia and abortions, questions that are based on the circumstances of the fetus. There is an accompanying prejudice against the taking of life in both cases, since the conflict between doing no harm and protecting from harm has reference to one and the same individual. The ambiguity of this situation serves to reinforce what has already been said about cautious and consultative decision-making."
What goes under the label .euthanasia. can be usefully distinguished as “active euthanasia” and “passive euthanasia.” The former, which is the act of taking life directly, can only be raised as a moral possibility in situations where we experience a conflict between out twofold obligation not to harm another and to protect that person as well. To justify such action morally requires the demonstration that the conflict is real, cannot be reduced, and that the action of protecting for harm is more consistent with respect for life. Each of these conditions is extremely difficult to fulfill. In any event, the inherent ambiguity of such a decision requires that it be [made] thoughtfully and prayerfully, in collaboration with knowledgeable persons not emotionally captured by the situation.
“Passive euthanasia” or “allowing to die” is indistinguishable from “active euthanasia” if the person is not in a condition of dying. If, however, the patient is determined by appropriate medical indications to be dying, the matter becomes one of a right understanding of the obligation to protect from harm. Protecting persons from harm involves caring for them and accompanying them, but not medical interventions which can only prolong dying. Decision-making requires expert medical consultation as well as other consultation that enables affected parties to distinguish meaningfully between prolonging dying and prolonging life. Of special importance is continuing to care for and support the person who is allowed to die. It is also important to acknowledge the fact of death whenever cerebral function, which makes possible human relationships, is irretrievably lost, distinguishing it from both taking life and allowing to die." (In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues)[19]

Withholding & Withdrawing Treatment

Official Statement: from In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues (1995), 62-63.

"The question is basically whether medical interventions should be made or continued, or whether the person should be allowed to die as a result of the medical condition.
The moral question posed here is not whether two obligations are in conflict. It is rather the question of what constitutes the fulfillment of the obligation to protect from harm. In allowing to die, one is not active but passive. It follows that the activity of doing harm cannot be attributed to the passive procedure of not intervening. Thus we are not confronted with a conflict between obligations to do no harm and to protect from harm. Rather, we are confronted with the question of what our obligation to protect from harm means in such circumstances.
In one sense, every medical intervention represents a decision not to allow a person to die. Therefore, it would appear that normally we assume that the obligation to protect from harm means that we do not allow people to die if we can do something about it. Yet a further distinction is relevant just at this point. When we speak of not allowing a person to die, we usually mean that we are prolonging their life. However, there is a difference between prolonging life and prolonging dying. If the effect of a given intervention is not to prolong life, but to prolong dying, then we cannot claim that we have protected human life from harm by the intervention. Our earlier discussion of the finite character of human life makes plain that death is not always to be understood as a harm. Where dying is judged imminent and inevitable, death is not a harm from which we can conceivably be protected. Hence, there can be no obligation to protect from this event."
Thus the fundamental judgment that has to be made in the matter of passive euthanasia is whether the person in question is dying or not. This is not the same thing as asking whether a patient is terminal. A person with a certain form of cancer may clearly be terminal, but this does not necessarily mean that the individual is confronted by impending death. The dying condition obtains when it becomes apparent that no available medical treatment will reduce the disability or improve the capabilities of a terminal patient facing impending death. The effect of medical treatment in this case cannot be to prolong life, but at most to prolong dying by marginally forestalling impending death. The determination of the condition of dying is fundamentally a medical judgment that will need to be rendered by qualified medical personnel. Once the judgment is made, the situation can be analyzed in terms of our obligation to protect from harm.
In such a situation the obligation to protect human life from harm does not require us to treat the condition that is leading to death. On the other hand, it does require us to accompany and care for persons in every relevant way. Certainly it obliges us not to abandon persons, leaving them to die alone. Instead, protection from harm means that we will remain with them, offering company and support as they confront the inevitable implication of their own finitude. Additionally, medical treatment designed to relieve pain and make persons more comfortable would continue to be very much in order. Entailed in this commitment to accompany dying patients is a readiness to undertake medical treatment that will prolong dying if requested by patients, assuming their competence. Perhaps most often in the situation of dying, the person will be unable to make judgments or requests of this sort. Here, where doctors and guardians are necessarily entrusted with the decision, no moral obligation to treat the dying patient exists." (In Life and in Death We Belong to God: Euthanasia, Assisted Suicide, and End-of-Life Issues)[20]


Notes

  1. https://www.pcusa.org/resource/problem-pregnancies-and-abortion/
  2. https://www.pcusa.org/resource/problem-pregnancies-toward-responsible-decision/
  3. http://index.pcusa.org/nxt/gateway.dll?f=templates$fn=default.htm
  4. https://www.presbyterianmission.org/blog/2016/02/23/abortion-issues-2/
  5. https://www.presbyterianmission.org/blog/2016/02/23/abortion-issues-2/
  6. http://index.pcusa.org/nxt/gateway.dll?f=templates$fn=default.htm
  7. http://www.pcusa.org/media/uploads/_resolutions/covenant-of-life-and-covenant-and-creation.pdf
  8. http://www.pcusa.org/resource/resolution-christian-responsibility-and-national-m/
  9. http://www.pcusa.org/resource/life-abundant-values-choices-and-health-care/
  10. http://index.pcusa.org/nxt/gateway.dll?f=templates$fn=default.htm
  11. http://index.pcusa.org/nxt/gateway.dll?f=templates$fn=default.htm
  12. http://index.pcusa.org/nxt/gateway.dll?f=templates$fn=default.htm
  13. http://index.pcusa.org/nxt/gateway.dll?f=templates$fn=default.htm
  14. https://www.presbyterianmission.org/blog/2016/02/23/abortion-issues-2/
  15. http://index.pcusa.org/nxt/gateway.dll?f=templates$fn=default.htm
  16. https://www.presbyterianmission.org/resource/paper-life-and-death-we-belong-god-euthanasia-assi/
  17. https://www.presbyterianmission.org/resource/paper-life-and-death-we-belong-god-euthanasia-assi/
  18. https://www.presbyterianmission.org/resource/paper-life-and-death-we-belong-god-euthanasia-assi/
  19. https://www.presbyterianmission.org/resource/paper-life-and-death-we-belong-god-euthanasia-assi/
  20. https://www.presbyterianmission.org/resource/paper-life-and-death-we-belong-god-euthanasia-assi/
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