Toward an Integrated Adventist Bioethics

In my initial Spectrum Column I asserted that there is no Seventh-day Adventist ethic. But there are certainly Seventh-day Adventist ethicists and, more specific yet, Adventist bioethicists exist in disproportionately high numbers. This fact is surely due to our traditional emphasis on healthcare as an essential element of the ministry of Jesus Christ. This week, at Loma Linda University, the first ever national meeting of Adventist Bioethicists was hosted by LLU’s Center for Christian Bioethics. Among the other goals for our meeting, the following two strike me as particularly important, and particularly difficult:

-“To strengthen the bioethics bond between the Adventist Church and its health systems in North America.”

-“To explore the potential for future cooperation in bioethics across the Adventist health systems.”

Worthy goals indeed. I'll address the first goal in this column and save the second for a future piece. My initial—and pessimistic—response is due to my reading of the history and current practice of the two relational elements set out in these goals. First, the "bond" noted between the subcultures of the Adventist Church and its health systems in the U.S. is tenuous to begin with, something admitted by the goal itself. To help us understand what is going on today, we do well to trace a bit of our history.

The dramatic growth experienced by the Church in its early days in Battle Creek, MI resulted in at least two sub-cultures, ministerial and medical. These cultures are typified by the impressive community involvement and outreach of Kellogg's Sanitarium and the ministerial attention given to the Press and the role it played in Church's evangelism and growth. Tension was not long in coming, following the success of these emerging Adventist institutions. Some of the leadership at the time were content to offer health care to the public as an end in itself. Others insisted that healthcare be an entering wedge; another form of evangelism. Historian James K. Davis notes that this “tension . . . has been present in Adventism ever since the early days of Battle Creek Sanitarium.” Davis refers to the “pole of professionalism” and the “pole of sectarianism,” or what I call the ministerial and medical sub-cultures of the Church (Davis, 1983, 48–59).

The locus of this tension in Battle Creek fell on the person and professionalism of John Harvey Kellogg and the Sanitarium he built with the backing of the Church. He and his medical supporters routinely clashed with the Church's leading ministers and administrators, primarily over the balancing of the purpose and goals of the Church and its ministries. Fire destroyed the Sanitarium in 1902. In the effort to rebuild, stress with Kellogg proved too much. By 1907, he was officially dis-fellowshipped by the Battle Creek Seventh-day Adventist church. Yet he managed to wrest the Sanitarium from the Church. According to the socio-historical work of Malcolm Bull and Keith Lockhart:

"The great question of Adventism at the time was whether the church would follow Kellogg or whether it would remain a clerically dominated organization. In the ensuing conflict, Kellogg set the medical network against the church hierarchy. . . .The clerical leadership did maintain control of the church, but it was unable to eradicate the form of Adventism Kellogg advocated. Adventist doctors continued to enjoy a special status within the church, continued to practice an ‘undenominational’ Adventism." (2007, 305–06)

Within ten months of the Sanitarium fire The Review and Herald Publishing Association also burned down. The loss of “The Press”on the heels of the Sanitarium’s destruction was a difficult blow to the Church and the decision was made to rebuild in Washington, D.C. Through the years, the ministerial group has held the Church together all around the world, focused primarily on evangelism with obvious concern for education, healthcare and disaster/development relief. It has not controlled the medical subculture of the Church, however, particularly in the United States.

After the Battle Creek fires, the medical subculture moved to the left coast (Southern California) and opened the College of Medical Evangelists (later Loma Linda University) in 1905. Over the years LLU and the rest of the spawning medical subculture have worked very closely with the ministerial culture (the General Conference) though rarely simply under its dictate. So these two subcultures continued to develop in the wake of the fires and moves east and west, one formed by medicine and liberal arts education, the other formed by ministerial and evangelistic fervor. In all honesty, they have always been slightly at odds with each other; tension is an ongoing characteristic of the relationship between the ministerial and medical subcultures in the Church.[1]

The question for us now, here in the U.S., is how we can recapture and strengthen the bond between these groups. We would fail ourselves and our Church if we let these historic tensions unravel the bonds completely. There are plenty of examples of other faith traditions who have allowed similar tensions (they are not unique to Adventism) to destroy their combined ministries. Here, my pessimism is slowly being crowded out by an optimism generated from a multi-year effort of a few determined leaders. While the meetings, conversations, and decisions are in their early stages, all the key parties are involved and apparently determined to make some progress.

A number of meetings over the past several years between leadership from each of the Adventist healthcare corporations and the NAD President and his team bring cause for hope. An important, early meeting happened in 2011 at Kettering, which seems fitting given the historic cooperative effort of that institution to blend Adventist and local community offerings in healthcare. Over the next three years a statement, "The Vision for Adventist Healthcare Ministry in North America," was written, vetted, and officially adopted by the NAD at the 2014 Year End Council.

The Vision calls for "new ways to bear witness to our Creator's love, and new avenues for vivifying the prophetic message of the Advent movement." The bond is clearly cooperative as opposed to the Healthcare Systems people acceding to the supremacy of the ministerial sub-culture. Rather, these Systems are hoping to "strategically align with the mission of the Church." Work of this sort, says the Vision, "is always more than business." Thus, those who approved the document are "dedicated to principles of transparency and integrity in the communities we serve." The emphasis on the local community is extremely important given both our Church history and the present day context where healthcare is under intense governmental and public regulation and scrutiny.

What I want to know is whether the strategic alignment aims at a sectarian evangelism that attempts to recover or reclaim the Healthcare Systems as the "entering wedge" of the ministerial sub-culture of the Church, or is the Church attempting to allow itself to be content with simply helping local communities through its Healthcare Systems. Is the Church's hope for this alignment associated with growth or does it simply, authentically, desire to benefit local communities? If the words of the Vision are to be accepted at face value the answer leans toward the latter, namely, they "imagine a world in which the communities we serve are blessed by the healthcare ministry to which our Creator has called us."

The historic tensions between the ministerial and medical sub-cultures have been mediated by the emerging business sub-culture in Adventism. Perhaps I should say the tensions have been buried in a tidal wave of size and influence. The Vision notes that "today, more people come into personal contact with Adventist ministry through our healthcare institutions than in any other way." By a long shot, and in ways that amount to a massive amount of money. Make no mistake about it, the healthcare dollar in North American Adventist ministry is the single most influential resource available. But its availability is indirect since the Church (the ministerial sub-culture) does not own the Systems. The “strategic alignment” must amount to an emotional, familial, authentic desire to advance the Adventist vision of whole person care to our communities. By that I mean that our Healthcare Systems may delight in the idea that their service may result in people actually joining our Church but this goal has to remain secondary to the simple need of helping their local communities maintain their health. The so called “population health” approach being advanced by the Affordable Care Act, is essential to that effort and something we are particularly suited to attend to. Our Healthcare Systems are well ahead of many others in that pursuit. This is good. But again, the blessing to the Church itself amounts to an indirect line.

The actionable items of the Vision include a number of events that do indeed help "strengthen the bond" between the ministerial, medical and business sub-cultures in American Adventism. The national Adventist Bioethics conference, just concluded, is one of the Vision’s actionable items. Referring back to the goal noted above, the language needs to be carefully parsed. The bond is not simply between the Church and its Healthcare Systems but a specific "bioethics bond" between the two parties. This may call for an entirely new column, but for now you should understand that the Church's bioethicists have always been most closely aligned with the medical sub-culture rather than the ministerial sub-culture. The Church's ethicists are typically seminarians and thus completely aligned with the ministerial branch of the Church. The two groups have some theological and social differences that are inextricably connected with those underlying tensions noted above and rooted all the way back to Battle Creek. One simple illustration to make this point is to note that there are no ethics textbooks or degree programs in any of our schools who train ministers. None. There is a Masters level degree program in bioethics at LLU.

As our meeting wrapped up and I turned my attention to this column, I am more optimistic than I had thought I would be. Each of the Systems sent important representatives to this national meeting. The Church was well represented and there was a good spirit in the room. Real progress is being made on the first goal. As for the second, the call for "cooperation in bioethics across the Adventist health systems," I fear we face a double uphill battle. Protestants (I think we're still Protestants) don't often cooperate nicely. Neither do American business leaders – read: Adventist business leaders. Competition is the name of the game, not cooperation. More on this later…

References:

Davis, J. K. “The Bitter Taste of Prosperity: Sectarian Jeremiads and Adventist Medical Work in the 1920’s,” Adventist Heritage 1983, v.8, n.2, 48-59.

Bull, M. and K. Lockhart. Seeking A Sanctuary: Seventh-day Adventism and the American Dream, 2nd edition, Bloomington: Indiana University Press, 2007.

[1] See Carr, Mark F. “Seventh-day Adventism’s Protestant Healthcare Ministry in America,” Christian Bioethics, (2015) 21 (2): 214-236.

Mark F. Carr is an ordained minister and theological ethicist with experience as a pastor, pilot, commercial fisherman, professor, and now clinical ethicist. He writes from his home town of Anchorage, Alaska.

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This is a companion discussion topic for the original entry at http://spectrummagazine.org/node/7421

“One simple illustration to make this point is to note that there are no ethics textbooks or degree programs in any of our schools who train ministers. None. There is a Masters level degree program in bioethics at LLU.”

This is a most unfortunate situation: that ministers who will so often answer questions and counsel members are at “sea” about the ethics needed to appropriately listen and offer advice.

Patients are much more willing to ask their personal physicians who know much more about them than their pastors who are ill prepared to offer good ethical advice.

As for integrating the two often competing entities in the church, we should be grateful that the healthcare professionals were never directly under the ministerial. Medical professionals are much more in tune with the economics when the only source of revenue is from patient healthcare and not dependent on free will tithes and offerings. When an individual or institution depends on its own ability to engender revenue it is in an entirely different category than a charity dependent on the good will of its donors.

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It will always be difficult for various people and organizations to have an integrated policy on any issue, but there is a clear virtue in the desire and the effort expended to bring it about. I can’t see that there is any downside to having various entities get together to share their viewpoints and seek unity.

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the are two dominate issues facing the healing arts, Adventist acquiring hospitals and clinics faster than they can truly incorporate them into the high standards of care noted for Adventist institutions. the other is the reimbursement system, both public and private. In order to get a fair return the bill has to be inflated. My cardiologist bills for $500.00 and gets $58.00 The work is worth about $125. More and more physians are becoming employees of tiriary hospitals. At 91 my pill box contains 9 prescription daily does. I use Generic yet the costs are taxing Any budget. tom Z

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A secure seat can hardly be balanced on two’ legs’. as it were. Many third world Adventists regard the opportunities for professional training provided by educational institutions owned by the SDA Church as powerful motivation to retain denominational loyalty throughout their lifespans. The ministerial cohort I regard as the prime moral “shock troops”, that is, the most important of the spiritual warriors affecting the growth of the church, but it may be in some danger of losing ground among “the new young” especially those who grew up in traditional SDA families and have become bored/ tired of the same ol’ reliance by their parents on what they regard as the shallow trad explanations purveyed by some of the ministerial cohort, notably characterized as unquestioned superiority of “Faith over Learning” whatever that may mean… The educational subculture is therefore assuming increasing importance. The values of the medical health care subculture was always a problem for me . The medical health care in Adventist sanitaria/ hospitals I was in no position to judge personally since I was never ill to the point of requiring such care but glowing reports from adults SDA/non-SDA in my community made me proud to be SDA. BUT I always why Dr Kellogg chose to develop "corn"as a food business and I never liked “soy” as a major food either. Both products, to My mind are not suited for achievement of optimum human health. After all even Jesus ate and fed fish to people who gathered round him to listen to his discourses.

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Bioethics should be a MAJOR course of study in all of our schools. As Adventists we need to recognize that Bioethics is a multidisciplinary field that draws upon medicine, law, philosophy, public health, public policy and theology to address problems and solve dilemmas that arise in the clinical, research or political arena. We should develop curriculum that begins in academy (high school years) for all of us. This is a subject that touches our lives at different levels.

Adventists need to understand and be part of the discussion on this important and growing field of study. Bioethics, is really a subfield of ethics, the philosophical study that looks at the moral basis of human behavior. For example, a bioethics committee, families, individuals needing to make important decisions, may be asked to answer such questions as:
• Is it okay to let a person refuse life-saving medical treatment?
• Should terminally ill patients be allowed to end their lives with physician-prescribed medication?
• Who should receive limited medical resources like organ transplants?
• Can researchers destroy frozen embryos in order to isolate stem cells that may be used to develop new medical treatments?
• Should parents be allowed to choose the sex of their child?
• Can doctors quarantine or forcibly treat patients carrying an infectious disease like tuberculosis?
There is an excellent on line article about this field of Bioethics and iit’s impact on all of us on this link:
scienceprogress.org/2009/08/what-kind-of-bioethics-council

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Just for a historical view back on SDA (and not at RCC or Protestant endeavours):

The first SDA in Germany . “Getaufte Christengemeinde” - were influenced by Pietist Health. Pator Bodeschwingh fouded the first mnetal illness asylumafter r asking for advice from a French Huguenot - At first in the healthy country atmosphere, at second a railroad station near - so the relatives easily could come for a visit , and then - the most important : have a believing, praying , helping church in the vincinity. And the Medical Facultiy of Halle fostered believe - guiden medical research and practice. already in the eighteenth cetury.

They called it “Life reform” - with a dress reform, educational reform ,whole wheat, no crops from artificially fertilized soil, no vaccination, water cure, Natures remedies.food - dietetics - the first Health Food Store was opened 1900 in Wuppertal, just where the first SDA Church was established quite fifty years before. They had a stong resistent position against “Schulmedizin” and Virchows Social Security Program. Virchow was - with his assumptions of cellular pathology - the one pathologist who influenced wide parts of Europe - and he was a politician too, enabled to foster hygiene. And he was a clearcut positivist / naturalist…

In fact : The nations health improved because of Virchows issues ! Hygiene, fighting tuberculosis - - vaccination.

And here now we have a not so positive mix of “Schulmedizin” , SDA “Helath Message” and ministers seeing their main mission to read every new book , just be it against Schulmedizin. and having acqured quite some partial knowledge of the mythical past (Yellow flowers are good for the liver - for example).

Now you have a sick member. The physician prescribes this or that. The faithful member asks the pastor - he objects and gives the advice for some herbs - - Nooo chemisties developements on Parkinson ! - So the Division Helath Secretary, once having been a surgeon.

Bioethics is a matter that interests just one friend and colleague and me here in Austria. Sometimes we are embarrssed, or sad or horrified . But we do not preach Vegan, so all we say on life and its end or on its beginning and procreation is worthless.

And some still could live , would they not have belived on diets, but had a coloscopy in time… ( I myself had two already !) .

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Ellen White had a skin cancer on her temple. She had radiation treatments for it.
If the colon has polyps, they need to be snipped off.
Oxidation is a part of our body chemistry. These radicals can cause us problems.
Question – Do we let “nature” take its course through our body?
OR, do we interfere with “nature” and "free radicals’ with “so called chemicals – drugs”?
and live happier.?

SAM – discussing TB. Back in early 2000 we had a patient with a respiratory problem admitted.
Was put in general population patient room. His sputum came back Resistant TB. He was then
put in isolation and given TB medications. But in the meantime me and 5 other nurses turned up
positive, and had to take the 6 months of daily TB drugs and have scheduled chest x-rays at the
health dept. in town.

Are they going to ban abortion in Adventist institutions? If not, why not?

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What does “ban” mean? All of them for any and all reasons?

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The Center for Financial Literacy and Entrepreneurship on La Sierra U’s campus named in honor of Edward C. Allred, the notorious abortionist and owner of abortion clinics and gambling venues, should have been named Center for Adventist Bioethics.

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What do you take to be “fact” and “extremely rare?” Are you working in a labor and delivery unit in a hospital? Do you speak from experience of some sort?
Secondly, you are completely wrong to say that the Adventist Church is pro-abortion; it is nothing of the sort.

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Substantially less than 1% is very common data.

Edward Allred… LSU, LLU grad. Personally claimed to have aborted 250,000. Was he ever asked to drop his SDA affiliations?

The Feldkamps. Adventists or not? Their clinics represent the largest for profit abortion chain in America.
Out- doing Planned Parenthood even.

If you did the eulogy at an aborted baby’s funeral, that wouldn’t make you pro abortion. If you own an abortion business, you are pro-abortion, and pro-death.

If it happens at your hospitals or your clinics, you are pro abortion by affiliation.

Fear not. Adventists make up for it by clamping down on more substantial sins. (Eating cheeseburgers, being the only mammal that drinks other mammal’s milk, not recycling, etc.

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Unborn Victims of Violence Act of 2004

[[Page 118 STAT. 568]]

Public Law 108-212
108th Congress

                             An Act

To amend title 18, United States Code, and the Uniform Code of Military
Justice to protect unborn children from assault and murder, and for
other purposes. <<NOTE: Apr. 1, 2004 - [H.R. 1997]>>

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress <<NOTE: Unborn Victims of Violence
Act of 2004.>> assembled,

SECTION 1. <<NOTE: 18 USC 1841 note.>> SHORT TITLE.

This Act may be cited as the Unborn Victims of Violence Act of 2004'' orLaci and Conner’s Law’’.

SEC. 2. PROTECTION OF UNBORN CHILDREN.

https://www.gpo.gov/fdsys/pkg/PLAW-108publ212/html/PLAW-108publ212.htm


EDIT:

HR.36. Pain-Capable Child Protection Act

2015

https://www.congress.gov/bill/114th-congress/house-bill/36


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It’s commonly CLAIMED, but it’s not actual data. And furthermore, it’s unclear why Adventists should be leaping to follow the whims of evangelicals- if evangelicals jumped off a cliff, does that obligate Adventists to?

There is absolutely nothing in the bible about abortion. In the old testament, assaulting a woman to cause a miscarriage was treated as a property crime. This notion that abortion is the moral equivalent of murder is a modern invention.

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That bill (never acted upon) was from 2004, a dozen years have passed and it has died, as it should. Attempting to label a zygote (when it it a “person” would open a flood of claims made by “persons” yet unborn. When is such a “person” able to establish all the rights given under the Constitution? This is one of the most ridiculous suggestions legislators have introduced, but not by very far. Mandating “Vaginal ultrasounds” might have been worse. Who should be prosecuted for murder when there’s a miscarriage?