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A New Face on Things 

The disappearance of the University Chapel from the cover of 
our Review has nothing to do with any recent events on campus. 
Happily, the Chapel stands. Yet we are in a period when church 
edifices generally seem inadequate as symbols of a relevant style of 
Christian life and witness. In this regard the university campus is 
certainly no exception. (The handsome new cover is by Richard 
Heitzenrater, Ph.D. Duke, 1969). 

No one needs to be told that university, church, and community 
life is presently marked by turbulence and controversy. This situa- 
tion is reflected in several of the articles in this issue. Perhaps it is 
not coincidental that the President of the United States is mentioned 
or alluded to in three of these articles, and never in an entirely com- 
plimentary light ! Possibly this implies that the authors are Demo- 
crats — and some may be — but more likely it simply reflects the way 
in which church, theology, and politics overlap one another in con- 
temporary discussions. The world is very much with us, for weal or 
woe, in every consideration of the mission and life of the church. 

D. M. S. 


Volume 35 Winter 1970 Number 1 


A New Face on Things Inside Front Cover 

Obsolescence and the Wisdom of God 3 

by Robert E. Cushman 

The Ecology of Theology 10 

by Howard C. Wilkinson 

Chapel Meditation 15 

by Andrew Sagar 

The School Of Babylon 19 

by Van Bogard Dunn 

Dean's Discourse 28 

Book Reviews 32 

Divinity School Review Committee: D. Moody Smith, Chairman; 
Frank Baker, Donn Michael Farris, Thor Hall, Creighton Lacy, 
Gene M. Tucker, and David Rutledge. 

Published three times a year (Winter, Spring, Autumn) 
by The Divinity School of Duke University 

Postage paid at Durham, North Carolina (27706) 

Obsolescence and the 
Wisdom of God 

Robert E. Cushman 
Dean, Duke Divinity School 

"But where shall wisdom be found, and where is the place of understand- 
ing?" (Job 28:12) 

"But of him are ye, in Christ Jesus, who was made unto us wisdom from 
God, and righteousness and sanctification, and redemption ..." (I Cor. 


The opening of the school year and the reassembly of the Divinity 
School family is the recurring occasion of this Convocation. As on 
previous anniversaries of this day, we pause to get our bearings and 
chart our course. Once again we celebrate our hopes in the light of 
God's promise and seek to refine our expectations. We welcome 
newcomers to our midst as fellow seafarers, both students and faculty. 
Some portions of the voyage may be stormy, some placid, and others 
favored with a steady blow to windward that spells progress for sails 
well trimmed and a proper pointing of the compass or manning of the 
rudder. Whatever the weather, today we say bon voyage to new- 
comers and mean it ! We only caution that, in sailing, advance is 
made by using the wind at oblique angles, not "luffing" the sails, and 
so arriving at one's destination. It is for this reason that sailing is 
a better guide to life than automotion, but few there are who now- 
adays could be expected to know it ! 

We are a Divinity School, and being what we are — a theological 
center committed to exaltation as well as preparation of the Christian 
ministry — our opening Convocation is, first of all and above all, a 
Te Deum. As such it is our corporate acknowledgement of our rea- 
son for being ; that is the service of God. And this is our "reasonable 
service" if we heed who and what we are as a school according to 
the charter of the University, the expectations of the Church, and 
the mandate of Christ. 

All are welcome here who desire to join in our corporate Te 

Opening Convocation Address for the Academic year 1969-70. 

Deum and in so far as each is searching to discover for himself the 
ways in which God is truly to be served in his generation. It is very 
true that the ways of serving God are not one, but many, and that the 
changing scenes of life conduce to the obsolescence of some ways and 
the greater timeliness of others. 

This circumstance is a mystery with which the poet Tennyson 
wrestled much, and Camelot was among us last year to underscore 
once more the enigma of the obsolescence of the good. Nothing in 
Anglo-Saxon literature highlights so well the glory and the misery 
of man as is dramatized in the Arthurian Legend. The glory of the 
Round Table and the tragedy of its dissolution were among the 
massive impressions of my childhood. And Tennyson struggled to 
give it meaning in the dying soliloquy of Arthur : 

"Time makes ancient good uncouth; .... 

And God fulfils himself in many ways, 

Lest one good custom should corrupt the world." 

I do not venture to judge whether Tennyson successfully illumi- 
nates the tragedy of obsolescence. This morning my eye is rather 
upon the sword Excalibur which Sir Bedevere, faithful to Arthur's 
last request, flung into the meer and was withdrawn from sight by 
the same mystical arm that committed it to Arthur in the first place. 
Excalibur was and remains the symbol of the divine calling. It is a 
parable offered to us, as to all God-fearers. No one inherits the 
divine calling; none have it by "divine right." In the Arthurian 
Legend, it falls to him who is worthy, able, and ready to rise to 
grasp it as a higher mandate and a life vocation. Excalibur stands 
for the diviner calling that is not a matter of inheritance nor in the 
power of men to transmit. Rather it is reserved for higher appoint- 
ment and bestowal upon him who will and can receive it. 

To rise and respond to such appointment and bestowal is that 
liturgy of life, that leitourgia or service to God, which, according to 
St. Paul, is our "reasonable service" and proper Te Deum. It is 
to find those ways in which God seeks to fulfill himself — that is his 
purpose — in every age and to make common cause therewith. More- 
over, Excalibur is the reservation of final authority to God. His- 
torically, it has been a check to the pretensions of absolutism in 
monarchy and statecraft. Excalibur publishes the truth that power 
and authority are God's. They are man's only for good usage, never 
for possession ! 

And one more observation about Excalibur of the Arthurian 

Legend : the bearer of the sword never presumes to know why he 
has been appointed to this high calling. He is not an enthusiast, 
verging upon fanaticism, who is over-confident of easy discernment 
of the purposes of God amidst the tangled web of human life and 
change. Among the altering and multifarious traditions of men, he 
struggles to discriminate the ways of God. He seeks the interwoven 
thread of meaning, the emerging pattern of the slow sure march of 
Destiny and aims to ally himself with the continuity of history. This 
is the living tradition. As it issues out of the past, it also holds the 
promise of the future. To unite with this tidal flow of history calls 
for maturing discrimination between what is merely in vogue and 
what is enduring. 

There is truly a past, a part of the human past, which is preface ! 
From another perspective, history is also the graveyard of dis- 
carded idols, vagrant enthusiasms, and obsolete cause which, in their 
time, offered themselves as God's ways for men. Perhaps in their 
time they were "broken lights" of the enduring purpose of God. 
Tennyson thought so. And such perhaps is human history at large, 
always and only a refraction of the larger light of God and his more 
ample purposes for his creation. 

It is this latter which I like to call the Tradition as distinguished 
from the multifarious and transient ways of men. And I say again 
as I urged a year ago at this time that the business of the theological 
center is to track the Tradition and, by the art of discrimination, find 
it out. Indeed, I say again, the heart-aim of theological education is 
cultivation of the art of discrimination. It is urgent today, for unless 
you learn to discriminate between current panaceas and God's ways, 
between apparent solutions and real ones, not only will your present 
endeavors be "dated," they will have become obsolete by the time you 
are forty. 


What I am also asking today, in the face of another academic year 
and our own particular enterprise of theological education, is the 
question about obsolescence. Of this reality the Arthurian Legend 
is the glorious and tragic embodiment. You students are not forty, 
and I am at least that ! Meanwhile, it is widely rumored that none 
over thirty are to be trusted ! On this premise most of you have not 
far to go before your usefulness will be spent and your contribution 
expendable. On this premise, indeed, you will hardly get started! 

What will you do? Will you take a cue from modern industry 

and merchandising and resort to a program of "planned obsoles- 
cence?" What will you do with the old model that is yourself and 
your life investment? Although they clutter the landscape, old cars 
may be junked and things discarded, but what will you do with your 
person at thirty or, possibly, at forty if you make it? The trend to- 
ward early retirement may assure you of getting out of the way if 
not out of sight ! 

Planned obsolescence could also include a studied effort to 
"change with the times," as it is said. "The old order changeth 
yielding place to new." Undoubtedly a wise flexibility is a guide to 
life if critical and discriminating. On the other hand, there are pit- 
falls; and, among assured ways of becoming obsolete, is uncritical 
espousal of contemporaneity as one's mode of life. Modish conform- 
ism is unplanned obsolescence for sure ! 

But there is a deeper problem that besets our common humanity 
and from which the devotees of change are not exempted. It is a 
question as old as Heraclitus and never more insistent than in our 
own time of unparalleled alteration of the face of human existence : 
in the deluge of change that is our era, to what passing events or 
cluster thereof shall we attach such ultimate significance as to hold 
our devotion and find our reason for being? 


Without such a vision we may already be obsolete ! So, I think 
we are confronted again with Job's old question : "Where shall wis- 
dom be found ? And where is the place of understanding ?" We sense, 
somehow, Job was so far right that, without that wisdom, the welter 
of events are overwhelming, the ways of the world inscrutable, and 
manner of our calling unknown. Or, without that wisdom our lives 
are already obsolete in principle, purposeless, however captivated 
they may have been by a lifetime of successive engrossments. It is 
for a similar reason, if in a different idiom, that St. John says : "the 
world passeth away and the lust thereof, but he that doeth the will 
of God abideth forever" (I John 2:17). 

What is not obsolete, then, is every alliance of man or institution 
with the long, long thoughts of God. What is not so allied is in 
process of obsolescence and passing away. So our obsolescence is 
guaranteed by attachment of life to what is transient or ephemeral. 
Conversely, the authenticity of our vocation and the efficacy of our 
days depend upon alliance with what abides just exactly through all 
the chances and changes of our mortal history. This is alliance with 

Destiny, with what I would call the perennial Tradition. It is al- 
liance with what is "aborning" rather than aborting in the purpose of 
things. To have such alliance as a personal vocation is the only rele- 
vance which seems to me to have any promise of preserving us from 
obsolescence either at thirty or at forty. 

In like manner, it is the business of the theological faculty and of 
theological education to assist men to discriminate between what is 
"aborning" and what is only aborting in history. Likewise, it is the 
business of the Church to know the same differences and to challenge 
and win the adherence of men and women in the world to what is 
"aborning" in the ways of God with men. We may call this emer- 
gent reality the thread of history. In the New Testament it is called 
the Kingdom of God ! 


"But where shall wisdom be found, and where is the place of 
understanding?" This past August I sat one morning at breakfast 
with a local tradesman. I have known him as a hard-working and 
humble man whose personal life has been touched by a succession 
of baffling family sorrows. I do not know his church or with what 
regularity he attends one. I do know that he is a seeker after the 
wisdom of which Job's search was predecessor. 

In some such words as these, with hesitant modesty and even 
trembling concern, he posed a question and offered his own answer : 
"Dr. Cushman," said he, "I wonder whether you think I am mis- 
taken. I believe Mr. Nixon is an intelligent and good man, but how 
could he say of the 'moon-walk' a few days ago, 'This is the greatest 
week in the history of the world since the Creation ?' Dr. Cushman, 
I may be wrong but my Christian faith can't square with that. Don't 
Christians hold that what Jesus Christ was and did, with Calvary 
and Easter, are the greatest events since the Creation?" 

I remembered St. Paul's words in Romans, 8:22: "For we know 
that the whole creation groaneth and travaileth in pain together un- 
til now." What, for the moon-walk? Plainly, the "now" referred 
to the "new creation" in Christ Jesus ! Elsewhere in First Corin- 
thians, Paul identifies the "wisdom" which liberates from the bondage 
of corruption and, thus, also from obsolescence : He speaks of Jesus 
Christ "who was made unto us wisdom from God." I think the 
tradesman was right, and President Nixon was wrong! 

Earlier in this address I raised a question. It persists, as peren- 
nial as human life itself. Amidst the welter of events and ceaseless 


change, to what passing event or constellation of events will you 
attach ultimate significance and so find ends and aims worthy of your 
final devotion? That is the perennial question of man, and, unless 
he has answer, his personal and communal history falter and become 
aimless. Torpor overtakes him ; all becomes vanity and a striving 
after wind. Where only "Whirl is king," to use Shakespeare's words, 
meaninglessness overtakes our human lot and we and all our works 
are destined to early obsolescence! 

Without depreciating the technological marvels dazzlingly dis- 
played by what even Pope Paul is reported to have called the con- 
quest of the moon by astronauts Armstrong and Aldrin, and, cer- 
tainly, without any detraction from the extraordinary physical cour- 
age of the latter, I have to register personal doubt whether this 
fabulous feat of applied science is more than the latest and, perhaps, 
the near zenith of man's age-old conquest of space. Solid state phys- 
ics and the electronic computer made possible this latest and most 
spectacular advancement of the Baconian program which Bacon 
called "the extension of the powers and greatness of man," indeed, 
"the kingdom of man founded in the sciences." 

Man may yet have some more millions of miles to range within 
the perimeter of the solar system, but I cannot wholly credit the 
Pope's deduction that, thereby, he faces "a new destiny !" To solve 
his problems man has regularly resorted to relocation in space by 
migration and exploration, but he has been stymied by two realities, 
the irreversibility of time and himself. Wherever he goes his nemesis 
is that he cannot elude himself ! He takes himself with him ! It is 
the same man who could not make it here that goes there ! For this 
reason it was wisely said long ago : 

"He that is slow to anger is better than the mighty, 
And he that ruleth his Spirit, than he that taketh a city." 

(Prov. 16:32) 

But the prevailing story of man is his disposition to take another city 
rather than rule his spirit. He seeks salvation by expansion in 
space, but, in every relocation or expanded Lebensraum, he cannot 
evade himself. That is his fate ! Something better may be his 
Destiny ! 

The Christian faith is premised on the finding that the man who 
ruled his spirit and successfully evaded himself did so, not by relo- 
cation in space, but by full self-identification with the Author of 
Being. Self-conquest with him was not by way of space-conquest 

but by self-surrender to the Diviner Calling. It is for this reason, 
too, that St. Paul declares : Jesus Christ . . . "was made unto us 
wisdom from God." He also saw Christ as the mediator of our 
righteousness, sanctification and redemption. 

This self-evasion through self-identification is hardly spectacular. 
Its only sign was a cross ! Yet Paul glories in the paradox : God 
chose the foolish and weak things, even the things that presently are 
not to revolutionize the things that are. The revolution still goes 
on in the face of the deceptive promises of space aggrandizement or 
empire building as the way of human salvation. 

Job is our predecessor; he asks "where is wisdom to be found, 
and where is the place of understanding?" The answer of the whole 
Bible, and pre-eminently the answer of the New Testament is that 
wisdom and understanding have no place until they are truly em- 
bodied in the life of man ! It is this embodiment that bears good 
fruit in the relations and affairs of men; if not, wisdom is not really 
embodied : "By their works ye shall know them." 

This school, unless I quite misunderstand its charter, is com- 
mitted to the proposition that the wisdom of which I have spoken 
is for embodiment; that among its human embodiments — of which 
there are not a few — the surest moment of truth, the unparalleled 
embodiment, is the man Jesus, called Christ ; and finally, we are here 
committed to the proposition that the likeliest way to avoid obsoles- 
cence is to be united with Christ who is said to be "the same yes- 
terday, today, and forever." 

This is the case just exactly because our Lord made salvation 
to consist, not in relocation in space but through self-identification 
with what transcends every place and time, that is, with God the 
Father. Obsolescence is guaranteed for every time in any place. 
The way of salvation, in the final analysis, is by transition from 
quantity to quality, but the way is strait and the gate narrow; and 
few there be that find it ! 

Until you are sure that better is he that ruleth his spirit than he 
that taketh a city, you may be fit for the kingdom of man, but you 
are a long way from the Kingdom of God. The apparent tragedy 
of King Arthur is his real victory and deathless glory : He was better 
at ruling his spirit than taking a city ! The sword Excalibur is 
still available to those who will receive it as a higher calling. Not 
unlike the Cross, it stands, I think, for what is "aborning" in con- 
trast with what is aborting, or obsolete, in human history. 

The Ecology of Theology 

Howard C. Wilkinson 
Chaplain, Duke University 

Several years ago I listened to Joseph Sittler speak about the 
ecology of faith. It was clear that he was discussing something im- 
portant about the life of the Christian enterprise in the world. Among 
other insights which he brought to focus was the idea that our 
Christian faith of necessity manifests itself in different forms, de- 
pending upon the particular environment in which it is being lived 

He clarified the point that Christian faith might properly seem 
different to a casual observer who is beholding its shape in two 
different settings or who is analysing its expression in successive 
eras. Yet it might be the same Christian faith which is being wit- 
nessed to in each instance. 

While listening to Sittler talk about that, a kindred idea occurred 
to me, and I have called it "The Ecology of Theology," not because 
this rhymes better than his "Ecology of Faith," but because that is 
what this short paper is about. Not the ecology of faith, but the 
ecology of theology. Forgive me while I make a somewhat simplistic 
distinction between the two concepts. 

We can begin with an analogy. One of the species involved in 
ecology is the rat. The rat and his ups and downs correspond to the 
life of faith. The study of the rat and his ups and downs corresponds 
to theology. The rat's diggings, his gnawing into the corn bin, his 
encounters with traps, dogs, smoke bombs and other rats, represents 
the life of faith, and Sittler can properly speak of how one rat's life 
will be different from another, depending upon whether he finds him- 
self in an Iowa barn or a Louisiana swamp. 

Theology is represented by the attempt to define the essential 
nature of rat-ness, to describe in intellectual terms what it means to 
be a rat, as opposed to being a skunk; the search to refine the con- 
cepts which are involved, so that one can speak precisely and mean- 
ingfully about the rat, his relationships to the universe and his 
terrestial peers. 

Theology, then, as distinguished from faith, is that intellectual 
process by which we take the raw materials of the life of faith and 


seek to establish meaningful categories through which they may be 
understood in the mind while they are encountered in the heart and 
applied in the life. A traditional definition of theology is that it is 
the intellectual expression of religion. Webster's Unabridged Dic- 
tionary defines it as the ideational element in religion, a methodologi- 
cal description of what the faith is, or in the light of its experience of 
religious values, ought to be. A second definition given by Webster 
is that theology is a system of religious theory. 

This then is what we are talking about in this paper. Of course, 
it is difficult to become involved in the life of faith without doing a 
modicum of theologizing and, conversely, the person who spends 
very much time theologizing will likely find himself in personal en- 
counter with the God about whom he is speculating. But to the ex- 
tent that the two can be separated and dealt with in different com- 
partments, it is important to the idea of this paper for me to em- 
phasize that we are concerned here with theology and not with the 
life of faith itself. 

Before moving on to the business at hand, it is necessary to strop 
and hone one additional concept, namely, ecology. It is crucial that 
we have a very clear idea of both theology and ecology if the two 
practical affirmations toward which this paper moves are to be clari- 

So, what of ecology? A twelve-volume work, entitled The Audu- 
bon Nature Encyclopedia, provides the following statement : "Ecology 
is the study of animals and plants in relation to each other and to 
the physical environment of their natural habitat. The word, ecology, 
first used in 1869 by Ernst Haeckel, the German zoologist, is based 
on a Greek word, meaning home. To study a plant or animal ecologi- 
cally is to observe a species in the home where it lives naturally and 
where it is intricately dependent on all the other plants and animals 
and physical features — rainfall, altitude, soil, and so on — with which 
any species coexists." 1 

Zoologists have discovered that it is one thing to study rats under 
the carefully controlled conditions of the laboratory, with its bright 
lights, microscopes, and dissecting apparatus; but another thing to 
study rats under the musty floors of rotting barns and in the dingy 
corners of grain elevators. Of prime importance, both to zoology 
and to its analogy for theology, is the fact that scientists now know 
that the laboratory study of rat-ness without a thorough study in the 

1. Philadelphia : Curtis, 1965, Vol. IV, pp. 594-96. 


filth of the barnyields up an inadequate and distorted picture of the 
rat-ness of the rat, even for the purpose of the science of zoology. 

Moving now from the ecology of the science of biology to the 
ecology of theology (said to be the "queen of the sciences"), one 
finds an interesting parallel. The ecological matrix of theology is as 
relevant to an intellectual understanding of the Author of nature as 
it is to an understanding of nature. 

I wish now to move quickly to a declaration of the two practical 
affirmations or contentions of the paper, and then to discuss them 
together briefly. ( 1 ) The first is that it is better to locate a theologi- 
cal seminary in the complex of a great university which is struggling 
with the conflicts between activists and the establishment, and in a 
city where it cannot escape being involved with the struggles of 
man's day-to-day agonies, than it is to locate a theological seminary 
in a secluded retreat, aloof from the clash of secular ideas and the 
smoke and din of vulgar men. To state the same emphasis in dif- 
ferent words, we might say that the ministerial student who is 
choosing a seminary will be wiser to choose one of the first type than 
to choose one of the other kind. 

(2) The second practical contention is that the parish minister 
should not quench the impulse to theologize a bit at the end of an 
exhausting day of crises and frustrations. Often the busy pastor is 
so burdened down with counseling demands, unexpected emergencies, 
bone-crushing tragedies, and organizational dilemmas that he feels 
he is not qualified to attempt any serious theology; yet it just might 
be true that he would, in that circumstance, write better theology 
than his brother who had nothing to do but write theology. There- 
fore, with an abundance of humility, but with a measure of confidence, 
let the active, practicing parish pastor yield to his impulse to the- 

Now that the two theses are before us, let me discuss them 
briefly. The raw materials of our Christian faith more nearly paral- 
lel the life of the rat in a dirty barn than they do the life of a rat 
in a sterile laboratory. Therefore, just as the ecologist who is on his 
knees and elbows under the musty floor of a rotting barn will learn 
things about the rat-ness of the rat which he would never learn in 
an antiseptic laboratory, even so the theologian who wears out his 
shoe leather serving as a mediator in one of today's social confron- 
tations will ponder dimensions of the doctrines of sin and grace which 
he would never visualize while merely wearing out the leather in 
the seat of a comfortable chair in his study. 


The theologian who helps sweep up the remains of a suicide vic- 
tim who fell from a great height ; the theologian who has been in 
jail because the world is still out of joint ; the theologian who has 
shared the agony of a young couple whose beautiful dream was 
shattered by an unwed pregnancy ; the theologian who has introduced 
a brilliant professor to Alcoholics Anonymous and has seen him 
begin to stay sober a day at a time — such theologians are likely 
equipped to articulate the great classical doctrines of theology with a 
pungency, a clarity, and a depth of relevant insight which the purely 
academic theologian likely could never achieve. 

Although at a given moment parish theologians may be three 
weeks away from a personal encounter with Tillich and three years 
away from Harnack, it is possible that they still may have something 
worth saying. 

This ecological aspect of theology provides for a type of exis- 
tentialism in our thinking about God's redemptive activity in the 
world which the traditionalist can at least find understandable if not 
comfortable. Paradoxically, it also occasionally may be true that 
the theologian who has less time to theologize will serve up better 
theology than the one who has never found time to do anything 
except to theologize in the academy. 

As we pause to reflect upon some of the catch-phrases on which 
theological ink has been spilled in recent years, we wonder about 
the relevance of these both to the human situation on the one hand, 
and to God's Incarnation in Jesus Christ, on the other hand. Instead 
of having theological trends, moods and emphases determined by 
catch-phrases conceived in the laboratory (e.g. "God is dead"), let 
serious theological attention be given to the poignant dilemmas of 
man in his "dirty barn" encounters with himself, other men, and a 
God who will not be denied. In short, let theory be structured around 
the empirical confrontations which make up the minister's week-to- 
week work load. 

To change the figure, there is much for the theological Geiger 
counter to be found in the "fallout" which comes from the fission of 
the youth's id and super ego — to mention only one heated encounter 
which the pastor witnesses in a day. There are implications for 
Christian ecclesiology in a Selma march. The Anniversary of Martin 
Luther King, Jr.'s death plunges us at once into thoughts of eschat- 
ology. Who among us has not wrestled with questions about the 
nature of grace when it became our duty to tell a parent that his son 
or daughter died as a result of drunken driving? 


One further word about the seminary : However incandescent its 
faculty may be, a school of theology which labors in excessive de- 
tachment from the struggle between labor and management, white 
and black, rich and poor, will be a school whose theology will be 
harmed rather than helped by that detachment. The effect of de- 
tachment may be only a matter of attitude or motive, but that will 
be ample to achieve sufficient alteration in the "end product" so as 
to render it less than true to the divine mysteries revealed in the 
shed blood and speared guts of Golgotha. 

The area of this paper's interest is the articulation of faith, the 
province of theoretical theology ; and the conclusion here presented 
is that the ecology of theology has a profound effect upon the theory, 
as well as the practice of our doctrines. 

In our time we have seen the rise of an entirely new school of 
psychiatry which was born, not in a laboratory or in a classroom, but 
in the hell of a death camp where a desperate psychiatrist saw mean- 
ing and purpose make the difference between sanity and insanity. 
Out of what he saw and experienced, he perfected a theory of healing 
called "Logotherapy," and it has been found to work outside the 
concentration camp as well as inside it. Similarly, some of our best 
theologizing about redemption might be done on a dark and cold 
night, after an exhausting day of ministering to people who literally 
cannot live without the grace of the Lord Jesus Christ. 

Chapel Meditation 

Andrew Sagar 
Duke Divinity School, 1970 

I am a Divinity School senior, with twenty years of education 
behind me. I am young, idealistic, theologically aware. I am eager 
to become a leader in the church militant, a catalyst for the inbreak- 
ing of God's kingdom. Soon I will take a church. I am the hero. 

He is a layman, with the Depression years behind him. He is 
middle-aged, pietistic in expression, materialistic in motivation. He 
is Richard Nixon's kind of people, a guardian of middle-class values. 
He is waiting in the pew. He is the enemy. 

The enemy appears in other guises, too : 

He's the little old lady who greets me after my most radically devastating 
sermon: "I enjoyed your message." 

He's the district superintendent's wife who told me: "You'll go far in 
ministry if you just keep that wonderful smile." 

He's the conference recruiter who recently gave me some practical advice : 
"Let's be realistic, Andy. The salary is what you should be con- 

He's all the nice, innocuous little ministers whose image I am inheriting, 
all the so-called Christians who hold Christ's church hostage to the 
narrow, complacent, self-serving values of middle America. 

You could say to me, "That's a rotten attitude for a prospective 
minister" — and you might be right. But I think I've made real prog- 
ress since just last month, when I was still trying to tell myself that 
I loved all those people. 

I don't think Jesus ever said, "Pretend you have no enemies." I 
could handle a commandment like that — Just flop back to where I 
was a month ago and repress all those nasty thoughts. 

No, you know the one that's giving me trouble : — "Love your 

But I never even had any trouble with that one until I figured 
out who my enemies really were. I always thought "enemies" re- 
ferred to the Ruskies or the Viet Cong or somebody like that. — Heck, 
I'm real good at loving them. They're on the other side of the 


But that doesn't get at what Jesus was talking about. Those are 
just the people my government tells me are my enemies. But they 
aren't my enemies. My enemies are the people I meet every day, 
the people who comprise that arthritic old behemoth which is sup- 
posed to serve as the body of Christ. 

These are the people with whom I am at war; these are the 
people I'm supposed to love. 

But how can I love them? They stand in the way of all I hope 
to accomplish through the church. 

For all their sentimental morality, for all their token charity, 
American churchmen generally devote their God-given talents and 
energies primarily to looking out for themselves. 

And that goes for most of our liberals, too. No matter what 
they say or who they campaign for, no matter what humanitarian 
programs they advocate, I get the definite impression that very few 
liberals would really be willing to give up the security and comfort 
of the American Way of Life — a way of life which we insist on 
maintaining at the expense of the poor, both here and around the 

The human cost of our collective sin is beyond imagination. We 
pile wealth on top of fabulous wealth, working feverishly to invent 
enough new junk to waste it all on, while all around us are poverty, 
disease, hunger and all the other human tragedies which we have 
managed to reduce to political cliches. 

And does the "great silent majority" we've been hearing about 
give a damn? I mean really. 

I'm not talking about misty eyes, and 5% of the church budget 
for social action and missions. I've heard it said that we're doing 
all we can. We may be doing as much as we can without pain. But 
how many of America's Christian majority really, really care enough 
to push for a genuinely sacrificial mission on the part of America 
the Rich? 

As I get closer to graduation, I become more and more frightened 
by the prospect of trying to bring my idealized understanding of 
Christianity alive in a real institution composed of such people — 
people who are part and parcel of our self-centered culture. 

But I would not deceive you, brothers. I do not do all my weep- 
ing on behalf of Christ. I was forced to recognize that, just this past 
week, when I finally got around to reading Newsweek' s report on 
"The Troubled American." 

As the article quoted one angry white after another, all I could 


see was a parade of small minds and the overwhelming evil which 
oozed from their irrational and intransigent attitudes, the same atti- 
tudes that I continually encounter within the walls of the church. 

But this time, reading the article in the privacy of my own home, 
I allowed myself the emotion I had denied in face-to-face encounters. 
Inside of me there welled up a great big, blinding ball of hate- 
unbridled hate for every one of those God-damned, small-minded 

What's the matter with them anyway? 

Why are they so stubborn ? 

Why won't they listen? 

How can I save the world, how can I bring in God's kingdom, 
if I can't change their attitudes? 

And then I knew why I hated them. 

I hated them, not because they wouldn't change, but because I 
couldn't change them. The great unwashed are a mirror for my own 
inadequacy, for my own sin. 

I can't even claim the excuse of a small mind. I have seen what 
the Gospel demands, I have been shown the better way. And I 
haven't measured up. 

The way of the cross is too much for me. I'm not at all sure how 
much I'm willing to give up on behalf of others. 

I crave security, and I'm much more secure with rhetoric than 
with action. Just think how great it would be if I could talk people 
out of their present life-orientations. Then they would change their 
ways — because of me; and I would be justified, and my inadequacy 
would be obliterated. 

It would be great — but it doesn't work. I've been trying to use 
these people to pick up some cheap grace, but none has come my way. 
I'm all tangled up in sin — just like they are. 

And that's it ! We're all in this thing together. No more good 
guys and bad guys ; no more pretense. Every one of us is caught. 

This strange-new-wonderful sense of community with the enemy 
has helped me to know what I've been trying to tell myself for so 
long. I am not the unique failure. God loves me. He really does 
love me just like I am. And he loves them, just like they are. 

And you know what ? So do I ! 

End of war ? No more enemies for Sagar ? No, sir ! 

Even as I bring this sermon to its happy ending, men, women 
and children are dying at the hands of our personal representatives 
in Asia, or withering for want of some of the wealth we continue 


to hoard. American policy has not changed in the last ten minutes, 
and the church is as arthritic as ever. Countless enemies of the 
kingdom remain on the church rolls, and they must be fought — 
fought and loved. 

Is that possible? I'm here to tell you now, for me, it is. 

The School of Babylon 

Van Bogard Dunn 
Dean, The Methodist Theological School in Ohio 

My text is written in the refrain of the first stanza of a poem by 
Thomas Blackburn : 

This is the School of Babylon 
And at its hands we learn 
To walk into the furnaces 
And whistle as we burn. 1 

The imagery, as you all know, is from the story of the fiery fur- 
nace in Daniel 3. When I read the poem last summer in a critical 
essay by May Sarton, I knew at once that here was my title and 
germinal idea for this lecture. 2 But what was on my mind then is 
not at all what I will say here today. The image of "the School of 
Babylon" has unsettled my mind and forced me to consider more 
than I had intended to say. For as Miss Sarton has written : "Ten- 
sion between idea and image has to do with the depth and complexity 
of the image ; if it is an inspired image, i.e., one that comes from 
deep below the surface, it may very probably change the original 
idea, for the image is all the time pointing the way to what we really 
mean, and not what we thought we meant." 3 So today I speak to 
you about the "the School of Babylon" in the hope that this image 
will help me say and you hear not what I thought I meant but what 
I really mean. 

I. This is the School of Babylon. 

To mention "the School of Babylon" in a gathering of Divinity 
School Alumni is to take a calculated risk. The image lends itself 
to easy application to all the negative experiences and unpleasant 
memories which clergymen often associate with their years of formal 

The Alumni Lecture for 1969, delivered at the Fall Convocation, October 
28, 1969, in Page Auditorium. Dean Dunn holds the B.D. degree from The 
Divinity School and the Ph.D. from The Graduate School of Duke University. 

1. Thomas Blackburn, "The School of Babylon," quoted by May Sarton, 
"The School of Babylon" in Don Cameron Allen, ed., A Celebration of Poets 
(Baltimore: The Johns Hopkins Press, 1967), p. 131. 

2. Ibid., pp. 131-151. 

3. Ibid., p. 143. 


theological education. If one allows a casual and superficial en- 
counter with the figure to lead him along the way of old hostilities 
and half-forgotten frustrations, he will find the subtle pleasure of 
prejudice confirmed but he will pass by the exhilarating joy of a 
new perspective unveiled. So I ask you in the beginning to resist 
the temptation to identify particular professors or administrators as 
Nebuchadnezzar and to forego the satisfaction of defining certain 
academic experiences as a fiery furnace. 

The power of this poetic image arises in large part from its in- 
clusiveness. The image appropriates our storied past but is not 
limited to what happened to us "back then." It focuses our attention 
on what is happening "right now" as we seek to realize our calling 
in the immediate present. "This is the School of Babylon." Wher- 
ever we are and whatever we are doing as men and as ordained 
ministers, we are enrolled in "the School of Babylon." When we think 
about our lives under the guidance of an inspired image like this, 
we may be freed from the illusion that we have to pick and choose 
from what happens to us in order to make life tolerable. "The School 
of Babylon" administers a course of study which includes all our ex- 
periences: the good and the bad, the exciting and the boring, the 
joyous and the sad. Here we are instructed not by what we accept 
as desirable or reject as undesirable but by the entire gamut of un- 
censored and unrestricted events as they occur. The image itself 
challenges us to affirm the reality of life instead of some fancy about 
a part of it. 

Now I think this is what faith is all about. It is a trusting re- 
lationship to what really is; an attitude of confidence toward what 
actually happens. The image, "the School of Babylon," may become 
the occasion for a decision about the trustworthiness of reality. Yet 
it does not endorse Pollyanna romanticism any more than it pro- 
motes the "power of positive thinking." It simply confronts us with 
the fact that we live in Babylon. What does that mean? Just this: 
in all that we think and do we overstep our human limits by claiming 
absolute and unconditioned value for that which is relative and 
contingent. This idolatrous claim is not restricted to some special 
sphere of life, nor is it the particular vice of the wicked as distin- 
guished from the righteous. It breaks out everywhere and in every- 
body. "This is the School of Babylon" because here on earth we 
are always making images of gold. 

This insight can be applied to any realm of human experience 
but it is particularly appropriate for those of us who are professionals 


in the religious sphere. No matter how we complain or resist, as 
clergymen we are supported by organized religion, the institutional 
church. We are the establishment. This religious organization is 
Babylon, for it often claims that its relative and contingent forms and 
doctrines have absolute and unconditioned worth. This holy institu- 
tion is sometimes no more than an image of gold which we have 
made. We not only fall down and worship the golden image but we 
seek to compel others to join us in our idolatry. The words of King 
Nebuchadnezzar have a familiar ring: "If you are ready ... to fall 
down and worship the image which I have made, well and good; 
but if you do not worship, you shall immediately be cast into a 
burning fiery furnace ; and who is the god that will deliver you out 
of my hands?" These are familiar words because they have been 
used to bring us to our knees before the golden image and we have 
used them in the name of the institution to force others to serve our 
gods and worship our idol. 

So this is Babylon. The only world we know is the realm where 
we make our idols. Yet Babylon is not a prison but a school. "This 
is the School of Babylon." Babylon is not simply the place where 
idols compete for our allegiance ; it is also the setting of our growth 
and development as persons. It is important that we recognize the 
complexity of our relationship to Babylon, for if we assume a simple 
attitude of either whole-hearted friendship or outright enmity we 
will destroy the creative tension which encourages our highest 
achievement. There is no escape from Babylon but there is the pos- 
sibility of going to school in Babylon. 

A man, especially a clergyman, is blind if he cannot see the 
idolatrous reality of contemporary church life. But that observation 
alone leads a man to frustration, cynicism and withdrawal. Without 
becoming the least bit sentimental, it is possible to affirm that a man, 
even a clergyman, may see that institutional religion, although it 
worships its idols, is one of those Babylonian structures which nur- 
tures and stimulates his growth as a human being. One might argue 
that there ought to be some other kind of setting for our schooling 
in humanity. But to what purpose? Either we get our schooling in 
Babylon or we don't get it at all. 

I didn't really intend to raise this subject. But what I thought I 
meant has given way to the pressure of what I really mean. I have 
always had trouble coming to terms with the establishment. My 
problem is even more acute now that I am the establishment. I don't 
claim at this stage to have reached a final solution. But the ministry 


of this inspired image, "the School of Babylon," has exposed me to 
the creative possibilities of growth within the tensions of my relation- 
ship to the institutional church. Faithfulness, at least for me in my 
ministry, requires that I walk the straight and narrow path of af- 
firmation of the reality of the church, neither wandering off into 
flabby complacency nor withdrawing into unyielding hostility. As I 
make my precarious way, hardly managing to keep my balance, one 
of the stabilizing forces is the simple assertion : "This is the School 
of Babylon." 

II. This is the School of Babylon 
And at its hands we learn. 

Paul Lehmann has argued forcefully that the mission of the 
church is the humanization of man. 4 If that is true, and I assume it 
is, then the competence of those who serve as clergymen in the church 
can never be reduced to narrow professional skills but must be mea- 
sured against the standard of true humanity. Competence to minister 
is basically competence as a human being or, as the author of Ephe- 
sians puts it, "mature manhood," "the measure of the stature of the 
fullness of Christ." Lacking this fundamental competence in man- 
hood, skills in the various clerical functions are the form of ministry 
without the substance. 

Where does one learn what it means to be truly human? As an 
administrator in a theological school I am haunted by that kind of 
searching question. I am tempted to overstate the case for theological 
education as a schoolmaster in humanization, but my experiences as 
student, teacher and administrator place me under great restraint. I 
suppose the highest praise I can give this Divinity School is to say 
that my years here have helped me to affirm the pedagogy of the 
School of Babylon. About all I can claim for theological education 
is that it may inspire one to go on learning at the hands of Babylon 
throughout all his days. And if that claim is realized now and then, 
it is enough to justify the process. 

How does Babylon instruct men in humanity? The answer is 
not different from what Babylon is. "At its hands we learn" what is 
ultimately important, for Babylon in all its forms demands that we 
decide under whose allegiance we will live. And that decision about 
our heart's devotion is absolutely crucial in defining what kind of 
men we are. Life's loyalties are decided in the shattering encounters 

4. Paul Lehmann, Ethics in a Christian Context (New York: Harper and 
Row, 1963). 


with the golden images of Babylon whose devotees promise death 
to all who refuse to serve their gods. 

You see, Babylon is the only setting for revelation. "At its hands 
we learn" to recognize the images of gold and the tyrants who build 
them. And that is not all we learn. In the classroom of confrontation, 
where the relativities of history are absolutized, we encounter the 
Absolute whose being is made known to us in the ambiguities and 
contingencies of our Babylonian captivity. Here in this struggle to 
determine what is ultimately important we settle the issue about the 
measure of mature manhood. If we fall down and worship the image 
of gold, we say that the measure of a man is determined by his own 
power. But if we say "no" to the idol, we proclam that the measure 
of a man is determined by God's purpose. The grandeur of Babylon 
is not the power to make men kneel before its images of gold but 
the courage which enables men to stand before tyranny in the name 
of the Most High God. In defiance of Nebuchadnezzar, Shadrach, 
Meshach and Abednego said : "Be it known to you, O king, that we 
will not serve your gods or worship the golden image which you 
have set up." The true glory of Babylon is not the pomp and power 
of Nebuchadnezzar but the mature manhood of men of faith. 

If we have not learned at the hands of Babylon what it means to 
be a man, it matters little what else we may have learned about the 
techniques of ministry. Our ministry is in Babylon and for Babylon. 
Here we are called to advance the humanization of man. We qualify 
for that task not just by acquiring certain professional skills but by 
becoming mature men. Growth in manhood always involves a de- 
cision about whom we will serve : Nebuchadnezzar's gods or the 
Most High God, the God of Shadrach, Meshach and Abednego. 

Learning at the hands of Babylon is always a rite of passage. 
Once a man has passed through the ritual nothing is ever the same 
again. The passage is never automatic or cheap. But always it comes 
as a possibility which can only be claimed by a tremendous act of 
will and at an incalculable price. Yet the transformation which one 
experiences in a decision to serve the Absolute is not self-induced. 
The Most High God is the author and finisher of our faith. Because 
the Absolute has claimed us we can faithfully commit ourselves to 
his service. Hence, to come of age in the School of Babylon, to learn 
at its hands, is to be saved by grace. The essential competence for 
ministry, mature manhood, "is not your own doing, it is the gift of 
God — not because of works, lest any man should boast." 


III. This is the School of Babylon 

And at its hands we learn 

To walk into the furnaces 

And whistle as we burn. 
It's a dangerous business to undertake the evaluation of one's 
own ministry or the ministry of another. The only thing I know 
more hazardous is the decision not to make any evaluation at all. 
So, fully aware of the pitfalls along the way, I turn now to some 
judgments about ministry. I hope they will not sound too judgmental. 
It seems to me that we can hazard certain judgments about our com- 
petence and effectiveness as ministers by considering how our school- 
ing at the hands of Babylon has brought forth fruit in our lives. If 
we have learned mature manhood in our encounter with idols and 
idol-makers, then that fact will be manifest in our ability: 

To walk into the furnaces 
And whistle as we burn. 

"To walk into the furnaces" is to unmask the idols and the idol- 
makers and denounce them for what they are. I can't think of any 
ministry that is more desperately needed at this moment in our his- 
tory or that is in shorter supply. "To walk into the furnaces" de- 
mands that one forsake the asylum of safe generalities for the ex- 
posure of specific action in response to concrete issues. Our cities 
are rotting at the heart ; our rivers and streams are fouled almost 
beyond redemption ; our atmosphere burns the lungs and blinds the 
eyes ; our human resources are either neglected or squandered. And 
yet, in the face of these real and present threats to our existence, we 
are preoccupied with the deployment of an ABM System, the de- 
velopment of a Supersonic Transport, and the pursuit of an immoral 
and insane adventure in Southeast Asia. While we decrease our 
commitments to those programs designed to humanize our lives, we 
increase our expenditures for projects which have already made it 
difficult for millions to live as human beings on this planet. 

These are the furnaces of our time. If you have any doubt about 
their fiery flames, ask those who have walked in them. Ask the 
men and women who have been harassed and hounded from this 
country by the very legal structures designed to protect their in- 
dividual rights and personal dignity. Ask those who have been per- 
secuted by the federal police power in an abortive attempt to silence 
their dissent from the government's policies. Ask the conscience- 
driven critics of our culture who have experienced at first hand the 


burlesque of legal procedures devoted to punishing protest and vin- 
dicating things as they are. 

The furnaces raise the fundamental question about our compe- 
tence for ministry, for they are the proving grounds of our manhood. 
The conclusion is unavoidable : if we have not learned "to walk into 
the furnaces," then we have failed the qualifying examination in the 
School of Babylon. If we really want to establish the credibility of 
our ministry and remove the questions about our manhood, the fur- 
naces of Babylon provide all the opportunities and programs we need. 
One man, walking in the furnaces, is worth more than a thousand 
conferences on the renewal of ministry. 

I cannot overemphasize the fact that in Babylon the basic issue 
is not priesthood but manhood. In our town, as in most towns, we 
have a public school system devoted to "death at an early age" for 
any signs of intellectual curiosity and enthusiasm for learning. One 
manifestation of the oppression of the system is the determination of 
administrators and teachers to maintain conformity among the stu- 
dents in dress and hair styles. I have a young friend, a junior in high 
school, who last week found himself threatened by the system. He 
came to school wearing a medallion on a ribbon around his neck. 
The assistant principal told him to take it off. He said, "No." He 
was warned and ordered once more. Again he said, "No." Then he 
was told that he had five minutes to report to the office. The five 
minutes passed and still he remained obstinate. He was commanded 
to go to the office. His answer was the same, "No." At last the 
principal and assistant principal carried him bodily from the room. 
I don't know what else he learned that day in school, but I'm fairly 
sure that he learned what it means "to walk into the furnaces" and be 
a man. 

I think we are entering into a period of severe testing in this 
country for all who commit themselves to the humanization of man. 
The testing will come at the point of deciding our priorities. Specifi- 
cally it has already come and is mounting in intensity as we are 
forced to decide which is more precious, the order of society or the 
rights of the individual. What is demanded now is men with insight 
and courage to say "no" to those powerful forces of government and 
industry which place a higher value on maintaining the order of social 
organization than on enhancing the dignity and freedom of persons. 
When the issue is the inviolability of the individual conscience, there 
can be no compromise. The law, no matter where it originates or 
how it is sanctioned, has no right to reach "into the personal domain 


of a man's soul." 5 As David King has said in reply to George Ken- 
nan's criticism of the Student Left, "In the end, every individual is 
responsible to a higher authority than the government and whether 
it is religious or personal, it is sacrosanct." 6 

Will the democratic processes and structures of this country be 
used to promote social order at the expense of social justice? The 
prevailing mood of the comfortable majority is becoming alarmingly 
clear. The "forgotten man" seems to think "order more important 
than justice." 7 His spokesman has raised his voice to shout that he 
will not be influenced by those who are criticizing our policies in 
Viet Nam, while at the same time he has lowered his voice to listen 
to the counsel of those who place profit before people. Government 
at all levels is obstinately deaf to the cries for social justice but is 
quick to hear the screams for law and order. To such an abuse of 
the privileges of power the answer must be "no." If we do not speak 
out now clearly and courageously, history will record that we chose 
to kindle the fires, refused "to walk into the furnaces," denied our 
manhood, and forfeited our ministry. 

If we learn in this crisis "to walk into the finances," we will also 
learn to "whistle as we burn." As I have talked with some of my 
friends who have chosen to leave the ordained ministry and as I 
have faced the possibility of that choice for myself, it seems that the 
one thing that makes that choice attractive is the meaninglessness of 
much that we do. Now I don't think we can overcome that empty 
feeling of purposelessness through a frenzied program to glamorize 
the life of a clergyman. But I do believe that when a man has made a 
costly commitment to the humanization of life on this planet, his 
time for burning lights up all that he is and does so that in the face 
of the absurdities and frustrations of his existence he can affirm 
ultimate meaning for human history. 

What I am talking about is not to be confused with whistling in 
the dark. Whistling in the dark is the desperate effort of those who 
walk alone to reassure themselves with they puny sound of their own 
chirping. But whistling in the fire is the confident assurance of those 
who burn that they never walk alone. Such men are not sustained 
by their whistling. On the contrary, they whistle because they are 
sustained by the Absolute which has claimed them absolutely. For 

5. Stephen Spender, The Year oj the Young Rebels (New York: Vintage 
Books, 1969), p. 120. 

6. Ibid., pp. 120-121. 

7. Ibid., p. 152. 


such men burning never comes as a surprise. They know that as 
surely as tyrants make images of gold they also build fiery furnaces 
for men who refuse to worship and serve their idols. So they do not 
whistle to escape the fire but they whistle because, even as they 
burn, they are aware of a power and presence which gives meaning 
and purpose to the choice they have made. The determination to 
throw all one's resources into the struggle to humanize life is always 
highly personal and often lonely but it is the foundation of the only 
true community available to men on this earth. Men who "walk into 
the furnaces" find themselves in good company, the goodly fellowship 
of "those who were truly great," 8 

.... Who in their lives fought for life, 

Who wore at their hearts the fire's center. 

Born of the sun they traveled a short while toward the sun, 

And left the vivid air signed with their honour. 9 

I have told you more than I thought I meant. Perhaps I have 
even revealed what I really mean. Along the way you may have 
discovered that we are classmates in the same school where we sing 
the same song. Therefore . . . 

We praise the School of Babylon, 
For where else could we learn, 
To walk into the furnaces 
And whistle as we burn ? 10 

8. Stephen Spender, "I Think Continually of Those Who Were Truly- 
Great," in Oscar Williams, ed., A Pocket Book of Modern Verse (New York: 
Washington Square Press, 1965), p. 505. 

9. Ibid., p. 505. 

10. Thomas Blackburn, op. cit. 

Dean's Discourse 

Is the Medium the Message? 

The American Association of Theological Schools will hold its 
biennial meeting in June of 1970. One of the principal reports of a 
sub-committee which will come up for discussion and possible action 
is that of a Committee on the Professional Doctorate as a First 
Theological Degree. The preliminary report was submitted to the 
member schools in October 1969 and regional hearings have been 
held in various parts of the country to receive and assess the evalua- 
tion of member schools. The actual recommendations are as follows 
reproduced in part : 

"Recommendation 1 : We recommend that the term Bachelor of Divinity 
(may) be phased out. We affirm the tendency in American education 
and culture by which the bachelor's degree is understood as the basis for 
graduate studies, academic or professional, and that professional fields 
with a B.A. prerequisite continue with masters' and doctors' degrees. . . . 

"Recommendation 2 : We recommend that a professional doctorate be 
the standard degree for the practice of ministry. (D.Min. or D.Div.) 

"We recognize that, in the continuing process of reexamination and 
restructing, faculties may well find that an adequate professional doctoral 
program will require approximately four academic years. This, in fact, 
already prevails in many B.D. and M.Div. programs. In view of the 
report, Theological Education in the 197 0's, and new awareness of the 
variety in and shifting nature of ministry, we find it wise and proper to 
refrain from specifying requirements beyond those now pertaining to the 
accreditation of the B.D. -M.Div. We expect the change in nomenclature 
to be coupled with serious attention to the professional character of this 
degree. We encourage experimentation by faculty and students and ex- 
pect a strengthening of both the academic rigor and the integration of 
field education and/or internships into such a doctoral program, both 
through professional supervision and by programs placed at significant 
points in the life of church and society. 

"We also recognize the place for a seminary program of shorter duration 
than that of the professional doctorate. One of the new facts of theologi- 
cal education in the 1960's has been the growing number of students who 
find seminary education significant as their preparation for various 
careers that call for theological perspective and knowledge. Field edu- 
cation may be either optional or required. We suggest that such a pro- 
gram be normally of two years' duration, although well-prepared students 


may qualify for the degree in less time. Such a degree could be called 
M(aster) of T(heological) S(tudies), and may be analogous to the 
M.R.E. and M.S.M." 

Of interest to our readers may be the response of the faculty of 
the Divinity School adopted at regular meeting for November 1969: 

"While it is acknowledged that we are in a period of experimentation in 
American education and that in theological education the proposed pro- 
fessional doctorate could be regarded as a symbol of innovation and up- 
grading, we do not favor the recommendation contained in the Report 
of the Committee on the Professional Doctorate as a First Theological 
Degree, namely, that a 'professional doctorate be the standard degree for 
the practice of ministry.' Our reasons for a negative response are out- 
lined below. 

1. The question of a professional doctorate as the basic theological de- 
gree cannot be reduced to a mere consideration of 'nomenclature.' This 
is perilously near to obscurantism that may be prompted more by con- 
siderations of a competitive society than by either the norms of the 
Gospel or integrity of honest educational objectives. In limiting its 
recommendation to the specific matter of nomenclature the committee 
has by-passed the more profound question of what is a standard theologi- 
cal education. What is meant by a professional doctorate? In an effort 
to achieve 'equality of nomenclature' the committee has reversed the 
order of priorities. Before a change is made in the name of the standard 
theological degree, it is essential that changes in the substance and dura- 
tion of the degree program be delineated. To attempt, by a change of 
title, to 'equalize' the status of the ministerial profession with that pres- 
ently associated with such professions as medicine and law would be a 
response to pressure and circumstance but not necessarily an up-grading 
of the degree program. Something more is needed in theological educa- 
tion than the equalization of degree titles with those used in other schools. 

2. On the premise of a "professional doctorate" as the standard theologi- 
cal degree either the generality of existing candidates would not qualify 
or the degree would be unworthy of the level of attainment claimed for it. 

3. The Committee nowhere indicates that it has inquired of the churches 
whether they regard the doctorate as a needed level of certification of 
the practicing ministry. 

4. To make a professional doctorate retroactive would adulterate and 
hold the degree up to ridicule ab initio. 

5. A doctoral program may not be feasible in all theological institutions 
in view of differences in size, location, denominational affiliation, and 
declared intention. It is apparent that if a number of schools adopt the 
doctorate as the first degree, others will inevitably have to try to follow. 
This could work to the disadvantage of schools limited in financial and 
other resources. Few persons will deny that the change as proposed by 


the committee will be expensive. For the most part the churches pay 
the bill for theological education. At the present time the financial sup- 
port from the churches is inadequate to support a three-year program. 

6. The Committee's sharp differentiation between a professional and 
research doctorate does not justify in our view the awarding of the 
doctorate as the first theological degree. 

Our reluctance to approve the professional doctorate as a first degree 
does not necessarily mean that we oppose such a doctorate as an advanced 
theological degree." 

The Preliminary Report, perhaps in an altered form, will come 
up for review and action by the Biennial Meeting of the A.A.T.S. in 
June of this year at Claremont, where, already for some years, a four- 
year professional doctorate has been the basic degree program. The 
biennial agenda and the place of meeting have an interesting coinci- 
dence. At the present writing the Preliminary Report, however, does 
not recommend a four-year program, but merely a change of "nomen- 
clature" without specifications. 

Implicit in the proposal is an unstated premise to the effect that a 
fully professionalized ministry is both relevant to the needs of the 
hour and is an adequate as well as suitable image of the ministry 
for tomorrow. Unstated also is the presupposition that the ministry, 
considered with respect to relevant function, takes precedence over 
a learned ministry, rooted in Biblical sources or historic revelation. 
The look is to the future ; the professional is to be groomed for it ; 
indeed, a prevailing ahistorical perspective presides over the pro- 
posed pedagogy and its product. 

Thus, by a succession of stages and steps, the A.A.T.S. — which 
began as an accrediting agency to enhance the standards of Ameri- 
can theological education — has become the chief promotional agency 
— with empowering Foundation support — for the up-dating of the 
image of the minister in the direction of full professionalization as 
the norm of excellence. In a true sense it is the benevolence of Foun- 
dations, not the Churches, which is greatly influential in the shaping 
of the new ministry under the auspices of the A.A.T.S. So far as I 
am aware the views of the Churches and practicing churchmen have 
not been consulted either as to the end-product in view or as to costs 
in educational outlay. With respect to the former — that is, the prod- 
uct or the ministry to be nurtured — it is doubtful that there will be 
sufficient alertness to the issues to expect either cautions or dis- 
suasives from beleaguered churchmen. So confused is the present 


climate and so wanting is any articulate consensus among churchmen 
concerning the desired or desirable shape of the ministry, that, in 
their perplexity, few churchmen, I think would incline to dampen 
any, however forlorn, hope that greater professionalization might 
relieve the doldrums presently afflicting the practicing ministry. 

Thus, silence of perplexity on the part of churchmen may contrive 
to lend just the needed consent of desperation that will put the pro- 
fessional doctorate on the ways as the basic degree for ministerial 
education at Claremont in June. If so, one may hope that it will be 
more than a change of nomenclature, that it will be at least a four- 
year program "beefed up" to a measure that will preclude its being 
made simply retroactive as in the case of the Juris Doctor, the new 
Law degree. Even so, it will be the pedagogy of as radically an 
ahistorical era as men have known since the Enlightenment. It is, I 
suppose, a minor concomitant that it will require another decade of 
vast curricular overhaul and readjustment. 

It matters not, especially, if what God requires and Christ's king- 
dom most needs these days are professionals ! After all, we have been 
instructed of late that "the medium is the message." On that anti- 
intellectual and positivistic basis, it is evidently presumed that pro- 
fessional doctors will provide viable media for becoming the message. 
This would be, indeed, a radical innovation in the reshaping of the 

— Robert E. Cushman 

Book Reviews 

The Growth of the Biblical Tradition: 
The Form-Critical Method. Klaus 
Koch. Translated by S. M. Cupitt. 
Scribner's. 1969. 233 -f- xvi pp. pb. 

This book is presented as "a guide 
for students, as an introduction to 
form-critical research. . . ." (p. ix.). 
The need for such a guide has been 
felt for some time. Though the form- 
critical method has been an impor- 
tant discipline in biblical criticism 
since the beginning of the century, 
no adequate systematic presentation 
of the method itself has appeared. 
Until recently, the best descriptions 
of the methodology were to be found 
in the programmatic articles of Her- 
mann Gunkel, written more than half 
a century ago. 

Koch attempts to present form 
criticism as a method for both the 
Old Testament and the New, but his 
roots are clearly in the Old Testament 
side of the discipline. He first de- 
scribes the various methods of form 
criticism: 1. the determination of the 
literary type or genre, 2. the history 
of literary types, 3. the search for the 
situation in life, 4. the history of the 
tradition (essentially at the oral 
level), and 5. the history of redaction 
(the literary stage of transmission). 
In each of these sections he shows 
how the various questions may be 
raised and answered by using the 
Decalogue and the Beatitudes as ex- 
amples. Secondly, Koch discusses the 
relationship between form criticism 
and some other issues and methods in 
biblical criticism, namely, literary criti- 
cism, the "oral tradition" school, the 
problems of Hebrew poetry, and issues 
concerning the canon. Third, he dem- 
onstrates the form-critical method by 
examining selected biblical texts from 
the narrative books, the songs, and the 
prophetic writings. 

This book can serve as a very use- 
ful pedagogical tool, but it must not 
be read uncritically. One of its major 
problems is that it perpetuates a con- 
fusion which has run through the 
history of the form-critical approach 
to the bible, that is, an ambiguity in 
the use of the terms "form" and 
"type." Koch himself asserts that "it 
is useless to try to differentiate be- 
tween 'type' (Gattung) and 'form' 
{Form)." (p. 5, n. 5.) But type (or 
genre) is one concept and form (or 
structure) is another. One of the im- 
portant facets of a given genre (or 
type) is its form (or structure), but, 
as Koch himself points out, both form 
and content determine type (p. S ; and 
cf. the review of the German edition 
in Dialog, 5 [1966].). 

Though it is a method which must 
be employed in concert with other 
approaches to the biblical text, form 
criticism has a very important role 
to play in interpretation. "It has 
arisen out of the recognition that we 
are faced here with a view of things 
which can provide us with a deeper 
understanding of the ancient texts, 
and which could make contact with 
them relevant to our own times. In 
my opinion this is because form criti- 
cism brings out the link between 
literature and life, between the bibli- 
cal text and the history of God's 
people, in a way hitherto unimagined." 
(p. xi). 

— Gene M. Tucker 

/ Saw a Nczv Earth: An Introduction 
to the Visions of the Apocalypse. 
Paul S. Minear. Corpus Books, 
1968. 385 pp. $10.00. 

If there is one area of Biblical 
study which needs the concerted ef- 
fort of scholars, it is indeed the area 
of apocalyptic literature in general and 
the book of Revelation in particular. 


This new book by one of the more 
respected New Testament scholars 
deals with the interpretation of Reve- 
lation. It is well written and thor- 
oughly provocative, and it is intended 
as a "companion" for a study of the 
Apocalypse for student and minister. 

The work itself is divided into three 
parts : part I gives a translation and 
exposition of the text; part II con- 
tains essays on debated issues con- 
nected with the book and its interpre- 
tation ; and part III is an annotated 
translation of the text. Part I is 
especially interesting and beneficial 
for the student. There are four head- 
ings which are utilized in the study 
of the various parts of the text: 1) a 
translation of the text; 2) a literary 
analysis of the text ; 3) a section 
which contains suggestions for reflec- 
tion and discussion ; and 4) a biblio- 
graphical section to direct the student 
in his further study. 

It would be indeed difficult, if not 
impossible, to relate to the reader 
even a small precis of the wealth of 
information contained within this very 
fine work. Perhaps it would be best 
to indicate one of Minear's chief 
themes in his attempt to interpret 
Revelation. Basically he feels that the 
book is written to the people of the 
churches to challenge them to loyal 
endurance and to warn against apos- 
tasy and false prophets in the midst 
of the churches. This latter point is 
especially predominant in this writing 
to the point of Minear's transferring 
many references concerning judgment, 
usually interpreted as being directed 
at the persecutors of the church, to 
the apostate Christian : for example he 
interprets the "Lamb" figure of chap- 
ter 13, usually thought to be the cult 
of the Emperor as ". . . the inroads of 
deceptive prophecy within the Church. 
. . ." (p. 256) He challenges the usual 
view that 666=Nero and the view that 
the "wounded" head refers to Nero. 
He says, "It [the wounded head] was 
the plague of death released through 
the Messiah in his own crucifixion 
and exaltation." (p. 254) 

It would be impossible to enumer- 
ate all the very significant points set 
forth in this book or to enter into a 
discussion of the controversial ones. 
There are many points with which 
this reviewer finds himself in agree- 
ment with Minear (sometimes for 
different reasons, however), and there 
are various places where one could 
quarrel with him. This is especially 
true with his basic emphasis on the 
false prophets within the church and 
his contention that the judgment is 
primarily upon them rather than on 
the persecutors. Nevertheless, this is 
a very good work on the book of 
Revelation (we need more), but it is 
not really for beginners. The arrange- 
ment leaves something to be desired 
since certain points are made in part 
I which are discussed in detail in 
part II. This does not cause great 
difficulty, only annoyance at points. 
Some of the translation is excellent, 
and Minear is to be complimented on 
this. An excellent bibliography 
divided into four parts is included 
which the student will find most help- 

New Testament scholarship is again 
indebted to Professor Minear. Hope- 
fully, this work will arouse greater 
interest in this very important aspect 
of the New Testament and cause 
further discussion and research into 
apocalyptic in general and Revelation 
in particular. 

— James M. Efird 

Saint Paul: A Study of the Develop- 
ment of his Thought. Charles Buck 
and Greer Taylor. Scribner's, 1969. 
278 pp. $7.95. 

This new work on Paul is quite 
adequately described by its title even 
though it contains much more than a 
discussion of Paul's thought. It is an 
attempt to determine a chronology of 
Paul's life and letters on the basis of 
the letters. It is assumed that there 
is development in Paul's theological 
thought especially in three areas : 
eschatology, Christology, and legal 
theory. The attempt is to date the 


letters ". . . on the basis of the de- 
velopment of the thought they reflect" 
(p. 9). From this investigation the 
authors have concluded that Paul's 
thought in each letter is consistent in 
these three areas just mentioned. In 
fact they go so far as to argue that : 
"In the fabric of each letter, the 
threads always make a complete pat- 
tern. There are no floating strands, 
and no loose ends." (p. 16) 

The best summary and outline of 
the work is supplied by the authors : 
"We have begun, therefore, with the 
assumption that the lines of develop- 
ment which are traceable in the three 
longest letters, I Corinthians, II Co- 
rinthians 1-9, and Romans probably 
extend into the others. Since these 
three letters can be shown to have 
been written in that order on grounds 
[i.e. references to the collection for 
the Jerusalem church] that have noth- 
ing to do with the development of 
ideas, they provide an objective deter- 
mination of the direction in which 
the development was moving. Once 
this direction has been determined it 
is relatively easy to arrange the other 
letters in the proper order. That done, 
it is possible to reconstruct the order 
of the principal events in Paul's mis- 
sionary career. And finally it is pos- 
sible ... to discover where the Acts 
chronology has gone wrong, and to 
correct the error in a simple but com- 
pletely satisfactory way." (p. 19) 

The first section deals with the let- 
ters, their dates, and their "thought." 
Using only the letters to determine 
the order, the authors reach the con- 
clusion that Paul's writings should 
be arranged as follows : II Thessa- 
lonians, I Thessalonians, I Corinthians, 
II Corinthians 10-13, Philippians, II 
Corinthians 1-9, Galatians, Romans, 
Colossians, Philemon, and Ephesians. 
The letter to the Ephesians is con- 
sidered authentic because it is ". . . 
exactly the sort of letter we should 
expect Paul to have written at the 
end of the theological development 
that the other letters reflect . . ." 
(p. 139) The date of the earliest 

letter is considered to be ca. Septem- 
ber 44 A.D. And from this chronology 
Paul is in Rome ca. 55 A.D. 

The second section deals with Acts. 
The authors do not dismiss it as 
completely unreliable but rather argue 
that the facts of Paul's life are es- 
sentially correct as stated therein but 
are in the wrong order. The account 
of Acts has one too many visits to 
Jerusalem and one journey too few! 
This had occurred because the author 
of Acts has used three sources (the 
Hellenist source, the Journey source, 
and the Log source) in his compo- 
sition and because of partial ignorance 
has placed them together in this man- 
ner. The misinformation is, however, 
not so much deliberate as it is an 
honest mistake based as much on 
faults in the sources as on Luke's 

In the third section a kind of syn- 
thesis is outlined. Paul's theology can 
be summarized by three stages. First, 
there was the idea that Jesus was 
soon to return; this came from the 
experience on the Damascus road. 
Secondly, there was the idea that 
Jesus had freed men from slavery to 
sin, which came from his meditation 
in an Ephesian cell possibly awaiting 
death. Finally, there was the idea of 
Christ's life of love and forgiveness, 
which stemmed from the Jerusalem 
Council. This Council, according to 
the authors, does not glorify Paul as 
the champion of Christian freedom but 
depicts him as a bitter man who 
angrily accuses the apostles of an 
action of which they are not guilty. 
"In a word, what Paul experienced at 
the Council was not merely vindica- 
tion of the position he had taken 
during the [Judaizing] controversy 
but forgiveness from those he had 
wronged." (p. 256) 

The book is fascinating reading. It 
plows some old ground with a new 
blade. At times it seems almost bril- 
liant; at others naive and almost 
ignorant of Pauline studies. The 
present reviewer is quite open to the 
idea of development in Paul's thought, 


to the order of composition which 
these authors list for the letters, and 
to the basic idea about Acts as a sec- 
ondary source, at times confused. But 
it does seem strange, however, that so 
little is made of the occasion for Paul's 
writing and how these factors shaped 
what he says in the letters. One 
gathers from reading this work that 
the occasion for Paul's writing is only 
the opportunity for him to set down 
his new thinking which has emerged 
from his own experiences. Further, 
there appears to be little understand- 
ing of Paul's Rabbinic interpretation 
(cf. p. 63, p. 72, n. 2, and p. 99). In 
the discussion of eschatology from 
imminent to present no mention is 
even made of the problem which arises 
from Philippians 4 :5 or Romans 
13:1 Iff. And, in spite of what the 
authors say, their argument does 
suffer from circular reasoning. 

Nevertheless, the present reviewer 
recommends this book for careful 
study because it definitely stimulates 
one's thinking about Paul, his life and 

— James M. Efird 

Christian Community and American 
Society. Waldo Beach. Westmin- 
ster, 1969. 190 pp. $6.00. 

In this book of nine brief chapters, 
Waldo Beach has given us a straight- 
forward, lucid and insightful introduc- 
tion to the dialogue between theology 
and social science which is at last 
getting under way today. He sets 
out to examine the meaning of com- 
munity from the point of view of 
Christian ethics as a normative sci- 
ence, "setting the terms of the good 
life as understood in the Hebrew- 
Christian tradition," and sociology as 
a descriptive science. His thesis is 
that the analysis of American society 
by contemporary sociologists, their 
description of the loss of community 
and some elements in prescription for 
its recovery, accords with the basic 
insights of Christian theology. He 
spells out the fundamental theological 
assumptions underlying the Christian 

understanding of community and ex- 
amines the value assumptions, ex- 
pressed or covert, operative on all 
levels of the social scientist's enter- 
prise. Beyond the mutual put-off of 
the theologians and social scientists' 
stereotypes and caricatures of each 
other lie common concerns that make 
dialogue imperative and promising. 

Beach focuses on the concept of 
anojnie, or normlessness, which soci- 
ologists have used to account for the 
loss of community. The negative as- 
pects of American society, alienation, 
anonymity, conformity and status- 
seeking, are exposed, and both secular 
sociological and Christian solutions 
examined. Whereas the sociologists 
generally prescribe some version of 
individualism in the face of the threat 
of the collective, Christian ethics ad- 
heres to the norm of agape, commun- 
ity-creating love. The Christian view 
of community is applied, in the last 
three chapters of the book, to the 
problem areas of politics, race and the 
university. The theological moments 
of creation, sin and reconciliation and 
the ethical qualities entailed in Chris- 
tian community, explicated in the 
first several chapters, are here adduced 
as illuminating insights for under- 
standing the dialectic of love and jus- 
tice, the nature of political choice and 
compromise, the sin of racial pride, 
the movement toward an integrated 
society and the recovery of community 
in the university. 

The reader of this book will have 
his own questions and cavils, depend- 
ing on his point of view. Because of 
the breadth of territory surveyed, 
depth of treatment is sacrificed at 
some critical points. To speak of a 
dialogue between "theology" and "so- 
ciology" suggests a homogeneity of 
each group that is conspicuously lack- 
ing in the real world. Beach explicit- 
ly adopts the theological approach of 
H. Richard Niebuhr, supplemented at 
points by insights from Reinhold Nie- 
buhr. While admittedly a major op- 
tion in American theology, and gen- 
uinely ecumenical in substance and 


spirit, it does not adequately reflect 
the movement and tenor of current 
theological discussion. A wide-ranging 
selective bibliography at the end of 
each chapter serves as a guide to the 
intramural debates in theology and 
sociology, but this debate is scarcely 
echoed in tbe treatment of issues in 
these disciplines. Consequently, the 
substance and methods of Christian 
Ethics appear less problematical than 
they in fact are in our situation today. 
Beach himself is vulnerable at the 
points at which the Niebuhr brothers 
can be criticized. H. Richard Nie- 
buhr's preoccupation with the Chris- 
tian tradition and his view of "Christ 
transforming culture" is somewhat 
eclipsed currently by the theologians 
of hope with their concern for es- 
chatology and its implications for a 
political theology. Reinhold Niebuhr's 
reduction of theology to a set of her- 
meneutical principles for the interpre- 
tation of history and society tended 
to ignore the role of the church as 
Christian community. In seeking to 
provide a Christian justification for 
democracy, he came perilously close to 
identifying the two; in Reinhold Nie- 
buhr's view, democracy was the only 
viable political system for the Chris- 
tian. Beach and Niebuhr's ideological 
bias (pp. 128, 139, 144) reveals an 
ethnocentric view of the relation of 
Christianity and American society. 
Beach asserts that "Christian com- 
munity" is the guiding norm for the 
state, i.e., for the citizens in their 
political relations. But this is to say 
both too much and too little. Too 
much, on the one hand, for some 
secular thinkers have paralleled 
Christian insights with principles and 
norms which serve the same function 
but without appeal to theological or 
metaphysical sanctions. Too little, on 
the other hand, because it treats the 
Christian faith as a set of insights and 
interpretative principles which if ab- 
stracted from a community of faith 
lose both their compelling sense of 
validity and their impelling power of 
motivation. Beach criticizes the view 

of those who make the community of 
faith coterminous with the whole so- 
ciety in the name of an American 
national "religion." But he nowhere 
deals with the question of where the 
Christian community may in fact be 
located. It may in theory be the pro- 
totype of all genuine community, but 
if it is more than a Platonic ideal — 
and historically it is certainly other 
than a Platonic ideal — it must have a 
social base, a "reference group." This 
points to a serious lacuna in the book 
— the failure to provide a sociological 
analysis of the Christian community 
in America. The viability of "Chris- 
tian values, or the norm of Christian 
community" (p. 123) should be dem- 
onstrated within the church, if any- 
where. While the dust jacket of the 
book carries an abstract design of a 
church, an examination of the institu- 
tional church is missing within (and 
by intent, p. 127), except in the recog- 
nition that the church too is plagued 
with anomie (p. 124). The church's 
contribution is "the word of the Chris- 
tian theologians to the problem of 
community" (p. 124). It is under- 
standable if secular sociologists are 
unimpressed with "Christian commu- 
nity" if it remains discarnate, a matter 
of what Beach himself calls "glittering 
generalities" (p. 139). 

The Christian perspective may en- 
able one to make evaluations of society 
from a "perch transcendent of the 
crowd" (p. Ill) but the urgent prob- 
lem in ethics — as in sociology — today 
is "what difference does it make?" 
While chapters are devoted to race 
and to the dynamics of American 
democracy, the failure to stress racism 
and injustice in the general analysis 
of American society points up the 
danger of remaining too long on the 
"perch transcendent." While appreci- 
ative of the compactness of this study, 
I could not but feel disappointed that 
the really critical issue of our time — 
the revolutionary demand for freedom 
now on the part of minority groups 
in this country and the Third World 
— is treated only in passing recogni- 


tion that both conservatives and revo- 
lutionaries have sought legitimation 
of their political ideology in the Chris- 
tian faith. The constructive sugges- 
tions in the book are too brief and 
sketchy. The high level of abstraction 
on which the two disciplines are 
treated contrasts with the level on 
which the problems of social and eco- 
nomic inequity, racial conflict and uni- 
versity turmoil are confronted. This 
does not vitiate the analysis, but it 
does necessitate the careful explication 
of middle axioms, a way of moving 
from abstraction to action. With all 
that sociologists might learn from 
theologians, they can teach a concern 
for the operational use of concepts. 
Ethics should be more than "judg- 
ment" ; it should throw light on what 
ought to be done in light of what can 
be done. At this point the dialogue 
between theology and sociology can 
be of more than theoretical interest, 
indicating the possibilities and limits 
of action in concrete situations. 

By limiting himself to analysis at 
the expense of proffering solutions, 
Beach has achieved a surprisingly 
comprehensive study of the problem 
areas of politics, race and the uni- 
versity. The ambiguity of universal 
principles provided by a particularistic 
faith in a pluralistic society remains 
to the end and makes this readable 
book a provocative source of discus- 
sion for students of contemporary 
religion and society. May it speedily 
appear in paperback ! 

— Thomas E. McCollough 

Norm and Context in Christian Ethics. 
Edited by Gene H. Outka and Paul 
Ramsey. Scribner's, 1968. 414 pp. 

Some theories and fashions in the- 
ology and ethics are ephemeral, some 
are perennial. God is dead is dead. 
But the storm raised about "situation 
ethics" or the "new morality" is of 
more permanent importance. Despite 
the claim of Professor James Gustaf- 
son (who contributes a discerning 

piece to the volume) that the debate 
was "misplaced," it will not fade out 
soon. This compendium of essays, 
edited by two Princeton Professors of 
Christian ethics, is the most thorough- 
going scholarly analysis of the con- 
textual ethics school, its forbears, its 
proponents, and its opponents that we 
have had thus far, containing over 
four hundred pages of close reasoning 
and pungent argument. 

It's quite an assemblage of minds. 
Four of the fourteen scholars are 
Roman Catholic; several are English 
dons. Contextual ethics is not an ex- 
clusively American or Protestant phe- 

In one sense much of the debate is 
indeed a semantic one. But even after 
one has determined the degree of 
hardness or flexibility of key words 
like "principles," "rules," "laws," 
"maxims," etc. (as Gene Outka's es- 
say sorts them out), there remains a 
substantial division of the house be- 
tween the "principled" and the con- 
textual ethicists. What is surprising 
to note, however, are the rich historic 
precedents for the situationist's per- 
spective. Fathers Curran and Hiring 
are at pains to exonerate the Catholic 
"natural law" tradition for the charge 
of legalism and affirm its dynamic 
flexibility, while Professors E. L. 
Long and David Little interpret Lu- 
ther and Calvin in similar terms. 

Properly understood, situation ethics 
moves between the opposite perils of 
legalism and lawlessness to a position 
beyond those centered on agapeic 
love. As Frederick Carney's opening 
essay delineates, however, Christian 
love's distinctive style is faithful love 
issuing in just action. The relevance 
of this norm is advanced by James 
Gustafson's treatment of Christian 
moral discernment. The problem of 
application is not much advanced by 
Paul Ramsey's own piece, where he 
floats off for sixty-eight pages on a 
cloud of refined and precious distinc- 

Professor Joseph Fletcher, whose 
Situation Ethics is the most widely- 


known statement of the new morality 
and who may be regarded as some- 
thing of the chief hero or villain in 
this affair, contributes a restatement 
of Situation Ethics, typically brisk, 
arresting, beguiling, and a bit slippery. 
(His essay is then painstakingly if 
pedantically taken apart by two En- 
glish Professors of Philosophy.) In 
the criss-cross of argument, this re- 
viewer finds Fletcher most convincing 
in his charges against legalism, but 
somewhat less persuasive in specifying 
the character of Christian love as 
dependent on its theological faith, or 
what he calls "metaethical considera- 
tions." His reading of how love is to 
decide moves too close to the prox- 
imate factual context of the immediate 
situation and too far from the ultimate 
theological context of faith which 
gives love its distinctive Christian 

— Waldo Beach 

Dialogue in Medicine and Theology. 
Edited by Dale White. Abingdon, 
1968. 176 pp. $1.95. 

In the spring of 1967 several hun- 
dred physicians and clergymen were 
invited — under the joint auspices of 
the Mayo Clinic, the Rochester Metho- 
dist Hospital, and several agencies of 
The Methodist Church — to Rochester, 
Minnesota, for a Convocation on 
Medicine and Theology. The stated 
purpose of this meeting (too lengthy 
to reprint here) was generally ac- 
knowledged, as one participant put it, 
to be "more and better communication 
between physicians and clergymen." 
The volume reviewed here contains 
the major addresses given at that con- 

As one who listened to these 
speeches, I have found it interesting 
now (after three years) to read them 
and reassess my initial impression of 
the convocation. I thought then that 
the range of participants and plenary 
session topics provided little oppor- 
tunity for specialized presentations 
and that too much time and energy 
was expended on generalities ; this 

judgment has been confirmed in re- 
viewing the contents of this volume. 
It is doubtless a function of mutual 
professional ignorance, which men of 
medicine and theology share, that 
conversation between us is ordinarily 
a miscellany, sometimes banal, of 
vaguely-held but commonly-supposed 
interests. Particularly the efforts at 
dialogue, both at the convocation and 
in this book, indicate that we do not 
yet find it entirely comfortable or com- 
pelling to talk in depth to each other 
about the things that we care about 

On the other hand, the principal es- 
says published in this symposium sig- 
nify that some physicians and clergy- 
men are willing to learn from each 
other and incorporate that learning in 
reflections upon their respective pro- 
fessional responsibilities. There is not 
space here to comment on each of 
these contributions ; but I think it 
worth noting that all of these authors 
make some attempt at inter-disciplin- 
ary conversation. This is an alto- 
gether hopeful sign and appropriate 
undertaking; and it deserves every 

Physicians and clergymen are in- 
creasingly obliged to talk to each 
other (and sometimes about each 
other!) ; and there is no reason cur- 
rently to suppose that this obligation 
will not intensify in the years ahead. 
If we are ever to get beyond the 
stage of polite euphemism and anec- 
dote and down to the business at hand, 
each of us will have to become better 
informed about and acquainted with 
the other. This book, like the convo- 
cation it reports, is a useful beginning. 

— Harmon L. Smith 

The Multiple Staff Ministry. Marvin 
T. Judy. Abingdon, 1969. 288 pp. 

In a most comprehensive approach 
the author utilizes wide experience, 
extensive research, keen understanding 
of the church's nature and mission, 
and a broad knowledge of human re- 


lations in presenting a timely and 
distinctive book at a strategic moment 
in the life of the church. For some 
time it has been my conviction that 
if the witness of the church is to be 
effective and if the administration of 
its program is to be efficient there 
must be two dominant characteristics, 
namely, long-range planning and co- 
operative effort. Driven by contem- 
porary change and challenge, the 
church has no alternative but to plan 
wisely and to work cooperatively. 
There is no better way for these char- 
acteristics to be displayed than in the 
multiple staff approach. Thus the 
book undergirds my conviction. 

As indicated by the author, three 
basic types of materials are used : the 
theoretical, which deals with theology, 
sociology, psychology, and administra- 
tion; the analytical, which deals with 
statistics concerning staff positions, 
human relations, and staff understand- 
ing; and the practical, which deals 
with administrative procedures for 
good human relations within the staff. 
Regardless of the type of material 
being presented, the author returns to 
his stated definition : 

A multiple ministry is composed 
of persons under the call of God in 
the universal Christian church who 
are selected by a congregation or 
appointed by a denominational offi- 
cial to be its chosen leaders. It is 
constituted or ordained and unor- 
dained persons, both men and wom- 
en. It has its mission in sharing 
a responsibility, of mutual concern 
and support of one another as it 
assists, directs, and participates in 
a local congregation of Christian 
believers as they assemble for wor- 
ship and nurture and are dispersed 
for work and service in the world. 

Though there must be definite pat- 
terns of operation and organization, 
clearcut job analyses, adequate support 
with proper fringe benefits, satisfac- 
tory facilities and working tools, and 
though there must be excellent under- 
standing and support on the part of 

the congregation, the multiple staff 
will function only if each person clear- 
ly understands himself as a person 
who has adopted, along with other 
staff members, a common goal and 
objective and is able to work with 
others to achieve the common purpose. 
Professional persons, competent in 
their respective fields, must be able 
to blend their contributions in order 
to carry out a unified ministry to the 
congregation. To this task the author 
addressed himself as he developed a 
theological basis, shared the principles 
of leadership, opened the broad field 
of personnel management, and dealt 
specifically with the task of the senior 
minister, the associate or assistant 
minster, the church educator, the 
church musician, the church business 
administrator, and the church secre- 

My prejudiced hope was that the 
title of the book might have been 
"The Multiple Staff Ministry in a 
Multiple Church Parish," for herein 
lies my area of concern and respon- 
sibility. Alas, there are too few such 
ministries ! In the lone chapter de- 
voted particularly to this theme the 
author effectively presents the char- 
acteristics which are more pronounced 
in multiple church situation : the ne- 
cessity to maintain a high degree of 
local autonomy, the diversity of par- 
ticipating congregations, the demand 
for highly motivated leaders (clergy 
and laity), the importance of mutual 
support through wholesome staff as- 
sociations and close family relations, 
the significance of the relationship 
with boards and agencies that provide 
financial support and supervision, the 
necessity to maintain intense relations 
between the parish on the one hand 
and the government and social agen- 
cies on the other. Add to these the 
basic factors of coordinated efforts, 
team planning, constant programming, 
and continuing preparation, and there 
seems to be no area of ministry that 
demands more creative imagination 
and personal dedication than the co- 
operative or multiple staff ministry in 


the multiple church situation. If a 
multiple staff in a station church can 
achieve established goals, why is it 
not equally true that a multiple staff 
in a multiple church parish can achieve 
comparable goals? 

Paramount are the dedication and 
the qualifications of the senior minis- 
ter, as well as the qualifications and 
devotion of all the members of the 
staff and their readiness to serve with- 
in the framework of their respective 
fields of responsibility. The needs of 
the staff members and the needs of 
the individual members of the congre- 
gation will best be met as staff mem- 
bers understand fully all that is in- 
volved in a staff ministry. Church 
administrators and members of a mul- 
tiple staff would do well to use Judy's 
book as a basic text and guide, uti- 
lizing selected resources from the ex- 
tensive bibliography to create an 
understanding of the necessity and the 
potential of a cooperative approach 
through the multiple staff. Judy's 
book was not intended to be extensive. 
It does a good job of opening avenues 
and providing the base for richer and 
fuller experiences and research. It is 
an excellent companion to his The Co- 
operative Parish in Non-Metropolitan 

— M. Wilson Nesbitt 

Liturgies in a Time When Cities 
Burn. Keith Watkins. Abingdon, 
1969. 176 pp. $3.75. 

The Reverend Sydney Smith, the 
caustic English clergyman, once re- 
marked : "I never read a book before 
reviewing it; it prejudices one so." 
I had read Watkin's Liturgies twice 
before I ran across Sydney Smith's 
insight, so I cannot make use of his 
counsel. How does one review a book 
which bores yet interests one from 
beginning to end? It is studded with 
professional gobbledegook, such as : 
"Worship is a symbolic form that 
combines words and actions in a 
stylized expression of the experience 
of ultimate concern" (p. 46), and "The 
church, too, must find its way, and 

for its provisional design I am pro- 
posing two elements : paradigmatic 
story as the approach to truth, and 
imaginative use of the Christian cal- 
endar as the approach to contemporary 
life styles" (p. 101) — presumably 
when cities burn. Yet it abounds in 
sentences which prime the thought : 
"At its best free prayer has a beauty, 
relevance, and power that prescribed 
prayer rarely attains. But free prayer 
is rarely at its best" (p. 84), and 
"Christian domination of the life of 
man has come to an end, and this 
vision of life must now make room 
for others that seek men's loyalties" 
(p. 139), and "The survival of the 
church in any form is of secondary 
importance. The urgent matter is the 
survival of the nation and of the 
world . . ." (p. 150). 

The author is Professor of Worship 
at Christian Theological Seminary, 
Indianapolis, Indiana, who spent a 
sabbatical leave with a front-line 
church instead of in a theological 
Pentagon. This book is a description 
of what he experienced and how he 
reacted liturgically, under the written 
influence of Ernst Cassirer and Su- 
sanne K. Langer. But the experience 
should have been recounted first and 
the liturgical rationale should then 
have followed — I think. But, is he 
talking to me — and to you ? He writes : 
"I speak to three accusers. A black 
barber in Seattle, ... a white execu- 
tive in Kansas City, ... a bishop from 
New York State" (p. 7). Is he speak- 
ing to us? Maybe you had better read 
it to find out. 

— James T. Cleland 

Words, Music and the Church. Erik 
Routley. Abingdon, 1968. 224 pp. 

Words, Music and the Church is a 
true, how-it-really-is, picture of the 
poor state of the general Protestant 
worship service. The book is an edi- 
torial : a critical study, with some 
answers to the problem ; and what 
the author has to say has needed say- 
ing for a long while. 


Although he deals with many as- 
pects of worship, Dr. Routley's basic 
theme is that worship is drama. 
Drama not to amuse or entertain the 
audience, but drama to be performed 
by the people set to do it (the clergy 
and musician), and involving a com- 
munity, (the congregation). 

According to the author, words and 
music are only important and relevant 
to this drama in the degree to which 
they adhere to the script of the drama. 
The author is very critical of the 
preacher, who has become sort of a 
star actor in the drama, but whose 
script often contributes little. 

Music and the musician are not 
treated any more kindly than are the 
word and the preacher. Unless the 
hymn, anthem, and incidental music 
contribute to the service, says the 
author, then leave them out of the 
service. And, he goes on to say, some- 
one has to be in charge of the produc- 
tion, namely the minister consulting 
with the choirmaster on selecting the 
hymns and the anthem. If music is 
selected without this consultation, it 
serves only as a break in the drama 
for entertainment. Dr. Routley feels 
this reduces the drama to sort of a 
revue or vaudeville in which short 
bursts of drama follow one another 
without relevance to each other. 

The author speaks much of society 
and the drama of worship. There is 
a most interesting section on the 
social implications of music in church. 

He points out how our attitude to- 
ward "good" music is closely associ- 
ated with a set of social values. It is 
often difficult for us to accept and 
value others whose musical values 
differ from our own. This leads to the 
reluctance of many to accept the use 
of popular and folk music in churches. 
On the other hand, we accept "good" 
music (because it is associated with 
"nice" people) even if it has nothing 
to do with the service at hand. To 
the statement, "Classical music is good 
and jazz is bad," the only answer, 
according to the author is, "Who says 

The preceding are but three of the 
many areas of worship covered in a 
book that deals with music from the 
very old to Jazz, Rock, and the Folk 
Song, and with the drama of worship 
from the medieval period to the pres- 

Originally a set of lectures, the book 
is loosely joined together ; this makes 
for questionable continuity and repeti- 
tion. However, Dr. Routley says in 
a readable book what always needs to 
be said, "It is time for those respon- 
sible for the music and worship ser- 
vice to get about their work." This 
book is highly recommended to all in- 
terested in improving the worship ser- 
vice and music program and for those 
who are just not happy with the way 
things are going on Sunday morning. 

— John Kennedy Hanks 


Spring 1970 

A New Departure 

The present issue of the Review represents something of a new 
departure, at least in recent history. It arose out of a discussion in the 
Review Committee, in which it was suggested that our readers might 
be interested in becoming acquainted with some of the new directions 
being pursued in The Divinity School. Recently, Professor Harmon 
L. Smith has been investigating certain ethical issues arising from the 
practice and procedures of modern medicine. In fact, he has con- 
ducted courses on this subject and now has a book scheduled for 
publication in the fall of this year. So, this area of research presented 
itself as a natural possibility. 

The proximity of the Duke Medical center has given Harmon 
Smith and a number of students opportunity to pursue these matters 
quite extensively and in an informed way. The articles in this issue 
represent the tentative results and proposals issuing from some of 
their investigations. They were submitted at the invitation of the 
Committee and under the direction of Professor Smith. All of the 
authors are students in Duke Divinity School. Hopefully, we shall 
again in the future be able to exhibit in this journal representative 
examples of the relatively new kinds of work going on here. 

D. M. S. 


Medical-Ethical Issues 
in a Christian Perspective 

Volume 35 Spring 1970 Number 2 


A New Departure Inside Front Cover 


by Harmon L. Smith 45 

Human Experimentation 

by Donald Dial, Russell Martin, and David Pacholke* 47 

Euphenic Engineering for Clinical PKU 

by Melvin Dowdy, Richard Richards, and 

Linda Van Tassel* 64 

Medically Induced Drug Addiction 

by George Ennis, Robert McConathy, and 

Morgan Peterson* 80 

Abortion: Responsibilities and Relationships 

by Richard Fisher and Paul Morrison* 96 

An Appropriate Time to Die 

by Gregory Dell, Powers McLeod, and John Mann* 112 

Dean's Discourse 129 

^Written in consultation with Prof. Harmon L. Smith and an editorial 

Published three times a year (Winter, Spring, Autumn) 
by The Divinity School of Duke University 

Postage paid at Durham, North Carolina (27706) 


No one who reads newspapers, listens to radio, or watches tele- 
vision (or pays taxes!) has to be convinced of the enormous accom- 
plishments of modern science and technology. Indeed, most of us 
benefit from these achievements in ways that make them seem more 
or less indispensable. If you yourself do not see Cinerama movies, or 
dress more comfortably, or eat healthier foods, or drive the latest 
thing in automotive design, or know what it is to recover from an 
illness that only a few years ago would almost certainly have caused 
your death, odds are that you know someone for whom these things 
do apply and that you could compose another list (comparable to this 
one) from your own experience. 

That modern science and technology provide a potential (and, in 
some ways, already actualized) boon to our common human existence 
appears self-evident. That this remarkable and relatively new power 
will in fact be put to uses that are genuinely directed toward humane 
goods remains, however, to be ascertained. Saying this, I do not 
mean to imply either a prejudice against or a naive approval for what- 
ever is done or might be done to advance or retard our science and 
technology. On the contrary, I would rather we try to assess what 
words like "advance" and "retard" mean in this context. Or, to put 
it differently, I believe with Reinhold Niebuhr that our capacity for 
doing evil is proportional to our capacity for doing good; and this 
suggests to me that we need therefore to be alert to both the promise 
and the threat of our science and technology if we are responsibly 
to exercise control over them for good rather than evil ends. It may 
be finally an article of faith — at least there is not space here to develop 
the argument — but I think that we function as men in the measure to 
which we control our technics and are not controlled by them, and that 
science and technology function best when they serve human need 
and purpose rather than vice-versa. 

Last fall the chairman of the Review committee indicated to me 
the committee's interest in developing an issue of this journal which 
would undertake to address some (but only some!) of the moral 
questions which are emerging from medicine and bio-medical tech- 
nology. The rationale for such a venture (if I may quote myself!) is 
that "Physicians and clergymen are increasingly obliged to talk to 


each other (and sometimes about each other!) ; and there is no reason 
currently to suppose that this obligation will not intensify in the years 
ahead. If we are ever to get beyond the stage of polite euphemism 
and anecdote and down to the business at hand, each of us will have 
to become better informed about and acquainted with the other." 
That, at least in part, is what these papers are about. 

Among several alternative approaches and resources considered by 
us, we elected to publish the following essays which, in their original 
form, were composed by students enrolled in an advanced course in 
Christian ethics in the Divinity School. In their present form, how- 
ever, these papers represent not only the primary research and reflec- 
tion of original authors but also the additional contributions of class 
members together with revisions and emendations by an editorial 
committee.* There is therefore an uncommon kind of corporate 
authorship and collaborative effort which has produced these articles. 

The focus of these essays is on the issues and elements which 
emerge in decision-making within these several contexts. Because 
of limited space the papers mainly intend merely to describe some of 
the ways in which these issues and elements raise theologically and 
morally significant questions, and then to offer some modest sug- 
gestions for direction in addressing them. There is, as you will see, no 
external coherence among the essays except a common sphere of inter- 
est. Moreover, you may also detect that internally the papers make 
different emphases and employ different approaches. We think that is 
as it should be, both as illustrative of the varieties in ethical method as 
well as affirmative of situational diversity. We submit them with the 
hope that you will find them informative, suggestive, and perhaps 
even useful. 

Harmon L. Smith 

Associate Professor of Moral Theology 

♦Members of the editorial committee were Gregory R. Dell, Melvin D. 
Dowdy, Russell E. Martin, L. Powers McLeod, and Richard P. Richards. 

Human Experimentation 

Donald Dial, Russell Martin, and David Pacholke 

In July, 1963, twenty-two very seriously ill patients at the Jewish 
Chronic Disease Hospital in Brooklyn, New York, were injected with 
live cancer cells without their informed consent. The patients had 
previously been asked only for their verbal permission to be used in 
tests to determine their resistance or immunity to disease. They were 
told that a lump would form, but only for a few weeks. They were not 
told in plain language, however, that this procedure was not^ part of 
their normal treatment. Neither were they informed that the cells to 
be used were cancer cells. This case became widely publicized when 
three physicians, who had resigned in protest of the manner in which 
the experiment was being conducted took their grievance to a New 
York lawyer who was also a member of the hospital's Board of 
Directors. After being refused permission by the hospital to examine 
the records of the experiment, the lawyer appealed to the Brooklyn 
Supreme Court for formal permission to see the information. The 
story was quickly picked up by the news media. 1 

In subsequent hearings before the Board of Regents of the Uni- 
versity of the State of New York, two primary arguments were 
presented on behalf of the two reputable doctors who had directed the 
experiment. It was argued that there were no clear standards to 
guide the researchers in such experiments and that the methods 
employed were not significantly different from those used by other 
professional researchers. Several notable medical researchers testified 
on behalf of the defendents. The accused doctors were found guilty 
of fraud and deceit and unprofessional conduct in the practice of 
medicine. The real importance of the case, however, came in the 
realization by physicians and concerned laymen alike that there were 
no adequate guidelines for medical experimentation on human sub- 

1. E. Langer, "Human Experimentation : Cancer Studies at Sloan-Kettering 
Stir Public Debate on Medical Ethics," Science (1964), 143:551-3; E. Langer, 
"Human Experimentation : New York Verdict Affirms Patient's Rights," 
Science (1966), 151:663-6. A good legal review of the case is contained in 
Robert D. Mulford, "Experimentation on Human Beings," Stanford Law 
Review (1967), 20:99-117. 


jects when the experiment was not for the direct benefit of the 
patient. Indeed, this case called to the attention of all concerned 
persons that the issue of non-therapeutic human experimentation 
had not been adequately explored as regards either its ethical or its 
legal implications. 2 

Although the above case is perhaps the most dramatized instance 
of non-therapeutic human experimentation in the past decade, it is 
far from being the most questionable. Dr. Henry K. Beecher has 
listed twenty-one other examples in which medical investigators 
ventured to "risk the health and life of . . . patients" in experiments 
without any direct benefit to them. 3 Dr. M. H. Papp worth, in his 
book Human Guinea Pigs: Experimentation on Man, 4 has given ex- 
tensive case material to indicate the ethical problems present in non- 
therapeutic human experimentation. These problems are not new, 
but they have come to the attention of many people lately because of 
the frequency with which they have occurred in recent years. 

The rapid growth and advancement in medical techniques and 
skills since World War II have kept medicine constantly on the 
frontier of new discoveries in the diagnosis and treatment of diseases 
which, before that time, had been beyond its reach. This rapid ad- 
vance has provided numerous situations in which human trials are 
necessary. Many new discoveries simply cannot be tested adequately 
on animals due to basic physiological differences between human 
beings and other species. Thus, medical research has been increas- 
ingly obliged to employ human experimentation as a means of testing 
and confirmation. 

Human experimentation is itself a very broad category; for, 
technically, every medical procedure is an experiment to the unique- 
ness of each individual and the subsequent uncertainty factor. How- 
ever, human experimentation is generally separated into two areas : 
therapeutic and non-therapeutic. The therapeutic experiment is 
characterized by having as its purpose the welfare of a particular 
patient. The doctor-patient relationship is typically based on the as- 

2. Two excellent contributions bring together much of the literature from 
various disciplines: I. Ladimer and R. Newman (eds.), Clinical Investigation 
in Medicine: Legal, Ethical and Moral Aspects (1963), and "Ethical Aspects of 
Experimentation with Human Subjects," Daedalus (1969), 98. 

3. Henry K. Beecher, "Ethics and Clinical Research," Neiv England Journal 
of Medicine (1966), 274:1354-60. 

4. M. H. Pappworth, Human Guinea Pigs: Experimentation on Man (Lon- 
don: Routledge & Kegan Paul, 1967). 


sumption that the doctor will act only in a manner that is intended to 
benefit the individual patient. In the non-therapeutic experiment, the 
primary objective is the discovery of knowledge. The invesigator- 
siibject relationship does not assume that the patient's benefit is the 
primary goal. The question of whether new knowledge obtained by 
the experiment might benefit the subject is of secondary importance. 
It is therefore the primary intention of the physician-investigator 
that tends to determine the nature of the experiment. 5 

Within the category of non-therapeutic experimentation are 
various sub-categories which are generally determined by what is 
being tested. One such division is between experiments designed to 
test new drugs and experiments designed to test new non-drug 
procedures. The experiment involving the injection of live cancer 
cells offers an example of non-drug, non-therapeutic human experi- 
mentation. Another important area of consideration concerns the 
subject involved in the experiment. Any subculture of society might 
be potential subjects : children, prisoners, the mentally-ill, hospital 
patients, healthy persons, etc. This paper will deal only with the 
ethical issues raised in non-drug, non-therapeutic human experimen- 
tation on mentally competent, non-imprisoned adults who are being 
treated in or by a hospital. 


The ethical questions involved in non-therapeutic human experi- 
mentation can ultimately be traced to the problem of individual rights 
versus social responsibility. 6 In principle, it may be argued that 
human beings should not be used as guinea pigs because this action 
conrtadicts an individual's rights. By appealing to other principles, 
however, it may be argued that it is the individual's responsibility 
to become an experimental subject for the good of the society. In 
any society certain individual freedoms have to be forfeited to the 
society in order that the society and the individual might exist and 
grow. Thus, the question concerns the degree to which an individual 
is to be called upon to forfeit his rights for the good of the social 

5. Hermann L. Blumgart, "The Medical Framework for Viewing the 
Problem of Human Experimentation," Daedalus, op. cit., pp. 248-74. 

6. For two excellent treatments of the philosophical problems see Otto E. 
Guttentag, "Ethical Problems in Human Experimentation," Ethical Issues in 
Medicine, ed. E. Fuller Torrey (1968), pp. 195-226; and Hans Jonas, "Philoso- 
phical Reflection on Experimenting with Human Subjects," Daedalus, op. cit., 
pp. 219-47. 


order. At what point does society have the right to take from its 
members their individual liberties? 

The actual balance between individual rights and social responsi- 
bility is never static but always responding to the circumstances which 
affect the society. For example, when a society is threatened by war, 
it requires its members to forfeit some of their individual rights for 
the defense of the society. Careful analysis would also show that 
certain basic attitudes about the individual are the basis upon which 
the society is built. These attitudes, moreover, are reflected in the 
laws of the society. 

In the laws of a democratic society, high value is placed on the 
individual and his personal physical integrity. The value of the 
individual is primary except in issues which threaten the society's 
existence — as in the case of war. The rights and freedoms of the 
individual are the very basis upon which a democratic society is 
founded. Any threat to the primacy of the individual under normal 
conditions represents a threat to the whole social order. This principle 
applies to all persons in the society, regardless of their objective merit 
or station or status of life, or nearness to death. The governing 
standard is the equal worth of each person as a human being. 

Normally in such a society, where the individual is primary, no 
individual or group of individuals is singled out as a special sacrifice 
for the good of the society. In fact, "we like to think that nobody is en- 
tirely and one-sidedly the victim in any of the renunciations exacted 
under normal circumstances, by society 'in the general interest,' that 
is, for the benefit of others." 7 This type of social order is primarily 
concerned with men's overt public acts and not with the individual's 
private life. The primacy of the individual is the foundation of a 
democratic social order. 

Totalitarian or communistic systems, on the other hand, are based 
on the principle of the primacy of the society. The freedoms of the 
individuals are always of secondary consideration under the primacy 
of the state. In such a society the individual is unquestionably used 
for the benefit of the social order. 

Justification for non-therapeutic human experimentation falls some- 
where between the totalitarian value of community and the demo- 
cratic value of the individual. 8 In human experimentation there is 
(for the most part) no extreme issue of social survival at stake; the 

7. Jonas, op. cit., p. 225. 

8. Ibid., p. 226. 


issue is rather societal benefit. The individual who is asked to be a 
subject is really being asked to forfeit some of his individual rights to 
the society in order that the society might benefit. Some forfeitures 
might be one or more of the following : 

1. invasion of privacy; 

2. donation or sacrifice of personal resources such as time, at- 
tention, dignity and physical, mental or emotional energy; 

3. surrender of autonomy as in studies entailing restriction of 
movement or action; 

4. exposure to procedures entailing mental or physical pain or 
discomfort, but no risk of injury or lasting harm; 

5. exposure to procedures that may entail risk of physical or 
emotional injury. 9 

What is being requested goes beyond what is normally asked of a 
person for the betterment of society in a democratic system. In light of 
these considerations, two questions need to be raised. What right does 
the society in general, and the medical profession in particular, have 
to ask persons to participate in non-therapeutic human experimenta- 
tion? What reasons justify a person in risking his health and well- 
being in a non-therapeutic experiment ? 

What is at issue is whether individual rights or social health is 
more important. Probably no one would argue that health is not a 
desirable good. If we had the opportunity to choose between health 
and disease, there is little doubt as to which of these two we would 
elect. Health is a value. Public attitudes reflecting our society's 
valuation of health over disease may be attested by the widespread 
public support of medical research by the federal government. 10 
People generally encourage the conquest of disease through medical 
research. This societal support for health is an indirect support of 

People associate health with life and illness with death. But life 
and health for whom ? For the society, of course ! The health in 
question is predicated on the whole of society. In reality, however, 
very rarely is disease of such an epidemic proportion as to threaten 
the health and, thus, the life of a society. Attributing health to the 
whole society has the effect of making society's health a higher good 

9. Wolf Wolfensberger, "Ethical Issues in Research with Human Subjects," 
Science (1967), 155:49. 

10. Medical research funds in the United States have steadily grown from 
approximately $45 millions in 1940 to approximately $2.5 billions in 1968; and 
current trends indicate that they will continue to grow. 


than the individual's health and thereby gives it more social appeal. 
Thus, in non-therapeutic human experimentation, the conflict is 
finally between two societal values, namely, health and individual 
physical integrity. Is an individual's physical integrity to be sacrificed 
for the benefit of a more healthy society or is the general health of 
society to be sacrificed to maintain the principle of the individual's 
physical integrity? Or more specifically does the society in general, 
and the medical profession in particular, have the right to use a 
person for non-therapeutic experimentation? Legally these questions 
are unresolved ; there seems to be great uncertainty about non- 
therapeutic human experimentation in the laws. 11 


Over the last several years the increase in human experimentation 
in medical research has put pressure on the legal establishment to 
give guidance to clinical investigators in their research. The develop- 
ment of legal wisdom to deal with the new techniques and dis- 
coveries has not kept pace with advancing medical research. This 
advance is a result of the basic scientific nature of medical research, 
wherein each breakthrough suggests a possible next step to be taken. 
Thus, medical research is constantly taking the initiative in new areas 
while the law must generally await these discoveries in order to 
respond with appropriate legal considerations. Not only does the law 
have to wait for medical science to initiate the new situation, but 
insofar as the law is frequently "no more than the technical and 
official formulation of the society's moral convictions," the law has 
difficulty in dealing with questions of a moral nature until the society 
has come to some conclusions about them. 12 Thus, in a sense, the law 
is caught between medicine's adventuresome research and society's 
conservative morality. 

The law embraces three major areas: the legislative (statutes), 
the executive-administrative (regulations and adjudication), and the 
courts (adjudication). Prior to 1960 there were no specific federal or 
state statutes purporting to regulate investigators or research organi- 
zations in their methods, their areas of research, or their use of 

11. For legal treatment of human experimentation, see Paul A. Freund, 
"Legal Framework for Human Experimentation," Daedalus, op. cit., pp. 314-24; 
and Howard N. Morse, "Legal Implications of Clinical Investigation," Vandcr- 
bilt Law Reviczv (1967), 20:747-76. See also Mulford, op. cit., pp. 99-117. 

12. Samuel E. Stumpf, "Some Moral Dimensions of Medicine," Annals 
of Internal Medicine (1966), 64:462. 


human subjects or patients in research. 13 Today legal experts who 
have examined this area believe that American courts, if confronted 
with the necessity to determine legal principles which are applicable, 
would turn to a small number of appelate court decisions in the 
United States and Great Britain which involve the common law (by 
which we mean the law devised and administered by the courts) of 
medical malpractice. 14 Thus, it may be expected that the law will 
develop on a case-by-case basis, in traditional common law fashion, 
i.e., the courts will look to expert witnesses from the research field 
to guide judicial understanding of the common, accepted practices in 
clinical investigations. 15 

In examining the common law, two principles are applicable to the 
consideration of non-therapeutic human experimentation : consent and 
reasonable care. The common law places high value on consent to 
physical invasions which threaten the health or physical integrity of 
the individual. 16 But consent presupposes some knowledge of the 
procedure to which consent is being given. The clinical investigator 
is therefore under a general duty to communicate to the patient such 
information as is necessary for his free and informed consent. The 
question of the kind and amount of information necessary for such a 
consent is a knotty problem. While in theory it is recognized that 
there is no relationship between consent and risk, it can generally be 
said that the courts will require understanding proportional to the 
risks involved. 17 It should be noted that the consent requirement 
allows the subject the final veto regarding participation in the experi- 
ment, thus affirming the basic democratic principle of individual 
physical integrity. In principle the consent requirement is the af- 
firmation of the equal worth of every person insofar as no man is 
legally justified in violating the physical integrity of another apart 
from the subject's informed consent. 

Legally, persons lacking the capacity to consent should not be used 
for any clinical investigations merely because they are convenient or 
available. At present there is no adequate legal defense for such 
action — neither arguing the benefit available to society nor the 

13. William J. Curran, "Government Regulation of the Use of Human 
Subjects in Medical Research: The Approach of two Federal Agencies," 
Daedalus, op. cit., pp. 542-3. 

14. Ibid. 

15. Ibid., p. 545. 

16. Morse, op. cit., pp. 748-57; and Mulford, op. cit., pp. 102-5. 

17. Morse, op. cit., pp. 751. 


minimizing of risk to the subject. These latter arguments are very 
unstable legal grounds. 

The second major principle of the common law bearing on human 
experimentation is the investigator's duty to exercise reasonable care. 
A person is liable when his negligence has caused injury to the 
person or property of another. This standard is applicable only to 
situations where improper care by the investigator can be related to 
injury to the subject. It is likely that the applicable standard in such 
cases would be determined by the testimony of other investigators 
regarding common research practices of reasonable care. 18 

In summary, the present legal requisites for legitimate, liability- 
free non-therapeutic experimentation can be described in three points : 

1. the exercise of due care in administering the procedures; 

2. soundness of experimental design, in that it must not be 
incapable on its face of producing significant results and its known 
hazards must not be disproportionate to the ends sought; 

3. informed, voluntary consent. 19 


The most hotly debated issue in non-therapeutic human experi- 
mentation is that of free and informed consent. It is the issue which 
historically has been most controversial as well as that point at which 
legal experts and others not involved in medical research most often 
enter into the debate. This is largely due to the central place of con- 
sent as the determining factor in adjudicating between individual rights 
and social rights. Consequently a large number of articles have been 
written which deal with this subject and in varying degrees of idealism 
and realism. 20 Realistic treatment of the subject has suffered due to 
the lack of research into the dynamics of the consent situation. Cur- 
rently, however, work is being done on what actually goes on in the 
consent situation. 21 

One point often forgotten has to do with the various levels of 
consent involved in a human experiment. This matter has been ob- 
scured by calling the subject's action a "consent" and the doctor's 

18. Ibid., p. 760. 

19. Freund, op. cit., p. 321. 

20. For an excellent review of the consent issue and a good bibliography, see 
John Fletcher, "Human Experimentation : Ethics in the Consent Situation," 
Law and Contemporary Problems (1967), 32:620-49. 

21. Ibid.; see also Lynn C. Epstein and Louis Lasagna, "Obtaining In- 
formed Consent," Archives of Interna! Medicine (1969), 123:682-8. 


action a "decision." In essence, of course, both the subject and the 
investigator consent to the experiment. A medical experiment is con- 
ceived in the mind of the investigator who pursues his hypothesis as 
far as possible in ways other than human trials. When he has reached 
the limit of testing his hypothesis on non-human subjects, he faces 
the decision of whether to try the experiment on human beings. This 
involves a moral decision on the physician's part. He must try not 
to allow his enthusiasm or pride to influence unduly his decision- 
making process. It is essential, for a relatively free decision on his 
part, that the investigator understand his motives in making his 
decision. Thus, introspection and a good understanding of ethical 
decision-making, as well as a definite set of values consistent with his 
profession, are essential for good clinical investigation. He should 
also be fully aware of the implications that his consent might have for 
the lives and well-being of others, in both a beneficial and a harmful 
sense. He must carefully weigh the possible benefits, risks, and 
hazards which he can predict. Primarily because of these considera- 
tions, the best guarantee for suitable human experimentation is "an 
intelligent, informed, conscientious, passionate, responsible investiga- 
tor." 22 

The "golden rule" has been suggested by some to be a guide for 
the investigator. Superficially this appears satisfactory, but it breaks 
down on practical, legal, and ethical grounds. Practically, one criti- 
cism has been that if an investigator submitted to his own experiment, 
it would not be a valid test because "those who are conducting the 
procedure, who will be his colleagues and very likely his subordinates, 
are likely to exercise particular care (with him). So that the element 
of risk may appear the same when the identical experiment is per- 
formed on others, yet it may actually be greater." 23 There is also 
the obvious health difference between a patient who is presumably 
suffering from a disease that has brought him to the hospital and the 
doctor who is supposedly in good health. Ethically and legally, an 
investigator's willingness to experiment on himself is not justification 
for repeating the experiment on a patient. 24 As one forceful critic has 
put it, "Some people deliberately expose themselves to stupid 
risks . . . but this does not entitle them to expose others to these risks, 
or to make others submit to their folly." 25 Thus, the golden rule does 

22. Beecher, op. cit., p. 1360. 

23. Pappworth, op. cit., p. 80. 

24. Blumgart, op. cit., p. 260. 

25. Pappworth, op. cit., p. 80. 


not provide an absolute answer to the investigator's decision-making 
process, although it can no doubt provide valuable data for the 
decision-making process. In this regard, Guttentag suggests that the 
motivation for self-experimentation is important. If the investigator's 
motivation is to identify more with the patient and thus help the 
patient in his decision-making, such self-experimentation would be 
beneficial. However, if the purpose is to sway the patient unduly, 
then the investigator is hindering the patient's freedom of choice. 
Guttentag goes on to point out the difficulty in determining the 
physician's motivation. 26 

After the investigator has consented to try his hypothesis on 
human subjects and has formulated a protocol for the experiment, it 
becomes the task of a committee of his peers under the National 
Institute of Health guidelines 27 to examine once again the purpose 
and protocol in order to weigh among themselves the proposed pos- 
sible benefits against the possible risks involved. Risks to be con- 
sidered should include not only the foreseeable hazards to a subject 
who might participate but also risks to the very basis of the social 
order. As has been pointed out, an experiment is moral or not at its 
inception and does not become moral post hoc. 28 Thus, an experiment 
whose basic nature is inconsistent with affirmed social values should 
not be allowed to continue regardless of possible benefit. It is the task 
of the committee, acting as representatives of the social order, to 
evaluate this risk. Under this rule, it is possible for a committee to 
reject an experiment for which persons have already volunteered. 
The criteria for this committee's consideration should be primarily 
moral in nature and should not be influenced by the availability of 

In addition to the institutional committee's consent, there is also 
the consent of the staff at NIH. The decision of these two groups 
comprises the second level of consent. 

Between the second and final levels of consent is the question of 
who will be approached as a potential subject. In some instances 
this group will be extremely limited due to the experimental require- 
ments. However, the investigator should be aware of the criteria he 

26. Guttentag, op. cit., p. 208. 

27. The NIH guidelines are reviewed in Curran, op cit., pp. 574-80. However 
the guidelines were revised 1 May 1969 and therefore Curran is not always 
accurate. To obtain a copy of the current guidelines write : Director, Division 
of Research Grants, National Institute of Health, Bethesda, Maryland, 20014. 

28. Beecher, op. cit., p. 1360. 


is using in selecting potential subjects because this has a direct bearing 
on the third level of consent, namely, the freedom with which the 
subject may decide to participate. Approaches to potential subjects 
should minimize undue influences and avoid expediency and avail- 
ability. Jonas suggests in this regard, "The poorer in knowledge, 
motivation, and freedom of decision (and that, also, means the more 
readily available in terms of numbers and possible manipulation), the 
more sparingly and indeed reluctantly should the reservoir be used, 
and the more compelling must therefore become the countervailing 
justification." 29 

The third and most debated level of consent is at the point of 
obtaining the free and informed consent of a subject. It has been said 
that this is the most important single aspect of human experimenta- 
tion inasmuch as it is decisive for the patient's sense of being 
respected as a person and the point at which the society's welfare and 
the individual's welfare are balanced and harmonized. There is no 
disagreement in principle that free and informed consent is necessary 
for all non-therapeutic human experimentation. In fact, it is basic 
to any society or system which places value on individual rights. If 
the person is denied the right to volunteer freely or to abstain from 
participating, he is denied a basic human freedom. Likewise, if he is 
denied any information that might affect this decision, he is also 
denied his humanity and reduced to a mere passive thing. 30 Insofar 
as the investigator withholds such information and thus denies a 
subject his humanness, in the same act he forfeits his own humanity 
and contradicts the very principle upon which the integrity of his 
experiment is based. "To violate a structural value (of the society 
that has enabled the experiment) is to violate the very structure 
which makes benefits meaningful." 31 Thus stripped of the require- 
ment of a reasonably free and adequately informed consent, experi- 
mentation and medicine itself would rapidly become inhumane. 

In principle, then, there can be no objection to requiring that the 
potential subject be allowed optimum freedom and maximum infor- 
mation regarding the experiment in which he is being asked to 
participate. The "rub," however, arises when one moves from theory 
to practice. Investigators, while agreeing with the theory, point out 

29. Jonas, op. cit., pp. 236-7. 

30. Ibid., p. 235. 

31. John Fletcher, "Informed Consent : The Nature of the Art," Unpublished 
paper, p. 8. 


that each case is different in terms of the makeup of the subject and 
the design of the particular study. All men are not equal in their 
ability to comprehend the intricacies of an experiment. Moreover, all 
the risks and hazards of any particular experiment are not always 
knowable in advance. It is difficult to determine what information 
about an experiment is important for informed consent. It is question- 
able whether a person is ever absolutely free in the sense that no 
external influences are affecting him. Thus, the whole issue of free 
and informed consent is highly ambiguous and it is little wonder that 
in a recent study investigators spoke of it as their chief difficulty. 32 

We have indicated that a serious problem in obtaining free and 
informed consent is the question of how much information is needed 
for the subject to be informed. Ideally, informed consent exists when 
the subject understands all essential aspects of the experiment — that 
is, what his consent means in terms of his rights, the types and 
degrees of risk, the detrimental and beneficial consequences, if any, 
as well as the procedure and objectives of the experiment. Prior to 
understanding the aspects of the experiment, however, the subject 
must understand that the procedure to which he is being asked to 
consent is not part of his treatment and has no direct relationship 
to his therapeutic treatment. As has been noted in recent studies of 
the consent relationship, this has not always been the case. "Patients 
tend not to distinguish between research and treatment and hence 
entertain an inner sentiment that the procedure, even when they are 
told it is non-beneficial, holds out some hope for their improve- 
ment." 33 Thus, in the use of hospital patients as subjects for non- 
therapeutic experimentation, the responsibility weighs very heavily 
upon the investigator to impress the non-beneficial nature of his 
experiment upon the patient. In all non-therapeutic experimental 
situations the responsibility for informing the subject always rests 
with the investigator ; he is not to assume that merely answering the 
subject's questions constitutes informed consent. 34 This is only one 
essential element of an informed consent. 


Two recent studies in the dynamics of the consent situation might 
aid the investigator in insuring a more adequately informed consent. 

32. Fletcher, "Human Experimentation," p. 627. 

33. Ibid., pp. 635-6. See also Pappworth, op. cit., p. 102. 

34. Pappworth, op. cit., p. 83 


In a study using three different written explanations of an experi- 
ment, Drs. Epstein and Lasagna found that "comprehension, 
maximum retention of information and ability to utilize information 
intelligently is obtained when the presentation of data is brief and to 
the point." 35 In tests following the informing process, it was dis- 
covered that the subjects who received the shortest forms in which 
the pertinent information was included, without detailed elaboration, 
retained more of the important information than did those who 
received more detailed forms. 

In a study by Professor John Fletcher of several consent situa- 
tions at the NIH Research Center in Bethesda, Maryland, three 
interesting conclusions resulted. 36 Professor Fletcher found that 
giving consent is actually a series of decisions rather than one solitary 
decision. He suggests that such decisions begin for the patient when 
he enters the hospital. In addition, the informing of the patient 
actually takes place over the course of several meetings prior to the 
actual formal consent request. Also the outcome of the formal 
request is largely due to the previous meetings rather than the formal 
request meeting. Within the meetings, the relationship between the 
investigator and the patient is extremely important. Fletcher notes 
three forces at work in this relationship: the illness of the patient 
which influences understanding and motivation; the investigator's 
expectations of himself, of the patient, and of the institution for which 
he works; and the perception of the doctor by the patient. These 
forces seem to have the greatest influence on whether the subject and 
the investigator conclude with informed consent. On inquiring into 
the patients' reasons for giving consent, three considerations were 
predominant. First, the patients were satisfied with the investigators' 
explanation of the risks and the procedure. Second, the patients were 
affected by the idea that they would be participating in a valuable 
medical project. Third, the patients trusted the investigator as a 
person and as a physician. On the basis of these studies, it seems that 
informed consent does not depend so much on the quantity of informa- 
tion as on the attitudes of the investigator and his sensitivity toward 
the subject in their relationship. 

The quality of the informed consent not only depends on the 
quality of the information the investigator imparts but also the manner 
with which he imparts it. The investigator's ability to explain the 

35. Epstein and Lasagna, op. cit., p. 685. 

36. Fletcher, "Informed Consent," pp. 18-22. 


technical aspects of the study in lay language is very important. This 
includes not only the procedure which will directly affect the patient 
but also the purpose of the study. 37 Due to the patient's lack of 
education and sophistication in scientific matters, and/or his lack of 
health, it is difficult for the patient to understand the full implications 
of the procedures and the purpose of the experiment even when these 
are carefully explained. 38 In response to this situation, it has been 
suggested that a physician who has no direct connection with the 
experiment counsel with the patient in an attempt to help him under- 
stand that to which he is being asked to consent. 39 The physician 
would assume the traditional role within the physician-patient rela- 
tionship and would act as a "physician-friend" in helping the patient 
to understand and respond to the investigator. This proposal does 
seem to offer an added measure of assurance that the patient will 
better understand the experiment and his own feelings toward it. 
Also, it helps the patient to distinguish between therapeutic and non- 
therapeutic procedures by personifying them in the physician-friend 
and the investigator. While there are criticisms of this procedure, we 
believe a person who is well-informed about the experiment and who 
acts as a counselor with the potential subject could be a great help in 
insuring the proper understanding and clear thinking of the patient. 
Another area of difficulty in fully informing the subject is an area 
also largely unknown to the investigator. The question of risk 
involved is often unknown. Investigators are frequently hesitant to 
inform patients that the consequences of an experiment are ultimately 
unpredictable. 40 If the investigator is working under the NIH 
guidelines, he may assume that if his procedure has been approved by 
the committee of his peers and he believes it to be the lowest possible 
risk or hazard to the subject, the experiment is, in fact, as safe as pos- 
sible. However, to express this belief as anything more than an im- 
perfect judgment based on insufficient information is to contradict 
the requirement of informed consent. The subject should understand 
that ultimately the result of the experiment is unpredictable even 

37. Fletcher, "Human Experimentation," p. 637. 

38. Henry K. Beecher, "Experimentation in Man," in Newman and Ladimer, 
op. cit., p. 8. 

39. Otto E. Guttentag, "The Problem of Human Experimentation : The 
Physician's Point of View," in Ibid., pp. 126-33. 

40. Pappworth, op. cit., p. 191. See also Louis G. Welt, "Reflection on the 
Problems of Human Experimentation," in Newman and Ladimer, op. cit., pp. 


though its probable outcome is predictable. The investigator's tenta- 
tive judgment should never be given as absolute. In this situation 
also, the "physician-friend" could help the subject to evaluate the 
evidence. Objection has been raised from some physicians and 
investigators "whether such a principle is always capable of application 
or even desirable." 41 Often the objection is based on the difference 
of such a role from the physician's traditional role "which is to 
provide hope for and comfort to the patient." 42 However, in non- 
therapeutic human experimentation, the traditional role of the 
physician no longer is applicable to the investigator-subject relation- 
ship. In non-drug experiments fully informed consent of the subject 
is always desirable. 43 If for any reason the person is incapable of 
giving a fully informed consent due to unconsciousness, then under 
normal circumstances any non-therapeutic procedure is impermis- 
sible. 44 It has been suggested that this might also be the case for 
children and mentally incapable persons. 

Regarding the ideal of totally free consent, much the same 
ambiguity exists. Total freedom in the consent situation is impossible 
due to the very nature of the human creature. What a man is cannot 
be separated from the past influences upon him and his dreams of the 
future. All of these influence him in the decision-making process. 
Likewise, man does not exist apart from other men ; he is a social 
being influenced by his many and various social relations. For 
example, a man whose wife or child had died of cancer would be 
greatly swayed in his decision if asked to participate in a cancer 
research project of no benefit to him. The aim of the investigator 
should be to allow the greatest amount of freedom possible. In 
response to the enormous difficulty in determining a man's motivation, 
some persons have suggested that perhaps too much emphasis is being 

41. Louis Lasagna, "Can the Public Be Overprotected ?" p. 15. A copy of 
this article was given the authors, but we are unable to supply full bibliographi- 
cal data. 

42. Comment by Edward Freis in Medical Ethics in Research: A Symposium 
(Veterans' Administration, Department of Medicine and Surgery, 17th Annual 
Medical Research Conference), VA monograph 10-2 (Cincinnati, 1966), p. 6. 

43. Drug experiments constitute a different problem due to the blind and 
double-blind experiments and the placebo effect. 

44. Jonas, op. cit., p. 240. "Normal," as used here, refers to a time when 
only an average number of persons is in danger of disease at any given time 
as opposed to an epidemic situation when large numbers of the population are 
endangered simultaneously, thus raising the danger to society as a whole. 


placed on freedom due to "an excessive ethical fastidiousness." 45 An 
alternative to the ideal of disinterestedness, the standard of "fairness," 
is substituted, by which the writer means "what in retrospect will 
seem fair to him (the subject)." 46 The problem here, however, is that 
at the time the subject has to make the decision he does not have the 
perspective that is required for retrospection, namely, a view of him- 
self after the experiment. If "fairness" can only be determined at the 
end of the experiment, what good does this do for the patient's 
decision-making ? Also, this proposal is based on the assumption that 
the ethics of an experiment are determined by its ends — but this is 
contrary to the view proposed above, namely, that the moral nature of 
an experiment is determined at its inception. This proposal, therefore, 
is inconsistent with the goals of society and the research itself. 

While it is correct that complete disinterestedness is unattainable, 
some reasonable criteria needs to be employed to insure the minimiza- 
tion of coercive and undue pressures on the freedom of the subject 
to decide upon participation in an experiment. It is this reasoning 
that makes the issue of free and informed consent central in all major 
attempts at establishing codes for the ethical conduct of human experi- 
mentation. 47 The writers of these codes, who were in most cases 
themselves physicians and investigators involved in human experi- 
mentation, realize the complexity of the issue of informed consent; 
but they also realize the necessity of some standard by which investiga- 
tors might be guided with their ethical sensitivities. As one prominent 
writer in the field said, "a requirement of 'voluntary, informed 
consent' ... is far from the be-all and end-all of legal and ethical 
safeguards but it is a valuable check. . . ," 48 

The weakness of the codes, as indeed of any legalistic answer to 
informed consent, has been justly acknowledged by both professional 
and lay critics. 49 In the last analysis there is danger in either too 
strict or too lax statements about informed consent. Here again the 
ambiguity involved in the issue of free and informed consent is evi- 
dent. The functional basis upon which decisions about this issue 

45. Louis L. Jaffe, "Law as a System of Control," Daedalus, op. cit., pp. 

46. Ibid., p. 424. 

47. For an analysis of codes and consent, see Fletcher, "Human Experimenta- 
tion," pp. 629-31. Cf. Mulford, op. cit., pp. 102-5 and Morse, op. cit., pp. 764-70. 

48. Freund, op. cit., p. 323. 

49. Henry K. Beecher, "Consent in Clinical Experimentation : Myth and 
Reality," Journal of the American Medical Association (1966), 195:34. 


will be decided is a certain anthropology affirmed by those involved 
in the various levels of consent mentioned above. Their attitudes 
about the nature of man, and the ways in which these attitudes are 
implemented in actual research processes, tends to determine in large 
measure the moral quality of non-therapeutic human experimentation. 
It may, therefore, be here, most appropriately, that the Christian 
theologian makes a significant contribution to the discussion. 

Euphenic Engineering for 
Clinical PKU 

Melvin Dowdy, Richard Richards, and Linda Van Tassel 

The primeval inorganic slime gave forth the first elementary forms 
of life nearly 2,000,000,000 years ago. From that time on evolution- 
ary history was marked by the interaction of DNA and the environ- 
ment. 3,000,000 years ago the species homo sapiens was born and is 
today a mere adolescent in evolutionary history. In the near future, 
however, evolution may no longer follow the whim of the laws of 
probability, but the direction of man ! 

In 1831 a young Cambridge theologian, who had a yen for beetle 
collecting, set out on a five-year voyage aboard the H. M. S. Beagle. 
The subsequent years found Charles Darwin struggling to integrate 
his observations of variability with a theory to explain them. In 1859 
he published The Origin of Species, which not only summarized his 
reflections upon the theory of natural selection, but caused an intel- 
lectual uproar in both science and theology. In 1870 he added further 
fuel to the debate when he published Descent of Man. 

At approximately the same time, an Austrian monk was con- 
ducting experiments in plant breeding in a small monastery garden. 
Gregor Mendel, heralded as the father of the science of genetics, 
published a paper in which he described the basic principles of the 
science of genetics. He observed that some characteristics remain 
relatively constant from one generation to another. He determined 
that genes interact in pairs, having similar functions and positions 
along the chromosome. He also found that the pair of genes may not 
be complimentary, i.e., one may dominate the other. Thus he found 
that the same gene may have a dominant form and a recessive form; 
and he named these differing forms of the same gene alleles. A reces- 
sive trait can only express itself when the pair of genes are both 
recessive. Mendel also discovered that when the genetic material 
duplicates itself, the alleles, or paired genes, will separate and reunite 
with other genetic material independently ; this he called independent 
assortment. His laws were innovative and highly significant as the 
first descriptive explanation of genetic functions. His discovery 


remained largely unnoticed until William Bateson brought Mendel 
to the attention of the scientific world around the turn of the twentieth 
century. It was Bateson who gave the modern science of genetics 
its name. 

An English mathematician, G. H. Hardy, and a German physician, 
Wilhelm Weinberg, simultaneously came to the same hypothesis 
about gene frequency and random mating in 1908. The Hardy- 
Weinberg law states that a balance of distribution or an equilibrium 
would prevail in a population with respect to the number of persons 
carrying a genetic trait. If certain factors held constant, they found 
that it was possible to determine mathematically the number of 
dominant, recessive, and mixed gene pairs in a population. By using 
the mathematical formula of Hardy-Weinberg, it is possible for 
modern geneticists to determine the occurrence of a deleterious gene 
in a particular gene pool (population) and predict its occurrence in 
the future. 

The study of human genetics began in earnest about 1900 when 
another Austrian, Karl Landsteiner, discovered the A, B, and O blood 
groups. The study of human heredity was given its greatest stimulus 
by medical genetics. This was most noted by the discovery of "in- 
born errors of metabolism" in 1908 by Sir Archibald Garrod. These 
were metabolic diseases (inability to digest certain nutrients) which 
had baffled physicians until Garrod demonstrated their hereditary 
nature. Interest in genetic influence on and participation in disease 
processes has gained significantly ever since and has added abundantly 
to current therapy procedures. 

The science of genetics continued to advance in all its subdisci- 
plines, discoveries in one adding knowledge in others. But it was not 
until 1953, when J. D. Watson and F. H. C. Crick published their 
landmark article in Nature, that an adequate model was proposed 
which would explain the four essential functions and properties 
of the genetic material : specificity of genes, sufficient coding capacity 
for multiple genes, self-replication, and mutation. Watson and Crick 
proposed that the chromosomes are made up of a macromolecule of 
deoxyribonucleic acid (DNA) in a double helix (spiral chain). DNA 
is made up of four bases : two single ring bases, thymine and cystosine 
(pyrimidines), and two double ring bases, adenine and quanine 
(purines). This discovery made it possible for the genetic code to be 
broken and for a dictionary to be compiled which lists the messenger 
RNA codons (specific protein compounds which carry messages from 


a gene to the cell). These two discoveries have brought the science 
of genetics to a place where, in theory, scientifically knowledgeable 
men can manipulate the very biochemical structure of life. 

Jim Shapiro and others reported on their success of isolating the 
"lac Operon DNA" gene. 1 Because of this discovery, it is now techni- 
cally possible to isolate a single gene. With this new insight, scientists 
may well be able in the near future to learn how genes act as adminis- 
trative watch-dogs, administrating the activity of cells, as well as what 
substances activate the gene itself. Such a discovery could ultimately 
be the beginning of learning to correct defective genes and thus cure 
(rather than just treat) hereditary diseases. 

After nearly 3,000,000 years in the evolutionary history of the 
species homo sapiens, a new day is dawning and once unimagined 
possibilities in man's control of his genetic destiny are now near 
realization. As scientists perfect their technology and gain greater 
control over its effects, they will be able to offer alternative genetic 
futures to their neighbors. Leaving aside, for a moment, the debate 
over whether our wisdom will match our technical powers, the moral 
question is raised in the problematics of a situation in which one has 
to choose among several alternative futures. Our capacity to challenge 
and change our hereditary endowment, both now and in the future, 
raises a decision-making moment with which men have not had to 
deal previously. 

Manipulation of our genetic future falls into three general tech- 
nological categories : eugenic engineering, or the selection and re- 
combination of genes already existing in the "gene pool" of the 
population; genetic engineering, or the change of undesirable genes 
to more desirable forms by a process of directed mutation ; or 
euphenic engineering, or the modification and control of the expres- 
sion of existing genetic information of an organism so as to lead to a 
desirable physical appearance. 

Eugenic engineering involves selection for or against certain 
genotypes. Herman J. Muller, a noted geneticist of our century, 
argued that men ought to practice this type of intentional selective 
breeding to improve the gene pool of the human race. There exist 
today at least two techniques which could accomplish these ends : 
artificial insemination by a donor (A.I.D.) and ovum implantation. 

1. Jim Shapiro, Lome Machattie, Larry Eron, Garret Ihler, Karin Ippens, 
and John Beckwith, "Isolation of Pure lac Operon DNA," Nature (1969), 


On the horizon are improved freezing techniques by which sperm 
and ova could be collected and preserved until such time as they were 
desired for conception. All of these techniques have been used suc- 
cessfully in the breeding of animals. Currently, A.I.D. is used by 
some physicians in the treatment of human infertility. The most 
formidable problem facing positive eugenics (selecting for positive 
or desired traits) is the establishment of criteria upon which "good" 
sperm and ova could be chosen. The problem arises in delineating the 
specifics of the word "good." Another problem lies in the fact that 
even the best genomes may carry between four and ten lethal recessive 
genes. In addition, because of the nearly infinite variety of gene 
combinations within any particular gamete (egg or sperm), it would 
be difficult, if not impossible, to guarantee that any particular sperm 
or ovum specimen contained the best combination of genes. To top off 
the problems faced by positive eugenic engineering is the debate over 
the importance of genes versus the importance of environment in the 
development of persons. 

Eugenic engineering also includes negative eugenics. This is the 
selection against deleterious genes to lower or eliminate defective 
genomes from a population's gene pool. Men have at hand various 
techniques to select against the propogation of these genes. The most 
effective technique, and perhaps the simplest, is sterilization: tubal 
ligation in women and vasectomy in men. There are also other less 
final, but nevertheless effective, methods of contraception which can 
assure that certain genomes are not passed on to other generations. 
Selection against deleterious traits is much easier than selection for a 
positive trait. By the technique of amniocentesis (a surgical proce- 
dure for observation of the developing fetus) it is possible to identify 
certain genetically defective fetuses in the womb and either treat them 
prenatally, abort them, or allow them to be born and attempt to treat 
them post-natally. Medical genetics coupled with more precise testing 
equipment and techniques of other sciences is becoming able to 
diagnose not only the homozygote, a fetus which has a high possibility 
of being affected by the negative characteristics, but also the heterozy- 
gote, who is a carrier of the negative characteristic in his genetic 
makeup while he may or may not be noticeably affected by it. For 
example, the heterozygote carriers of the deleterious genes which 
cause phenylketonuria, muscular dystrophy, Down's Syndrome 
(mongoloid idiocy), or the Cru Di Chat Syndrome are all able to be 
identified in the heterozygous state. Such carriers, when identified, 


can be given the needed information about the chances of passing the 
gene on to their progeny, the techniques to prevent this from 
happening, the treatability of the disease. On the basis of this infor- 
mation, such persons may be ready to make a decision for negative 

Another procedure by which we may manipulate genomes in the 
future involves direct intervention to change the composition of the 
chromosomes by mutation. This is known as genetic engineering. 
This science is still in the earliest stages of research with human 
subjects. Although we have the power to cause mutation we are not, 
as yet, able to control and direct the process of genetic mutation with 
sufficient precision. Experience with X-rays, LSD, and Rubella indi- 
cate at least three ways that mutations can be caused. The biggest 
problem with genetic engineering at present revolves around the in- 
ability to make precise point mutations or precise interchanges of 
healthy genetic material for strands of DNA. At present, geneticists 
have not mapped human chromosomes completely enough to know 
where the affected loci are. There are, however, some techniques 
being used in other facets of genetics which look promising for the 
future. For instance, significant genetic engineering is adding to 
our knowledge of deleterious genes, especially as they may relate to 
cancer and leukemia. Studies with cancer and leukemia are adding 
to evidence for the use of viruses to re-program affected strands of 

Another way to change a person's genetic complement is the 
process known as transformation. 2 This is the incorporation of a 
segment of DNA from one cell into the genetic material of another 
cell, thereby transforming the affected cell into a normally functioning 
cell. It has also been found that certain micro-organisms and chemical 
compounds have this mutagenic power. 3 This means that they can 
induce changes in the genetic material which can mutate a gene 
from one form into another. There is some evidence that this can 
be done in a non-random fashion and, thus, controlled mutation may 
be possible some day. Genetic engineering is still very much in the 
experimental stages of development, but may offer the greatest 
potential of genetic control and perfectability available to man. 

2. Elizabeth H. Szybalska and W. Szybalska, "Genetics of Human Cell 
Lines: I. V. DNA-Mediated heritable transformation of a biochemical trait," 
Proceedings of the National Academy of Science (1962), 48:2026-34. 

3. Donald Huisingh, "Should Man Control His Genetic Future," unpublished 


Euphenic engineering is perhaps the most common and perfected 
procedure for genetic manipulation. This refers to the modification 
of gene expression by manipulation of the genetic environment or the 
interference in the way a gene would "normally" express itself. For 
instance, there is evidence that diabetes is a genetically inherited 
disease and it is treated by injections of lacking insulin. Agammaglo- 
bulinemia, characterized by the inability of the body to produce gam- 
maglobulines, is treated by the routine addition of these blood consti- 
tuents. Among "inborn errors of metabolism" which are treated by 
euphenic engineering is galactosemia; it is a genetic disease caused 
by the inability of the affected person to metabolize galactose to 
glucose because of a lacking enzyme. If the disease is allowed to take 
its normal course, the affected infants die at an early age from large 
concentrations of galactose in their blood. This can be avoided by the 
use of a diet which does not contain the amino acid, enabling the child 
to mature into an adult, otherwise normal. 

Not altogether dissimilar to galactosemia, phenylketonuria (PKU) 
is a genetic disease caused by the inability of the affected person to 
oxidize the amino acid phenylalaine into the amino acid tyrosine. Un- 
like galactosemia, this disease is not easily treated and may result in 
infant death, mental retardation, or both. Because of the significant 
number of persons affected by this disease, and the apparent neglect of 
confronting the problematics of treatment by genetic manipulation, 
the authors of this paper have chosen to examine the nature of pos- 
sible treatment of phenylketonuria, including genetic engineering and 
its correlated ethical considerations. We have selected a representa- 
tive case to focus upon salient issues and to offer a tentative prospectus 
for a total medical and ethical treatment. This is an innovative task 
and one which cannot be conclusive at this time. However, the hope 
lies in doing an ethical exercise which may prepare us for future dis- 

PKU is a disease inherited as an autosomal (the genes are one of 
a pair of chromosomes other than the x or y) recessive trait. Since it 
is a recessive condition, the individual who exhibits the disease is a 
homozygote ; i.e., he has two recessive, defective genes. The normal 
or dominant gene produces the enzyme phenylalanine hydroxylase (a 
catalyst or agent which causes chemical changes to occur). The reces- 
sive allele, or genes which carry PKU, prevents or fails to produce 
this enzyme. This failure is its only genetic defect, but it has a variety 
of effects on the organism. 


Phenylketonuria was first described by Foiling in 1934. 4 Since 
then, the biochemistry of the disease has been conclusively demon- 
strated to be a disruption in the normal metabolism of phenylalanine. 
This disruption results in an abnormally increased level of phenyla- 
lanine and a lower incidence of tyrosine in the blood. As the primary 
channel of metabolism by which phenylalanine would normally be 
broken down is blocked, the body finds other pathways to rid itself of 
the excess phenylalanine. Much of it is transformed into phenyl- 
pyruvic acid and is excreted in the urine. Because of this, the disease 
is easily detected by the testing of urine with a solution of ferric 
chloride. This is a very simple, inexpensive test which is reliable for 
the detection of the disease, and provides a method for early detection, 
which is vital for treatment. The abnormal amount of phenylalanine 
can also be demonstrated by a blood test which is conclusive proof of 
the presence of the disease. The blood test is required by law in most 
states and is performed on newborns before they leave the hospital. 

Heterozygotes, persons who carry both a dominant and a recessive 
gene for PKU, can be detected by the phenylalanine tolerance test. 
Because these people carry the defective gene they are not able to 
metabolize phenylalanine as well as a normal person, thus the excess 
can be detected in the blood. It has been found that these people are 
twice as likely to suffer from mental disorders and mental deficiency 
as the normal population. 5 

Phenylketonuria has an incidence of 1/25,000 births and PKU 
patients make up about 1% of institutionalized mentally defective 
people. This disease expresses itself phenotypically in severe mental 
retardation. In the first few weeks after birth it is not unusual for 
the PKU infant to be very irritable, have epileptic seizures, or vomit 
severely. 6 As far as physical appearance is concerned, some PKU 
victims may be slightly stunted, have lighter coloration than their 
siblings, and have abnormally vigorous reflex responses. 7 

The exact physiological cause of retardation is not known for 
sure, but there are several theories. One popular theory is that "it 

4. W. Eugene Knox, "Phenylketonuria," The Metabolic Basis of Inherited 
Disease, ed. T. B. Stanbury, J. B. Tyngaarden, and D. S. Fredrickson (New 
York: McGraw-Hill, 1966), 2nd ed., p. 258. 

5. Ibid., pp. 279ff. 

6. David Yi-Yung Hsia, Inborn Errors of Metabolism, I (Chicago: Year- 
book Medical Publishers, 1966), 2nd ed., p. 135. 

7. H. Harris, Human Biochemical Genetics (Cambridge: Cambridge Uni- 
versity Press, 1962), pp. 36ff. 


results from the toxic action of one or another of the various metab- 
olites which occur in unusual amounts as a consequence of the block- 
age of phenylalanine hydroxylation." 8 Pathologically, autopsies have 
indicated that the brain weights of PKU victims are two-thirds 
normal weight. But, more importantly, the most consistent problem 
was deficient myelin formation in the central nervous system and 
brain. "Not only may the myelin formation in phenylketonuria be 
deficient, but also the myelin itself may be defective, so that it ulti- 
mately breaks down." 9 

We have already seen that failure to metabolize phenylalanine 
causes the disease phenylketonuria. It has been stated that the result- 
ing symptomatology is a severe arrest of intellectual processes which 
normally develop beyond the basic sensory-motor behavior. We can- 
not conclusively say that the resulting mental retardation is caused 
by the deleterious gene for PKU. 

There are several factors which contribute to the intelligence of a 
given person ; i.e., environment as well as innate ability affects the 
intelligence. Our study leads us to assert that intelligence has a 
genetically derived basis in the total organization of a person. A 
person is a highly complex organism with sensory-motor systems, 
kinesthetic (or moving) systems, central nervous system, and so on. 
The unity of all these systems and others comprises the biological 
structure of a person. The biological structure has as its property the 
capacity to receive from or to extend oneself into the environment ; the 
dynamic equilibrium between the assimilation of the environment; 
and the accommodation to it is basic to learning. 10 Initially, intel- 
ligence develops in this person by means of sensory-motor behavior. 
He learns by doing, before he learns through abstractions. It is the 
nature of human behavior to seek active interaction with an adaptation 
to the environment. Adaptation to one's environment is manifested in 
the ways in which one copes with himself in relation to the world 
around him; in the degree to which his behavior corresponds to the 
resources and the limits of his environment, we say that he has begun 
adaptation. This is an over-simplification; however, the fundamental 

8. Ibid., p. 135. 

9. Knox, op. cit., pp. 266-7. 

10. Many disagreements exist on this issue. R. C. Tyron and others have 
argued experimentally for a hereditary basis for intelligence; while others 
have produced contradictory evidence from "free versus deprived" environ- 
mental experiments. Moreover, experiments with identical twins, who were 
separated at birth, have not given conclusive evidence in either direction. 


notion is apparent. Intelligence itself is not inherited ; only the 
biological structure necessary for its development is inherited. 11 

It is precisely this organization of genetically determined biologi- 
cal structure which is impaired by the unmetabolized amino acid. 
Thus, we do not attribute to the untreated PKU patient "bad," 
"wrong," or "illogical" thinking. Rather, we simply recognized an 
arrest of development prior to the emergence of integrated rational 
processes, or at least a dysfunctioning of adaptive behavior, issuing 
from the disorganization of the basic structure. The untreated PKU 
patient will not develop at the expected rate, and he may not develop 
beyond the most infantile behavior. For example, his behavior may 
remain rigidly imitative, copying the motions of others without any 
awareness of the purpose or meaning of these movements. He may 
never develop a concept of number or any notion of the permanence 
and constancy of objects. He may never develop an ability to 
discriminate the differential size of objects, or that the size of some 
objects remains constant. 12 Thus, while his cognitive capacity to 
understand his world is severely impaired, this handicapped person 
lives within a mysterious world of frightening fluctuation and change. 

We must keep in mind that the handicapped PKU patient does not 
fail to develop cognitively without also failing to develop related socio- 
emotional abilities. During the years before the age of seven, we may 
observe the normal child learning to focus upon an object from a 
perspective different from his own; we call this capacity "decenter- 
ing." This ability to decenter is in contrast to the perception of the 
former stage, egocentrism (prior to three years). The surrender of 
egocentricity is the early manifestation of social consciousness and is 
a necessary developmental shift if the child is to learn to cope with the 
social world. Thus, we observe in the untreated PKU patient a lack 
of true social consciousness, a pervasive egocentricity with manifest 

There are other behavioral and somatic symptoms which indicate 
an arrest of development. In the case of one particular patient, she 
did not sit without support at the expected age of six months ; rather 
sitting occurred at twelve months. She did not walk at twelve months, 
but at four years. Her speech remains infantile and meaningless, even 

11. John Flavell, Developmental Psychology of Jean Piaget (New York: 
Van Nostrand, 1963). 

12. B. Inhelder and Jean Piaget, "Diagnosis of Mental Operations and 
Theory of the Intelligence," American Journal of Mental Deficiencies (1947), 
51 :401-6. 


at age twenty-eight. She discharges pervasive hand tremors and 
seizures. She also suffers from skin lesions, a common somatic condi- 
tion among PKU patients. 

The girl, who will never score above the two year level on 
standard intelligence tests (Stanford Binet, Gessel Block Test, and so 
on), is a tragic example of the underdeveloped child. What appears 
more tragic is that the neurological damage could have been pre- 
vented. In addition to this, she was one of four children, all of whom 
suffered from a deleterious genotype. Her birth might have been 
prevented, provided our society had sought early diagnosis of the 
genotype and legalized limitations to reproduction. No institutional 
care, regardless of its altruistic intentions, will substitute for the 
quality of life this child lost. The potential for conquest, achievement, 
self-awareness, and interpersonal relationships — these qualities com- 
monly shared and understood to be a meaningful contribution to 
humanness will never be fully experienced by this patient. In this 
regard, she has lost distinctly human possibilities. 

Since the time of the disease's discovery in 1934, several treat- 
ments have been tried to alleviate the symptoms without much success. 
In 1952, Bickel was the first to institute the diet low in phenylalanine. 
He had good results and this has become the treatment of choice since 
his discovery. 13 The purpose of this diet is to lower the blood level of 
phenylalanine and at the same time promote growth through good 
nutrition. It was found that a certain amount of phenylalanine was 
necessary for proper synthesis and general growth ; thus, the diet is 
not devoid of the amino acid. 14 After a time, the dietary treatment 
diminishes the excess phenylalanine in the body and the patient estab- 
lishes a "normal" metabolic pattern. 15 Presently, the diet is available 
in commercial formula. 

The administration of the diet should be started as soon as pos- 
sible, for, the sooner the treatment is begun, the better the chance to 
prevent any further cerebral damage and deterioration. The diet does 
not seem to correct any damage already present. 16 Centerwall states 
that if treatment is begun by the age one month, the affected child 
should develop normally. If treatment is begun by age two months, 
the person's mentality should be normal, but may be 10-15 I.Q. 

13. Clinical Team Looks at Phenylketonuria, U. S. Department of Health, 
Education and Welfare (Washington: U. S. Children's Bureau, 1964). 

14. Harris, op. cit., p. 41. 

15. Hsia, op. cit., p. 139. 

16. Clinical Team, op. cit., p. 33. 


points behind other persons of that age level. However, if treatment 
is put off until after the child is six months old, there will be exten- 
sive retardation. Regardless of when treatment is begun, there always 
seems to be some behavioral improvement. 

How long does one have to continue on the diet? This is a 
question that is still debated. There is some evidence that indicates 
that the cerebral damage does not continue too long after three years 
of age. Others say that the treatment should continue until adoles- 
cence. 17 

If a PKU woman becomes pregnant, evidence indicates that she 
should return to the diet throughout the course of her pregnancy. 
However, there is conflicting evidence in this situation. Some reports 
indicate that the mother's high level of phenylalanine may cause fetal 
damage, regardless of the diet. On the other hand, it has been 
reported that some PKU mothers have given birth to normal chil- 
dren. 18 

Though the medical profession is inclined to end a discussion of 
treatment with the introduction of a diet, control of seizures, and so 
on, we must argue that this treatment only relieves the symptoms; 
i.e., it does not cure the disease. Moreover, treatment implies "total 
care" and, as such, must extend into non-medical interests. We would 
like to demonstrate the possible areas involving total care with which 
the medical profession and others must deal. 

Recently, a southeastern institution for the care of mentally 
retarded faced a difficult decision. During the course of treating 
hundreds of patients, a clinical case of phenylketonuria was admitted, 
examined, positively diagnosed, treated for one year, and then dis- 
charged by the request of the patient's parents. At no time during 
her custody at the institution, nor after her discharge, were the 
parents or the patient informed of the nature of the diagnosis. Nearly 
five years elapsed when, to the panic of the resident physicians, the 
institution received a formal wedding invitation from their former 
patient and her family. Evidently, the patient and family knew of no 
reason why this marriage would be undesirable. 

The physicians immediately notified the patient and her family of 
the nature and consequences of her condition. The response was 

17. Willard Centerwall and Seigreid Centerwall, Phenylketonuria, An 
Inherited Metabolic Disorder Associated zvith Mental Retardation (Washing- 
ton: U. S. Department of Health, Education, and Welfare, 1965), pp. 16-7. 

18. Ibid., p. 17. 


threefold. On the one hand, her parents were outspoken in their op- 
position to the extent of consulting their clergyman and their at- 
torney about possible religious and legal prohibitions to the marriage. 
The parents would have followed through with a formal request to 
the state Eugenics Board for the mandatory sterilization of their child, 
but it was felt that this would be undesirable and likely to alienate the 
child permanently. 

The prospective husband was apparently undisturbed by the 
physician's appeal and generally refused to accept that any genetic 
deformity existed. (This appears as insensitivity and ignorance on 
this man's behalf.) In fact, the physicians adjudged him to be less 
intelligent than the patient. The patient, who has a mid-range I.Q. 
of 50 and who is in her late teens, did not oppose her prospective 
spouse. The two of them were married. Under the law of that state, 
either the institution or a local welfare officer could have formally 
requested the patient's sterilization prior to their marriage. In that 
state no statute provides for sterilization once the couple is legally 

The problem of Pandora (name fictitious) was made evident as a 
result of the forthcoming marriage. However, the beginning of this 
problem occurred five years prior to the wedding announcement, 
when the physicians neglected to inform the family of the nature of 
the patient's illness. In an attempt to correct this initial mistake, 
the doctors, at the time they received the wedding announcement, in- 
formed the family about the nature of phenylketonuria. 

This then created a problem for the parents. They were afraid 
of insisting on sterilization for Pandora for fear of alienating her in 
light of the forthcoming marriage, a condition which did not exist five 
years earlier. Thus, the decision about sterilization was passed on to 
the future spouse. The institution informed him of the situation. His 
reaction was to deny that any genetic condition existed. The result 
of this series of discussions is that Pandora is given the full weight 
of responsibility which incorporates a decision that she is incompetent 
to make. 

The theologian and the humanist will both agree to the intrinsic 
claim of human life to health. Christian ethics is not needed to justify 
this claim; it seems to be self-evident. Yet, Pandora is among those 
persons deprived of this natural claim, and, while no single individual 
can be held responsible, each decision preceding her present condition 
and dilemma has had a relative contribution. The relative nature of 


each contribution, however, indicates to us the need for joint decision- 
making in which each person, professional or friend, is informed by 
the other. The time when we can remain isolated within a private 
exercise of our own will has long ago passed away. To encourage this 
private modality is to encourage apathy, impotence, and enlarged 
ambiguity. Besides, Pandora's future, together with the future of all 
other PKU patients, directly and adversely affects the future of yet 
unborn persons, persons who also have claim to a healthy life. A 
responsive decision cannot ignore these unborn individuals, nor can it 
afford to neglect all the resources available through the joint decision- 
making context. 

The Christian ethicist especially will appreciate the call of this 
situation to the intrinsic claims of the PKU person. In Tillich's ex- 
plication of Christian love {Love, Power, and Justice), he defined the 
response to this intrinsic claim as love fashioned after the love of God. 
Similarly, Tillich asserts that the whole body of persons, the com- 
munity, also has claim to this love. Thus, we are faced again with 
an ethics of joint management between individual and society, as well 
as management by the individual and society. This two-sided tension 
is the balance of two legitimately based self-interests : 1 ) patient's 
interest in health, and 2) society's interest in protection from defec- 
tive genes such as the PKU gene. But as a tension, lest either pole 
dominate the other, we are faced with a situation of potentially en- 
larged ambiguity and alienation. In the case of Pandora, neither her 
legitimate self-interest nor the legitimate self-interest of the com- 
munity-at-large was adequately managed. The results were painful, 
especially for Pandora and her family. Her family was left with an 
ambiguous situation, a situation in which no clear and just alterna- 
tive was available. And they were faced with a potentially alienating 
situation, a situation in which they stood to lose the understanding of, 
rapport with, and respect of their daughter and her prospective 
spouse. Theologically, we abstract from this concrete situation the 
existential notion of sin. 

Certainly, much of the potential for alienation was implicit in the 
nature of the disease. Yet, the responsive person must not allow this 
threat to immobilize his capacity for an ethical management. The 
responsible person cannot abandon the PKU patient to the natural, 
deleterious whim of the disease. For, such an abandonment acquiesces 
to the tragic consequences, to impeded development and its implica- 
tions for the remainder of the life-history. The full and complete 


joint management of responsibility is what is called "total care," and 
it is noteworthy that such care extends beyond medical, technological 
treatment. Explicating "care" as a psychological and theological 
phenomenon, Rollo May has developed upon the usage of care by 
Martin Heidegger. In his book, Love and Will (W. W. Norton, 
New York: 1969), May described care as "moving toward the other," 
becoming involved, establishing relational qualities in community. As 
such, care is diametrically opposite to a laissez-faire and apathetic 
management of decision. Care is total pouring out of oneself in 
responsive love to the intrinsic claims of individual and community; 
i.e., the Christian principles of neighbor love. 

Returning to our dilemma, we may observe the PKU patient 
requiring care (neighbor love) that extends from conception to death; 
i.e., total care in the historical as well as the technological sense. For 
a complete treatment program, all concerned persons are called to a 
decision on behalf of the patient (or potential patient) and on behalf 
of the community-at-large. When these persons are not jointly 
involved, partial treatment results in enlarged ambiguity and potential 
alienation. Moreover, the most responsible decision will hold in ten- 
sion the legitimate self-interest of both patient and society. With 
these responsibilities in mind, three alternatives are immediately ob- 
vious : 

1) to refrain from the dietary treatment and, thus, condemn the 
child to retarded growth in the community ; 

2) to offer the dietary treatment and place the solution of his 
social alienation totally upon his shoulders ; or 

3) to couple the dietary treatment with a socially responsible 
solution which limits ambiguity and potential alienation. 

Operating from the principle of legitimate self-interest and the 
principle of total care, the first alternative is eliminated. It is in the 
legitimate self-interest of society to have individuals function at their 
fullest capacity. The diet allows for an increased capacity for socializa- 
tion, personal development, self-care, and overall social functioning. 
In terms of the obligation to love the neighbor, we hold that the treat- 
ment enables the affected PKU to enter more fully into a qualitatively 
fuller, richer, and more personalizing relationship. It is our responsi- 
bility in care to provide both an environment and a treatment (in this 
case) in which this person can enter as fully as possible the process of 


The second alternative provides for the partial fulfillment of 
society's legitimate self-interest and the total care principle but com- 
plicates the context. Once we decide to treat the PKU, we provide 
for his entrance into society's life and future. He is now subject to its 
laws and to a second facet of its legitimate self-interest. The treated 
PKU person, who is intellectually developed and sociable, has 
simultaneously become a potential parent who could pass on his 
deleterious trait and in that sense, he may propogate an ambiguous 
and alienating condition. This is embodied in the threat to society's 
physical well-being, and to his potential offspring, which results in a 
breakdown in community with the patient. He suffers from alienation 
perpetrated in the treatment of his disease. Thus, the community 
participates, through the medical treatment, in the genesis of his and 
future persons' alienation. 

Whatever we mean by responsible decision-making, prerequisite to 
it are intelligent responsiveness and the ability to relate socially. Al- 
though the low phenylalanine diet does seem to allow increased devel- 
opment of all these capacities, just how effective it is remains debated 
by physicians. The genetic incidence indicates that mental damage 
probably occurs or begins occurring prenatally. Persons such as 
Pandora are not recognized as legally competent to make decisions 
for themselves. Adolescents are also held to be legally incompetent. 
It is precisely during adolescence that PKU persons reach the age of 
fertility, and, as we have seen, become a threat to society's future. 
Normally, society does not hold children responsible for the decisions 
that they make. 

The later stages of the decision-making context are centered on 
whether or not this person is going to be allowed to procreate, since 
procreation is the sole vehicle of PKU. We would argue that the 
ability to procreate is not an unlimited nor an absolute license. It is 
influenced by contextual and social circumstances and claims. Thus, 
it is a social function and subject to social responsibility ; i.e., joint- 
management. We also assume that no individual genetic endowment 
has an unlimited and absolute right to survival. Consequently, we 
affirm that there is an appropriate time for certain genotypes to 
expire. With the limits placed upon these affected persons, consid- 
ering the age at which such a decision would have to be made, and 
remembering the social implications of not making a decision about 
procreation, all these indicate for society to assume the responsibility 
for joint-management and for the risk involved. 


The discussion has examined the concept of total care as it en- 
courages us to establish the conditions and community in which 
persons can reach the fullest potential in their relationships with other 
persons and with God. Consequently, we would opt for the use of the 
diet to enable victims of PKU to become as fully human as they pos- 
sibly can, while recognizing the various responses and successes that 
that treatment holds for these people. 

The paper has also discussed the various facts which have to be 
recognized and accepted regarding PKU. There is damage prenatally 
in PKU patients ; the diet is not 100% effective, i.e., the test does not 
assure treatment. A corollary to these facts is that decision-making 
requires a certain amount of intelligence. Intelligence is a prerequi- 
site for knowledge and freedom, which are essential elements in 
decision-making. Considering the facts and the corollary to them, we 
have persons whom society cannot trust with whether or not they 
should procreate. Society must assume that responsibility, if it is to 
assume the responsibility for treating PKU patients. In other words, 
total care of PKU persons is required, both as patients with a 
biological disease and as patients with a disease of radical social 
consequences, requiring joint-management. It is the conclusion of 
this paper that for total care the diet be coupled with sterilization. 
Therefore, we propose that all detected PKU homozygotes be treated 
with the diet and sterilized. Also, we propose that heterozygotes 
receive adequate information and counseling about the disease they 
carry and its effects, and, in the event that they have a child with 
PKU, they should at that time be sterilized. 

As long as treatment for PKU persons is limited to a treatment 
of the symptomatology and not a treatment of the enzymatic condition, 
this proposal stands. If an artificial or a synthetic enzyme is produced 
which allows for normal metabolism of phenylalanine to tyrosine, the 
proposal would be modified because we would then be treating the 
disease and not the symptoms. Such a state of affairs could potentially 
remove the problem of alienation, since the danger from the deleteri- 
ous gene would be muted ! 

Medically Induced Drug 

George Ennis, Robert McConathy, and Morgan Peterson 

Drugs are tools of the physician for treatment of the sick and 
protection of the healthy, and the medical doctor participates at every 
stage in their creation, development, evaluation and use. It is the 
physician's responsibility to relieve pain by eliminating its cause if 
possible. In the treatment of patients with chronic or painfully 
incurable conditions, it is purportedly ethical practice to administer 
morphine-like drugs over a prolonged period when all reasonable 
procedures have failed. Generally, this situation is most frequently 
found in cases of terminal disorders. 1 On the other hand, "continued 
administration of drugs for the maintenance of dependence is not of 
itself a bona fide attempt at care, nor is it always ethical treatment." 2 

According to John J. Bonica, M.D., in his book The Management 
of Pain (p. 578) : 

The complications which are inherent to the administration of opiates for 
the relief of pain make it mandatory that when employing those drugs 
one should observe and adhere strictly to the fundamental principles of 
good therapeutics: namely, (1) to give a specific indication, (2) to 
administer the drug in optimal doses, i.e., the smallest amount which will 
cause the desired effects, (3) to administer it by the optimal route. These 
entail individualization of type and amount of drug and the route of the 
administration for the particular patient and the particular pain. Routine 
uses of opiates is haphazard therapeutics and should be avoided. 3 

It is in the process of individualization that problems arise in the 
evaluation and use of drugs. 

Medically speaking, drugs having a stimulating or calming effect 
on the central nervous system may produce psychic dependence. A 
number of these drugs lead to a physical dependence that manifests 
itself by a typical abstinence syndrome when the drug effects are 
interrupted by its sudden withdrawal. According to one medical 

1. Drug Dependence: A Guide for Physicians, American Medical Associa- 
tion, Committee on Alcoholism and Drug Dependence (Chicago, 1969), p. 83. 

2. Ibid., p. 83. 

3. John J. Bonica, The Management of Pain (Philadelphia, 1954), p. 578. 


source addiction is a condition that develops after continued adminis- 
tration of certain drugs. 4 It is characterized by altered physiological 
processes and psychic craving when the drug is withheld. Somehow 
the drug has become essential to the maintenance of ordinary cellular 
activities. (Tolerance is also manifest in true addiction.) 

In treatment of pain the risk of dependence occurs with potent 
analgesics of morphine type and with other central nervous system 
depressants. The mechanism leading to physical dependence on mor- 
phine and allied substances is set in motion with the first therapeutic 
dose. Such dependence has been observed to occur less rapidly in the 
use of barbiturates, sedatives, and tranquilizers. 5 Therefore, addiction 
is problematic prior to the first administered dose. 

In order to avoid, or at least delay, the development of dependence, 
good clinical management will endeavor to keep dosages at the lowest 
effective level and to change between drugs within the same type or 
to combine representatives of both types. The alternation between 
substances of the same type is ineffective, however, because of the 
rapidly developing cross-tolerance within each of the types in question 
here. 6 While the techniques of management are clear, other prob- 
lematics make management of drugs an oftentimes ambiguous activity 
for the medical doctor. Aside from the management of addictive 
drugs are the problems of the subjective reactions to pain on the part 
of the house staff. These will be mentioned later. 

The legal aspects of this situation of narcotic drug addiction are 
monumental. At present it is difficult to define where the legal juris- 
diction of drug addiction ends and the medical jurisdiction begins ; so 
much so that at present physicians are reluctant to handle such cases. 
For instance, the doctor may feel that he has a responsibility to cure 
a medically induced addiction which he has perpetrated, but due to 
present legal and enforcement standards he may be reluctant to fulfill 
his responsibility. In such a situation as this, the question of who is 
responsible for medical drug addiction becomes more complex. 

Religious views of medically induced addiction and its participants 
differ. One may view pain as a means whereby, in God's presence, 
one can assure growth and maturity of the soul. Pain may also be 
seen as an interloper in the Divine-human drama. Consequently, 

4. B. S. Bergersen and E. E. King (eds.), Pharmacology in Nursing (St. 
Louis, 1966), p. 107. 

5. H. Halback, "Treatment of Pain and Risk of Drug Addiction," Pain, ed. 
A. Soulairac and J. Charpentier (London, 1968), p. 500, 

6. Ibid., p. 500. 


patient and doctor may be said either to be participating in a process 
that immorally interrupts that which is naturally good or to be 
facilitating an unnatural state for the sake of another good. Dif- 
ferences in religious attitudes should not be lightly regarded, since 
it is at this point that the foundation of morality is established. 
Medically induced drug dependency prompts queries about the nature 
of pain, the status of that which is natural, and the moral dilemmas 
which often occasion a choice between the lesser of two evils. 

Fourteen per cent of all narcotic drug addicts in the United States 
are medical or accidental addicts. Accidental or medical addiction 
caused through therapeutic means falls under the same laws and 
legal standards as non-medical addiction. The existing legislation 
does not deal directly with medical addiction. Nowhere in the world 
is it a crime to have an incurable or a curable disease either due to 
mental or physical illness ; yet it is a crime, punishable by some form 
of incarceration, to be helplessly addicted to a narcotic drug in twenty- 
eight of the United States. In all fifty states it is a crime to possess 
any form of narcotic drug without a prescription. Although it is not a 
crime to be an addict in many of these states, mere possession brings 
the addict under the condemnation of the law. Whether narcotic drug 
addiction, medical or non-medical, is a crime or a disease is debateable. 
Drug addiction is treated as a disease by some experts, a symptom 
of a mental disease by others, and a crime by many legal standards. 

In the United States the physician has generally been deprived of 
an appropriate and an adequate role in the treatment of drug ad- 
diction. The doctor may often find that the operation of the law pre- 
vents him from acting in the interests of the addict patient. Although 
the Federal Statutes allow for the treatment of addicts by physicians, 
due to the interpretations of these statutes by the Supreme Court and 
The Federal Bureau of Narcotics and Dangerous Drugs, doctors have 
been stifled in their treatment of addicts. Through the interpretation 
of these laws, doctors have only been allowed to treat addicts with the 
intention of cure. The policies established by the Federal Bureau of 
Narcotics and Dangerous Drugs are basically derived from federal 
statutes and Supreme Court decisions on the "good faith" of a doctor 
and "bona fide" medical practice as prescribed by the laws. Accord- 
ing to these policies, no continued dosage is permitted either at a 
constant or an increased level. The dosage of the narcotic drug must 
be gradually decreased in order for addiction treatment to be within 
the bounds of the law. 


It is usually taken for granted that one of the functions of medi- 
cine is to relieve unnecessary pain and suffering and to keep patients 
in relative comfort. Yet the medical doctor who seeks to apply these 
principles to drug users is usually threatened with criminal prosecu- 
tion. Prevention of withdrawal is often prohibited and withdrawal is 
often more detrimental to the addict's health than the drug itself. On 
the other hand, in the hospital setting, there is no legislation to control 
the dosage of a narcotic analgesic drug that a doctor may give to a 
patient to relieve pain. In this case, the doctor is permitted to 
administer drugs as he sees fit, even where drug addiction is virtually 

The medical addict, although often able to receive prescriptions for 
his addiction, is, because of the Supreme Court's interpretation of the 
law and the enforcement policies of the Federal Bureau of Narcotics, 
a type of criminal, punishable by harsh laws. The medical addict is 
invariably treated in the same manner as the non-medical addict and 
must face the same laws, prosecutions and other consequences, even 
though these laws are generally inadequate in dealing with drug ad- 

Overall, laws have tended to become increasingly stringent and 
inflexible concerning narcotic addiction, and seem designed in the 
interest of police expediency rather than the structures of justice. In 
the entire process, the man feeling the brunt of condemnation has been 
the addict. His degradation and hopelessness have been increased 
by denying him the benefits of adequate care from the medical profes- 
sion and by turning the unsolved medical problem of addiction over 
to the law enforcement agencies. 

According to the law, narcotics can only be dispensed for legiti- 
mate medical purposes and in the course of a doctor's professional 
practice. When administering narcotic analgesics to patients in the 
hospital setting, the doctor must take into account the fact that while 
attempting to alleviate pain there is also the possibility that the patient 
may become addicted. According to legal and medical ethics, the 
hospital physician is permitted to administer narcotic drugs to alleviate 
pain. The doctor is entitled to employ solutions of narcotic drugs as 
local anesthetics in the performance of operations and may prescribe 
preoperative narcotics for a patient on whom he intends to operate. 
He may use narcotic drugs for the relief of pain in acute conditions 
such as pneumonia and for the relief of pain due to chronic ailments 
such as arthritis. A doctor is also considered to be legally justified in 


dispensing narcotic drugs in adequate amounts to keep the victim of 
an incurable disease from suffering unnecessary pain during the last 
days of life. He may also administer narcotics to an aged or infirm 
patient whose collapse and death might result from withdrawal of 
the drug to which he is accustomed. 7 

The only regulations for a doctor to prescribe narcotic drugs are 
that he must have a narcotics license and a license to practice medicine 
in his particular state. He is also required to register with the Bureau 
of Internal Revenue which requires a tax on all narcotic drugs dis- 
pensed. Legislation policies, treatment policies and public attitudes 
generally reflect a judgment that narcotic addiction is an evil to be 
stamped out at any cost. The application of increasingly severe 
penalties in an effort to stamp out the use of narcotics except by 
patients suffering from serious pain from illness other than that 
resulting from addiction presents several problems. The narcotics 
laws present several ambiguities concerning the dispensing of narcotics 
within the hospital setting and by the doctor in private practice. There 
seems to be a tight web of enforcement on medical treatment outside 
of the hospital setting, while a laissez-faire attitude exists toward the 
dispensing of narcotics by physicians to relieve pain and suffering in 
the hospital setting. 

Early Supreme Court rulings concerning the relationship of 
doctors to narcotic addicts were based upon cases involving physicians 
who prescribed large quantities of drugs to many patients in an indis- 
criminate manner. These early rulings formed the policy for law en- 
forcement officials and began the process of severing addict-doctor 
relationships. The Supreme Court rulings seemed to be moving 
toward the idea that the physician could not legally prescribe drugs to 
relieve withdrawal distress or to maintain the addict's habit, but could 
provide drugs only to an addict undergoing institutional withdrawal 
and then only in diminishing doses. 

Several Supreme Court cases are monumental in the formation 
of Federal Bureau of Narcotics and Dangerous Drugs policy. In 1919, 
a Dr. Webb was convicted of selling drugs indiscriminately to his 
patients. In the case of Webb vs. the U.S., the court upheld the 
doctor's conviction on the grounds of an illegal prescription. 8 This 

7. B. Shartel and M. L. Plant, The Law and Medical Practice (Springfield, 
1959), p. 308. 

8. Edwin M. Schur, Crimes Without Victims (Englewood Cliffs, 1965), p. 


particular case was the beginning of a constant action in court 
decisions to curb the illicit use of drugs by expressing the feeling that 
the only responsible reply to drug addiction is the cure of the addict. 
For the court, the cure of the addict meant either gradual or abrupt 
withdrawal but not sustaining the addict on a constant or an increased 

Even though a new direction seems to have been taken by the 
court in the Linder Case, 9 Federal Bureau of Narcotics policy re- 
mained unchanged, and many doctors were convicted for prescribing 
narcotics to sustain addiction. The Courts constantly ruled on the 
"good faith" of the doctor and the doctor could only know the 
legitimacy of his act after the trial. The federal courts have done little 
to restrict their jurisdiction in narcotic addiction treatment in a 
manner consistent with their own theory that addiction is a disease. 
Although the courts seem to be more lenient after the Linder case, 
the Federal Bureau of Narcotics' policy has remained stringent. In 
numerous court cases that followed, the good faith of the doctor was 
constantly left up to the judgment of twelve jurors. In cases such as 
Hawkins vs. U.S. in 1937 and the U.S. vs. Brandenberg in 1946 the 
good faith of the doctor was decided by the jury on the basis of the 
frequency and quantity of the prescription issued. 10 

Federal Bureau of Narcotics policy presents several issues because 
it seeks to police the use of narcotics by private practitioners while 
being relatively lenient in policing the administration of narcotics in 
the hospital setting. The policing of narcotic drugs outside of the 
hospital setting is basically done by agencies which have little or no 
interest in the medical cure or treatment of addicts. Their major 
interest in treatment occurs only in so far as it deals with the pre- 
vention of illicit narcotics and the prosecution of violation. It would 
seem that the medical profession has a responsibility not only to 
police narcotics use more closely within the hospital setting but to 
take a greater role in policing narcotic addiction treatment in the 
private clinic or doctor-patient relationships outside of the hospital 

In the hospital setting, the doctor can legally supply a patient with 
an addicting narcotic analgesic in any amount for severe degrees of 
pain, with the possibility of making that patient an addict. Outside 

9. Drug Addiction: Crime or Disease, Joint Committee of the ABA and AMA 
on Narcotic Drugs (Bloomington, 1961), p. 70. 

10. Ibid., p. 79. 


of the hospital setting the physician is limited in treating addicts, al- 
though the physician can legally treat an addict but only with the 
intention of curing him. Because of Federal Bureau of Narcotics 
policy, a hospital physician may supply a patient in pain with all of 
the narcotic drugs he may require on the basis that relieving pain is 
bona fide medical practice, yet the relief of withdrawal distress outside 
of the hospital setting is not considered to be bona fide medical prac- 
tice. The basic issue of whether any treatment of addicts, whether 
medical or non-medical, is bona fide medical practice remains un- 
settled by the Harrison Act. In essence the policies controlling nar- 
cotic drug use are less stringent in the hospital than outside of the 
hospital setting; being too harsh outside of the hospital and too 
lenient within the hospital. 

Applied to the medical or accidental addict, these conditions are 
multiplied and the magnitude of the addict's dilemma is increased. 
The medical addict being forced into the drug situation comes under the 
constant surveillance and jurisdiction of the Federal Bureau of Nar- 
cotics and Dangerous Drugs. In many states if he attempts to supply 
the needs of his addiction or his disease, he is incarcerated and labeled 
a criminal. 

In general, the doctor has no criteria or standards to guide him in 
dealing with drug addicts since each case is different. Doctors may 
legally treat addicts and prescribe narcotic drugs to an addict under 
the Harrison Act. Moreover, they must act in good faith and accord- 
ing to proper medical practice. But the medical profession should not 
leave the problem of determining proper medical standards and good 
faith to an ex post facto judgment made by so-called experts in the 
enforcement agency alone, who have differing views as to the treat- 
ment of narcotics addiction. The courts have not renounced their right 
to rule on the good faith of the doctor or to submit this question to a 
jury. Because no definition of "good faith" has ever been created, the 
doctor can only discover whether he acted legitimately after the trial 
itself. Other legislation provides the same problems as the Harrison 
Act. The Boggs Act of 1951 and the Narcotic Drug Control Act of 
1956 only provide for more severe penalties and inflexible penalties 
for addicts. 

Generally, the laws regarding addiction in this country tend to 
offer a simplistic solution to a problem which is for us both complex 
and morally ambiguous. It is morally preferable to be free from drug 
dependency than to be drug addicted. If one is addicted, the treat- 


ment of choice would be that which would free one from drugs. To 
this point we can share common value with current statutes. Rarely, 
however, can a complex human problem like drug addiction be 
resolved on the basis of a single value choice. As we will demonstrate 
in the following sections, there are situations in which it may be 
morally preferable to support an addiction. Such an action is not legal, 
however, at this time. Since this paper deals with the problem of 
medically induced drug addiction, the apparent double standard 
between in-hospital and out-of-hospital drug regulations is a cause for 
moral concern. 

Within the hospital setting, several groups of drugs have proven 
problematic in that they all may lead to addiction. Two of these 
groups are barbiturates and analgesics. Some physicians have ex- 
pressed concern over the misuse of barbiturates. These drugs are 
classified as central nervous system depressants and have many uses, 
two of which are as hypnotics and as sedatives. The extent of effect 
varies from mild sedation to deep anesthesia. Some of the side effects 
and toxic effects include: 

( 1 ) addiction if given over a prolonged period ; 

(2) marked symptoms of hangover — listlessness, prolonged de- 
pression, nausea, and emotional disturbances; 

(3) skin rash, urticaria, swelling of the face, and asthmatic attack ; 

(4) bad dreams, restlessness, and delirium. 11 

A recent editorial in the Journal of the American Medical As- 
sociation expressed concern over the negligent use of barbiturates. 
It read : 

When it is remembered that 200 mg of a barbiturate or the equivalent 
of another hypnotic is what is almost routinely order for sleep in hos- 
pitals (not so much for the patient's sleep, we suspect, as for the house of- 
ficer's sleep), these findings deserve serious consideration. It is not 
common to hear of patients who first received hypnotics in a hospital and 
then continued to use them after discharge for an indefinite period, often 
for years. Over a period of years tolerance to quite high dosages can 
develop. 12 

The clinical manifestations of barbiturate addiction are similar to 
those of chronic alcoholism. Because of the poor motor coordination, 

11. Bergersen and King, p. 266. 

12. "Sleep Now, Pay Later," Journal of the American Medical Association, 
208 (May 26, 1969), p. 1485. 


patients may fall and be injured. Often they are unable to work, and 
they constitute a real hazard if they attempt to drive power machinery, 
e.g., an automobile. Furthermore, their judgment may be so im- 
paired that they take additional doses of their drug when they are al- 
ready seriously intoxicated. Some authorities feel that the addiction 
resulting from the overuse of barbiturates is, in some respects, more 
dangerous and undesirable than the addiction resulting from the mis- 
use of opiates. 13 

In another recent issue of the Journal of the American Medical 
Association a physician complains about the therapeutic misuse of the 
barbiturates. He asserts, "Perhaps I am in error, but it appears so 
obvious ! Sedatives and hypnotics are given for insomnia. Insomnia 
is almost invariably due to depression. Barbiturates are central 
nervous system depressants. When are we going to stop giving de- 
pressants to treat a symptom which is due to depression." 14 

The other group of drugs, to which we have already alluded, that 
induce dependence are among the analgesics. Basically, analgesics are 
drugs that relieve pain without loss of consciousness. Opium and its 
derivatives, related synthetic compounds, and aspirin belong to this 

A drug of the analgesic group which is addicting and often used 
is meperidine hydrochloride (demerol). Essentially, meperidine is a 
synthetic substitute for morphine to produce analgesia. When so used 
it has the advantage of producing much less sedation and constipation. 
It is suited to the management of intermittent pain such as renal colic. 
An average dose varies between 50 mg and 100 mg, although 150 mg 
may be given for relief of severe pain. Most important, it is addicting. 

Side effects of meperidine include dizziness, nausea and vomiting, 
dry mouth, sweating, headache, fainting, and drop in blood pressure. 
In addition, toxic effects include dilated pupils, mental confusion, 
tremor, incoordination, convulsions, respiratory depression and death. 
Toxic effects are said to produce more physical impairment than any 
of the narcotic drugs. 15 

As with the barbiturates, the mismanagement of meperidine has 
resulted in drug dependence for some patients. According to one 
report, the number of meperidine addicts at the U.S. Public Health 

13. Bergersen and King, p. 271. 

14. W. C. Ellerbrock, "Barbiturate Addiction," Journal of the American 
Medical Association, 209 (August 18, 1969), p. 1089. 

15. Bergersen and King, p. 246. 


Service Hospital, Lexington, Kentucky, has risen from six per year in 
1945 to one hundred and forty-four per year in 1953 and 1959. It is 
purported that nearly all meperidine addicts begin the use of the drug 
as a result of therapeutic administration by physicians, and depend on 
physicians for their supply of drugs. 16 

Since the analgesics are used for the relief of pain, and, because it 
is as a consequence of this action that the danger of drug dependence 
exists, a consideration of the nature of pain and pain relief would be 
in order. 

In determining the amount of analgesic drug which is to be 
administered, several factors must be considered, including the age, 
weight, and physical status of the patient, the reflex irritability of his 
nervous system, the intensity of pain, and the presence of co-existing 
disease. However, excepting extremes in age, the intensity of pain is 
the most important factor determining the amount of analgesic medi- 
cation required for relief. Thus, it is essential that an attempt be made 
to estimate the degree of pain before giving the initial dose of the 
drug. 17 

Though drugs are often prescribed for the alleviation of pain, 
progress in the field of analgesia has been hampered by lack of knowl- 
edge of the fundamental physiology of pain and of the mechanism by 
which drugs can relieve pain. Everybody knows what pain is from 
personal experience, but none of us can define it. Even so, one of the 
points which aid in understanding the problem is that pain involves 
two main processes, the perception of noxious impulses giving rise to 
the sensation of pain and the reaction in response. The reaction in 
response to pain is seen, moreover, as a complex physiopsychologic 
process which involves the highest cognitive functions of the individ- 
ual. Basically, it represents the emotional and physiological expres- 
sions resulting from the perception of pain. 18 According to H. K. 
Beecher, the pain for which medication is needed is a combination of 
a response to a physical stimulus and psychic modification of the sen- 
sation, which could better be called 'suffering,' in distinction from 
simple 'pain' as a response to a stimulus." 19 In any case, it is a 
contention of this paper that the presence of pain should instigate 

16. John O'Donnell and John C. Ball (eds.), Narcotic Addiction (New 
York, 1966), pp. 171-172. 

17. Bonica, p. 578. 

18. Ibid., p. 73. 

19. Charles A. Winter, "The Physiology and the Pharmacology of Pain and 
its Relief," Analgetics, ed. George DeStevens (New York, 1965), p. 12. 


study of its underlying causes, rather than mere relief of the patient's 

To the Christian ethicist who holds to the belief in a benevolent 
God, the existence of pain and evil is a problem. While pain is often 
seen as having a soul-making characteristic, adherent in its nature, 
such an understanding seems to be an assessment made after the fact. 
Moreover, while the existence of pain and mutilation which interferes 
with the humanizing process remains a theological problem, there is 
the equally difficult question of an appropriate response to that pain. 

In his book, Evil and the God of Love, John Hick makes a 
distinction between pain and suffering. Pain is a biological phenom- 
enon, while suffering is a spiritual and psychological interpretation 
of that pain. This distinction has been suggested frequently in medi- 
cal research. It is for this reason that we hold tenaciously to the 
crucial importance of the patient in pain to receive not only medical 
relief from his pain but widespread and comprehensive care in dealing 
with his suffering that accompanies both the pain and the dependency 
which relieves the pain. 

We are open to the theological interpretations of pain, and sym- 
pathetic to understanding pain as a "soul-making process." Ultimate- 
ly, however, we find no necessity so to justify that which is natural in 
the world, and note that the existence of pain can often interfere with 
and become a hindrance to one's ability to relate to and respond to 
other persons. It is just this humanizing process which we value most. 
We therefore favor elimination of pain, even by the use of addictive 
drugs, when that pain seriously interferes with one's capacity to relate 
to the neighbor. 

Such value choices are predicated upon theological commitments 
at several points. (1) We believe that God reveals himself in and 
acts through history. (2) We believe that God reveals Himself in 
and acts through nature. He acts through an ever-changing process of 
actualizing creative possibilities so that the world, history, and human 
life are ever in the process of becoming. (3) We believe that God 
has revealed himself uniquely in the person and ministry of Jesus 
Christ, and that this is a full and sufficient revelation. Christ reveals 
the nature of God as agape. This love is made incarnate in the 
person and ministry of Christ in his relation to both man and God. 

From such theological affirmations, we can begin to discern 
certain ethical foundations from which the morality of medically in- 
duced drug addiction may be analyzed. While the natural world is 


seen as a part of God's creation, it need not be viewed as completed or 
perfect. The natural world is still becoming, and one of its frontiers 
is the frontier of human health. The doctor not only has the possibil- 
ity of interfering with natural illness but the obligation to do so as 
well. His is not an unprincipled participation, but one which occurs 
within the framework of what it means to be fully human. 

At least part of what it means to be human is the capacity for 
relating and responding to our neighbors. To be fully human is to 
have one's life characterized by agape; such is the norm for human 
existence. The humanizing process is that of growth and maturation 
in relationship to God and fellow man toward the end goal of perfect 
love. God's love for man is therefore the basis of Christian virtue and 
action; it is the ground of our love for the neighbor and the self's 
aspiration to perfection. Yet an abstract ethic of love is not to be 
desired over the equally concerted effort to translate tradition into its 
appropriate counterpart for contemporary man. 

For the moralist, the immediate problem is the translation of 
agape into the realm of contemporary and existential life. We see 
pain in all its aspects to be the enemy and destroyer of that which is 
human. There are cases in which the administration of addictive 
drugs within the hospital setting will produce side effects that are 
more problematic than the pain they are intended to relieve. It is the 
physician's responsibility, as earlier stated, to insure that the side 
effects of addictive drugs will not be disproportionate to the therapeu- 
tic effects. It is the patient's obligation to discriminate choices in light 
of that knowledge and to seek out the course of action that allows 
optimal realization of himself in relationship to the neighbor and to 
God. This also means that there will be cases in which no simple 
choice is available and where the options are frankly morally ambigu- 
ous. Administration of drugs which will eventually lead to and foster 
dependency may well be the only moral choice open to physician and 
patient, not only in times of terminal illness but also in extreme cases 
where pain disrupts that which is distinctively human. The transla- 
tion of agape at such times will not be encapsuled in uncritically ac- 
cepted solutions. 

When operating out of the Christian tradition, rules and laws 
for all occasions are not to be found. Jesus was not a lawgiver. 
"What Jesus was concerned about was not rules but principles, not 
obedience to commands but purity of heart. It was love to God and 
man, and a transcendent and holy will that he required of man, and 


these are timeless." 20 Again, one is thrown back upon the grace of 
God in the individual's imperfect translations of that which is perfect. 

In a word, to use Bonhoeffer's terminology, the love of God is 
indicative and not imperative. In faith and hope, men carve out 
tentative arrangements of perfect love in relation to one another in an 
imperfect world, arrangements that are always new and changing but 
ever faithful to the principle of love as set forth in the incarnation, 
arrangements in constant need of the redeeming grace of God. And 
that is what it is to be human. That which maximizes man's response 
to God and his fellow man is morally desirable ; that which diminishes 
his capacity for love and service is morally undesirable. 

It is out of such a beginning that we have made some proposals 
relating to the person who is dependent upon drugs which we feel 
maximizes the possibilities for his being fully human. The following 
case study will help to intensify and exemplify the reasons for such 

Jane Smith (name fictitious) is an attractive, twenty-two year old 
female who is married and the mother of one boy, aged four years. 
In 1965, during pregnancy for her only child, she was noted to have 
enlarged glands in the left supraclavecular node diagnosed as 
Hodgkins Disease. During five subsequent hospitalizations through 
1969, she received radiation treatment. During these hospitalizations, 
further complaints ensued, the most notable being ulceration of skin 
nocules on the left shoulder and pectoral regions, cervical vertebrae 
damage, and subsequent plastic surgery from the left thigh to the 
pectoral region. Her latest admission was for severe pain in the neck 
requiring large doses of narcotic analgesics, accompanied by the char- 
acteristic signs of addiction to Demerol such as constipation, anorexia, 
and sleeplessness. At this time, she was diagnosed as having stage 
IV-B Hodgkins Disease and Demerol addiction. The question was 
whether to continue administration of Demerol or to find alternative 
methods of treatment which had previously failed, notably radiation 
therapy. The moral question the staff faced was, "Ought we try to 
withdraw this young woman or should we continue to administer 
Demerol ?" 

Here is the situation the staff faced. Mrs. Smith works as a clerk 
in a grocery store in a small, Southern community. Mr. Smith works 
in a factory in their home town. Mr. and Mrs. Smith live in a trailer 

20. George C. Knudson, Principles of Christian Ethics (New York, 1943), 
p. 299. 


court. They have used their savings for a house to pay for the 
expenses incurred during her frequent hospitalizations. Social con- 
tact seems to be minimal. Mrs. Smith's son is a regular attender of 
Sunday School. She has indicated membership in the Holiness 
Church on previous admissions, although on this last admission she 
declared that she had no religious preference. 

During hospitalization, many persons remarked how pleasant a 
person Mrs. Smith was. Most of the ward personnel found them- 
selves invested emotionally with her. Conflict was in evidence when 
Mrs. Smith became depressed or would make tearful demands for 
relief from intense pain. Visitors consisted of the patient's mother, 
aunt, and husband. The mother was observed to be protective, foster- 
ing a dependent relationship. Both the aunt and mother entertained 
considerable religious talk between themselves and Mrs. Smith, 
centered about the necessity of her repentence in order for God to 
heal her. Mr. Smith impressed the staff as being the younger of the 
couple, dependent upon his wife. He communicated infrequently with 
the staff. During the last hospitalization, the mother and husband 
were noted to be reversing their patterns of behavior with favorable 
effect upon the patient. 

Mrs. Smith's prognosis is indefinite. In most cases, Hodgkins 
disease races to a fatal conclusion, but the course is extremely varied 
and it is impossible to predict what changes will occur and when. 
While in some cases patients have died within a few weeks after ad- 
mission into the hospital, others have gone away to live useful lives 
for the next ten years. 21 

The attending physician decided upon continuation of Demerol 
therapy after a careful and sustained study. Although we might up- 
hold his action as being within the context of the principles outlined 
in the preceding sections, there are a number of additional ethical 
questions which arise. 

Since it is the patient who is going to suffer the possible side 
effect of the drug, possible addiction, and possible criminal prosecu- 
tion for medically induced addiction, should not she have a choice in 
whether or not addictive drugs are administered to her during the 
course of her hospitalization ? Our considered opinion is, within the 

21. Lloyd Craver, "Treatment of Hodgkins Disease," Treatment of Cancer 
and Allied Disease, ed. George T. and Irving M. Ariel (New York, 1964), p. 



limitations of a context of severe illness and pain, a patient has the 
right to know as much as he can understand about the proposed drug 
therapy and has the right to enter into the decision-making process. 
Or, to put it differently, the attending physician has an obligation to 
inform his patient about the nature and consequences of addictive 
drug therapy prior to the administration of the initial dosage of an ad- 
dicting drug. We are assuming that the choice for or against the use 
of addictive drugs should be a shared responsibility. At the same 
time we would opt for the right of a doctor to act in the best interest 
of his patient and withhold addictive drugs. 

There are a number of other morally significant questions which 
surround the initial dosage of drugs. Is a physician justified in lend- 
ing sleep and relief from pain when it is the patient who pays in 
terms of side effects and/or after effects ? Does a physician have the 
right to addict a patient as a solution to another problem such as 
chronic illness or severe pain? On what model and for what reasons 
are addictive drugs administered ? Should a doctor be allowed to ad- 
dict a patient in the patient's own best interests? The preceding 
paragraph hints at our proposal for answering these questions ; how- 
ever, these queries are in need of much further discussion, investiga- 
tion and research than can be covered in the space of this paper. 

In cases such as Mrs. Smith's, we would opt for the patient's right 
to enter into the decision-making process. In cases where the patient 
is addicted as a result of medical treatment, he should be apprised of 
the various avenues of treatment, withdrawal, continued addiction, 
increased dosages of drugs, and the rest. The attending physician 
should still retain the obligation to act in his patient's best interest, 
if the patient is not capable of doing so. We recommend that this 
not be a lonely decision, but done rather in the company of disinter- 
ested persons not associated with the patient's immediate care — such 
as, perhaps, another physician, a psychiatrist, a clergyman, or a social 

Whatever the decision for withdrawal or continuation of drug 
dependency, comprehensive care for the patient should include more 
than just the removal or administration of addicting drugs. This 
could be accomplished by the creation of a narcotic team whose job 
it would be to review and advise cases of medically induced drug ad- 
diction. We favor increased research into non-addicting drugs which 
would have the same pain relieving qualities of morphine type drugs. 


Finally, we think that revision of state statutes, to bring them into 
more accord with the reality of the situation of drug addiction, is 
urgently needed. Special attention should be given to specific legal 
protection of medically or accidentally addicted persons and their 
treatment under the law. 

Abortion: Responsibilities and 

Richard Fisher and Paul Morrison 

Induced abortion has been a special problem for all civilizations 
since the beginning of recorded societal life. The specific methods em- 
ployed to induce the abortion have varied widely; it has, moreover, 
been performed under a variety of circumstances. Many societies 
have readily accepted induced abortion as merely another birth con- 
trol measure with no major moral complications. However, as the 
staff of the Kinsey Institute has pointed out : "The attitude toward 
abortion takes on a particular intensity when abortion becomes a 
matter of religious rather than purely secular concern." 1 Christianity 
appears to have been greatly influential in raising questions concern- 
ing the moral implications which induced abortion might have for a 

Before we proceed further, we need to define our terms in order 
to avoid any possibility of confusion at a later point in our discussion. 

Abortion is the expulsion of a living fetus from the uterus before 


Spontaneous abortion is that which results from accident or disease. 

Induced or voluntary abortion is that which results from man's intentional 

interference with the normal course of pregnancy. 2 

According to Dr. Frederick J. Taussig : 

. . . for the present, and perhaps for some time to come, the lower limit 
of viability may be taken to range between the twenty-sixth and the 
twenty-eighth week of fetal life. 3 

In this discussion we are concerned with induced abortion, i.e., inten- 
tional expulsion of a living fetus from the uterus by deliberate inter- 
ference with the course of pregnancy. 

1. Paul H. Gebhard, Wardell B. Pomeroy, Clyde D. Martin and Cornelia V. 
Christenson, Pregnancy, Birth and Abortion (1st edition; New York: Harper 
and Brothers Publishers and Paul B. Hoeber, Inc., Medical Books, 1958), p. 190. 

2. Charles J. McFadden, Medical Ethics (4th edition ; Philadelphia : F. A. 
Davis, Co., Publishers, 1956), p. 135. 

3. Frederick J. Taussig, Abortion, Spontaneous and Induced: Medical and 
Social Aspects (St. Louis: The C. V. Mosby Co., 1936), pp. 21-22. 



There need be little argument with the statement that induced 
abortion is a problem in the United States today. An indication of a 
few of the statistics concerning the social incidence of induced abor- 
tion may be helpful in discerning just how great a problem such a 
phenomenon is. Dr. Harmon L. Smith has stated that : 

According to reliable estimates, about one million abortions are performed 
annually in the United States. Of this number, approximately 99 per- 
cent are estimated to be illegal. About 1,000 deaths annually are at- 
tributed to illegally performed abortions and, beyond these fatalities, 
thousands of other women suffer irreparable mutilations. 4 

Some other estimates are more conservative. In either case we have 
a picture of the possible extent of the problem. The Kinsey staff has 
done considerable research on the subject of induced abortion. Un- 
fortunately their figures are a dozen years old ; but they still offer one 
of the best breakdowns of the social distribution of induced abortions. 
In analyzing "270 females who account for 355 pregnancies that 
ended while the females were unmarried" it was discovered that "the 
great majority (316) terminated in pre-marital induced abortion." 5 
This rather alarming statistic may be set within the context of a 
larger group of women who had married at some point in their lives. 
A survey of this group revealed that 

... in their reproductive lifetimes about three quarters of them experi- 
enced a live birth, one quarter had a recognizable spontaneous abortion, 
and one fifth to one quarter had had an induced abortion. 6 

Speaking of divorced or widowed women the researchers reported : 

Of the 157 terminated post-marital conceptions, 4 per cent resulted in live 
births, 10 per cent in spontaneous abortion, 79 per cent in induced abortion, 
and 7 per cent were carried into a subsequent marriage. 7 

The researchers reported that induced abortion is most prevalent 
among women aged sixteen to twenty years, and that it decreases con- 
sistently in incidence of occurence after the age of twenty. 8 This helps 
us further to define the limits of the group with which we are con- 

4. Harmon L. Smith and Louis W. Hodges, The Christian and His Decisions 
(Nashville and New York: Abingdon Press, 1969), p. 233. 

5. Gebhard et al., op. cit., p. 54. 

6. Ibid., pp. 93-94. 

7. Ibid., p. 147. 

8. Ibid., p. 94. 


cerned, although we are by no means dealing with women within this 
age group exclusively. 

Negative social consequences following an induced abortion ap- 
pear to be infrequent. As might be expected, the women who receive 
these unfavorable social reactions are the single females who would 
likewise have received the harshest societal treatment if they had 
continued their pregnancies rather than choosing to terminate them. 

So far as the medical complications resulting from induced 
abortion are concerned, it appears that if the abortion is performed 
under sanitary conditions and with the proper technique and super- 
vision it carries with it about the same risks as a tonsillectomy. 
Boeth's comment concerning the technique of dilation and curretage 
(D&C) (in this case, in illegal abortions) is helpful in understanding 
the procedure employed in many cases : 

The operation itself is quick and simple: the cervix is stretched by a 
series of increasingly large dilators. Then the abortionist uses a tiny, 
rake-like instrument called a currette to scrape the embryo from the wall 
of the womb. If there are no complications, the patient can go home 
the same day. If there is trouble, any hospital will take her if she has but 
sense enough to go to one — without recriminations from the law. 9 

It also appears that, like any other operation, abortion becomes 
safer the more experience the person performing the operation has. 
There is a good deal of speculation that many doctors are becoming 
quite skilled in the performance of such a procedure. Dr. Mary S. 
Calderone has made the following observation concerning the im- 
proved quality of abortion techniques : 

. . . abortion, whether therapeutic or illegal, is in the main no longer 
dangerous, because it is being done well by physicians. 10 

The state of medical science in relation to this operation is rather 
highly advanced. There are at least five accepted techniques which 
are successful and indicated at different times, depending upon the 
duration of the pregnancy. D&C (described above) is indicated in the 
first twelve weeks of a pregnancy. An alternate D&C procedure 
involves vacuum aspiration of the uterus, a procedure which employs 
a suction currette and is relatively safer than D&C, since the suction 
currette is not as apt to puncture the wall of the uterus as the surgical 

9. Richard Boeth, "The Anatomy of Abortion : 1968," The Washington Post, 
June 16, 1968, p. 2. 

10. Mary Steichen Calderone, "Illegal Abortion as a Public Health 
Problem," American Journal of Public Health (1960), 50:949. 


currette. After 16 weeks an intravenous injection of a concentrated 
drug brings about premature labor. If the pregnant woman is not to be 
sterilized and is fairly far advanced in her pregnancy when she comes 
for the abortion, a hysterotomy may be done. Sometimes a caesarian 
section of the pre-viable fetus is done, in which case future pregnancy 
is not foreclosed. If the woman is to be sterilized, a hysterectomy will 
ordinarily be done, i.e., the removal of the uterus and the tying of the 
fallopian tubes. 11 

There is a growing body of opinion that psychological reaction, 
though generally rare, may be the most serious complication to arise. 12 
Dr. Harold Marcus, Associate Attending Psychiatrist at the Mount 
Sinai Hospital in New York City, has addressed himself to this 
subject : 

The question might be asked, does abortion do any harm psychiatrically ? 
Do these women suffer? Is the abortion harmful to them rather than 
therapeutic? This, of course, is a very valid question. It is a question 
that we are in the process of studying right now at Mount Sinai. We are 
following up all of our women who have therapeutic abortions. We see 
them before and after the abortion in an attempt to find out just what are 
the effects of a therapeutic abortion and attempt also to survey the popula- 
tion that comes from therapeutic abortion. We have not been doing it 
long enough to come up with any real definitive results although we 
certainly have not had any adverse effects. 13 

In one of the most complete studies of the subject, Dr. Martin 
Ekblad (Stockholm, 1955) checked the psychiatric reactions of 479 
women who had been granted induced therapeutic abortions for 
psychiatric reasons. The results of his study are, in part, as follows : 

With reference to the women's statements concerning their attitude to the 
abortion at the follow-up examination the material has been divided into 
four groups. 65% had been only satisfied with the abortion and had not 
felt any self-reproaches, and another 10% had also not felt any self- 
reproaches, but had thought that the operation itself was unpleasant, 14% 
had felt mild self-reproaches and 11% had felt serious self-reproaches or 
regretted the operation. 14 

11. Alan Guttmacher, "Techniques of Therapeutic Abortion," Clinical Ob- 
stetrics and Gynecology, Vol. 7 (March, 1964), p. 102; Jaroslav F. Hulka, 
Therapeutic Abortion: A Chapel Hill Symposium (Chapel Hill: Carolina 
Population Center, 1968), pp. 75-95. 

12. Gebhard et. al., op. cit., pp. 208-9. 

13. Symposium on "The Social Problem of Abortion," Bulletin of the Sloane 
Hospital for Women (Fall, 1965), 11:70. 

14. Martin Ekblad, Induced Abortion on Psychiatric Grounds: A Follow-up 
Study of 479 Women. (Stockholm, 1955), p. 233. 


In speaking of a smaller group of women within the group mentioned 
above, Ekblad noted : 

Detailed case-histories are given for the 54 women (11%) who had felt 
serious self-reproaches or who had regretted the operation. A closer 
study of the case-histories of these women with serious self-reproaches 
shows that even if their subjective sufferings due to the abortion were 
severe, from a psychiatric point of view their depression must in general 
be designated as mild. It is only rarely that the women's working 
capacity has been impaired or that they have needed to consult a doctor 
on account of their mental troubles. 15 

Further examination of the statistics in the above citation reveals 
that only five cases (10%) required consultation with a doctor. Of 
these five cases, four reactions could probably be linked to desertion 
by the male partner after the abortion. Thus in only one case (2% 
of the 54 women who had felt serious self-reproaches) was the re- 
action inexplicable. 


The opinions of Jewish, Roman Catholic, and Protestant theologi- 
cal authorities appear in works on medical ethics with varying degrees 
of frequency and clarity. It is essential that we understand the 
opinions of the various faiths in order to formulate our own opinions 
and determine how they compare with established attitudes. 

The orthodox Jewish opinion on induced abortion can be neatly 
summarized in a quotation from Jakobovits' Jewish Medical Ethics: 

The point at which human life commences to be inviolable and of equal 
value to that of any adult person is . . . distinctly fixed at the moment 
when the greater part of the body — or, according to some versions, the 
head — has emerged from the birth canal. 16 

Such an attitude plainly leaves the option of induced abortion open for 
the woman and the physician. Since the life of the fetus is considered 
to be of a lesser value than that of an adult person, the disposition of 
the fetus can take a position of subordinate importance to the disposi- 
tion of the life of the adult involved. Jewish ethicists have also held 
that the fetus can, under certain circumstances which endanger the life 
of the mother, be considered an aggressor against her and dealt with 

15. Ibid., p. 234. 

16. Immanuel Jakobovits, Jewish Medical Ethics (New York: Bloch, 1962), 
p. 184. 


Roman Catholic ethicists have taken a very strict position on the 
inviolability of fetal life. Their concern seems to center on a concern 
for the innocent soul which is endangered by induced abortion. 
Charles McFadden has stated the Roman Catholic position on induced 
abortion in the following manner: 

Direct and voluntary abortion is a moral offense of the gravest nature, 
since it is the deliberate destruction of an innocent life. The very nature 
of direct abortion is such that it involves the deliberate and direct removal 
of the inviable fetus from its natural situs, the womb of its mother, to an 
environment in which it cannot possibly live. Such an action is es- 
sentially murder. 17 

Roman Catholic theologians, however, have added the distinction 
between "direct" and "indirect" induced abortion. A summary of 
this distinction is indicated in the following quotation from Fr. Mc- 
Fadden's Medical Ethics: 

Induced abortion may be of two types : direct and indirect abortion. 

By direct abortion we mean any instance in which means are specifically 

employed to procure the expulsion of the fetus. 

By indirect abortion we mean any instance in which a treatment or 
operative procedure is performed for some other purpose but incidentally 
and secondarily does cause the expulsion of the fetus. 18 

Applying the rule of double effect to the problem of induced abortion 
would seem to be arbitrary and perhaps even cruel, placing a tre- 
mendous burden on the individual physician as to how he will interpret 
the intended results of a procedure which he may undertake. 

Canon P. Tiberghien, observing the way in which this distinction 
has been handled in practical application, suggests an interesting 
reservation for the Roman Catholic position : 

A distinction must ... be made between 'direct abortion,' which is always 
forbidden, and 'indirect abortion,' permitted for grave reasons. 

Experience shows that this distinction, when left to the doctors, is very 
often badly handled by them. Abortion is really indirect only if the 
removal of the foetus is not willed, either as end or means. Now, doctors 
very often convince themselves that, when they decide to save the life 
of the mother by an abortion, it is the safety of the mother they aim at and 
not the removal of the foetus. In certain cases, it is quite true to say that 
the safety of the mother is willed as the end ; but the removal of the foetus 
is also willed as the means to save her. This is very clearly so for the 
moralists, and therefore the operation is forbidden. 

17. McFadden, op. cit., p. 138. 

18. Ibid., p. 136. 


Let no one plead 'purity of intention.' There is no 'purity of inten- 
tion' which renders lawful an act contrary to moral principles. 'Purity of 
intention,' as thus understood, is merely the disguised masquerading of 
the false principle that the end justifies the means. 

We must therefore eliminate the term 'indirect abortion' from our 
phraseology, and supply a definition which answers only to direct — always 
unlawful — abortion. 

Here then is the proposed definition : 'Abortion is the medical inter- 
vention, by operation or medical treatment, which has for its object to 
expel a living, non-viable foetus from the mother. 

Abortion is here defined by its object. A clear distinction is also made 
between the object or the action and the motive which places the action 
and which can vary. What one wishes is distinguished from why one 
wishes it. 19 

Tiberghien's comments are not a part of official Roman Catholic 
doctrine, but they do offer a good illustration of what would result 
from an absolute application of the rule of double effect. 

Unfortunately Protestant theologians have written comparatively 
little on the ethical standards involved in induced abortion. In what 
follows we will include quotations from several Protestant thinkers 
on various aspects of the question of induced abortion. Thereafter we 
will attempt to derive some conclusions from these citations. 

Paul Ramsey has pointed out : 

The legal reason for prohibiting abortion is not because it is believed 
to be a species of murder; it is the religious tradition, we shall see, 
and not the law which inculcates the latter view. The law's presumption 
is only that society has a stake in the pre-human material out of which 
the unique individual is to be born. 

The theologians debate the question, when between conception and birth 
the unique not-to-be-repeated individual human being has arrived on the 
scene. Wherever the line is drawn, the direct destruction of a fetus after 
that point will, by definition, be murder, while before that point its 
direct destruction would fall under some other species of sin or grave 
violation. 20 

Dr. Harmon Smith has spoken of abortion in relation to the 
subject of personhood: 

19. Canon P. Tiberghien, "Principles and Moral Conscience," New Problems 
in Medical Ethics, edited by Dom Peter Flood and translated by Malachy 
Gerard Carroll and Norman C. Reeves (Cork, Ireland: The Mercier Press 
Limited, 1953), pp. 141-142. 

20. Life or Death: Ethics and Options, edited by Ed Shills, Norman St-Iohn 
Stevas, Paul Ramsey, P. B. Medawar, Henry K. Beecher, and Abraham 
Kaplan (Seattle and London: University of Washington Press, 1968), p. 64-65. 


To be a human person is not a matter of statically being a certain kind 
of substance, but rather a matter of becoming personal through temporal 

... In some important sense being and becoming a human person means 
entering into both inter- and intra-personal relationships. 

In the final analysis 'personhood' or 'being personal' may be an empiri- 
cal concept, but in the process of becoming-personal-in-time the per- 
sonalizing relationships of other persons exercise continuing antecedent 
priority. 21 

Joseph Fletcher has taken a considerably more radical stand on 
the issue of induced abortion. Speaking of the fetus in induced abor- 
tion, he has stated : 

... an embryo in therapeutic abortion has no personal value or develop- 
ment at stake and cannot exercise the moral qualities of freedom and 
knowledge. 22 

Thus it appears that Protestant thought on the subject of induced 
abortion covers a broad range. The more moderate Protestant 
thinkers seem generally to feel that abortion may be justified under a 
variety of circumstances but that man, in taking such an action, can 
never claim moral exemption from the consequences which may 
sooner or later follow upon his choice. "Caution" seems to be the key 
word in most Protestant consideration of induced abortion. 


In the United States the designation of abortion as a crime is 
fairly recent. 23 The first U. S. anti-abortion law was passed in Mis- 
souri in 1835; and it was not until 1943 that the last state (North 
Dakota) adopted an abortion statute. The state laws remained 
generally unchanged until 1966; typically, they provided that any 
abortion save one to preserve the life of the woman is a crime. Four 
states, in substance, allowed no abortions. 24 All states in 1966 defined 
abortion as a crime; the definition of therapeutic abortion is found 
in the exceptions. 25 

The laws remained vague for several reasons; among them that 

21. Smith and Hodges, op. cit., pp. 248-9. 

22. Joseph Fletcher, Morals and Medicine (Boston: Beacon Press, 1954), p. 

23. Louis J. Regan, Doctor, Patient and the Law (St. Louis: 1956), p. 320. 

24. Louisiana Revised Statutes, Sec. 27, 1285. Massachusetts General Laws, 
Ann. Ch. 272, Sec. 19, 1957. New Jersey Revised Statutes, Sec. 2a:87-l. 
Pennsylvania State Ann. title 18, Sec. 4718 (1963). 

25. Regan, op. cit., p. 321. 


in the few cases brought to trial, the defense has usually been to deny 
the act. Modern abortion law reform is related to a notable English 
case: Rex vs. Bourne. In this 1939 test case, an English physician 
was brought to trial, under an 1861 law, for aborting a fifteen year 
old girl who had become pregnant as a result of rape. In the charge 
to the jury, the judge instructed them to find the defendant "not 
guilty" if they were convinced that Bourne had performed the 
abortion for the purpose of preserving the physical and mental health 
of the girl. Mr. Bourne was acquitted. 

Another cause of vagueness, also adding to the physician's liability, 
is that the term "abortion" in law does not take into account the 
medical nuances which distinguish "miscarriage" and "premature 
birth" from each other and from abortion. Abortion is most common- 
ly defined as the administration of any drug to a woman or the use of 
any instrument on her for the purpose of procuring an abortion or 
miscarriage. Under this definition, the majority of states punish even 
an attempt to bring about an abortion. In a number of states there is 
no requirement that the woman be pregnant — the performing of the 
prohibited acts upon the woman with the intention of producing an 
abortion constitutes the body of the crime. 26 In an Iowa case, the 
substance used in an attempt to produce an abortion was tobacco. 
An expert medical witness testified that tobacco would not produce 
miscarriage, but the court ruled that this fact did not prevent the 
conviction of the defendant for attempted criminal abortion ! 27 

The medical profession has not reacted to the vagueness of the 
laws in a uniform manner. Some physicians refuse to perform any 
abortions; most work under a system of elaborate safeguards and 
rationalizations. One physician claims that in order to rationalize an 
abortion on medical grounds the facts are distorted. Abortions are 
done for hypertensions "because pregnancy in such cases may lead to 
a heart attack or stroke," whereas the actual risk of these complica- 
tions in pregnant hypertensives is not significantly higher than the 
risk in nonpregnant hypertensives. 28 To obtain an abortion on 
psychiatric grounds often means the risk of suicide is exaggerated. 29 
Whatever the reason, and although the laws are vague, the courts 
have been at times lenient with the physician acting in "good faith." 
The New Jersey Supreme Court, for example, in 1967 held that : 

26. Ibid. 

27. State vs. Fitzgerald, 49 Iowa 260, 31 Am Pep 148 (1878). 

28. Robert Hall, Ethical Issues in Medicine (New York: 1968). 

29. Ibid. 


. . . when a physician performs an abortion because of a good faith 
determination in accordance with accepted medical standards that an 
abortion is medically indicated, the physician has acted with lawful justifi- 
cation within the meaning of the statute and has not committed a crime. 80 

It was not until 1959 that the American Law Institute incor- 
porated in its Model Penal Code the suggestion that an abortion be 
permitted if : 

(1) a licensed physician believes that there is substantial risk that con- 
tinuance of the pregnancy would gravely impair the physical or mental 
health of the mother or that the child would be born with grave physical or 
mental defect, or the pregnancy resulted from rape ... or from incest; and 

(2) two physicians, one of whom may be the person performing the 
abortion, have certified in writing their belief in the justifying cir- 
cumstances. 31 

Since 1966 the legislatures of twelve states have enacted laws pat- 
terned to some extent on this model, and permitting abortions to be 
done in hospitals by licensed physicians. In 1967 the House of 
Delegates of the American Medical Association approved the ALI 
model penal code. This was the first policy change by the A.M.A. in 
96 years ! (The North Carolina Abortion Act of 1967 is similar to the 
revised laws mentioned above.) 

The more permissive laws have thus far resulted in no convictions 
of medical doctors. However, the fact that the freer laws have not 
made abortions more generally available to other than the middle 
and upper class has had an effect on certain pressure groups in this 
country. Instead of trying to get abortion laws changed, a strategy 
is now evolving which seeks to have the laws declared unconstitu- 
tional. The New York Times of November 12, 1969, reported that an 
anonymous donor recently gave the James Madison Law Institute 
$60,000 to challenge the constitutionality of the State laws. In ad- 
dition to three suits in New York, this institute is in cooperation with 
the American Civil Liberties Union in suits being brought in Indiana, 
New Jersey, South Carolina, South Dakota, Pennsylvania, and 

Roy Lucas, a lawyer who is contesting the constitutionality of 
New York's law in a federal suit, claims that 90% of the women 
who get legal abortions in New York are white, while 90% of the 
women who die from illegal abortions are black or Puerto Rican. 

30. Gleitman vs. Cosgrove, 49 N. J. 221, 1967. 

31. Model Penal Code, Section 230.3 (2), (3). Proposed official draft, 1962. 


The issues raised in the New York suit therefore include the follow- 
ing major points : 

1. that the law allegedly discriminates against poor women and 
denies them the equal protection of the laws by prohibiting them 
from obtaining medically safe abortions ; 

2. that it is so vague that physicians grant legal abortions at their 
peril, thus denying the doctors and the women due process of law ; 

3. that various provisions of the Bill of Rights create a right of 
marital and sexual privacy — similar to the right that overturned 
Connecticut's ban on the use of contraceptives — which the state 
cannot invade by regulating abortions. 

In the District of Columbia, U. S. District Judge Gerhard A. 
Gessell ruled on November 11, 1969, that the District of Columbia's 
68 year -old statute which permits abortions only where necessary 
"for the preservation of the woman's life or health" was unconstitu- 
tionally vague when applied to physicians and when it placed upon 
the defendant the responsibility for proving that the abortion was 
necessary. Therefore, ruled Judge Gessell, any "competent licensed 
practicioner of medicine" could legally perform an abortion in the 
District of Columbia for reasons satisfactory to himself and his 
patient. At the same time the judge invited the U. S. Attorney's Of- 
fice to appeal to the Supreme Court. The Justice Department has 
announced that it will appeal the ruling. 32 

Judge Gessell also upheld a similar indictment against a hospital 
nurse's aid, on grounds that the Government could properly outlaw 
illicit medical practice. 

The New York Times of December 11, 1969, reported that none 
of the hospitals in the District of Columbia had announced any 
changes in their rules or procedures since the court ruling. A com- 
mittee of twenty doctors and citizens, appointed by the Mayor of 
Washington, recommended to D. C. General Hospital that the decision 
"be implemented immediately;" but as of December 11 the hospital 
had made no statement. Because the decision by Judge Gessell is not 
binding on any other Federal district judge who might be called to 
rule in any abortion proceeding, 33 the Times reported that doctors in 
Washington were cautious in proceeding under the ruling. The 

32. New York Times, November 16, 1969, p. E9. 

33. New York Times, December 11, 1969, p. 40. 


Medical Society of the District of Columbia has formed an ad hoc 
committee to formulate a policy. 


It may be a truism that induced abortion is a complex problem, 
but there is a danger of oversimplifying the matter if we do not 
recognize this from the beginning. As with any ethical decision this 
involves many claims and counter-claims which impinge upon the 
people participating in it. We would therefore like at this point to 
set forth the various responsibilities incorporated in the problem of 
induced abortion. The moral obligations appear to fall mainly upon 
the prospective parents, society, and the ethicist, as together they 
consider the problem. These three groups obviously cannot be as 
neatly discriminated in a real situation as we will do in the analysis 
below, but perhaps an initial consideration in this manner can elim- 
inate some of the emotionalism involved in particular concrete situa- 

Prospective parents have moral obligations to the fetus, to the 
society, and to themselves. The prospective parents have an obligation 
to each other. Coitus implies responsibility. While this responsibility 
varies with circumstance, it is never appropriately abdicated. The 
simple fact is that two persons are directly involved in pregnancy. If 
coercion, insensitivity, or ignorance are present in the inaugural 
act, responsibility and obligation may be weighted differently than if 
the act is one of acceptance, love and knowledge. But it nevertheless 

The responsibility of the parents in all cases is to weigh and share 
obligations and benefits of the pregnancy insofar as biological and 
personal circumstances admit. This sharing represents an affirmation 
of the value of each party without an abrogation of uniqueness. Thus, 
a father does not undergo the struggle of physical delivery of a child, 
but he does have a responsibility to share in the decision-making 
which accompanies it. Similarly, the prospective mother cannot 
share her physical responsibilities as a hostess of a foetus, but she has 
a responsibility to share with the potential father the burden of moral 

It is important to emphasize a reservation for the sharing of 
responsibility. If either party is incapable of participating in the 
decision-making process by virtue of biological or mental insufficiency, 
or if either breaks the covenant of partnership in pregnancy, a re- 


assignment of responsibility obviously takes place. Thus a rapist 
chooses, by virtue of his coercive participation in the inaugural act, to 
disqualify himself from much of what would normally be shared 
decision-making. Similarly, the prospective mother's responsibility 
may be diminished if for any reason she is incapable of making 

The prospective parents' obligation to the fetus includes their 
responsibility to maintain the expectant mother in such a way during 
her pregnancy as to insure the child a safe birth. This obligation 
implies the preliminary obligation to realize such responsibility before 
they ever participate in an act which may result in the conception of 
a child. Their obligation to the fetus also implies the obligation care- 
fully to consider the potential mother's ability and willingness to care 
for herself in such a way as to insure the child's safety. If, after such 
consideration, they find that she is either unable or unwilling to care 
for herself (and indirectly for the child) then — within the framework 
of Christian love — it would appear to be their moral obligation to do 
the most loving thing for the fetus and consider abortion as an option 
to endangering the quality of this potential life. 

The potential parents have an obligation to society to present a 
child that is normal and healthy and to make provision for its care, 
either through caring for it themselves or by providing for its care by 
others, e.g., through adoption. However, it is important to remember 
that this obligation to present a normal and healthy child to society is 
not a final or absolute obligation inasmuch as it is ultimately condi- 
tioned by an understanding of the child's and their own relationship to 

The prospective parents also have an obligation to themselves to 
maintain and to safeguard their personal and marital integrity. This 
obligation arises out of their realization that life in an absolute sense 
is not theirs but the gift and creation of God. Full recognition of the 
individual's stewardship obligations clearly reveals the necessity of 
caring for the life given into their care to the best of their ability. 
Nevertheless, this mandate to care for the individual personal life is 
conditioned by the impinged relative responsibilities of the framework 
of Christian love. Therefore the prospective parents are under the 
obligation to consider the other individuals around them as well as 
their stewardship responsibilities to God in making their decision 
concerning induced abortion. 

Society has certain obligations to the prospective parents in its 


consideration of the option of induced abortion. From the Christian 
doctrine of the Incarnation, which implies the primacy of human life 
fulfilled through the exercise and presence of Christian love, we 
observe that the society's primary obligation to the prospective parents 
is to provide them with the opportunities for fulfilling their personal 
worth. This obligation is closely related to a doctrine of radical 
freedom with its implicit limitations. The couple's freedom, and their 
fulfilling of their personal worth, are conditioned by their obligation 
to act in accordance with the Christian injunction to love their fellow 

Perhaps an even more important obligation which the society has 
to the prospective parents is its obligation to provide them with all 
available information concerning the pregnancy and the options 
which are available as alternatives to that pregnancy. This is partic- 
ularly important in instances in which the fetus may stand significant 
chance of being born deformed in one way or another. It is also im- 
portant in that the society should provide the prospective parents 
with information concerning the alternatives to an induced abortion 
(such as adoption of the child after birth.) 

The above-mentioned obligations of society to the prospective 
parents may be thought to apply mainly to the situation after the 
woman has become pregnant. Therefore it is essential to note the 
prior obligation that the society has to the couple before the woman 
becomes pregnant. It ought to inform them of the obligations which 
they will have to the fetus, the society, and themselves if the woman 
should become pregnant. In order for them to be qualified to exercise 
their own decision-making faculties in a proper manner, they must be 
informed and aware of the possible implications of their actions. In 
this manner, it might be possible to avoid many of the tragedies which 
result from situations in which couples are unaware of all of the impli- 
cations when they decide to participate in relationships which then 
produce children who must suffer the consequences. 

Society's responsibility to the potential child is equally as complex 
as its obligation to the prospective parents. The central thrust of its 
obligation to the child is to provide a favorable environment into 
which it can be born. This includes an obligation to provide an 
atmosphere of love and justice for it, and also the attempt to insure 
its ability to participate meaningfully in the relationships which are 
a part of such an environment. 

Society likewise has a responsibility to itself, i.e., those members 


of the society other than the pregnant woman and prospective father. 
Its obligation to itself is basically twofold. It has an obligation to 
protect its members from the growing menace of the social dangers 
imposed by deformed or incompetent children that might be born, 
and also to incompetent mothers who might be incapable of making 
appropriate decisions. Society also has an obligation to itself in that 
it must protect itself from the social dangers which often result from 
the presence of unwanted children. Statistics on juvenile delinquency 
amply substantiate the opinion that unwanted children pose a great 
danger to the society, especially if the society makes no provision for 
their care after they are born into an environment which deprives 
them of the loving family relationship to which they should be entitled. 

The ethicist has many responsibilities when he considers the 
problem of induced abortion. He has obligations to all parties 
involved. It is his responsibility to delineate the factors involved 
in the moral judgments of the situation. 

The ethicist has a responsibility to the unborn child in that he is 
in a unique, i.e., relatively detached position, from which to view the 
situation and protect the rights of the fetus. This is particularly im- 
portant since the fetus itself is not specifically protected by law. The 
ethicist can utilize his position of detachment to act as the agent for 
both the prospective parents and the society by viewing all sides 
of the question in relation to the rights of the fetus. 

From a Christian perspective, it is apparent that the desired 
quality of human life is one of love and justice. Under this influence 
it is obvious that the child has a right to be born into an atmosphere of 
parental and societal love in conjunction with favorable social and 
economic factors. The child also has a right to be born a whole 
person, physically and mentally, in order to participate in the rela- 
tionships which create the environment of love and justice. 

The ethicist is under a further obligation to safeguard the rights 
of the prospective parents. The rights of the prospective parents 
include the right to exercise their freedom (within the limits explicated 
above), the right to know all the available pertinent information about 
the woman's condition and the options open to them, and the right to 
maintain their personal mental and physical health through their 
decisions in light of the information which has been provided them. 
The ethicist must also point up the prospective parents' moral obliga- 
tions to them in order to aid them in making their decision. 

The ethicist's responsibility to society focuses, moreover, on his 


obligation to maintain a fitting societal attitude regarding the char- 
acter and quality of human life. This is important since, without a 
proper attitude on this matter, neither the ethicist nor the society as 
a whole can operate effectively in making decisions regarding any of 
the related concerns. The ethicist attempts to help the society decide 
just what its considerations should be, and how to weigh those 
considerations against its basic system of values. He also has a sub- 
sidiary responsibility to remind the society of the consequences which 
may result whatever their decision may be. 


Induced abortion is at best an unfortunate and inadequate solution 
to a problem which man brings upon himself. Man's violation of 
potential relationship between an individual and God is something 
which we should strive constantly to avoid. 

It would be a better situation if adequate programs of birth con- 
trol, preconception medical investigation, and comprehensive examina- 
tion of potential parents could be instituted, thereby largely removing 
the need for extensive use of induced abortion. It should be possible, 
with the techniques currently at our disposal, effectively to eliminate 
any large demand for interference with pregnancy once it is begun. 
There will probably always be need for some induced abortion — 
perhaps in cases involving a pregnancy which resulted from rape or 
incest — but medical, legal, and ethical authorities should do all in their 
power to reduce that need to its absolute minimum through prelim- 
inary checks on potential pregnancies. Until such programs are devel- 
oped and implemented, however, discriminating utilization of induced 
abortion appears to be one way to deal with unwanted or dangerous 

An Appropriate Time to Die 

Gregory Dell, Powers McLeod, and John Mann 

Man dies. That seems to be one of the few certainties about death. 
The questions of death's how, when, and where are answered mostly 
by conjecture. So it is largely a mystery. But it does occur. And 
because it occurs in a world of men living in finite space and time, the 
question of the appropriate circumstances surrounding death arises. 

Already it is clear that some ambiguities surround this question. 
These ambiguities are reflected in attitudes toward euthanasia. Basi- 
cally, these attitudes reflect one or more of the particular formulations 
of the phenomenon, formulations which fall into the following basic 
categories : involuntary direct, involuntary indirect, voluntary direct, 
voluntary indirect. Each of these four types of euthanasia may be 
further defined by subject : first, concerning the euthanasia of adults ; 
and second, the euthanasia of children. 

The defense and prosecution of euthanasia ordinarily focuses on 
the fourth form, i.e., voluntary indirect. Joseph Fletcher calls this 
form 'anti-dysthanasia' (against a bad, or inappropriate, death) and 
says about it : 

even though death is brought about quite rationally and deliberately, it 
is accomplished only indirectly through omission rather than directly by 
commission. It is, in short, a procedure by which death is not induced but 
only permitted. In some kinds of Christian ethics and moral theology an 
action of this kind is called an "indirect voluntary." 1 

It is the purpose of this paper to explore the problem of 
euthanasia, suggest working guidelines for its possible implementa- 
tions, and examine some of the implications of such guidelines. 

Euthanasia of one type or another was a common practice in 
classical Greece and Rome. This practice seemed to stem largely 
from the intrinsic bond seen between the welfare of the state and the 
good of the individual. In general the state's welfare ranked quite 

1. Joseph Fletcher, "Anti-Dysthanasia — the Problem of Prolonging Death," 
Journal of Pastoral Care (1964), 18:78. Fletcher sees basically three types of 
anti-dysthanasia. They are: 1) administration of a death dealing pain killer; 2) 
stopping treatment (where it has begun) ; 3) withholding treatment not already 
begun (p. 79). 


high as a priority of concern. The sacrifice of an individual was not 
regarded as a great loss if done for the good of society. 

Theistic conceptual schemes hold a somewhat different position. 
God is the ultimate value and it is from him that life proceeds. 
Individual and societal well-being are derivative from that primal 
and ultimate value. Thus, "society has no natural right to take away 
what it has not given." 2 Correspondingly, individuals do not possess 
or exercise unconditional control over their private existence. 

The statements on euthanasia by the various institutionalized 
faiths of the Judeo-Christian tradition are permeated by this as- 
sumption. That they also usually arrive at a negative consensus on 
euthanasia is the result of this principle's being coupled with and 
reinforced by a fear of genocide and the introduction of a "wedge 
principle" into human decision. That is, the reality of Nazi genocide, 
together with the fear that one permissive action may lead to other 
more permissive action, bolsters the subordination of society's value 
to individuals and supports the prohibition against euthanasia. 

The precise formulation of the prohibition is complex but we can 
summarize by saying that euthanasia is identified with murder. And 
murder violates the commandment, "Thou shall not kill." 

It is usually the more conservative, legalistic or fundamentalist 
branches of Christianity which make this connection most binding. 
They are, because of this correlation of euthanasia with murder, most 
likely to be quite vehement against all forms of euthanasia. 

Conservative Protestants would tend to' agree with this position. 
Because they eliminate involuntary euthanasia from consideration, 
they seem to concentrate more on the problem of the relation of 
voluntary death to suicide. Suicide, like murder, is believed to be 
wrong, but the prohibition appears to be aimed at taking one's own 
life for selfish motives, rather than at self-destruction in principle. 
Society sanctions heroic self-destruction. The Protestant churches 
endorse this sanction when such heroism is done for "altruistic" 
reasons. It is, in fact, altruism to which appeal is made for exceptions 
to the euthanasia prohibition. The sanctions which result apply to 
both the patient and the practitioner but they are not very frequent. 

Where sanctions for euthanasia do occur in institutional religion, 
they seem to occur first and with the greatest frequency in this 

2. William S. Hockman, "Letters to the Editor," Christian Century (1967), 


humanist-Protestant tradition. 3 However, the incidence and strength 
of opposition seems to overshadow the influence of sanctions. 

The Roman Catholic view can be summarized by the following 
points : 

1. That mercy killing is murder. 

2. That no one except God has the direct right to dispose of human life. 

3. That 'self mercy killing, that is, the killing of a person who asks to 
be killed, is suicide and therefore wrong. 

4. That mercy killing solves no problems and benefits no one. In fact 
it causes greater evils in that it permits anyone and everyone to 
judge who shall live and who shall die. 

5. That to kill off by mercy killing the incurable, the insane, the crippled, 
the defective is not justified by science, since science's knowledge of 
the laws of human heredity is sadly lacking in certainty. 

6. That no matter how great the suffering or helplessness of a man, he 
is useful to himself and to society; if he bears his suffering and 
offers it to God, he can earn for himself and for others an almost 
infinite amount of grace. 

7. That to permit mercy killing would be to retard the advance of medical 
science, since the practice would make it almost impossible to do 
research in diseases that are now considered incurable. 

8. That in the Bible, God definitely and emphatically condemns as intrinsi- 
cally evil this most vicious practice of mercy killing, which is nothing 
less than murder. 

9. That if mercy killing is permitted, patients' confidence in their doctors 
will be completely destroyed. 

10. That the practice of mercy killing will ultimately lead us into the 
abominable practices that characterized Nazi Germany. 

11. It is to be accentuated that we are obliged to use ordinary means of 
prolonging life, but not extraordinary means. 4 

These reasons should be kept in mind as answers are addressed 
to the problem of euthanasia. 

With the more or less specific (though admittedly ambiguous) 
responses of Protestants and Roman Catholics presented, it now 
becomes appropriate to examine some of the basic ethical and theo- 
logical presuppositions upon which society's current, basically nega- 
tive, attitudes are based. 

Human life has been given to man by God. Because it is a divine 
gift, it is regarded with a certain sanctity. Its holy nature is such that 

3. Joseph Fletcher, Morals and Medicine (Boston: Beacon Press, 1954), 
p. 179. 

4. Bernard J. Ficarra, Newer Ethical Problems in Medicine and Surgery 
(Westminster, Md. : The Newman Press, 1951), p. 95. 


it deserves care and respect. Therefore, we may not ordinarily tamper 
with human life without the consent of that life ; nor may we directly 
terminate life, even with the consent of that life. The only instances 
in which interference with human life is permitted without consent 
are those in which organic life would otherwise be lost ; consent is 
unobtainable; or life has lost its recognized sanctity through a for- 
feiture of innocence. 

Because life was bestowed upon an individual, the individual 
person is granted priority in making decisions affecting his life. 
Although there is recognition of the existence of and need for com- 
munities, the individual typically sees himself as autonomous. Com- 
munity is therefore supplementary rather than definitive. Man 
makes contracts with communities when and where he chooses. He 
does this in the view that community is a potential source of benefit. 
However, he realizes that a certain serious forfeiture of individual 
prerogatives is necessary for the community to operate. Community 
prerogatives thus have a relatively high priority. They tend to be 
expressed, however, in terms of restrictive guidelines rather than 
prescriptive formulae (i.e., indicating the points beyond which it is 
not safe to act, rather than which action is desirable). If there is a 
very deep conflict between community prerogatives and individual 
priorities, the individual may exercise his own will, realizing that to 
do so he must suffer the consequences of a violated or broken com- 

One of these consequences may be death. This, however, is a rare 
consequence; for death, like life, is viewed as an "ultimate." It is a 
separate ultimate but an ultimate none the less. These two phenomena 
define man's being. Life is existence ; death is non-existence. Man is 
alive, so death is seen as the enemy ; it is the unknown other-than-life 
fighting for the person. When death comes, it means defeat. Yet, it 
must come ; it does come to all. Death then is omnipotent — it always 
wins. Because of its power it inspires a certain awe and fear. The fear 
is predominant. Man does not know what occurs so he will not become 
involved. Death's mystery inspires fear and causes man to attempt 
to hide from death. 

In his flight man "hangs on," as it were, to the belief that death 
is only somatic. Death does not really affect the person, only the body. 
But the sense of loss incurred by death seems sufficient to keep this 
last assumption more in the realm of hope than of assurance. 


At worst, death is God's punishment; at best, it is His cruel 
joke — the painful initiation into a new and different existence. 

Medical Aspects 

In face of the present legal structure, there is no place in medical 
practice for active euthanasia. There is, indeed, no legal sanction for 
any action which causes or allows one's patients to die. Action on 
the part of a doctor with the intent of causing the death of a patient 
may be seen under law as first or second degree murder. 5 

However, when we get into the matter of what has been called 
passive euthanasia, we must make some different statements. We 
become concerned here with ordinary and extraordinary means of 
prolonging life. Doctors feel themselves obligated to do whatever is 
ordinary to prolong a human life. (This has always been their 
practice.) Doctors do not, however, feel that it is always in the best 
interest of the patient or the society to perform extraordinary feats 
in attempting to prolong life. 6 One reason for this is that many of the 
methods which would be termed extraordinary methods are very 
expensive, very painful, or very inconvenient. 7 

The terms, ordinary and extraordinary, are ambiguous and rela- 
tive in the present situation. In present practice there are several 
factors which may determine what is ordinary and what is extra- 
ordinary. Medical consensus is one of these factors. Financial con- 
siderations and the location of the hospital may be others. What 
might be ordinary for President Nixon at Walter Reed Hospital may 
be quite extraordinary for a construction worker in a small North 
Carolina town. 

In cases such as these, tacit legal sanction is given to the practice 
of not performing extraordinary acts to prolong life in every case 
everywhere. There have, therefore, been some instances in which 
what is called passive euthanasia has been practiced by physicians. 8 

5. George Fletcher, "Legal Aspects of The Decision Not To Prolong Life," 
Journal of the American Medical Association (1968), 203:65-8. Fletcher points 
out that there has not been a single instance in the annals of Anglo-American 
judicial proceedings in which: 1) a doctor has been convicted of murder or 
manslaughter for having killed to end a patient's suffering, 2) a layman or 
doctor has been convicted for failing to take steps that could have averted death. 

6. David Daube, "Sanctity of Life," Proceedings of the Royal Society of 
Medicine (1967), 60:1238. See also Mary M. Shiedler, "Coup de Grace," 
Christian Century (1966), 83:1499. 

7. Joseph F. Fletcher, "Anti-Dysthanasia— the Problem of Prolonging 
Death," op. cit., p. 80. 

8. Samuel D. Kron, "Euthanasia, a Physician's View," Journal of Religion 


Tacit sanction is also given to the fact that medical consensus as to 
what is ordinary and what is extraordinary may, and does, differ 
from case to case and from place to place. In the present situation this 
tacit sanction adds to the moral, legal, and medical ambiguity which 
already exists. 

At present, one may observe a change in the medical attitudes 
toward, and the legal understanding of, the Hippocratic Oath. For 
nearly two thousand years western practice of the healing art has been 
greatly affected by the presuppositions behind one particular section 
of that oath : 

I will follow that system of regimen which, according to my ability and 
judgment, I consider for the benefit of my patients and will abstain from 
whatever is deleterious and mischievous. I will give no deadly medicine 
to anyone if asked, nor suggest any such counsel. 9 

Instances of passive euthanasia (i.e., those instances where no extra- 
ordinary means are undertaken to prolong life) suggest to us that the 
Hippocratic Oath is undergoing some informal reinterpretation. 
Indeed, some doctors have opted for a formal reevaluation of the oath 
or the formulation of a new oath based, like the Hippocratic Oath, 
on a deep concern for the welfare and dignity of patients, but also 
geared to the problems of modern medicine. 

What do these present circumstances seem to indicate? They 
obviously point to some kind of credibility gap between articulated 
medical values, on the one hand, and certain contemporary medical 
practices on the other. For while doctors openly affirm a stated inter- 
pretation of the Hippocratic Oath, and while they view the role of the 
doctor as being that of preserving and prolonging life (i.e., biologi- 
cal life), they themselves ineluctably make decisions involving the 
appropriate time and manner of another person's death. 

It often appears that when doctors argue against legalized consid- 
eration of the possibility for euthanasia in certain cases, they do so 

(1968), 7:335. "There is no question that passive euthanasia is widely practiced, 
even though this fact is not publicized." 

9. L. B. Hohman, in "The Right To Live and The Right To Die," ed. by 
Cleland, Medical Times (1967), 95:1184: "I, personally, would not be critical 
of a person with incurable cancer who took the suicide route. Again, I would 
not personally aid such a person to die. That is because something seems to 
be woven into the mind and feeling of a physician that he must preserve life. 
/ realise this is somewhat irrational." (Italics added) See also Otto Guttentag, 
"The Meaning of Death in Medical Theory," Stanford Medical Bulletin (1959), 


not because they value the Hippocratic Oath so greatly, but because 
they would rather make such decisions themselves without inter- 
ference from other disciplines. Viewing the doctor/patient relation- 
ship as a sort of holy of holies, doctors seem to feel themselves the 
only professionally qualified persons to deal with the problems sur- 
rounding death. 

We are unwilling to accept the rationale that doctors are the only 
persons qualified to decide when and if another human being is to be 
put to death mercifully. While the most obvious aspects of this matter 
are medical, other vitally important aspects are of social, legal, and 
theological significance. Doctors should and must have an irreplace- 
able role to play in the consideration of euthanasia for another human 
being. But to leave the decision solely to a doctor, or a group of 
doctors, would be unfair, both to the doctors and to society. No one 
profession is prepared to deal with the medicine, psychology, sociol- 
ogy, and theology involved in a decision such as this. To make the 
doctor solely responsible for the decision is to put an awful and unfair 
burden upon him. Further, our society with its web of family, eco- 
nomic, legal, and religious principles, is not such that other than 
medical interests can easily and fairly be left out of such a considera- 

Legal Aspects 

The current law regarding euthanasia embodies the popular, and 
largely unconsidered, theological and medical perspectives elaborated 
previously in this paper. These premises bind the law to awkward 
and sometimes inconsistent conclusions in actual cases of euthanasia. 

One reason for difficulty in the case of mercy-killing is the in- 
ability of the law formally to consider the motivation behind criminal 
activity. Thus, if the facts establish the guilt of the individual, there 
is no legitimate mechanism through which the motivation may affect 
the verdict. 10 

The immense latitude in practical application of the law demon- 
strates the inadequacy of the present theoretical presuppositions. 
Currently the legal situation is seriously compromised, with the fol- 
lowing results. Disrespect for the law is fostered, for example, when 
a judge instructs the jury in a case of mercy-killing that motivations 
are not to be considered, and that the facts must be weighed in isola- 

10. Luis Kutner, "Due Process of Euthanasia," Indiana Law Journal (1969), 


tion to determine the guilt or innocence of the defendant on a charge 
of murder. The jury may then acquit an obviously guilty party with 
the result that the entire legal structure loses respect and effect. 

The law is compromised also in the measure to which the present 
structure allows inconsistent sanctions. When doctors are practically 
immune to punishment for the same activity which nets other citizens 
years of imprisonment and even death sentences, the justice of law 
itself is threatened. 

Finally, the present system may allow persons who have practiced 
murder disguised as euthanasia, to go free. Because of lax application 
of the statutes regarding murder in cases of mercy-killing, some who 
cause death for less unambiguous and less worthy motives are ac- 
quitted. Confusion and contradiction in technical law and practical 
application hinder sound legal practice. 

The specific premise in today's law which permits all of these 
(we think deleterious) effects is the connection of malice and pre- 
meditation. In the statutes concerning murder, the first degree of 
homicide is established when "malice aforethought" has been proven. 
Unfortunately, subsequent interpretation of this phrase has not 
demanded the presence of both, but rather assumed that "malice" was 
an adverbial qualifier for "aforethought." The establishment of pre- 
meditation is automatically supposed to prove malice. This is an 
especially difficult problem for responsible mercy-killers who act not 
out of vindictiveness or hostility or frenzied emotion, but painful and 
responsible decision before-the-fact. 

It might also be pointed out that human life is not an ultimate if 
common practice be any indication. Practices of capital punishment 
and war make it evident that the debt owed to society or the safety of 
society are higher goods than a human life. This is to say that a 
human being may be called on to surrender his biological life for some 
good seen as higher. Certainly a dying patient could be considered to 
be in a similar position and voluntarily relinquish his life for what he 
considers a higher good. Current legal processes make no allowance 
for this possibility, however. 

A Proposal 

We argue the justifiability and the advisability of active euthana- 
sia under certain conditions. These conditions and the implementation 
of the act of euthanasia are described in the following proposal. How- 
ever, it should be noted that the proposal is intended to do more than 


activate machinery which would "legalize" euthanasia. Its primary 
purpose is to propose an economy of structures under which fair 
consideration of the issue would be most likely to occur. Thus, it 
does not assume infallibility, but it does intend to mobilize the maxi- 
mum potential for just decisions in this highly complex matter. 
All prescriptions presently used in channeling the decision-making 
process can realistically have only this intent for their goal. Every 
situation is unique, and cannot therefore be fitted precisely with a 
preconceived prescription. Uncertainties and ambiguities will always 
be present. Thus, maximization of guidelines is the most we can 
hope for. If this proposal satisfies that criterion then it should, like 
some of its prescriptive counterparts, be made effective through legis- 
lative action on the state or federal level. 

Perhaps the easiest way to present the particulars of the proposal 
is to view it from the perspective of a possible result of its implementa- 
tion. We present here in order those conditions and criteria which 
must be satisfied if active euthanasia be advocated. 

Three conditions must be present before euthanasia would become 
a serious option for any person of legal age judged to be mentally 
competent. First is the presence of an incurable "mutilation" of the 
person. Such a mutilation could be in the form of physical disability, 
disease, or mental disability. 

The second is the absence of the patient's opposition to the per- 
formance of the act. The possibility for altering this second condi- 
tion (i.e., recognition of a patient's opposition) presupposes the 
mental awareness of the patient. (If mental awareness were absent, 
or if the patient's will could not be discovered for any other reason, 
or if he actively sought the procedure, then this second condition 
would be established.) It would be the duty of the hospital adminis- 
tration, through an appointed representative (e.g., a chaplain or other 
professional equipped to inform, understand, and discern the patient's 
feelings), to discover the explicit wishes of the patient at the time of 
the consideration of his case. 

Such a consideration would take place in the procedures of the 
third condition, that is, the agreement of three of five members of a 
panel appointed to deliberate such cases. Such a panel would be acti- 
vated only if and when the other two conditions were met and if it 
were notified of the case by a concerned individual or group. 11 

11. Such notification would start the procedures outlined for condition num- 
ber 2. 


Panels would be appointed preferably by city or county govern- 
ments and in sufficient number to meet the demand on their services. 
The appointing body would also voir dire prospective panel members 
in order to establish the absence of an inprincipled objection to the 
practice of euthanasia. In legal terms voir dire, meaning to speak the 
truth, is a preliminary examination to determine the competency of a 
witness or juror. It is within the voir dire that evidence is sought 
concerning any preconceived ideas or notions concerning a case or 
practice. It is often felt that such preconceptions might affect one's 
ability to weigh evidence fairly under the law. 

In this case, the panel members must be free to vote for euthanasia 
should deliberations on the case warrant its exercise. The patient's 
personal physician and a representative of his religious faith would 
be the only members exempt from the voir dire. The five members 
of a deliberating panel would be : ( 1 ) a physician not otherwise con- 
nected with the case or the family; (2) the attending physician; (3) a 
professional representative of the patient's religious faith, other than 
the patient's own clergyman. 12 (4) a lawyer or judge not presently 
involved with the patient; (5) a psychiatrist previously uninvolved 
with the patient. (The psychiatrist would be the only member of the 
panel other than the patient's physician who would be able to inter- 
view the patient if he felt it necessary to do so. ) 

The decision of the panel would be binding on the hospital in 
which the patient was being treated. Individual physicians on the 
hospital staff could only be prevented from performing certain life- 
saving or death-assuring procedures by the decision of the panel. 
All actions, however, must be by licensed physicians. Finally, any 
decisions of the panel would be made immediately void if the first two 
conditions were altered. 

It remains to outline the criteria upon which the panel would make 
its decision. The panel is not limited in the scope of its consideration 
except in one respect. (While it may include in its deliberations any 
factors it sees proper or necessary for a complete consideration of a 
case, it must include at least the following.) Further, it would be 
understood that these required criteria would be weighted in descend- 
ing order as they appear here : 

12. In the case where the patient voices no denomination or faith preference, 
the last theologian to sit would remain. For atheists, no theological consultant 
would sit on the panel, but three votes would still be required. 


a. The patient's desire for death or the absence of his opposition to 
death, and his preference for direct or indirect action. 

b. The patient's same desires as expressed through a legally recognized 

c. The patient's same desire as expressed prior to the present crisis to 
legally recognized witnesses who thus testify. 

d. The nature and status of the illness and the amount of suffering and 
duress experienced. 

e. The ability of the patient to engage in reciprocal human relationships. 

f. The presence or absence of the family's opposition to euthanasia for 
the patient. 

g. Financial considerations. 

h. The presence or absence of spontaneous respiratory, circulatory, and 
cerebral functions. 

In the case of a patient who is a minor or who is judged mentally 
incompetent the procedure would be altered in the following way : 

Since such a person cannot express a legally binding will, the 
second condition as stated above would not apply. That is, such a 
patient could not, on his own, express legally recognized preference 
for or opposition to euthanasia. At least he could not do so with the 
authority which such a legal requisite demands. 

However, such an expression is a valid consideration for the mix 
of factors which the panel must review in making its decisions. While 
the law recognizes diminished responsibility, it seldom would contend 
that any individual's voice is meaningless. Operating on this as- 
sumption of worthy, though diminished, expression, the criteria of the 
panel's deliberation would be changed at four points. 

Criterion (f), "The presence or absence of the family's opposition 
to euthanasia for the patient," would follow criterion (a), "The 
patient's desire for death or the absence of his opposition to death, 
and his preference for direct or indirect action," as the second-most 
important factor. 

For reasons stated above, criterion (b), "The patient's same 
desires as expressed through a legally recognized 'pre-will,' " could 
not be established unless the patient had at some previous time estab- 
lished a "pre-will" when he had the authority of a competent person 
of majority. In such a case it would follow criterion (f) as noted 
above. Criterion (c), "The patient's same desire as expressed prior 
to the present crisis to legally recognized witnesses who thus testify," 
would remain in order. 

Following this, an additional, parallel criterion (b) would be 


inserted stating, "The attitude of the family as expressed prior to the 
recent crisis to legally recognized witnesses who thus testify." 

If Criteria (a), (f), (b), (c), and (i) as they are denned here 
are all in agreement, they would be recognized, under this proposal, 
as having the authority of condition #2 concerning the absence of the 
patient's opposition. If they were not in agreement, or if their agree- 
ment did not result in opposition (i.e., the breaking of condition #2), 
then the panel would be activated for further deliberation. 

Such deliberation would follow the altered order as described en- 
compassing the additional criterion in its place and including the re- 
maining criteria as they stand. 

The flowsheet for the consideration of criteria would then be as 
follows : 

(a). The patient's desire for death or the absence of his opposition to 
death, and his preference for direct or indirect action. 

(f). The presence or absence of the family's opposition to euthanasia for 
the patient. 

(b). Where possible — the patient's same desires as expressed through a 
legally recognized "pre-will." 

(c). The patient's same desire as expressed prior to the present crisis 
to legally recognized witnesses who thus testify. 

(d). The nature and status of the illness and the amount of suffering and 
duress experienced. 

(e). The ability of the patient to engage in reciprocal human relation- 

(g). Financial considerations. 

(h). The presence or absence of spontaneous respiratory, circulatory, and 
cerebral functions. 

If, as a result of the panel's action, the three conditions were met 
and the obligation of the hospital was thus incurred, the question 
would remain concerning the means and timing of the act of 

It is here proposed that the act should take place as soon after the 
decision as possible. The patient's opposition again should be checked 
as the minimum preparation. The means employed should be those 
causing a minimum of duress to the patient and should be checked 
against his preference for direct or indirect action as it was expressed 
in establishing criterion (a). 

A Theological Basis for the Proposal 

The theological and ethical presuppositions and implications of the 
proposal are central to its understanding. It is of course impossible 


to examine exhaustively these concepts or even to bring all pertinent 
concepts to light. It is, however, possible to examine some of the con- 
cepts which have the most immediate and forceful bearing upon the 
proposal. Death is one of these concepts. 

The first thing which might be said about death is that it is uni- 
versal. It occurs to all men and thus to each man sometime. It is 
one process in life which is inescapable. It has been said that with 
man's first breath he begins dying. While this is not strictly true by 
our definition, it does indicate strongly that death is part of life and 
that properly it can not be isolated from it. 

As has been said, the prevalent attitude about death is to see it as 
being apart from life. Further, death is seen as the enemy of life. 
In fact, whether death is seen as a part of life or not, this charge is 
still levelled against it. It is a correct observation that death has 
emotional overtones both for the dying and for those around the 
dying. However, it is arguable whether the emotional impact of death 
must leave a negative impression. Death is not necessarily an enemy. 
This can be true for the dying person because death can come to him 
as one of the processes of life. Indeed it may be a welcomed process, 
one of relief from suffering and depersonalization. It also may have the 
positive value of being a deep experience in itself. 

Death is not necessarily an enemy to those around the dying 
person. Being considerate of the patient's state they may find for 
instance that the void caused by the individual's absence is not as pain- 
ful as watching the patient suffer. Thus death is not necessarily an 
enemy and dying not necessarily a horror. 

To substantiate this position and to draw out its implications it is 
necessary to examine the terms life and death, as they operate within 
our conceptual economy. 

Life is created by God. That is, the totality of life as a qualitative 
distinction is under the influence and jurisdiction of God. Human 
life is not a birthright. It is a given, a gift from God, who seeks 
continually to work with it. In every situation, from conception 
onward, God is seeking to work for the enhancement and preserva- 
tion of the human dignity and personhood which makes life human. 
Death is not beyond the scope of this influence ; it is rather an integral 
part within it. 

Life then, in its totality including the death process, is caught up 
in a relationship with the Divine. It is from this relationship that life 


gains its value. 13 Insofar as a person is available to dignity and 
personhood, his life has value and is to be highly respected. But the 
referrent for dignity and personhood — for the humanness of life — is 
not the isolated somatic system which seems to serve as the present 
criterion. It is rather the community of systems. The wholistic view 
of man upon which this proposal is based demands the perception of 
man as an integrated whole. His somatic, psychological and spiritual 
aspects are completely interwoven. Further, his individual self which 
is formed by the mix of these aspects does not become a personal self, 
a human self, until its social and theological relationships are 
realized. 14 The individual is still the referent ; but it is the individual 
in community. 15 As the disintegration of these interrelated systems 
becomes irreversible and accelerated, the patient begins to die. Death 
occurs when the disintegration is seen as accomplished. Personal life 
is over. The humanness of life is gone. 

But "human" dignity is not irrelevant until "human" life is judged 
as terminated. Thus, while an acceptance and recognition of death is 
called for, such an acceptance and recognition is not unqualified. As a 
process in life, dying is acceptable only insofar as it does not un- 
necessarily interfere with the dignity and personhood of the indi- 
vidual. That is, while the various factors of the integrated self begin 
to break down and some imbalance will take place, it is not necessary 
to accept an acute imbalance and disintegration. And it is certainly 
not necessary to prolong such a misfortune. 16 

13. B. Baird and J. Fletcher, "The Right To Die," Atlantic Monthly (1968), 
221 :64 : "The sanctity is not in life itself, intrinsically ; it is only extrinsic and 
bonum per accidens ex casu — according to the situation." For the Christian the 
accidens is the status of the relationship with God. 

14. "For a person to live, he must either be realizing his potential or have 
the capacity to realize his potential ... 1. To have a rational awareness and 
2. To interact emotionally with other people." (P. Wesley Aitken, "The 
Chaplain," included in the article by James T. Cleland, "The Right to Live and 
The Right to Die," Medical Times (1967), 95:1186. 

15. This is excellently summarized by Adrian Verwoedt, Communication 
with the Fatally III (Springfield, 111.: Charles C. Thomas, 1966), p. 160: "The 
psychological level . . . cannot exist without the integrated biological function 
which make possible an intact central nervous system and the resultant mental 
activity by which man distinguishes himself from lower animals. Even with 
the psychic apparatus intact, however, man is not complete. He must also func- 
tion as a social creature. For, just as his intellectual power sets him apart 
from other animals, his social orientation sets him apart from his fellows and 
imparts his unique individuality." 

16. "The right to life does not necessarily entail the obligation to live, 
especially when continued existence is so hideous and demoralizing that the 


This conclusion is reached by the following reasoning : If, in fact, 
the dying process is part of life and if God's will is for personhood 
and dignity to be enhanced, then it can be assumed that God's will is 
to enhance personhood and dignity in the dying process. When this 
is not done, then there is in fact a certain evil present which hinders 
the will of God. Such an evil, and thus such a death, cannot be ac- 
ceptable. To look at it another way: it is as if the natural arena of 
God's activity is insufficient in this case for His will to be done. Some 
"natural" deaths thus go against God's will, disintegrating rather 
than terminating human life. In such a situation, God's will may be 
acted out by instrumentalities other than the natural processes. Man 
has a part to play in such a situation. His role can be seen by 
exploring the implications of the assumption that God does work 
through the instrumentality of man. To most men there does not seem 
to be a ready-made interpretation of God's will for each situation. 
Further, because man is free he can realize the possibility of choice. 
Man chooses and his decision may be, in a given situation, better or 
worse. But even if he does not select an alternative, he has chosen. 
His choice is simply whether to participate actively in the decision. 
Such a choice may be relatively good or bad. Since God works 
through the instrumentality of man and since part of man's God-given 
dignity is his freedom to act and choose, it can be said that God does 
work through the choices of men. This is almost tautological. It 
would not make sense for God to work for dignity and personhood by 
a means which denies one of the central components of the goal. 

Thus man's decision becomes very important in the working out of 
his instrumentality. He must decide how he will interpret God's will 
in a given situation. Understanding the limitations of time and knowl- 
edge, man is aware that his actions must remain imperfect. But risk 
of mis judgment does not free man from his responsibility to act in the 
best way possible to him. Luther's admonition to "sin boldly," and 
its accompanying concept of munificent grace, seems few places more 
applicable than here. Where man seeks to do the will of God, and 
through his finitude fails, forgiveness is available. 

Certainly man does not shirk this responsibility in many of the 
matters of human well being. He freely and properly disseminates 
services which overcome the minor sicknesses, sufferings, and injuries 
of life. Further, he is actively engaged in affecting the beginning of 

person is blotted out and reduced to coma or ungovernable nerve-reactions." 
J. Fletcher, Morals and Medicine (Boston: Beacon Press, 1954), p. 188. 


life as he discusses contraception, practices pre-natal care (including 
surgery and abortion), and aids in the childbirth process. In all 
of these instances man can be seen trying to affirm the dignity and 
personhood spoken of above. He is taking seriously natural events as 
an indication of his sphere of activity. He is then attempting to en- 
hance the personal-social integrity by the means available to him. 
The problem arises when man confronts death. As was said, his at- 
titude is one of fear; his actions normally are attempts to prolong 
life. This seems to be the result of misplaced priorities. Life becomes 
the object of our veneration and individual existence the center of all 
meaning. 17 

Such an approach not only has touches of blasphemy but per- 
petrates an inconsistent system of medical ethics. Certain practices 
used to aid the patient during other phases of his life are withdrawn 
during terminal phases. 18 An artificial limitation is placed on permis- 
sible practices for the patient's care. 

This limitation is more often than not the result of restricted 
conscious deliberation. Medical ethics tells the doctor to save life. If 
death's process is not recognized as the end of life, ignored as being 
what it is, then the doctor may ignore its special implications for the 
care of his patient and continue fighting a hopeless battle or merely 
allowing, without influencing, the inevitable. 

This seems to shirk the responsibility of decision for the best care 
to the patient. Such decision by default is acceptable neither within 
the decision-making economy described above nor in the scope of 
true humanitarian concern for the patient. 19 Responsibility requires 

17.". . . if we are dedicated to preserving life under all conditions, at all 
cost, then we are wrongly worshipping life as a substitute for God." D. P. 
Sholin, "Death of a Son," Ladies' Home Journal (1968), 85:70. 

18. Fletcher points out the irony : ". . . we are, after much struggle, now 
fairly secure in the righteousness of easing suffering at birth, but we still feel 
it is wrong to ease suffering at death!" (Morals and Medicine, op. cit., p. 196). 

19. The argument may be substantiated in this way: Default activity is the 
result of a type of rationalization. "We are so afraid that someone will make 
a wrong decision that we take refuge in the maxim that because we can keep 
these persons alive, we must — a maxim that has been reached not by intelligent 
and compassionate study but by default, or at best by transferring a sound 
principle of medical ethics bodily into social ethics." M. M. Shiedler, op. cit., 
p. 1500. However such rationalization has its consequences. "Still it may be 
asked whether greater depths of inhumanity are not reached when we allow 
people to die in isolation, walled off from effective community with others under 
the cover of medical necessity." James T. Laney, "Death and Ethical Reflection," 
Reflection (1969), 66:4. 


that positive decisions be made and implemented. 20 

In summary what has been attempted by the proposal is the crea- 
tion of an arena within which God's will for personalization of indi- 
viduals could be acted upon. It is an attempt to check both natural 
insufficiency and man's foibles while being aware that it operates 
within an atmosphere of imperfection and forgiveness. 

Fletcher speaks to our position quite well : 

The right of spiritual beings to use intelligent control over physical nature 
rather than submit beastlike to its blind workings is the heart of many 
crucial questions. Birth control, artificial insemination, sterilization, and 
abortion are all medically discovered ways of fulfilling and protecting 
human values and hopes in spite of nature's failures or foolishnesses. 
Deatb control, like birth control, is a matter of human dignity. Without it 
persons become puppets. 21 

20. A course of positive action could be dictated if the assumption is correct 
that : "When a Christian is dying, a doctor needs to be aware of his patient's 
sense of values. For such a one a vegetable existence offers no opportunity of 
living for Christ . . ." Andre Bustanoby, "The Right to Die," Christianity Today 
(1963), 7:39. 

21. Fletcher, "Anti-Dysthanasia — the Problem of Prolonging Death," op. cit., 
p. 83. 

Dean's Discourse 

Thoughts on the University* 

"Brethren, whatsoever things are true . . . think on these things . . . 
these things do, and the peace of God will be with you." Phil. 4:8, 9. 

The nation is deeply troubled. Some universities are in partial 
disarray ; many seethe with unrest. Academic life is disturbed, studies 
are in jeopardy. Students are aroused and profoundly stirred; 
teachers are disquieted ; administrators alternate between hope and 
despair. Cambodia touched off the smoldering pile of young adult 
resentment toward a protracted war that had already amassed an 
appalling record for debauchery, atrocity, and futility. The pattern of 
turbulence and closed universities of southern Europe may lie ahead 
for us. Mass education adds to the problem by geometric progression : 
not only does it provide arenas for massive ferment, but mass educa- 
tion is itself potentially a massive reservoir of political power, for 
good or ill. 

In the face of these realities, it is, perhaps, already too late in the 
day to hope for a constructive answer to the question, what is the 
role of the university in today's society ? In some ways, the events of 
the past three years make the answer all too apparent. For the "new 
left," the decision has already been made : it holds that the university 
is a chief instrument of social revolution. It is just this that astute 
conservative reactionaries perceive, and it is this which many teachers 
and scholars, pursuing their researches with time-honored non- 
judgmental objectivity have been slow to take in. 

All decent people, inside and outside the universities, are aghast 
over the desperate events at Kent State and, now, at Jackson State. 
They are also bewildered and shocked by recent calculated student 
indecencies at Princeton in March. These plainly violated standards 
of academic process and scholarly restraint. Ordinary people do not 
comprehend disruption of the university when disruption is planned 
and then justified as an instrument of social protest. They have not, 

* A sermon preached by Dean Robert E. Cushman in Duke Chapel May 17, 


up till now, understood the university as the chief instrument of 
societal change. 

They are, perhaps, still thinking of the university in the manner of 
John Henry Newman's idea of it ; namely, as the place of liberal learn- 
ing where "knowledge," as he said, "is capable of being its own end." 
In his Idea of a University, Newman spoke of university education as 
"a comprehensive view of truth in all its branches." This "liberal 
education," he taught, engenders the "philosophic temper." It instills 
a "habit of mind," serene and composed, which fosters "throughout 
life the personal attributes of freedom, equitableness, calmness, 
moderation and wisdom." 

For such conceptions of university education, the platform of the 
"new left" is, on the face of it, unintelligible. From the Newman 
19th century perspective, the eloquent defense of Princeton graduate 
student, Michael Teitelman, on behalf of his fellows charged with 
disruption and insubordination must seem incredible and outrageous : 

"This is a political trial," Teitelman declared, "and that's what we 
want everyone to understand. We're not on trial here. What's on 
trial is the ruling class and its racism and imperialism. We have said 
that the real explanation of all that we do in this trial is to be found 
in the unhuman, unfree, repressive social reality all about us. We do 
not deny we organized a demonstration against Mr. Hickel. We ex- 
plained why we did so and why we thought it right to do so." 
(Princeton Alumni Weekly, April 28, 1970, pp. 11, 14). 

It is not necessary to enlarge upon the bill of particulars with 
which Mr. Teitelman indicts the established orders of society, includ- 
ing those of the university. It suffices to observe two or three things : 

The first is that, by asserting the "political" character of the hear- 
ing for students charged with violating the university code, Mr. 
Teitelman means to exempt the defendants from the standards pertain- 
ing to their membership in a university community. He does so on 
grounds of the Tightness of their political views ! 

Secondly, and behind this, is the premise that the really sufficient 
reason for continuing university membership is political "enlighten- 
ment" issuing in liberating social action. 

Thirdly, that disruption of university practice and academic 
protocol is non-censurable if it is politically justifiable. The end 
justifies the means! Our ends are right, therefore our behavior, how- 
ever obnoxious, is justified ! 

But beyond this is the underlying premise about the nature of 


the university that justifies this logic of expediency with immunity. 
It is that the university is, at the least, a staging area for, perhaps even 
an instrument of, social revolution. Certainly, the "new left" is not 
above using the university as such under the guidance of ends taken 
to be, as Teitelman says, "right." So "right," indeed, so valid he 
believes, is the end in view that even means which denature the uni- 
versity are not deterrents to the apostles of social reform, urged on as 
they are by revulsion against oppressive established orders — both 
inside and outside the university. 


The agony of the present-day university is something like this : 
it is caught in the pincers of a societal revolution surrounding it, while, 
at the same time, the university is itself disturbed and disrupted from 
within by morally defensible outrage against maladies without. It is 
caught in the middle between societal inaction and leftist reaction. 
Meanwhile, often, as at Princeton, the leftist reactors within claim all 
the immunities of the academy while exhibiting the behavior of 

The resulting internal conflict is insupportable. For, of all civilized 
institutions, the university — committed as it is to rational inquiry, 
persuasion, and the honor code of the gentleman — is most vulnerable 
to disorder. The discipline of the university is still mainly self- 
discipline. When the university, however, becomes the focus of the 
infectious ills of the environing society, it is the first casualty of the 
prevailing cultural disorder. Liberal education is incompatible with 
the illiberal spirit ; when the latter waxes, the former wanes. 

But this special vulnerability is not all that imperils the university. 
In addition, by its very nature, the university tends to' invite, however 
unintentionally, the disorders with which it is presently afflicted. For, 
the university is, as the medieval schoolmen understood, a microcosm 
of the world. It is microcosm of the surrounding culture. In so far as 
there is reasonable working harmony between the ends or goals of a 
society and its institutional support of them, there is stability. In such 
a case, there is also stability enough for the peculiar role and func- 
tion of the university. When the contrary prevails, that is, when there 
is contrariety between new emerging goals and the institutional 
vehicles for their realization, then the resulting ferment and strife in 
the surrounding culture first comes to articulate consciousness in the 
university — as the microcosm of the macrocosm. 


To be more explicit, it is the nature of the academy, from the time 
of Plato, that it should proceed on the Socratic premise that "the 
unexamined life is not worth living" and that, therefore, the purpose 
of the academy is just exactly to examine life as it is being lived to the 
end of its progressive betterment. In a sense, the academy has always 
stood in the role of critic of the established or prevailing culture. That 
is why "the gown" and "the town" have frequently experienced some 
measure of estrangement and some need of reconciliation. But in 
times of intense cultural revision, when the nisus of history moves 
toward the renovation of cultural forms in the interest of squaring 
the practices of society with a larger human good, this pressure 
frequently has its initial acknowledgment in the university. 

Here, the inequality, or the contrariety, between the things that 
are and the things that ought to be come first to disquieting aware- 
ness. And in our time of immense societal distortion — stubbornly 
resistant, it seems, to humane solutions by way of present modes of 
political and institutional response — the university tends to become 
the home of radical solutions to social ills. All this obtains while the 
ailing society is laggard either frankly to acknowledge its sickness or 
to resolve it by finding the cure. 

So the university spawns social activists — students and faculty 
with varying degrees of revolutionary commitment. Among these the 
most zealous, like those at Princeton, are not above turning the 
academy into an instrument of social change, disrupting the educa- 
tional process itself in the interest of radical renovation of the political 
order and its economic base. Unfortunate as it may be, their strength 
is that they have too good a case ! But, at the same time, they 
denature the function of the academy by using it as a political tool. 

So it has come to pass that the currently ascendant idea of the 
university is that of the "new left." They hold that the university 
is properly an agent of societal change. At times they act and speak 
as if the university should become the Church. It cannot be denied 
that, in some part, they represent a rebirth of conscience of which 
the Church should always be the promoter. But prompted by great 
"righteous indignation," these apostles of social reform have their 
residence in the Academy. Yet the Academy is not the Church. Un- 
like the Church, the Academy has not required that its members be 
regenerate. But apostles of righteousness who are not regenerate 
may easily become fanatics. 

The "new left" does, I think, follow in some part the admonition 


of St. John: It comprehends what the academy has characteristically 
been slow to acknowledge. This, namely, that the Truth is not some- 
thing to be known only, or always to be being sought after, but rather 
something to be done, and now. The "new left" in part seems to hear 
what churchmen ought always to heed : "If we say that we have 
fellowship with him and walk in darkness, we lie, and do not the 
truth." It is the New Testament and the Church which always say 
that the truth is for doing. The "new left" is urging that there is a 
no more needed pedagogy, and no Christian can deny it. The fact is 
that the truth for doing, as St. Paul declared, is just exactly faith, 
hope and love. And the exasperating thing is that the "new left" 
concurs with St. James that faith without works is dead. 

Nevertheless the academic apostles of social righteousness are 
mainly blind, or perhaps uninformed, respecting Isaiah's more authen- 
tic apostolic calling. They are unaware that, just because he was 
a man of "unclean lips" dwelling among "a people of unclean lips," 
Isaiah could not be trusted with mission until he had acknowledged 
his complicity in the sin and guilt of his people. He could not be 
trusted with mission until he had been cleansed for mission. He was 
not sent until he had received the grace of a diviner forgiveness which 
preserves "righteous indignation" from supercilious fanaticism. From 
the Princeton Weekly nothing is plainer respecting the academic 
apostles of righteousness than is declared in Proverbs: 

"There is a generation that curse their father, 
And bless not their mother. 

This is a generation that are pure in their own eyes, 
And yet are not washed from their filthiness." 

The Biblical view of man does not indulge such an interpretation 
of "the generation gap" as would distinguish between one generation 
and its successor by the sinfulness of the former and the righteousness 
of the latter. Nevertheless, only invincible ignorance would deny that 
the young adult generation are warranted in some of the grave indict- 
ments they bring against contemporary American society. 


What happened at Kent State and, perhaps, at Jackson is a 
frightening disclosure, I fear, of the moral sickness of our culture. 
Surely it is a time of peril for any nation when agents of government, 
charged with maintaining the peace, resort to overwhelming force 
against an indiscriminate body of unarmed citizenry — especially 


youthful ones. Such official excess is probable evidence, as was stated 
by John W. Gardiner this week in The New York Times, that "we 
are dealing with disintegrative forces that threaten our survival as a 

As for the universities — and I speak after nearly thirty years' ex- 
perience in three such institutions — the universities, as microcosms, 
cannot sustain much longer the inner turmoil engendered by the un- 
resolved ills of the larger society. After nearly three years of internal 
divisiveness the universities are becoming disfunctional. It is true, as 
Mr. John Gardiner also is reported to have said, that "today's divisive- 
ness is not confined to one issue. There are multiple points of conflict," 
he said, "the war, race, the economy, political ideology. There are 
multiple rifts — between old and young, between regions, between 
social classes." 

This is all true; yet I suspect — so far as the universities are con- 
cerned — it is much as I wrote for the Divinity School Alumni a year 
ago, namely : ". . . that until the futility of Viet Nam is retired, with 
its violation of conscience, the scepticism of youth toward the wisdom 
of their elders and the propriety of established orders will not recede. 
Viet Nam is the scandalous symbol of the bankruptcy of capitalistic 
democracy's way of meeting the future or dealing with human destiny 
by stereotyped and outworn patterns of response. More than anything 
it epitomizes . . . the frustration of the young with the sheer inertia of 
the Establishment." And I would affirm again what I then declared 
that, "Unless creativity replaces inertia, Viet Nam may turn out to be 
the fatal nemesis of the American way of life — its dissolution of 

This past week Mr. Gardiner declared that "a crisis of confidence" 
is indeed upon us : "We must move vigorously," he said, "to solve our 
most crucial problems" and we must seek "a healing of the spirit of 
the nation." It was in commentary upon these words that the Times 
noted that "Almost two years ago, the National Commission on the 
Causes and Prevention of Violence warned that the greatest threat to 
American survival was not from without but from within." 

The real enemies are those of our own household : it is this un- 
blinkable fact that simply renders obsolete, I believe, the premises and 
consequent policies that seemed to justify Viet Nam in the first place. 
Certainly, they are now discredited for any further extension of the 
war. And that is the scandal of Cambodia : it not only offends against 


the decent opinion of mankind, but flies in the face of reason itself. 
To many, it seems an invitation to societal suicide. 

But if there is to be, as Mr. Gardiner has urged, a "healing of the 
spirit of the nation," then, surely, there must be, in addition to 
acknowledgment of our moral blame as a people, a recovery of moral 
integrity and vision. If, as Proverbs has it, "without vision the people 
throw off restraint and perish," will we as a people give heed to our 
foundations ? 

"Brethren, whatsoever things are true, whatsoever things are 
honorable, whatsoever things are just, whatsoever things are pure, 
whatsoever things are of good report . . . think on these things." So 
counsels St. Paul. But, more emphatically he enjoins: "these things 
do, and the peace of God shall be with you." 

Brethren, our jeopardy as a nation, the threat of our dissolution 
as a people and as a society, is that we cannot continue to exist in 
defiance of the moral Universe. At last and inescapably, the truth is 
for doing! But it is the nation, and the individuals who compose it, 
that must do the truth. The universities cannot, in this, substitute for 
society. Neither can they safely assume the apostolate of the Church. 
Only this week student activism has resorted to the legitimate 
avenues of democratic legislative process. This may be a turn of the 
tide. I pray God the legislators may hear them. 

May 17, 1970 Robert E. Cushman 


Autumn 1970 


Oh God, 

whose glory is in all the earth, 

and by whose presence we are preserved from 


and from all else that would quench 

Thy light and warmth of life, 
We praise Thee. 

Forgive our feverish ways, 
our random ventures, 

our bold and thoughtless prods at life, 

our fear-filled and our hate-ridden incubations. 
Grace us 
with the discipline of trust in Thee, 

that we may find footing on the firmament of hope and love, 
that our vision may pierce 
the low-hung-cloud-ceilings of 

and self-indulgence. 
We thank Thee 
for this place of service. 

Fructify our minds that we may better understand our tasks. 
Strengthen our hearts that we may be in warm pursuit of our goals. 
Inspire our wills that we may be steadfast in Thee towards all people. 

Oh God, 

in the midst of the Darkness of our times 
grant that we may not succomb 

to the strange allures 

and gaping easement of 


By Thy grace 

keep our gaze steadfast on the light that shines forth from 
Thy Christ, 

and from the refracted rays 
leaping all around us in 

Thy fractured image that is 

We commit ourselves to 

Thy goodness and mercy, 
Creator, Preserver, Redeemer. 

Seal our commitment by Thy gracious Spirit 
with the assurance that 
those who labor in Thee and for Thee 
labor not alone nor in vain. 

And to Thee the only true 

only wise 

only faithful 

living and loving God, 
through Christ our Lord 

be all honor and glory now and from the ages unto the ages. 



Volume 35 Autumn 1970 Number 3 


Prayer (at the first meeting of the Faculty) Inside Front Cover 

by Franklin W. Young 

Worship, Our Ministry 139 

by Robert E. Cushman 

A Man to Stand in the Gap 146 

by Gene M. Tucker 

On Styling It 152 

by Charles K. Robinson 

Focus on Faculty 161 

by Paul A. Mickey, Robert L. Wilson, 
and Robert Terry Young 

Looks at Books 167 

Editorial Committee : Frank Baker, Donn Michael Farris, Paul Field, 
Ray C. Petry, Charles K. Robinson, Robert L. Wilson, and McMurry 
S. Richey, Chairman 

Published three times a year (Winter, Spring, Autumn) 
by The Divinity School of Duke University 

Postage paid at Durham, North Carolina (27706) 

Worship, Our Ministry 

Robert E. Cushman 
Dean, Duke Divinity School 


Today we enter upon the forty-fifth academic year of the Divinity 
School. As the first established graduate professional school of 
Duke University, the Divinity School began its distinctive service 
to Church and University in 1926. Today it is an honor and privilege 
to greet returning students, in the name of the University and the 
faculty, and to welcome the new students who come to partake of 
what we can offer here. We are committed to offer, in word and deed, 
the substance of Christian faith as a life and a vocation. In the course 
of your passage, and ours, we hope that your misgivings may recede 
before enlarged understanding and firm aspiration for ministry in 
Christ's name. A theological school is not an escalator ; it is more 
nearly a ladder of discipline which may, if you will, assist you "to 
make your calling and election sure" (II Pet. 1 :10). 

This morning, as in previous years, we reassemble in this opening 
convocation of praise and thanksgiving. We remember that our Lord, 
in discharge of his ministry, arose a great while before day and went 
into the desert to pray. Because we do not suppose that our need of 
prayer is less than his, we reassemble as a community for worship. 
We propose to make our beginning in worship as, indeed, the Chris- 
tian life — if it is to be possible at all — must begin, continue and end 
in worship. So today we find worship our starting-point and believe 
that in this context we may rediscover again, also, our reason for 
being as a school. 

For a theological school, worship is native air. This morning I 
propose to show that it is not only the matrix of our life as a school, 
but the substance of it. Our presupposition is God and God as Lord. 
In this convocation we properly begin our year in acknowledgment 
of Him. 

In the final analysis, all worship is man's acknowledgment of God. 
Its language is the language of response. Accordingly, this convoca- 

Divinity School Opening Convocation Address September 22, 1970. 


tion intends at least two things. First, it convokes the Divinity School 
community for listening and for self-recognition as a people who are 
addressed. But, secondly, our convocation intends that our communal 
self-recognition should take place in the corporate recognition of 
God. For it is necessary, if we are to know ourselves in our dis- 
tinctive corporate identity, to recognize ourselves as a community 
under God. Yet we can do this only as a people at worship. There- 
fore it is further clear that the prior purpose of this convocation is not, 
primarily, that we meet here to relate to one another, but that our 
meeting is open to a wider dimension of Being, which we assemble to 
acknowledge. Moreover, finding one another in the presence of God 
may be the only auspices under which we can really meet and get 
through to one another at all. If there is to be a real community of 
men with men, perhaps it must begin, continue, and end in worship, 
that is, under the acknowledged Lordship of God. This at least is 
the message of the Bible. With it, there is no lasting community of 
man with man save under the common acknowledgment of God. 


No other division of the University avowedly operates on the 
prior acknowledgment of God either as its presupposition or reason 
for being. It is not, however, that God as Lord is denied by the other 
schools ; it is only that their reason for being does not have acknowl- 
edgment of God as the distinctive objective of their function. Even a 
department of religion in the University may delineate the phenomena 
of faith, without either enjoining it or inviting acknowledgment of 
its presumed divine Co-implicate. If a theological school were simply 
a "school of religion" as a part of the Graduate School of Arts and 
Sciences, its faculty would be under no mandate save to exhibit the 
historic forms of the Christian consciousness in relation to the suc- 
cession of its institutional expressions, called churches, and possibly 
to indicate contextually suitable models for today. 

But, eo ipso, 2l theological school has God as its presupposition and 
his acknowledgment as its reason for being. It is the momentous if 
neglected distinction between knowledge and acknowledgment which 
signifies the difference between the kind of study that confines itself 
to the phenomenology of religion, even of the Christian religion, and 
the kind of endeavor that goes on here or in any school of theology. 

To add that we are a professional school helps but does not fully 
disclose the differentia of a seminary unless "professional" is taken 


in its literal sense — as it may be — meaning "to profess." In that case, 
what is entailed in our context is a profession of faith. That pro- 
fession of faith takes the form of ministry, or, better, is embodied in it. 
And that ministry is a ministry after the fashion of Christ. 

Now, none takes upon himself such a ministry unless he professes 
its significance for him and its mandate upon him. This is when 
profession of faith issues in practice. When profession issues in 
practice, there is evidence that knowledge has been transformed into 
acknowledgment. And acknowledgment of God is worship. Con- 
versely, when, after the analogy of electrical conduits, acknowledg- 
ment is transformed downward, "stepped-down" to the voltage level 
of knowledge, faith gives way to conclusions rated according to more 
or less probability. Then, worship becomes something else — prob- 
ably "science" or some form of it. Then profession of faith ceases 
to be also vocation, that is, a personal commitment, and may become 
the subject-matter of a learned discourse. 

No theologically literate person, responsible for this Divinity 
School, supposes that it is a school of the science of religion. On the 
contrary, in a variety of ways — some more informed than others — all 
recognize that the Divinity School is pledged to education for min- 
istry. But, if so pledged, then by implication pledged also to ac- 
knowledgment of God in the form of life commitment. Students do 
and may come here to find out whether they can make that com- 
mitment their own, but they cannot rightfully presume or expect that 
the school, for its part, will share their ambiguity, or that it should 
intentionally accommodate its purposes to their own ambivalence. The 
school is prepared to nurture, embrace and assist. It is prepared to 
illuminate, exalt, and invite participation in the ministry of Christ, but 
it is not permitted to denature its own distinctive role and purpose 
as keyed to that ministry. 


The subject of this convocation message today is worship. What 
has so far been said is intended to introduce the subject in relation 
to our role as a Divinity School. I have suggested that our endeavors 
after knowledge here have a distinctive difference from those of other 
schools. It is proposed that all our endeavors after knowledge have 
their proper issue in acknowledgment, namely, the acknowledgment 
of God. Acknowledgment entails the involvement of the whole man. 
On the one hand, it means hearing and being grasped and, on the 


other, it means loyalty. Acknowledgment entails a pledge, a commit- 
ment; and commitment is a giving up to the other. Generically, I 
have said acknowledgment of God is the heart-meaning of worship. It 
is, in fact, self-offering. 

So I say also that worship as acknowledgment is the aim and 
end of this school ; the end is not scientia, science ; the end is consent 
to the Being of God. As worship is the end, so prayer, as the language 
of worship, is the medium of its fulfilment. Plainly, then, this school 
has a distinctive role and purpose just because it has a distinctive 
presupposition. Every school has its distinctive presuppositions: 
For Law, it is that, in the strife of counter claims and counter claim- 
ants, order is better than disorder and equity the surest bar to in- 
justice. For Medicine, the presupposition is that health is better than 
disease and that there are ways of avoiding the one and enhancing 
the other. Neither Law nor Medicine, as such, may wish to probe be- 
hind these presuppositions for, let us say, their ontological co-impli- 
cates. For Divinity, however, the presupposition is ontological. It 
is God as self-disclosed, as mysteriously eruptive in history, in the 
ministry of Jesus called Christ. Plainly, with this presupposition, the 
derivative purpose of a Divinity School is the nurture of men and 
women for acknowledgment of God after the manner of and by par- 
ticipation in this ministry. But now, as the acknowledgment of God 
is worship, so the acknowledgment of God by participation in Christ's 
ministry is, precisely ministry in Christ's name. Therefore, from 
the Christian standpoint, worship and participation in the ministry 
of Christ are inseverable and, in most respects, one and the same 
thing. Hardly, therefore, can this school nurture in ministry apart 
from worship, nor worship without nurture in ministry. Where these 
fall asunder, worship and ministry, both are denatured. 


This outcome, then, invites a closer look at the question, what 
is the worshipful life, or what are the parts of worship? If we would 
know, at least in Christian perspective what is the nature of worship, 
then, in fact, these things are best disclosed in a life. The meaning 
of Christian worship is its manifestation in a worshipful life. For it 
is my thesis that the ministry of Jesus Christ is the fulfillment of 
worship. Because I cannot say better or more concisely what I 
wrote and published some years ago in a volume entitled, Worship 


in Scripture and Tradition (Ed. M. Shepherd, Oxford Press, 1963), 
I will quote the summation : 

"To sum up, in 'the full, perfect, and sufficient sacrifice' of Jesus 
Christ, the whole meaning of the Law is fulfilled, in unfaltering love 
of God and unhesitating love of man. This is the enpersonalization 
of worship; therefore the early Church saw it as God's own deed. 
God himself set forth this sacrifice to be an 'expiation' for sin available 
to those who receive it in faith (Rom. 3:25). The true worshipper 
is, first, Jesus Christ himself, and true worship is attained for those 
who, 'crucified with Christ,' walk in newness of life. This is life in 
which God's dominion is regnant. It is life in which autonomy is no 
longer reserved, and in which the stewardship of all life is acknowl- 

The article might have been entitled "the enpersonalization of 
worship." What is meant is that, in the personal history of Jesus 
Christ, that is his ministry, is fulfilled all that God requires of man in 
acknowledgment of Him. Accordingly, I also wrote: "The worship 
of the New Testament is celebration of the fullness of sacrifice. It 
is the unreserved acknowledgment of God accomplished in Jesus 
Christ and, through him, made possible as the vocation of every man. 
Worship is living sacrifice, a way of life open to the humble and the 
contrite heart — but a heart moved to contrition by 'the glory of God 
in the face of Jesus Christ.' " {Ibid., p. 41) 

Christian worship is living sacrifice in the likeness of Christ's 
ministry. It is a way of life open only to the humble and the contrite 
heart. It is only this openness that has in it any possibility of par- 
ticipation in the sufferings of Christ or the unreserved acknowledg- 
ment of God the Father as the mastering motivation of existence. 
It is only such openness to the Grace of God's forgiveness that will 
sustain and empower a would-be-follower for the hard, long, fre- 
quently disappointing and toilsome way of ministry in Christ's name. 
Without this openness, this self-abasement in the presence of his 
sacrifice, without a recurring unreserved acknowledgment of "the 
glory of God in the face of Jesus Christ," I am convinced that 
nothing that we do here as a faculty and nothing that may happen 
to you here as students will count for very much for very long 
toward the enlargement of God's lordship among the children of men. 

In this and other eras — now in one way, now in another — aspirants 
after the manner of Christ's ministry presume to buy it too cheap. 
Nothing is needed more these days, I think, than to rediscover with 


St. Paul what it means "to die with Christ in the likeness of his 
death" in order to be able to rise with him to "newness of life" (Rom. 
6:4,5). It is this newness that makes ministry possible. Only so 
is it supportable through all the chances and changes of this mortal 
life. Only so can Christ's "yoke" be easy and his "burden" light. To 
resolve that paradox requires more than all things human. 


So far, then, we have identified the truly worshipful life. We have 
found in it the fullness of worship because also the fullness of sacrifice. 
It is this fullness that, in fact, we call the ministry of Jesus Christ, 
and in our own worship we find it fitting to celebrate his victory. 
Our worship is always, and appropriately, thanksgiving as well as 
confession, and celebration as well as dedication to mission. 

But here we may pause to observe that perhaps a perennial weak- 
ness of Christian worship — that of the churches and that of all of us 
— has been a greater readiness to celebrate than to participate. It 
may be a greater readiness to celebrate the victory of Christ by way of 
the liturgy than to endure his sufferings. It is in this way that we 
divorce liturgy from life. In this way, we reduce ministry to good 
works and liturgy to ceremony. So, this divorcement fosters, as it 
also manifests, two perennially recurrent aberrations of the Christian 
religion, the enshrinement of worship or prayer without works and, 
conversely, the desacralization of worship or works without prayer. 
Liturgy is for life. It pre-figures ministry and may empower it. Yet 
the current dismissal of liturgy is understandable insofar as it has 
become celebration divorced from participation. The recovery of 
liturgy will be the remarriage of celebration with participation. 

Finally, then, what is this ministry that comprises the substance 
of our worship? The answer is openly declared in the New Testa- 
ment ; and, in the Old, there are foregleams of its manifestation. The 
ministry of Jesus Christ is just exactly suffering God to be Lord of 
the whole life. It is embodying in the rugged stuff of daily vocation 
the words of the Psalmist : "O my soul, thou hast said unto Jahweh, 
Thou art my Lord. I have no good beyond thee." To mean it, to 
make "I have no good beyond Thee" the spring of thought and action 
is suffering God to be God in "the muck and scum of things." It is 
heeding and enacting the words of the Shema : "Hear, O Israel : The 
Lord our God, the Lord is One." Worship is fulfilled in the Old 
and the New Testament when God is the One, that is, when he is 


acknowledged with all the soul, mind, and strength. At that point 
there is a true worshipper. All idols and lesser gods are dethroned. 
"I have no good beyond Thee" is the end of both pluralism and am- 

The suffering of Christ is first of all his suffering God to be Lord. 
Thus was the fullness of worship and sacrifice. It was the onset of 

That was the first victory and after that the other was conse- 
quential. The remainder of worship for one who has no good beyond 
God is the freedom to seek the good that God wills. That good is the 
inclusion of the neighbor also in the love of God. It is both to care and 
to labor for the neighbor's good. This is the second part of worship. 
It, too, is fulfillment of the commandment. For, said Jesus, "and the 
second is like unto it : Thou shalt love thy neighbor as thyself" 
(Mk. 12:31). The ministry of Christ, and his victory, is the fulfill- 
ment of the two-fold commandment. This is true worship. It is the 
unreserved acknowledgment of God. It is the prototype both of our 
worship and our ministry. 

The question that confronts us all is the question whether ministry 
can really be enpersonalized in us? Not, I think, in our own strength 
without the plainest presumption and the assurance of failure : Surely, 
not until, like Isaiah in the Temple, we behold the Lord, high and 
lifted up, acknowledge the uncleanness of our lips, and receive the 
divine cleansing (Isa. 6:1-8). Only thereafter may we be able to 
receive a mission and discharge a ministry. If this should come 
to be in some mode and measure then it will be true that mission and 
ministry have issued from worship. It will be true that worship is 
the enablement of ministry, and ministry is the fulfillment of worship. 
They will remain forever inseverable. So be it, Amen. 

A Man to Stand in the Gap 

Gene M. Tucker 

Ezekiel 22:23-31 
I Timothy 1:18-20 

When the invitation to speak at this service first came to me it 
was inevitable — most of you will know — that I should first ask myself, 
"What genre, what Gattung, is most appropriate for this particular 
Sitz im Lcben ?" Then I thought : You are leaving, and I am leaving ; 
since many of us are departing from this world, perhaps a last will 
and testament is called for. But I rejected that idea; the occasion 
is solemn enough as it is. And, after all, the baccalaureate sermon 
is a distinctive genre, well-known in our society. It is closely related 
to the commencement address. It belongs to a distinctive setting, 
follows within broad limits a certain form, and has a particular in- 
tention. Perhaps the most common feature of the baccalaureate 
sermon, whether it is to the local high school or the great university, 
is its free use of empty cliches, such as "The youth of today is the 
hope for tomorrow." It speaks about the challenge of the great 
world "out there" and the open future which lies before the new 
grads. It is full of admonitions to work hard and to remain faithful 
to some kind of "ideal." One of the best graduation addresses I know 
of is one by Art Buchwald, who summed it all up: "All right now 
kids, we've given you a great world. Now just don't go and foul 
everything up." 

And what divinity school baccalaureate would be complete with- 
out a text from Timothy ? 

It is inevitable that this sermon will follow some of those patterns. 
If not I would be contradicting everything I have said to you about 
genres of speech and their settings. And I don't want to do that so 
late in the day. 

But I want above all to speak personally, as we think together of 
what you have before you in the years ahead ; and I want to be as 
faithful as possible to our tradition, represented in the text from the 

Dr. Tucker, formerly Associate Professor of Old Testament in Duke 
Divinity School, is now on the faculty of Candler School of Theology, Emory 


book of Ezekiel. This is a text which speaks not only to the exiles of 
Israel in Babylon, but to all of us who perceive our existence in 
many ways as exile. Further, it has a particularly pointed word for 
those of us who have responded and do respond to God's call to 
special duties. 


This speech by Ezekiel is presented not as his own thoughts but — 
as usually is the case in the prophets — as the very word of the Lord. 
The situation is the exile. The land of Israel — the holy land promised 
to the fathers and received from God's gracious hand — lies in ruin. 
The temple — the chosen, holy place — is a pile of stone. All of Israel's 
old sacred institutions have come to an end. And for the exiles in 
Babylon as well as the tattered remnant in the land, it is a fate almost 
as bad as death itself. 

Ezekiel is looking back somewhat nostalgically to the days before 
the fall. What went wrong? How could such a thing happen to 
God's chosen people? The point of this speech is to answer such 
questions. And what he says is nothing new. It had already been 
shouted by the prophets as early as the eighth century: Your cor- 
ruption and evil and violence — especially in high places — lead to 
death and destruction. What is different is that now — now that it 
is too late — the people hear and understand. It is just possible that 
we who feel our world crumbling around us can hear the warning in 
these and similar words before it is too late. 

The prophet first reviews the failures and crimes of all classes of 
Israel's leaders. He specifies the sins of each in turn — the princes, 
the priests, the prophets, and the landed aristocracy — in order to 
emphasize the radicality of the evil in the land. He is not willing to 
confine himself to one problem or one group, but tries to say it all. 

First, the princes : ". . . they have devoured human lives ; they have 
taken treasure and precious things; they have made many widows in 
the midst of [the land]." Can't you hear that same word in the 
weekly report of casualties from Viet Nam — and now Cambodia? 
Statesmen and politicians and princes and presidents are making 
many widows, not only in this land but in many others. And taking 
treasure and precious things. Is that the prophetic word in the de- 
fense budget and the reports of the systematic destruction of property 
and vegetation in Viet Nam? 

Next he turns to the priests : They "have done violence to my 


law . . . they have made no distinction between the holy and the 
common, neither have they taught. . . ." One of the most important 
duties of ancient Israel's priests was to teach, not only the distinc- 
tion between clean and unclean, but all the covenant requirements to 
the community. Such teaching involved handing down the tradition, 
and also interpreting it in each concrete situation. If people are not 
taught, how can they act responsibly ? And here is one of those sharp 
words for us : When and if we fail to teach, or in our teaching dis- 
tort the nature of Christian responsibility — for example by identifying 
Christian ethics with the morality of one class or another — we blur 
the distinction between the holy and the common. 

And the prophets : They "have daubed for them with white- 
wash, seeing false visions and divining lies for them, saying, 'Thus 
says the Lord God,' when the Lord has not spoken." A lying prophet 
is a contradiction in terms, for a prophet is simply one who tells the 
truth. He speaks the word of God. But it is not always easy to tell 
the truth, and many prefer to follow the teaching of Flip Wilson's 
prophet Leroy. The prophet Leroy says, "A lie is as good as the 
truth if you can get somebody to believe it !" 

But today we are finding prophets — and prophets of doom — in 
surprising places : The quiet academician who has spent years in his 
laboratory examining water samples, the civil servant who spends 
his days studying specimens of air from above Los Angeles or Dur- 
ham, and the little slip of a girl who works for Planned Parenthood. 
These and many like them are telling the truth : Massive action on an 
international scale is required immediately if our planet is to survive ! 

Finally Ezekiel turns to the landed aristocracy : They ''have prac- 
ticed extortion and committed robbery; they have oppressed the poor 
and needy, and have extorted from the resident alien without redress." 
The Lord holds the rich and powerful responsible for the plight of 
the poor and — if we may interpret the text loosely — for the oppression 
of minorities. Can't we hear that same accusation in the reports of 
poverty and hunger in rural communities in the South, of unemploy- 
ment and underemployment of blacks, South and North? Granted, 
all are not equally responsible simply because they are rich. But if 
someone is allowed to starve by those who are able to provide food, 
there is oppression as surely as if bread had been snatched from a 
man or milk from a baby, oppression by employers who discriminate 
or government officials who ignore the hard facts about hunger while 
storing tons of surplus food. 



Thus Ezekiel deals with the crimes of the princes, the priests, the 
prophets and the landed aristocracy, crimes which led finally to the 
downfall of the nation. But all of this, his catalogue of sins, is merely 
background. That was — and to a great extent is — the situation. This 
just summarizes some of the problems — war, poverty, racism, the 
ecological crisis — and notes some of the duties of leaders. To put it 
somewhat grimly as Lucy has been telling Charlie Brown recently, 
"These things are very high on my list of 'Things You Ought to 
Know.' " Or only somewhat more optimistically with Pogo : "We are 
faced with insurmountable opportunities !" 

The special word for us — here and now and in the years ahead — 
is in the sentence which follows the catalogue: "I sought for a man 
among them who should build up the barricade and stand in the gap 
before me for the land . . . but I found none." In that situation, once 
upon a time in Israel, the result of the Lord's failure to find a man was 
disaster. It can happen again — do you believe it? — if you and I do 
not take this word more seriously than it was taken in pre-exilic 

The Lord seeks, first of all and quite simply, a man. No special 
qualifications are given. No experience is necessary. Behind this 
search lies the assumption that God's will for his people will not be 
accomplished without men who respond to his call. The biblical tra- 
dition never lets us forget that men shape history. And now we begin 
to hear the word of hope in this account of tragedy : The future can 
be changed, if the Lord can find a responsive man. 

It is reassuring that all the Lord seeks is a man, but it is also 
frustrating. The danger, especially in our time of instant communi- 
cation and greater awareness of the multiplicity of powerful economic 
and social and political forces which shape our existence, is that we 
become convinced that the individual is helpless and ineffectual. The 
result is paralysis. But more and more men and women, especially 
in your generation, are realizing that the only way one can maintain 
his humanity is to act as if his decisions make a difference. And they 
do. Our awareness of history surely teaches that not only do historical 
circumstances produce men but men affect history. 

Next, the Lord wants his man to stand. I interpret that as both 
a call to stand up and an admonition to endure. First, to stand up, 
to speak in accordance with conscience, lest, in the words of the letter 
to Timothy, one make a "shipwreck of his faith." One could, of 


course, quibble about the ambiguities of conscience. We all know that 
conscience depends to a great extent upon training and experience. 
But let us come clean : On the basic issues we know what is right. 
Our Christian tradition and training and experience have taught us 
that much. War is hell. Racism is wrong. There is no way to justify 
poverty in our rich land. And, as far as I know, according to any 
doctrine of creation in the Christian tradition, the rape of nature 
stands condemned. 

Naturally, we shall continue to disagree concerning the solutions 
to these complex problems. But neither these disagreements nor 
one's lack of total knowledge of a given situation qualify as excuses 
to remain silent. Our main duty is to call attention to the problems 
and to point directions, as we see them in the light of the Gospel. 
The role is similar to the one which historian and philosopher R. G. 
Collingwood perceived for himself. He said, "When Rome was in 
danger, it was the cackling of the sacred geese that saved the Capitol. 
I am only a professorial goose, consecrated with a cap and gown and 
fed at a college table ; but cackling is my job, and cackle I will." 

And if we need an example of a contemporary "sacred goose" 
whose cackling has been heard, look at Ralph Nader. Almost single- 
handedly he is bringing about reforms in the safety standards of the 
automobile industry, and now turning to other fields. One young 
man who had given up a very promising and lucrative career to 
work with Nader for the protection of the consumer said, "If I don't 
do it, who is? There is a tremendous amount of satisfaction in know- 
ing that." 

But it may turn out to be even more difficult to endure than to 
stand up. I am confident that most of us can stand up in the dra- 
matic moment, and risk everything when the issues are clear. But, 
God save us, what is required is standing day by day, when the issues 
seldom are clear, when the routine and boredom of apparently in- 
significant duties begin to take their toll. 

Two things will enable us to endure. First, we have the knowl- 
edge that we are not alone. You and I need one another and — what 
is more — we know that we need one another. However much we are 
separated geographically, we stand together. We shall think of one 
another often in the years ahead, and take courage. When I am 
tempted to despair, I think of the Lord's response to Elijah when he 
whined that he was the only faithful man left in Israel : "Look around, 
there are at least seven thousand who haven't bowed the knee to Baal !" 


And then we have hope. Pessimism has no survival value at all. 
But hope and expectation arouse and sustain the determination to act, 
to do what is possible. The word of judgment, when it is required, 
is viable because it is predicated upon hope. You know — as did the 
prophets before you — that beyond and even within the word of judg- 
ment lies the word of salvation. You are able to point to wrong and 
call for change within the church and the society not just because you 
want something better, but because the Gospel demands and promises 
a future, God's future. 

Finally, God calls for his man to stand in the gap. Ezekiel is 
thinking of the battle, of the city under siege, when the wall has been 
breached. The Lord needs a man for the most vulnerable place, the 
front line, where the action is. 

Now, as never before in America, the front line is the church at 
the local level. That's where the action is. William Sloan Coffin 
said recently, "People say, 'The church is a crutch.' My answer is: 
'It certainly is — but what makes you think you don't limp.' " And you 
are going to be, to a great extent, the church at the local level, whether 
you are destined for the small parish in rural North Carolina, an 
assistantship in the suburbs of Chicago, a mission school in Sarawak, 
or even a private school in New England or a public school in Florida. 
You will be the church by virtue of your training here and — more 
importantly — by virtue of your calling, which may be no more than 
your perception of the human needs around you. 

God grant that each of us may be, in the years ahead of us, the 
Lord's man to stand in the gap. 


On Styling It 

Charles K. Robinson 
Associate Professor of Philosophical Theology 

Skillful adaptiveness, we all know, may be an important virtue. 
After all, that ultimate authority, "SCIENCE," teaches — does it 
not? — the adaptive "survival of the fittest." Yet we have also learned 
not to give unqualified respect to skillful adaptiveness in any and 
every form. Take the middle class, establishment-oriented conformist, 
for example — and that is the example we usually take : we all know 
as a current "self-evident truth" that establishment conformism, wher- 
ever it rears its ugly head, is bad. However, I would derive little 
satisfaction, and you small benefit, were I merely to belabor today's 
version of self-evident truth. 

Rather I am going to say that conformism is where you find it. 
Or more accurately, conformism is wherever it functions — whether or 
not you "find" it, that is recognize it, there. I would even be willing 
to say that, functionally viewed, some of the prime loci of conformism 
in our culture are cults of "noncomformity." 

Now that we have the material essential to all theology to work 
with — namely, a "paradox" — let us begin to demythologize it. We 
can, of course, only do this by means of another myth. So let me 
sketch out one. Let us pretend that there are imaginary creatures 
whom, for want of a better name, I will call "cool stylists." 

The cool stylists are the children — twenty years later — of the 
"other-directed" members of David Riesman's The Lonely Crowd 
(1950, read it!). They are indeed the appropriate offspring of their 
parents' seed, come to harvest in due season in a space meanwhile 
grown much closer together and light years more distant apart and 
in a time now hot as "the lake of fire" and cold as "the outer dark- 
ness" of Apocalypse. 

Style — if you'll pardon something as out-of-style as a little meta- 
physics — is the analogicality of concrete expressions of sensibility 
mediated through concrete modes of embodiment. As analogical, 
style is a concretely perceivable integration of relationality and indi- 
viduation : of participation and differentiation, of dependence and 
origination. The stress, however, is on the side of relationality: 


participation and dependence. As an embodying expression of sensi- 
bility, style is functionally adaptive. 

For our imaginary creature, the cool stylist, his life-embodiment 
is his expressive style ; his life-sensibility is his interiorizing adaptive- 
ness. Life as he lives it has little by way of larger purpose or end 
for the sake of which adaptiveness and style might function as means. 
Life is simply lived as adaptive stylizing. 

The embodiment of the cool stylist is the style of his external 
image as projected by him and received by others — namely, others 
who count, other cool stylists who are "in." The embodiment of 
the cool stylist is thus constituted by the principle of Bishop Berkeley : 
esse est percipi, to be is to be perceived. If the style of his image- 
projection is perceived favorably,' he is "in" ; he exists. If it is un- 
favorably perceived, he is "out" ; he exists not ; he is nihilated. 

The sensibility of the cool stylist is the adaptiveness of his finely 
tuned computer adjustment which is constantly calculating the feed- 
back he is getting on his radar screen. The sensibility of the cool 
stylist is thus constituted by the principle of B. F. Skinner : to be 
is to react to determining stimuli. (Though, indeed, Professor Skin- 
ner might be hard put to account for the tacitness and subtlety of the 
behavioral clues to which the skilled stylist reacts!) 

In the life of this imaginary creature, the cool stylist, the dialectic 
of the functional relation between inwardness and outwardness is a 
basically simple one. He indeed interiorizes. He is in a peculiar 
sense quite introspectively "reflective." He may even be at times 
painfully "self-conscious." But the controlling mode of his inward- 
ness is simply the interiorization of externalities. He is, again, indeed 
"expressive." Style is expressive or it is nothing. But the controlling 
mode of his outwardness is simply the momentary expression of his 
immediate impressions. 

His immediate impressions, moreover, are immediate impressions 
of the immediate impressions of other cool stylists. In the game of 
cool stylism it always takes at least "two to tango." Though indeed 
"group grope" is better. "Instant intimacy" is best served in mass 
phenomena. The ideal is total interchangeability. The open secret 
of every cool stylist is that he does not know who he is. His only 
really functional identity is a group-identity. Hence he is radically 
vulnerable to rejection by and isolation from the group. 

I spent one summer during college years living alone in the fire 
lookout tower on top of Bald Mountain in Idaho. I had no radio 


and rarely used the phone except for reporting fire information. I 
went for weeks at a time without beholding a human face. I had 
nature and God and silence and no man but myself. That summer was 
one of the richest experiences of my life. But, for the cool stylist, a 
summer at hard labor in Siberia would be preferable. There, at least, 
would be a group ! 

The circular dynamics of cool stylism as a group phenomenon 
reminds me of one of my favorite cartoons by one of America's great 
cartoonists, Thomas Nast. (Actually, I had to wait awhile to enjoy 
the cartoon. It was published in Harper's Weekly in 1869.) Nast 
himself, while a master of style, was nobody's cool stylist. He in- 
dignantly rejected a private offer of half a million dollars to "cool it" 
and take a European vacation ! In this cartoon Nast pictures the 
members of a political organization known as Tammany Hall standing 
around in a circle. The caption reads, "Who stole the people's money?" 
In the picture each person in the circle is pointing to the person 
standing next to him. The conclusion is perhaps that every body 
did it and hence no person did. 

The circularity of the game of cool stylism is a trick with mirrors. 
Every body in the group is reflectively mirroring every body in the 
group. The mirroring game has no transcendent in-put of content. 
Some content there must, of course, be — but only as a contingent 
necessity. The kind of content matters little. The game has no trans- 
cendent purpose beyond the exhibition of adaptive skill in playing it. 
"The play's the thing." The circularity is hollow and empty. But 
boredom and futility are staved off by dynamisms of change and inter- 
changeability, novelty and feeling. 

Intensity of feeling is not incompatible with the "coolness" of 
cool stylism. Feeling is okay as long as it is not kept private and as 
long as it serves the superficial group rapport of pseudo-intimacy. 
Indeed the more intense and sensation-al the generation of immediate 
feeling the better. For boredom is never more than a step away. But 
through it all the cool stylist must not "lose his cool." Through it all 
he must remain peculiarly detached. Yet for the adept adaptor this is 
scarcely difficult. He does not know or believe in himself enough to 
be capable of involving and committing himself deeply and enduringly. 

Let me indulge in a little more metaphysics. Integration involves 
the complementary interpenetration of transcendence and immanence. 
The level of integration is a function of the depth of the transcendence 
and the comprehensiveness of the immanence involved. Now, the 


experiential togetherness of cool stylism is integrative. Indeed, 
integration is its only essential positive function (though its negative 
functions are manifold). But the integration tends to operate down- 
ward toward the level of the lowest common immediate contextual 
denominator. The depth of the integration is essentially superficial 
and the comprehensiveness of the integration is essentially exclusi- 

The cool stylist can find his functional identity only as an "in- 
group" identity in reaction to others. Similarly, a collectivity of 
cool stylists can find its functional group identity only as an "in 
group" in reaction to some other group which functions in negatively 
identifying contrast as an "out group." YAF needs the SDS as 
surely as the SDS needs YAF. Thus if any of my imaginary creatures, 
the cool stylists, actually existed they could as well stylize themselves 
on the radical right as on the radical left. Attitudes, slogans, and 
ideology the cool stylist must have. But which is essentially a matter 
of indifference. (Though if the cool stylist were to recognize this fact 
he might begin to discover himself as a self.) Cool stylists are not 
leaders, but they are peculiarly susceptible to manipulation and ex- 
ploitation by the charismatic leader of the left or right. All they like 
sheep have gone astray and may be led ... to the slaughter. 

Cool stylism is characterized not only by superficial relational 
immediacy but also by ahistorical absorption in the temporal present. 
In his rhetoric the cool stylist may appeal to heroes, real or imaginary, 
in the past and extol the ideological program of the "inevitable" 
wave of the future. But he is substantially concerned neither with 
mastery of comprehensive rootage in historical traditions of the past 
nor with enduring commitment to practical action and long-range 
planning toward the task of shaping the historical future. He lacks 
the temporal-historical transcendence to live in the sustained dialectical 
tension between recollection and hope. He lives only in the present 
tense where experience is to be experienced. There is neither yester- 
day nor tomorrow. There is only always now. Satisfaction must be 
obtained and tensions relieved now. Instant victory, instant euphoria, 
instant capitulation, instant sex, instant interchangeability. All values 
of life are ideally concentrated in the instant pay-off: the enduring 
climax of the "good trip" in which time stands still and euphoria is 
all there is ... is all there is ... is all there is . . . 

Now I have been saying, somewhat with tongue in cheek, that, 
cool stylists are creatures of my imagination. There is some truth iru 


that. No one can simply be a cool stylist without remainder, anymore 
than a man can simply be a machine. Yet human beings can asymp- 
totically approach becoming simply cool stylists. Frankly, I have yet 
to meet a Duke Divinity student who approximates very far toward 
cool stylism. And, while my contacts with undergraduates are now 
rather limited, I would doubt that the majority of college students 
could be classified as "cool stylists" without many important reserva- 
tions and qualifications. 

But this sketch of cool stylism might be tentatively suggestive in 
pointing toward one direction in which a considerable part of our cul- 
ture, especially among teen- and subteen-agers may be moving. I say 
this with concern and — God knows — with compassion. It is not as 
though youth were somehow perversely opting against meaning in 
favor of meaninglessness ! It is rather that they are increasingly 
unable to find significant meaning. 

I have thus far talked, not too happily, about "cool stylism." How- 
ever if I may paraphrase and reverse Shakespeare — I come not to 

bury style, but to praise it. 

I have good reason to praise style : like . . . namely ... I could 
use some. If you've ever happened to notice how I walk down the 
hall, you'll recognize that I have some stylistic problems that are quite 
unsolvable — and you won't bother to ask me whether I used to be a 
basketball star. I have other stylistic problems that may be equally 
serious. I am, for example, supposed to be a professor of "philosoph- 
ical theology" and yet I know everybody knows there isn't any such 
thing. I am, to my shame, as Bultmann would put it, not only 
"weltanschaulich" but also "metaphysisch." And you just can't be 
anything more out-of-style than that. I could add that I'm still in the 
process of "questing for the historical Jesus." (I wouldn't, of course, 
mention these things, except that they've already leaked out.) The 
sum and substance of my anachronistic professional plight is that I 
have somehow or other gotten myself irrevocably committed to the 
lifetime task of system-building, trying to integrate into one compre- 
hensive world view all kinds of unlikely partners, such as wave- 
particles and Jesus. Now, for being out-of-style, man, you just can't 
beat that ! 

But I'm really not hostile to such stylistic helps as I can get. 
For example, I noticed awhile back that men's ties had gotten wider 
while I wasn't looking. I rushed right down to Sears and bought one. 
I would have been willing to buy several, but even with my SRC 


I couldn't quite afford that. I would have worn it this morning but 
it doesn't go with black. And under this robe you can't really tell 
what I'm wearing, anyway. Also, I noticed last summer that men's 
hair styles were getting longer. So I've let my hair grow a little 
longer too. I was glad to make that stylistic adjustment since I've 
long been in process of losing my hair, anyway. 

Also, I pay some slight attention to women's styles. I have, for 
example, noted the existence of the mini-skirt. I might add, by way of 
cultural observation, that in the midst of transience, flux and rapid 
social change, there is a basic human need for some stylistic stability 
somewhere. Accordingly, it would, I think, be helpful in this transitory 
life if the mini-skirt, at least, can endure. As for the maxi-coat, 
neither time nor stylistic proprieties allow me to express myself. 

Clearly, and on any accounting, there is a great deal of novelty 
in the stylistic factors of contemporary life. Yet the degree of novelty 
is likely not as great as may appear on the surface. A great deal 
about style is not basically new. 

The centrality and essentiality of style in human life and culture 
is, as such, certainly not new. The achievement of any great human 
civilisation has always been in considerable measure correlated with 
the richness and comprehensive integrativeness of its stylistic com- 
ponents. Style has, in antecedent epochs, served the functions of 
concretely mediating, expressing and commun-icating the transcen- 
dent values and depth insights and commitments, as well as the more 
superficial orientations, of human interpersonal life in more or less 
comprehensively integrating ways. 

Style, we say, can either "turn-on" or "turn-off" receptivity in 
the processes of would-be communication. But this in itself is not 
new. Style has always functioned to facilitate communication or dis- 
functioned to block communication. Style affects, often crucially, 
interpersonal and intergroup relations. It always has. Stylistic rap- 
port has always served to mediate community. And major stylistic 
differences have always operated as both effect and cause of inter- 
personal and intergroup alienations. None of this is fundamentally 

What is new — relatively new, since there is no absolutely new 
thing under the sun — is the contemporary cultural matrix which 
affects and is affected by style. 

New is the interconnected complexification of our global culture. 
The increasingly intricate network of interconnectedness means that 


escape from interrelation with one another in ever-more-complex 
ways is impossible or, even if possible, disastrous. This complexifica- 
tion is a more bewildering challenge to human life-integrative powers 
than that faced in any previous and relatively more simple epoch. In- 
sofar as the overwhelming tasks of effective and comprehensive inte- 
gration are not accomplished, the options are schizophrenic rejections 
of the integrative tasks or lowest-common-denominator superficial 

New also is the ever-increasing momentum and acceleration of 
the global processes of interconnected complexification — yet further 
complicated by the differential paces of acceleration in different com- 
ponents and dimensions of global culture, with resultant "cultural 
lags" and increased tensions. 

In tribal communities and even in previous great civilizations, 
especially among the masses who were not style innovators, contex- 
tually appropriate style could be adaptively acquired by the young, one 
might almost say, "by osmosis." Little conscious attention to style and 
certainly no painful "self-consciousness" about it was required. That 
day is gone, presumably forever. 

Today, and for all our foreseeable tomorrows, inattention to style 
is a luxury of irresponsible sloth which our humanity can no longer 
afford. Some basic principles of what is required are simple enough to 
state: (1) The interconnected complexification of our culture de- 
mands sensitivity to and some mastery of not one style, but many. 
(2) The ever-increasing acceleration of cultural change demands 
constantly alert adaptiveness to changing contexts and stylistic inno- 
vations. (3) The communicative will to understand will increasingly 
demand a depth sensitivity toward significant meaning which can 
penetrate beneath superficial differences of styles to discern the depth 
of content, meaning and intention which they express — not being 
easily "turned off" by stylistic differences. (4) On the other hand, 
the will to communicate will increasingly demand a flexible stylistic 
adaptiveness so as not unnecessarily to "turn off" those to whom we 
want to, need to, must communicate. 

There are two, opposite, ways of "copping out" on the human 
stylistic task. The cool stylist cops out by reductionistically equating 
human life with life-style, reducing himself to mere stylizing for the 
sake of nothing beyond the empty circular game of reactive adaption, 
foregoing depth commitment and forfeiting transcendent purpose 
and meaning. The rigid traditionalist cops out in the other direction : 


unable or unwilling to distinguish between style and meaning or 
form and content, he clings inflexibly to the relative simplicity of 
prior weddings of transcendence and immanence, determined stat- 
ically to hang on, even at the cost of the break-down of the immanence 
of communication and the break-down of interpersonal life. 

The Apostle Paul once wrote: "I have become all things to all 
men that I might by all means save some." Paul was keenly sensitive 
to the possibility of and need for a variety of viable weddings of 
immanent style and transcendent meaning. Paul had some fairly 
definite notions about the transcendent meaning of the gospel of 
Christ and the Christian life. But he was too wise to equate these 
with externalities of stylistic expression. And he was too compas- 
sionately committed to restrict his communication to those who might 
respond to a single style. Paul's task is the task of the Church today 
and tomorrow. Doubtless that task is much more complex than it 
was in Paul's day. But the same Spirit is with us. And He is able 
insofar as we are willing. 

If style becomes everything; if "the medium" simply "is the 
message" : the message is nihil ; the message is that there is no 
message. But, on the other hand, if the message is not relevantly 
mediated there is no message either: for the message exists only in 
its being communicated. 

Now and again I am haunted by the words of the Simon and 
Garfunkel song, "The Sounds of Silence." God in heaven knows . . . 
I want to communicate. I know — I say I "know" it — there is some- 
thing overwhelmingly, incommensurably important to be communi- 
cated. For that I live, and insofar as I cannot do that I die. But so 
do we all — whether or not we know it. 

Not everything in life can be measured. Insofar as reality is 
transcendent it cannot be measured : it is incommensurable. Skillful 
adaptiveness as a basic life-orientation (whether in unlimitedly flexible 
cool stylism or in establishment-oriented conformism) undercuts the 
human capacity to recognize the incommensurability of transcendent 
reality and thereby undercuts the possibility of genuine faith, love, 
trust, obedience and worship. The adept adaptor may be, if he so 
chooses, quite skillful in using language and performing acts which 
would be relevant and appropriate to love or even to worship. But 
his language and acts are hollow style without relational depth and 
meaningful comprehension, though he himself — never having ex- 


perienced, and being securely insulated against, the real thing — may 
have little awareness of self-deception. 

All genuine experience of transcendent reality exhibits a two- 
sided paradox: on the one hand, a recognition of the incommen- 
surability, such that no possible expression can be fully or adequately 
expressive in response to the reality known; yet, on the other hand, 
an inescapable compulsion to express some relevant, appropriate 

So it is with the experience of falling in love. The "lover" who 
thinks he can adequately express his love is — whatever he may be — 
not in love : he has not experienced an incommensurable relationship. 
Falling in love cannot be adequately expressed. But, on the other 
hand, the "lover" who can avoid any expression of love, perhaps 
because it is not adequately relevant or appropriate, is not genuinely 
in love either. For falling in love compels expression — no matter 
how inadequate. 

So it is with faith. So it is with worship. 

There may be principles of style, but there is no such thing as a 
"manual of style." Style is communicated and learned tacitly and 

But I will conclude with just two little suggestions for life-style: 
humor and seriousness. If you cannot "hang loose" to the jolts and 
surprises of life with a transcendent sense of humor, especially to- 
ward yourself, God have mercy on your mortal life; you're in for a 
pretty rough time of it. But if, on the other hand, in and through all 
the relativities and contingencies and trivia of life, you cannot 
serve the times with an ultimate seriousness, God have mercy on your 
soul. This life matters. You had better believe it, baby. You had 
better live it. The task of Christian life-style is, in ever-changing 
contexts, to say in ways that may be heard, two words, which are 
distinguishable but not separable: "God" and "love." 


Paul A. Mickey 
Assistant Professor of Pastoral Theology 

One year ago I had no inkling that I would be in Durham, 
let alone on the Divinity School faculty this fall. But our whole 
family is taking it in stride. One thing about being a minister's son, 
having wrestled in school, being a private pilot as well as an ordained 
clergy, I've learned to take my opportunities when they come. So 
it is. The opportunity to come to Duke was surprising and offers 
unexpected potential to me, my family, and hopefully to the students 
and fellow faculty members who must bear the brunt of my insights in 
the field of pastoral theology. 

Being here continues to amaze me. Growing up in Ohio one went 
to college at Ohio State either to study medicine or play football. I 
enjoyed both football and medicine in high school but never went to 
Ohio State. In fact I joined the Air Force right after high school 
in order to avoid going to Ohio State or that now famous university, 
Kent State, where I attended high school and where, in a revolution- 
ary fit of insight my senior class nominated and elected me president 
from the "convention" floor. Kent State or Ohio State would have 
been all right but long before the days of Joe Kapp or Joe Namath I 
held out for a grant-in-aid to attend Harvard College. After four 
years churning through the enlisted ranks of the Air Force, winding 
up as one of the youngest (if not the youngest looking) peace time 
Staff Sergeants, I jumped at an early out, took my accrued leave- 
time pay, bought a diamond (at PX prices), being a firm believer in 
the "theology of hope" five years early, for someone in the future 
who I trusted would eventually become known to me ! 

After getting in shape for freshman football by working on con- 
struction work during the summer of 1959 I started Harvard four 
years behind my times. Through sleight of hand or lapse in imagina- 
tion I was admitted to the first of the Harvard Freshman Seminar 
programs, not, as I found out later, because of academic qualifications 
but because I had made enough money sharecropping while in high 
school to buy a car. The Seminar was the best part of my freshman 


year because seminar was a joint Harvard-Radcliffe group. The 
professor had statistically proven (at Sarah Lawrence) a positive cor- 
relation between bust size and intelligence; this astute academic in- 
sight was further exchanged by the fact that these seminars began in 
the dark ages of undergraduate education when RadclifTe girls did not 
try deliberately to look ugly as they seem to today ! That seminar was 
the saving grace for three years of Harvard. The fourth year and all 
years since, have been saved by my marriage to the former Jane 
Becker, of Lancaster, Pennsylvania. With good Dutch "plain folk" 
blood cheerfully coursing through her presence, Jane, long before the 
public was aware of the "tell it like it is" campaign, showed the value 
of calling "a spade a spade" in the Mickey household — and we're all 
stronger for it. 

At Princeton Seminary I spent most of my time scrambling: 
grubbing for grades, negotiating two new foreign languages (Greek 
and Hebrew), part-time jobs, time with my family, and a more 
mature understanding of the church, due largely through a wonderful 
relationship as student assistant under Ken Wildrick at the Com- 
munity Congregational Church, Short Hills, New Jersey. I finished 
out my B.D. work with a senior thesis on "Hartshorne and Freud" 
under Seward Hiltner, took an inner city assignment in the Ohio 
East Conference (EUB), and became, almost on schedule a father 
for the second (and thanks to miracle medicines!) and last time. The 
inner city work was nip and tuck all along including my promise to 
Jane that I would paint the driveway and sidewalks at the parsonage 
green so my children would at least know what color grass (lawn 
type) looked like. 

Through the sudden availability of a Fellowship I began doc- 
toral studies in September, 1967 under Seward Hiltner in Theology 
and Personality. By May 1970 my dissertation (which my wife 
claimed was harder to understand than some of the physics papers 
she had typed as a secretary) was complete, and immediately follow- 
ing my oral examination Jane and I drove from Princeton to Durham 
to house hunt. 

My greatest concern before coming to Durham seems unfounded 
now : my "southern drawl" has not thickened. We are settled com- 
fortably, enjoying the warmth and privacy of our home in Durham 
and the openness of airways for private flying. A lingering but daily 
reminder from my parish in Bay Head, New Jersey, calls me forth 


to my tasks here : the senior highs in that parish gave me a desk pen 
set as a going away present, inscribed : "Do It To It, Rev." 

Robert L. Wilson 
Research Professor of Church and Society 

In an age of mobility one may come from many places. My child- 
hood and youth were spent in the anthracite coal region just outside 
Scranton, Pennsylvania. Graduation from high school which came 
during World War II was followed by three years as a medical corps- 
man in the Navy. A portion of this time was spent aboard an escort 
carrier in the Pacific. 

With the end of the war, I joined the returning veterans crowding 
the college campuses. My undergraduate work was taken at Asbury 
College. This was followed by an M.A. in American History from 
Lehigh University. 

At this point two significant events occurred. First, I was married 
to Betty Berenthien of Macon, Georgia. Second, we moved to 
Havana, Cuba where we taught English to Spanish speaking students 
at Colegio Metodista Central. After two interesting years, punctuated 
by the revolution which ended Cuba's last elected government, we 
returned to the United States. 

We moved to Chicago where I became pastor of the Wyclif 
Methodist Church, an inner city congregation located just southwest 
of the Loop. I also attended seminary at Garrett and became a 
member of the Northern Illinois Annual Conference. 

Upon completing seminary I became a Research and Teaching 
Fellow at Garrett, a post I held while completing a Ph.D. in Sociology 
of Religion at Northwestern University. During this period I also 
taught at the National College of Education. 

After graduate school I joined the research staff of the National 
Division of the Board of Missions which was first located in Phila- 
delphia and subsequently in New York. I remained with the National 
Division for twelve years, the last seven as Director of the Department 
of Research and Survey. This department serves as the research 
arm of the National Division and conducts a variety of research and 
planning studies for churches and Methodist denominational orga- 
nizations throughout the United States. 


Here at Duke I shall be working in two related areas. The first will 
be teaching in the area of church and community. The second will be 
as Director of the J. M. Ormond Center for Research Planning 
and Development, which will involve studies for churches and de- 
nominational groups. The center will therefore have both an edu- 
cational and service function. 

We moved to Durham from New Jersey in mid summer and are 
living on Monticello Avenue. We have two children, Keith, fifteen, 
and Marian, ten. 

Robert Terry Young 
Assistant Dean for Admissions and Student Affairs 

There were thirteen children in my large, active, and independent 
family. We were all born in a small, rural section of Buncombe 
County in the Western North Carolina mountains. I am the twelfth 
of these thirteen children and I was born some thirty-five years ago 

Until I became a student in Scotland, all of my education was 
gained in North Carolina schools — in the public schools near Ashe- 
ville, undergraduate studies at the University of North Carolina in 
Chapel Hill, and seminary work at the Divinity School of Duke Uni- 
versity. When I finished Duke, my family and I spent the year 1960- 
61 at the University of Glasgow in Scotland where I was a special 
student in Trinity College. 

And then, to work in a local parish. There for nine years and now 
back at Duke — in a new role, of course. 

In the process, many things have happened to me and with me. 

The most important experience that has happened to me con- 
tinues — in my relationship with my wife, Jackie. She has worked 
hard now for fourteen and one-half years trying to keep me honest and 
real and open. Not an easy task ! Our relationship began at Carolina 
on February 19, 1956, continued through an election where she ran 
for secretary of the student body and I for president. We both won 
and served in 1956-57. She was Miss Alumna and I Mister Alumnus 
of the U.N.C. Class of '57. 

We made "Mr. and Miss" into Mr. and Mrs., and she went to 
work teaching to put me through Divinity School. We have expanded 


our family and now have four young Youngs — Sherri Leigh, Terri 
Lynn, Robby, and Andrew — the oldest eleven and the youngest four. 

We have served in three parishes — when I was Associate Min- 
ister in a Church of Scotland church ( 1960-61 ) , Minister at Skyland 
Methodist Church (1961-67), and at Boone United Methodist Church 
(1967-70). Hopefully, we have ministered and served in each place. 
Surely, we have learned in each. 

I have always been related to the church — baptized in a little 
Baptist Church at twelve years of age, joined the Methodist Church 
at fifteen, and have been there ever since. I was moderately active 
in the church in high school and college — after all, a young man's 
interests are wide and varied at these times ! 

Seminary was a mind-stretching, faith-deepening experience for 
me. I began to learn that the church, and its people, are to serve 
and love and care rather than just to be loved and served and cared 
for. This learning came as I saw some people really concerned about 
others. Included in my seminary days was a period of cynicism, 
and I was ready to leave the church. From all I could see, the church 
was a money-seeking, self-satisfied, and prejudiced institution that 
promoted those ministers and laymen who "played the game" and 
rejected or ignored those who did not. And, I did not care to waste 
my ministry in such an institution. 

I then met a friend who helped me to see that a man can be a 
man and serve God also ; that a man compromises and "sells himself" 
only if he wants to ; and that a man can have a creative, honest min- 
istry if he seeks it. With this friend's guidance and support, I headed 
for the parish ministry. 

All along there have been persons who have helped me see what 
living and ministry are to be — Bernard Boyd and Hugh Lefler and 
Bill Poteat and Jim Wallace at Carolina; John Carlton and Egil 
Grislis and Don Williamson and Bob Cushman at Duke; William 
Barclay and G. H. C. McGregor and Willie Wright in Scotland; 
Carlyle Marney at Interpreter's House; Ed Harrill and Ruth Ingle 
and George Kirchoff and Ruth Petrey in the parish. 

There are many experiences that have been meaningful to me, 
but my greatest vocational satisfactions have come from two types of 
experiences : being a pastor and being a preacher. No greater or 
deeper joy can a man feel than that he knows when he feels claimed 
by God to preach a given message or when he feels led by God's 
Spirit to show compassion for a person in need. 


Life is caring. My purpose in the church, and specifically in being 
here at this time, is to try to let someone (and hopefully many "some- 
ones") know that I care. To be human and to allow others to be 
human, all the time knowing that we are loved by God and are to 
love one another. It's hard to care. Or, it is, for me. But, this is what 
life's all about to me — at least for the present time. 



Thomas Coke: Apostle of Methodism. John Vickers. Abingdon. 1969. 394 
pp. $14.50. 

During his own day Dr. Thomas Coke was misunderstood and vilified by- 
many who were jealous of his speedy rise to prominence in the Methodist 
movement, and especially of the great trust reposed in him by the aging John 
Wesley. Such men too readily jumped to the conclusion that Coke was little 
more than a vain and ambitious man who in his zeal for pre-eminence inserted 
his finger in too many Methodist pies. In spite of occasional tributes to Coke's 
enthusiasm, generosity, and self-sacrifice, he has constantly been pursued by 
this tradition of being a little man with grandiose ideas about his own impor- 
tance and destiny. At long last we have a carefully-documented and honest 
portrait of the man, in the pages of Mr. John Vickers' Thomas Coke: Apostle 
of Methodism; at last we are able to see him in the round. 

The word "round" is deliberately chosen, for what struck most people when 
first they set eyes on Dr. Coke was his rotund figure, five foot and one inch 
tall, but compensating with corpulence for what he lacked in height, topped 
off with what William Wilberforce described as a "smooth apple face, and 
little round mouth," so that "he looked a mere boy when he was turned fifty." 
This is revealed by his portraits, though not so fully in the one chosen as the 
frontispiece for this volume. 

Until now, however, it has been much more difficult to visualize Coke in 
the round spiritually. Earlier writers have not tried, or have found it an almost 
impossible task, to portray his global enthusiasm from every angle, but have 
concentrated a malevolent, or a myopic, or even an admiring eye, on one 
aspect or another only, so that they have drawn little more than a two-di- 
mensional plan of one part of the man, instead of giving us an experience 
of the spinning globe of Coke as a restless ecclesiastical conjuror dizzily 
changing his many hats. Only a multi-volume work could adequately ac- 
complish this formidable task, but Mr. Vickers has come as near a definitive 
biography in this handsome volume as we can reasonably expect. 

This book began to take shape when the author was invited to deliver the 
Wesley Historical Society Lecture for 1964 on the subject of Coke, upon whom 
he had been working for some years. His researches have continued during 
the following years, greatly enriching the final product. Especially valuable 
has been Mr. Vickers' search for Coke's letters and other manuscripts, and his 
researches among many allied documents not touched by Coke's earlier bi- 
ographers. The mass of materials thus accumulated has been carefully gleaned 
to provide many hitherto unknown details about Coke's life, as well as il- 
lustrations serving to bring him to life for the modern reader. 

The first few chapters deal chronologically with the early phases of Coke's 
life — his childhood and youth at Brecon in Wales, his carefree career as a 
gentleman commoner of Jesus College, Oxford, his ordination and curacy at 
South Petherton in Somerset, where John Fletcher's writings led to a deepened 
sense of his spiritual calling, so that he became more and more "Methodist" in 
discharging his parish responsibilities, even trying to substitute Wesley's 
hymns for the Psalms in public worship. In 1776 he was dismissed from his 


curacy, and his enemies celebrated the event by pealing the church bells and by 
broaching several hogsheads of cider in the street. 

When they first met that year Wesley was 73, Coke not quite 29. Although 
Wesley was served by many trusted senior lay itinerant preachers, and even 
by one or two ordained helpers, Coke quickly gained his confidence, and became 
his right-hand man, at first travelling with him, and then setting forth as his 
deputy on various missions, both as evangelist and as trouble-shooter. This 
culminated in the epochal year of 1784, when Wesley signed the Deed of 
Declaration which incorporated the annual Conference to take charge of 
Methodism after his death, prepared a revised Book of Common Prayer for 
overseas Methodists, and began ordaining preachers for America. In each of 
these important steps Coke was in close consultation with Wesley, though in 
each instance Wesley himself was in control, and apparently pushing Coke 
rather than being pushed, as has frequently been charged. 

This year of 1784 witnessed the proliferation of Coke's own activities to 
the point where his enthusiasms almost ran away with him. He continued to 
serve as Wesley's chief supervisor over British Methodism, he published his 
first appeal for overseas missions, and he became the senior bishop and co- 
founder of the Methodist Episcopal Church of America. Over three-quarters of 
Mr. Vickers' book is devoted to following these three major themes through 
the remaining thirty years of Coke's life, in a series of overlapping and inter- 
meshing chapters, with one chapter devoted to a fourth theme — important, yet 
subsidiary to the other three — his literary work. 

Although Coke had at first been somewhat prejudiced against the Amer- 
icans, he was sincerely converted to a deep sympathy for their cause, a genuine 
love of the American landscape and people, and a keen desire to serve American 
Methodism fully as their senior bishop. In this he was constantly being 
frustrated by Francis Asbury. Asbury was two years older than Coke, had 
loyally served American Methodism through its most trying decade, and had 
insisted that if he were to accept ordination at Wesley's behest and at Coke's 
hands he would only do so after a vote of confidence from his American 
brethren. Coke's wanderlust seems to have justified Asbury's reluctance to 
yield him any real episcopal power. In spite of the Welshman's sincere offer 
to put America first and to live there permanently if accorded authority and 
loyalty, after his ninth visit he left in 1804 intending to return but in fact never 
did, having married a frail English wife — though he continued in readiness for 
the recall that never came. Nevertheless his ministry in America left lasting 
marks, not only in conversions and new societies, but in securing the overthrow 
of Asbury's proposed government of American Methodism by a permanent 
council, for which Coke won the substitution of the system of annual and 
general conferences which still prevails. 

In his attitude to Negro slavery Coke was well ahead of contemporary 
American opinion, and this occasionally involved him in serious trouble, as 
when he urged the Christmas Conference of 1784 to threaten slave-holding 
Methodists with expulsion. In order that the general work should not suffer 
unduly, however, he found it expedient to moderate the vehement expression of 
his views. Although he was similarly deeply concerned about slaves in the 
West Indies also, he was less militant about slave-owners there, possibly be- 
cause American opposition had convinced him that it might be wiser to attack 
some social evils indirectly and gradually, even though this was quite contrary 
to his temperament. 

Coke's standing in British Methodism was prejudiced not only by jealousy 
over his comparative youth but by his involvements both with America and 


overseas missions. Nevertheless he maintained his position as Wesley's 
lieutenant. He shared the direction of Irish Methodism to such good effect 
that even though at the Irish Conference immediately following Wesley's death 
the preachers elected one of their own members to preside, in most subsequent 
years this honour and responsibility was accorded Coke, who maintained, "I do 
love Ireland above all other places" — though it must be acknowledged that he 
said the same thing about America also. It was Coke who was chiefly re- 
sponsible for founding in 1799 a successful mission to the native Irish, followed 
a year later by a similar Welsh-speaking mission in his own native country. 

In England also Coke remained a dominant force after Wesley's death, 
even though in their desire to avoid having "another king in Israel" the preach- 
ers at the 1791 English Conference similarly passed over Coke to elect the rela- 
tively obscure William Thompson as their first President. Mr. Vickers points 
out that this rebuff was graciously taken by Coke, although Alexander Mather, 
who was also rejected, was "deeply wounded," and circulated an angry handbill. 
Coke accepted instead the arduous though less prestigious task of serving 
as secretary to the Conference, a position which he occupied for seventeen of 
the twenty-three conferences between Wesley's death and his own. When in 
1797 Coke intimated that he intended returning to America permanently the 
British preachers pleaded with him not to do so, and showed their sincerity by 
belatedly electing him as President, which they did a second time in 1805. 
He was, indeed, one of their best friends, and it was he more than any other 
preacher who was responsible for the formation in 1803 of the Committee of 
Privileges, and for its subsequent success in defending Methodists from dis- 
criminatory legislation. 

Despite his genuine claims to lasting gratitude as a builder of both British 
and American Methodism, however, Coke is chiefly remembered as the un- 
doubted father of Methodist missions. In 1784 he published A Plan of the 
Society for the Establishment of Missions among the Heathens, following this 
up in 1786 with An Address to the Pious and Benevolent, proposing an annual 
subscription for the support of the missionaries in the highlands and adjacent 
islands of Scotland, the Isles of Jersey, Guernsey and Newfoundland, the West 
Indies, and the Provinces of Nova Scotia and Quebec. Almost unaided he 
wrestled with Wesley and the British preachers to secure men and money 
for such ventures. His mission to the Caribs of St. Vincent was unsuccessful, 
as was one to Sierra Leone in 1796, but other undertakings were eminently 
successful. This was especially true of his great missionary love, the work in 
the West Indies, the dearer to him because he regarded the storm which drove 
him and his Canadian-bound missionaries to Antigua in 1786 as a providential 
sign. He made only four tours of the islands, occupying about seven months 
in all, his last ending in 1793, but he continued to supervise the expanding 
mission there, he fought successfully in 1808 for the right of the Jamaican 
Methodists to minister among the slaves, and in the midst of all his other 
labours compiled A History of the West Indies in three volumes (1808-11). 

Thomas Coke could not be confined to the West Indies, however, no more 
than to the varied aspects of home missions in Britain, among the soldiers in 
Gibraltar, in the Channel Islands, and even in revolutionary France, for which 
he brushed up his French. He wanted the world for Christianity. In 1798 the 
Methodist Conference legitimized what it could not ignore by officially desig- 
nating him for the task that he had long been carrying out, naming him 
superintendent of overseas missions. His was almost a one-man show. He 
generated what little missionary enthusiasm there was ; he raised money, often 
by arduous collecting from house to house, as well as by dipping deeply into 


his own pocket and that of his wife ; he recruited men ; he formulated and 
directed policy, so that when he was absent in America the committee ap- 
pointed to assist him was almost helpless. 

Frustrated by poorly-chosen leaders and the killing climate from realizing 
his persistent dream of founding Methodist missions in Africa, increasingly 
Coke's eyes turned to the east. In 1800 the Conference authorized him to send 
a missionary to Madras, though the project did not materialize. During the 
years 1805-6 he sounded out the Directors of the East India Company, and 
made several abortive attempts to begin an Indian mission. In 1809 his atten- 
tion turned to the more promising prospect of Ceylon as a springboard for 
India, and in 1811 he secured Conference authorization for the venture. Dur- 
ing the years of preparation he lost one wife, married another, and lost her 
also, yet pressed on through his grief with what was becoming his master 
project. In 1813 he even secretly offered himself as a candidate should an 
Anglican bishop be appointed for India, apparently having in mind the needs 
of India far more than the merits of Thomas Coke, though this indiscretion 
furnished further evidence to his enemies of his personal ambitions. Rescued 
from an imprudent third marriage by the skin of his teeth, and plagued by 
controversy over the expenditure for the mission, on 30 December 1813 Coke 
set sail with his companions, only to die and be buried at sea. The mission 
itself continued, however, and became his lasting memorial. 

Mr. Vickers has told Coke's complex story with sufficient detail to bring 
it to life, but not to distort the perspective. The secular background is touched 
upon only so far as it is essential for grasping the main point of any incident, 
and further research in those fields is needed for a full understanding of Coke's 
relationships with the leaders of British politics and the interactions of 
Methodism with the world of the Napoleonic wars. Coke himself is painted 
"warts and all." We see his simple piety and his gullibility, the Welsh charisma 
of his eloquent preaching and his administrative acumen, the charm and courtly 
manners which readily won friends, and the impetuous lack of tact that lost 
them. We are not surprised to discover that he needed to be handled with kid 
gloves, so ready was he to take offence, though swift and generous in for- 
giveness. We realize that his many projects, his mercurial enthusiasms, were 
in some part the side-effects of emotional instability, though beneath lay a 
solid foundation of deep concern for people deprived of the gospel, which 
sustained him in the courageous facing of monotonous labours, frequent frus- 
trations, and constant criticism. 

Thomas Coke: Apostle of Methodism appears in a handsome format — 
indeed one wonders whether the margins on the heavy paper are somewhat too 
ample, especially at the foot. The printing is well executed, with a minimum 
of the almost inevitable printing errors, though two of these are in prominent 
places — "Louisberg" instead of "Louisburg'' on Mr. Curwen's attractive front 
endpaper map, and "Cosummation" as the Contents title for Chapter 23. Some 
of the errors are probably slips in the typescript, such as William Newcome 
(correctly) in the text for the Archbishop of Armagh, but "Newcombe" in the 
index, and the consistent spelling Edward "Smythe," though the evidence of 
Smythe's many publications shows that he spelt his name without the final "e". 
The apparatus is of real value, especially the list of 62 publications by Coke, 
but this reviewer would have valued a chronological summary that enabled the 
reader to find his way at a glance through the complexities of Coke's life. 
These, nevertheless, are minor flaws in a work of major importance, which 
will almost certainly remain the definitive life of Thomas Coke for this 



The Bible Reader: an interfaith in- 
terpretation. Prepared by Walter 
M. Abbott, S.J.; Rabbi Arthur Gil- 
bert ; Rolfe Lanier Hunt ; and J. 
Carter Swaim. Bruce (New York) 
and Geoffrey Chapman (London). 
1969. 995 pp. $7.95. 

Here is a book of a thousand pages 
at a modest price (paperback), pre- 
pared by no less than four editors 
of three faiths. It consists of many 
things, all in one. Foremost, it is a 
shorter Bible (about fifty-fifty) in- 
cluding something from every book 
except Second and Third John. Even 
the Apocrypha is represented, in six 
of its major books, and is here 
entitled "deutero-canonical" (reflect- 
ing Catholic usage, as contrasted with 
Jewish practice). The Biblical text 
printed is a mixture of the RSV, the 
Catholic Confraternity edition, and 
the Jewish Publication Society ("Old 
Testament") plus the Tor ah; unfor- 
tunately, the separate passages are 
not labeled. 

Further, the book has brief and 
elementary commentary — on the Bible, 
on each Testament, on each book, and 
on each passage ; it is again unfor- 
tunate that the distinctive contribu- 
tion from each editor and so from 
each faith is not identified. The 
Commentary is a pot-pourri of inter- 
faith ideas, not resolved in harmony or 
agreement but merely standing in 
juxtaposition. The editorial philos- 
ophy holds that "if we know more 
about each other we can hope to live 
together in harmony." This is cer- 
tainly not a truism, and yet it ex- 
presses the optimistic reason for this 
mixture of ingredients. Most of the 
Commentary is commonplace, and 
some would impress one as indoc- 

The intellectual position of this book 
is a humanistic liberalism such as was 
common among us a generation ago. 
We are reminded of our "pluralistic 
society," of current extra-religious 
legal opinion, and of objective de- 
cisions as to scriptural questions. The 

editors would "live together" in mat- 
ters of history, literature, culture, and 
religious institutions ; implying that 
this way lies harmony, if not unity. 
It is considered useful to learn merely 
"why another believes differently" 
though we still remain different. Our 
Bible is optimistically defined as "a 
book that binds the world together," 
even though this Bible belongs to a 
minority of the world's population 
showing little cohesion in our time. 

The Biblical criticism reflected in 
the editorial Notes is quite conserva- 
tive. The "Gospel according to Mat- 
thew" is attributed to Levi the tax- 
collector disciple. "The Letter of 
James" is attributed to James the 
Less, "the brother of the Lord" (said 
to mean really "cousin"). Other lit- 
erary problems are alluded to but deli- 
cately. Of course, "The Bible Reader" 
here is seen to be an uninstructed 
layman unaware of the many schol- 
arly investigations that underly this 
"interfaith interpretation." One may 
hope that as he reads, serendipity may 
reward him. 

— Kenneth W. Clark 

Amos and Isaiah: Prophets of the 
Word of God. James M. Ward. 
Abingdon. 1969. 287 pp. $6.50. 

The stated reasons for treating 
these two prophets together in one 
book, instead of the more usual 
combinations of Amos and Hosea or 
Isaiah and Jeremiah, are that they 
were the first literary prophets to 
Israel and Judah, respectively and 
also that there is considerable literary 
and theological affinity between the 
two, in addition to their near con- 
temporaneity. One may add that the 
amount of genuine literary material 
from each of these two prophets is 
approximately the same : most of the 
nine chapters of the book of Amos 
may be considered as coming from 
the prophet of that name, whereas 
of the sixty-six chapters in the book 
of Isaiah, barely ten can be reliably 


attributed to the original prophet. 
Thus it comes about that this study 
is divided almost equally between the 
two protagonists. 

Professor Ward believes that the 
book of Amos is mainly "a collection 
of oracles composed initially for oral 
publication," afterwards recorded in 
haphazard fashion. Thus our author 
feels no need for minute literary 
analysis and so uses most of the 
allotted space for discussion of the 
prophet's message and of the prophet's 
theological stance as deduced from his 

This discussion begins with the 
confrontation of the prophet by Ama- 
ziah, priest of Bethel (7:10-17). Here 
our author scores a good point by 
returning to the use of the past tense 
in 7:14bc, as in the King James 
Version, against the present tense of 
more recent translations. Since the 
passage stands in a past context, a 
past translation of these nominal 
clauses is grammatically valid. It may 
indeed be true that Amos zvas not a 
prophet originally; but he could hard- 
ly have said "I am no prophet" while 
in the very act of delivering one of 
the most significant prophecies in the 
entire Bible. 

In general it can be said that Ward 
is not trying to be old-fashioned or 
new-fashioned ; he looks calmly at the 
whole gamut of critical study and 
tries to reach sensible and construc- 
tive conclusions. We have space only 
to summarize a few more of his 

The visions of 7:1-9; 8:1-3 are 
really only one vision, a "visionary 
drama," and is not necessarily to be 
connected with the call of the prophet. 
It is erroneous to assume that all 
prophets had inaugural visions. In 
any case, the implied doom is uncon- 
ditional with regard to the political 
existence of the Kingdom of Israel ; 
Amos never changed his mind on 
this, though he could very well have 
allowed for the survival of a rem- 
nant of the faithful. 

With regard to the antiforeign 
oracles, Ward is somewhat conserv- 
ative in denying the genuineness of 
only the oracle against Judah. In the 
presentation of these oracles under 
the head of "Liturgical Forms," a 
broad background is sketched, ex- 
tending all the way from the Egyp- 
tian execration texts and the curses 
from the royal archives of Meso- 
potamian Mari, both of the early 
second millennium B.C., to Jeremiah 
19, Deuteronomy 28, and Leviticus 
26, long after the time of Amos. Good 
background material is also presented 
for the cosmological doxologies (4:13; 
5:8; 9:5-6), leading to the conclusion 
that they might have been adapted by 
Amos from his liturgical environment 
instead of having been added by a 
post-exilic editor. This is not to 
say, however, that Amos did not 
criticize the sacrificial cult in Israel. 
He criticized it bitterly and probably 
even rejected it in principle, though 
without rejecting in principle all pub- 
lic worship. 

Finally, with regard to the "happy 
ending" (9:8b-15), Ward, rejects it 
flatly and completely as belonging to 
Amos : "There is not a single word 
in these lines about the righteousness 
that God demands of men." Here our 
author turns away from some of the 
newfangled criticism that allows a 
prophet to say something one day and 
contradict it the next. Was this 
prophecy without hope? No Amos's 
faith in the unwavering righteousness 
of God "was one of the truly hopeful 
factors in the religious consciousness 
of Israel in his time." That is prob- 
ably why his little book survived. 

We must deal more briefly with the 
second half of the book. Isaiah 6 is 
treated first, though Ward is not 
sure that the vision therein is inaug- 
ural. There is the problem of why 
the people were to be made too stupid 
to hear. Ward struggles with this 
without a very clear result, except 
that perhaps it was already too late 
for them to be saved or that they must 


become deaf to the wrong teaching 
which had misled them so long. Later, 
Ward says that Isaiah's "dominant 
tone" was negative and included 
"harsh criticism." 

In Chapter 6, Ward deals with 
Isaiah 7 and 8, especially the three 
children and their naming at the time 
of the Aramaeo-Israelite attack on 
Judah about 735 B.C. Shear-Yashubh 
is translated A-Remnant-Shall-Re- 
turn, but interpreted as "a remnant of 
them would be left," that is to say, 
both a warning and a promise. There 
would be a time of trouble, but not 
all would be lost if Judah trusted in 
God rather than in political expedi- 
ents. Immanuel is taken as another 
child of the prophet; the name means 
God-Is-With-Us, which is to say 
that God will be with us if we trust 
in him rather than in political ex- 
pedients — the same message as before. 
The reviewer has been teaching this 
interpretation for years and welcomes 
support for it. The name of the third 
child, M aher-shalal-hash-bas, is trans- 
lated as Speedy-Spoil-Quick-Plun- 
der, and refers to what will happen to 
Aram and Israel if Judah stands firm. 
In other words, all three names carry 
essentially the same message for 
Judah : practice your religion properly 
and stay out of international politics. 
The prophet's warning was not heeded. 

Chapter 7 treats of "Zion in the 
Oracles of Isaiah." Ward's view on 
Zion's inviolability is best expressed 
in his own clear words : "Isaiah never 
proclaimed the military or political 
inviolability of the city of Jerusalem, 
either in the present or future." The 
prophet could never have said, "My 
country, right or wrong," for righ- 
teousness was a key word with all 
the preexilic prophets. Ward feels 
that Isaiah felt that the sacrificial cult 
in Jerusalem was so bad that it must 
be destroyed at any cost. Only a 
purified city inhabited by a purified 
remnant could have satisfied the proph- 
et. Such a concept is expressed in 
2:2-4 and 4:2-6, though both of these 

passages, and especially the latter, 
may be later interpretative additions 
to the original book. 

Chapter 8 deals with "The Rem- 
nant and the Future King." Isaiah 
has traditionally been credited with 
the doctrine of the remnant and with 
much messianism. Ward takes up the 
latter idea first. The question is 
whether 9:1-7; 11:1-9; and 32:1-8 
are from the prophet or from a later 
editor. Ward is not sure about this, 
and so allows the possibility that these 
passages may be from the prophet, 
since they avoid the old nationalism 
and instead "represent a prophetic 
transformation of the Judean royal 
ideology." If they are not by Isaiah, 
they are by someone who was in his 
tradition in repudiating nationalism 
and cultism in favor of righteousness. 
With regard to the remnant idea, it 
does belong to Isaiah, as seen in the 
name of his first son, and as developed 
in 10:20-27, where we see present 
tragedy leading to a great hope for 
the future. 

This is a worthwhile book, with 
much of which the reviewer agrees ; 
but it is not an introductory work, 
and had best be read by those already 
somewhat advanced in their study of 
the Old Testament prophets. On the 
whole it is well written, well edited, 
and well printed. Two questionable 
translations may be noted : p. 234 
(Isa. 1:18), "Though your sins are 
like scarlet, they shall be as white as 
snow" probably should read "could 
be white as snow," since the promise 
was conditional, depending on good 
conduct; p. 242 (Isa. 4:4), the trans- 
lation "daughter of Zion" is clearly 
erroneous, since Zion did not have a 
daughter — Zion was the daughter; 
the proper rendering is "daughter 
Zion" or "maiden Zion." 

— W. F. Stinespring 

The Tendencies of the Synoptic Tra- 
dition. E. P. Sanders. Society for 
New Testament Studies, Mono- 
graph Series 9. Cambridge. At the 


University Press, 1969. 327 pp. 

Although form critics and others 
have for more than a generation 
spoken of tendencies and laws govern- 
ing the development of the synoptic 
tradition, the latter cannot be re- 
garded as having been clearly estab- 
lished. Form critics have classified 
the gospel material according to form 
and have shown or suggested its re- 
lationships to situations in the early 
church. They have not, however, 
established any "laws" for the trans- 
mission of tradition on the basis of 
a systematic study of comparative 
folk literature or oral tradition. While 
Gerhardsson has attempted to define 
these matters precisely on the basis 
of rabbinic procedures, his effort is 
less than convincing. For, on the 
one hand, he takes rabbinic statements 
concerning the transmission of tra- 
dition uncritically as indicative of 
actual rabbinic practice ; while on the 
other he assumes that the analogy 
between the Christian church and 
rabbinic Jewish communities is ap- 

Given this state of affairs, Sanders 
proposes to examine several commonly 
held principles or assumptions fre- 
quently employed in gospel criticism 
as criteria of whether traditional 
materials are early or late. While the 
relevance of Jewish and other sources 
is not denied, Sanders sets about to 
examine, as of primary importance, 
the tendencies of the Christian tradi- 
tion, using the evidence of the textual 
tradition, the early fathers and the 
apocryphal gospels. Sanders prin- 
cipally investigates three widely held 
principles or tendencies thought to 
be reliable indicators of change, and 
therefore lateness, in the tradition : 
increasing length, increasing detail, 
and diminishing Semitism. His can- 
vassing of the manuscript traditions, 
the fathers and the apocryphal gos- 
pels is not, of course, comprehensive, 
but wide enough to be adequately rep- 
resentative. The balance of the evi- 

dence supports neither the view that 
the later recension of a pericope is 
the longer nor the principle that 
Semitisms diminish in the transmission 
of Christian traditions. Yet on the 
whole increasing detail does seem to 
be a rather reliable indicator of 

Sanders' investigation, while neces- 
sarily not exhaustive, is an exemplary 
piece of scholarly research both in 
conception and in execution. The 
material he has collected will prove 
valuable for further study and re- 
flection. Interestingly enough, how- 
ever, Sanders' results are most closely 
analyzed with a view to their impli- 
cations for source criticism rather 
than form criticism ; and the author 
concludes that his research lends no 
unambiguous support either to the 
Marcan hypothesis or to its alterna- 
tives. It is nevertheless arguable that 
the implications of his study for form 
criticism may be equally, if not more, 
significant. Sanders' research may 
not support the Marcan hypothesis 
any more than it supports Farmer or 
Griesbach. But the Marcan hypothe- 
sis is basically a judgment based on 
the comparison of specific New Test- 
ament texts, not a theory dependent 
upon alleged general tendencies of the 
tradition. The argument from order, 
recently under such sharp attack, does 
not, as Farmer has pointed out, prove 
Marcan priority. It does, however, 
suggest either that Matthew and Luke 
used Mark or that Mark conflated 
Matthew and Luke. If these are the 
alternatives, most critics will probably 
go on believing that the more prob- 
able explanation of the relationship 
in view of the character of the texts 
and the state of our knowledge of 
early Christianity is that Matthew 
and Luke used Mark. 

At the least Sanders' research 
should put an end to loose generaliza- 
tions about the development of tradi- 
tion. Moreover, it shows that the 
Marcan hypothesis is neither confirmed 
nor overthrown by the evidence of 


the tendencies which actually emerge 
in later tradition. Readers of this 
Revieiv will be interested in the fact 
that Sanders' work was done orig- 
inally as a Th.D. dissertation at 
Union Seminary in New York under 
the direction of W. D. Davies, now 
George Washington Ivey Professor 
in the Divinity School. 

— D. Moody Smith, Jr. 

Wisdom, Christology, and Law in 
Matthew's Gospel. M. Jack Suggs. 
Harvard University Press. 1970. 
132 pp. $6.00. 

This new book by Professor Jack 
Suggs (Brite Divinity School at 
Texas Christian University) revolves 
basically around the examination of 
several synoptic pericopes which the 
author argues have been influenced by 
". . . Jewish and early Christian 
speculation about Sophia [Wisdom]." 
(p. 1) The thesis is that Wisdom 
speculation is not a "tangential" but 
an important and central part of 
Matthew's Christology. 

In Chapter I, "Traces of a Wis- 
dom Speculation in Q," the author 
assumes the existence of Q and in- 
terprets it in the light of a "gnosti- 
cising Wisdom speculation." Matthew 
23:34-36 (and its parallel, Luke 11: 
■19-51), the saying about the rejection 
of the prophets and wise men, is 
examined. It is concluded that this 
saying was derived from a lost wis- 
dom apocalypse originally given as 
an oracle by personified Wisdom. 
The use of this saying in Q demon- 
strates that Q has moved toward a 
Wisdom Christology, and therefore, 
does not have (at least in this say- 
ing) a Christology but rather a 

Chapters II and III deal with Mat- 
thew 11:28-30 and Matthew 23:37-39 
respectively which, the author argues, 
are dependent on Jewish Wisdom 
speculation. As an envoy of Wisdom 
Jesus (and John as well) is rejected, 
but in addition Jesus is a sender of 

prophets as was Sophia. Thus Mat- 
thew has moved away from "Sophia- 
logy" toward the identification of 
Sophia with Jesus. "Jesus is Sophia 
incarnate." (p. 58) "I hope that our 
investigation thus far has served to 
establish that speculation about Wis- 
dom emanated from circles which 
tended to see Jesus' significance large- 
ly in terms of his function as Sophia's 
finest and final representative, as the 
mediator of eschatological and divine 
revelation. . . . Matthew is at pains 
to correct the tradition in certain 
ways. First, he brings the tradition 
within the framework of the passion- 
dominated gospel form. Second . . . 
Matthew proceeds to an identification 
of Jesus with Sophia." (p. 97) 

Chapter IV, "Wisdom and Law in 
the Gospel of Matthew," contains the 
argument that for Matthew Jesus is 
the "Wisdom-Torah," "the embodi- 
ment of Torah." The Sermon on the 
Mount is naturally the locus for this 

Dr. Suggs concludes : "My thesis 
was that Wisdom speculation was a 
major current in Matthew's Chris- 
tian environment and that Matthew 
was a lively participant in the cur- 
rent." (p. 130) 

It is difficult in a work such as this 
to argue with the author unless one 
has the space to argue in detail. This 
is not possible here. The author has 
made his point in a well-written and 
logical monograph. The present re- 
viewer, however, feels that the case 
has been over-stated, but this criti- 
cism is not intended to detract from 
the very fine work and presentation 
by Professor Suggs. Perhaps it would 
have been better had the thesis been 
directed toward a broader interpre- 
tation of Matthew's gospel. This was, 
as the author stated, not the purpose 
of this work, but it would be useful 
and helpful to see a second volume 
with the thesis of this book applied 
systematically to the gospel as a 
whole. It may prove to be enlighten- 
ing especially in some passages. And 


further it would test the thesis that 
"Jesus is Wisdom Incarnate" in the 
broader context of the Gospel rather 
than derive this hypothesis from a 
few selected passages which are al- 
ready recognized to have wisdom 
motifs and overtones. This kind of in- 
vestigation would possibly lend sup- 
port to the conclusion of the author 
and also demonstrate where the thesis 
needs to be modified. 

This is a scholarly work not pri- 
marily suited to the needs of the 
average pastor, but those who will 
read it will find some interesting in- 

— James M. Efird 

Mark the Evangelist: Studies on the 
Redaction History of the Gospel. 
Willi Marxsen. Translated by Roy 
Harrisville et al. Abingdon. 1969. 
222 pp. $5.50. 

Marxsen's book first appeared four- 
teen years ago, and the second edition 
is now over ten years old. It has 
been extensively reviewed and dis- 
cussed, so there is scarcely need for 
another thoroughgoing Auseinander- 
setzung or summation at this point. 
(For a full report and critique see J. 
Rohde, Rediscovering the Teaching of 
the Evangelists, pp. 113-140.) 

The appearance of the English trans- 
lation does, however, afford an oppor- 
tunity for calling attention to the 
importance of the book. After Conzel- 
mann's The Theology of St. Luke, 
Marxsen's monograph stands as the 
second major work in the field of 
gospel redaction criticism. It takes 
up and continues the tradition of 
Wrede, Lightfoot, J. M. Robinson and 
others who have sought the theolog- 
ical meaning and purpose of the 
Second Gospel. 

Unlike the form critics (and un- 
like earlier interpreters), the re- 
daction critics have concentrated upon 
the editorial framework of the Gos- 
pels as the key to the intention of the 

Synoptic writers. Given the hypothesis 
that the framework is editorial, while 
the stuff of the individual stories and 
sayings is traditional, this procedure 
is altogether logical. Redaction critics 
have by the separation of tradition 
from redaction and the close analysis 
of the latter successfully contested 
the view of the early form-critical 
works that the Synoptic Evangelists 
were little more than collectors of 
traditional materials. They were 
authors in their own right. 

Perhaps Marxsen's chief contribu- 
tion is rigorously to set forth and 
advocate the redaction-critical task 
both by precept and by example. His 
attempt to see Mark as theologically 
informed proclamation rather than 
history is a healthy antidote to his- 
toricism, if somewhat exaggerated or 
one-sided. His effort to distinguish 
the purpose and character of Mark 
(an evangelion) from Matthew (a 
biblos) and Luke (a diegesis — the 
terms are found near the beginning of 
the respective gospels) may be some- 
what overdrawn. Nevertheless, it is 
a needful corrective of the once com- 
mon opinion that the Synoptics em- 
body a common point of view. While 
Marxsen may be correct in seeing 
eschatological expectation still very 
much alive in Mark and in taking 
16:8 to be the end of the original 
gospel, his theory that Mark is a 
Galilean gospel calling Christians to 
assemble in Galilee for the parousia 
of the Lord lacks unambiguous sup- 
port in the text. There is, for ex- 
ample, considerable evidence that 
Mark was written for a Gentile au- 
dience (presumably not in Palestine), 
as Rohde (p. 138) has pointed out. 
Moreover, if one were trying to 
assemble Christians for the imminent 
parousia, would writing a Gospel in 
which this purpose is at best subtly 
expressed to be the most expeditious 
way to go about it? To ask the 
question is to imply an answer. 

Nevertheless, Marxsen's book is 
full of valid and stimulating insights 


and worth the expenditure of effort 
entailed in working through it. 

— D. Moody Smith, Jr. 

Bonhoeffer's Theology. James W. 
Woelfel. Abingdon. 1970. 350 pp. 

As William Kuhns observed in the 
preface to his study of Bonhoeffer's 
theology (The Pursuit of Dietrich 
Bonhoeffer, 1967), Bonhoeffer's emer- 
gence as a focal theological figure 
for the thought and efforts of our 
time — from civil rights to a theology 
celebrating the "death of God" — has 
been rapid and unmistakable. Further 
evidence of the validity of this scarcely 
debatable assessment of Bonhoeffer 
is this latest addition, by Woelfel, to 
the growing, if not burgeoning library 
of Bonhoeffer interpretation. Hardly 
without exception the watershed that 
finally distinguishes the interpreters 
is, of course, the question of how one 
reads Bonhoeffer's call from the Te- 
gel prison for a "religionless Chris- 
tianity." The conservative approach, 
represented for instance by Thomas 
Torrance, reads the letters from prison 
altogether in terms of Bonhoeffer's 
previous writings and these, incidently, 
in terms of Barth. The revolutionary 
interpreters, such as William Hamil- 
ton, regard the letters as offering a 
radically new vision, to be pursued 
not by reference to Bonhoeffer's past 
but in the creativity and imagination 
of his successors who admittedly must 
go beyond Bonhoeffer himself. The 
middle road is taken by those who see 
"religionless Christianity" as the last 
phase of an organic evolution of 
Bonhoeffer's polyphonic, highly dialec- 
tical thought which focuses according 
to Woelfel (and also John Godsey in 
The Theology of Dietrich Bonhoeffer, 
1960) on Christology. On this as- 
sumption Woelfel is persuaded that 
another interpretation of Bonhoeffer 
is in order, one that would analyze 
Bonhoeffer's thought systematically, 
thematically, so as to trace the poly- 

phonic interaction and development of 
these themes in the organic evolution 
of his thought. Thus he finds at the 
beginning and traces through to the 
end, Bonhoeffer's "liberality" and 
openness to the secular world, as well 
as his Barthian-based respect for rev- 
elation as opposed to religion, and the 
integrity of dogmatic theology vis- 
a-vis natural theology and apologetics. 
I came away from Woelfel's study 
persuaded, both by the theological 
evidence Woelfel adduces as well as 
by the image of the man Bonhoeffer 
that emerges, that Bonhoeffer was 
simply a classical theologian, as Woel- 
fel contends, who, like his mentor, 
Barth, is both markedly consistent 
and yet just as radically open, for 
whom the mystery of Christ infinitely 
and always transcends the knowledge 
of theology. Woelfel is therefore 
justified when he eschews the his- 
torical, chronological approach taken, 
for instance, by Godsey, Phillips and 
Kuhns, in favor of his more system- 
atic study. However, because his 
argument depends so heavily on cross 
references between the Letters and 
Papers from Prison and the earlier 
writings, having to turn to the back of 
the book for the footnotes is a serious 
handicap. As for the substance of the 
argument, I was a bit put off by his 
handling of another matter of con- 
tention among Bonhoeffer students, 
namely the issue of Bonhoeffer's debt 
to Karl Barth who, without question, 
was the most formative of the in- 
fluences on the young Bonhoeffer. 
Woelfel convinces me that while Bon- 
hoeffer was indeed in debt to Barth, 
he nevertheless was an independent 
thinker who went beyond Barth, 
especially in his very concrete Chris- 
tological focus, at a time (in the early 
thirties) when Barth had yet to free 
himself from notions of transcendence 
that inhibited a fully Christological 
concentration. It is tribute enough to 
Bonhoeffer to show that he did antici- 
pate Barth's later Christocentrism, 
but the eminence of Bonhoeffer is 


hardly enhanced when Woelfel, rein- 
forced by the very dubious criticisms 
of Emil Brunner, takes Bonhoeffer's 
charge of "revelational positivism" 
as the definitive word about what 
finally emerged in the Church Dog- 
matics, so that we are asked to believe 
not only that Bonhoeffer moved ahead 
of Barth, but that when Barth finally 
caught up he had sold out to a scho- 
lastic fideism. A much more flattering 
tribute to Bonhoeffer would be to 
demonstrate, as could be done, that 
while Bonhoeffer learned from Barth 
how theology would be done, Bon- 
hoeffer showed Barth what it is 
finally all about — namely, Jesus 

This is a fine book. Read the last 
chapter, "Paths in Bonhoeffer Inter- 
pretation," first, then cut out the foot- 
notes for a ready reference, and finally 
read Karl Barth to see where the 
direction Bonhoeffer was taking does 
indeed lead. 

—Robert T. Osborn 

Companion to the Hymnal. Fred D. 
Gealy, Austin C. Lovelace, and 
Carlton R. Young. Abingdon Press. 
1970. 766 pp. $10.00. 

The Companion to the Hymnal, a 
handbook to the 1964 Methodist 
Hymnal, has been awaited with much 
interest. The authors and publisher 
have gone to great effort to make 
this a complete hymnody, and they 
have very nearly succeeded. 

The work is divided into four main 
sections. Part I contains three his- 
torical articles ; two concerning 
hymns, their texts and music, and a 
third on the 'American Methodist 
Hymnal," past and present. Part II 
is devoted to comments on the texts 
and tunes in the 1964 hymnal ; Part 
III is a biographical study of each 
composer, arranger and author; and 
Part IV contains the bibliographies 
and indexes. 

Part I begins with a rather com- 
plete article on "The Psalms and 

Hymns of the Church" by Fred D. 
Gealy. In this study are especially 
good sections on Greek, Latin and 
American hymns. However, the sec- 
ond article, "A Survey of Tunes" 
by Austin Lovelace seems very brief 
and too shallow in its coverage. Both 
the Lovelace and the Gealy articles 
are hampered by the way they use the 
hymn examples. Dr. Gealy, in most 
cases, uses only the number of the 
hymn in the new hymnal, while Dr. 
Lovelace uses the tune name and 
number. It seems to this reviewer, 
that using the first line and number 
of the hymns would have been prefer- 
able in both cases, since most persons 
who will use this handbook are more 
familiar with the first line of the 
hymns. The third article, "American 
Methodist Hymnbooks" by Carlton 
Young, is interesting, informative, and 
contains a useful chronological chart 
on Methodist hymnals from 1780 to 
the present. 

The real meat of the book is Part 
II, which deals with the study of the 
texts and tunes of the hymns, can- 
ticles, service and communion music 
in the new hymnal. The hymns are 
listed alphabetically by first line which 
makes for easy usage and quick iden- 
tification. This is an excellent work 
and covers most of the texts, their 
authors and sources, in a very 
thorough manner. Unfortunately, 
coverage of the music is uneven, often 
very brief, and in some instances in- 
complete since it is often the great- 
ness of the tune that gives a hymn its 
appeal. However, considering how 
bad the coverage of music has been 
in most hymnodies, this is a small 
complaint indeed. 

In Part III, Dr. Young has com- 
piled concise, to-the-point, biograph- 
ical sketches. Again, this reviewer 
would have appreciated more in- 
formation concerning the composers, 
their musical style and compositions. 

Most readers will find the bibli- 
ography in Part IV very adequate. 
It contains a complete list of hand- 

books (Hymnal Companions of other 
denominations), a long listing on 
hymnology, and a general list of 
church music. 

To sum up : The general articles 
are for the most part very good, al- 
though a consistent system of refer- 
ence to hymns would have been help- 
ful. The study of the texts and 
tunes is the best available so far, 
even though the treatment of the 
music is still not quite what it could 
be. The biographies and bibliographies 
are excellent. The criticisms made 
by this reviewer are in no way serious 
enough to impair the real value of 
this book. For the average minister, 
choirmaster, organist and layman, it 
should prove most valuable in aid in 
the successful use of the 1964 Meth- 
odist Hymnal. 

— John Kennedy Hanks 

Companion to the Book of Worship. 
Edited by William F. Dunkle, Jr. 
and Joseph D. Quillian, Jr. for the 
Commission on Worship of the 
United Methodist Church. Abing- 
don. 1970. 207 pp. $4.50. 

This long-awaited book is addressed 
to central and urgent needs of our 
church as we seek to reclaim and 
effectuate our unique Wesleyan 
"campmeeting and cathedral" her- 
itage. Addressed to any and all who 
use the Book of Worship, and the 
Hymnal, it is intended to aid us in 
"creative use of the traditional forms," 
and "in the creation of new forms, 
without sacrificing continuity and in- 
tegrity." I have tested it by use in a 
Divinity School summer class of stu- 
dent-pastors, and we have found it a 
useful book. 

We now have a Methodist equiv- 
alent of Massey Shepherd's Protestant 
Episcopal Oxford Prayer Book Com- 
mentary, and so crucial are the issues 
of Christian life and work it ad- 
dresses that every serious owner of 
the Book of Worship and of the 
Hymnal should own and consult it. 


For it is intended to explicate Chris- 
tian worship personal and corporate, 
in study and classroom no less than in 
the great congregation. 

So varied are our interests, so lim- 
ited my space, I have decided to 
identify authors, and make a brief and 
too-general statement about each 
chapter. It would be helpful were 
each reader to open his Book of Wor- 
ship, noting its five divisions, which 
are treated in ten chapters, by nine 
writers. Thus you may be "clued" 
to your concerns. 

Chapter I "The Order of Worship : 
The Ordinary Parts," by James 
White, teacher and co-author of The 
Celebration of the Gospel, is the best 
account I know of the tortuous pro- 
cess by which our present Morning 
Service, displacing the Lord's Sup- 
per, is today "a curious but workable 
fusion of ancient Christian tradition 
with Nineteenth Century evangelical 
Protestantism, tidied up in the Twen- 
tieth Century." Stronger historically 
than pastorally, and descriptive rather 
than prescriptive, here are identified 
"points of leverage" at which creative 
pastors are working. 

II "The Order of Worship: The 
Proper Parts" is also by James White. 
Since most of the proper (or change- 
able) Aids to Worship and Acts of 
Praise — as well as hymns — are in- 
tended to flesh out the Christian year 
Sunday by Sunday, this expounds its 
development and values. It will help 
us to remember Christ in gratitude 
and participate in his ministry as we 
offer praise, prayer, and preaching 
to the Father and are built up to par- 
ticipate in his work in his world. 

III "Baptism : Its Historical, The- 
ological and Practical Considerations" 
is by David James Randolph, former 
teacher of preaching, now Associate 
Director of the Board of Evangelism, 
and editor of Ventures in Worship. 
Released in 1968 by the Commission 
as an official brochure, the title would 
imply that it was also written for this 
book. Pastoral rather than formally 


theological and scholarly, it suffers 
from lack of footnotes, and does not 
adequately communicate the present 
world-wide concern with our theories 
and practices of baptism, child and 

I must report with consternation 
that there is no chapter on "the 
Order for Confirmation and Recep- 
tion into the Church." In the light of 
Dean Quillian's earlier statements 
that this service is our most signifi- 
cant liturgical recovery, and the ap- 
pointment by General Conference in 
1968 of a special three-commission 
group to study and effectuate this ex- 
perience in young people's lives, this 
is amazing. 

IV "The Lord's Supper or Holy 
Communion," is by Dean Joseph D. 
Quillian, Jr., former chaplain, pastor, 
teacher, editor, and a Methodist mem- 
ber of the liturgical commission of 
C.O.C.U. The three-page history of 
the Lord's Supper (51-4) is helpful 
indeed, meanings of the Supper 
(drawn from The Celebration of the 
Gospel) less felicitous, with the an- 
amnesis motif separated from Eu- 
charistic thanksgiving. "The great 
offertory" (55-6) is a less successful 
attempt to explain our participation in 
Christ's self-offering. 

Throughout the careful explication 
of the shall and may rubrics I detect 
discreet suggestions for strengthening 
and contemporizing our weak liturgy, 
safeguarded by faithful adherance to 
its basic "shape" and intent. Pre- 
dictably, these focus at sermon, offer- 
tory (65), fraction (67), and sharing 
of bread and cup (69-70). The muted 
notes of Eucharistic thanksgiving and 
hope are not sounded, the Wesleyan 
"evangelistic sacrament" motif is not 
mentioned, and the lack of specific 
allusions or footnotes deprives us of 
Dean Quillian's experiences with sev- 
eral more contemporary and cele- 
brative liturgies. 

V "The Order for the Service of 
Marriage," by Professor Paul Hoon, 
of Union Theological Seminary in 

New York, one of the most scholarly 
and theologically explicit, expounds 
Biblical data concerning sexuality, 
covenant and sacrament. As through- 
out the Book of Worship, the note 
of Eucharistic thanksgiving and mem- 
ory is muted, and liturgical participa- 
tion and response by the congrega- 
tion is not highlighted. 

VI "The Funeral," is by Professor 
Grady Hardin, Duke alumnus, pastor, 
teacher of liturgy and preaching. 
Brief historical preamble leads into 
explication of the rubrics, by which 
means helpful pastoral -liturgical prac- 
tices are suggested. Values and func- 
tion of the sermon are highlighted. 
He neglects to mention the emerging 
values of a brief spoken obituary, 
and he could well have showed how 
skillful use of the name of the de- 
ceased can personalize the service. 
Again, sources would have aided. 

VII "The Ordinal" by Albert C. 
Outler, Duke alumnus and teacher, 
and "Mr. Ecumenical Theologian," 
is a scholarly and detailed exposition 
of Protestant, Wesleyan and later 
Methodist doctrines of ministry and 
ordination services. Made cogent by 
excellent sources and the Outlerian 
wit, it ends on an ecumenical note. 

VIII "The Lectionary" is by Wil- 
liam F. Dunkle, Jr., pastor, author and 
co-editor. After a brief, illuminating 
exposition of lectionaries (lists of 
lessons or Bible readings, usually fol- 
lowing the Christian calendar), he 
explains the principles shaping our 
lectionary. Then follow thirty-eight 
pages charting the lectionaries of all 
the major denominations. Valuable 
as this may be for scholars, Dr. 
Dunkle's own skills in preaching the 
Gospel following the Gospel Year, 
are not brought to our aid, as we 
endeavor to recover Biblical Praise, 
prayer, and preaching in a Christ- 
centered context. I regret that he 
did not write chapter II. 

IX "Uses of the Book of Worship 
in the Home and with Small Groups," 
by M. Lawrence Snow, United Meth- 

odist pastor and author, is so lum- 
inous, cogent and helpful that one 
could wish that he had written chap- 
ter II, or that this chapter had been 
expanded to include "Morning Wor- 
ship." Every pastor, church school 
teacher, and every editorial writer for 
the Upper Room should study these 
suggestions for small group devotions, 
love feasts, and household commu- 
nions. This pastor brings alive his 
Methodist "campmeeting and cathe- 
dral" heritage and the subtitle of the 
Book of Worship" ; "for church and 

X "Other Occasional Services" by 
Professor Roy A. Reed, teacher of 
worship in one of our United Meth- 
odist theological schools, highlights 
theological, liturgical and pastoral 
elements in the Wesleyan genius for 
guiding ministers and people into 
numerous experiences of personal and 
corporate dedication and consecration, 
focused by various occasions in our 
common life. For through such we 
may recognize and communicate our 
identity as God's people, grow in 
Koinonia with Christ and each other, 
grow in grace by "using the means of 
grace," and do Christ's work. Here 
a sacramental theology begins to 
emerge (195-7), and the term "sacra- 
mental celebrations" becomes an apro- 
pos term for all these "life-experience" 
occasional services. Anyone concerned 
with realistic and authentic pastoral 
leadership is wrestling with the prob- 
lem of wholeness of life and cele- 
bration : here are suggested funda- 
mentals — fundamental because they 
root back into Christ's consecration 
of himself and our constant renewal 
in Koinonia and liturgy with him. 

Imperfect though it is, this book 
is useful and we should use it. And we 
should hope that the Commission will 
now plan a careful series of "tracts 
for the times" "bracketing" and sup- 
plementing this book : several brief 
background expositions of New Test- 
ament-Wesleyan Eucharistic theology, 
explicating the central, unifying and 


vitalizing functions of grateful anam- 
nesis of Christ and thanksgiving in 
each of our sadly drab and wordy 
services. And several "practical" 
articles, supplementing Ventures in 
Worship, should make available var- 
ious creative recoveries of corporate 
prayer, Concerns, and contemporary 
idiom by pastors and their people. 
These should appear in the national 
Advocate. And let them seek authors 
outside their own group. Thus they 
may break out of the in-group ap- 
proach which so seriously limits their 
work and this book, and we shall be 
led into the larger meanings of lit- 
urgy as Christ's work, done by his 

—John J. Rudin, II 

Crisis in Eden: A Religious Study 
of Man and Environment. Fred- 
erick Elder. New York. Abingdon. 
1970. 172 pp. $3.95. 

Frederick Elder seeks a theological 
base for both interpreting and hope- 
fully correcting man's careless ex- 
ploitation of nature's forces and forms. 
In light of western man's historic 
disregard for environmental impacts 
of his technologies the writer pro- 
poses an "environmental theology" 
which leans heavily upon tutelage of 
the natural sciences. In this context 
Crisis in Eden provides Elder with 
an interdisciplinary forum for distin- 
guishing environmental "doves" from 
their hawk-like counterparts. 

Elder classifies his line of thought 
on environmental issues with partic- 
ular reference to man's place in the 
natural order. Arguing this "inclu- 
sionist" position, he asserts the neces- 
sity of regarding "man as an inex- 
tricable part of nature," differing 
primarily in intellectual power and 
technical prowess from less developed 
biotic forms but sharing with them, 
nonetheless, an essential unity. Elder 
indicts a number of well known the- 
ologians, among them Teillard de 
Chardin, Herbert Richardson, and 


Harvey Cox, for abstracting homo 
sapiens from the ecological calculus 
and making of him merely homo faber. 
These "exclusionists" assume man 
potentially controls and will eventually 
generate his own environment, an en- 
vironment of simplified, self-contained 
subsystems for biological and social 
support quite apart from what one 
currently knows as nature. For Elder 
and the representatives of the in- 
clusionist approach, biological and 
social interdependence hold infinitely 
greater survival value and fulfillment 
potential in man's evolutionary rela- 
tionship with his environment than 
either artificial environments or ab- 
stracted independence from nature. 
The exclusionist mentality, devoid of 
awe and reverance (Otto's sense of 
the numinous) and remiss in wonder 
before nature's complex webs of life, 
invites simplified reductions of in- 
herantly complex processes and unified 
systems. The viability of these inter- 
dependent systems, argues Elder, de- 
pends directly upon highly perfected 
levels of natural integration and inter- 
system integrity. Elder's criticism of 
the exclusionist attention to technol- 
ogy without regard to ecology raises 
several questions about Elder's own 
theological groundings. 

Although Elder chides exclusionist 
thinkers for brands of callous anthro- 
pocentrism instrumental in buttressing 
unenlightened views of nature's econ- 
omy, his own theological perspective 
reveals admitted anthropological pro- 
clivities. Early he notes as funda- 
mental to the environmental crisis 
"the issue over the correct perspective 
on man." He attributes increased 
"desacralization" of Nature and con- 
comitant exploitation for narrowly 
conceived gain to a historical destruc- 
tion of theological unity between na- 
ture, man, and God. He observes 
this trend beginning in early neo- 
orthodox theologies in which man is 
elevated above nature as God's chosen 
instrument of creation. Elder will not 
agree to Richardson's proposal for 

a God-concept designed specifically to 
". . . undergird the primary relations 
of the cybernetics world. . . ." He 
insists that the environmental theo- 
logian's task is to move from human 
centered systems of relations to those 
in which man and nature interface. 
"The inclusionist could well agree that 
God is the unity of manifold systems 
. . . emphasizing that relations, to be 
truly encompassing, must include those 
of nature to man as well as man to 
man." At this point Elder stands 
open to the tradition of Schleier- 
macher, though one might question 
the author's awareness of that tradi- 
tion. The danger of latent pantheism 
in this system certainly exists. De- 
spite this possibility, however, biolog- 
ical pan-entheism provides an evalu- 
ation more responsive to Elder's in- 
tent. This notion, articulated by Ian 
Barbour, includes a hierarchical sys- 
tem of reality, in this instance bio- 
logical interfaces, levels of which 
share and incarnate the encompassing 
unity of the Divine. Such a system 
resurrects possibilities of awe and 
wonder. Depth and reverance before 
nature's organic diversity rejuvinate. 
Throughout his study the author 
is malcontent to allow discourse about 
theological implications of environ- 
mental crises to remain at strictly 
erudite levels. Elder's commitment 
to a fundamentally interdisciplinary 
approach to theology well prepares 
him to present poignant glimpses of 
the inclusionist position applied. Close 
personal relation to Berkeley ecologist 
Daniel Luter and equally strong af- 
fection for the work of landscape en- 
vironmentalist Ian McHarg reinforce 
the writer's perception that natural 
consequences of undetermined magni- 
tude await already deployed tech- 
nologies. If technology alone is not 
Elder's bete noir, then man's predelec- 
tion for insensitive and uninformed 
application of technology certainly is. 
His call for broadening interdisciplin- 
ary interaction on academic and pro- 
fessional levels in which theology may 


take note of its own historic miscon- 
ceptions and move to more inclusive 
orientations bears serious considera- 
tion by those who fashion models for 
theological education. Perhaps Elder 
heralds a theological holism which 
swings wide for the 70's doors which 
theological pluralism merely cracked 
for past decades. In Elder's words : 

The human race probably has no 
more than a generation left in 
which to decide whether it will 
live in a diversified, balanced 
world or one either biologically 
devasted or imperialistically con- 
trolled in order to avoid bio- 
logical devastation. This means 
that environmental theology, and 
its concommitant environmental 
ethics, must emerge .... The 
time is now; a failure to proceed 
properly insures a future that is 

— William M. Finnin 

Professional Education for Ministry: 
A History of Clinical Pastoral Edu- 
cation. Edward E. Thornton. Ab- 
ingdon. 1970. 301 pp. $7.50. 

This is essentially the story, as the 
subtitle indicates, of the Clinical Pas- 
toral Education movement treated 
historically, with the opening chap- 
ters centering on men, the middle 
chapters on structures, and the clos- 
ing chapters on issues and processes. 

Articles by Tom Klink whose con- 
ceptualizations of the supervisory 
process are unsurpassed and by other 
recent articles on preparing students 
for ministry in the 70's such as those 
appearing in Theological Education, 
the journal of the American Associa- 
tion of Theological Schools would be 
valuable and necessary supplements 
to Thornton's discussion of issues and 

The appeal of this book may be 
limited to professional educators, 
whether in academic or clinical set- 
tings. Nevertheless, it is interesting 
reading in what is considered as the 
most significant movement in theo- 
logical education in our time. 

— Richard A. Goodling 

A Pastoral Counseling Casebook. 
Aldrich C. Knight and Carl Nighs- 
wonder. Westminster. 1968. 224 pp. 

Would you like to join a group of 
fellow ministers weekly with a psy- 
chiatrist and a chaplain supervisor to 
discuss pastoral counseling cases? A 
Pastoral Counseling Casebook is the 
next best thing. Discussions at such 
weekly case conferences were tran- 
scribed and edited and published in this 
informative and very readable book. 
The consultants were Aldrich, a psy- 
chiatrist, and Nighswonger, a chap- 
lain, both at the University of Chi- 
cago School of Medicine. Cases con- 
sidered deal with grief, anxiety and 
depression, suicidal threat, marital 
conflict, delinquency, adolescence, al- 
coholism, and one with a couple which 
called for collaboration with a psy- 
chiatric consultant. The spontaneous, 
conversational style of a case con- 
ference is retained but the material 
was carefully edited to provide clarity 
and precision of thought. Good use 
was made of the "teaching moment" 
to draw out the pastor's investment 
in each case, to introduce in a natural 
and relevant way conceptual material 
on the life problems being considered, 
and to enhance professional counsel- 
ing skills. An introductory chapter on 
personality development provides an 
excellent theoretical framework for 
the behavioral patterns revealed in 
the case materials. 

— Richard A. Goodling