Teachers of Health or Teachers of Sin? A Reexamination of Contraception Prescription
by Robert Maddox, M.D.
A man presents to his physician prior to his trip to South America. He requests penicillin, the long-acting kind, prior to departure. He states that he intends to engage in sexual intercourse and knows from previous experience that he will most likely contract certain venereal diseases. Would you "prophylactically treat?"
This example is analogous to decisions we must make regarding teenage pregnancy. Several years ago, a favorite topic of social planners and politicians was the issue of adolescent sexuality. The actual focus of the discussion was on preventing the consequences, since that was the tangible aspect. At that time, the consequences were pregnancy and various sexually-transmitted diseases. The diseases have changed through the years but pregnancy was usually of more concern than the diseases. The problem has become even more imperative now because no longer are the consequences simply annoying; with the advent of AIDS they are fatal. The solutions that have been proposed are faulty because the focus on consequences is faulty.
The problem of teenage promiscuity has been handed to doctors and educators (reflecting the improper focus). Doctors have been expected to intervene by preventing the consequence of pregnancy. Only doctors can prescribe the oral contraceptive pill (OCP). (Public Health agencies can prescribe and dispense, but this is usually through a doctor's authority.) With the advent of AIDS, condoms are receiving greater attention and the same arguments will apply. Teenage promiscuity has become a health issue, rather than a moral issue. The middle step was to make it a social issue. As social planners made it an issue of public policy, parents and churches retreated from their responsibility and allowed the humanists to advance their agenda.
We must certainly deal with the issue of teenage pregnancy. But are we acting Biblically? As Christian doctors (and pastors and parents) we must seek the Biblical response. The Biblical response requires focusing on the real problem.
Too often the focus of blurred by humanistic rationalizations. The babies that will be born to these mothers will not be properly cared for. They will be reared in undesirable situations. The cycle will repeat itself. The State must pay for these "unwanted children," and it is more cost-effective to prevent pregnancy than to have children. "They will do it anyway, so we might as well prevent further problems." So our children are offered oral contraceptive pills (OCP), condoms and "education" as the solutions. Not only are these inadequate and unbiblical, they are sinful solutions for the Christian.
Pregnancy is not a sin. Nor are gonorrhea and chlamydia sins. All can certainly result from sin, but sin is not an object or a thing. "Sin is any want of conformity unto or transgression of the law of God."1 Sin is relating to God in a wrong way. It is doing or being other than our Creator and Sovereign requires. God specifically tells us not to have sexual intercourse outside of marriage. Thus premarital sexual intercourse is sin.2
Sin is grievous to God. He hates sin and his wrath is against those who sin. The greatest consequences of sin is death, separation from God. Those who sin must bear God's wrath. Pregnancy, gonorrhea, and even AIDS pall to insignificance compared to sinners in the hands of an angry God.
There seems to be little attention given to the question of whether a doctor should prescribe OCP's to unmarried girls. (The larger question of whether contraceptives should be used at all will be by-passed here.3) When the question is discussed, the issue is usually that of parental authority. This is a legitimate issue. The Public Health Department and other public agencies have effectively undermined the family by their contraceptive policy. The issue will not be dealt with here for two reasons: conceivably, some parents will request contraceptives for their children (this has occured in my practice), and what follows is a larger priority which makes clear the doctor's necessary position regardless of the parent's decision.
Prescribing OCP's (or recommending condoms) is an attempt to prevent the consequences of a sin prior to the commission of that sin. There is no doubt that this facilitates the sin. Only willful blindness can allow one to question this. If we hand a gun to a man who states that he wants to shoot his neighbor, we are facilitating his sin. If we offer to pay his bond and take away his sentence, we are facilitating his sin. Prescribing penicillin to the man in the opening paragraph is also facilitation of sin. Taking away the consequences of an action "makes it easier" to act. Granted, that does not necessarily cause the sin.
By focusing the patient's attention on pregnancy rather than promiscuity, we are acting as false teachers (and making a profit at that, since they are more likely to pay if they obtain what they want.) We give a false sense of security, as deceitfully as the false prophets and priests of Jer. 6:13-15. They said, "Peace, peace" when there was no peace. As Is. 48:22 reminds us, there is no peace for the wicked.
The act of providing contraception gives tacit approval to promiscuity, even if the words speak against it. Not only is approval implied by the act but it is also expressed.
It is commonly objected that the good of preventing unwanted pregnancies, even abortions, outweighs the evil of facilitating sin. Paul answers this very clearly in Rom 3:7,8. Murray notes, "What he is controverting is the pernicious logic that we may do evil that good may come."4 Preventing abortions is certainly good. Using sinful means to obtain that goal is not. The ends do not justify the means, no matter how holy and good our intentions.
Facilitating another's sin is itself sin. The Westminister Assembly, in its Larger Catechism, expounded several rules to be observed for the proper understanding of the Ten Commandments. Among others, they state "4. What . . . where a sin is forbidden, the contrary duty is commanded . . . " And "7. That what is forbidden or commanded to ourselves, we are bound, according to our places, to endeavor that it may be avoided or performed by others, according to the duty of their places. 8. That in what is commanded to others, we are bound, according to our places and callings, to be helpful to them; and to take heed of partaking with others in what is forbidden to them."5 It is not enough to keep the letter of the law. We must obey the intent of the law as well. This involves doing the positive when the negative is forbidden. Not only should we not steal, we must work with our hands and share with those in need (Eph 4:28).
We must certainly keep the commandments ourselves, but we are explicitly commanded by Scripture to endeavor that those under our influence, instruction and authority also obey. This is made especially clear in the fourth commandment, wherein we are bound to endeavor that the Sabbath is kept by our household, our animals, and the stranger within our gates. Deut 6:6,7 further enjoin us to teach our children to obey the commandments. With Scriptural precedent, this is understood to apply to all those governed or placed under our authority.6 So those in a place to do so, must make every effort to help others obey. Doctors, whether rightly or wrongly, are in a position of authority. By our title alone, we are teachers. As teachers, we are in a position of great responsibility to those under our care. We are bound by Scripture to help others obey.
Scripture takes our responsibility even further. When something is commanded to others, we are bound to be helpful, to them. Likewise, when something is forbidden, we are not to partake with them. The first part is clearly seen in Heb 10:24, where we are told to spur one another on to love and good deeds. The negative side is commanded in Eph 5:11. Not only are we to have nothing to do with evil deeds, we are to expose and reprove them. This is the clear command of Scripture. Eph 5:7 states that we are not to be partners with the disobedient. I Tim 5:22 repeats this command. Paul here seems to give an example, perhaps somewhat trite in our eyes. Timothy is commanded not to lay hands suddenly or quickly on a man. To do so might lend his approval to sin. Paul was well acquainted with this concept. He tells us in Acts 22:20 that he, while simply holding the coats of the actual offenders, was there lending his approval of the stoning of Stephen. Approving of those who practice disobedience is as deserving of death as actually practicing the evil, according to Rom 1:32. John tells us that even to welcome or greet a false teacher is to share in his wicked work (II John 11).
Christ warns us in Mt 5:19 that to teach others to sin would make us least in the kingdom of God. Further, an action on one person's part can cause another to sin. This is the case with unlawful divorce. In Mt 5:32, Christ tells us that a man who unlawfully divorces his wife causes her to commit adultery.
Ezekiel was made a watchman of Israel. He was told that if he failed to warn a wicked man of the coming judgment, attempting to dissuade him from his evil ways, he would be accountable for the man's blood (Ez 3:18)
We are likewise commanded in Scripture to rescue those being led away to death, and not to endanger another's life (Prov 24:11,12; Lev 19:16). If it is true that fornication is sin and the wages of sin is death, we must make it our highest priority to rescue those standing in judgment of this and other sins. In Lev 19:17, we are commanded to rebuke our neighbor frankly, so we will not share in his guilt. If we fail to rebuke our neighbor, we may be found guilty. Christ explains to us who our neighbor is, and it definitely is not restricted to our brothers in Christ (Lk. 10:29-37). The commands to rescue and rebuke indicate more than simply not becoming involved in another's sin. It is an active step that we must take. This is certainly counter to the prevailing "antijudgmentalism" of our day, but that does not attenuate our responsibility. Christ warns us not to judge lightly though, lest we be found of greater guilt.
Josiah illustrates a righteous man interfering with the sin of others. He realized that God hated the worship practices in which his fellow Israelites were engaged and so took measures to destroy those practices (II Kings 23:7).
As doctors, we are in a position of authority. Ours is not kingship, but we are responsible for what has been entrusted to us. We are asked to facilitate sexual promiscuity. If we participate, we ourselves are sinning. We have the additional responsibility of warning the sinner of the judgment of God, and teaching the means to forgiveness and obedience. Our duty lies with our neighbor, with those who seek our help and advice, and with those who have, by reason of the "implicit contract" of medical practice, been placed in our care. This would certainly apply to all our patients, whether Christian or non-Christian.
There are additional reasons we should not prescribe contraceptives to Christians who are remaining unmarried. Christians have the Spirit of God dwelling in them. One of the benefits of the Spirit is the sanctification of our lives. Our behavior and attitudes can be truly changed. The Spirit is the agent of change. Not only is change possible, it is commanded. We are to live as children of light. To make provision for the desires of the sinful nature is to deny the power of the Spirit to change us, to acquiesce to failure of the spirit of self-control (Rom. 13:14; I Tim. 1:7).
It would be degrading a daughter to make her a prostitute, and this is specifically commanded against in Lev. 19:29. Is it any more permissible to allow one of our covenant children to wander unwarned into promiscuity? Proverbs commands us to discipline our children so as not to be willing parties to their deaths (Prov. 19:18). The rod of discipline will drive folly from the heart of the child (Prov. 22:15). This is our duty to the children God has committed to us.
Paul does not give the option of providing for promiscuity to the unmarried: In I Cor 7:9, he commands that they marry rather than burn with lust. This is a very practical and Biblical solution. (In fact, it is one step before the command that a couple who engages in premarital intercourse must marry, if the girl's father ap= proves - Ex. 22:16,17)
We are responsible for the children God has given us. This responsibility extends to the point where God judges us for the sexual appetites of our children. In Jer. 5:7, God condemns the nation for the fornication of its children. They abandoned God and sought prostitutes. The fathers were guilty too of "breaking off the yoke" of God's righteous requirements. Because they strayed from God's righteous way, the children were lead to even more explicit rebellion against God.
Let us then as those God has called to be teachers of health be true to our calling and not lead others into sin. Let us reexamine our practices in the light of Scripture, not yielding to the pressures of our God-forsaking society.
1. Westminister Shorter Catehism, Q 14 (The modern version by Dr. Doug Kelly states that "sin is disobeying or not conforming to God's law in any way.")
2. Murray, John. Principles of Conduct, Vim. B. Eerdmans Pub Co., Grand Rapids, 1971, pp. 45-81, esp p.56. see also Davis, J.J., --Evangelical Ethics, Presbyterian and Reformed Pub. CO., Phillipsburg, New Jersey, 1985, pp. 52-55. Most dictionaries of Christian ethics are agreed on this point.
3. This issue is beginning to receive attention in evangelical circles. Dr. Hicks makes passing mention of it in his interview in JBEM, Vol. 2 x2, p. 33.