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The Anabaptist Tradition

Religious Beliefs and Healthcare Decisions

By Joseph J. Kotva Jr.

ennonite, Brethren, , and Hutterite com- Mmunities are the main heirs of the Anabaptist movement. This movement grew out of the Protestant in the early 16th century. Following years of study, a small group of young scholars concluded that the Reformation leaders, including and Ulrich Zwingli, were not Contents radical enough in their use of Scripture to criticize The Individual and the 5 church practices. While the Anabaptist critique Patient-Caregiver Relationship included questions about the mass, the use of images, and the morality of church officials, the argument , Sexuality, and Procreation 6 quickly centered on the role of . On the basis Genetics 9 of passages such as Matthew 28:19-20, these young Organ and Tissue Transplantation 10 radicals argued that baptism was solely for believing adults, since infants and small children cannot under- Mental Health 10 stand the teaching about salvation or repent and Medical Experimentation 11 promise to live lives of costly obedience to Christ.1 and Research The movement’s first adult took place in Death and Dying 11 January 1525, in Z¨urich, Switzerland. This new movement was immediately declared illegal through- out Europe and its adherents were denounced as “Anabaptists”—that is, re-baptizers. The movement was declared illegal, largely because the radicals’ insistence on adult baptism and voluntary member- ship in the church was rightly seen as a threat to the social fabric of Europe. A central symbol in the cen- turies-old link between church and state, infant bap- tism conferred both church membership and citizen- Part of the “Religious Traditions and Healthcare Decisions” handbook series published by the Park Ridge Center Joseph J. Kotva Jr. is of First Mennonite Church, for the Study of Health, , and Ethics Allentown, , and is a scholar in , specializing in ethics and medical ethics.

THE PARK RIDGE CENTER ship. By insisting on adult baptism, the Ana- get their name from , a gifted were denying the state’s authority in Dutch Catholic priest who joined the Anabaptist matters of the church and were pulling apart the movement in 1536. The Brethren, the next religious and political threads of Europe’s social largest group, derive from a combination of fabric. Radical Pietist and Anabaptist influences. Within months of the first “re-baptism,” the Beginning in early 18th century , the Anabaptists were fleeing for their lives. Driven Brethren fled to North America almost immedi- by persecution and zeal, ately, seeking religious liberty and economic spread to many areas of Europe. Thousands of opportunity. The Amish, the next largest group, Anabaptists were imprisoned, tortured, burned, take their name from Jacob Ammann, a Swiss drowned, and even dismembered by both Anabaptist leader who separated from other Protestant and Catholic authorities. Many sto- Anabaptist groups in 1693. In an attempt at ries of this harsh persecution and the witness of reform within the Anabaptist movement, the early Anabaptists are found in the more than Ammann advocated stricter policies of church 1,100 pages of the —until recent- discipline and . Amish communi- ly, the book most frequently found (except for ties are usually more geographically and socially the Bible) in Mennonite homes. isolated than their Mennonite siblings. The The Anabaptists emphasized the authority of , numbering only around 7,000 adults Scripture and salvation by grace through faith in in the United States, take their name from Jakob Christ. However, they understood these Hutter, who was tortured and burned alive in emphases differently than both the Catholic 1536.3 The Hutterites go beyond mutual aid to Church and the Protestant reformers.2 For a formal community of goods. Although as geo- instance, the Anabaptists did not entrust the graphically separate as the Amish, the Hutterites interpretation of Scripture to individuals or actively engage the broader society in matters of scholars or the church hierarchy. Instead, the and peacemaking. Scriptures were to be read by all believers who Contemporary Anabaptist groups have a had received the , their meaning was congregational polity. The center of authority to be discerned in the context of the believing rests largely with the member congregations. community, and every interpretation was to be However, depending on the Anabaptist group, a tested against the Gospels’ stories of Christ’s life regional district or conference may exercise sig- and words. The Anabaptists also differed from nificant authority, often through the role of the reformers by asserting that to accept ’s bishops or elders. The Amish do not have forgiveness in faith was to set out on the way of organizations at the denominational level. With discipleship—a journey, enabled by the Holy Mennonite and Brethren communities, the Spirit, of following Christ in every aspect of life, denominational organizations exercise little con- including simplicity, accountability within trol over individual congregations. Instead, Christian community, and love of enemy. these organizations enable congregations and Combined with the insistence on voluntary bap- conferences to speak with one voice on matters tism, these commitments led the Anabaptists to deemed important and to collaborate in areas of claim that the true church would be a visible mission, education, publication, mutual aid, and church. Distinct from the state and separate service. Because denominational resolutions from the evils of the world, the true church is to and pronouncements arise from a denomination- be visible through the transformed lives of its wide process of collaborative discernment, they members and their commitment to mutual sup- represent the broader community’s position even port and accountability. while remaining non-binding on individual con- , the largest group of Anabaptists, gregations.

2 THE ANABAPTIST TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS From an Anabaptist perspective, notions of cisely because it allows us to love God and serve health and illness must be placed in a larger our neighbor as a witness to God’s inbreaking theological context that includes the church kingdom. community and its witness to the Kingdom of For Anabaptists, the church community is God, the pervasive power of sin, and Christian central to the connection between kingdom and stewardship. One instance of situating health health. The church is “a sign of the kingdom of within this larger theological framework is this God.” As a distinct, recognizable body, “the sentence from the Mennonite Church’s Vision church is called to witness to the reign of Christ Statement (adopted 1995): “God calls us to be by embodying ’ way in its own life and pat- followers of Jesus Christ and, by the power of terning itself after the reign of God.” Believing the Holy Spirit, to grow as communities of that Christ is already Lord (although unrecog- grace, joy, and , so that God’s healing and nized by the world), and empowered by the Holy hope flow through us to the world.” This larger Spirit, the church strives to pattern its current theological context is likewise evident when the life “after our life together in the age to come.” Mennonite Brethren confess, “We believe that Thus, every aspect of the church’s life—from its God is at work to accomplish deliverance and internal life of fellowship and mutual aid to its healing, redemption and restoration in a world external life of proclamation and relief work—is dominated by sin.”4 to show “the world a sample of life under the For Anabaptists, health and healing are par- lordship of Christ.”7 tial manifestations of God’s redeeming Kingdom, This emphasis on the church as a sign of the which broke into the world in Christ and will be kingdom helps explain why Anabaptists cannot complete at Christ’s return. Health and healing talk about health and illness without talking are therefore signs of God’s redeeming love. about restored relationships. From an However, by framing issues of health in a king- Anabaptist perspective, the salvation that God dom context, Anabaptists insist that health can offers, the kingdom that God is bringing, simul- never be understood in a singularly physical taneously involves being “reconciled with God sense. Moreover, understandings of health must and brought into the reconciling community of be ordered by kingdom priorities and realized in God’s people.”8 Thus, the most fundamental the context of restored relationships. Thus, one notion of health concerns well-being in our rela- who is physically well is actually unhealthy if tionships with God and others, especially fellow she is not at peace with God or the church or believers in the church. All other aspects of lives a life of selfishness. Conversely, one who is health (physical, psychological, economic, etc.) approaching death is largely healthy if she loves derive their orientation from this basic focus on God, is cared for by the church, and has lived a restored relationships.9 life of justice and mercy.5 The emphasis on the church as a sign of the The centrality of the kingdom for understand- kingdom also helps to explain the Anabaptist ing health is captured by Erland Waltner, former insistence on mutual aid and bearing each President of Mennonite Health Association, other’s burdens—practices that are directly relat- when he describes the search for physical, spiri- ed to issues of health and illness. Since the tual, and emotional well-being “as fitness for church is “a visible body of Christ mirroring the kingdom life and service.”6 For people whose kingdom of heaven . . . love and corporate care life together should witness to God’s kingdom, of members . . . [is] simply assumed to be a physical health cannot become an idol sought norm of redeemed behavior.”10 Anabaptist for its own sake; nor should health be sought groups accept the reciprocal responsibility of primarily to avoid suffering or to maximize our members within the community to care for each years on earth. Instead, health is valued pre- other’s emotional, social, spiritual, material, and

THE PARK RIDGE CENTER 3 physical needs. relationship to suffering: “Through sin, the pow- At one level, such mutual care implies eco- ers of domination, division, destruction, and nomic interdependence and security. The death have been unleashed in humanity and all Amish farmer knows that if he gets sick, fellow of creation.” Indeed, “governments, military church members will plow his fields and help forces, economic systems, educational or reli- pay the hospital bills. Similarly, an urban gious institutions, family systems, and structures Mennonite who lacks health can share determined by class, race, gender, or nationality the cost of insurance with the local congregation are susceptible to [the] demonic spirits” and denominational institutions. unleashed by sin.14 Given this systemic under- At another level, mutual care means that one standing of sin, Anabaptists readily assume a is not alone in illness and suffering. Remaining connection between suffering and sin without present with the sick is a shared responsibility of thereby assuming the individual sufferer’s culpa- the entire believing community, not just the bility. responsibility of and or elders. Because Anabaptists frame this broad sense This responsibility is expressed in ways ranging of sin within a focus on the kingdom, they are from sitting at the bedside to providing meals free to “recognize and be grateful for whatever for the sick individual’s family. ways God’s healing comes to us,” whether At still another level, mutual care means that through and with oil, through “in all complex ethical decisions regarding life exorcism, or through physicians and therapists.15 and death, we seek to offer . . . support and Whatever the mechanism, true healing is a gift counsel in the context of the Christian commu- of God and a sign that sin’s hold on the world is nity.”11 Anabaptist groups insist that hard deci- not final. Precisely because Anabaptists see sin sions, including serious medical decisions, as a real power enslaving humanity and corrupt- belong in the context of the prayerful communi- ing creation, they see true healing as a real man- ty. Individuals need not, indeed should not, ifestation of God’s redeeming Kingdom. make such decisions in isolation. They should This sense of sin as a power in the world also instead seek the wisdom of the church commu- explains the meaning that Anabaptists find in nity, usually in the form of a small group. suffering. Suffering that is a result of disciple- Anabaptists insist, moreover, that such commu- ship, especially “suffering for the right without nal moral discernment consider the repercus- retaliation,” is seen “as sharing in the sufferings sions for the church community of any proposed of Jesus.”16 Suffering that comes because we course of action. refuse to repay evil for evil is for Anabaptists a As health and healing are manifestations of part of discipleship and, therefore, a participa- God’s coming kingdom, suffering and illness are tion in Christ. So, too, suffering that derives manifestations of sin and its consequences. indirectly from discipleship—for example, illness Although Anabaptists emphasize the ability of that comes from a life of solidarity with the poor believers in community to live faithful and obe- or sustaining an untimely pregnancy—is seen by dient lives, most Anabaptist groups have a deep Anabaptists as participating in Christ’s redemp- sense of sin’s corrupting power. Anabaptists rec- tive suffering.17 Such discipleship-based suffer- ognize that personal sin can be the cause of suf- ing is meaningful as suffering for the kingdom fering and illness. Such illness can become an and as a participation in Christ’s overcoming of opportunity to repent of one’s sins and learn to sin’s power in the world. The many forms of rest secure in God’s forgiveness.12 However, suffering that do not derive from discipleship Anabaptist groups seldom attribute illness or are seen as signs of sin’s continuing power in suffering to personal sin.13 Instead, Anabaptists the world and a reminder that we await the full have a systemic or cosmic sense of sin and its realization of the Kingdom. In all cases of suf-

4 THE ANABAPTIST TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS fering, Anabaptists strive to trust the sufficiency An emphasis on stewardship also explains of God’s grace and the love of the believing why Anabaptists sometimes reject costly therapy community. and life-sustaining treatment even when the The other theological element that must be individual or community can afford them or the mentioned here is Christian stewardship. “We treatment would be covered by insurance. Such believe that everything belongs to God, who treatments can be rejected as “poor steward- calls us as the church to live as faithful stewards ship”—that is, the misappropriation or misuse of of all that God has entrusted to us.”18 God’s resources. Thus, the Mennonite Church Anabaptists have a strong tradition of steward- General Assembly in 1993 affirmed the “call on ship, including stewardship of our physical, psy- both our health care professionals and members chological, and emotional health. An under- to exercise greater restraint and stewardship in standing of stewardship, rather than a preoccu- the utilization of healthcare resources.” With pation with personal sin, explains why the same rationale, the Mennonite Church pub- Anabaptist groups exhibit lower levels of smok- licly affirmed the idea of a national healthcare ing and excessive drinking than the broader system that would limit the range of medical population. Over the last several decades, an services that people “might want or need” so understanding of “whole-life stewardship” led that “all people . . . [would] have access to basic most Anabaptist groups to develop congrega- preventative, curative, supportive, and emer- tional and denominational programs promoting gency services.”20 lifestyles consistent with health and wellness.19

THE INDIVIDUAL AND THE PATIENT-CAREGIVER RELATIONSHIP

ased on their commitments to community Such professionals must not violate the patient’s Band reconciled relationships, Anabaptists or client’s conscience or emotional well-being by emphasize individual autonomy far less than is attempting to impose their own convictions. common in contemporary American medicine. Conversely, those professionals need not partici- Thus, Anabaptists frequently involve family, pas- pate in procedures that are contrary to their tors, church elders, and other church members moral convictions, including, for example, abor- in their decision-making. This involvement can tion. When support for decisions not to partici- be so extensive that clinicians deem it a viola- pate is lacking in broader society, Anabaptist tion of the patient’s autonomy or confidentiality. healthcare professionals should anticipate While it is possible for fellow church members receiving moral and economic support in the to exercise undue pressure on the patient, the congregation and denomination.21 caregivers are more likely witnessing the patient’s faith commitments at work through the inclusion of the community’s wisdom and inter- CLINICAL ISSUES ests in the decision-making process. Anabaptist commitments to and Informed consent, truth-telling, and freedom of conscience also affect the patient- confidentiality caregiver relationship. These commitments Anabaptist convictions about nonviolence, truth- imply, for instance, that Anabaptist healthcare telling, humans as created in the image of God, professionals must respect choices by individuals and the importance of voluntary commitments22 that conflict with their own moral commitments. provide the foundation for a strong support of

THE PARK RIDGE CENTER 5 complete candor and confidentiality in the ed: “We commit ourselves to completing health worker-patient relationship. advance directives (e.g., living wills and proxies) as an affirmation of our beliefs about life and Advance directives and proxies death and as a symbol of our commitment to Anabaptist groups encourage the use in tandem stewardship and justice.”23 The merits of of both living wills and proxies. Anabaptist advance directives include protecting the fami- groups view advance directives not as an instru- ly’s emotional and financial well-being, witness- ment of autonomy, but as an opportunity to ing to in the resurrection, and freeing express Christian faith. For example, in 1993 resources for the health care of others.24 the Mennonite Church General Assembly assert-

FAMILY, SEXUALITY, AND PROCREATION

nabaptist groups greatly value family life, al intimacy, “sexual intimacy rightfully takes Abut they are clear that “in the kingdom of place only within marriage.”29 This understand- God our family ties take second place to obey- ing precludes premarital, extramarital, and ing the will of God.” In addition, the “commu- homosexual sex. Within the marriage context, nity of faith which emerges through belief in however, sexual intimacy is seen as a good gift Jesus Christ is family for believers.”25 Marriage from God meant “for pleasure and closeness and biological family thus involve penultimate and for procreation.”30 commitments. Marriage and biological family Given these understandings of marriage and find their proper orientation and place when set sexual intimacy, the vast majority of Anabaptists within the more fundamental commitment to consistently reject homosexual genital activity, serve God through the church, the family of including sexual activity between same-sex part- faith. This focus on the faith community as a ners in a committed relationship, as sinful. family explains why many Anabaptist groups Despite the majority support for this position, emphasize that “singleness is honored equally the question of how to regard homosexual rela- with marriage, sometimes even preferred.” tionships has been the most contentious issue of Since one already has a family in the church, the last several decades within Anabaptist com- singleness is an option that may offer “unique munities. There are strong dissenting voices, opportunities to advance the kingdom of God.”26 including the Brethren/Mennonite Council for Anabaptists believe that marriage is “to be a Lesbian and Gay Concerns, which has published covenant between one man and one woman for a newsletter-style periodical (Dialogue) for 23 life.” This covenant “is meant for sexual intima- years. There are also congregations that have cy, companionship, and the birth and nurture of been placed under district discipline for their children.”27 Most Anabaptists view the marriage acceptance of same-sex partnerships. Yet, in relationship as one of mutuality and equality, July 2001, the largest Anabaptist group reaf- where inequality and subordination are manifes- firmed the teaching position of previous church tations of human sinfulness.28 However, some “statements describing homosexual, extramarital Amish and conservative Mennonite groups have and premarital sexual activity as sin.”31 a more hierarchical view of the family, with the This rejection of homosexual sexual activity husband/father exercising clear authority over is not meant to be a “rejection of those . . . with the wife and children. a different sexual orientation” or a “lack of While all people need relational and emotion- compassion for their struggle to find a place in

6 THE ANABAPTIST TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS society and in the church.”32 Indeed, sympathy ed pregnancies that often lead to abortion. with this struggle led the Mennonite Central Regarding the former rationale, a 1985 Committee in 1998 to endorse a letter sent by Mennonite study book says that “our under- various Protestant church agencies to congres- standing of Christian stewardship envelops all sional representatives urging rejection of a bill areas of our lives, including that of family plan- that would legalize discrimination against feder- ning.”41 The context of this statement suggests al employees on the basis of sexual orientation.33 concern for Christian stewardship of both family All Anabaptist groups view children as “a gift finances and the earth’s ecosystem.42 from God.”34 Consequently, “children are to be Regarding the latter rationale, a 1980 loved, disciplined, taught, and respected in the Mennonite statement on abortion says that home and in the church.”35 Children are also “where children are not wanted, proper contra- taught to honor their parents. Anabaptists do ception should be used to prevent pregnancy. not baptize babies, but they do offer child dedi- We believe that many abortions could be pre- cations, at which parents vow “to provide their vented if persons would take responsibility for children with a Christian home” and the church sexual behavior.”43 While wanting to maintain family commits itself to share in that responsi- the importance of chastity outside of marriage bility.36 and faithfulness within marriage, most While maintaining that “sexual purity, believ- Anabaptists would advocate the use of contra- ers marrying believers, lifetime marriages, loving ception for anyone who is sexually active and , and fulfilling singleness” are does not wish to become pregnant.44 normative,37 Anabaptists also recognize that The Amish constitute a probable exception to “some in the church experience divorce, abuse, this affirmation of contraceptive methods. sexual misconduct, and other problems that Amish communities distrust the world’s values make marriage and family life burdensome and and are very cautious in their appropriation of even impossible.” In these situations, the new technology—recognizing that new technolo- church strives, however imperfectly, to be a gy frequently has unforeseen negative conse- “reconciling and forgiving community [that] quences for community life. When this appre- offers healing and new beginnings.”38 hension is combined with the great value that Amish place on children and large families, it is likely that many Amish communities will frown CLINICAL ISSUES AND PROCEDURES on contraception.

Contraception Sterilization Most Anabaptist groups readily accept the use of A 1974 study for the General Conference various contraceptive methods. In 1961 a Mennonite Church includes sterilization as an Mennonite statement on parenthood includes acceptable means of pregnancy prevention. the assertion that “we do not regard as evil the This study recommends vasectomy as the prefer- reasonable spacing of children through methods able form of sterilization.45 Vasectomies are approved by Christian physicians.”39 By 1974, a common among married Anabaptist men who study book on abortion for the General have children. Conference Mennonite Church mentions oral contraceptives, mechanical barriers, spermicides, New reproductive technologies and the rhythm method as appropriate methods Anabaptist groups offer a cautious acceptance of for preventing pregnancy.40 in vitro fertilization (IVF). The acceptance The main rationales for accepting contracep- comes from the high value placed on children tion are stewardship and preventing the unwant- within families. The cautiousness relates to

THE PARK RIDGE CENTER 7 questions of stewardship—whether pursuing this value simply because we are loved by God. course is the best use of time and money—and Given their communal orientation, fears that IVF is too closely associated with prac- Anabaptists also affirm the contribution that tices that diminish human dignity, such as ware- children make to the community. Therefore housing fertilized eggs and using selective abor- they ask about the long-term ramifications for tion to reduce risk in cases of multiple community life when the unborn are not valued gestation.46 highly. Anabaptists insist that we recognize that There is a debate among Anabaptists as to decisions to terminate pregnancy affect the whether artificial insemination by donor (AID) entire church community directly or indirectly. is sometimes acceptable. AID was affirmed as a Second, despite the firm opposition to abor- possible blessing for infertile couples in a tion, there is a near-universal rejection of efforts Mennonite study document. This judgment has to promote legislative initiatives that would pro- been challenged on grounds that it gives inade- hibit abortion. The commitment to nonviolence, quate attention to the negative consequences for a strong sense of the church-state distinction, a broad range of familial, marital, societal, and and the expectation (expressed in adult baptism) psychological considerations.47 that Christian moral convictions will differ from While there are no official statements, it is those of the larger society, make Anabaptists clear that Anabaptists reject the use of surrogate ready to abandon legislative control of the larger mothers. Besides questions of stewardship, this culture. rejection is based on several interrelated con- Third, there is a recognition of the multiple, cerns: introducing a third party into the mar- complex social conditions that contribute to riage relationship; unnecessarily breaking the unwanted pregnancies and the resort to abortion. bond formed between mother and child during Consequently, Anabaptists focus on alternatives pregnancy; using another’s body to achieve our to abortion and on programs that address the ends, and turning children into commodities.48 underlying causes. This focus includes elements such as promoting adoption and responsible sex- Disease treatment of pregnant mothers ual behavior. It also includes programs to assist There are no official statements on this topic. unmarried pregnant women, single mothers, and families with children with disabilities. Overall, Abortion there is a commitment to work toward a society While there are differences of opinion within the that values women and children, childbearing Anabaptist churches about when abortions and child rearing, family life, and mutuality might be justified, numerous church-wide dis- between women and men. cussions and official statements over several Fourth, the communal emphasis means that decades show remarkable uniformity in their in those rare situations of genuine conflict approach to this question.49 First, the vast between mother and unborn child, prayerful dis- majority of intentional abortions, especially cernment should be sought within the context of those used as a mechanism of family planning the believing community, usually in a small or contraception, are viewed as wrong, repre- group setting. This communal emphasis also senting sinful acts that are not pleasing to God. means a commitment to stand with those endur- In explaining this view, Anabaptist churches do ing difficult pregnancies and to share in the not appeal to rights language or to arguments responsibility of raising the children. about the personhood of the human fetus. Finally, there are repeated reminders against Instead, the explanations are theological: life is judgmental attitudes toward those with different a gift from God, and that gift deserves respect. convictions and repeated calls to show care for We (including the unborn) have incalculable those who have had abortions.

8 THE ANABAPTIST TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS Care of severely handicapped newborns very severe disabilities. There is also a quantity There are no official statements regarding of literature that addresses parental struggles, neonatal intensive care for severely handicapped recounts efforts at community support, and newborns. The high regard for all children, the describes what people gain in love, self-knowl- values of stewardship and communal discern- edge, and knowledge of God while learning to ment, and belief in the resurrection would play a care for these children. One such resource is role in these decisions. the quarterly publication, Dialogue on Within Anabaptist circles there is, however, a Disabilities, now in its twenty-second year.50 tradition of caring for children with moderate to

GENETICS

here are no official statements regarding Sex selection Tgenetic research and its ramifications. All Anabaptist groups would agree with this Anabaptist groups are just beginning serious statement: “We believe that prenatal screening conversations about how the church should techniques should be permitted only for diag- respond to the various developments in genetic nosing the most serious genetic problems and technology. However, it is clear that Anabaptist certainly not for the determination of sex or groups would reject germ line efforts at other genetic characteristics.”53 “enhancement” and are concerned about the ways in which the use of genetic technology may Selective abortion exacerbate problems of racial or gender discrim- The tradition’s strong opposition to abortion and ination and the economic disparities between the great value placed on fetal life rule out rich and poor.51 selective abortion except in the most extreme cases, i.e., when the mother’s life is endangered or when it is impossible to carry all the fetuses CLINICAL ISSUES to term. In such cases, the mother/family should be surrounded by the church community Genetic testing and counseling for discernment and support. Most Anabaptist groups would support “genetic counseling where genetic diseases are possible.”52 Gene therapy There are no official positions on gene therapy.

THE PARK RIDGE CENTER 9 ORGAN AND TISSUE TRANSPLANTATION

here is among Anabaptists a certain ambiva- with their communities, some Anabaptists will Tlence regarding organ and tissue transplan- decline to be placed on recipient lists. tation. The procedures themselves are not viewed as problematic, and the Anabaptist emphases on loving service to neighbor and CLINICAL ISSUES mutual aid would seem to argue for extensive church promotion of organ donation.54 Indeed, Use of fetal tissue many Anabaptists do sign organ donation cards. There are no official statements on this issue. However, among many Anabaptists, the high However, the tradition’s high regard for fetal cost and limited availability of transplants are life, along with concerns about encouraging “viewed as symbolic of the excess and individu- future abortions, means that Anabaptist groups alism in health care which thwarts every attempt would reject harvesting of tissue or organs from to provide basic care and equality in the health aborted fetuses for use in transplantation or care system.”55 As a result of this ambivalence, research.56 Anabaptist churches do not actively promote or discourage organ donation and, in consultation

MENTAL HEALTH

nabaptist groups, especially the Mennonite of what might be done with rightly motivated Achurches, have an extensive tradition of psychiatric aides and mental health profession- offering care and services to those suffering als.”57 This vision led to the establishment of from mental illness. During World War II, thou- the Mennonite Mental Health Services, various sands of conscientious objectors (the majority other mental health programs, and several from Anabaptist traditions) were assigned to church-related psychiatric hospitals. two- to four-year service terms in state mental Currently, of the few church-related psychi- hospitals and training schools for the mentally atric hospitals in North America, over half of retarded through (CPS). them are affiliated with the Mennonite church. The conditions in the state hospitals were Like other such hospitals, these institutions deplorable. By sharing their observations with use a variety of therapeutic strategies and strive the public, in part through a 1946 issue of Life for a high level of professional competency. magazine, the CPS men helped effect reform in They also strive to respect individuals as these institutions. More important, these men children of God and to offer, but not impose, helped establish change through the quality of the resources of faith and community. Services their service—by working hard and showing gen- are provided to all faith groups. At the congre- uine care and interest in the patients. The CPS gational level, there are repeated reminders men also engaged in educational efforts to help within the Mennonite churches of the need to them better prepare for their work in these hos- be welcoming communities that offer emotional pitals. and economic support for people struggling Out of this direct involvement with mental with emotional and mental illness.58 illness, Mennonites began to develop “a vision

10 THE ANABAPTIST TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS MEDICAL EXPERIMENTATION AND RESEARCH

here are no official church statements Tregarding the issues surrounding medical experimentation and research.

DEATH AND DYING

or Anabaptists, death is not the greatest evil, as a sign of grace and accept the community’s Fnor one to be avoided at all costs. While dif- efforts to share in the suffering and pain. fering on whether there is an afterlife that begins immediately after death, Anabaptists Forgoing life-sustaining treatment agree that “since Christ destroyed the power of Because they believe in the resurrection and do death . . . believers need not be afraid of death, not view death as the last word or the worst evil, the last enemy.”59 Anabaptists look forward to Anabaptists see it as often appropriate to stop pro- God’s final victory over the powers of evil and cedures or forgo treatments that simply impede an sin, to the resurrection of the dead, and to the inevitable, natural death. To some, this position kingdom come in full. will appear to contradict Anabaptist convictions In Anabaptist communities, death is an occa- regarding euthanasia and suicide. However, for sion for community support of the bereaved. Anabaptists there remains an important distinction Members gather around the family, support between aiming at death and allowing people to them, and offer their services. When the die.62 The former implicitly rejects God’s rule over deceased has died well, often the gathering is our lives; the latter accepts God’s timing for our not only an occasion to mourn the loss of a deaths. Because the application of such distinc- loved one but also a time to celebrate the well- tions is often quite difficult in practice, Anabaptists lived life of a fellow believer. trust that “these kinds of decisions are best made in community—with the individual, the family, the physician, and a praying church family cooperat- CLINICAL ISSUES ing and seeking a wise decision.”63

Suicide, assisted suicide, and active euthanasia , burial, and mourning traditions Anabaptists believe that “God values human life Anabaptist groups do not have “last rites.” The highly.” Moreover, life is a gift and a trust that funeral and burial services include the liturgical is not at our disposal. Anabaptists therefore elements of singing, scripture reading, prayer, and reject “procedures designed to take life, includ- . Anabaptist services tend to be much ing . . . euthanasia . . . and active suicide, . . . less formal than most Protestant or Catholic litur- [as] an affront to God’s sovereignty.”60 These gies. Anabaptist funeral and mourning traditions procedures violate the sanctity of life and usurp usually include significant story sharing by the God’s role in determining the time of our death. family and church community. Most Amish com- Suffering and pain are an inevitable part of munities are more immediately involved in the life in a broken world. Thus, rather than seek- burial process: family members or others in the ing to determine the time of their own deaths, community will make a simple wooden casket Anabaptists seek God’s “grace to suffer with and the casket will be physically buried by mem- dignity.”61 In times of pain and suffering, bers of the church community. Anabaptists will gratefully accept palliative care

THE PARK RIDGE CENTER 11 NOTES

1. C. Arnold Snyder, Anabaptist History and : exercise, and stress management. An Introduction, 54-55. 20. Mennonite Church General Assembly, “Resolution on 2. C. Arnold Snyder, From Anabaptist Seed; Walter Health Care in the United States.” Klaassen, Anabaptism: Neither Catholic Nor Protestant. 21. General Conference Mennonite Church, “Guidelines 3. Kraybill and Hostetter, Anabaptist World USA, 25, 33. on Abortion,” 5; Shantz, comp. and ed., MCC Canada Resource Packet on Abortion. 4. General Conference of Mennonite Brethren Churches, Confession of Faith: Commentary and Pastoral 22. Confession of Faith in a Mennonite Perspective, 28, 39, Application, 55. 75, 81-83.

5. For example, Mennonite Mutual aid, Congregational 23. Mennonite Church General Assembly, “Resolution on Health Ministries, 3-5; Mennonite Church General Health Care in the United States.” Assembly, “Resolution on Health Care in the United States.” 24. Krabill, Advance Directives: The Quest for a Good Death, 10; Mennonite Mutual Aid, Making Your 6. Waltner, “New Call to ‘Health-Making’”; Waltner, Wishes Known: Guidelines for Creating Your Advance “Health and Wholeness in Christ,” 2. Medical Directive, 7-8.

7. Confession of Faith in a Mennonite Perspective, 42, 90. 25. General Conference of Mennonite Brethren Churches, Confession of Faith: Commentary and Pastoral 8. Ibid. Application, 122.

9. Willard S. Krabill, I’m Not Whole Without You: 26. Ibid., 115. Wholeness and Mutual Aid, 4-6. 27. Confession of Faith in a Mennonite Perspective, 72. 10. Swartley and Kraybill, eds., Building Communities of Compassion: Mennonite Mutual Aid in Theory and 28. General Conference of Mennonite Brethren Churches, Practice, 15. Confession of Faith: Commentary and Pastoral Application, 115. 11. General Conference of Mennonite Brethren Churches, Confession of Faith: Commentary and Pastoral 29. Ibid. Application, 153. 30. Confession of Faith in a Mennonite Perspective, 73. 12. Cf. Waltner, “Toward an Anabaptist Theology of Chaplaincy in Health Care Institutions,” 5-6. 31. Mennonite Church USA, Membership Guidelines.

13. Graydon F. Snyder, Health and Medicine in the 32. General Conference Mennonite Church, “Resolution Anabaptist Tradition: Care in Community, 64. on Human Sexuality.” Cf. the virtually identical docu- ment: Mennonite Church, “A Call to Affirmation, 14. Confession of Faith in a Mennonite Perspective, 31-32. Confession, and Covenant Regarding Human Sexuality.” 15. General Conference of Mennonite Brethren Churches, Confession of Faith: Commentary and Pastoral 33. Mennonite Central Committee, signatory, “Letter in Application, 62; see also Confession of Faith in a Opposition to Hefley Amendment to H.R. 4104.” Mennonite Perspective, 42-44. 34. General Conference of Mennonite Brethren Churches, 16. Confession of Faith in a Mennonite Perspective, 66-67. Confession of Faith: Commentary and Pastoral Application, 115. 17., “The Biblical Evaluation of Human Life,” 10. 35. Confession of Faith in a Mennonite Perspective, 72.

18. Confession of Faith in a Mennonite Perspective, 77. 36. General Conference of Mennonite Brethren Churches, Confession of Faith: Commentary and Pastoral 19. For example, the topic sheets developed by Mennonite Application, 126. Mutual Aid on “Stewardship for Life.” These include discussions of nutrition, time management, prayer, 37. Ibid., 124.

12 THE ANABAPTIST TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS 38. Confession of Faith in a Mennonite Perspective, 74. Handicapped: A Case Study in Christian Character.”

39. Mennonite General Conference, “Statement on 51. Cf. section, “Genetic Manipulation,” Mennonite Christian Parenthood.” Central Committee Canada, Occasional Papers, No. 17.

40. Friesen, Moral Issues in the Control of Birth, 18, 36. 52. General Conference Mennonite Church, “Guidelines on Abortion,” 4. 41. Charles et al., Human Sexuality in the Christian Life, 100-101. 53. See section, “Prenatal Screening,” in Mennonite Central Committee Canada, Occasional Papers, No. 17. 42. See also General Conference of Mennonite Brethren Churches, Confession of Faith: Commentary and 54. Cf. Ebersole, “Organ Transplants,” 109, 111. Pastoral Application, 161. 55. Scot D. Yoder, “Transplants, Justice, and Health Care 43. General Conference Mennonite Church, “Guidelines Reform: What Can Health Insurers Contribute?” 52. on Abortion.” 56. See section, “Foetal Research,” in Mennonite Central 44. The same logic applies regarding the spread of AIDS: Committee Canada, Occasional Papers, No. 17. “Recommendations for condom use come after the preferable recommendation to abstain or be monoga- 57. Newfeld, ed., If We Can Love: The Mennonite Mental mous” (Mennonite Mutual Aid, Responding to HIV Health Story, 27. and AIDS: A Resource Guide for Congregations, 15). 58. Horning, A Christian View of Mental Illness: 45. Friesen, Moral Issues in the Control of Birth, 18, 37. Understanding and Response.

46. See section, “In Vitro Fertilization,” in Mennonite 59. General Conference of Mennonite Brethren Churches, Central Committee Canada, Occasional Papers, No. 17: Confession of Faith: Commentary and Pastoral Brief Submitted to the Royal Commission on New Application, 198. Reproductive Technologies; cf. General Conference of 60. Ibid., 153. The reference to “active suicide” is meant Mennonite Brethren Churches, Confession of Faith: to distinguish the active aiming at death in suicide or Commentary and Pastoral Application, 162; Hershberger, assisted suicide from appropriate cases of allowing to “Procreation: Extraordinary Means,” 93-101. die by removing life-sustaining technology. In such 47. Charles et al., Human Sexuality in the Christian Life, cases the likelihood of death is recognized, but death 101-103; Miller, “The Maze of Bioethical Dilemmas,” is not directly sought. Most Anabaptist groups recog- 211. See also section, “Artificial Insemination by nize that numerous factors may play a part in an indi- Donor,” in Mennonite Central Committee Canada, vidual’s decision to commit suicide. For example, sui- Occasional Papers, No. 17. cide may be the tragic result of mental illness, and thus grow out of the fallen conditions of creation. 48. See section, “Surrogacy,” in Mennonite Central Sometimes suicide is an act of fear or despair that may Committee Canada, Occasional Papers, No. 17. Cf. also reflect the community’s failure to surround the General Conference of Mennonite Brethren Churches, individual with appropriate comfort care and support. Confession of Faith: Commentary and Pastoral At other times, suicide is an act of hubris whereby Application, 117; Miller, “The Maze of Bioethical humans claim the divine prerogative of determining Dilemmas,” 210-11; Hershberger, “Procreation,” 98. the timing of life and death. By contrast, allowing someone to die by removing life-sustaining technology 49. General Conference of Mennonites in Canada, (sometimes mistakenly referred to as passive suicide) “Resolution on Abortion”; Conference on Life and is often a humble acknowledgement of God’s timing Human Values; Mennonite Church General Assembly, and of human limitations in the face of death. “Summary Statement on Abortion”; General Conference Mennonite Church, “Guidelines on 61. Ibid. Abortion”; 198th Annual Conference of the , “Statement on Abortion”; Shantz, comp. 62. Cf. Kotva, “A View from Two Sides: The Principle and and ed., Resource Packet on Abortion. Its Cases.”

50. See also Graber and Graber, Lessons from Emily; 63. General Conference of Mennonite Brethren Churches, Preheim-Bartel and Neufeldt, Supportive Care in the Confession of Faith: Commentary and Pastoral Congregation; Kotva, “Welcoming the Mentally Application, 161.

THE PARK RIDGE CENTER 13 BIBLIOGRAPHY

198th Annual Conference of the Church of the Brethren. Hershberger, Anne Krabill. “Procreation: Extraordinary “Statement on Abortion.” Messenger [official publica- Means.” In Medical Ethics, Human Choices: A tion of the Church of the Brethren], August 1984, 14. Christian Perspective, edited by John Rogers, 93-101. Scottdale, Pa.: Herald Press, 1988. Braght, Thieleman J. Van, comp. and ed. Martyrs Mirror. Translated by Joseph F. Sohm. Scottdale, Pa.: Herald Horning, Crystal. A Christian View of Mental Illness: Press, 1987. Understanding and Response. Educational resource. Goshen, Ind.: Mennonite Mutual Aid, 2001. Charles, Howard, et al. Human Sexuality in the Christian Life. Scottdale, Pa.: Mennonite Publishing House, 1985. Klaassen, Walter. Anabaptism: Neither Catholic Nor Protestant. Scottdale, Pa.: Herald Press, 2001. Conference on Life and Human Values. Proceedings of the conference, sponsored by Mennonite Medical Kotva, Joseph J., Jr. “A View from Two Sides: The Principle Association. , 1973 (available from the and Its Cases.” Christian Bioethics 3, no. 2 (August Associated Mennonite Biblical Seminary Library [con- 1997): 158-72. tact information below]). ______. “Welcoming the Mentally Handicapped: A Case Confession of Faith in a Mennonite Perspective. Scottdale, Study in Christian Character.” Restoration Quarterly Pa.: Herald Press, 1995. 34, no. 4 (1992): 223-37.

Dyck, Cornelius J. An Introduction to Mennonite History: A Krabill, Willard S. Advance Directives: The Quest for a Popular History of the Anabaptists and the Mennonites. Good Death. Educational resource. Goshen, Ind.: Third ed. Scottdale, Pa.: Herald Press, 1993. Mennonite Mutual Aid, 1991.

Ebersole, Myron. “Organ Transplants.” In Medical Ethics, ______. I’m Not Whole Without You: Wholeness and Human Choices: A Christian Perspective, edited by John Mutual Aid. delivered at College Mennonite Rogers, 103-112. Scottdale, Pa.: Herald Press, 1988. Church. Goshen, Ind.: Mennonite Mutual Aid, 1984.

Friesen, Duane K. Moral Issues in the Control of Birth. Kraybill, Donald B., and C. Nelson Hostetter. Anabaptist Newton, Kan.: Faith and Life Press, 1974. World USA. Scottdale, Pa.: Herald Press, 2001.

General Conference Mennonite Church. “Guidelines on Mennonite Central Committee, signatory. “Letter in Abortion.” Adopted at the Triennial Sessions, Estes Opposition to Hefley Amendment to H.R. 4104.” Park, Colo., 1980. 1998. Http://www.ambs.edu/LJohns/Hefley.htm.

______. “Resolution on Human Sexuality.” Adopted at the Mennonite Central Committee Canada. Occasional Papers, 1986 Triennial Session, Saskatoon, Sask. No. 17: Brief Submitted to the Royal Commission on Http://www.ambs.edu/LJohns/Resolutions.htm. New Reproductive Technologies. 1992. Available from MCC East Coast (contact information below). General Conference of Mennonite Brethren Churches. Http://www.mcc.org/respub/occasional/17.html. Confession of Faith: Commentary and Pastoral Application. Hillsboro, Kan.: Kindred Productions, Mennonite Church. “A Call to Affirmation, Confession, and 2000. Covenant Regarding Human Sexuality.” Adopted at the 1986 Triennial Session, Saskatoon, Sask. General Conference of Mennonites in Canada. “Resolution Http://www.ambs.edu/LJohns/Resolutions.htm. on Abortion.” In A Theology of Life and Human Value (proceedings of a conference sponsored by the Mennonite Church General Assembly. “Resolution on Mennonite Medical Association). Chicago, 1973 (avail- Health Care in the United States.” , 1993. able from the Associated Mennonite Biblical Seminary Library [contact information below]). ______. “Summary Statement on Abortion.” Abortion Packet, p. 60. 1975. Available from the Associated Mennonite Graber, Peter, and Mary Graber. Lessons from Emily. Biblical Seminary Library (contact information below). Educational resource. Goshen, Ind.: Mennonite Mutual Aid, 1994.

14 THE ANABAPTIST TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS Mennonite Church USA. Membership Guidelines. Adopted ______. From Anabaptist Seed. Kitchener, Ont.: Pandora at the delegate assembly, July 2001. Press, 1999. Http://mcusa.mennonite.net/membership_guide- lines/membership_guidelines.html. Snyder, Graydon F. Health and Medicine in the Anabaptist Tradition: Care in Community. Valley Forge: Trinity Mennonite General Conference. “Statement on Christian Press International, 1995. Parenthood.” 25 August 1961. Swartley, Willard M., and Donald B. Kraybill, eds. Building Mennonite Mutual Aid. Congregational Health Ministries. Communities of Compassion: Mennonite Mutual Aid in Manual. Goshen, Ind.: Mennonite Mutual Aid, n.d. Theory and Practice. Scottdale, Pa.: Herald Press, 1998.

______. Making Your Wishes Known: Guidelines for Waltner, Erland. “Health and Wholeness in Christ Creating Your Advance Medical Directive. Educational (Presentation to the Health Assembly at the resource. Goshen, Ind.: Mennonite Mutual Aid, n.d. Mennonite World Conference, , France).” 1984. Available in the General Papers archive, ______. Responding to HIV and AIDS: A Resource Guide Associated Mennonite Biblical Seminary Library (con- for Congregations. Educational resource. Goshen, Ind.: tact information below). Mennonite Mutual Aid, n.d. ______. “New Call to ‘Health-Making’ (A Sermon by Miller, Marlin E. “The Maze of Bioethical Dilemmas.” In Erland Waltner, President of Mennonite Health Bioethics and the Beginning of Life, edited by Roman Association).” 1983. Available in the General Papers J. Miller and Beryl Brubaker, 203-213. Scottdale, Pa.: archive, Associated Mennonite Biblical Seminary Herald Press, 1990. Library (contact information below).

Newfeld, Vernon H., ed. If We Can Love: The Mennonite Mental ______. “Toward an Anabaptist Theology of Chaplaincy in Health Story. Newton, Kan.: Faith and Life Press, 1983. Health Care Institutions (Given at the Mennonite Health Assembly, St. Louis, ).” 1980. Available in Preheim-Bartel, Dean A., and Alfred H. Neufeldt. the General Papers archive, Associated Mennonite Supportive Care in the Congregation. Educational Biblical Seminary Library (contact information below). resource. Published collaboratively by Mennonite Central Committee, Mennonite Mental Health Yoder, John Howard. “The Biblical Evaluation of Human Services, and Mennonite Developmental Disabilities Life.” Paper in A Theology of Life and Human Value Services, 1986. Now available from Mennonite Mutual (proceedings of a conference sponsored by the Aid (contact information below). Mennonite Medical Association). Chicago, 1973 (avail- able from the Associated Mennonite Biblical Seminary Shantz, Kathy, comp. and ed. MCC Canada Resource Library [contact information below]). Packet on Abortion. 1991. Available from Mennonite Central Committee (contact information below) and Yoder, Scot D. “Transplants, Justice, and Health Care MCC Canada (contact information below). Reform: What Can Health Insurers Contribute?” Second Opinion 18, no. 1 (July 1992): 49-67. Snyder, C. Arnold. Anabaptist History and Theology: An Introduction. Kitchener, Ont.: Pandora Press, 1995.

CONTACT INFORMATION

Library MCC Canada MCC East Coast Mennonite Central Mennonite Mutual Associated Mennonite 134 Plaza Drive 21 South 12th St. Committee Aid Biblical Seminary , MB PO Box 500 21 South 12th St. 1110 N. Main St. 3003 Benham Ave. R3T 5K9 Akron, PA 17501-0500 PO Box 500 PO Box 483 Elkhart, IN 46517 (888) 622-6337 (717) 859-3889 Akron, PA 17501-0500 Goshen, IN 46527 (574) 296-6253 (204) 261-6381 (888) 563-4676 (800) 348-7468 (717) 859-1151 (574) 533-9511

THE PARK RIDGE CENTER 15 Introduction to the series eligious beliefs provide meaning for people substitute for discussion of patients’ own reli- R confronting illness and seeking health, par- gious views on clinical issues. Rather, they ticularly during times of crisis. Increasingly, should be used to supplement information com- healthcare workers face the challenge of provid- ing directly from patients and families, and used ing appropriate care and services to people of dif- as a primary source only when such firsthand ferent religious backgrounds. Unfortunately, information is not available. many healthcare workers are unfamiliar with the We hope that these booklets will help practi- religious beliefs and moral positions of traditions tioners see that religious backgrounds and beliefs other than their own. This booklet is one of a play a part in the way patients deal with pain, ill- series that aims to provide accessible and practi- ness, and the decisions that arise in the course of cal information about the values and beliefs of treatment. Greater understanding of religious tra- different religious traditions. It should assist ditions on the part of care providers, we believe, nurses, physicians, chaplains, social workers, and will increase the quality of care received by the administrators in their decision making and care patient. giving. It can also serve as a reference for believ- ers who desire to learn more about their own tra- ditions. Each booklet gives an introduction to the his- tory of the tradition, including its perspectives on health and illness. Each also covers the tradi- tion’s positions on a variety of clinical issues, with attention to the points at which moral dilemmas often arise in the clinical setting. Final- ly, each booklet offers information on special concerns relevant to the particular tradition. The editors have tried to be succinct, objec- tive, and informative. Wherever possible, we have included the tradition’s positions as reflected in official statements by a governing or other formal body, or by reference to positions formulated by authorities within the tradition. Bear in mind that within any religious tradition, there may be more than one denomination or that holds views in opposition to mainstream positions, or THE PARK RIDGE CENTER groups that maintain different emphases. FOR THE STUDY OF HEALTH, FAITH, AND ETHICS The editors also recognize that the beliefs and 205 West Touhy Avenue ● Suite 203 ● Park Ridge, 60068-4202 values of individuals within a tradition may vary from the so-called official positions of their tradi- tion. In fact, some traditions leave moral deci- The Park Ridge Center explores and sions about clinical issues to individual enhances the interaction of health, faith, conscience. We would therefore caution the read- and ethics through research, education, and consultation to improve the lives of er against generalizing too readily. individuals and communities. The guidelines in these booklets should not © 2002 The Park Ridge Center. All rights reserved.

16 THE ANABAPTIST TRADITION: RELIGIOUS BELIEFS AND HEALTHCARE DECISIONS