ABORTION

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ABORTION

ABORTION
Abortion has been with us throughout the ages. While first accepted as a necessary measure or “therapy” in saving the life of the mother, it has also been accepted in many countries as a means of population control, “quality of life” control (in the case of deformed fetuses) and reproductive control. It is often a choice for teens and women in economic hardship who do not have the resources to care for a child, as well as for women who are victims of rape and incest. In modern Western culture the justification and acceptance of this practice has widened as women’s rights and reproductive rights have come to the forefront. Often a woman’s request for abortion is justification enough for the procedure.

Medical Considerations

Medical Considerations
Abortion is termination of a pregnancy. It can be classified as either spontaneous or induced. A spontaneous abortion is a miscarriage, that is, the pregnancy ends usually due to various chromosomal or congenital defects, diseases or infections—of fetal or maternal origin. Unlike spontaneous abortion, an induced abortion is not a natural process of the body and involves a medical intervention. This intervention is of two types—therapeutic or elective—depending on the reason for the abortion. If the mother’s life is in danger, as in the case of cardiovascular and hypertensive diseases, an abortion might be performed for therapeutic reasons. An elective or voluntary abortion, on the other hand, is requested for reasons other than maternal health and is the most commonly performed type of abortion in the West today. It is estimated that approximately 25 percent of all pregnancies in the world are terminated by elective abortion, making this the most common method of reproduction limitation.
The method chosen for an abortion is commonly determined by factors like the duration of the pregnancy, the patient’s health, the experience of the physician and the physical facilities. The methods include (1) suction or surgical curettage; (2) induction of labor by means of intra- or extraovular injection of a hypertonic solution or other oxytocic agent; (3) extraovular placement of devices such as catheters, bougies or bags; (4) abdominal or vaginal hysterotomy and (5) menstrual regulation. About 75 percent of induced abortions in the United States are performed by suction curettage for a pregnancy of twelve weeks’ duration or less; these are usually performed in abortion outpatient clinics. There are, however, medical concerns about this spreading practice.
The two major medical reasons for limiting abortion today are fetal viability (which changes with technological capabilities) and medical consequences to the mother. Viability, the point at which a fetus can survive outside the mother’s womb, now stands at twenty-four weeks and can often be easily defined. Yet the consequences of an abortion procedure to the mother are debated and controversial. While most abortions, especially those done in the first trimester, are safe for women physically, the psychological sequelae have gone undocumented. Some reports deny serious psychological effects of abortion, but most cite overwhelming statistics indicating dire long-term negative effects, including guilt, shame, depression, grief, anxiety, despair, low self-esteem, distrust and hostility. Women with previous histories of psychiatric illnesses tend to be affected to a greater degree.
Both the Canadian Medical Association and the American Medical Association recognize abortion as a medical procedure available under the law. Recently, the Accreditation Council for Graduate Medical Education called for compulsory abortion training for students of obstetrics (McFarland, p. 25). In contrast, the Christian Medical and Dental Society (CMDS) opposes the practice of abortion.

Prolife Versus Prochoice

Prolife Versus Prochoice
It is most unfortunate that the abortion debate is divided into two clearly opposing camps: the prolife and the prochoice, each entrenched in its respective uncompromising positions. The prolife stance holds the view that the fetus is a developing human being with intrinsic values and inviolable rights. She is as much a human being as the mother. So the sanctity of the fetal life in the womb, however developed, should have priority over the reproductive freedom of the woman. Abortion should be considered only when the life of the mother is in jeopardy. The basis of the prolife position is largely, but not exclusively, grounded on divine authority and the belief that human life is a gift of God.
The prochoice position does not see the fetus as possessing rights independent of the mother, who alone has the right to decide the fate of the fetus. This maternal right is in turn grounded in the principle of autonomy or self-determination, which provides the mother with freedom to make reproductive choices. The prochoice position also views access to abortion as necessary for women’s complete social equality. They see reproduction as the major obstacle to women’s competing successfully with men, and hence control of reproduction, including abortion, is necessary for equality. Any restriction of the availability of abortion is interpreted as coercing women to carry pregnancies to term against their will.

Personhood

Personhood
While it is seldom disputed that a conceptus or a fetus is human, there is hardly a consensus as to when a human person begins. Personhood is still a crucial and practical issue, since modern society accords a person certain moral rights, such as the right to life. General philosophical criteria for personhood include any one, a few or all of the following: rationality, consciousness, self-consciousness, freedom to act on one’s own reasons, capacity to communicate with others and capacity to make moral judgments. Some hold that only when one or all of these qualities have been actualized should a human being be considered a person (actuality principle). Others feel that these qualities of personhood only emerge gradually in the course of fetal and early childhood development, so what counts in defining personhood is the potential that the human life possesses (potentiality principle). In this view fetuses and infants are recognized as having different degrees of personhood and therefore are given different measures of right to life.
The Bible does not use specifically the words person or personhood, but a biblical view of personhood can be established on the basis of a Christian doctrine of the image of God. Genesis 1:26-27 reads: “Then God said, ‘Let us make man in our image, in our likeness, and let them rule.’ . . . So God created man in his own image, in the image of God he created him; male and female he created them.” Because God exists as three persons in communion, we also believe that human persons are created in his image to live in community. The most fundamental attribute of being in the image of God and human personhood, therefore, is relationality. God creates every single human person in order to relate to him or her. In response, every created human person seeks to relate to the Creator and other fellow creatures. Since each human being is created uniquely by God, every single human being is God’s image bearer. This is the ground for personhood, uniqueness and the right to life. Life is sacred because God creates a particular life for a unique relationship between him as the Creator and us as his creatures. This relationship begins when a conceptus is formed as God permits a human sperm and ovum to unite in the creation of a new unique life. How that life unfolds and whether all the inherent potentialities are actualized or not do not take away the intrinsic value of that life as God’s image bearer, a human person.

A Christian Response

A Christian Response
Such a Christian understanding of personhood undergirds the proper attitude toward abortion. The sixth commandment in the Bible (not to kill; Exodus 20:13) carries the positive mandate of stewardship of all lives as sacred to God. This means not that the value of life is absolute (Matthew 24:9) but rather that no life is to be taken without an absolutely and unequivocally justifiable reason. As the Creator and Giver of life, it is God who ultimately has the sovereign right to take away life. So any attempt to terminate life, as in an abortion, must be done with the fullest sense of accountability before the sovereign God. For this reason the CMDS, both in the U.S. and Canada, in contrast to its secular counterparts, opposes the routine practice of abortion. Four main points are maintained in their position: (1) CMDS opposes abortion, yet supports alternatives; (2) CMDS believes abortion is in opposition to the Word of God, to respect for the sanctity of life and to traditional, historical and Judeo-Christian medical ethics; (3) CMDS believes that the Bible espouses principles that oppose the interruption of pregnancy (the sovereignty of God, the value of life over quality of life, moral responsibility in sexual conduct); (4) in the face of rights arguments put forth by patients and physicians alike, CMDS adheres to the final authority of Scripture, which teaches the sanctity of human life.
But resolving the dilemma of abortion takes more than ardently defending the sanctity of life in the unborn, for there is sacred life to embrace, though tragically unwanted, when abortion is opposed and denied. As a community that espouses Christian teachings and opposes abortion, we must be prepared to parent any children, not just our own, as a shared obligation. This means taking concrete steps to receive unwanted children into our families as a gesture of taking seriously the sacred lives God has created and exercising stewardship.
As a community of grace, Christians must, in addition to exercising the stewardship of life, honor our obligation of love. Love sees a woman seeking abortion as a neighbor in need of compassion. Regardless of whether abortion is given or denied, the pregnant mother, father and other members of the family will likely feel wounded. The Christian community must live out its spirit of koinōnia by developing various forms of care and support during such a difficult time and by providing a context in which repentance, reconciliation, healing and nurturing may take place.
Finally, the Christian community must not abdicate its responsibility in the prevention of abortion in our society. This must be achieved through education of our teenagers and young adults with regard to moral sexual conduct and responsible family planning. Sexual abilities are given to human beings to experience in part on earth what God is fully in eternity—love. Children, as a product of the love between husband and wife, are gifts from God to deepen the experience of love. No sex or childbearing outside the institution of marriage fulfills this divine intention. Christian education in the form of counseling is also important, and participation with a Christlike humility and patience in organizations such as Pregnancy Crisis Center enables a Christian community to resolve and persevere with the abortion dilemma.
» See also: Parenting
» See also: Self-Esteem
» See also: Sexuality

References and Resources

References and Resources
T. Beauchamp and L. Walters, eds., Contemporary Issues in Bioethics (Belmont, Calif.: Wadsworth, 1989) 181-239; S. McFarland, “The Abortion Rotation,” Christianity Today 39, no. 4 (1995) 25; F. Mathewes-Green, Real Choices: Offering Practical, Life-Affirming Alternatives to Abortion (Sisters, Ore.: Multnomah, 1994); M. L. Pernoll, ed., Current Obstetric and Gynecologic Diagnosis and Treatment, 7th ed. (Stamford, Conn.: Appleton & Lange, 1991); P. Ramsey, “Morality of Abortion,” in Life or Death: Ethics and Options (Seattle: University of Washington Press, 1968) 60-93; D. C. Reardon, Aborted Women, Silent No More (Westchester, Ill.: Crossway Books, 1987); N. Stotland, “Psychiatric Issue in Abortion, and the Implications of Recent Legal Choices for Psychiatric Practice,” in Psychiatric Aspects of Abortion, ed. N. Stotland (Washington, D.C.: American Psychiatric Press, 1991) 1-16; J. R. W. Stott, “The Abortion Dilemma,” in Issues Facing Christians Today (Old Tappan, N.J.: Fleming H. Revell, 1984) 2:187-214.
ABUSE
There has been a dramatic increase in the public’s awareness of and concern about various forms of abuse, primarily family abuse. Most of this is physical and sexual assault as well as psychological and emotional abuse against women and children. According to the Federal Bureau of Investigation one out of every two American women is beaten during her marriage; 28 percent are battered at least once a year. A woman is battered every fifteen seconds. Battering is the single greatest cause of injury to women in the U.S., more than accidents, rapes and muggings combined. Over 70 percent of men who batter their wives also physically or sexually assault their children. The vast majority of women who are beaten, raped or murdered are assaulted by someone with whom they are intimate. By contrast, men who are beaten or murdered are assaulted by total strangers. The FBI estimates that less than 10 percent of domestic violence is reported to authorities.

Understanding Abuse

Understanding Abuse
Abuse is a buzzword today. One way of overcoming this is to view abuse on a continuum. At one end of the continuum we place brutal, systematic exploitation and oppression. Here power abuse is often premeditated, and the perpetrator knows full well that the abuse hurts others. At the opposite end of the continuum we place relatively mild and sporadic social manipulation. Here the abuser does not intend harm but blindly pursues personal desires and hurts others in the process. Many such abusers are curiously naive about the damage they do to others. This naiveté is usually a factor when abuse occurs in the church.
Abuse of any type occurs when someone has power over another and uses that power to hurt. Physical abuse means that someone exercises physical power over another and causes physical wounds. Sexual abuse means that someone exercises sexual power over another and causes sexual wounds. Spiritual abuse means that someone in a position of spiritual authority uses that position to inflict spiritual wounds. And so, social, political and psychological abuse occurs when those in power use that power to cause unjust suffering to those around them.

The Silent Epidemic

The Silent Epidemic
The American Medical Association refers to physical and sexual abuse against women and children as the “silent epidemic” of the 1990s. The AMA tells physicians to be on the lookout for symptoms of abuse and then to go beyond just treating those symptoms. Once doctors see evidence of abuse they are urged to report it to authorities. If necessary, doctors are to assist in pressing charges against the perpetrators of the abuse. This new activism on the part of physicians is one indication of society’s alarm over abuse.
Is there a real increase of abuse today, or are we just reporting it and talking about it more? The answer to both questions is yes. There is a documented increase of child abuse in the home and sexual abuse in and outside the home. For instance, twenty-year-old women are reporting nearly twice the instances of sexual assault against them as their mothers had experienced at the same age.
Also, abuse has become a less taboo topic. For years Americans maintained a virtual silence on the issues of child abuse and sexual violence against women in the home. The church was most reticent of all to discuss these concerns, but now they are out in the open. The Roman Catholic Church, for example, is dealing openly with child sexual abuse by its priests. Some leaders estimate that by the year 2000, the Catholic Church will have paid out over one billion dollars in settlements to victims of clergy sexual abuse.
Spiritual abuse happens when a leader with spiritual authority uses that authority to coerce, control or exploit a follower, thus causing spiritual wounds. Unlike physical abuse, which often results in bruised bodies, spiritual abuse leaves scars on the psyche and soul. Counselors report that those wounded by spiritual abuse share many symptoms seen in victims of childhood sexual abuse, including deep fearfulness, depression, anxiety and an inability to trust. They are often too ashamed to talk openly about it. Some who do talk about their experiences are called “divisive” or “troublemakers” or are told that they are the problem.
Spiritual abuse is as widespread today as it was at the time Jesus spoke the words which contain the Bible’s clearest teaching on the subject. Jesus points out that abusive spiritual leaders demand authority for themselves, based on title and office (Matthew 23:6-7), whereas healthy leaders rely on their demonstrated servanthood to exercise influence. Abusive leaders oppress and manipulate people by heaping on people loads of legalism, guilt and shame (Matthew 23:4), while nonabusive leaders lift those burdens off, directing their followers to Jesus Christ for rest and for “yokes” that are light and fit well (Matthew 11:28-30).
Spiritual abuse occurs on a continuum from minor and sporadic to heavy-handed and systematic. Some abusers are easy to identify by their obviously immoral behavior. Others are much more subtle, but equally damaging. They may officially embrace an orthodox theology and present a polished, respectable public image. But in reality they practice “another gospel” which undermines adult reasoning and personal relationship with God in favor of unbalanced submission to an authoritarian church leadership. Such people subtly coerce their congregations through skillful use of language of intimacy and trust. When these types of leaders pretend to be a friend representing the heart of God and use this illusion to dehumanize and manipulate people, they inflict deep spiritual wounds.

Exploring the Reasons

Exploring the Reasons
Many factors contribute to the increasing incidence of abuse: sociological, political, cultural and spiritual. People in the Western world feel an increasing sense of powerlessness, pressured as they are by an increasingly automated, depersonalized and globalized society. One way of responding to powerlessness is by violence, and persons closest at hand frequently are the targets of this frustration. Further, society in general is decaying. Increasingly we hear our culture described as “post-Christian.” One symptom of this is that what is right and wrong from a biblical perspective is taught and understood less and less. Since there no longer exists a moral consensus among us, people increasingly do what is right in their own eyes.
The breakdown of the family also contributes to the increase of abusive behavior in children. Children who grow up in broken and otherwise dysfunctional homes often suffer from poor emotional health and tend to be less psychologically stable. Statistically they are also more likely to be the victims of abuse. Add to this their anger and frustration over being neglected and their efforts to survive under oppressive living conditions, and it is easy to see why disadvantaged children often act out and tend to become abusive toward others. Abusive parents today were very likely victims themselves of parental abuse. This creates a dismal generational view of the problem.
Sadly, there is little difference between the moral performance of the general public and churchgoers. Frequency of all kinds of abuses is more or less the same for the “Christian” and non-Christian population—the abuse of power among church leaders approximates the abuse of power among leaders elsewhere. Power always brings privileges, and all too frequently these privileges are abused.

Using and Abusing Power

Using and Abusing Power
The idea of power is complex. Every living human being possesses power. That is to say, every living person has some capacity to act on the environment and effect change—some more, some less. Some people are strong physically, intellectually, spiritually, politically, socially and so on. They have more power. Others are weak. They obviously have less power. Society dictates how certain kinds of power are distributed. Some people are awarded more power, some less. That means that some are dominant and others must defer. In most societies police officers are assigned power. In business bosses are assigned power. In religion pastors and priests are assigned power. In all our social arrangements, power is unequally distributed.
This unequal distribution of power is not the problem so far as the Bible is concerned. “Everyone must submit himself to the governing authorities, for there is no authority except that which God has established” (Romans 13:1). The problem arises when those with power use that power to hurt others. When the power arrangements in church and society produce injustice, then God comes against the power abusers and to the aid of the victims. As God’s people, we must have the same attitude.
The Old Testament prophets spoke frequently on God’s behalf against the political and religious power abusers of their day: “For three sins of Damascus, and even for four, I will not turn back my wrath. Because she threshed Gilead with sledges . . .” (Amos 1:3). When those who were abusing power did not repent of their sin, God stepped in to judge them and work justice for the victims. “The Sovereign Lord says: I am against the shepherds and will hold them accountable for my flock. I will remove them from tending the flock. . . . I myself will search for my sheep and look after them” (Ezekiel 34:10-11).
Jesus continued God’s justice work as he spoke out against the ecclesiastical power abusers of his day and offered help to their victims: “Woe to you, teachers of the law and Pharisees, you hypocrites! You shut the kingdom of God in men’s faces” (Matthew 23:13). “They tie up heavy loads and put them on men’s shoulders” (Matthew 23:4). “Come to me, all you who are weary and burdened, and I will give you rest” (Matthew 11:28).
God not only distributes power and allows society to make power arrangements but also demands that those in power act responsibly. Specifically, God calls those in power to use it to serve those subject to them. Isaiah says to the power brokers of his day, “If you do away with the yoke of oppression . . . and if you spend yourself in behalf of the hungry and satisfy the needs of the oppressed . . . the Lord will guide you always” (Isaiah 58:9-11). That is to say, those in power with the ability to serve the needy are obliged to do so. Jesus put it this way: “You know that the rulers of the Gentiles lord it over them. . . . Not so with you. Instead, whoever wants to become great among you must be your servant” (Matthew 20:25-26). Jesus has no problem with someone becoming powerful so long as the power of greatness is exercised in servanthood.

Healing Abuse

Healing Abuse
Anyone with power over others is a potential abuser. Parents have power over children, husbands over wives, bosses over workers, police over citizens, pastors over church members. Before God, these positions of authority, privilege and power come with obligations. Jesus himself models how to carry out these obligations. Jesus exercised authority and power over his followers by washing their feet and laying down his life for them. He was among them as one who served. Paul says that if we possess power and authority of any kind we are to follow Jesus’ example. “Your attitude should be the same as that of Christ Jesus: Who, being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant” (Phil. 2:5-7).
Abuse should not become the next cause or the witch-hunt of the nineties. We must be careful to discern patterns of abuse from incidents of mistakes. However, Jesus was certainly not silent on this issue, and we should, as always, follow his example. Any type of abuse continues because of ignorance and silence. As we responsibly discuss it, we can identify and stop it. As we learn to spot and correct abusive leaders and systems, we can also identify and support healthy, nonabusive leaders and systems. In addition, we can bring understanding and healing to many who remain shamed and wounded by past abuse.
The cure for abuse is spiritual healing. This begins with knowing the truth. “You will know the truth, and the truth will set you free” (John 8:32). The truth is that God is angry at abuse perpetrated in the divine Name. God stands ready and able to heal the effects of such abuse and to turn bad family and church experiences into wisdom and power in our lives.

References and Resources

References and Resources
K. Blue, Healing Spiritual Abuse (Downers Grove, Ill.: InterVarsity Press, 1993); P. R. Gaddis, Battered but Not Broken: Help for Abused Wives and Their Church Families (Valley Forge, Penn.: Judson Press, 1996); Bruce A. Chadwick and Tim B. Heaton, eds., Statistical Handbook on the American Family Violence (Phoenix: Onyx, 1992); Linda Schmittroth, ed., Statistical Record of Children Crimes (Washington, D.C.: Gale Research, 1994).
ACCOUNTABILITY, RELATIONAL
It used to be popular to say, “No one is an island,” reflecting a cultural understanding of connectedness and responsibility between people. But it is different today. Simon and Garfunkel’s plaintive 1960s folksong preached, “I am a rock; I am an island,” reflecting the extreme of our society’s rugged individualism. It is in this environment that accountability has almost disappeared and loneliness has become dominant.

Designed for Accountability

Designed for Accountability
Rugged individualism goes against God’s design for human society. We were designed to be interconnected and complementary to each other. Even though the word accountability does not occur in most Bible translations, the concept is foundational. Male and female were designed to “become one flesh” (Genesis 2:24). People of faith are to answer to one another (Acts 15:1-4; James 5:14-20).
A very clear picture of accountability is presented by Paul in his letter to the Corinthian church. Here he uses the image of a builder to describe all people of faith. He then describes how what we build will be measured and the quality or lack of it will bring either reward or loss. He clearly explains how responsible we are to God for all we are and do (1 Cor. 3:10-23).

Meaning of Accountability

Meaning of Accountability
What does accountability actually mean? Some contemporary definitions include the following:
Reckoning. Computation. A statement explaining one’s conduct. (Webster’s Dictionary)
Accounting denotes certain theories, behavioral assumptions, measurement rules and procedures for collecting and reporting useful information concerning the activities and objectives of an organization. (Encyclopedia Britannica)
Accountability looks back to some deed done or attitude held. Obligation looks forward to moral demands that need to be met in relationships. (Cole, pp. 734-35)
Our cultural understanding suggests that accountability is best designed when it encourages desirable performance. This process is served by the disciplines of bookkeeping or the classifying of data and activities in order to measure them against agreed-upon standards and expectations.
But in the community of faith it is much more. Accountability for believers is more dynamic. It is organic in nature and expressed through relationships, networks and systems. It is developed through visibility as in commissioning or storytelling, reporting and case-study processes. Further it is developed through strong relationships and creating a “confessing” environment among congregational or small-group leaders, thereby encouraging it among others (James 5:16). Reflection questions can be used in small groups to help people self-audit and mutual friends inquire of each other. Finally, accountability is demonstrated through stewardship and audit rhythms through annual reports, budgets, building upkeep, staff reviews and so on that are magnetic, enriching and clarifying.

Accountability in Scripture

Accountability in Scripture
There are examples of accountability in Scripture. Jesus exhibited accountability to his Father as he prayed and reviewed his work in his high priestly prayer (John 17:1-25). He illustrated our accountability to particular kinds of people by his concern for “the least of these” (Matthew 25:40). Ananias and Sapphira were held accountable for their manipulation of money and reputation in the early church and were punished for their violation of the group’s integrity (Acts 5:1-11).
Paul and Barnabas demonstrated their understanding of accountability when they voluntarily reported to the Jerusalem council regarding the controversy about non-Jews coming into the faith through their new work in Antioch (Acts 15:1-35). Paul declared, “Each of us will be accountable to God” (Romans 14:12 NRSV). Rewards and penalties will be administered in light of whether we construct our lives on the foundation of Jesus Christ or something less (1 Cor. 3:9-17). James held his churches accountable for their treatment of widows, the poor, the wealthy and sinners (James 1:9-11, 18; James 3:12-18; James 5:7-8, 17-18). John demonstrated that evil will be judged and recompensed in absolute and final ways (Rev. 20:1-5).

Outcomes of Accountability

Outcomes of Accountability
Accountability is essential to healthy living. Herein we find protection from our worst tendencies. Sin has given us the terrible ability to misuse every good thing. Belonging to a body of faithful believers shields us from the worst manifestations of this condition. Living in relationships that call for responsibility to others brings balance and complementarity in our areas of weakness and encourages love, forgiveness, insight, protection and care. We are designed for and are called to this, and herein we thrive. Being held responsible to each other in the faith is a human demonstration of our creation nature as those who belong to God and who delight in that relationship.

ACCOUNTABILITY, WORKPLACE

ACCOUNTABILITY, WORKPLACE
Accountability is not a new concept. Deeply ingrained in the prophetic mind of the Old Testament was the understanding that God holds the leaders of Israel accountable for the care and nurture of his people. For example, God says to the shepherds of Israel, “who only take care of themselves! . . . I am against the shepherds and will hold them accountable for my flock” (Ezekiel 34:2, 10). Where there is expectation, there is also accountability. This is true for family life, for church membership, for volunteer work, in organizations and in business.
How am I doing? Am I going anywhere? Am I growing? Am I learning? These are the questions of accountability. The expectation of progress, change or movement carries with it the element of accountability.

Accountability and Mission

Accountability and Mission
Accountability therefore rests on a corporate purpose. Without a goal, objective, mission or expectation, there would be no need for accountability. It comes into play as soon as someone desires to change from the status quo to a new level of reality, experience or accomplishment, a future against which the present is compared. Accountability accepts responsibility for movement from the present in line with the purpose and measures progress toward the mission. It does this whether the responsibility is a self-expectation or the expectation of others.

Accountability and Responsibility

Accountability and Responsibility
Accountability is in fact the flip side of responsibility. While we often use the concept of accountability to refer to the measurement of specific action or behavior in pursuit of the mission or objectives, it might be more appropriate to keep accountability closely linked with responsibility. It is only when a person is understood (and understands himself or herself) to be responsible for a particular action or progress that he or she is accountable. So accountability measures the progress or growth for which a person has accepted responsibility. It assumes that we want to grow, that we expect some movement which we want to measure, unless of course we want to stay in a steady state, in which case accountability seeks to measure that we have not lost ground!
While it is possible to be held accountable by another for a responsibility assigned, accountability and responsibility are most powerfully linked when they are owned. Ownership is the intentional internalizing of responsibility so that a person holds himself or herself accountable. When responsibility is owned, when accountability is internalized, it becomes a personal commitment and a powerful motivating force within the person.

Accountability and Commitment

Accountability and Commitment
Peter Block, in his excellent book The Empowered Manager, calls attention to the difference between commitment and sacrifice. When responsibility is imposed from outside and not owned by the person responsible, it requires sacrifice. The individual must sacrifice his or her personal vision to pursue a vision owned by someone else. This is neither satisfying nor motivating. Responsibility is assigned by someone else, and accountability is measured by someone else. On the other hand, ownership of responsibility leads to commitment. When the individual owns responsibility for the purpose, accountability flows from personal commitment. This is the highest form of motivation. The individual is accountable to himself or herself to fulfill the accepted responsibility as an expression of his or her own personal vision.

Accountability and Power

Accountability and Power
This distinction becomes painfully important in organizational settings where responsibility is given (and accepted), where accountability is expected, but the authority or resources necessary to fulfill the responsibility are not provided. This is the classic definition of powerlessness and leads to a significant loss of motivation and performance. It is critically important that the appropriate authority and resources be available to enable the person to fulfill the responsibility. Otherwise accountability is personally frustrating and organizationally meaningless.
In an organizational setting it is important to distinguish between accountability for results and accountability for tactics or strategies. Responsibility is best shared when it focuses on results and allows the individual to invest himself or herself in the determination of the best way to achieve those results in line with the organization’s mission and values. If too much specificity is involved in this, there is little responsibility given and thus little accountability. The assumption here is that responsibility can and should be shared, recognizing that this does not release those drawn into its exercise from responsibility and accountability.
Whether in business or volunteer church work, accountability structures need to be clearly defined. This can be one to one in spiritual friendships, through small groups, by means of performance reviews and through formal accountability groups, such as those outlined in David Watson’s book Covenant Discipleship.
Accountability at its best is the ownership of responsibility for results with self-evaluation and self-correction as one moves toward the accomplishment of a purpose or the living of a vision. It assumes personal integrity and organizational trust and loyalty.
ADDICTION

ADDICTION

In the past the term addiction was reserved for the compulsive and uncontrolled use of certain psychoactive substances, notably alcohol, cocaine, narcotics and other mood-altering drugs. In recent times the term has been used as an overall label for a set of diverse addictive behaviors to objects, people, relationships, ideas or pursuits. So we now talk about addictions to food, work, sex, perfection, religion, ministry, gambling and even computer games. It is commonly believed that there is an underlying similarity among the entire spectrum of addictive behaviors—that all addicts desire a sense of well-being, a temporary heightening of self-esteem, a transient experience of ecstasy, a state of oblivion or some measure of relief from pain or tension.

The Addictive Process

The Addictive Process
The first step in a potentially addictive process is the individual’s encounter with the addicting “object” and the mood-altering experience it produces, the so-called peak experience. This affects different people in differing degrees. Those who are more susceptible to addictive behaviors tend to seek repetition of the peak experience until they become mentally obsessed by this emotional craving and preoccupied by the euphoric recalls, often fed with fantastic imaginations. Because of the mental obsession, the individual begins to lose contact with self and the environment; this is most obvious in the person’s denial of his addictive relationship to the peak experience by saying, “I am not an addict.” Other forms of denial may present themselves as a tendency to minimize the problem, to find an excuse for the preoccupation or to blame others for it.
The next stage in the addictive process is a loss of control. This is manifested not only in the frequent mental recall of the peak experience but also in an escalation of the frequency of acting out. In this stage, seeking peak experiences has become a behavioral obsession, and the individual usually develops observable personality changes, becoming defensive and irritable. Although the addictive behavior may still be within socially acceptable limits, the individual begins to feel shame and remorse and may make repeated resolutions and compulsive attempts to control his or her own thought patterns and behaviors. There is a need to create an illusion to oneself and to others that he or she is still in control.
Nevertheless, repetitions of the peak experience require an increasing amount of the addictive object (for example, alcohol) to be established and maintained. (This process is known as tolerance—a form of physiologic habituation in which the nerve cells become less sensitive and responsive to repeated stimuli so that an increase is required in order to produce a similar level of satisfaction.) When this stage is reached, the addicted individual’s loss of control becomes obvious, as it is accompanied by personal and social breakdowns. Often the addicting behaviors have to be interrupted abruptly due to a number of possible reasons, including financial exhaustion or repeated troubles with the law leading to incarceration. The individual will experience a state of withdrawal that can be mentally, emotionally and physically terrible. The physical withdrawal from some substances can be life threatening.

Psychosomatic Interpretation of Addiction

Psychosomatic Interpretation of Addiction
Throughout the last century, a number of theories have been advanced to explain the causes of addiction. One approach starts from the observation that addicted persons commonly exhibit one or all the following attributes: (1) exaggerated emotions and inability to deal with them, (2) difficulty with forming and/or maintaining normal relationships, (3) inability to look after oneself and (4) low self-esteem. A psychodynamic interpretation following the Freudian tradition suggests that the addicted person may be seeking to counterbalance an unfulfilled need experienced in infancy or a developmental defect due to either a physical or a psychological deficiency; in this view an addictive behavior serves as an affective prosthetic designed to strengthen the individual’s self-esteem. In this sense, addictive behavior is seen as a form of self-medication.

Disease Model of Addiction

Disease Model of Addiction
While the psychodynamic model is valuable in explaining certain psychological aspects of addiction, it tends to disregard any biological factors as possible determining forces in addictive behaviors. In contrast, the biologic/disease model views addiction as a form of physiologic-genetic abnormality more or less beyond the control of the individual. This has been proposed since 1933 as a cause for alcoholism, with the result that hospitals were opened to treat alcoholics. The biological basis of addiction has since been corroborated by an enormous amount of neurophysiological and genetic research.
One of the most fascinating and significant studies was undertaken by James Olds and Peter Milner, who accidentally discovered in 1954 that stimulation of certain parts of the brain in experimental animals was able to elicit a pleasurable response. When allowed to self-stimulate through an electrical device, a variety of animals would seek these stimulations until they collapsed from exhaustion.
These brain areas are now referred to as reward centers or pleasure centers, and the activities within these centers are mediated by neurotransmitters such as serotonin, GABA and a number of opioid peptides. It is postulated that defects in these centers are linked to a loss or impairment of the sense of well-being and induce in the animal or human a craving for a substance(s) or activity that will relieve the feeling of dysphoria. Heroin, cocaine and amphetamines are known to interact with these centers, making them good candidates for substance abuse. Studies have also shown that activity-related elations and mood upswings associated with physical exercise, such as jogging, are related to an increased release of certain opioid/peptides (for example, endorphins known to be active in these brain centers), thus making health conscious compulsive joggers classic addicts.

Addiction and Heredity

Addiction and Heredity
Furthermore, to some extent deficiencies and imbalances in the pleasure centers have been shown to be inheritable. A degree of heredity in addictive behavior was postulated as early as the 1940s, when studies showed that the children of alcoholic parents often underestimated the amount of alcohol they consumed and usually drank considerably more than others before sensing any effect. Recent genetic research has shown that children of alcoholics have an unequal and increased susceptibility to alcoholism or other addictive behaviors when compared to their peers, even if they are raised by a nonalcoholic family.
In a thorough study based on the statistical analysis of the families of 2,651 alcoholics and 4,083 nonalcoholics, parental alcoholism was correlated specifically to alcohol problems in the children. Other adoption studies have shown a high incidence of alcoholism among the children of alcoholic parents, even if they are raised in a nonalcoholic home. These and other studies strongly suggest a possible genetic predisposition for addictive disorders, although the biological mechanism has yet to be elucidated. While the biologic/genetic model is scientific and rational and provides clear explanations for a relatively complex phenomenon, it is too much influenced by a modern paradigm of biomedicine and as such is reductionistic. Specifically, it overlooks social context and personal responsibility in health and sickness.

The Sociocultural Context of Addiction

The Sociocultural Context of Addiction
The sociocultural/behavioral model emphasizes the impact of the social and cultural environment upon the behavior of the individual and its role in the development of an addiction. This approach regards addiction as a socially acquired habit carried to the extreme. Because family plays the most significant role in one’s psychosocial well-being, the stability of the family and particularly its interactive patterns, between parents and between parents and children, may be regarded as the main psychosocial determinant for addictive susceptibility. On the whole, research has shown that a family in which adolescents are living with both biological parents represents a low-risk family environment because it allows secure attachment patterns to be established; children growing up in such an environment are less susceptible to addictive behaviors than those living with single parents or stepparents. High-risk family environments are those in which anxious and fearful parents are extremely protective and restrictive, emotionally abusive parents are contradictory and misleading in communication, or parents are physically and emotionally abusive. Marital and psychiatric problems or conflicts with the law on the part of the parents are also factors in promoting addictive behaviors in children. Outside the family, societal values and worldviews also contribute to a person’s sociocultural milieu and thus play crucial roles in causing addictive behaviors. An example of the influence of social values is seen in the spread of eating disorders, which is correlated to the idealization of slimness in modern society.

Spiritual Basis of Addiction

Spiritual Basis of Addiction
Finally, there is the moral/spiritual model. This interpretation takes into consideration the importance of human desire as a basic determinant of human life. It views human desire as created by God and for the purpose of relating to God (Genesis 1:26; Psalm 42:1-2; John 17:5). Saint Augustine’s prayer “You have made us for yourself, and our soul is restless until we find rest in you” testifies to this basic human desire. But this desire has been distorted by our sinful nature. When we are disengaged from desiring God, our proper desire is derailed. Turning away from the Creator, we look for created things, objects and relationships to replace God (Exodus 20:3-5; Romans 1:18-32; 1 Cor. 8:4). We seek peak experiences and tend to indulge in them even when they are harmful to ourselves and others. Ultimately, human desire is corrupted to lust, worship to idolatry, devotion to addiction. This model views all addictions as sinful and all sins as addictive. A true test of grace is, therefore, freedom from all our addictions. The Christian life is a pilgrimage from lust to desire and from addiction to freedom.
It is unlikely that an adequate theory of addiction will be provided by any one single model. To the extent that humans are created and redeemed to be whole (see Healing; Health), any satisfactory analysis of addictive disorders must include biological, psychological, social and spiritual dimensions.

Recovery

Recovery
The first step to recovery is to overcome the denial of addiction, not only by the addict but also by the significant others, who often act as codependents. This may involve painful but necessary confrontations, for which prayer, education and counseling are useful preparation. Next, a modification of one’s sociocultural milieu by avoiding addictive environments (for example, bars, casinos) and joining a specifically antiaddiction group (for example, Alcoholics Anonymous) is important. There is also a need to develop new skills and activities to fill the void after addictive behaviors are removed and to relearn to attend to such basic needs in life as relationships, family, physical health, housing, work and finances. At the same time, one needs to develop new skills to cope with stress, tension and inner hurts involved in feeling one’s true self, which has been masked by the addictive process in the past.
The popular Twelve Steps is a powerful and indispensable program in addiction recovery. Christians may recapture its Christian roots and put the biblical foundation back into this program. Many have witnessed it to be a life-transforming spiritual journey in which they have met God. Admission of one’s powerlessness and surrender to God (steps I, II, III; Proverbs 3:5-6; Romans 12:1) is followed by an honest self-examination and a taking of one’s personal moral inventory (step IV; Psalm 139:24; Lament. 3:40). Confession of wrongdoings and asking for forgiveness ensue (steps V, VI, VII; Psalm 37:4-5; James 4:10; James 5:16; 1 John 1:9), which also includes making restitution to those who have been harmed (steps VIII, IX; Luke 19:8). Ongoing recovery involves an ongoing journey of sanctification by continuing personal inventory and confession whenever necessary (step X; 1 John 1:7-8), and this means daily prayer and meditation to maintain conscious contact with God and to seek his will and power to carry it out (step XI; Col. 3:16). Having been visited by grace and set free, one also tries to share the good news with others who are in bondage and reach out to others who may need help (step XII; Galatians 6:2).
» See also: Drivenness
» See also: Drugs
» See also: Healing
» See also: Health
» See also: Spiritual Conflict
» See also: Spiritual Disciplines
» See also: Spiritual Growth

References and Resources

References and Resources
G. May, Addiction and Grace (San Francisco: Harper & Row, 1988); J. E. Royce, Alcohol Problems and Alcoholism (New York: Free Press, 1989); The Twelve Steps—A Spiritual Journey (San Diego: Recovery Publications, 1988).
—Edwin Hui