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What the Bible Says about Abortion, Euthanasia, and End-Of-Life Medical Decisions

"Wayne Grudem has faithfully offered a biblical-theological groundwork for making some of the most difficult decisions at the edges of life--its beginning and end."
--C. Ben Mitchell, Graves Professor of Moral Philosophy, Union University

From the beginning of life to the end, every human life is precious. In this accessible booklet, Wayne Grudem demonstrates that because humans were created in God's image, life should be treasured and preserved at all stages.

Topics Include:

The personhood of unborn children Abortion in the case of rape or to save the life of the mother Euthanasia and its legal implications Guidelines for difficult end-of-life decisions

96 pages, Paperback

Published April 28, 2020

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About the author

Wayne Grudem

125 books354 followers
Wayne Grudem (PhD, University of Cambridge; DD, Westminster Theological Seminary) is research professor of theology and biblical studies at Phoenix Seminary, having previously taught for 20 years at Trinity Evangelical Divinity School. Grudem earned his undergraduate degree at Harvard University, as well as an MDiv from Westminster Seminary. He is the former president of the Evangelical Theological Society, a cofounder and past president of the Council on Biblical Manhood and Womanhood, a member of the Translation Oversight Committee for the English Standard Version of the Bible, the general editor of the ESV Study Bible, and has published over 20 books, including Systematic Theology, Evangelical Feminism, Politics—According to the Bible, and Business for the Glory of God.

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Displaying 1 - 11 of 11 reviews
Profile Image for Dr. David Steele.
Author 9 books280 followers
February 17, 2020
Wayne Grudem has never steered clear from controversial subjects. Instead of avoiding controversy, he addresses with biblical wisdom and clear argumentation. Such is the case in his new book, What the Bible Says About Abortion, Euthanasia, and End-of-Life Medical Decisions.

The book tackles each subject in a forthright and sensitive way. Grudem presents biblical and practical arguments to each topic in a way that generates more light than heat. Readers who oppose his viewpoint will be impressed with the measure of humility and graciousness that he offers. The arguments that the author presents are winsome and accurately reflect the teaching of Scripture.

The great strength of this book is its brevity. This is a tool that nearly anyone could pick up and devour in less than two hours. Certainly, other more comprehensive resources are available but Grudem’s accessible work is solid, short, and packs a powerful punch!

Highly recommended!
Profile Image for Cole Shiflet.
215 reviews8 followers
April 26, 2020
Since 1980, there have been over 1.5 billion abortions worldwide. Since Roe v. Wade in 1973, there have been nearly 62 million abortions in the United States, thirty percent of which were African-American children. For the Christian and non-Christian who view these babies as humans with moral status, this is surely a heart-breaking reality.

Why I Read This Book
Recently, Anna Claire Noblitt invited me to come on The Dual Citizen Podcast as a guest for a panel discussion she was leading on “What Makes an Opinion?” In this episode, I joined Anna Claire and two other guests in discussing the practice of forming opinions, particularly in regards to controversial topics such as abortion. In my preparation for this podcast, I came across John Piper’s book Exposing the Dark Work of Abortion.

After reading the concise collection of sermons compiled together to form this book, I felt confident in the Christian’s responsibility to protect life, but was unsure how to defend the actual personhood of unborn life from a Biblical perspective. In my attempts to find a satisfactory answer, I stumbled upon this new book. Grudem provides ample Biblical evidence to support the personhood, and therefore distinct and inherent worth, of both the unborn and the elderly.

The Primary Objective of this Book
Grudem, a prominent theologian in conservative evangelicalism, makes his aim clear from the beginning of this book when he writes,

This book examines the Bible’s teachings on two subjects—abortion and euthanasia—that in many ways are subcategories of the same topic, the protection of human life, both at the beginning of life (in the mother’s womb) and at the end of life (in a hospital bed).

For Grudem, these are not two isolated debates, but instead are both issues regarding the sanctity of human life. He also notes that the primary objective of this book is not to analyze the scientific or logical arguments for the “protection of human life” but to “examine the Bible’s teachings on the two subjects.”

If you are to appreciate this book, it will not be because of the witty logical arguments presented in this book or the scientific research that is mentioned, but because of the way that Grudem engages with the Biblical text.

Abortion
The author begins his book by focusing on the most heated political topics of the current time: abortion. Grudem discusses the issue of abortion in regards to the Biblical, scientific, logical, and legal arguments, yet the Biblical argument is by far the strongest.

The Strengths
The author rightly prioritized the Biblical argument, thus fulfilling the initial thesis. In many ways, the interaction with the six passages of Scripture presented here in the early pages of the book were the strongest of the entire book.

Rather than building his entire case for personhood on an isolated verse, he masterfully guides the reader through various genres of the Biblical literature from Genesis and Exodus to the Psalms and the Gospels. He does this in order to present a holistic picture of the Biblical teachings.

Perhaps one of the most compassionate paragraphs in this section comes after the seemingly exhaustive list of Biblical passages that present a pro-life ethic from the point of conception. Grudem takes a break from establishing an exegetical defense of this ethic, to pastorally care for those who have fallen into sin.

It is likely that many people reading this evidence from the Bible, perhaps for the first time, have already had abortions. Others reading this have encouraged others to have abortions. I cannot minimize or deny the moral wrong involved in these actions, but I can point to the repeated offer of the Bible that God will give forgiveness to those who repent of their sin and trust in Jesus Christ for forgiveness.

The great weight of this pause is the disclosure of the author’s heart. Grudem is not primarily concerned with merely changing minds, but points readers towards the repentance and faith in Christ.

The Weaknesses
After such a strong Biblical case for the personhood of the unborn, the scientific evidence falls flat. Grudem, a systematic theologian and not a scientific expert seems to realize that he is not the best person to guide the readers through the depths of fertilization and chromosomes. Instead, he pulls an excerpt out from Dianne Irving, a biochemist and biologist from Georgetown University.

While the actual content that Irving presents is somewhat helpful, it seems incomplete and often incomprehensible to one who is unfamiliar with the science behind the fertilization process. Grudem attempts to reconcile this by summarizing the writings of Irving in a short sentence, yet this fails to satisfy the needs of his readers. Perhaps, the most frustrating part about this section is that in comparison to the well-developed, multi-faceted Biblical case for personhood, the scientific case is presented by a single author and explained with a single sentence.

Euthanasia & End-of-Life Decisions
As the book progresses, Grudem shifts his focus away from abortion and towards euthanasia and end-of-life decisions. Again, the author made it clear that he viewed these issues as parts of a whole rather than two distinct issues.

The Strengths
Regardless, Grudem opens by analyzing the Biblical case against euthanasia and physician-assisted suicide. As a theologian, it is to no surprise that this is again the strongest argument.

Grudem points to 2 Samuel 1:1-16, the passage where a man comes to King David to describe the death of King Saul. In this passage, Saul was apparently so wounded that he would not be able to make a recovery and begged the man to end his life. Grudem notes that this was essentially an early act of Euthanasia. He writes,

The patient (Saul) appeared to be terminally injured, with no reasonable human hope of
Recovery. The patient was in extreme pain, and if he did not die, he faced the prospect of even more suffering. The patient clearly requested, even begged that someone would put him to death. This request was also a command from the head of the government at that time, because Saul was still the king.

Yet despite these circumstances, look at the response of David in the early verses of 2 Samuel 1.

Then David called one of the young men and said, “Go, execute him.” And he struck him down so that he died. And David said to him, “Your blood be on your head, for your own mouth has testified against you, saying, ‘I have killed the Lord's anointed.’”
-2 Samuel 1:15-16

Grudem does well to distinguish “killing” and “letting someone die of natural causes.” In this passage, he notes that though the Amalekite man obeyed Saul, he was not letting him die, but actually killing him.

Unlike the incompleteness of the scientific case for the personhood of unborn children in the firest section, the content comprised in the medical reasoning against euthanasia was quite comprehensive.

The Weaknesses
While it is possible that it was exhaustive to a fault, the primary weakness of this section was the formatting rather than the content. In an attempt to make the content more easily digestible, it was formatted into pages and pages of bullet points. This, in fact, made it more difficult to read than if it had been in clearly defined paragraphs.

What Would Have Made This Better
Again, Grudem’s thesis is still supported and well-developed through the Biblical evidence. It just seems odd that the author, who is first and foremost a theologian with a background in economics, would not pull in a medical professional to write the scientific portion of the book.

In Depression, Anxiety, and the Christian Life: Practical Wisdom from Richard Baxter, J.I. Packer did this well when he teamed up with Dr. Michael Lundy to analyze depression and anxiety. It would have been beneficial for Grudem to follow the model of Packer in order to give the readers a clear and substantial picture of the scientific evidence of personhood.

My Closing Thoughts
If you are looking for an extensive look at the medical and legal thought behind the personhood of unborn children, this book will only scratch the surface. But, if you are a Christian or a non-Christian wondering what the Bible teaches about abortion, euthanasia, and end-of-life medical decisions, this book is for you. The way that Grudem points out, explains, and applies the Biblical text is quite impressive and convincing.

I received a review copy of this book from Crossway. The opinion of this review are my own.
This entire review has been hidden because of spoilers.
Profile Image for Paul John Nelson.
31 reviews1 follower
February 25, 2025
The analogies used in this book are what would be expected from a pro birther. Biblical passages and mistranslations of such. The ancient Israelites didn’t believe in abortion? They certainly did for Amalek. God doesn’t like abortion? Amalek.

Contraceptives and education are what prevent abortion, not Calvinist biblical word salads and using the word “child” instead of “fetus.” You want to actually save children? Do something about mass shootings in schools. The author is merely Bible thumping around a woman’s loins and freedoms.
Profile Image for Jim.
27 reviews
May 26, 2020
Grudem, Wayne A. What the Bible says about abortion, euthanasia, and end-of-life medical decisions. Wheaton, Illinois: Crossway. ISBN 9781433568305 (trade paperback) | ISBN 9781433568329 (pdf) | ISBN 9781433568312 (mobi) | ISBN 9781433568336 (epub)

What the Bible Says about Abortion, Euthanasia, and End-of -Life Medical Issues, a straight forward title from an author who's known for his straight forward approach to all forms of theological discourse. In this volume Wayne Grudem offers his readers answers to some of the most perennial ethical questions with clear Biblical insight and a reader-friendly style of writing.

What I found most interesting in this work is how Grudem speaks from multiple perspectives in this book. He begins the subject of abortion from the perspective of a theologian as he presents the biblical arguments against abortion. His explanation of person-hood is among the best as he works through the texts of Old and New Testament. From this the reader gets a thorough view of the relevant Biblical texts.

Where most discussions end Grudem takes the discussion one step further as he removes his Theologian hat and dawns his Pastoral hat. Here his discussion and tone change as he begins to address those who have fallen into sin. This part of the book is very beneficial to those who have gone through abortion or those who are intervening for someone who is considering it. Here Grudem presents his pastoral heart as his intention isn’t argument for argument’s sake but to point his reader to repentance and faith in Christ.

When his discussion shifts to euthanasia and end of life decisions Grudem continues with his clear explanations and argumentation. He provides an analysis of biblical examples against euthanasia and physician-assisted suicide. He also works through the thorny distinction between killing and allowing someone to naturally die which was very helpful.

I found this book to be very informative and well organized for anyone who is interested in the topic. I did not mention this above but Grudem also discusses these topics from a legal and scientific standpoint. I thought the content here was very interesting but it left me thinking there was more that could have been covered. Either way I would definitely recommend this book and give it 5 stars.

My personal rating 5 stars out of 5.
1,803 reviews
April 4, 2020
Evidently Crossway is chopping up Grudem's big ol' ethics tome from a few years ago into bite-sized chunks (and according to the back of this book, the series will be called "What The Bible Says About" series--I kid you not). This first little book was excellent. He has good answers for common pro-abortion arguments. He navigates well the difference between euthanasia and letting someone die naturally. He makes a strong case for personhood from conception.

A lot of his argument hinges on, "You wouldn't do this to a baby after birth, would you, so why do it in the womb?" However, that is dangerous, because we're seeing (and will see more) that people would in fact do X or Y after birth. We might need to go back to the basics on personhood to cover both instances, which Grudem doesn't do here.

Also, I'm not sure I'm convinced by his argument that abortion is okay to save the life of the mother. Thankfully, he points out that this is exceedingly rare, and that this is NOT the same as the "for the sake of the mother's health," which now covers any sort of burden up to and including general unhappiness or malaise. He says in the case of saving mother is okay because the intention is to save a life, not to end one. But I'm not sure we can split that hair, because the intention of the actual procedure is to, well, end the life. And I'm uncomfortable with the value judgment between mother and baby. Not to mention the mother knew what she was getting into when she got pregnant, but the child did not. That's what it means to be a mother, after all--risking one's life for the next generation.

But that is an important issue and I should probably think about it more. In any case don't let this detract from my strong endorsement of this important book.
18 reviews
April 24, 2020
Having reached an age only 8.54 years away from the average lifespan of males in the US, I thought it was time to think about end of life decisions and how best to face them. Of course, with Mother’s Day approaching in a few weeks, the beginning of life is also of importance.

Grudem makes an attempt to provide a cogent look at both abortion and euthanasia. In my estimation he succeeds.

The two sections begin with a Biblical justification for preventing both abortion and euthanasia. In the case of abortion, he includes a section on scientific evidence for the personhood of an unborn child. Grudem follows with a refutation of common arguments made to support abortion. He finishes the section dealing with pertinent legal matters.

Grudem then deals with euthanasia. Here he must deal with the sometimes-tricky difference between killing and letting die. He provides biblical reasons and evidence against each, and follows with a refutation of common arguments made in support of each. As with abortion, he spends time dealing with legal issues.

The book ends with an appendix from the Christian Medical & Dental Association’s guidelines on artificially administered nutrition and hydration.

After reading the book, I feel better informed when end of life issues become personal.

I believe Grudem succeeded in his attempt at covering these tough subjects. I’m thankful that my mother was able to celebrate the birth of two sons after the painful loss of a daughter following her birth. I know how it marked her for the remainder of her life. I can only imagine what scars the deliberate killing of a child will leave.

Crossway was kind enough to provide me a copy of the book in exchange for an unbiased review.
86 reviews
May 6, 2021
This is a handy size book covering the topics in the title. It is a small portion of Grudem's larger work called "Christian Ethics". I am thankful for this size resource as it is much smaller and may be something that people would rather use based upon the topic that they're interested in rather than having to go through the entire larger work.

While Grudem's words can get scholarly at times, for the most part this is an accessible read for most adults. As the culture of the world continues to change, I could see this little book being one that I would give away numerous times. It is a wonderful resource to help equip the saints.

The publisher mailed me a copy for review. The review above is my own and has not been influenced in any way outside of the written manuscript.
Profile Image for Joshua Chipchase.
210 reviews1 follower
September 7, 2025
Short but richly biblical and well written. Grudem is very adept in his explanations of things and he has the ability to deal with complicated or controversial issues in a simple, straightforward, and refreshing way.

Grudem also does a good job in dealing with objections to his assertations. You walk away not only understanding his viewpoints, but also the opposition and his responses to the opposition.

Grudem makes clear from scripture the value and importance of human life and does an excellent job defending life from those who try to end it through abortion or euthanasia.

I would highly recommend this book.
5 reviews
August 10, 2023
good…but….

As you would expect from Grudem, the book has a clear biblical base; but if I’m honest, it felt weak in its application and lacked pastoral insights to actually help us engage with people who are facing these issues.
Profile Image for Preston Milligan.
23 reviews
June 25, 2025
Very short read. Less than 70 pages. Covers a lot of important points in building biblically based cases surrounding these controversial medical procedures. Although it is very cut and dry, I would recommended it.
Displaying 1 - 11 of 11 reviews