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Dr. C. Everett Koop's 1986 Address before the
14th General Assembly of the Presbyterian Church in America

[excerpted from the Minutes of the Fourteenth General Assembly, pages 300-303]


JUNE 6, 1986

I am not here as your Surgeon General. I am on station leave and speak to you as a Presbyterian layman, but not in biblical or theological terms but rather as one concerned about the public's health.

In June of 1984 President Reagan at a ceremony in the Rose Garden asked the Attorney General to appoint a commission on pornography. The Presidents concern stemmed from studies indicating the wide spread prostitution of children in this country, an ever increasing number of reports of child abuse including child sexual abuse, and the large numbers of runaway and missing children.

On May 29, 1985, Attorney General Edwin Meese III announced the names of the members of the commission on pornography and indicated they would study the dimensions and affects of pornography and recommend measures if appropriate, to control its production and distribution.

The last time that obscenity and pornography were in the hands of a commission in this country was
in 1969 and 1970 with a report sent to the President and the Congress in September of 1970.

At that time, researchers in the behavioral sciences had barely scratched the surface of pornography. Hence, the 1970 report was based upon a very limited universe of scientific literature and experience.  As a result, the commission concluded there was "no evidence that exposure to or use of explicit sexual materials plays a significant role in the causation of social and individual harms, such as crime, delinquency, sexual or nonsexual deviancy, or severe emotional distrubance."

As you may recall President Nixon refused to accept the report and only six members of the senate voted to accept the report.

However, even though not officially accepted by the President or the Congress it has been the only document on pornography carrying any legal weight over the last 16 years.

But those 16 years have gone and now we know quite a bit more about pornography and its potential effects upon health.  And during those intervening years society has also become much more concerned
about the way pornography invades our public and our private lives.

The hucksters of pornography have invaded cable television, the popular music world, telephone communications, and the whole new field of home video players.  To the pornographers, these technologies
offer new opportunities to expand the dissemination of sleaze and trash.  But to us they are complex challenges in the public's fight for decency.

A fierce debate has raged in this country ever since 1970 and two separate committees, the Williams committee and the Fraser committee tried to fill a vacuum.  Yet apart from their concern for protecting children from abuse in pornography, the Williams and Fraser committees really gave little attention to the circumstances in which sexually explicit material was produced and particularly its affect upon those who are involved in its production.

At the time of the appointment of the Attorney General's commission in May of 1985, Attorney General Meese had this to say:
"Reexamination of the issue of pornography is long overdue.  Its impact upon society was last assessed fully 15 years ago.  Since then, the content of pornography has radically changed, with more and more emphasis upon extreme violence.  Moreover, no longer must one go out of the way to find pornographic materials. With the advent of Cable T.V. and video recorders, pornography now is available at home to anyone - regardless of age - at the mere touch of a button.

"It is abundantly clear that with pornography we are not dealing with one passing incident - one magazine, or one play, or one film.  We are dealing with a general tendency that is pervading our entire culture including the culture known to our very young children.

"The formation of this commission reflects the concern a healthy society must have regarding the ways in which its people publically entertain themselves.  The commission is an affirmation of the proposition that the purpose of a democracy involves not simply the functioning of its political system but also achievement of the good life and the good society."

The commission's life of 1 year will expire on July 7, when their report will be released.

I know many of you have been reading criticisms of that report although it is unreleased. 

The reason for that is that the American Civil Liberties Union under the Freedom of Information Act sued the commission and were able to get all copies of all of their draft papers that they put together during the working sessions. Eighty per cent of what you have read in criticism is based on drafts statements and not upon the final
report, which the chairperson, Henry Hudson, assures me is drastically changed from the draft.  Is it more liberal?  Is it more conservative?  I cannot answer that question because I have not seen the final report.

Having said that, I can't predict the future and so in a sense I would know a lot more if I were talking
to you after July 7.

The phenomenon of pornography, is a mean pursuit that deadens the human spirit... it mocks the human heart ...and it defiles the human form.

Unhappily, when it is embraced by some people, pornography can do permanent damage, preventing
its victims from ever again being able to experience true human love, tenderness, and compassion.. .separating them sometimes forever from the joys and comfort of a safe and healthy childhood...and denying them the grasp of a clean hand in friendship.

For those of us in the fields of medicine and public health, pornography presents a special kind of problem, because pornography attacks at once the moral and the emotional health of the American people.

But those of us who labor in the vineyards of public health feel a great frustration, since pornography
will not yield to the power of something like a vaccine.  We don't have such a vaccine, nor is there a "magic bullet"... or a particularly good capsule...or a simple pill that can protect a man, woman, or child from
the corrupting influence of the pomographer.

The only way we can repel this blight upon our communities is to bring together all of our relevant resources.  And I mean those resources in public education, in civil and criminal law, in mental and physical health, and in spiritual and political leadership.  And that is precisely what is happening all across America. Decent people everywhere are committed to waging a long, hard fight against pornography.

But it's a good fight.  And I believe - as I know you, also believe - that this is a fight that decent people are going to win.

I believe that society has enough evidence to implicate pornography as a contributing factor to certain disorders of human health, as a kind of "accessory" if you will to certain anti-social actions that produce profoundly harmful outcomes.  For example...

Men who see or read sexually violent material over a period of time tend to have a higher degree of tolerance for sexual violence and acts of sexual degradation.  And we suspect that for men who are even slightly predisposed to such behavior, this material may push them from the unreal world of fantasy over
into the real world of overt action.

A second area involves both the use of children as subjects in pornography and the use of such child pornography to arouse children and adults to engage in illicit and often violent sexual activity.  Lately,
we've been learning just how devastating the long-term effects of this kind of pornography can be upon
the physical and mental health of the victimized children.

We also are discovering that many children exploited by the pomographer soon become victims of the even more frightening world of child prostitution.  And there is growing evidence that child pornography stimulates some adults into sexually abusing defenseless children.  That's why I call child pornography an "accessory" to the crime of child abuse.

Last Sunday evening, in Crystal City, Virginia, I convened a Surgeon General's workshop on pornography and public health at the request of the Attorney General.  The issue of pornography in American life has
been a professional and personal concern of mine for many years.  Pornography was to have been one section
of Whatever Happened to the Human Race which I did with Francis Schaeffer - But we dropped it in
order to focus more attention on the three issues dealing with life, namely abortion, infanticide, and euthanasia.

Almost a year ago to this day when I appeared before the Attorney General's commission I offered to provide them with information, that was solidly based on scientific evidence, on the health effects of pornography, especially as it affects children and adolescents.  I also offered to show those areas where the evidence was not complete but where experience and intuition indicate a health effect from pornography.

Now that is a difficult task because it is unethical to do studies in reference to pornography prospectively on children.  Lacking so-called scientific evidence, the scientific community - which tends anyway to minimize the effects of pornography - are never satisfied with the results of any type of research.

The traditional research paradigm was developed in the nineteenth century from an attempt to subject human behavior to empiric scientific methodology, much as one would test chemical substances.  This model conveniently coincides with John Stewart Mill's exclusion of purely moral considerations, since a physical scientist obviously can study overt behavior, but cannot study entities so nebulous as moral valuation, conscience, or spiritual sensitivity.  The physical science model has thus contributed to the very narrow
focus of research itself and of political debate.  Until recently, research has been substantially restricted to
the narrow, overt behaviors of physically aggressive individuals or those who had sexual dysfunction. Influence of human science has encouraged study of attitudinal changes toward victims of aggression, but
it is only in the last two years that there have been even a few isolated studies treating the effects of pornography on attitudes of users toward marital fidelity, toward the desire for children, or desire for
marriage at all.

Initially, some psychologists did make efforts at introspective research, but the physical science model has been virtually the only model for most of the twentieth century, has restricted data to hard, observable responses.  And I have said that you just cannot do that ethically in children.  The causal milieu of sex offenses includes family influence, idiosyncratic tendencies, educational and social influences, and peer influence, and I suppose thousands of other formative events which are virtually impossible to rigidly isolate and quantify in any kind of causal relationship.  Social scientists therefore frequently state that results are inconclusive and that further research may yield more conclusive results just as did research, for example, on smoking as a cause of cancer.  But the comparison of the complexities of human behavior to the pathology of lung tissue is too simplistic, and the assumption that human beings are subject to rigid control like lung tissue is even more strained.  Traditional research certainly has a place, but it is questionable whether it will ever reach a satisfactory consensus regarding causality of pornography in the minds of those who are dedicated to the scientific model.

I believe the anecdotal evidence of law enforcement agencies, of health officers, of child psychiatrists and child psychologists is overwhelming and so I acceded to the Attorney General's request and proceeded with that workshop.

Over the past several months since it was announced that I would do this, I've been roundly criticized
by liberals who warn of the threat to our civil liberties posed by the workshop.  On the other hand, I have
been taken to task by conservatives who warn of the threat to the nation's moral fiber posed by the workshop.

Both groups urged me to call the whole thing off.

I had the distinction of being attacked from both sides of the Washington Post in the same day so I thought I must be right in the middle.

But I have to tell you that I think that both groups are wrong.

So I did hear the complaint of the liberals, but I rejected it.

Similarly, I was warned by the conservatives that the workshop would be just another forum for those people who want to destroy every vestige of morality in our society.  But all of us were deeply concerned about any harmful effects pornography may have upon certain vulnerable groups in our society, especially children and adolescents.  Hence, in those terms, I think our discussions were profoundly moral.

So I heard the complaint of the conservatives, but I rejected theirs also.

It was the liberals however who picketed the meeting place last week and now you will be happy to know that I am called a sexorcist, whatever that is.

I have steadfastedly believed that, in the general discussion of pornography thus far, Americans have paid scant attention to the important effects that pornography may have upon the physical and mental health
of our citizens, especially upon our children.

That's the fundamental issue we confronted in the few days of the workshop.

And I asked that group of investigators the following three key questions:
First, what do we know with some degree of certainty about the effects of pornography upon the physical and mental health of our people, especially young children and adolescents?
Second, what kind of things do we still need to know.. .in other words, what is our research agenda for the future?

And finally, as professionals in public health and medicine, what do we think ought to be done next, either by our colleagues in research and clinical practice or by our government?

Now we gave good, thoughtful answers to these three questions, and I believe the public interest was served in a timely and a vital manner.

My report will go to the Attorney General on August 1.  Although it may be supplementary or complementary to the Attorney General commission's report to be released July 7, it will not be part of it.

The pornographer, with his hateful message of human degradation, violence, and subordination, would deny our history and destroy the cohesion we feel as members of our own and of the whole human family.

These are the concerns that I believe should galvanize you into unity and bring you into the fellowship
of those of like mind.

And therefore, I call upon you to renew your pledge of vigilance and action on behalf of concerned people everywhere.

I call on you to use every possible ally in this effort...public education and public health...our courts
of law.. .our colleagues in public safety.. and the leadership of our political and yes, our religious institutions.

I call on you to re-affirm your belief in an American society based upon equity, compassion, and decency.

But remember you are not only to point the accusing finger at the pomographer but also to extend the hand of support to our primary human institution...the family.

Let me close now with a somber reminder to everyone that, while we may feel committed to this great work .. .
we, too, are only human. And being human means that we, also, can suffer the torments of human condition.

We have to be ever watchful...of our own behavior as well as the behavior of others.

And this is a stern lesson, taught throughout the ages by great men and women of every culture.  But
let me leave with you these few words on the subject by a writer who knew evil first-hand before he left
his native Russia to live amongst us in these United States.

In this extraordinary book, The Gulag Archipelago, Aleksandr Solzhenitsyn described life in the Soviet concentration camps, and at one point, he wrote this:  

"If only it were all so simple!  If only there were evil people somewhere insidiously committing evil deeds, and it were necessary only to separate them from the rest of us and destroy them.  But," says Solzhenitsyn, "The line dividing good and evil cuts through the heart of every human being.  And who is willing to destroy a piece of his own heart?"

Who indeed?

And this is the ever-present challenge to each of us.

Thank you.