What is a central issue in Hills Like White Elephants?

This is a
tough question on a couple of levels.  The first is that any discussion of a central issue of
the short story remains unfulfilled because Hemingway does not render much in way of absolute
judgment and clear certainty.  I would say that one issue that comes out of the short story is
the difficulty in relationships.  Jig and the American are involved with one another, certainly
reflecting some level of commitment to one another.  Yet, there is difficulty in both of them in
terms of their approach of the "procedure" that is the center of their discussion.  On
one hand, the American continually stresses that he is fine with whatever Jig chooses to do. 
Yet, there is an undercurrent in his conversation and discussion with her that he wants her to
go with the abortion.  This psychological dynamic is only mirrored by Jig's challenges with
trying to determine what the right thing is to do and how to reconcile with this in her
relationship.  The questions that end up dominating her mind only add to the complexity of the
choice needing to be made.  In this, the central issue of the short story becomes evident in
that relationships make choices and consequences even more complex than they already are. The
traditional thinking would be that a relationship would make the issue of choice and the reality
of consequences clearer because of two reasonable people engaging in a process of reasonability
and clarity.  I think that this becomes the central issue of the short story, and something that
makes clear the often confusing and lack of clarity that exists in relationships and the
emotional challenges within them.