CMA briefs congressional staff in religious liberty forum

CMA Vice President for Government Relations Jonathan Imbody recently briefed congressional staff on conscience rights at a religious liberty forum held in the U.S. Capitol. The seminar, "Free to Serve: Safeguarding the Religious Freedom of Institutions and Professionals," also included panelists Mark Rienzi, Catholic University law school; Richard Doerlinger, U.S. Conference of Catholic Bishops; and Susan Post, Exec. Dir., Esperanza Health Clinic in Philadelphia, Penn.

Imbody highlighted the tie between conscience rights and patient access to health care, noting that faith-based professionals and institutions often purposely locate in medically underserved areas and serve patients in medically underserved populations. Faith-based health care is the only option for many patients nationwide.

Imbody presented results of CMA's national polling, showing public support for conscience rights and laws. He also highlighted the comments of several CMDA members, including the following:

• Dr. "H": "I entered OB/Gyn residency at a university hospital. Within a month, I left due to pressure from faculty and upper residents, solely due to conscientious objection. I chose not to participate in tubal ligation and contraceptive prescription. I … was blackballed from education. The program director basically stated that I could do these procedures, or leave."
• Dr. Rebecca Lavy: (On faculty at teaching hospital in Dallas.) "In certain cases, faculty were required to prescribe post-coital use of oral contraceptives. I refused to prescribe it and was told, 'This may be an employment issue.' The obvious, not-so-subtle implication was that I would be fired if I refused. I didn’t agree with simply calling someone else in (one of the residents) to prescribe the medication. If prescribing them is ethically wrong, asking someone else to do it for me is equally wrong."
• Trevor Kitchens: "I am a first-year medical student in the beginning stages of deciding which specialty I would like to pursue. I am currently very interested in OB/Gyn, but I am afraid of the relationship between this field and abortion. I am 100 percent against abortion, and there is no way I would perform one. My fear is that taking this stand would cost me my residence position. Now, if that is what it comes down to, I will be glad to take the stand for Jesus Christ and give up my position. However, I would really like to be able to avoid this situation and complete my residency so that I could go on and serve the Lord in that field."
  
  
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Hospital forces nurses to participate in abortions

Excerpted from "NJ nurses say suit hasn't halted abortion duties," The Washington Examiner, November 14, 2011--A group of nurses who objected to helping abortion patients on religious grounds said Monday they were still being compelled to assist with the procedures, despite having filed a federal lawsuit against the New Jersey hospital where they work. The suit was filed by 12 nurses at the University of Medicine and Dentistry of New Jersey hospital in Newark. Several said despite the lawsuit, they were still being trained and scheduled to assist.

"My spiritual conviction tells me, I would not want to kill innocent babies, and not in my wildest dream, as a nurse, as a person, as a Christian, did I ever think that I would be trained to assist with this kind of procedure," Fe Esperanza Racpan-Vinoya, said at a news conference in front of the hospital.

Racpan-Vinoya and other nurses who attended the news conference — all but four in their unit have signed on to the lawsuit — said they had made their objections known to their supervisor and to hospital officials, and claim their concerns were dismissed or ignored. Hospital officials said previously they would temporarily stop requiring nurses to assist, and a federal judge issued a restraining order to that effect, but the nurses claim it's still going on. The hospital issued a statement Monday saying no nurse is compelled to participate, or even be in the room, during a procedure to which they object on cultural, religious or ethical grounds.

Matt Bowman, an attorney with the Alliance Defense Fund, a coalition of Christian lawyers and organizations that is representing the nurses, said the hospital had previously hired per-diem nurses or those who volunteered to assist with abortions to help perform them.

Bowman said the hospital notified nurses in writing in September that its new policy would require same-day surgery unit nurses to assist in abortions. The nurses filed suit on Oct. 31, claiming the hospital was compelling them to undergo training that involved assisting in abortions, and indicated they could be subject to termination if they didn't comply.

U.S. Rep. Chris Smith (R-NJ): (pictured on right at White House with CMA VP for Govt. Affairs Jonathan Imbody; comments excerpted from press conference) "UMDNJ’s coercive anti-conscience policy is not only highly unethical but blatantly illegal. Federal and state law couldn’t be clearer on this matter.

"The 1974 Church Amendment makes absolutely clear that 'no entity (and that includes UMDNJ) which receives a grant, contract, loan or loan guarantee under the Public Health Service Act, the Community Mental Health Centers Act or the Developmental Disabilities Services and Facilities Construction Act may discriminate in the employment, promotion or termination of employment of any physician or other health care personnel or discriminate in the extension of staff or other privileges to any physician or other health care personnel...because he refused to perform or assist in the performance of... abortion on the grounds that his performance or assistance in the performance of ...abortion would be contrary to his religious beliefs or moral convictions...'

"To further protect conscience rights, the U.S. Congress enacted the Hyde-Weldon conscience law in 2005 that bars funds appropriated under the entire Health and Human Services Appropriations Act to any federal agency or program or to a state or local government if they engage in discrimination by violating conscience rights.

"The relevant NJ statute states unambiguously that 'no person shall be required to perform or assist in the performance of abortion... .' New Jersey law further states that 'the refusal to perform, assist in the performance of, or provide abortion... shall not constitute grounds for civil or criminal liability, disciplinary action or discriminatory treatment.'

"In pursuit of an illegal and highly unethical policy to coerce its own nurses to participate in abortions including support activities such as pre- and post-procedure complicity in abortion, UMDNJ has not only imposed irreparable harm and suffering on its own nurses, but has willfully and recklessly put federal funding for the institution at risk.

"Because the nurses recognize the innate value and dignity and preciousness of the child in the womb and have refused to participate or be complicit in an act of violence against a vulnerable child, they are punished. Because the nurses have deep religious and moral convictions and believe women deserve better than abortion, they are punished. Because the nurses are compassionate and care deeply for every human life, regardless of age or condition of dependence, they are punished. The illegal and highly unethical policy of coercion by UMDNJ must cease immediately."

Resources
Written statements by nurses Fe Vinoya and Beryl Otieno Ngoje
Alliance Defense Fund News Release
Audio Recording of the Press Conference
Written statement by Rep. Chris Smith
Press Advisory with links to additional information and Fact sheet by ADF
Philadelphia Inquirer (Opinion): Freedom of not having a choice
National Review (Post to the Corner by Matt Bowman): NJ Hospital Should Tell the Truth about Its Abortion Policy

State-mandated classes versus parental rights

State-mandated classes versus parental rights
"Does Sex Ed Undermine Parental Rights?," The New York Times. October 18, 2011--IMAGINE you have a 10- or 11-year-old child, just entering a public middle school. How would you feel if, as part of a class ostensibly about the risk of sexually transmitted diseases, he and his classmates were given “risk cards” that graphically named a variety of solitary and mutual sex acts? Or if, in another lesson, he was encouraged to disregard what you told him about sex, and to rely instead on teachers and health clinic staff members? That prospect would horrify most parents. But such lessons are part of a middle-school curriculum that Dennis M. Walcott, the New York City schools chancellor, has recommended for his system’s newly mandated sex-education classes. There is a parental “opt out,” but it is very limited, covering classes on contraception and birth control.

Observers can quarrel about the extent to which what is being mandated is an effect, or a contributing cause, of the sexualization of children in our society at younger ages. But no one can plausibly claim that teaching middle-schoolers about mutual masturbation is “neutral” between competing views of morality; the idea of “value free” sex education was exploded as a myth long ago. The effect of such lessons is as much to promote a certain sexual ideology among the young as it is to protect their health. But beyond rival moral visions, the new policy raises a deeper issue: Should the government force parents — at least those not rich enough to afford private schools — to send their children to classes that may contradict their moral and religious values on matters of intimacy and personal conduct?

Liberals and conservatives alike should say no. Such policies violate parents’ rights, whether they are Muslim, Jewish, Christian, Hindu, Buddhist or of no religion at all. To see why, we need to think carefully about the parent-child relationship that gives rise to the duties that parental rights serve and protect. Parenting, especially in moral and religious matters, is very important and highly personal: while parents enlist others’ help in this task, the task is theirs. They are ultimately responsible for their children’s intellectual and moral maturity, so within broad limits they must be free to educate their children, especially on the deepest matters, as they judge best. This is why parental rights are so important: they provide a zone of sovereignty, a moral space to fulfill their obligations according to their consciences.

True, the state needs to protect children from abuse and neglect. It is also true that the state has a legitimate interest in reducing teenage pregnancy and the spread of sexually transmitted diseases. But it is not abuse or neglect to protect the innocence of preteenage children or to teach one’s children more conservative, as opposed to more liberal, moral values. Nor is it wrong or unreasonable to limit the state’s control over what one’s children learn and think about sensitive issues of morality. On the contrary, that is just what is required if parents are to fulfill their duties and exercise their legitimate rights. Unless a broader parental opt out is added, New York City’s new policies will continue to usurp parents’ just (and constitutionally recognized) authority. Turning a classroom into a mandatory catechism lesson for a contested ideology is a serious violation of parental rights, and citizens of every ideological hue should stand up and oppose it.

Founder and Chairman of The Medical Institute for Sexual Health Joe McIlhaney, MD: "Teaching middle-schoolers about mutual masturbation or about masturbation of any type and teaching them about a variety of other solitary and mutual sex acts is unhealthy enough. Teaching them to ignore parental teaching about sex and to trust only the school is even more unhealthy. Ignoring for a moment the sexual issue, remember that parents are with the children day after day until they leave home. It is the parents' responsibility to teach their children how to eat in a healthy way, how to drive the car without speeding or running red lights and on and on. If the schools undermine in the children’s minds the wisdom of their parents about sex, why should the children not also question their parents wisdom about a host of other warnings they have been given at home? And besides, the children do not belong to the school, they belong to the parents to raise. For these and many other reasons, invalidating parental authority in the lives of children is the worst part of the middle-school sex-ed curriculum advocated by Dennis M. Walcott, the New York City school's chancellor.

"Giving children as young as 10 and 11 'risk cards' that graphically name a variety of solitary and mutual sex acts, ostensibly to warn them about sexually transmitted disease (STI), is almost as inane and destructive. Teaching kids about mutual masturbation, masturbation of any form or of any number of other sexual acts has never been shown to decrease children’s risk of becoming infected with STIs. However, one thing we know is that even though the number of children involved in sexual behavior has somewhat stabilized, it is still too high and the incidences of sexually transmitted diseases among our children is rampant, in spite of the prevalence of sex-ed programs similar to this one advocated by Chancellor Walcott.

"One wants to ask Chancellor Walcott, given that since programs similar to the one he so dearly wants in the New York schools have been shown time and again to be such failures in preventing STIs and pregnancies, why does he persist in supporting this program and in undermining parental guidance for their children? Does he have an underlying philosophy about sex that he is attempting to force on the young people he has some control of? Is he trying to impose HIS morality, HIS sexual ideology? Though he 'waves' a limited opt out for parents as a weak argument to prove he isn't imposing his beliefs on the students, one still has to wonder about his motives.

"It seems that it would behoove parents to exercise their responsibility to their own children by vigorously opposing Chancellor Walcott’s efforts by every legal means they and their friends can muster, to not only protect the health of their children but also for their 'goodness' as well."
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Resources
CMA joins push to restore abstinence education funding
Hooked: How Casual Sex is Affecting Our Children

Forced religious tolerance becomes discrimination

Forced religious tolerance becomes discrimination
"Conformity for diversity's sake," The Washington Post. November 2, 2011--Illustrating an intellectual confusion common on campuses, Vanderbilt University says: To ensure “diversity of thought and opinion” we require certain student groups, including five religious ones, to conform to the university’s policy that forbids the groups from protecting their characteristics that contribute to diversity.

Last year, after a Christian fraternity allegedly expelled a gay undergraduate because of his sexual practices, Vanderbilt redoubled its efforts to make the more than 300 student organizations comply with its “long-standing nondiscrimination policy.” That policy, says a university official, does not allow the Christian Legal Society “to preclude someone from a leadership position based on religious belief.” So an organization formed to express religious beliefs, including the belief that homosexual activity is biblically forbidden, is itself effectively forbidden.

The question, at Vanderbilt and elsewhere, should not be whether a particular viewpoint is right but whether an expressive association has a right to espouse it. Unfortunately, in the name of tolerance, what is tolerable is being defined ever more narrowly.

Although Vanderbilt is a private institution, its policy is congruent with “progressive” public policy, under which society shall be made to progress up from a multiplicity of viewpoints to a government-supervised harmony. Vanderbilt’s policy, formulated in the name of enlarging rights, is another skirmish in the progressives’ struggle to deny more and more social entities the right to deviate from government-promoted homogeneity of belief. Such compulsory conformity is, of course, enforced in the name of diversity."

CMDA CEO David Stevens, MD, MA (Ethics): "In a show of linguistic sleight of hand, Vanderbilt asserts that they are defending freedom of religion while enforcing a freedom from religion policy. That effort goes back almost a hundred years. Vanderbilt was founded by the Methodist Episcopal Church to train pastors in 1875. It was initially endowed by Cornelius Vanderbilt as a gesture to bring reconciliation between the north and south after the Civil War. Forty years later, the school took the church to court and eliminated their representation from the institution's board. Hostility towards organized religion is apparently not new to the school.

"The school maintains they are simply applying a religious anti-discrimination mandate, though their very interpretation and application of that mandate discriminates against those who have religious faith. That is not a policy of religious tolerance but intolerance. Other student organizations may select their leadership based on their compatibility with their stated mission, but if religious organizations do the same, they are guilty of religious discrimination.

"The guilty ones are not the Christian groups on campus. It is the board and administration of the school who are violating the first amendment of the Bill of Rights by not allowing the free exercise of religion and freedom of association. Unless the school backs down, this issue will end up in the highest court of the land.

"I have a family member who attended Vanderbilt. I couldn't recommend it in good conscience now, anymore than I would recommend to someone they attend a school that discriminated on the basis of race, ethnic group or gender. Discrimination is discrimination is discrimination, no matter what words you wrap around it."
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Resources
Email from Vanderbilt University to campus chapter of the Christian Legal Society
Letter from the Christian Legal Society to Vanderbilt University
If you are interested in writing a letter to Vanderbilt's administration regarding this issue, click here for a template letter we have prepared for your convience that can be downloaded, signed and sent.

Doctors and prayer: kindness or coercion?

Doctors and prayer: kindness or coercion?

Excerpt from "Should Doctors Be Involved With a Patient's 'Spiritual Care?'," Medscape. October 21, 2011--Science and religion have always had a complicated relationship, so it's not surprising that, as interest in holistic care grows, physicians are trying to come to grips with whether they should play a role in patients' spiritual care. More than half of physicians believe that religion and spirituality affect patient health in some way, according to research conducted by the University of Chicago. In a survey of 2,000 physicians, 56 percent believed that religion and spirituality have much or very much influence on health, but only 6 percent believed they often changed "hard" medical outcomes. Rather, respondents suggested that religion and spirituality help patients cope, give them a positive state of mind, or provide emotional and practical support via the religious community. While doctors might believe religion and spirituality influence health, acknowledging a connection raises some fundamental and tricky questions. The American College of Physicians' ethics manual encourages physicians to explore a patient's religion and spirituality as part of an overall physical. But how are they to do that? What does it mean, and what are they to do with the information?

Research indicates that roughly 80 percent of medical schools now offer spiritual care courses or integrate spirituality into their curricula, according to Christina Puchalski, MD, an internist at George Washington University and director of the George Washington Institute for Spirituality and Health. But what's included and how it's taught differs tremendously from one institution to the next. In an effort to bring consistency to the spiritual history and assessment process, various proponents have development of myriad tools represented by apropos acronyms such as FAITH, SPIRIT and HOPE as well as the slightly less catchy FICA and FACT. Assessing a patient's spiritual health is important, because spiritual issues can not only impact a patient's health, but they can impact a patient's medical compliance and treatment choices as well, says Puchalski. However, not everybody believes spiritual care belongs in the examination room. Indeed, those who oppose the idea present a litany of arguments: Spirituality is a private matter. Over-zealous physicians might abuse their position and proselytize to their patients. Pragmatically, many note that in the real world of 15-minute office visits, taking the time to ask questions about spirituality would come at the expense of addressing clinical issues. Most worrisome says Richard Sloan, professor of behavioral medicine at Columbia University Medical Center and author of Blind Faith: The Unholy Alliance of Religion and Medicine, taking a spiritual history sets a doctor up to be a spiritual guide, "which they are completely untrained and unequipped to do."

Still, fitting spiritual assessments into practice is a hodgepodge. "From what we've seen in our research almost nobody is using those acronyms," says Farr Curlin, MD, co-director of the Program on Medicine and Religion at the University of Chicago. "It's the rare physician who uses these pneumonic tools. Rather they try to pay attention to signs from the patient and then they try to query them to bring those issues out and connect the patient with spiritual resources in the community or their organization's pastoral care department." Carol Taylor, PhD, director of the Center for Clinical Bioethics at Georgetown University, says clinicians are caught in a theory-practice gap. "The problem is we say, 'spiritual care matters,' but we haven't gotten to the point where clinicians can identify spiritual need," she says.

Neurosurgeon, Author of Gray Matter and CMDA Member David I. Levy, MD: "Wherever there is power, there is potential for abuse. If approached correctly, prayer honors, gives comfort and encourages. We are spiritual beings and our awareness of this fact is heightened when we feel out of control or in danger. When a problem arises that is too big to solve with our resources; we pray.

"My desire is to recognize and honor the spiritual aspect of every patient; to give him or her peace, to comfort and to use everything in their armamentarium to help them heal. Asking if someone would like prayer should be done in a sensitive manner without making people feel uncomfortable; patients must feel free to decline without affect to their care or our relationship. Joint Commission guidelines state that a patient’s “spiritual needs should be assessed and accommodated in ways that are meaningful to them.” The only way that I will know if prayer would be meaningful is to ask – and in most cases it is very meaningful.

"Although patients trust me to do the best job possible, we both realize that ultimately I am not in control of their response to medication, the outcome of their surgery or their healing process. No matter how extensive my experience or education, if I am trusted to do something that involves risk, then I believe that an offer of prayer is honest, appropriate and authentic. Given the peace and comfort many patients receive, I believe that withholding prayer from those who would benefit is unethical and even cruel."

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Resource
CMDA Ethics Statement - Sharing Faith in Practice