CMDA human trafficking expert teaches doctors and students

Excerpted from "Doctor on a mission to combat modern slavery," (Ky.) Courier-News, August 31, 2013 - As he talked to Louisville doctors and medical students last week, Ohio physician Jeffrey Barrows said he saw familiar expressions on their faces. Shock. It was the same response he had when he began learning about modern slavery less than a decade ago.

Barrows had worked for years with the Christian Medical & Dental Associations, conducting short-term educational trips throughout Asia and Africa. Through a contact with the State Department, Barrows said, he was asked to do research into the health effects of human trafficking as it relates to the global spread of HIV and AIDS.

“The more I read, the more I was shocked,” Barrows, an obstetrician and gynecologist, recalled in an interview Aug. 23 after his Louisville lecture. Many people are still not aware, he said — and his fellow doctors can play a vital role in combating it.

“Of all the sectors within society, health care is one of the most likely to encounter these victims,” he said. Research indicates that a quarter to a half of trafficking victims encounter health care professionals at some point when they are enslaved, Barrows said.

Barrows spoke at Norton Hospital at the University of Louisville Department of Pediatrics Grand Rounds, a continuing-education lecture attended by about 160 students, doctors and other social-service and government representatives. Barrows spends his time educating health care professionals on the signs of trafficking and promoting the development of homes that help recovering victims. He is vice president of Abolition International, a group that works to end sex slavery.

Emergency-room staff and other medical professionals need to watch for the signs of trafficking, Barrows said — just as they have been trained on signs of domestic violence and child abuse.

“Getting the word out is part of the puzzle, getting the people to understand this is happening,” Barrows said. Otherwise, “they’ll encounter a patient and they’ll walk away saying, ‘Something strange is going on, but I don’t know what it is.’”

Warning signs, he said, include:

The victim being accompanied by a highly controlling person — who might even be a family member.
The body language of the patient indicating fear of the accompanying person.
Tattoos indicating a handler’s street name — often a brand of “ownership” by the trafficker.
Signs of abuse.
For sex workers, multiple sexually transmitted diseases.
For manual laborers, such injuries as back trauma or hearing loss.
The victim may also be unaccountably silent on some issues — such as why he or she waited until symptoms became severe to seek medical help.

Commentary

CMDA Health Consultant on Human Trafficking Jeffrey J. Barrows, DO, MA (Bioethics) – “Dr. David McLario, a CMDA member, is on staff at Louisville Children’s hospital and made the arrangements for this presentation. He also did an excellent job organizing a symposium afterward to develop a protocol for their ED to respond to trafficking victims. His reward was encountering a patient the next day who, with further investigation, may turn out to be a victim of trafficking.

“Consider following his example by learning about trafficking and developing a strategy to respond. Every healthcare professional working with patients needs to be educated on human trafficking. Limited studies show between 28 to 50 percent of trafficking victims encounter a healthcare professional while being trafficked.

“CMDA has an excellent educational resource available online at cmda.org/tip. It’s even free if you don’t take the available CME credits. If you need assistance in developing a response strategy, contact me at jeff@abolitioninternational.org.”

Resources

CMDA human trafficking page

Action Take the CMDA education course, optionally with Category One CME credit, on human trafficking.

Washington Post: Zygote is not a "living being"

(Excerpted from "Ken Cuccinelli’s ‘personhood’ travails," Washington Post editorial, Sep. 4, 2013) -- Six years ago, when Virginia’s General Assembly considered the so-called “personhood amendment” to the state constitution, which granted full rights to “preborn human being[s] from the moment of fertilization,” the list of co-sponsors was short. Not only would the amendment have banned abortion, as the sponsors clearly intended, it also provided an opening to prohibit common methods of birth control, including the pill and intrauterine devices.

The practical effects of “personhood” measures … would easily include banning the most popular forms of contraception. This is because the pill, as well as other forms of birth control, work partly by preventing the implantation of eggs in the uterus wall after they have been fertilized. If the “preborn” are protected “from the moment of fertilization,” as the 2007 bill demanded, then contraception — which defeats a fertilized egg’s chances of becoming a living being — could be prohibited.

Commentary

CMA VP for Govt. Relations Jonathan Imbody: The Post is entitled to its own editorial opinions but not its own facts, and scientific fact clearly contradicts the assertion that "contraception … defeats a fertilized egg’s chances of becoming a living being."

Embryology textbooks clarify the lay term "fertilized egg" as "… a zygote or fertilized ovum which is the primordium or beginning of a new human being. Human development begins at fertilization…. This highly specialized, totipotent cell marked the beginning of each of us as a unique individual."¹

"Although life is a continuous process, fertilization is a critical landmark because, under ordinary circumstances, a new, genetically distinct human organism is formed…."²

So contrary to the Post, not only is a "fertilized egg" a living being; he or she is a human being. A human being is by nature a person, defined as "a human being regarded as an individual."³ But political ideology prevents the admission that abortion claims the life of a moving, smiling, hiccupping, grimacing, living human being--a person.

¹Keith L. Moore & T.V.N. Persaud. The Developing Human: Clinically Oriented Embryology, 6th Edition, 1998
²Ronan O'Rahilly & Fabiola Muller, 2001 Human Embryology & Teratology, 3rd Ed.
³Apple Inc. dictionary, ver. 2.21.
Resources

Reproductive Technology and Heath
The Beginning of Human Life
Abortion
Human Life: Its Moral Worth
The Endowment for Human Development

Action
Use the pre-written, customizable forms at CMA's legislative action website to encourage your legislators to pass life-honoring bills on issues such as abortion and stem cell research.

Lawmakers focusing on abortion and harms to women

Editor's note: AUL attorney Mailee Smith, whose commentary appears below, has written several amicus briefs for the Christian Medical Association, which has participated in 40 court cases.

Excerpted from "The state of pro-life legislation, commentary by Mailee Smith, staff counsel at Americans United for Life (aul.org), published in The Washington Times, Sep. 4, 2013 -- In 2013, life-affirming federal and state legislation designed to protect women from the harms inherent in abortion has garnered increasing attention and support from legislators and the American public — and engendered increasing fear and consternation among abortion advocates and their allies.

Abortion advocates appear particularly dismayed with recent legislative efforts to enact laws prohibiting abortion after five months of pregnancy. The reality is that a woman seeking an abortion at 20 weeks is 35 times more likely to die from abortion than she is in the first trimester. At 21 weeks or more, she is 91 times more likely to die from abortion than she is in the first trimester. Legislative efforts to limit abortion after this point directly protect maternal health, no matter how the pregnancy began. Even the liberal Huffington Post recently admitted that Americans overwhelmingly support limitations on such late-term abortions.

Yet abortion advocates oppose banning late-term abortion as well as laws requiring that women be informed of the health risks they face from abortion. The evidence of abortion’s devastating harms to women is overwhelming. Consider this partial list of the short-term and long-term physical and psychological risks associated with abortion:

• Short-term risks include blood loss, blood clots, incomplete abortion, infections such as pelvic inflammatory disease, cervical lacerations and other injuries to organs.
• Premature birth: At least 130 studies have shown an increased risk of subsequent premature birth and low birth-weight infants after abortion. The increased risk of these devastating complications is estimated to be approximately 37 percent after one abortion, 90 percent after two abortions and further increased risk for each additional abortion.
• Placenta previa is the condition during pregnancy in which the placenta covers the cervix, increasing the risks of life-threatening maternal hemorrhage, premature birth and perinatal child death. Abortion increases the risk of placenta previa in subsequent pregnancies by from 30 percent to 50 percent, and much more so for women who have had multiple abortions.
• Breast cancer: It is undisputed that a woman’s first full-term pregnancy reduces her risk of breast cancer. Numerous studies show that abortion may increase a woman’s lifetime risk of breast cancer. In one study funded by the National Cancer Institute, pro-choice researcher Dr. Janet Daling found that “among women who had been pregnant at least once, the risk of breast cancer in those who had experienced an induced abortion was 50 percent higher than among other women.”
• Mental health: A 2011 study in the British Journal of Psychiatry examined 22 studies conducted from 1995 to 2009 and found that women face an 81 percent increased risk of mental health problems following abortion. Women experienced increased risks for anxiety at 34 percent, for depression at 37 percent, for alcohol abuse at 110 percent and for suicide at 155 percent.
• Maternal mortality: Abortion advocates wrongly assert that abortion is safer than childbirth. Many studies show the opposite, including one that found maternal death to be three times more likely from abortion than from childbirth.
• Risks of later-term abortions: Abortion’s risks increase the further into pregnancy it is performed. Beginning at five months of pregnancy, the risk of complications from abortion rises dramatically.

Abortion advocates cannot counter this growing medical data. Instead, they resort to outrageous arguments camouflaging the fact that they are ignoring the health risks of abortion to pregnant women, who deserve our protection.


Resources

Court Briefs Summary
Korte v. HHS Amicus Brief
Isaacson v. Horne Amicus Brief of AAPS et al
Action

Use the pre-written, customizable forms at CMA's legislative action website to encourage your legislators to pass life-honoring bills on abortion.

Stem cells, tissues and regenerative medicine

Excerpted from "Stem cells mimic human brain," Nature. August 28, 2013 -- With the right mix of nutrients and a little bit of coaxing, human stem cells derived from skin can assemble spontaneously into brain-like chunks of tissue. “It’s a seminal study to making a brain in a dish,” says Clive Svendsen, a neurobiologist at the University of California, Los Angeles, who was not involved in the study. “That’s phenomenal.” A fully formed artificial brain might still be years away, he notes, but the pea-sized neural clumps developed in this work could prove useful for researching human neurological diseases.

In the latest advance, scientists developed bigger and more complex neural-tissue clumps by first growing the stem cells on a synthetic gel that resembled natural connective tissues found in the brain and elsewhere in the body. Then they plopped the nascent clumps into a spinning bath to infuse the tissue with nutrients and oxygen.

“The big surprise was that it worked,” says study co-author Juergen Knoblich, a developmental biologist at the Institute of Molecular Biotechnology in Vienna. The blobs grew to resemble the brains of fetuses in the ninth week of development. Under a microscope, researchers saw discrete brain regions that seemed to interact with one another. But the overall arrangement of the different proto-brain areas varied randomly across tissue samples — amounting to no recognizable physiological structure.

“The entire structure is not like one brain,” says Knoblich, adding that normal brain maturation in an intact embryo is probably guided by growth signals from other parts of the body. The tissue balls also lacked blood vessels, which could be one reason that their size was limited to three to four millimeters in diameter, even after growing for 10 months or more.

Commentary

CMDA Member and Senior Fellow for Family Research Council David Prentice, PhD: “There have been numerous stories lately about using induced pluripotent stem (iPS) cells to form various tissues, including vascular endothelial cells for blood vessels, myocardial tissue for heart muscle regeneration and even brain tissue for study of normal and abnormal brain development.

“The iPS cells, because they are created from the patient’s own normal cells, could potentially provide tissues for personalized drug development or for transplant. There are still significant practical problems to overcome with iPS cells, including their penchant for growth, which may make them more suitable for laboratory study than for the clinic.

“But the ethics of the research is also significant. The iPS cell creation technique (for which Dr. Yamanaka won the Nobel Prize) does not rely on creation or destruction of human life—it does not use embryos, eggs or cloning techniques. Thus, it provides an ethical source of cells for study (as long as the molecular tools used for creation of the iPS cells are ethical, of course; i.e., not using aborted fetal tissue for DNA production, etc.). As more and more cellular and molecular techniques approach the clinic, this ethical consideration is very important if we are to maintain our stance for life. “Do no harm” applies not only to the patient treated, but to the origin of the treatment as well. We should reject any ethically-tainted treatments just as we would reject any bacterially-tainted or chemically-tainted drug or instrument.”

Resources
CMDA Ethics Statement on Stem Cell Research and UseScientific Demagoguery in the Stem Cell Wars by David Stevens, MD, MA (Ethics)

Using social media in clinical practice

Excerpted from "Docs Need to Get Up to Speed, Social Media Advocate Says," MedPage Today. August 15, 2013 -- Bertalan Mesko, MD, PhD, is counting on old media to convince more clinicians about the value of new media. The clinical genomics specialist has just published a handbook on social media in clinical practice -- and he hopes it will bring late adopters up to speed with their social-media-savvy colleagues, and even with some of their electronically empowered patients.

While "expert" patients voraciously pursue credible medical information and communities online, clinicians "usually lag behind," Mesko, who is based in Budapest, said in an email exchange with MedPage Today. Instead of disdaining this kind of behavior, doctors need to see themselves as a gatekeeper of vetted online information and activities, he said.

“Social media provides us with a lot of opportunities, but only if we know the potential limitations and security issues. Acquiring such knowledge takes years, and my goal with the handbook was to shorten this time significantly for those medical professionals who would like to become a bit more digital, but at the same time use these online tools in a secure way,” said Mesko in an online engagement via email.

“I think communication methods in real life and in the online world are the same. If medical professionals understand this and create a proper online presence, as well as give their patients a chance to communicate with them through certain online channels, the doctor-patient relationship can become more efficient by saving time for both parties. Using digital technologies, especially social media, is now an integral part of medical communication, and as more and more patients use these platforms, their physicians must be able to deal with this in an evidence-based manner,” said Mesko.

Commentary

CMDA Vice President and National Director of Campus & Community Ministries J. Scott Ries, MD: "Mention 'social media' during a conversation with one of your colleagues and observe the resulting reaction of the facial muscles. I predict you'll identify a subtle pupillary dilation, upturning of the corners of the mouth and an increase in pace of speech...or else you'll view a burrowing of the forehead creases, tightening of the lips and clenching of the jaw. When in past history has any other 'tool' ever evoked such emotional response from its users (or haters)?

"At its core, social media is indeed simply a tool—a forum to communicate, share ideas, explore information, engage conversation and create community. If you already embrace social media at some level, you won't be surprised to hear that I'm more likely to be contacted via Facebook than email by students, residents and even some doctors.

"If you find yourself beset with the clenched jaw, here are a few things that might help you dip your toe in the social media waters without catching a cold.

1. Recognize that social media does not equal Facebook. Not all of social media is Facebook. As social media expands, the relative amount of the landscape occupied by Facebook is diminishing. If Facebook seems daunting to you, choose another option to explore.
2. Peruse areas of CMDA’s social media engagement. CMDA is actively engaged with social media with both the current and upcoming generations of doctors.
3. Consider following just one blog, along with following their Twitter and/or Facebook posts. This will let you ease into the foray a bit without becoming overloaded.

For more practical insight into how to use social media, the benefits it can offer you and your practice and other information, check out Social Media in #Healthcare: Why You Should (Like) Social Media by Bill Reichart, MDiv.

"But won't social media consume any vestiges of time remaining in our overloaded schedules? Only if we let it. It's like when I was taking driver's ed as an inexperienced 15-year-old. In attempting to pass a slow moving truck, I was hesitant to exceed the speed limit. Seeing the approaching car, the instructor promptly pushed her 'instructor’s accelerator' to quickly get us by the truck, while calmly saying 'Control the car. Don't let the car control you.' So it is with social media. However you choose to engage, control it...don’t let it control you."

Resources
Social Media in #Healthcare: Why You Should (Like) Social Media by Bill Reichart, MDiv

CMDA's Social Media Pages

• Facebook
  
• CMDA Student Life Facebook
  
• Twitter
  
• YouTube

Hardwired for empathy

Excerpted from "Study finds that our brains are hardwired for empathy, friendship," Medical News Today. August 26, 2013 -- Perhaps one of the most defining features of humanity is our capacity for empathy - the ability to put ourselves in others' shoes. A new University of Virginia study strongly suggests that we are hardwired to empathize because we closely associate people who are close to us—friends, spouses, lovers—with our very selves.

"With familiarity, other people become part of ourselves," said James Coan, a psychology professor in U.Va.'s College of Arts & Sciences who used functional magnetic resonance imaging brain scans to find that people closely correlate people to whom they are attached to themselves. The study appears in the August issue of the journal Social Cognitive and Affective Neuroscience.

Researchers found that regions of the brain responsible for threat response displayed little activity in the cases of shock to a stranger. However, when the threat of shock was to a friend, the brain activity of the participant became essentially identical to the activity displayed under threat to the self. "The finding shows the brain's remarkable capacity to model self to others; that people close to us become a part of ourselves, and that is not just metaphor or poetry, it's very real. Literally we are under threat when a friend is under threat," Coan said.

This likely is the source of empathy, and part of the evolutionary process, Coan reasons. "A threat to ourselves is a threat to our resources," he said. "Threats can take things away from us. But when we develop friendships, people we can trust and rely on who in essence become we, then our resources are expanded, we gain. Your goal becomes my goal. It's a part of our survivability."

Commentary

CMDA Member and Executive Director of Lighthouse Network Karl Benzio, MD -- "Some Christians have a hard time accepting science, associating science with Darwin, thus getting flustered thinking most science contradicts the Bible. Others really struggle accepting psychological sciences, associating it with Freud or thinking that psychotherapy is man worshipping man, trying to solve problems without God, or looking for an excuse for or to normalize aberrant behavior.

“But science is just the study of: 1) What God made; 2) Understanding how He designed it to function; and 3) Learning how to maximally steward it for His glory and our abundant living. Obviously, I am partial, but God’s two most incredible creations are the human mind and free will (our psychological process which produces decisions).

“As our Creator, like any good developer of a product, God gave us an awesome instruction manual, called The Holy BIBLE (Best Instruction Book for Living Everyday). Throughout the Bible, God clearly teaches us His design for us to be in relationships from the beginning in the Garden of Eden through our ultimate union with Him in the life after this in Heaven. Mark 12:30, the Greatest Commandment, instructs us to love God with all our heart, soul, mind and strength, but then to love others and ourselves (in healthy and Godly ways).

“This study reveals science about the circuitry God created for us to accomplish His command to engage in healthy and caring relationships. The missing piece science has a hard time quantifying, though, is the spiritual sphere, that spiritual part of man that is unique for each of us. Our spirit allows a special connection to God and a special connection to others. Unfortunately, Satan is always attacking our mind, but as we manage life the way the Bible instructs, circuitry for empathy, forgiveness and agape love grow as we carry out the Greatest Commandment and develop the mind of Christ.

“So engage the awesome science of our mind as it helps us understand how God designed us, but more importantly, how to steward our mind to glorify Him and live life abundantly. How you manage every minute is your decision, so choose well.”

Resources
“Cleaning Up” Marital Communication by William Curtrer, MD, and Sandra Glahn, ThM
Summer 2012 edition of Today’s Christian Doctor