Oncologists being forced out of private practice

Excerpted from "Private Oncologists Being Forced Out, Leaving Patients to Face Higher Bills," The New York Times. November 23, 2014 — When Dr. Jeffery Ward, a cancer specialist, and his partners sold their private practice to the Swedish Medical Center in Seattle, the hospital built them a new office suite 50 yards from the old place. The practice was bigger, but Dr. Ward saw the same patients and provided chemotherapy just like before. On the surface, nothing had changed but the setting.

But there was one big difference. Treatments suddenly cost more, with higher co-payments for patients and higher bills for insurers. Because of quirks in the payment system, patients and their insurers pay hospitals and their doctors about twice what they pay independent oncologists for administering cancer treatments.

There also was a hidden difference — the money made from the drugs themselves. Swedish Medical Center, like many others, participates in a federal program that lets it purchase these drugs for about half what private practice doctors pay, greatly increasing profits. Oncologists like Dr. Ward say the reason they are being forced to sell or close their practices is because insurers have severely reduced payments to them and because the drugs they buy and sell to patients are now so expensive.

It raises questions about whether independent doctors, squeezed by finances, might be swayed to use drugs that give them greater profits or treat poorer patients differently than those who are better insured. Health care economists say they have little data on how the costs and profits from selling chemotherapy drugs are affecting patient care. Doctors are constantly reminded, though, of how much they can make if they buy more of a company’s drug.

While individual oncologists deny choosing treatments that provide them with the greatest profit, Dr. Kanti Rai, a cancer specialist at North Shore-Long Island Jewish Cancer Center, said it would be foolish to believe financial considerations never influence doctors’ choices of drugs. “Sometimes hidden in such choices — and many times not so hidden — are considerations of what also might be financially more profitable,” he said.

Commentary

CMDA Past President and Oncologist Al Weir, MD: “As Christian healthcare professionals, even as we care for those who suffer most, we are caught up in questions of motive and profit. Kolata’s article is quite accurate regarding system changes and finances in oncology. Hospitals are buying oncology practices rapidly on a large scale. Oncologists are fleeing toward hospital ownership as a place of financial refuge from falling incomes. Profits are higher for hospitals than for private doctors. Patients are paying higher copays. Some uninsured are receiving better care. And most of us as healthcare professionals just want to settle into the new systems as we treat individual patients with good science and compassion, as we did before.

“Biblically, I do not know how much profit healthcare professionals should make in caring for the suffering---I have made such profit most of my career and have probably made too much. I do know that we must weigh our profits against the financial suffering we add to our patients' physical sufferings. I do know that we must care for those who cannot afford the standard cost of care, even if we sacrifice to do so. I do know that we are not only responsible for the economic suffering of each individual patient, but also for the suffering caused as we accept system changes. We have a voice; and within these system changes, we, as Christian healthcare professionals, must speak out for the welfare of all patients, just as if they were telling us their individual stories in our own exam rooms.”

Resources

Professionalism in Peril – Part 2: Unjust Scales in Healthcare by Gene Rudd, MD
The Changing Role of the Doctor by Richard A. Swenson, MD
CMDA’s Professionalism Ethics Statement

Study shows therapy reduces suicide

Excerpted from “Study discovers a simple but powerful way to reduce suicide,” Fox News. November 24, 2014 — Talk therapy is a simple but powerful way to stop people at high risk of suicide from harming themselves, according to new research. In a study published in the Lancet Psychiatry journal, researchers who tracked tens of thousands of Danes over an 18-year period found that suicides were down 26 percent over a five-year period among people who had attempted suicide and received talking therapy sessions at a suicide prevention clinic, compared to those sent home with no treatment, the BBC reports.

In the first year, those who received talk therapy were not only 27 percent less likely to attempt suicide again, they were 38 percent less likely to die of any cause—and the positive effects could still be seen more than a decade later.

The researchers say the study is the first solid evidence "that psychosocial treatment—which provides support, not medication—is able to prevent suicide in a group at high risk of dying by suicide." A study co-author tells Bloomberg that even though previous studies showed that one in six people who survive a suicide attempt go on to harm themselves again within a year, many suicide survivors who don't require hospitalization for a mental illness are simply sent home without being referred to a counselor.

The researchers, who say the study reinforces the fact that it's "very important to offer support for people who have attempted suicide," plan follow-up studies to determine which kinds of therapy work best.

Commentary

Founder, Executive Director and Psychiatrist at Lighthouse Network Karl Benzio, MD: “God has blessed us with tremendous scientific advancements, leading to some incredibly helpful psychotropic medications. But in my 25 years of prescribing most of them, none of these medications are curative of any behavioral health issue, but rather they only provide symptom management. As this article nicely shows, the more potentially curative intervention for behavioral health struggles is talk therapy specifically aimed at helping an individual see their life circumstances more accurately, then respond with better decisions. Godly decision-making skills, as Solomon wished for, is the most important skill to master because decision-making is the exercise for, or what strengthens, the brain circuitry. The Bible tells us in Romans 12:1-2 and 2 Corinthians 10:4-6, Godly decision-making actually renews the mind and is our divinely powerful weapon. Many studies are now validating this principle, showing psychotherapy is a neurobiological intervention.

“Contrary to evolution mentality, the human condition is still fragile, decaying and suffering. Even in this great scientific era, suicide is the second leading cause of death in the U.S. when counting unreported and passive suicides. Some say Freud was the father of modern psychiatry, but Jesus was the first psychiatrist, starting the modern behavioral health revolution 2,000 years ago with His radical teachings and life example that show us how to make healthy life management decisions to live the abundant life (John 10:10) and ultimately transform our mind.

“Our calling is to continue what Jesus started. So when you see a patient in clinical practice in any circumstance, assume they’re all broken and struggling psychologically to some extent. Ask about life, stress, satisfaction, fulfillment and goal achievement, and see what responses they have, especially if their presenting symptoms might have some stress or psychological contributing factors. Then be a lighthouse guiding them to God’s peace and transformation using some basic counselor/discipling skills and referring them if more professional guidance is needed.”

Resources

A Relentless Hope: Surviving the Storm of Teen Depression
CMDA’s Psychiatry Section
CMDA’s Suicide Ethics Statement

Women hold egg freezing parties

Excerpted from “For women in tech, egg freezing parties are new post-work event,” SFGate. November 10, 2014 — In Silicon Valley, where many tech employees put in long hours, Dr. Aimee Eyvazzadeh wants women to think about freezing their eggs — after work, and over drinks. The fertility expert is hosting three informational events this week, called egg freezing parties, at restaurants in the Bay Area. Over wine and appetizers, a small group of women will learn more about the egg freezing process and there will be experts to help with any questions.

Eyvazzadeh, who calls herself “The Egg Whisperer,” is jumping on growing interest in preserving eggs in Silicon Valley, as some tech companies have decided to make the procedure a standard health benefit for a young workforce that is faced with the decision on whether to delay parenthood.

More tech companies are offering perks for parenthood in order to keep employees happy. Facebook already covers up to $20,000 for several procedures, including egg freezing, and also offers other benefits for parents, including giving $4,000 in “baby cash” for each child born. Meanwhile, Apple plans to include egg freezing and storage as part of items covered by its health insurance policy next year.

“They are bringing a lot of these women who are graduating from college with very high level coding degrees and they really want them to work … during their younger years, knowing full well that once they get a family, the pressure on them are very different,” said Tim Bajarin, president of advisory services firm Creative Strategies. “What this does is it gives these women another level of choice.”

Alec Levenson, a senior research scientist and labor economist at USC’s Marshall School of Business, called the egg freezing parties “innovative.” “It’s another example of what marketers have always known,” Levenson said. “If you can get people to refer something by word of mouth to friends and family, it’s a much more effective marketing method than trying to do something through general advertising.”

Commentary

Medical Director for the National Embryo Donation Center Jeffrey Keenan, MD: “While egg freezing is medically indicated in limited situations, such as prior to chemotherapy or pelvic radiation in women who desire to maintain their fertility, marketing this service to women in their 20s who are in good health is inappropriate, in my opinion. I disagree with Dr. Eyvazzadeh, that this is just ‘raising awareness.’ I believe throwing ‘egg freezing parties’ is done to raise doubt, not awareness, in a group of people who are typically unsure of exactly what their life will look like in 10 or 20 years. Once doubt has been raised, and especially if your employer pays for it, it’s an easy jump to freeze eggs ‘just in case.’

“That translates into $15,000 for this physician’s practice and some good public relations. Profit and PR are often good things. But the problem with that approach is the great majority of women will never need or use those frozen eggs for a variety of reasons.

“There is a better approach. For younger women who have anxiety about their chances of eventually having a child, we offer a ‘fertility checkup’ to determine her relative fertility compared with her peer group. Then, we discuss her relational status, when she thinks she would like to conceive and how many children she’d like to have before even mentioning an expensive, invasive and (usually) unnecessary procedure like freezing eggs.

“As for the Silicon Valley companies that are offering this as part of employees’ health plans, I think the analyst in the article said it best—they are doing it because ‘once they have a family, the pressures on them are very different.’ In other words, the companies are doing this out of self-interest, although it is cleverly disguised as ‘increasing diversity in the workforce.’”

Resources

Assisted Reproductive Technology Ethics Statement
Dr. Jeff Keenan’s Interview about Egg Freezing Options
National Embryo Donation Center

CMDA-affiliated physician dies of Ebola

Editor's note: Dr. Martin Salia was a general surgeon and graduate of CMDA’s Pan-African Academy of Christian Surgeons residency in Cameroon.

Excerpted from "Ebola-infected physician dies in Nebraska," USA Today, November 17, 2014, - A surgeon infected with Ebola while treating patients in Sierra Leone has died in Omaha, Nebraska Medical Center announced Monday. Martin Salia, whose family lives in Maryland, arrived in Omaha on Saturday for treatment at the specialized biocontainment unit. He became ill Nov. 6 and tested positive for Ebola a week ago. Before his dad died, the son of Doctor Martin Salia said treating patients infected with Ebola was his "calling from God."

"It is with an extremely heavy heart that we share this news," Phil Smith, medical director of the Biocontainment Unit at the hospital, said in the statement. "Dr. Salia was extremely critical when he arrived here, and unfortunately, despite our best efforts, we weren't able to save him."

Smith said Salia was suffering from advanced symptoms of Ebola when he arrived, including kidney and respiratory failure. He was placed on dialysis, required a ventilator and received plasma, Smith said. Multiple medications included ZMapp therapy, a new drug that has shown promise in fighting the disease.

Salia is the second person to die of Ebola in the United States. A Liberian man living in Texas, Thomas Eric Duncan, contracted the disease in his native country but was not diagnosed until after his return to Dallas. He died Oct. 8.

Salia's wife, Isatu Salia, has said that her husband believed he had malaria or typhoid when he fell ill Nov. 6. Her husband had two negative tests for Ebola before the third came back positive Nov. 10, she said. Isatu Salia said her husband's voice sounded weak and shaky when they spoke early Friday. But she said he told her, "I love you."

Salia said her husband traveled frequently between the United States and his native Sierra Leone. He never stayed in the U.S. long because he believed people in Africa need him, she said. Ebola has killed more than 5,000 people in West Africa, mostly in Liberia, Sierra Leona and Guinea.

Commentary

Professor of Clinical Medicine at Georgetown University Medical Center and CMDA Campus Advisor Allen H. Roberts II, MD, MDiv: “With heavy hearts the news of Dr. Martin Salia’s death was shared, and with heavy hearts it is received. Most keenly is his death felt by his wife and sons, to whom our hearts and for whom our prayers go out, but it is felt deeply and dearly by his CMDA family as well. We pause in the midst of our daily rounds and of our own Ebola preparations to think about our brother in Christ, the life he lived and the death he died – both in the service of the Lord he loved.

“Martin’s predicament confirms what we are learning about Ebola. Patients who arrive at U.S. medical centers early in the course of the illness and are treated with aggressive fluid and electrolyte administration fare better. Many hospitals are developing protocols and ethics statements reflecting that with appropriate disease-containment interventions, the disease, when treated early, is survivable and containable.

“Dr. Salia’s death also came in the aftermath of an appeal that went out to CMDA members that we pray without ceasing for his recovery, and scores of members did just that. Yet, this dear brother died.

“Now is a good time to remember Jesus at the tomb of Lazarus (John 11:17-44). We may join Martha and Mary in their deep sorrow; we may join Jesus Himself in absolute indignation and anger over the death of a friend.

“And we are invited, then, to listen to Jesus utter these most astonishing words, “I am the resurrection and the life…” (John 11:25, NIV 2011). It was in the certain hope of the resurrection that Martin Salia responded to God’s call to minister to those with Ebola in Sierra Leone. He counted the cost, and he went.

“We know how the story ends for Lazarus and how it will end for Martin Salia and all who are in Christ. It may be in the months ahead that God in His mercy will lead us to an effective treatment for this dreaded disease. We don’t know. But it was on the cross that the fate of Ebola was sealed, along with that of all disease and all death in all history. Jesus’ tomb is empty, and so will be Martin’s.”

Action
Participate in CMDA's End Ebola Project

Resources
Ebola: ‘Beat the fire while it is far’ by Dr. David Stevens Ebola and Medical Missionaries

Pro-life movement makes gains in election

Excerpted from "Polling Shows Impact of Abortion Issue in Mid-Term Election," National Right to Life News, November 6, 2014 - A new post-election poll of actual voters conducted by The Polling Company/ WomanTrend, found that the issue of abortion once again played a key role in the mid-term elections, and that National Right to Life and its state affiliates were key to getting out the pro-life vote for pro-life candidates.

Twenty-three percent of voters said that the abortion issue affected their vote and voted for candidates who oppose abortion. This compares to just 16 percent who said abortion affected their vote and voted for candidates who favor abortion, yielding a 7 percent advantage for pro-life candidates.

These poll results help explain the victories experienced by the right-to-life movement in Tuesday’s elections. Despite being vastly outspent by pro-abortion organizations such as Planned Parenthood and EMILY’s List, pro-life candidates won Tuesday by significant margins. There were 26 races in which a candidate supported by National Right to Life was running against a candidate supported by the pro-abortion PAC EMILY’s List. Nineteen (73 percent) of the National Right to Life-supported candidates won.

“The abortion issue has played a key role in every major election since Ronald Reagan won the presidency in 1980,” said Carol Tobias, National Right to Life president. The poll also found that voters heard and saw the right-to-life message in the days leading up to the election.

Editor's note: As a 501(c)3 organization, CMA educates on issues and legislation but does not endorse candidates for office.

Commentary

CMA VP for Government Relations Jonathan Imbody: “Activist electioneering is hard but potentially productive work, and this round of advertising, phone calling and one-on-one conversations leading up to the November 4 elections paid off for the pro-life cause. The House of Representatives gained at least seven pro-life members, and the Senate's switch of party control (the GOP will have at least a 53-47 edge, with not all races decided) means that pro-life bills now should at least gain a vote.

“To some followers of Christ, following politics seems at best pointless and at worst counter-productive. Some believers disdain or shrink from the controversies and contention that mark modern politics. Some even decry any public policy involvement including voting, asserting that engaging in worldly politics is beneath heaven-bound Christians.

“Here's a case for robust Christian engagement in public policy:

1. Scripture (Romans 13) teaches that God has ordained governments for two primary purposes—to punish evil and to reward good.
2. While God provides everyone with a conscience to subjectively sense right and wrong (Romans 2), God's Word and His Spirit enable believers uniquely to objectively and spiritually discern good and evil (1 Corinthians 2).
3. In a democratic republic such as the United States, We the People—including We the People of God—possess the power, privilege and duty to guide our government toward truth and justice.
4. When believers disengage from public policy and refuse to guide their government as political leaders, activists and voters, their government suffers a critical loss of counsel regarding truth and objective standards of justice.
5. This dereliction of duty by believers, who by the gifts of God's revelation and Spirit know right from wrong most clearly, opens the door to control of the government by power-seeking individuals with a self-concocted, upside-down worldview.
6. When subjective ideologies and arbitrary assertions replace the Judeo-Christian objective standards that formed the foundations for Western governments and justice, evil becomes good, and good becomes evil.
7. In the absence of objective standards, ideology replaces the rule of law and justice, and government enforces its ideology with unchecked power. Individuals holding opposing worldviews and the politically powerless suffer most, and no one remains safe from arbitrary autocratic attack."

Action

1. Join our Freedom2Care coalition Federal Registry on LinkedIn (registration is free) to gain updates on opportunities to advise government officials, serve on federal commissions and secure federal jobs.
2. Visit our Freedom2Care legislative action website for easy-to-use forms to voice your values to your legislators.

Resources
Defending Life 2014 - a state-by-state legal guide to abortion, bioethics, and the end of life, by CMA legal partner Americans United for Life.
CMDA Abortion Ethics Statement
Remember to Remember: The Modern Implications of Abortion by Dr. John Patrick

Choosing to live

Excerpted from "The Courageously Mundane Faithfulness Of Kara Tippetts," Breakpoint commentary by John Stonestreet, November 7, 2014 - A young Oregon woman with a brain tumor recently made the choice to die. But a Colorado woman facing a terminal disease is choosing to live. What can we learn from their stories?

Oregon allows physician-assisted suicide; California doesn’t. Brittany Maynard chose November 1 as the day she would end her own life, with the help of a doctor. And I’m sad to say she carried through with her plans—despite the enormous outpouring of love and prayers from people across the country who urged her to change her mind.

One of those people was Kara Tippetts, a 38-year-old married mother of four who knows well the fear and pain of a stage 4 cancer diagnosis. Her approach to illness has been to rest on the grace of God and to find power in living faithfully moment by moment, squeezing the goodness out of each day, and exhibiting, no matter what the prognosis, “mundane faithfulness,” which is the name of her blog.

Kara tells a story of mundane faithfulness in her new book, The Hardest Peace.

Kara has used her voice to reach out to Brittany Maynard, asking her to reconsider, gently telling her that there’s more to life than good physical health and the avoidance of suffering. “Suffering is not the absence of goodness,” Kara says in an open letter to Brittany, “it is not the absence of beauty, but perhaps it can be the place where true beauty can be known. ...That last kiss, that last warm touch, that last breath, matters—but it was never intended for us to decide when that last breath is breathed.”

Kara has been learning that lesson on her own journey. Go to her blog and you’ll see that Kara is not throwing around a lot of cheap Christian clichés. Here’s an entry from October 18:

“How do you love when you are at the bottom of yourself? The last gulp of a drink you feel tentative to swallow? How do you swallow that last gulp of life and fight to live it well? I’m struggling today,” she writes, “and I knew it would be a hard one. Chemo brings a low that I struggle with words to describe.”

And then on October 20: “...The hand held, the time spent reading together, the little loves that when faced with death have become the giant important moments in my life. The time praying together, laughing together, cooking together and crying together. They add up to a life well lived. [They] are simply the best of life.”

Friends, let's pray for Kara and for all those facing terminal illness—as well as for their families. And let’s also pray for our culture, that we learn that life is always a gift, without exception.

Commentary

CMA VP for Government Relations Jonathan Imbody: "Even if moving stories like those of Brittany Maynard prompt some to think we need to legalize assisted suicide, it's crucial to remember that such laws affect many more people and have many more consequences than originally imagined. The elderly, the handicapped and the depressed all become much more vulnerable under assisted suicide laws. You as a health professional know that much can go on behind the curtain that will never show up on a chart or in court. What appears on a document as a voluntary decision may in truth be coerced or otherwise improperly influenced--by an unduly negative presentation of a prognosis, or by family members who want an easy way out for themselves.

"Laws teach principles, and assisted suicide laws teach that suicide is not only good but a right. The right to die too easily becomes the duty to die. How many elderly patients already consider themselves a burden? How many heirs already wish their benefactor would die? What is a severely depressed teen supposed to think when society legalizes suicide?

"I know from conducting on-site research in the Netherlands what happens when the medical community and society make medical killing normal. I spoke to a son whose father, who had chosen euthanasia out of fear and a lack of his wife's support to choose life-extending surgery, told the doctor he didn't want to die after the doctor had administered the first shot to put him to sleep. The doctor ignored his statement and quickly administered the lethal injection. A grandfather asked for help with a painful thrombosis and instead died at the hands of a physician who interpreted his request as one for euthanasia.

"When doctors gain the power to kill, no patient remains safe. Hippocrates helped transform medicine with a proscription against assisting suicide--a measure that for the first time protected patients. Do all in your power to see that your state does not turn the clock back to the days when patients had to fear their physicians."

Action
State Legislative Issues - Physician-Assisted Suicide

Resources
Jonathan Imbody Senate Testimony on Euthanasia
Kara Tippetts, blog
"Small wonders" - Kara Tippetts - World magazine
CDD STAT Interview with Kara Tippetts
Euthanizing Medicine, a presentation on the implications of legalizing physician-assisted suicide
Top Reasons Why Physician-Assisted Suicide Should Not Be Legal

Terminally ill patient ends her life

Excerpted from “Brittany Maynard, right-to-die advocate, ends her life,” USA Today. November 3, 2014 — Brittany Maynard, the 29-year-old face of the controversial right-to-death movement, has died. She captivated millions via social media with her public decision to end her life.

Sean Crowley, spokesman for the non-profit organization Compassion & Choices, confirmed Maynard's death Sunday evening. "She died peacefully on Saturday, Nov. 1 in her Portland home, surrounded by family and friends," according to a statement from Compassion & Choices. The statement said Maynard suffered "increasingly frequent and longer seizures, severe head and neck pain, and stroke-like symptoms." She chose to take the "aid-in-dying medication she received months ago."

Her death brings a new element to the movement in the age of social media because the conversation has included younger people. "She's changed the debate by changing the audience of the debate," Abraham Schwab, an associate professor of philosophy at Indiana University-Purdue University Fort Wayne, told the Associated Press earlier.

Maynard was diagnosed with a stage 4 malignant brain tumor. She moved with her family from California to Oregon, where she could legally die with medication prescribed under the Oregon Death With Dignity Act.

"I understand she may be in great pain, and her treatment options are limited and have their own devastating side effects, but I believe Brittany is missing a critical factor in her formula for death: God," said Joni Eareckson Tada last month in an article for Religion News Service.

Commentary

CMDA CEO David Stevens, MD, MA (Ethics): “I’m deeply saddened by Brittany Maynard’s suicide. As far as we know, she had no hope—despite Joni Erickson Tada, Kara Tippets (who is dying with Stage 4 breast cancer) and others pointing her toward God, our real source of hope. I’m saddened because Compassion and Choices used and possibly abused her as their ‘poster child’ for legalizing physician-assisted suicide in a slick media campaign that drew millions of Facebook and YouTube hits, as well as enormous favorable media attention. I can’t help but wonder why she announced she was going to postpone her suicide, only to take her life two days later? Did she feel pressured or obligated to do it?

“I’m even more saddened that many more patients are likely to die because Ms. Maynard glorified suicide as the answer to suffering, and it won’t just be highly controlling, terminally ill patients like her. In the short term, it will be vulnerable teens and the depressed. In the long run, it will be handicapped newborns, Alzheimer’s patients, the chronically sick and the mentally ill, as we have already seen in Europe. It’s inevitable, despite all the so-called safeguards. Who can deny ‘this right to death with dignity’ to anyone who is suffering or is even afraid they may suffer in the future? And if the patient is incompetent, should the physician, exhausted caregiver or the son or daughter set to inherit the estate decide ‘on their behalf?’ Ultimately, it will kill the ethos of healthcare as doctor-patient trust is destroyed.

“It is too late for Brittany, but not for you and me to speak the truth in love to alter the predictable future. I’m heading to New Jersey next week to meet with legislators to urge them to say ‘No’ on an expected physician-assisted suicide vote scheduled for Thursday, November 13. I’m then traveling from one end of Montana to the other, speaking out against physician-assisted suicide in every major city and doing media interviews along the way to hopefully halt their march off the physician-assisted suicide cliff.

“What are you going to do to alter the future—before it is too late?”

Resources

CDD STAT Interview with Kara Tippetts, a stage-four cancer patient
Euthanizing Medicine, a presentation on the implications of legalizing physician-assisted suicide
Top Reasons Why Physician-Assisted Suicide Should Not Be Legal

Action

Physician-assisted suicide legislation is now being attempted in California, Connecticut, Massachusetts, Nevada, New Jersey, New Mexico and Pennsylvania. If you’d like to get involved in the fight against this dangerous legislation, please contact communications@cmda.org.

Tennessee passes abortion amendment

Excerpted from "Tennessee Amendment 1 abortion measure passes," The Tennessean. November 5, 2014 — Tennessee voters by a solid margin backed Amendment 1, a measure that gives state lawmakers more power to restrict and regulate abortions. The measure was perhaps the most closely watched and most contentious Election Day vote in Tennessee's midterm elections. It passed with 53 percent of the vote. Its passage has no immediate effect on abortion policies in Tennessee. But it will give lawmakers far more power in enacting abortion regulations and restrictions in Tennessee.

Backers of the amendment were jubilant, embracing at the offices of Tennessee Right to Life, the campaign headquarters for the effort. "Obviously for those of us who believe life is sacred, this was the necessary first step toward protection not only for the unborn but for women and girls who fall prey to people looking to profit from untimely or unexpected pregnancies," said Brian Harris, president of Tennessee Right to Life and a coordinator for the "Yes on 1" campaign, who has devoted much of the past 14 years fighting for the measure to get on the ballot.

Opponents on Tuesday night called the measure a "dangerous ballot measure that strips away the state's established right to safe and legal abortion" and vowed abortion rights supporters "will not stand for restrictions that serve only to create barriers to service," said Ashley Coffield, president and CEO of Planned Parenthood — Greater Memphis Region.

The abortion measure drew the close attention of national groups on both sides of the abortion divide — and large contributions from abortion rights advocates outside the state concerned not only about the impact in Tennessee, but beyond its borders. One in four abortions in Tennessee is sought by a woman from out of state. Proponents of the measure called on Tennessee voters to end the state's status as an "abortion destination."

Commentary

CMDA Member and Board Certified Obstetrics and Gynecology C. Brent Boles, MD: “The votes have been counted and Amendment 1 is now part of Tennessee’s Constitution. This amendment corrects the poor decision made by the Tennessee Supreme Court in 2000 in Planned Parenthood v. Sundquist, in which four of five justices decided that Tennessee’s Constitution had stronger protections for abortion than the U.S. Constitution. Since that decision, the Tennessee legislature has been unable to pass meaningful regulation having to do with abortion in our state. As a result, the abortion industry was not accountable to the state’s Department of Health in any significant way. Now, the Tennessee legislature can work to protect vulnerable women from being victimized by the abortion industry and reduce the number of innocent babies lost every year in Tennessee. I hope we will see a restoration of a standard informed consent process and a brief waiting period, as well as the health department’s ability to enforce the same patient safety standards respected by all of legitimate medicine.
“How did the amendment pass? Planned Parenthood poured millions into the state to defeat this amendment because its passage was a threat to the abortion industry’s business model. They outspent the amendment’s supporters 2 to 1. Supporters of Amendment 1 couldn’t outspend Planned Parenthood, but they did outwork Planned Parenthood. A tremendous grassroots effort all over the state resulted in success.

“One of the key pieces resulting in success was the involvement of churches. Success for life and for women in Tennessee shows we can begin to see the tide turn if the church in America will find its voice. How can Christian healthcare professionals play a role? Paul tells us in Romans 12 that we are all parts of Christ’s body and we all have roles to play, and he admonishes us to fulfill our roles with diligence.

“Christian healthcare professionals are in a unique position to make a difference on this issue across the country. We are leaders in our churches and communities. Legislators listen when we call. Pro-abortion forces do not hesitate to use pro-abortion physicians in this fight on both the state and federal levels to promote the abortion industry’s many deceptions. We can do no less. The church has been silent on social issues in America for far too long, and if the church is to truly be salt and light in today’s society, then it is incumbent upon Christian healthcare professionals as members of Christ’s body to take the lead on the issue of life. Successful passage of Amendment 1 is cause for praising our God, but it is not the last chapter in the story of abortion in America. Now is the time to not only stand firm, but to also press forward at every opportunity. It may be that the church is finding its voice once again, and we as Christian healthcare professionals need to be part of the choir.”

Resources

CMDA Abortion Ethics Statement
Remember to Remember: The Modern Implications of Abortion by Dr. John Patrick

Public supports quarantine for Ebola health workers

Excerpted from “NBC/WSJ Poll: 71% Back Mandatory Quarantines for Ebola Health Workers,” NBC News. November 2, 2014 — More than seven in 10 Americans support mandatory quarantines for health professionals who have treated Ebola patients in West Africa, even if they have no symptoms, according to a new NBC News/Wall Street Journal poll. The survey shows that 71 percent of those surveyed say the health workers should be subject to a 21-day quarantine, while 24 percent disagree.

The question of mandatory quarantines exploded into the public debate after nurse Kaci Hickox battled with the governors of New Jersey and Maine over the mandated isolation, arguing that she has exhibited no symptoms and tested negative for the virus. Those who oppose the practice – including top health officials and White House administration officials – say that it is unnecessary and discourages health workers from fighting the Ebola outbreak at its source.

Support for the quarantines varies by political party, age and education level. Eighty-five percent of self-described Republicans say they think the quarantines should be enforced, versus 65 percent of Democrats and 60 percent of independents. Ninety-one percent of Tea Party backers also believe the quarantines are necessary.

Older Americans are also more likely to back mandatory isolation for the health workers. A third of those 18-34 years old oppose the requirements, compared with just one in 10 seniors. And those with lower levels of education are more likely to support quarantines (80 percent of those with a high school education or less are in favor) than those with college or post-graduate educations (63 percent are in favor.)

Commentary

CMDA Member and Chief of Infectious Diseases at Moffitt Cancer Center John N. Greene, MD: “The majority of people, including healthcare workers, favor the quarantine of those who care for patients infected with the Ebola virus, both at home and those returning from West Africa. This paradox exists despite the clear scientific evidence pointing to a lack of contagion of the asymptomatic but exposed person. The fear and hysteria created by the Ebola epidemic is unprecedented.

“Just to point out one of many examples: A teacher returning from Kenya (a country with no cases of Ebola) was asked to remain at home for 21 days and bring in a note from a doctor at the end of her home-bound detention stating she is non-contagious before returning to teach children. All this due to parents and faculty being fearful of contagion despite the impossibility of transmitting an endemic virus the teacher was never in contact with.

“The real question is why would rational people, especially those of the Christian faith, believe the unbelievable? I think it is fear, which clouds one’s judgment, and a lack of trust in authorities and experts who have led us astray and do not hold our Christian values. If we believe the Bible commands us to be a beacon of light for unbelievers, then we need to allow perfect love to cast away fear.

“Jesus and the apostle Paul did not fear death but instead entered into dangerous situations that ultimately claimed their lives. Why? They entrusted their lives to Him who judges righteously and did not count their lives as dear to themselves. Why can’t we have the same attitude and encourage those who risk their lives to care for those stricken with Ebola virus disease? Let’s not punish them for their service by placing an unwarranted burden on them and forcing them into quarantine to be shunned and avoided. Rather, let’s tell them, ‘Well done,’ and embrace them with a warm hug for their Christ-like service of those who can’t help themselves. What a testimony for Christ the world would see if we could lead this charge and go against the tide of unreasonableness and a lack of love.”

Resources

Ebola: ‘Beat the fire while it is far’ by Dr. David Stevens
Ebola and Medical Missionaries

Action

Participate in CMDA's End Ebola Project

CMDA offers marriage principles

Excerpted from "Leading Christian medical association unanimously affirms traditional marriage," Life Site News, October 13, 2014, - The Christian Medical & Dental Associations (CMDA) unanimously adopted its Same-Sex "Marriage" Public Policy Statement September 18, criticizing the “radical revisionist view” which “ignores millennia of legal and cultural affirmation” of marriage, and endeavors to replace it with a subjective concept of marriage based on emotional relationship.

The CMDA said this skewed belief is divorced from the natural and objective elements of marriage - physical union and procreation.

“Marriage is a consensual, exclusive and lifelong commitment between one man and one woman, expressed in a physical union uniquely designed to produce and nurture children,” the CMDA statement said.

“The universal recognition of conjugal marriage by virtually every civilization throughout history, arrived at from both secular and theistic perspectives, testifies to the natural evidence for marriage, its objective structure and its significant contribution to human flourishing and societal stability.”

The CMDA statement was released just a few weeks prior to the U.S. Supreme Court’s October 6 dismissal of five U.S. states’ petitions to review lower court decisions overturning their marriage protection amendments.

The CMDA said that recognition of marriage as being between one man and one woman does not necessarily impede acceptance of other consensual relationships.

“The core debate hinges not on a moral evaluation of various types of relationships, but rather on the objective qualities that make marriage, marriage,” the CMDA statement said.

The benefits to children raised by both a mother and a father, the greater economic stability of intact families and the high cost to government and society when marriage breaks down were all listed by the CMDA to illustrate the government’s stake in preserving marriage.

The CMDA also critiqued court decisions that have asserted that support for marriage is not rational and instead based on hostility toward homosexuals, saying that these judgments have paved the way for religious persecution toward proponents of traditional marriage.

“Once the government adopts an official position that opposition to ‘same-sex marriage’ is based solely on animus and constitutes discrimination, the state can assert a compelling interest to advance this social policy--even if doing so means trampling the rights of religious conscientious objectors,” the CMDA statement said. “This assertion of government power to enforce the ideology of the state threatens not only the individual exercise of conscience but also the entire constitutional balance of the church-state relationship.”

“Such an aggressive, state-sponsored squelching of the free exercise of religion, as expressed in faith-based dissent, creates a powerful deterrent to free speech and the exercise of conscience,” the CMDA said. “Apart from the intervention of courts and/or a reversal of societal values, faithful supporters of conjugal marriage stand to face a virtual ideological Inquisition of increasing intensity.”

The CMDA statement concluded with a list of policy recommendations that would protect the rights of faith and conscience in law and policy, and in particular safeguard against legal assault of physicians who practice in accord with their conscience.

Commentary

CMA VP for Government Relations Jonathan Imbody: “Why even get involved in such a controversial area as same-sex marriage? How does this apply to healthcare professionals?

“A number of medical organizations have officially endorsed same-sex relationships, with sanctions and the censure of dissenting members sure to follow. The administration, through the Dept. of Health and Human Services and other federal agencies, has begun to require assent to its same-sex marriage ideology as a condition for receiving federal grants. As same-sex issues politics takes root in our legal system and professional organizations, you will likely find yourself at risk as a healthcare professional or student if you:

• deviate from governmental or professional organizational same-sex policies when counseling or treating patients regarding their sexuality;
• decline to provide a requested recommendation for a same-sex couple seeking to adopt a child;
• affirm, during a medical school or placement interview, the moral principle of reserving sex for male-female marriage;
• do not fulfill requests by same-sex couples for reproductive services such as in-vitro fertilization (physicians already have been sued successfully for this on grounds of discrimination).

“The church in Germany in the 1930s failed to heed the warning signs, succumbed to state coercion and experienced the absolute disintegration of their religious freedom. The tragic loss resulted in part because naïve people of faith opted for compromise with the rising Nazi regime and failed to confront ruthless oppression as Hitler marched toward absolute power.

America is not fascist Germany, but the principle remains the same: Government tends to increase its own power at the expense of individual freedoms--unless We the People take action. “Now is the time to determine to remain faithful, to defend truth and religious freedom--and also to prepare to take a stand in the face of pressure and even persecution.”

“Then Mordecai told them to reply to Esther, ‘Do not imagine that you in the king’s palace can escape any more than all the Jews’” (Esther 4:13, NASB).

“But Daniel made up his mind that he would not defile himself with the king’s choice food or with the wine which he drank...” (Daniel 1:8, NASB).

“Blessed are you when people insult you and persecute you, and falsely say all kinds of evil against you because of Me. Rejoice and be glad, for your reward in heaven is great...” (Matthew 5:11-12, NASB).

Action
Use our easy, pre-written form at our Freedom2Care legislative action website to urge your legislators to support the Marriage and Religious Freedom Act--S.1808, which prohibits discrimination because of moral beliefs regarding marriage and sex.

Resources

1. Read the CMDA statements on what marriage is and on same-sex "marriage." The two new, board-approved public policy statements on marriage state support for public policy measures that:
   • Recognize marriage as exclusively between one man and one woman.
   • Accord protections, incentives and privileges that reflect a recognition of the economic, social and child-related benefits to the state of conjugal marriage.
   • Do not conflate conjugal marriage with same-sex relationships.
   • Comport with the original intent of Amendment XIV of the U.S. Constitution.
   • Maintain equal protection of applicable laws for those who engage in homosexual activity without according special status or privileges based on that activity.
2. A Thoughtful Approach to God's Design for Marriage, by Sean McDowell & John Stonestreet.
3. What is Marriage? By Sherif Girgis, Ryan T. Anderson and Robert P. George.

California: Churches must cover abortions

Excerpted from "Churches forced to cover abortion file federal complaint against Calif. agency," Alliance Defending Freedom news release, October 09, 2014 - Life Legal Defense Foundation and Alliance Defending Freedom filed a formal complaint Thursday with the U.S. Department of Health and Human Services over the California Department of Managed Health Care’s decision to force all employers, including churches, to pay for elective abortions in their health insurance plans. LLDF and ADF represent seven California churches that object to offering their employees insurance plans covering elective abortions and allege that DMHC’s coercion of abortion coverage violates federal law.

Last month, LLDF and ADF filed a separate complaint with HHS on behalf of employees at Loyola Marymount University that also do not want a health plan that covers abortions. In August, LLDF and ADF lodged a letter with DMHC itself warning it of its violation of federal law. DMHC responded by affirming its decision to force all plans to cover all abortions, without explaining how that decision squares with a federal law insisting otherwise.

Commentary

Alliance Defending Freedom Attorney Casey Mattox: “Forcing a church to be party to elective abortion is one of the utmost-imaginable assaults on our most fundamental American freedoms. California is flagrantly violating the federal law that protects employers from being forced into having abortion in their health insurance plans. No state can blatantly ignore federal law and think that it should continue to receive taxpayer money.” audio sound bite


Action
Use our easy, pre-written forms at our Freedom2Care legislative action website to contact your legislators on the following religious freedom bills:

1. Protect healthcare professionals from discrimination - S. 137 - Protect your choice of pro-life healthcare professionals - take action on the Abortion Non-Discrimination Act
2. Protect conscience freedom in healthcare: HR 940 - Preserve patient choice and protect pro-life professionals from discrimination for moral and ethical views.

Resources
Freedom2Care - CMDA's one-stop source for news, commentary and resources on freedom of faith, conscience and speech

Faith-based health insurance alternatives growing

Excerpted from "Following evangelicals, traditional Catholics create a health insurance alternative," Religion News Service, Oct. 3, 2014 - Taking a cue from evangelicals, a group of traditionalist Catholics on Thursday unveiled a cost-sharing network that they say honors their values and ensures that they are not even indirectly supporting health care services such as abortion that contradict their beliefs. Christ Medicus Foundation CURO, as the group is called, will be financially integrated with Samaritan Ministries International, which was launched in 1991 by an evangelical home-schooling dad. The SMI network now serves 125,000 people and is exempt from the Affordable Care Act.

Proponents of "health care sharing" say they are not insurance plans, but ministries that cut Christians’ health care costs and tend to their souls. The groups, according to the Illinois-based Alliance of Health Care Sharing Ministries, together include more than 300,000 Americans.

Critics point out that health care sharing programs are unregulated and that there is no guarantee that any particular medical need will be covered. As Jonathan Gruber, a health care economist at the Massachusetts Institute of Technology, told CNBC: “The whole goal of health care reform is to ensure that people are protected against risk and illness, and this violates that fundamental goal.”

As with similar programs, those who join CMF CURO expect other members to pay for most of their medical costs — except preventive health care and pre-existing conditions — for expenses of up to $250,000 for each medical need in the basic program.

For a two-parent household, CMF CURO costs $489 a month; an individual plan costs $264 a month. Members vote on whether to raise the costs of membership, and the program will pay health care providers 125 percent of what they get from Medicare.

Commentary

CMA VP for Government Relations Jonathan Imbody: “I attended a religious freedom meeting recently that included a presentation by the founders of this new health sharing initiative. I asked them to candidly summarize what they have found that doctors like and don't like about health sharing ministries. (You can add your own perspective by clicking the "Comment" link below; here's what the program advocates answered.)

• What doctors like – Faith-motivated doctors can participate in a program consistent with their faith values. Doctors can have a closer patient-physician relationship, because getting paid more (the target is 125 percent of what Medicare pays) can translate into more time with patients. Health sharing programs eliminate the third parties typically involved in order to get paid, involve little to no paperwork and provide cash payment within 90 days.
• What doctors don't like – the cap on [Samaritan Ministries and CURO] benefits currently only goes to $250,000 (though a new Save to Share program will offer an unlimited amount, and a charity program will also be included). Ministry advocates gave an example of how a representative of one major healthcare institution insisted that a patient under the program would not be accepted, saying, “No, you have to have insurance.” (CURO can intervene in such cases and get involved with the non-cooperating institution.)

“Time and experience will tell whether health sharing ministries prove advantageous for both patients and doctors; more research and analysis is warranted. In the meantime, I appreciate the motivation to (a) protect religious and conscience freedom by offering an alternative that does not subsidize abortion and other items contrary to faith values; (b) provide a way for Christians to band together to support one another financially and spiritually; and, (c) eliminate the bureaucracy that frustrates so many doctors and diverts resources away from real healthcare.

Action
Whether or not you endorse health sharing ministries, if you support the ability of patients enrolled in these faith-based programs to gain equal access to health savings accounts, use our Freedom2Care easy form to voice your values on HR 207.

Resources
World Magazine - "Networks of care: Formal and informal groups of healthcare providers are keeping the poor from missing the safety net."

Comparison of Samaritan Ministries and Christian Care Ministry (does not imply endorsement)

Woman gives birth from a transplanted womb

Excerpted from “World first: baby born after womb transplantation,” Medical News Today. October 6, 2014 — In September, a 36-year-old Swedish woman became the first ever to give birth from a transplanted womb. A new paper published in The Lancet provides a "proof of concept" report on the case. The woman received her womb from a 61-year-old family friend. As the recipient had intact ovaries, she was able to produce eggs, which were then fertilized using IVF prior to the transplant.

"Absolute uterine factor infertility" is the only type of female infertility still considered to be untreatable. Adoption and surrogacy have so far been the only options for women with absolute uterine factor infertility to acquire motherhood. However, the news of the first baby to be born from a woman who received a womb transplant brings hope to women with forms of absolute uterine factor infertility.

The researchers who performed the transplant - from the University of Gothenburg, Sweden - have been investigating the viability of womb transplantation for over 10 years. In 2013, the researchers initiated transplants in nine women with absolute uterine factor infertility who had received wombs from live donors. The Swedish woman who recently gave birth was one of these women. Although two of the women in the trial had to have hysterectomies during the initial months - because of severe infections and thrombosis - the team reported success in the other seven women.

According to Prof. Brännström, who led the team of researchers, "Our success is based on more than 10 years of intensive animal research and surgical training by our team and opens up the possibility of treating many young females worldwide that suffer from uterine infertility. What is more, we have demonstrated the feasibility of live-donor uterus transplantation, even from a postmenopausal donor."

Commentary

CMDA National Director of Campus & Community Ministries J. Scott Ries, MD: “At first glance, it seems like a heartwarming tale of the newest medical ‘miracle’ and a triumph of life. But one doesn’t need to squeeze hard to deliver a very sour and sobering insight of what lies ahead. Though it is at its surface a sweet story of an otherwise impossible birth, deeply thinking and conscientious physicians must pause and ask, ‘At what cost?’

“Three things should deeply concern us in the pushing of these ethical boundaries:

1. How many developing babies will we immolate on the altar of innovation? This patient on three separate occasions nearly rejected her uterine transplant. How many babies will be sacrificed in future trials of uterine transplantation?
2. At what age do we stop? If it works for a 36-year-old woman, why not a 56-year-old woman? Or perhaps a 76-year-old woman? Where does the ‘right’ to bear a child end?
3. Why limit a uterine transplantation to only women? In this day of gay and transgender rights, why not allow a male partner to receive a uterine transplantation? If the barrier is simply vascular anastomosis and hormone infusion, why not permit gestation within the abdomen of a man?

“The story is both a wonder and a worry. That a uterus dormant for years can suddenly spring to life with mere influx of blood and hormone is wondrous testimony to its divine design.

“Yet if we abandon moral standards given by that same Designer, on what basis shall we then make these decisions? We have so quickly progressed from challenging the boundaries of moral standards to repudiating their existence altogether. As followers of the Way, we must infuse in our culture the distinction between what could be and what should be.”

Resources

CMDA Resources on Reproductive Technology
CMDA Ethics Statement – Assisted Reproductive Technology

Walking as a superstar

Excerpted from "Walking is the superfood of fitness, experts say," Reuters. September 29, 2014 — Walking may never become as trendy as CrossFit, but for fitness experts who stress daily movement over workouts and an active lifestyle over weekends of warrior games, walking is a super star.

For author and scientist Katy Bowman, walking is a biological imperative like eating. In her book, “Move Your DNA: Restore Your Health Through Natural Movement," she suggests there are movement nutrients, just like dietary nutrients, that the body needs. “Walking is a superfood. It’s the defining movement of a human,” said Bowman, a biomechanist based in Ventura, California. “It’s a lot easier to get movement than it is to get exercise.”

Leslie Sansone, creator of the “Walk at Home: Mix & Match Walk Blasters” DVD, said too many people believe that spending grueling hours at the gym is the only way to fitness. “There’s this “Biggest Loser” idea out there that if you’re not throwing up and crying you’re not getting fit,” she said, referring to the popular television weight-loss show. Three miles (5 kilometers) per hour is a good beginning, gradually working to 4 miles per hour, she said about walking.

Dr. Carol Ewing Garber, president of the American College of Sports Medicine (ACSM) and a professor of movement sciences at Columbia University in New York, said research suggests that even one bout of exercise causes beneficial physiological effects. But she concedes that walking does not do everything. It is less beneficial for bones than running, and for strength, it is better to lift weights. “Still,” she said, “If you’re going to pick one thing, research says it should be walking.”

Commentary

CMDA Member Mark McQuain, MD: “In her book, Katy Bowman makes the case that the natural movement of humans, namely walking, is the ‘superstar of exercise,’ adding that it is ‘easier to get movement than it is to get exercise.’ The above Reuters article sources additional experts in support of her thesis. Given our struggle with an epidemic of obesity,¹ whether secondary to poor diet choices and/or sedentary lifestyles, we would like an easy way back to health. Is walking our panacea? That answer really depends on whether our walking is ‘just movement’ or ‘superstar exercise.’

“A large study by Lawrence Berkley National Laboratory² found moderate (walking) and vigorous (running) exercise produced similar reductions in hypertension, hypercholesterolemia, diabetes mellitus and possibly CHD, but only with equivalent energy expenditure. That means you have to walk further than you ran for similar benefits. Not exactly ‘just movement.’

“We know lack of movement, as is seen in spinal cord injury, produces increased risks of DVT and osteoporosis,³ and improved motion mitigates some of these risks, even improving psychological well-being.⁴ The Reuters article references a similar study in able-bodied subjects showing the benefits of minimal movement (three five-minute walks) reversing the harmful effects of prolonged sitting on arteries in the legs.

“Whether movement or exercise, the benefits of walking depend on the type of walking you do.”

¹Hicks, A L, et al. "Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being." Spinal Cord 41 (2003): 34-43.
²Jiang, S D, L Y Dai, and L S Jiang. "Osteoporosis after spinal cord injury." Osteoporosis International 17, no. 2 (Feb 2006): 180-92.
³Wang, Youfa, and Mary Beydoun. "The Obesity Epidemic in the United States—Gender, Age, Socioeconomic, Racial/Ethnic, and Geographic Characteristics: A Systematic Review and Meta-Regression Analysis." Epidemiologic Reviews (Johns Hopkins Bloomberg School of Public Health) 29, no. 1 (Jan 2007): 6-28.
4 Williams, P T, and P D Thompson. "Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction." Arteriosclerosis, thrombosis and vascular biology 33, no. 5 (May 2013): 1085-91.

Resources

Prescribe-A-Resource from CMDA
Complete Guide to Family Health, Nutrition & Fitness

Drug firms release payment information

Excerpted from “Drug and device firms paid $3.5B to care providers,” Associated Press. September 30, 2014 — Drug and medical device companies paid doctors and leading hospitals billions of dollars last year, the government disclosed Tuesday in a new effort to spotlight potential ethical conflicts in medicine. The value of industry payments and other financial benefits totaled nearly $3.5 billion in the five-month period from August through December 2013, according to the Centers for Medicare and Medicaid Services, which released the data.

It's part of a new initiative called Open Payments, required by President Barack Obama's healthcare law. It was intended to allow patients to easily look up their own doctors online, but that functionality isn't fully developed. In future years, the information will cover a full 12 months and will be easier to search, officials said.

Consumer groups said it's a step toward much-needed transparency. But doctors and industry said the government rushed to release the data, and they raised questions about accuracy and lack of context.

The American Medical Association said it remains "very concerned" about release of the payments file, adding that the data may contain inaccuracies and lacks context to help the average person evaluate the information. Consumer groups say disclosure is overdue. "Research has shown over and over that these financial relationships influence doctors, even a meal," said John Santa, medical director for health projects with Consumers Union. "Studies also show that doctors believe it does not affect them, but strongly believe it affects other doctors."

Commentary

CMDA Member John Dunlop, MD: “Wow! $3.58 billion spent by pharmaceutical and device manufactures to directly influence physician choice is an impressive amount. I naively thought that these payments and gifts went out with the free lunches and logos on pens several years ago. It appears that those restrictions do not have much substance and thus the potential for ethical abuse persists as a real threat. The number comes from the website “Open Payments,” a project of Obamacare intended to bring accountability to the heretofore undisclosed inducements given by industry to practicing physicians. It should be noted, however, that just two days after this article was released, another article pointed out many potential flaws in this data.

“As Christians, when faced with the possibility of receiving incentives from industry, we must remind ourselves that our primary responsibility is not to make money but to provide the best, compassionate and cost effective care to our patients. In Proverbs 19:6, Scripture warns that receiving gifts influences our behavior, and this may be true even when those gifts do not obligate the recipient to prescribe the products involved.

“The CMDA Ethics Statement on Doctor & Pharmaceutical/Medical Device Industry Relationships states the ethical principle: ‘Doctors should consider carefully the basis of their therapeutic decisions to assure that they are made in accordance with best possible evidence applied to the welfare of the patient. Personal gain must never be the compelling reason for our decisions. Incentives from industry, intended to influence therapeutic choices, can compromise doctor integrity and behavior.’”

Resources

Christian Physician’s Oath
Doctor & Pharmaceutical/Medical Device Industry Relationships Ethics Statement
Professionalism in Peril - Part 3: Professional Adultery

Govt. report links tax dollars and abortions

Excerpted from "GAO: Taxpayer funds likely paying for abortion under Obamacare," World magazine, September 18, 2014, - The Affordable Care Act requires insurers to separately itemize and charge for abortion coverage, a compromise designed to prevent taxpayer funding of abortions. The compromise drew support from pro-life Democrats in 2010, and was crucial to overcoming Republican opposition.
 
Federal law under the Hyde Amendment prohibits taxpayer funding of abortions except in cases of rape, incest, or threats to the life of the mother. President Barack Obama promised in March 2010 that the Affordable Care Act policies would adhere to the Hyde Amendment.

But the Government Accountability Office (GAO) report revealed taxpayer funding is likely subsidizing elective abortions. The report evaluated the 27 states and Washington, D.C., that do not restrict elective abortion coverage in their insurance markets. It found that 1,036 of the 2,098 subsidized plans in those states cover elective abortions. The 18 evaluated insurers offered a quarter of those policies. Although the GAO report didn’t specify that taxpayer money funded abortions under Obamacare, it raised serious concerns.

“Americans throughout the country have raised serious concerns that they find it nearly impossible to determine whether the plan they purchase finances the killing of unborn children—there is little or no transparency—hence the request by several members of Congress including [House Speaker John] Boehner that GAO investigate,” said Rep. Chris Smith, R-NJ, who also co-chairs the Bipartisan Congressional Pro-Life Caucus.

“Now we know that at least 1,036 plans cover abortion, and the so-called ‘surcharge’ for abortion coverage is simply an accounting gimmick,” said Penny Nance, president of Concerned Women for America.

The Health and Human Services Department acknowledged in a written response that “additional clarification may be needed” regarding the healthcare law’s abortion coverage.

In response, pro-lifers have called for the passage of the “No Taxpayer Funding for Abortion Act” authored by Smith. The House of Representatives passed the bill in January, but it met opposition in the Senate.

Commentary

Mary Harned, Staff Counsel, Americans United for Life (AUL): (from her NRO commentary): “Given the Affordable Care Act's extensive list of shortcomings and controversies, the GAO report may elicit little more than a yawn from the media. Yet, the report is stunning in that it documents how the Obama administration has abandoned and even undermined the very promises that enabled the healthcare legislation to pass the U.S. House of Representatives.

“When objections to taxpayer funding for abortion or abortion coverage nearly brought down the bill, it took an eleventh hour ‘compromise’ — statutory language provided by Senator Ben Nelson (D., Neb.) and a promised executive order — to save the ACA. Now, over four years later, the GAO report confirms that the abortion deal was effectively meaningless.

“The language in the law is unambiguous — ‘separate payments’ are required. Yet, insurance issuers are not collecting separate payments. In fact, the Obama administration is telling issuers that they do not need to collect two checks.

“States that do not require these ‘segregation plans’ cannot know if and how much taxpayer funding is being used to pay for abortions. Insurance issuers who are not collecting separate payments or even itemizing abortion premiums are not likely to be keeping abortions premiums separate from federal funds.

“So, abortions are being paid for out of federally subsidized premiums. That is taxpayer funding for abortion.”

Resources
GAO report. (To see which plans cover abortion, click on "Abortion Services Interactive Map.")

Data links religious freedom to peace and stability

Excerpted from "If Policy Makers Cared about Data, They’d Care about Freedom of Religion or Belief," the Weekly Number blog, September 15, 2014 - The past decade has seen the largest social science effort to collect and analyze data on international religious demography. This body of research points to one thing – religion is growing and will continue to grow globally, with about 9-in-10 people projected to be affiliated with religion in 2030 compared with 8-in-10 in 1970. This growth is projected to occur despite trends toward disaffiliation in the global north, where population growth is stagnating.

Studies show that there has been a dramatic rise in the level of religious restrictions and hostilities. The data point to a global religious freedom crisis that will become even more acute as the world becomes more religious and as global mobility mixes people and their beliefs at an unprecedented rate.

The data on religious freedom provide more than just information – they provide knowledge. Specifically, analysis of the data reveal two very important empirical relationships:

• The combined effects of government and social restrictions on religious freedom lead to violent religious persecution and conflict.
• The respect of freedom of religion or belief leads to peace and prosperity.

As the world navigates away from years of poor economic performance, freedom of religion or belief may be an unrecognized asset to economic recovery and growth, according to this new study.

Commentary

CMA VP for Government Relations Jonathan Imbody: “Our Judeo-Christian heritage has provided for religious freedom, since we know that God has bestowed on all people freedom of choice and that true belief cannot be coerced. The rise of radical Muslim terrorist groups such as ISIL (Islamic State of Iraq and the Levant, also known as ISIS) shows what happens in the absence of those fundamental understandings. A prayer request I recently received illustrates the tragedies that ensue:

A friend just got a text message from her brother asking her to shower him and his parish in prayer. He is part of a mission and ISIS has taken over the town they are in today. He said ISIS is systematically going house to house to all the Christians and asking the children to denounce Jesus. He said so far not one child has. And so far all have consequently been killed. But not the parents.

The UN has withdrawn and the missionaries are on their own. They are determined to stick it out for the sake of the families - even if it means their own deaths. He is very afraid, has no idea how to even begin ministering to these families who have seen their children martyred.

Yet he says he knows God has called him for some reason to be his voice and hands at this place at this time. Even so, he is begging prayers for his courage to live out his vocation in such dire circumstances. And like the children, accept martyrdom if he is called to do so.

She asked me to ask everyone we know to please pray for them. These brave parents instilled such a fervent faith in their children that they chose martyrdom. Please surround them in their loss with your prayers for hope and perseverance.”

Resources
Freedom2Care - CMDA's religious freedom headquarters

Action
Pray for our brethren—and especially the children—under siege by the terrorists, that they may both remain faithful to Christ and also escape their persecutors. Pray for the political and military defeat of the persecutors and for religious freedom in these countries. Pray against the spiritual forces of darkness and the propaganda that is winning converts to the cause of terror and for the spread of the gospel of Jesus Christ.

Use our easy, pre-written forms at our Freedom2Care legislative action website to contact your legislators on any of the following domestic religious freedom bills:

1. Protect conscience freedom in healthcare: HR 940
   Preserve patient choice and protect pro-life professionals from discrimination for moral and ethical views.
2. Uphold religious freedom, 1st Amendment - S.1808
   Marriage and Religious Freedom Act - S.1808 - prohibits discrimination because of moral beliefs regarding marriage and sex.
3. Protect faith-based adoption agencies from discrimination - S 2706
   Keep states from cutting off faith-based adoption agencies that assist couples with adoptions according to faith standards.

Congress eyes charitable giving

Excerpted from "Protect giving: A chance for real bipartisanship," commentary by Vikki Spruill in The Hill, September 15, 2014 - Foundations and charities face a pivotal moment. In July, the U.S. House of Representatives passed the America Gives More Act (H.R. 4719) with a bipartisan vote of 277 to 130. Now it needs to pass the Senate. It will give individuals and private foundations the certainty that allows for more charitable giving.

The America Gives More Act makes permanent three important provisions that have been part of the “extenders package” for a number of years. Though they are proven to increase giving and have broad bipartisan support, it’s become the norm for Congress to allow these provisions to expire, then retroactively reinstate them. This inconsistency from Congress leaves donors uncertain of how much they can contribute.

The bill addresses this uncertainty in three key areas:

• Gifts from IRA distributions (referred to as the “IRA charitable rollover”) where generous donors are directing their mandatory distributions directly to charity.
• Gifts of property, specifically conservation easements, which are complicated transactions that can take more than a year to plan and execute.
• Gifts of food inventory, which are often perishable and so demand quick action.

The strong bipartisan alignment around this bill is rare these days in Washington. The vote in the House showed that both Democrats and Republicans understand the importance of supporting charitable giving. Still, this uncommon consensus is at risk of being undermined by Washington gridlock.

Commentary

CMA VP for Government Relations Jonathan Imbody: “In dozens of visits focused on this topic with Congressional leaders and their staff, I have been impressed with a bipartisan, general commitment to charitable giving. Still, the temptation for our deficit-spending Government to tap into new revenue sources is great, and the potential remains for Congress to unwittingly trim giving by fiddling with charity incentives and protections in the tax code.

“Why would Congress take steps that would make fewer Americans able to deduct charitable gifts, or subject givers to stingier limits on how much they give? Don't lawmakers realize that charities provide billions in social services—such as through faith-based medical and dental clinics that care for needy patients—that Government would otherwise have to fund?

“Government always seeks more money, due to the sheer pull of the power derived from money. Many politicians also redistribute our tax dollars to their constituents and pet projects as a means of retaining political power. Years of undisciplined spending now threaten Government's power and politicians' futures, so they are turning to previously sacred sources such as charity for more tax revenue.

“When I visit Members of Congress to persuade them to preserve our charitable gift deductions, I make the following simple points:

1. Government should not tax individuals for giving their money away to help others.
2. Charities can provide services much more efficiently and effectively than Government bureaucracies and save billions that the Government would otherwise have to fund.
3. Any cuts to charitable giving will ultimately penalize the needy individuals served by charities.”

Action
Use our Freedom2Care easy form to let your legislators know that Government should not tax us for money we give away to help others, and that you want your charitable gifts to remain tax-deductible.

Resources
Fact sheet on charitable giving
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Christian campus groups face persecution

Excerpted from “The Wrong Kind of Christian,” Christianity Today. August 27, 2014 — Two years ago, the student organization I worked for at Vanderbilt University got kicked off campus for being the wrong kind of Christians. In May 2011, Vanderbilt's director of religious life told me that the group I'd helped lead for two years, Graduate Christian Fellowship—a chapter of InterVarsity Christian Fellowship—was on probation. We had to drop the requirement that student leaders affirm our doctrinal and purpose statement, or we would lose our status as a registered student organization.

In writing, the new policy refers only to constitutionally protected classes (race, religion, sexual identity, and so on), but Vanderbilt publicly adopted an "all comers policy," which meant that no student could be excluded from a leadership post on ideological grounds.

Like most campus groups, InterVarsity welcomes anyone as a member. But it asks key student leaders—the executive council and small group leaders—to affirm its doctrinal statement, which outlines broad Christian orthodoxy and does not mention sexual conduct specifically. But the university saw belief statements themselves as suspect. It didn't matter to them if we were politically or racially diverse, if we cared about the environment or built Habitat homes. It didn't matter if our students were top in their fields and some of the kindest, most thoughtful, most compassionate leaders on campus. There was a line in the sand, and we fell on the wrong side of it.

Those of us opposed to the new policy met with everyone we could to plead our case and seek compromise. But as spring semester ended, 14 campus religious communities—comprising about 1,400 Catholic, evangelical, and Mormon students—lost their organizational status. After we lost our registered status, our organization was excluded from new student activity fairs. So our student leaders decided to make T-shirts to let others know about our group. Because we were no longer allowed to use Vanderbilt's name, we struggled to convey that we were a community of Vanderbilt students who met near campus. So the students decided to write a simple phrase on the shirts: WE ARE HERE.

And they are. They're still there in labs and classrooms, researching languages and robotics, reflecting God's creativity through the arts and seeking cures for cancer. They are still loving their neighbors, praying, struggling, and rejoicing. You can find them proclaiming the gospel in word and deed, in daily ordinariness. And though it is more difficult than it was a few years ago, ministry continues on campus, often on the margins and just outside the gates. God is still beautifully at work. And his mercy is relentless.

Commentary

CMDA’s National Director of Campus & Community Ministries J. Scott Ries, MD: “It is a remarkable story, but unfortunately not an isolated one. Just this week, InterVarsity announced that it has been booted off of all California State University campuses for the same reason, because they insist on a rational basis of faith as criteria for holding a leadership position.

“This is just the tip of the iceberg. In the last 18 months, two CMDA chapters have also been de-recognized for, yes, the exact same reason. At the University of Illinois, Chicago, we were told that because we require our student leaders to agree with CMDA’s statement of belief, we therefore violate their anti-discrimination policies. At the Case Western Reserve University School of Dental Medicine, our CMDA group was denied official recognition “because of the emphasis on God and especially because of the Bible sessions.”

"Thankfully, in both cases the Lord gave us favor after I sent a letter with assistance from Kim Colby, Sr. Legal Counsel for Christian Legal Society’s Center for Law and Religious Freedom to the respective deans, explaining that this misapplication of their policy actually was, in fact, discrimination at its core. Both universities promptly reversed their positions, and CMDA is thriving on both campuses. But it will get worse. Our 280 campus chapters will be a lightning rod as this storm builds.

“So why is official recognition important after all? Why not just exist under the radar, meet off campus and avoid the toil, expense and pain of fighting what has become a cultural landslide smothering both orthodox beliefs and religious pluralism? Because lack of recognition impedes ministry and increases the cost of doing ministry. Greg Jao, attorney and National Field Staff Director for InterVarsity, explains it well.

“When one group loses religious freedoms, we all lose religious freedoms. Historically, what starts at the university campus trickles into all of society. That remains true, but what has changed is the rapidity with which it now happens. It seems as though someone has poured accelerant onto the fire of intolerance that is consuming those who share the very faith that brought tolerance to this world.”

Resources

Standing Against Persecution: My Journey to Start a CMDA Campus Chapter
The Erosion of Tolerance by John Patrick, MD