Thursday, May 7, 2015

The Point Blog is Moving!

You can now read and comment on The Point blog on CMDA's website!

Senate passes human trafficking bill

Excerpted from "Senate Passes Human Trafficking Bill With Abortion Restrictions On Victims," Huffington Post. April 22, 2015 — The Senate passed a sex trafficking bill on Wednesday after a bitter, weeks-long fight over an anti-abortion provision tucked into it. The Justice for Victims of Trafficking Act passed 99-0.

At its core, the bill has had broad support. It provides resources to law enforcement officials and collects fees from sex traffickers that go into a new fund for victims. But Republicans included language subjecting the victim fund to the Hyde Amendment, the federal provision that bars the use of taxpayer funds for abortions except in cases of rape and incest. Democrats refused to let the bill advance over the Hyde language, particularly because, for the first time, it would have applied to non-taxpayer funds.

It took a month of back-and-forth between Sen. John Cornyn (R-Texas), the bill's author, and Sen. Patty Murray (D-Wash.) to find a compromise. They settled on creating two funding streams in the bill. One collects fines from traffickers and uses them for survivor services, excluding health care. That stream doesn't include Hyde restrictions. The second one comes from community health center funds already subject to the abortion limits.

The deal lets both parties walk away with a solid talking point: Democrats can say they prevented an expansion of Hyde, and Republicans can say they prevented victims of sex trafficking from using federal funds for abortions.

Commentary


Dr. Jeffrey BarrowsCMDA Health Consultant on Human Trafficking Jeffrey J. Barrows, DO, MA (Bioethics): “This legislation passed unanimously by the Senate focuses on the trafficking of children under age 18 and will provide many resources should it become law. There are provisions that apply to the healthcare profession, especially those who are “first responders” and healthcare officials. The bill provides grants to train professionals who commonly encounter victims of trafficking on how to identify victims of human trafficking, address their unique needs and facilitate their rescue. Emergency department personnel are a prime example.

“One study has shown that almost 88 percent of victims of domestic sex trafficking regularly encounter healthcare professionals while being trafficked, especially those working within emergency departments.1 Unfortunately, fewer than three percent of emergency department personnel have been trained on human trafficking and so these victims are rarely identified.2

CMDA’s Commission on Human Trafficking has addressed the issue of training by developing a series of online educational modules on human trafficking specifically designed for the healthcare profession which can be found at www.cmda.org/tip. In addition, the commission is planning an in-depth training seminar later this year in Atlanta on November 13-14. More information will be forthcoming and registration will be open to anyone who desires to learn more about the interface between healthcare and human trafficking. Any questions about CMDA’s work against human trafficking can be addressed to humantrafficking@cmda.org.

1Lederer L, Wetzel, CA. The Health Consequences of Sex Trafficking and Their Implications for Identifying Victims in Healthcare Facilities. The Annals of Health Law 2014; 23:61-91.
2Chisholm-Straker M, Richardson LD, Cossio T. Combating Slavery in the 21st century: The role of emergency medicine. J Healthcare for Poor and Underserved 2012; 23:980-987.


Resources

CMDA’s Human Trafficking Ethics Statement
Commission on Human Trafficking
Human Trafficking Continuing Education

The key to a thriving practice

Excerpted from Majority of ETSU’s Quillen graduates heading into primary care,” Johnson City Press. April 25, 2015 — As the world of health care dramatically changes around East Tennessee State University’s Quillen College of Medicine, Dr. Kenneth Olive, a professor and associate dean for academic and faculty affairs, is still seeing medical students follow specialties about which they’re most passionate. The majority of the time, ETSU’s statistics show that this passion is involved with primary care, which includes family medicine, internal medicine, pediatrics and general obstetrics and gynecology. For the May 8 graduating class, 52 percent of the students are going into the primary care field.

Olive meets with each and every one of the 59 graduates, getting a sense of their time at the Quillen College of Medicine and what path they’re currently on. They discuss job options and how to be competitive as well, citing the changes in health care. Changing reimbursement models, electronic health records, the effects of the Affordable Care Act and the use of team collaboration among health care professionals are some of the topic issues in the field.

Dr. Brian Cross, an associate professor and vice-chair of the Department of Pharmacy at ETSU’s Bill Gatton College of Pharmacy, and Dr. Reid Blackwelder, a medical professor in the Quillen College of Medicine, recently delivered the keynote address at the American Pharmacists Association annual conference in San Diego in late March, centering their talk on the ongoing transformation of the health care system and the need for collaboration to meet the needs of a community and the outcomes a patient meets.

Citing egos and the established hierarchy among health care providers, the pair have made it their mission to start a collaborative mentality early on in a student’s education. “That’s something that we’ve been doing at ETSU,” Blackwelder said. “There’s no question that this is a very powerful and readily available way to improve outcomes.”

Through team collaboration, ETSU’s involvement is leading the charge in the way a patient receives health care in this area, which is getting noticed across the country. In his opinion, the use of team collaboration is huge for community-based medical schools and health care systems.

Commentary


Dr. Peter AndersonFamily Practice Physician Peter Anderson, MD: “As a family physician of 30 years, I was negatively impacted by the changes that came from an aging population, health information technology and declining reimbursement. But teamwork became my practice’s salvation. As much as ‘collaboration’ is needed between the larger entities of healthcare like pharmacy, nursing, behavioral medicine and community resources, it would not have fixed the difficulties I faced daily in the exam room.

“Two main responsibilities are associated with the primary care exam room. The first is the compilation of a complete medical picture and decisions for the patient’s care. The second is the documentation of data and explanation of decisions to the patient with the necessary education and implementation of actionable steps. The first part is physician work; the second is non-physician work. The first part is effective today because it evolved as medicine advanced. The second is broken and archaic because the process has not changed for the last century.

“We have accepted the notion that only the physician belongs in the primary care exam room. This belief has led to a delivery process that absolutely fails to make primary care physicians accessible. And this failure of the delivery process is the only reason primary care practices are not thriving.

“The problem is the delivery process, not primary care itself. Primary care is incredibly valuable and desperately needed. But the lack of teamwork in the exam room has kept our product from our culture.

“Build a team inside your exam room and your practice will thrive.”

Resources

June 2015 Christian Doctor's Digest Interview with Peter Anderson, MD - Joyful and Efficient Patient Care (CMDA member only content)

The summer edition of Today’s Christian Doctor includes an article by Dr. Anderson with more information about team care medicine. Visit www.cmda.org/tcd for more information when this article becomes available.

German mom expecting quadruplets at 65

Excerpted from German Mom Expecting Quads at 65 Is 'Irresponsible': Bioethicist,” NBC News. April 14, 2015 — Berlin school teacher Annegret Raunigk is proudly prolific and, at age 65, not done making babies — pregnant with quadruplets that would enlarge her family from 13 to 17 children. Raunigk said she became pregnant again because her 9-year-old daughter asked for a younger sibling. (Her first 12 children — by five men — are ages 22 to 44). She told German tabloid Bild that donated eggs were fertilized and implanted at a clinic in Ukraine. Multiple attempts were required to get the eggs to fertilize. She did not say whose sperm was used or if the egg donor was paid.

What she is doing is unethical. She doesn't think so. But she left her country to receive an infertility treatment that's illegal in Germany due to her age. And she sought that help on the sole grounds that her youngest daughter wants a sibling. Of course, given that logic, future requests by any of her newest kids apparently guarantee no end to her pregnancies.

The number of reasons why this very-late-in-life pregnancy is morally wrong nearly equates to the number of children Raunigk has conceived. But let's stick to the main issues. First, she likely will not live long enough to raise her current children, much less any new kids. It is not fair to children, as adoption agencies know when they limit adoption to those under 55, to intentionally create a family where mom and dad will enter a nursing home as the kids enter junior high.

Making four kids in a 65-year-old body also is irresponsible. The quadruplets are likely to be premature and, if they survive, may pay a steep price for this decision in terms of their health. Her older body makes the pregnancy extremely high risk all the way around. There will be a C-section, which is dangerous for her. And there certainly will be no breast-feeding by mom.

And what clinic would agree to accept as a patient a woman with 13 children — simply because her daughter wants a sibling? What clinic would not insist on a surrogate mom? What clinic would not demand she stay nearby during the pregnancy? What clinic would even let her try to deliver four fetuses?

The answer: One looking to gain fame and clients by engaging in a publicity stunt with nascent lives. Then again, this theoretically could have happened as well in the U.S. where there are no restrictions about who can use technology to have a baby — grandparents, mentally ill, very old single parents, even child molesters. Despite the headlines babbling about "miracles" and "gifts," and despite Annegret Raunigk's insistence that she should be free to reproduce however and whenever she wants, what's needed is a far more thoughtful, moral stance to govern reproductive technology.

Commentary


Dr. John PierceCMDA Member John Pierce, MD: “The case of Annegret Raunigk is another clear example of doing what is ‘…wise in your own eyes’ (Proverbs 3:7a, NIV 2011). In the world, there are arguments for age limits on IVF including the multiple health risks for the older mother and her infant, as well as arguments against age limits purporting reproductive freedom, equality for women (as older men can father a child) and social factors ‘to help fulfill lifelong dreams.’ Moral arguments might ask questions such as, ‘Is it right to have a child when the average life expectancy (about 80 years old for women in the developed world) means the child would be without a mother before driving a car?’ or ‘On what grounds do you deny the patient her rights?’

“Clear thinking using the principles of autonomy, beneficence, non-maleficence and justice has been supplanted with situational ethics incorporating intense emotions and cultural relativism. Why would we not have these struggles when there is no standard and a crumbling foundation? The law is silent on age in reproductive rights and most medical organizations provide weak recommendations,i leaving the decision up to individual clinics,ii or refute the need for practitioners to use their conscience.iii

“Solomon sincerely asked the Lord, ‘So give your servant a discerning heart to govern your people and to distinguish between right and wrong...’ (1 Kings 3:9, NIV 2011). While we may argue vehemently, the loudest voice will be undeniable examples of healthy relationships, thriving marriages, happy families and renewed minds.”

iEthics Committee of the ASRM. Oocyte or Embryo Donation to Women of Advanced Age: A Committee Opinion. Fertil Steril, 2013;100:337-40.
ii Fisseha S and NA Clark. Assisted Reproduction for Postmenopausal Women, AMA Journal of Ethics, Jan 2014, Vol 16, No 1:5-9.
iiiCommittee on Ethics. ACOG Committee Opinion: The Limits of Conscientious Refusal in Reproductive Medicine. Obstet Gynecol, 2007 (reaffirmed 2013);110:1203-8.

Resources

CMDA’s Assisted Reproductive Technology Ethics Statement
Standards4Life – Infertility and Reproductive Technology

Thursday, April 23, 2015

How assisted suicide corrupts medicine

Excerpted from "Physician-Assisted Suicide Corrupts the Practice of Medicine," Heritage Foundation Issue Brief by Ryan T. Anderson, PhD, April 20, 2015 - The heart of medicine is healing. Doctors cannot heal by assisting patients to kill themselves or by killing them. They rightly seek to eliminate disease and alleviate pain and suffering. They may not, however, seek to eliminate the patient. Allowing doctors to assist in killing threatens to fundamentally corrupt the defining goal of the profession of medicine.

Physician-assisted suicide will not only corrupt the professionals who practice medicine, but also affect patients because it threatens to fundamentally distort the doctor–patient relationship, greatly reducing patients’ trust of doctors and doctors’ undivided commitment to the healing of their patients.

Our laws shape our culture, and our culture shapes our beliefs, which in turn shape our behaviors. The laws governing medical treatments will shape the way that doctors behave and thus shape the doctor–patient relationship.

Physician-assisted suicide will create perverse incentives for insurance providers and the financing of health care. Assisting in suicide will often be a more “cost-effective” measure from the perspective of the bottom line than is actually caring for patients. In fact, some advocates of PAS and euthanasia make the case on the basis of saving money.

Instead of helping people to kill themselves, we should offer them appropriate medical care and human presence. We should respond to suffering with true compassion and solidarity. Doctors should help their patients to die a dignified death of natural causes, not assist in killing. Physicians are always to care, never to kill.

Commentary


Farr A. Curlin, MDVideo Commentary by Josiah C. Trent Professor of Medical Humanities at Duke University School of Medicine Farr A. Curlin, MD: "The question that arises is, 'Why is [the Hippocratic oath prohibition on physician-assisted suicide] there?' Why is that something that physicians, with tremendous consistency, over 2,000+ years, have continued to affirm and profess? A commitment to never participate in assisted suicide is essential for the possibility of doctors continuing to care well for patients who are dying."

Listen to the rest of Dr. Farr’s commentary from “Living Life to Its Fullest: Supporting the Sick and Elderly in their Most Vulnerable Hours” as part of the Heritage Foundation symposium.

Action

If your state is included on this list of states considering assisted suicide, join with CMDA and others in your state to protect your patients and the medical profession. To learn more, contact communications@cmda.org.

Resources
CMDA Resources on Physician-Assisted Suicide and Euthanasia
Physician-Assisted Suicide Fact Sheet
CMDA Physician-Assisted Suicide Ethics Statement

A new national religion?

Excerpted from "The Shifting Definition of Religious Freedom," Breakpoint commentary by Eric Metaxas, April 13, 2015 - Just this month, we watched a family-owned pizzeria close its doors after its owners received hate mail and death threats from around the country. Their offense? Giving the wrong answer to a question about whether they'd cater a gay wedding.

But gay columnist Frank Bruni recently took it to the next level in the New York Times, writing that it's time Christians get with the program and “take homosexuality off the sin list.” The lived experience of same-sex couples ought to trump what he calls the “scattered passages of ancient texts” condemning his lifestyle. Wow.

As for freedom of religion, Bruni suggests a new definition: “freeing ... religious people from prejudices that they ... can indeed jettison, much as they’ve jettisoned other aspects of their faith’s history, rightly bowing to the enlightenments of modernity.”

Writing at National Review, Yuval Levin says what we're witnessing isn't so much the suppression of free exercise of religion as it is the establishment of a new national religion; the religion of secular liberalism. And dissenters must be forced to worship at its altar and affirm its creed of anything-goes sexuality.

Given the likely outcome of this summer's Supreme Court case on same-sex marriage, Rod Dreher asks what will it be like to be a Christian in our brave, new society—and what will become of orthodox Christianity now that the price of professing it could be our credibility and livelihoods.

Friends, the fight for religious liberty is far from over. And as John Stonestreet and I have been saying again and again, it’s time for the Church to wake up, to pray, and to publicly defend our religious rights and our brothers and sisters under assault for their beliefs.

Commentary


Jonathan ImbodyCMA VP for Government Relations Jonathan Imbody, MEd: “Beyond the significant public policy battle over what marriage means, social issues agitators both inside and outside the church are advancing arguments that try to pry Christians off of our moral foundation, the Scriptures. New York Times commentator Frank Bruni suggests that ‘the continued view of gays, lesbians and bisexuals as sinners is a decision. It’s a choice. It prioritizes scattered passages of ancient texts over all that has been learned since — as if time had stood still, as if the advances of science and knowledge meant nothing.’ Clearly Bruni has little understanding or respect for the divine inspiration, authority, unity, integrity and timelessness of the Scriptures that many of us trust with our lives both here and for eternity.

“Even some within the church are making similar arguments. These arguments seem to boil down to the notions that Bible writers injected personal bias and that science had not yet enlightened the early church. Therefore, Scriptures prohibiting and condemning homosexual behavior (and by extension, it would seem, Scriptures prohibiting any sex outside of marriage) can be thrown out like potshards from an ignorant, ancient culture.

“The trouble is that in the pursuit of social activism, these views undermine Scripture in order to reinterpret Scripture, leaving no real Scriptures at all. For if Bible writers did not actually write God-breathed words but instead injected their own personal bias, why would we elevate the Bible over, say, the Aeneid, or the works of Shakespeare, or the New York Times?

“If today's claims of science trump millennia of biblical truths, why would anyone persist in believing in the miracles described in the Bible or in anything supernatural at all? Following this train of thought, Jesus' virgin birth, healings, miracles, resurrection and promised return become a bunch of bunk to be debunked by science and social activists. Jesus Himself becomes suspect, since He unwaveringly treated Scripture as divinely inspired and authoritative. (What can we expect from an unschooled Galilean?)

“Rejecting this Bible-devaluing approach is not to say that nothing in the Bible is culturally based, but that we must discern between superficial cultural symbols and deep and consistent moral teaching in the Bible. Contrary to the assertions of those who would remake in their own image the Bible's teachings on sexuality, the evidence from Genesis through Revelation is far too compelling, deep and consistent that God clearly designed sex for marriage between one man and one woman in a lifelong relationship uniquely geared to raising children.”

Action

Sen. Patrick Leahy (D-Vt.) has introduced legislation that would shrink religious freedom and marginalize faith-based organizations simply because they view boys as boys and girls as girls based on biology. By inserting "gender" issues into federal program requirements and by leaving the definition of gender open to liberal interpretation, while also leaving out any exemptions for those who view gender biologically and according to faith tenets, this legislation holds the potential to unfairly discriminate against and exclude faith-based organizations from funding. Click here to learn more and to send your senators an editable pre-written message to oppose S 262.

Resources
CMDA’s Same-Sex "Marriage" Public Policy Statement
CMDA’s Marriage Public Policy Statement
CMDA’s group letter supporting Marriage and Religious Freedom Act

Silence on religious persecution and killings

Excerpted from "Christians thrown overboard left to drown by Obama," commentary by Kirsten Powers in USA Today - When a throng of Muslims threw a dozen Christians overboard a migrant ship traveling from Libya to Italy, Prime Minister Matteo Renzi missed the opportunity to label it as such. Standing next to President Obama at their joint news conference Friday, Renzi dismissed it as a one-off event and said, "The problem is not a problem of (a) clash of religions."

As Renzi was questioned about the incident, Obama was mute on the killings. He failed to interject any sense of outrage or even tepid concern for the targeting of Christians for their faith. He just can't seem to find any passion for the mass persecution of Middle Eastern Christians or the eradication of Christianity from its birthplace.

Religious persecution of Christians is rampant worldwide, as Pew has noted, but nowhere is it more prevalent than in the Middle East and Northern Africa, where followers of Jesus are the targets of religious cleansing. Pope Francis has repeatedly decried the persecution and begged the world for help, but it has had little impact. Western leaders — including Obama — will be remembered for their near silence as this human rights tragedy unfolded. The president's mumblings about the atrocities visited upon Christians (usually extracted after public outcry over his silence) are few and far between. And it will be hard to forget his lecturing of Christians at the National Prayer Breakfast about the centuries-old Crusades while Middle Eastern Christians were at that moment being harassed, driven from their homes, tortured and murdered for their faith.

A week and a half after Obama's National Prayer Breakfast speech, 21 Coptic Christians were beheaded for being "people of the cross." Seven of the victims were former students of my friend and hero "Mama" Maggie Gobran, known as the "Mother Theresa of Cairo" for her work with the poorest of the poor. She told me these dear men grew up in rural Upper Egypt and had gone to Libya seeking work to support their families. They died with dignity as they called out to their God, while the cowardly murderers masked their faces.

Rather than hectoring Christians about their ancestors' misdeeds, Obama should honor these men and the countless Middle Eastern Christians persecuted before them.

Commentary


Jonathan ImbodyCMA VP for Government Relations Jonathan Imbody, MEd: The president's reticence on the international persecution of Christians, coupled with his administration's policies that threaten domestic religious freedom, is puzzling yet alarmingly consistent.

As the Washington Post reported, the Obama administration waited months before appointing a replacement for Rev. Suzan Johnson Cook, a reputedly ineffective ambassador-at-large for international religious freedom, a position that should function as the State Department’s religious freedom watchdog. The administration had taken more than two years to appoint Cook, a failure of action that evidenced an extremely low priority on religious freedom.

The U.S. Commission on International Freedom, by contrast, explains that "As Americans, religious freedom reflects who and what we aspire to be as a nation and people. For the vast majority of people across the globe, religion matters: Fully 84 percent of the world’s population identifies with a specific religious group."

Pro-life colleague and Catholic scholar Dr. Robert P. George serves as vice chairman of the U.S. Commission on International Religious Freedom (USCIRF). He notes, "Abuses against Christians span the globe. A key reason is the confluence of two factors. First, there are more than 2 billion Christians in the world. Second, according to a Pew Research study, in one-third of all nations, containing 75% of the world's people, governments either perpetrate or tolerate serious religious freedom abuses. A six-year Pew study found that over six years, Christians were harassed in 151 countries, the largest of any group surveyed."

Though our own political leaders may shrink back from responsibly responding to the worldwide persecution of Christians, our persecuted brethren are standing tall as a shining example of courage and faithfulness.
  • The Christian Post reports, "A number of the 21 Coptic Christians who were recently shown being beheaded in a horrific video by Islamic State militants in Libya were reportedly whispering the name of Jesus as their heads were being hacked off their bodies."
  • Christianity Today reports, "The Archbishop of Canterbury, Justin Welby, arrived in Cairo to offer condolences for the previous martyrs in Libya: 20 Coptic Orthodox Christians and a sub-Saharan African. 'Why has Libya spoken so powerfully to the world?' asked Welby during a public sermon. 'The way these brothers lived and died testified that their faith was trustworthy.'"
As we move on our government to stand up to persecution, may we also personally imitate the trustworthy faithfulness of this great cloud of witnesses.

Action

  1. Write to your elected officials (simply enter your zip code under "Find your elected officials" on our legislative action website) and urge them to take appropriate and strong legislative, diplomatic and military action to stop the persecution and killings of Christians overseas and to advance religious freedom worldwide and at home.
  2. Consider serving our brethren overseas, some of whom experience great hardship under governments hostile to Christians, on a Global Health Outreach or Medical Education International trip.

Resources
USCIRF 2014 Annual Report

Thursday, April 9, 2015

Global campaign to protect disabled infants

Excerpted from "Irish group Every Life Counts launches global campaign to end ‘incompatible with life’ label," LifeSiteNews. March 11, 2015 — Irish families have joined with international medical experts and disability advocacy groups to launch the Geneva Declaration on Perinatal Care at the United Nations. The Declaration, which is the centerpiece to a global campaign to end disability discrimination caused by the “incompatible with life” label, has already been signed by more than 200 medical practitioners and researchers and 27 disability and advocacy NGOs. It aims to improve care for mother and baby where a life-limiting condition has been diagnosed before or after birth.

At the event, families from Ireland, Northern Ireland, Canada, Spain and Switzerland said that the label “incompatible with life” was not a medical diagnosis and was causing “lethal discrimination against children diagnosed with severe disabilities, both before and after birth.”

Barbara Farlow, whose ground-breaking research led to a new understanding of the experiences of families where children had a life-limiting condition, said that the label “incompatible with life” had been shown to lead to sub-optimal care after birth and the phrase dehumanised children.

Professor Giuseppe Benegiano, former director of special programmes for the UN, said that the UN should give support for this important initiative against disability discrimination. Professor Bogdan Chazan, an imminent obstetrician from Poland, said that babies with a challenging diagnosis deserved better care than abortion.

Commentary

Dr. Sandy ChristiansenCMDA Member and Care Net Medical Advisor Sandy Christiansen, MD, FACOG: “The mark of a civilized society is the degree to which it protects its weakest most vulnerable members. Psalm 82:3 admonishes us to ‘Defend the weak and the fatherless; uphold the cause of the poor and the oppressed’ (NIV 2011). The Geneva Declaration is a beautiful example of the fulfillment of this passage.

“Routine prenatal testing seeks to detect fetal abnormalities before birth. With the discovery of a problem, what choices are offered? Data across the globe report that anywhere from 29 percent to 85 percent of fetuses with Down Syndrome are aborted.123 But some families are choosing a different path and finding joy in the journey. Turning away from the offered termination of pregnancy for a fetal anomaly that has been pronounced ‘incompatible with life,’ some couples have instead chosen to embrace every minute of life their child has—both inside and outside the womb. They face pressure from healthcare professionals to abort and experience lack of understanding from family and friends. Yet, 97 percent of respondents in a 2012 study of families with children with trisomy 13 and 18 described their child as happy and parents reported these children enriched their family.4 Their experience was incongruent with the dismal picture predicted by their physicians. The most common negative comment made by parents in this study was a sense that healthcare professionals did not see their baby as having value, as being unique and as being a baby.

“A recent study looked at women who aborted and women who carried after learning their babies were diagnosed with a life-limiting diagnosis. The abortion group experienced more grief, depression and emotional stress, and they also had symptoms consistent with post traumatic stress disorder (PTSD) for up to seven years after the abortion as compared to the women who chose to carry group.

“Evidence is mounting to support the benefits of taking a hands-off approach to a life-limiting prenatal diagnosis and simply allowing couples to spend time with their unborn babies for as long as they have them. As Christian healthcare professionals, we should be prepared to offer families a different option to the default termination solution so often given for an adverse prenatal diagnosis. Words need to be chosen carefully, avoiding terms like ‘incompatible with life;’ instead, we should use words that affirm the baby’s life and value as a human being. Couples who choose to carry their child should be connected to resources that provide the support and understanding they desperately need.

“Perinatal hospice5 is a unique solution and can be thought of as ‘hospice in the womb.’ It is easily incorporated into routine prenatal care and birth planning. A team approach can include obstetricians, perinatologists, labor and delivery nurses, NICU staff, chaplains/pastors and social workers, as well as genetic counselors and traditional hospice professionals. It enables families to make meaningful plans for the baby's life, birth and death, honoring everyone.”6

1Siffel, C., Correa, A., Cragan, J., & Alverson, C. (2004). Prenatal Diagnosis, Pregnancy Terminations And Prevalence Of Down Syndrome In Atlanta. Birth Defects Research Part A: Clinical and Molecular Teratology, 70(9), 565-571.
2Khoshnood B, De Vigan C, Vodovar V, Goujard J, Goffinet F (2004) A population-based evaluation of the impact of antenatal screening for Down's syndrome in France, 1981–2000. BJOG 111: 485–490.
3Leroi, A. (2006). The future of neo-eugenics. Now that many people approve the elimination of certain genetically defective fetuses, is society closer to screening all fetuses for all known mutations? EMBO Reports, 7(12), 1184-87. Retrieved April 2, 2015, from http://embor.embopress.org/content/7/12/1184.
4Janvier A. Farlow B. Wilfond B. (2012)The Experience of Families With Children With Trisomy 13 and 18 in Social Networks Pediatrics Vol. 130:293 -298 (doi: 10.1542/peds.2012-0151).
5Hoeldtke, N., & Calhoun, B. (2001). Perinatal Hospice. American Journal of Obstetrics & Gynecology, 185(3), 525-29.
6Calhoun, B., Napolitano, P., Terry, M., Bussey, C., & Hoeldtke, N. (2003). Perinatal hospice. Comprehensive care for the family of the fetus with a lethal condition. Journal of Reproductive Medicine, 48(5), 343-8.

Resources

Perinatal Hospice Resources in the U.S.
CMDA’s Abortion Ethics Statement
CMDA’s Human Life Ethics Statement

Bringing empathy back into the doctor’s office

Excerpted from Instilling empathy among doctors pays off for patient care,” CNN. March 26, 2015 — Developed by medical faculty at Duke, the University of Pittsburgh and several other medical schools, "Oncotalk" is part of a burgeoning effort to teach doctors an essential but often overlooked skill: clinical empathy. Unlike sympathy, which is defined as feeling sorry for another person, clinical empathy is the ability to stand in a patient's shoes and to convey an understanding of the patient's situation as well as the desire to help.

Clinical empathy was once dismissively known as "good bedside manner" and traditionally regarded as far less important than technical acumen. But a spate of studies in the past decade has found that it is no mere frill. Increasingly, empathy is considered essential to establishing trust, the foundation of a good doctor-patient relationship.

Studies have linked empathy to greater patient satisfaction, better outcomes, decreased physician burnout and a lower risk of malpractice suits and errors. Patient satisfaction scores are now being used to calculate Medicare reimbursement under the Affordable Care Act. And more than 70 percent of hospitals and health networks are using patient satisfaction scores in physician compensation decisions.

"The pressure is really on," said psychiatrist Helen Riess. The director of the empathy and relational science program at Massachusetts General Hospital, she designed "Empathetics," a series of online courses for physicians. "The ACA and accountability for health improvement is really heightening the importance of a relationship" between patients and their doctors when it comes to boosting adherence to treatment and improving health outcomes.

Commentary

Dr. Al WeirCMDA Past President and Oncologist Al Weir, MD: “Is it possible to ‘instill empathy’ into our healthcare professionals, and is it a good thing to try?

“It is certainly good for us to have and demonstrate real compassion for our patients. Those of us who love Christ should have His compassion flowing naturally from us to those who are suffering. If we do not, there is something wrong with our relationship with the Christ. Perhaps, if we learn to love Him more, we will indeed love our patients more and demonstrate that compassion better.

“This is foremost, and all the training in the world cannot mimic true love for those we serve.

“However, though our character of love is most important, we certainly also need to develop communication skills to best demonstrate that love in a way that best demonstrates the heart of God. Communication skills can indeed be learned and practiced so that we ‘do best’ what we ‘are’ inside. I am familiar with the training instruments listed in this article. They, among others, can be quite valuable tools for Christian healthcare professionals to use in honing our skills, so that our communication actions might match our hearts of compassion.

“Just as a missionary physician must learn new roads to carry his message of Christ into the deserts of northern Sudan, all of us should learn new skills of communication through which we may best carry the message of God’s love to each patient we serve.”

Resources

Grace Prescriptions – Learn how to share your faith in your practice
Spiritual Assessment in Clinical Care – Part 1: The Basics
The Practice of Medicine: More Than Just Science

HIV epidemic hits Indiana

Excerpted from HIV ‘Epidemic’ Triggered by Needle-Sharing Hits Scott County, Indiana,” NBC News. March 25, 2015 — An HIV "epidemic" fueled by needle-sharing opiate addicts has infected at least 72 people in one southern Indiana county as Gov. Mike Pence plans to declare a public health emergency in that community on Thursday. The outbreak's swift acceleration in Scott County — beginning with seven known HIV-positive patients in late January — has prompted state officials to ask the Centers for Disease Control and Prevention to deploy investigators to test residents and to help control further spread of the virus, Pence said.

The epidemic's true epicenter is the town of Austin, in northwestern Scott County, said Dr. William Cooke, medical director at Foundations Family Medicine. He opened the facility in Austin about 10 years and, since then, he's watched opiate abuse take a far deeper hold.

Used needles litter roadsides, ditches and yards, said Cooke, who has been publicly voicing his concerns about a brewing HIV outbreak. On Wednesday, Cooke also lobbied Indiana lawmakers to launch a clean-needle program — a strategy that, in his vision, would offer safe fresh needles and safe places to dispose of dirty needles while also connecting participating residents to addiction therapists.

Austin's population is about 4,200 people, according to the U.S. Census Bureau, and the majority of the nearly 80 known HIV cases are people who live in that town, Cooke said. Poverty is driving the mass opiate-addiction rate — and, now, the HIV epidemic, Cooke said. “We need help. But that costs money. My clinic serves the poorest people in Indiana, potentially the poorest in the country," Cooke said. "We do a sliding scale here. If they can, they may pay us 10 dollars for care. I'm hopeful this declaration provides the funding we have needed.”

Commentary

Dr. Reginald FingerCMDA Member and Assistant Professor at Indiana Wesleyan University Reginald Finger, MD, MPH: “The HIV infection outbreak in Scott County, Indiana, straddling I-65 between Indianapolis and Louisville, occurred because at least three unfortunate factors came together at once. Lying astride a heavily traveled north-to-south transportation corridor in the Eastern U.S., it unfortunately acts as a pipeline for illegal drugs. The county struggles with poverty and poor health, ranking last among Indiana counties for health indices by the Robert Wood Johnson Foundation. Many communities nationally, however, are just as much at risk. Any one of them has enough people injecting illegal drugs with shared needles to fuel a lethal epidemic if the right virus were introduced, as it was to Scott County. Even in this age of anti-retroviral medications, HIV still makes a mess of human lives, while piling up millions of dollars in healthcare costs onto a community already struggling to make ends meet.

“What is the lesson for healthcare professionals in similar communities across the country? First: one needs a high index of suspicion not only for HIV infection itself but for any of the associated risk factors and conditions. Hepatitis C infection is often seen first. Not every injecting drug user fits a ‘stereotypical’ profile. I have decided never to be offended when a doctor, pastor or counselor asks me a blunt question about lifestyle choices, even ones that may be far from my experience. My response is ‘No, sir, but thank you for asking.’ By the question, I know that this professional is on the ball, interested not only in whatever may affect my health—as important as that is—but on protecting my community as well. Next, be well connected to social, legal and spiritual resources in your community. You may be the only human services professional that your patient has seen in a long time, especially if the person has low regard for ‘the system’ and came to you only because their need is acute. “Finally, each clinician must remember that better health for our nation depends on community and environmental factors, yes, but also on individual decisions and interventions that can only occur one patient or family at a time. The person whose life you touched in the office today may be the index case of the epidemic that did not happen—because you were there!”

Resources

Professionalism in Peril – Part 5: Our Obligation to the Poor
Healthcare for the Poor

Thursday, March 26, 2015

Abortion and human trafficking: CMA commentary in Washington Post

Jonathan ImbodyReprinted from “The Hyde Amendment’s effect on human-trafficking victims,” commentary by CMA VP for Govt. Relations Jonathan Imbody, published in the Washington Post, March 21, 2015: In annual appropriations bills since 1976, Democrats routinely have united with Republicans in passing the Hyde Amendment, which simply prevents taxpayer monies from funding abortions except in cases of rape or incest or to save the life of the mother. Americans overwhelmingly oppose opening public coffers to the abortion industry.

Nevertheless, Democrats increasingly have been injecting abortion partisanship into human trafficking programs. Congressional hearings revealed how Obama administration officials denied a grant to a faith-based organization over abortion and other morally objectionable issues.

Many would note that abortion would only add to the trauma that human trafficking victims have already experienced. Yet even the Hyde Amendment does not disallow government-funded abortions in cases of rape, nor does it prevent abortions paid for with nongovernment funds. So protests over the Hyde Amendment in this trafficking-victims program are little more than partisan politics designed to enforce a radical abortion ideology. Jonathan Imbody, Ashburn. The writer is vice president for government relations for the Christian Medical Association.

Resources

CMDA Resources on Human Trafficking
CMDA Resources on Abortion

Action


Educate yourself (CME credit available) with CMDA’s comprehensive online education modules on recognizing, reporting and caring for victims of human trafficking: www.cmda.org/TIP

Marriage merits: CMA commentary published in The Tennessean

Jonathan ImbodyReprinted from “Tennessee affirms opposite-sex marriage, not bigotry,” commentary by CMA VP for Govt. Relations Jonathan Imbody, published in The Tennessean, March 13, 2015 - Re: "Discriminated after crossing state lines," March 6, 2015 - In a letter to the editor, a Chicago resident complains that Tennessee does not recognize in law the fact that Illinois considers him married to another man; he labels Tennessee's legal definition of marriage a matter of discrimination and inequality.

The state of Tennessee retains a constitutional right, highlighted in the Supreme Court's recent Windsor decision, which deemed a federal definition of marriage as usurping states' rights, to determine by objective qualifications and definitions who qualifies for a marriage license. Tennessee also uses objective qualifications to determine which of its citizens can vote, practice medicine, own a gun or teach in public schools.

These qualifications only constitute "discrimination" in the sense of discerning the relevant factors that merit granting legal status and privileges.

Why would Tennesseans legally define marriage as between a man and a woman?

Social science research clearly demonstrates that marriage between a man and a woman in a lifelong, exclusive commitment offers society, and children in particular, unique benefits — economical, educational, psychological — that no other relationship offers as well.

These benefits have led governments for millennia to recognize and endorse in law the marriage of a man and a woman.

A state's recognition of the unique benefits of man-woman marriage does not preclude love, respect, dignity or the extension of a host of government benefits and privileges to non-married citizens.

It's simply an objective affirmation of what marriage is and an endorsement of the unique benefits it provides to society and children.

Jonathan Imbody, VP Government Affairs, Christian Medical Association

Resources
CMDA Marriage Public Policy Statement
CMDA Same-Sex "Marriage" Public Policy Statement

Action
Learn how to legislatively counteract the politics of same-sex marriage to prevent harm to children served by faith-based groups providing social services:
  • Child Welfare Provider Inclusion Act - S 667 - would ensure that organizations with religious or moral convictions are allowed to continue to provide services for children
  • Youth services bill OPPOSED for gender / religious freedom issues threatening services by faith-based organizations to runaway youth - S 262

DC tramples religious freedom in healthcare

Excerpted from "Sen. Ted Cruz seeks to upend D.C. laws on contraception coverage, gay rights," Washington Post, March 18, 2015 - Last month, more than a dozen prominent conservative groups and Catholic institutions asked Capitol Hill leaders to overturn the two D.C. laws, calling them “unprecedented assaults upon our organizations.” The laws would restrict the ability of private groups to discriminate based on religious beliefs.

One, the Reproductive Health Non-Discrimination Amendment Act of 2014, would prevent employers from taking action against workers based on their decision to use birth control or seek an abortion. The other, the Human Rights Amendment Act of 2014, repeals a longstanding, congressionally imposed measure exempting religiously affiliated educational institutions from the city’s gay nondiscrimination law.

As is the case for all D.C. laws, the two are now under a mandatory 30-day review period before Congress. Without congressional action, they could take effect as early as next month. That happened last month with the city’s marijuana-legalization law, when, despite threats from House Republicans, no lawmaker introduced a measure to stop it. Some Republicans feared a vote on marijuana legalization could expose a rift between conservative and libertarian wings of the party.

Freshman Sen. James Lankford (R-Okla.), who co-introduced the measures [disapproval resolutions of Congress to overturn the DC laws], issued a statement Wednesday saying “what the D.C. Council has done is a major threat to the fundamental right to religious freedom for D.C. residents and organizations, and a brazen display of intolerance.” As evidence that Congress would be within its rights to disapprove the D.C. measures, Lankford pointed to a Supreme Court decision last year that family-owned businesses do not have to offer their employees contraceptive coverage under the Affordable Care Act if doing so conflicts with owners’ religious beliefs.

Commentary

Jonathan ImbodyCMA VP for Government Relations Jonathan Imbody: “The Washington Post suggests that these recently enacted DC ‘laws would restrict the ability of private groups to discriminate based on religious beliefs.’ In fact, the laws target and discriminate against religious groups by dictating that they must hire individuals who directly contradict the groups' tenets, standards and mission.

“That's a flagrant violation of First Amendment freedoms, as upheld by a unanimous Supreme Court in the Hosanna Tabor case and by Congress in the Religious Freedom Restoration Act.

“What the ironically entitled Human Rights Amendment Act of 2014 actually does is repeal a measure that for decades had advanced tolerance by ensuring that the DC Human Rights Act could not be used to coerce religiously affiliated schools into violating convictions of conscience.

“The DC Council apparently has decided, however, that there is not enough room in the District for religious dissenters who question the Council's edicts on sexual morality. Their discriminatory laws inject unconstitutional governmental coercion that subverts the democratic process of free speech and debate that historically has shaped American public opinion and values.

“Intolerance does not advance tolerance.”

Resources
www.Freedom2Care.org - CMA's one-stop-shop for news, analysis and resources on freedom of faith, conscience and speech.

Action

Protect conscience freedom in healthcare - HR 940, which would preserve patient choice and protect pro-life professionals from discrimination for moral and ethical views.

Protect freedom of faith and conscience related to abortion - S 50. No health professionals should be forced to choose between their careers and following the principles of ethical medicine.

Thursday, March 12, 2015

New study finds link between doctor’s office and deadly bacteria

Excerpted from CDC investigates deadly bacteria’s link to doctors’ offices,” CNN. February 26, 2015 — The Centers for Disease Control is raising a red flag that a potentially deadly bacteria may be lurking in your doctor's office. The bacteria, C. difficile, is typically found in hospitals, but a study out Wednesday, February 25 reports a substantial number of people contracted the bug who hadn't been in a hospital, but had recently visited the doctor or dentist.

The bacteria can cause deadly diarrhea, according to the CDC, with infections on the rise. The new report shows nearly half a million Americans infected in various locations in one year, with 15,000 deaths directly attributed to C. diff. The CDC is so concerned that they're starting a new study to try to assess nationally whether people are getting C. diff in doctors' offices.

In the meantime, patients should wash their hands after visiting the doctor's office -- with soap and water, because alcohol-based gels don't get rid of C. diff. Another tip: Question your doctor whenever you're prescribed an antibiotic. Powerful broad-spectrum antibiotics wipe away good bacteria in your gut that fight off the bad bacteria, which leads the way to C. diff. Johns Hopkins safety expert Dr. Peter Pronovost recommends asking your doctor if you really need an antibiotic, if there's a less powerful one that will treat your infection, and if you're being prescribed the antibiotic for the shortest time possible.

The CDC study, published Wednesday in The New England Journal of Medicine, said 150,000 people who had not been in the hospital came down with C. diff in 2011. Of those, 82% had visited a doctor's or dentist's office in the 12 weeks before their diagnosis. The CDC is hoping its new study will help determine cause and effect, because it's possible the patients had C. diff to begin with and went to the doctor to get help. It's also possible that antibiotics prescribed during the doctor's visit, and not microbes at the doctor's office, caused the infection.

Commentary

Dr. Eva QuirozInfectious Disease Specialist and CMDA Member Eva Quiroz, MD: “Clostridium difficile infections are of significant concern given the recent CDC reports of increased incidence, mortality and changing epidemiology of the disease. CDC reported half a million infections in the year 2011, and 29,000 people died within 30 days of initial diagnosis.

“Two of the most common preventable risk factors are: antibiotic prescription and infection control practices. (There are also many other risk factors being investigated such as food, animals and household contacts.) Antibiotics disrupt intestinal microbiota which renders a person more susceptible to illness. One study showed that some bacteria remain disrupted for long periods of time: up to two years following treatment with Clindamycin and up to four years after treatment for H. Pylori with Clarithromycin, Metronidazole and Omeprazole.

“I recommend screening our patients for diarrhea much like we screen for the flu. I would ask about history of diarrhea more than three times per day, any antibiotic exposure and exposure to anyone in the household who is ill with diarrhea. You can then test for c. diff if pertinent. We can also educate our patients about the perils of taking antibiotics when not needed, the importance of hand hygiene and how to avoiding handling food while sick with diarrhea.

“The organism is a spore and it might survive longer in the environment, so you need to decontaminate exposed areas with a sporicidal agent and wash your hands with soap and water between patients, even if you use gloves. The danger of acquiring the infection not only lurks in our offices but anywhere we are exposed to the spores excreted in the feces of an infected person.”

Resources

More information from CDC

Colorado seeks to extend abortion protections

Excerpted from Abortion bill scheduled for state house committee,” 9News. March 2, 2015 — The third abortion bill sponsored by Republicans in the Colorado legislature appears in committee on Tuesday. The "Born-Alive Infant Protection Act" addresses infants born alive during a botched abortion.

HB15-1112, sponsored by Rep. Lois Landgraf (R-Fountain), would require a physician to "take all medically appropriate and reasonable steps to preserve the life of a born-alive infant" and prohibits denying nourishment to a born-alive infant with the intent of ending the infant's life. It also prohibits using a born-alive infant for scientific research or other experimentation.

In 2002, President George W. Bush signed into law the "Born Alive Infants Protection Act" recognizing that every infant born alive at any stage of development is to be recognized as a person and a human being. This act, however, only applies to providers and hospitals operated by the federal government or which receive federal funding. HB15-1112 would expand born-alive infant protections to all hospitals and providers in the state.

The bill sponsor acknowledged that there are no cases of born-alive infants being refused life saving measures in the state of which she is aware, but, she says, the bill puts guardrails around the practice to prevent it from happening and "keeps doctors from coming into Colorado and doing this."

Rep. Lois Court (D-Denver) feels that the legislation is unnecessary. "It is already illegal to kill a living human being," Court said, also adding, "I am really tired of my Republican colleagues bringing forward divisive social issues when we really should be focused on rebuilding our middle class here in Colorado."

Commentary

Steven AdenSenior Counsel for Alliance Defending Freedom Steven H. Aden, Esq: “From the time of Roe v. Wade in 1973, medical-legal evidence has played a critical role in shaping courts’ views of the nature of abortion and its risks. This is all the more true since the U.S. Supreme Court’s last pronouncement on abortion in 2007, Gonzales v. Carhart, in which the Court held that as long as the legislature had ‘some evidence’ on its side, it will be enough for the statute to pass constitutional muster. ‘The Court has given state and federal legislatures wide discretion to pass legislation in areas where there is medical and scientific uncertainty,’ the Court instructed.

“Consider Texas’ admitting privileges and chemical abortion regulations, which effectively closed approximately three-quarters of the state’s abortion clinics. The court of appeals that upheld the law particularly credited trial testimony offered by pro-life physicians Dr. John Thorp and Dr. James Anderson. The court found that Dr. Thorp ‘offered the most comprehensive statement of the requirement’s rationale,’ and quoted his testimony on the benefits of admitting privileges verbatim. Dr. Anderson, an ER physician and CMDA member, testified that ‘an abortion provider with admitting privileges is better suited than one not admitted to know which specialist at the hospital to consult in cases where an abortion patient presents herself at an ER with serious complications.’

“While the work that testifying experts do is best known to the public, it should be noted that there are other levels of involvement available, such as reviewing medical records or serving as a ‘consulting expert’ who equips the lawyers to understand medical evidence but does not testify. The process of testifying as a medical expert is a little more involved, but not terribly complicated. Court rules qualify expert witnesses to render opinions when they have ‘scientific, technical, or other specialized knowledge [that] will help the [court] to understand the evidence....’ Thus, even physicians in general practice may be able to offer opinions in cases involving specialties, depending on their particular education, training and clinical experience. Doctors who enable lawyers to put on evidence in abortion defense cases provide an invaluable service to both professions and the sanctity of human life itself.”

Action
If you are interested in getting involved by testifying, reviewing medical records or serving as a consulting expert, sign up for CMDA's Freedom2Care coalition's Federal Registry on LinkedIn (registration is free) and stay updated with notices of opportunities plus tips, updates and discussions.

Resources

CMDA Standards for Life - Abortion
CMDA’s Abortion Ethics Statement

Smart implants making a difference for patients

Excerpted from "CyborgRx: How Smart Implants Could Change Medicine," NBC News. February 17, 2015 — The cyborgs are coming ... and that's a good thing. A new breed of smart devices designed to be implanted in the brain, heart and other body parts could be used to treat everything from epilepsy to Parkinson's disease. They're already helping people like Chelsey Loeb. The 26-year-old can't feel the responsive neurostimulator (RNS System for short) firing electrical pulses into her brain. It's about the size of an iPod Nano and is constantly monitoring electrical activity from under her skull, looking for signs of a seizure so it can send out a targeted pulse to cut one off before it begins.

Designed by Silicon Valley-based NeuroPace, the RNS System is on the frontier of this new technology. But there are hopes that devices implanted under the skin could one day do things like automatically regulate glucose levels in diabetics or tell someone when their knee is about to give out. Right now, smart implants are giving hope to epilepsy patients like Loeb. Across the nation, 128 of them have been installed since the FDA approved the device in 2013. Clinical trials showed a 38 percent drop in the average number of seizures per month.

DARPA, the research arm of the U.S. Department of Defense, is also looking into smart implants. In August 2014, it announced the Electrical Prescriptions (ElectRx) program, which encourages the development of "ultraminiaturized devices" the size of nerve fibers that would "continually assess conditions and provide stimulus patterns tailored to help maintain healthy organ function."

Researchers are also starting to think about how multiple smart devices might work together. The EU-funded WISERBAN is a project aimed at creating a 'wireless body-area network' (WBAN) that would let smart implants communicate wirelessly with each other and the outside world without draining their limited power resources.

Commentary


Dr. William CheshireCMDA Ethics Committee Chair and Academic Neurologist William P. Cheshire, MD, MA: “As physicians, we have become doctors of cyborgs, and that's a good thing, provided we meet the ethical challenges. The wise application of sophisticated technology always requires proportionately thoughtful ethical analysis to enable appropriate use, prevent inappropriate use and limit unintended harmful consequences.

“Talk of cyborgs conjures up fantastic science fiction images of men and women whose bodies have been taken over by powerful runaway technologies threatening to supersede our humanity. The present reality, by contrast, is that technology is being used to rescue patients. Nearly all physicians in the developed world care for patients who have been implanted with artificial joints or pacemakers. A smaller but growing number of patients are living healthier lives with implanted cardiac monitors, nerve or brain stimulators, cochlear implants and programmable catheters. These and other biomedical electronic devices are to be welcomed for their therapeutic potential to bring healing and restoration to patients with disease and disability.

“Cyborg biomedical technologies also touch on profound questions about what it means to be human and what it might mean to be a redesigned human. Futurist Ray Kurzweil predicts, ‘We're going to become increasingly non-biological to the point where the non-biological part dominates and the biological part is not important any more.’ Taken to the extreme, the philosophy of transhumanism looks to the day when the human organism will be radically redesigned, if not inevitably replaced, by synthetic, artificial intelligences.

“Aside from the practical question of whether radical re-engineering of the human species is technically possible is the more immediate concern—if we were to become too enamored by technological bodily enhancements, how would we then regard our biological neighbors? We know one another not as amalgams of flesh and silicon but as embodied persons bearing the image of God. Would we value people less if we believed that bodily parts were easily replaceable or that minds could be uploaded to computers? Would remaking humanity in our own image cause us to lose sight of the face of Christ in those who suffer?

“Chelsey Loeb's story reminds us that each and every one of us is unique and special. ‘It's like a big puzzle,’ she says, ‘because my brain is unlike any other.’ Chelsey's experience is yet another example of how advances in neuroscience and biotechnology do not lead to a cold, mundane, materialistic understanding of humanity. Rather, through science we discover new levels at which human life is a great mystery.”

Resources

CMDA’s Eugenics and Enhancement Ethics Statement
Till We Have Minds by Dr. William Cheshire
Why Human Bioenhancement Technologies Are a Bad Idea

Thursday, February 26, 2015

CMA commentary in Washington Times magazine

Jonathan ImbodyExcerpted from "Selling suicide," commentary by CMA VP for Govt. Relations Jonathan Imbody, published in The Washington Times online magazine, American CurrentSee,

Compassion & Choices, the never-say-die advocates for state-sanctioned assisted suicide, seem to have mastered the art of putting lipstick on a pig. Whether or not Americans learn to see through their euphemisms and illogic may well determine the fate of many vulnerable patients, including those in California and 20 other states where the organization now is leading a well-funded lobbying campaign to legalize assisted suicide.

Reincarnated from a previous life when known as The Hemlock Society, the more politically correctly named Compassion & Choices non-profit organization claims on its website, "For over 30 years we have reduced people’s suffering and given them some control in their final days."

That claim would come as news to the medical and pharmaceutical professions, which, unlike non-profit advocacy groups, actually are trained and authorized to prescribe and provide medications that reduce suffering. Pain medication reduces suffering; lethal pills end lives. Suicide does not control death; it merely accelerates it.

The group also claims to "increase patient control and reduce unwanted interventions at the end of life." Yet the law has long recognized patients' right to decline "unwanted interventions at the end of life." Given the pressure by insurers, unscrupulous heirs and uncompassionate caretakers on vulnerable, depressed and disabled patients to end their lives early, assisted suicide represents the real threat of an "unwanted intervention at the end of life."

[As evidenced by polling], government-leery conservatives tend to critically analyze the smooth rhetoric designed to advance state-sanctioned assisted suicide, no doubt wondering:
  • Would state governments that sanction suicide block the media, watchdog groups and the public from investigating suspected abuses? (Yes; Oregon's assisted suicide law actually stipulates that "information collected shall not be a public record and may not be made available for inspection by the public.")
  • Might activist judges liberally construe and expand the phrase "pain" to mean not only physical but also psychological pain? (Yes; European courts already have slid down that slippery slope.)
  • Could courts determine that disabled persons' inability to ingest lethal pills means that they must be allowed to request euthanasia--thus empowering doctors to actively kill their patients? (Almost certainly, under equal access principles.)

Critical thinkers who have studied history and health may also ask probing questions such as:
  • Can physicians help kill their patients and still follow the Hippocratic ethic, which protects patients by forbidding physicians to "give poison to anyone though asked to do so" and insists on, "first, do no harm"? (No.)
  • Can physicians can accurately predict a patient's life expectancy? (No.)
  • Can physicians treat most patients' pain? (Yes, and updating legislation could ensure even more aggressive pain treatment.)

Anyone with a loved one facing a difficult illness, depression or financial hardship should ask:
  • Might family members not learn of their loved one's suicide until after she's dead? (Yes--as under Oregon's law.)
  • Could legalizing suicide send suicide-vulnerable young people a deadly message? (How could it not?)
  • Would vulnerable patients be pressured into requesting assisted suicide? (Only when heirs, insurance companies and governments could save money with a quick death rather than expensive healthcare ... or when caregivers became tired or uncaring ... or when a depressed patient felt like a burden on others.)

Read rest of commentary...

Action
  1. Check this list of states considering legalizing assisted suicide.
  2. If your state is included on this list of state legislative issues, will you join in your local state efforts to help stem the tide and defeat physician-assisted suicide? Contact communications@cmda.org to get involved.
Resources
Physician-Assisted Suicide Fact Sheet
CMDA Physician-Assisted Suicide Ethics Statement
State Legislative Issues

Hippocratic physicians face "medical martyrdom"

Excerpted from The Coming of Medical Martyrdom, commentary by Wesley J. Smith, First Things, February 20, 2015 - Despite abortion’s ubiquitous legality and the accelerating push to normalize assisted suicide, space remains for dissenting doctors to practice their art in the traditional Hippocratic manner.

But that space is diminishing. Today, “patient rights” are paramount; the competent customer is always right and, hence, held to be entitled to virtually any legal procedure from “service providers” for which payment can be made—be it abortion, assisted suicide or, someday perhaps, embryonic stem cell therapies and products made from cloned and aborted human fetuses.

Hippocratic-believing professionals ... are increasingly being pressured to practice medicine without regard to their personal faith or conscience beliefs. This moral intolerance is slowly being imbedded into law. Such laws are a prescription for medical martyrdom, by which I mean doctors being forced to choose between adhering to their faith or moral code and remaining in their profession.

Canada is heading in [this] direction regarding euthanasia. Quebec legalized doctor-administered death last year and allows no conscience exemptions along the lines of Victoria’s abortion law. Meanwhile, the Canadian Supreme Court just made access to euthanasia a Charter right for those with a diagnosable medical condition that causes “irremediable suffering,” including “psychological” pain.

Recognizing that some doctors will have moral qualms about “terminating life,” the Court gave Parliament twelve months to pass enabling legislation, stating that “the rights of patients and physicians will need to be reconciled” by law or left “in the hands of physicians’ colleges.” That doesn’t bode well for medical conscience rights.

If these trends continue, twenty years from now, those who feel called to a career in health care will face an agonizing dilemma: either participate in acts of killing or stay out of medicine. Those who stay true to their consciences will be forced into the painful sacrifice of embracing martyrdom for their faith.

Commentary

Jonathan ImbodyExecutive Director of the Christian Medical and Dental Society of Canada Larry Worthen, MA (Th.), LLB: “Comments by Wesley Smith regarding conscience rights for healthcare professionals in Canada should sound an alarm for our friends in the United States about the dangers of complacency. Advocates for a rationalistic and exclusively secular approach to healthcare are gaining ground and are shamelessly flexing their muscles behind the scenes with the provincial colleges that regulate the practice of healthcare in Canada.

“Buoyed by a recent unanimous decision of the Supreme Court of Canada which struck down sections of the Criminal Code dealing with assisted suicide and euthanasia, they are setting about the work of forcing physicians to refer for, and in some cases provide, procedures that go against the conscience of the physician. This has already resulted in physicians questioning whether they should move from their jurisdiction or dramatically alter their practice.

“However, all is not lost. In the recent case, the Supreme Court cited a previous decision that acknowledged that a physician could not be forced to participate in a procedure that went against the physician's conscience. CMDS Canada is currently using this argument in lobbying efforts with the two provincial colleges that have proposed policies that encroach on the freedom of conscience.

“If those lobbying efforts fail, then we will be forced to commence legal action to vindicate our rights to freedom of conscience and religion guaranteed by the Canadian Charter of Rights and Freedoms. We ask our friends in the United States for your prayer support in this challenging time.”

Action

Use our easy, pre-written forms at our Freedom2Care legislative action website to contact your senators and protect freedom of faith and conscience in healthcare - S 50.

Resources
Freedom2Care - Visit CMDA's one-stop source for news, commentary and resources on freedom of faith, conscience and speech.
View Canada CMDS's video interviews with doctors on this issue (navigate to right-hand column on home page).

CMA commentary in Baltimore Sun

Jonathan ImbodyExcerpted from "Assisted suicide is not 'death with dignity'," commentary by CMA VP for Govt. Relations Jonathan Imbody, published by the Baltimore Sun, February 21, 2015 - An advocate for a Maryland "death with dignity" bill complains, "Why is it that I can put my dying pet to sleep to end its suffering, then have to sit with my dying spouse at a hospice?" ("Md. needs a death with dignity law," Feb. 18).

The comments suggest exactly why assisted suicide is far from "death with dignity."

Unlike animal pets, human beings possess the ability to transcend their physical bodies to achieve dignity and purpose.

The fact that a caretaker expresses regret at "having to sit with my dying spouse at hospice" unwittingly illustrates the pressures that can be brought to bear on the vulnerable, the disabled and the dying to end their lives prematurely.

The unpleasant truth is that when sick, elderly or disabled individuals are experiencing challenges that render them weak, depressed and extremely vulnerable, their caretakers will all too often prefer emotional relief to persevering in care-giving; insurers and governments will save money with a quicker end to life; overeager heirs may want to cut care short to preserve their inheritance; and coldly pragmatic health workers may want to clear the bed that patients nearing the end of life "uselessly" occupy.

As former Surgeon General C. Everett Koop observed, the "right to die" becomes the duty to die. We should instead focus on palliative care, assisting families with vulnerable patients and upholding the true human dignity that transcends our frail bodies.

Action
  1. Check this list of states considering legalizing assisted suicide.
  2. If your state is included on this list of state legislative issues, will you join in your local state efforts to help stem the tide and defeat physician-assisted suicide? Contact communications@cmda.org to get involved.

Resources
Physician-Assisted Suicide Fact Sheet
CMDA Physician-Assisted Suicide Ethics Statement
State Legislative Issues

Thursday, February 12, 2015

Illinois approves child use of medical marijuana

Excerpted from Child use of medical marijuana ahead in Ill.,” Baptist Press. January 13, 2015 — Children in Illinois will be eligible for medical marijuana prescriptions, according to rules announced by state health officials in late December. The rules by the Illinois Department of Public Health amend the medical marijuana pilot program approved by lawmakers in June. A handful of parents subsequently spearheaded a campaign to open the program to children under age 18, especially those who suffer from epileptic seizures.

Under the new rules, which went into effect on New Year's Day, children diagnosed with a qualifying debilitating condition will be able to obtain marijuana-infused products but not raw marijuana for smoking. To obtain the treatment, children need a signature from their own physician, an additional doctor's review and authorization and parental permission.

Supporters see the Illinois action as a step toward allowing children the potential benefits of medicinal marijuana. A hybrid marijuana strain called Charlotte's Web has a growing following of parents who believe it's an effective treatment for children suffering from severe seizures. Two U.S. drug companies have launched studies into the effects of CBD on childhood seizures but results will not be available for years. In the meantime, skeptics question whether the treatment is truly helpful.

Commentary

Dr. J. Scott RiesCMDA’s National Director of Campus & Community Ministries Dr. J. Scott Ries, MD: “It didn’t take long. The marijuana joy-ride train that seems to be traversing the nation stopped at a station in Illinois. With that state’s legislature legalizing the use of so-called ‘medical marijuana’ for children, it begs the question of what’s next.

“To be sure, there is hardly a more difficult scenario for a family and their physician than to see a child suffering from painful and tragic disorders that are difficult to control. I have sat beside parents as they bear the intensely painful burden of their child’s last moments on earth. I have held seizing children as yet another episode of their refractory seizures takes hold. However, this move opens a Pandora’s box of ethical and clinical concerns related to using marijuana products in children.

“Though it may be that newer genetically modified marijuana plant derivatives may have a lower THC component, low-THC is not no-THC. The truth is we simply do not know the ramifications of allowing children access to marijuana—be they short-term or long-term consequences.

“We do know that: the younger a person is exposed to marijuana, the greater their likelihood of addiction; the majority of the limited studies available on ‘medical marijuana’ are limited to animal models, not human subjects; and safer, better studied options are available for the scenarios for which marijuana has been legalized in Illinois.

“It seems political agenda and emotional response have trumped scientific rationale and a cautious primum non nocere. At best, what we can say pertaining to the use of marijuana in our children is we simply don’t know its consequence. At worst, it hails of even more problems to come.

“As I mentioned in a previous commentary, we would do well as Christian healthcare professionals to remember Paul’s counsel that while everything may be legal, everything is not necessarily good. ‘We are free to do all things, but there are things which it is not wise to do. We are free to do all things, but not all things are for the common good’ (1 Corinthians 10:23, BBE).”

Editor's Note: Though proponents claim that medical marijuana (ie. cannabinoid) has less addictive THC, "low THC is not the same as "no THC."

Resources

A five-part series on marijuana from Dr. Walt Larimore
The Effects of Marijuana by Donal O'Mathuna
University of Notre Dame Myths and Current Research

The death of physician-assisted suicide in Colorado

Excerpted from Colorado lawmakers vote down assisted suicide bill,” Reuters. February 7, 2015 — After 10 hours of emotional testimony and debate, Colorado lawmakers late on Friday voted down a proposed assisted-suicide law that would have allowed terminally-ill patients to end their lives with prescription drugs.

By an 8-to-5 bipartisan vote, the so-called "Death with Dignity" bill was rejected by the Public Health and Human Services Committee in the state's House of Representatives. The measure was sponsored by two Democratic lawmakers.

The Colorado proposal would have required two physicians to verify that the patient is terminal, had made both verbal and written statements of their intentions, and was able to self-administer the lethal medications. Hundreds packed the committee room in Denver, as lawmakers heard testimony from both advocates and opponents of the measure. A poll conducted last month by Colorado pollster Talmey-Drake Research showed 68 percent of state residents surveyed favored the bill.

Commentary

Natalie DeckerAlliance Defending Freedom Legal Counsel Natalie Decker: “The bill Colorado legislators rejected sought to override a historic governmental commitment that has existed since the beginning of time: preserve and protect human life. Alliance Defending Freedom highlighted in testimony the numerous problems with the proposed law. The bill lacked safeguards to prevent abuse and mistakes which would have resulted in people being killed without their consent. Indeed, there could never be adequate safeguards.

“Despite assertions to the contrary, the bill did not require lethal drugs to be ‘self-administered,’ nor did it even define what that term meant. In fact, the bill provided no oversight of lethal drugs once dispensed, nor did it require consent, legal capacity to consent or the presence of any witnesses (not even the attending physician) during the administration of the lethal drugs. In addition, the bill defined ‘terminal’ illness or disease broadly and arbitrarily. Understandably, some of the bill’s proponents presented emotional, heartrending stories to which any compassionate person can relate. Those cases are very rare, however, particularly given the high quality of healthcare and technology in our nation.

“Many Coloradans from diverse backgrounds and perspectives told their legislators why they opposed physician-assisted suicide. Their testimony was based on a sound and rational analysis of the facts and the law.

“The poll referenced by Mr. Coffman was commissioned by Compassion & Choices (formerly known as the Hemlock Society), the organization promoting the bill. The questions C&C asked were based on false premises, which resulted in skewed responses. It is highly unlikely that anyone asked directly if doctors should be permitted to kill their patients would respond ‘yes.’ Indeed, that is why the Legislature voted ‘no.’

“It is a hallmark of our society to expect healthcare professionals, as well as the legal system, to protect its more vulnerable members—the elderly, the infirm, infants and the disabled. The Colorado Legislature rightly rejected the idea that our state and its healthcare professionals should be agents of death instead of protectors of life.”

Editor’s Note: CMDA staff and CMDA Colorado State Representative Dr. James Small participated in the coalition Coloradans Against Physician Assisted Suicide which developed educational tools and strategies as well as obtaining testimonies at the hearing.

Late Breaking News: SB 202 (to legalize assisted suicide in Montana) was tabled in Montana. CMDA State Representative Dr. David Hafer and his wife Bobbie have labored continuously and provided leadership in opposing PAS for the last six years after a Montana judge ruled PAS was legal. CMDA members who gave testimony at the hearing this week were Dr. David and Bobbie Hafer, Drs. Chris and Jennifer Gilbert and Dr. Annie Bukacek. In addition, CMDA members Dr. Samuel Reck, Dr. Dennis Dietrich and Dr. Rick Blevins provided written testimony.

Action Item

We praise God for His faithfulness in defeating physician-assisted suicide in Colorado. Unfortunately, more than 25 states in the U.S. are now considering legislation to legalize this dangerous practice. We need your help. If your state is included on this list of state legislative issues, will you join in your local state efforts to help stem the tide and defeat physician-assisted suicide? Contact communications@cmda.org to get involved. Resources

Physician-Assisted Suicide Fact Sheet
CMDA’s Physician-Assisted Suicide Ethics Statement
Ongoing State Legislative Issues