Legalized recreational pot

Excerpted from "Colorado, Washington first states to legalize recreational pot," Chicago Tribune, by Keith Coffman and Nicole Neroulias. November 7, 2012--Colorado and Washington became the first U.S. states to legalize the possession and sale of marijuana for recreational use in defiance of federal law, setting the stage for a possible showdown with the Obama administration. But another ballot measure to remove criminal penalties for personal possession and cultivation of recreational cannabis was defeated in Oregon, where significantly less money and campaign organization was devoted to the cause. Supporters of a Colorado constitutional amendment legalizing marijuana were the first to declare victory, and opponents conceded defeat, after returns showed the measure garnering nearly 53 percent of the vote versus 47 percent against.

The Colorado measure will limit cultivation to six marijuana plants per person, but "grow-your-own" pot would be still be banned altogether in Washington state. "The voters have spoken and we have to respect their will," Colorado Governor John Hickenlooper, a Democrat who opposed the measure, said in a statement. "This will be a complicated process, but we intend to follow through." He added: "Federal law still says marijuana is an illegal drug, so don't break out the Cheetos or gold fish too quickly."

Critics say the social harms of legalizing pot - from anticipated declines in economic productivity to a rise in traffic and workplace accidents - would trump any benefits. Backers point to potential tax revenues to be gained and say anti-pot enforcement has accomplished little but to penalize otherwise law-abiding citizens, especially minorities. They also argue that ending pot possession prosecutions would free up strained law enforcement resources and strike a blow against drug cartels, much as repealing alcohol prohibition in the 1930s crushed bootlegging by organized crime. "It's no worse than alcohol, and it's widely used in Colorado anyway," said Jean Henderson, 73, a retired resident of Broomfield, explaining her vote in favor of legalization. "The state can benefit from the taxes rather than put people in jail." Click here to read full article.

Commentary

CMDA CEO David Stevens, MD, MA (Ethics): “VISIT ASPEN – great vistas, marvelous skiing and you can grab a joint of Supergrass before you hit the slopes this Christmas season! I can see this or similar ads on billboards and the internet in the next month when recreational marijuana becomes available. Far-fetched? There are no restrictions on advertising marijuana in the Colorado law passed this month. Along with Washington state, children and teenagers in the state will be getting the message loud and clear: smoking a joint is no different than drinking a beer and then thinking, 'Why wait until I’m 21?'

"The bill passed because medical marijuana has been more tightly regulated in Colorado than any other state. It’s planting, growing, processing and shipping is all under constant video monitoring. The referendum backers advertised that marijuana had been regulated until it was safe, and that allowing recreational use would bring millions of dollars of tax revenues that was now going to cartels into the state for education.

"The uncounted medical and societal costs of this decision will be evident in the years ahead. Alcohol use and related illnesses skyrocketed after the end of Prohibition. Marijuana worsens symptoms of psychotic illnesses, contributes to depression and increases attention deficit and memory problems. Traffic accidents and fatalities will increase and there is presently no easy way to test drivers to see if they are driving under marijuana’s influence. Marijuana is often cut with mind-altering drugs like PCP, LSD, heroin and cocaine. Its use delays people looking for the emotional causes of their problems as it puts a Band-Aid on their psychic wounds. Many experts see marijuana as a gateway to the use of even more dangerous drugs. One-third of users, who now will be able to grow up to six marijuana plants in their backyard in Colorado, show signs of dependence. Parents will have one more reason for not allowing their children to go over and play at the neighbor’s house.

"How will Colorado and Washington deal with the economic issues of price, supply and demand? Monitoring production for so-called medical use is ridiculously simple compared to the quantities demanded as use skyrockets, 'potheads' move to the state and marijuana attracts tourism. Will the state Department of Agriculture promote it as a new cash crop instead of allowing its import from outside the state? With the state tax of 15 percent, will people still grow it illegally and drug runners run it across the state line to avoid the added cost? How will law enforcement know what marijuana is taxed and what has not been once it is in the user’s possession?

"If the supply is more than adequate, will the price drop fuel increased usage and an increase in the tax rate? According to priceofweed.com, marijuana now costs $152 to $254 dollars an ounce in Colorado depending on quality. Where can it be sold? If it is treated like alcohol sales in the state, residents may soon find it in the grocery store between the basil and rosemary. In the medical marijuana trade, there are popular marijuana-infused edibles, oils and even drinks. With the harms of inhaling smoke, will restaurants in Colorado and Washington soon be offering marijuana-infused desserts?

"Bottom line, I view the legalization of marijuana with sadness. It is another step, a giant one, along the path of the decline and ultimate destruction of our culture and our country. It is another clear indicator of the need for Christians to be shining lights in the growing darkness."

Faith at crossroads in US: Poll reveals decline in faith affiliation

Excerpted from “Nones”on the Rise survey report by the Pew Research Center, October 9, 2012 - The number of Americans who do not identify with any religion continues to grow at a rapid pace. One-fifth of the U.S. public – and a third of adults under 30 – are religiously unaffiliated today, the highest percentages ever in Pew Research Center polling.


In the last five years alone, the unaffiliated have increased from just over 15 percent to just under 20 percent of all U.S. adults. Their ranks now include more than 13 million self-described atheists and agnostics (nearly 6 percent of the U.S. public), as well as nearly 33 million people who say they have no particular religious affiliation (14 percent).

This large and growing group of Americans is less religious than the public at large on many conventional measures, including frequency of attendance at religious services and the degree of importance they attach to religion in their lives.

These findings represent a continuation of long-term trends.

The religiously unaffiliated population is less convinced that religious institutions help protect morality; just half say this, considerably lower than the share of the general public that views churches and other religious organizations as defenders of morality. Overwhelmingly, they think that religious organizations are too concerned with money and power, too focused on rules and too involved in politics.


CMA VP for Government Relations Jonathan Imbody: “I've prepared an analysis of and strategies to respond to this poll's findings, which represent a wake-up call to Christians nationwide. We must not, however, conclude on the basis of this poll that Christians should get out of public policy.


"First, many of those who disapprove of advancing Christian values through public policy--regarding homosexuality, abortion and premarital sex, for example--will naturally want Christians to get out of politics, so they themselves can prevail politically. Christian involvement in politics for such people is not somehow preventing them from embracing Christ; it is preventing them from pursuing their own ideological political agenda and personal values.

"Second, if Christians were to leave public policy to those who do not share our faith values on the sanctity of life, defending the defenseless and caring for the poor, what kind of laws and policies do you think would result?

"Imagine where this nation would be today without the historical and continuing political influence of the faith community on issues such as slavery, abortion, civil rights, assisted suicide and religious liberty.

"The first two chapters of the book of Romans teach us that when people defy God as revealed in nature and in their consciences, by making evil choices counter to God's principles, they end up with a depraved mind and a hardened heart. Consider that the reverse is also true: When individuals act in accordance with God's revelation through nature and their consciences, by making good choices consistent with His principles, they maintain an open mind and a softened heart toward God. They also experience God's principles working in their lives, which can lead them to embrace His fuller revelation through Scripture and the Good News of a personal relationship with Jesus Christ.

"Therefore, when followers of Christ help individuals (through relationships and counseling) and our society (through public policy) to make choices consistent with God's principles, we are actually participating in evangelism. We Christians participate in public policy--by voting, advocating politically and voicing views in the public square--not because we think that laws consistent with Christian principles will save people spiritually, but because we realize that such laws can help keep minds and hearts headed in God's direction, to the One who can save."

Action

• REGISTER to VOTE

!

Contact lawmakers

Track bills

Resources
View or download "Faith at crossroads," a CMA PowerPoint analysis of and strategies related to the Pew poll survey

CMA fights HHS mandate in court

Excerpted from "Battle against abortion mandate," Baptist Press, Oct. 15, 2012 - A friend-of-the-court brief filed Oct. 12 asks a federal appeals court to reverse the dismissal of two lawsuits against the controversial abortion/contraception requirement under the 2010 health care law. The brief supports challenges by Wheaton College, an evangelical Christian school in suburban Chicago, and Belmont Abbey College, a Roman Catholic institution in North Carolina, to the mandate that employers provide workers with health insurance that covers contraceptives and abortion-causing drugs.
[Eleven] evangelical organizations joined by invitation in a brief filed by Christian Legal Society (CLS) in support of the colleges' appeal on religious liberty grounds to the District of Columbia Circuit Court of Appeals. The lawsuits seek the overturn of a rule by the Department of Health and Human Services (HHS) that includes -- in coverage paid for by employers -- drugs defined by the Food and Drug Administration as contraceptives, even if they can cause abortions. Among such drugs are Plan B and other "morning-after" pills, which can prevent implantation of tiny embryos, and "ella," which -- in a similar fashion to the abortion drug RU 486 -- can act even after implantation to end the life of the child.
Though the 2010 health care law says it is not to affect conscience protections regarding the performance of or funding for abortion, the HHS mandate "tramples religious employers' conscience rights and thereby discredits the time-honored commitment to respect religious conscience rights in the health care context," the brief says.
[Organizations] signing onto the CLS brief included the Ethics & Religious Liberty Commission, the Christian Medical Association, Prison Fellowship, National Association of Evangelicals, Patrick Henry College, Association of Gospel Rescue Missions, Association of Christian Schools International and Institutional Religious Freedom Alliance.

Commentary

CMA VP for Government Relations Jonathan Imbody: "The Christian Medical Association has participated in 34 court cases to vie for principles our members value. This latest brief counters the administration's efforts to limit the scope of religious freedom by narrowing the definition of which organizations are 'religious enough' to qualify for exemption from the new health law's contraceptives and sterilization mandate. The mandate forces U.S. employers to have included in their health insurance plans a new requirement under Obamacare to provide 'free' contraceptives and sterilization surgeries to anyone on demand.


"Our legal brief asserts:

'The mandate’s inadequate definition of 'religious employer' departs sharply from the nation’s historic bipartisan tradition that protects religious liberty, particularly in the context of abortion funding. Exemptions for religious objectors run deep in American tradition. Exemptions for religious conscience have been a bipartisan tradition in the health care context for four decades. The mandate’s definition is so narrow that many religious congregations may fail to qualify as a 'religious employer.' The mandate’s 'religious employer' definition certainly does not cover most religious ministries that serve as society’s safety net for the most vulnerable.'

"Other examples of assaults on religious liberty and conscience rights include the gutting of the only federal conscience regulation in health care, the denial of federal grant funds to a ministry simply for opposing abortions and the administration's court action to restrict faith-based organizations' hiring rights. Unless we halt this trend of governmental restricting of religious and conscience freedoms, you will find yourself subject to increasing pressures--motivated by ideologies opposed to your beliefs--to violate your faith principles in your professional practice and ultimately in your personal life."

Action

1. Sign the petition to Stop the HHS contraceptives / sterilization mandate
2. Sign the Healthcare professional petition to Congress and the President to uphold conscience rights

Resources

• Read the CMA brief against the HHS mandate
• CMA legal briefs summary

Treating a difficult patient

Excerpted from "Treating the difficult patient," Medscape News, by Batya Swit Yasgur, MA LMSW. September 20, 2012--Some patients warm your heart. They help you remember why you went into medicine. Other patients make you wish you had become anything but a physician. They yell or whine, manipulate or threaten. Some ignore their treatment plan and blame you when they don't improve; others insist they know more than you do. Some don't pay their bills, and others fail to show up for appointments. Hard as it is to admit, you wish they'd go away. "Many physicians feel they 'should' be loving and tolerant toward all patients, but that's not realistic," said Auguste Fortin, MD, Associate Professor of Medicine, Yale University School of Medicine, New Haven, Connecticut. "In every setting in life, we all get along better with some people than with others, and medicine is no exception." Although everyone has their own positive and negative traits, there are several categories of unpleasant behavior that may cast a very dark cloud over the patient visit.

Anger Outbursts - Some patients may periodically erupt. "Anger in a patient is one of the most difficult emotions for a physician to deal with," observed Neil Baum, MD, a New Orleans-based urologist. There are several reasons why a patient may snap at the physician. However, not every patient who displays anger has an identifiable "reason." Some people are easily irritable and don't restrain their anger in any aspect of their life. Still, it's up to the physician to diffuse or deal with that anger.

The "Dependent Clinger" - James E. Groves, MD, Associate Clinical Professor of Psychiatry, Harvard Medical School, Boston, Massachusetts coined the term "dependent clingers" to describe excessively needy patients who require endless attention and reassurance. They seem to regard themselves as having "bottomless needs" and the physician as being able to provide an inexhaustible stream of services.

An Impatient, Demanding Patient - "Physicians complain about patients who want their medications to bring an instantaneous cure. These patients call the office, screaming that their treatment isn't working," said Dennis Hursh, Esq, Founder and Managing Partner of Hursh and Hursh, PC, a Pennsylvania-based law firm specializing in physician-related legal issues. Some patients make unethical demands, such as asking for documentation supporting a disability claim when there is no disability, or opioid drugs when they are not truly experiencing pain, cautioned Hursh. In these situations too, explain to the patient that you are unable to fulfill their request. And be sure to document all of these discussions in the patient's chart.

"I'll Never Get Better! - Some patients remain perpetually ill, despite your best efforts -- not because their illness resists treatment, but because they reject medical interventions, believing that no treatment will help them, says Dr. Groves. They seem smug when they return to your office, time after time, complaining that your latest treatment has been useless. According to Dr. Groves, these patients are not seeking relief from illness but rather an "admission ticket" to a relationship with the physician that can exist only when the symptoms remain. Many of these patients are depressed, but typically they refuse to see a psychiatrist.

The Stubbornly Non-adherent Patient - When a patient disregards the necessary treatment regimen, a physician may begin to feel like a parent dealing with a rebellious teenager. Dr. Groves added, "I think there are 2 prongs to dealing with noncompliant patients. The doctor should decrease the expectation that all patients can be helped, and should look for ways to make small changes -- and keep looking. "The second is to realize that sometimes the best you can do is to keep the relationship going and trust that this alone is doing some good for the patient, at least in providing a humane environment," says Dr. Groves.

Latecomers, No-Shows, and Bill-Dodgers - "Patients who are always late, don't show up for appointments, or don't pay their bills are devastating to a practice," said Dennis Hursh. "If it happens repeatedly, you need to make it clear that your practice cannot tolerate it."

"When dealing with difficult patients, bear in mind that in the profession of medicine, we tend to see people at their worst, not at their best," Dr. Fortin commented. "We don't have to deny our own human needs, but we need to build skills that will help us treat even the most difficult people." Click here to read full story.



CMDA Past President Al Weir, MD: "Certainly, we have patients who cause us to groan a bit when we see them coming and we have those who surprise us with their anger or inappropriate behavior. We also care for patients who may behave appropriately but whose personalities grate against our own, simply because we view life differently.

“Some patients are more difficult to care for than others but none are less important. Just as we have cool drugs that put some malignancies into remission with a simple prescription, while other tumors require complex, multidisciplinary management, some patients are a cinch to deal with, while others require hard work. Whole person health is our business with the entire person package of disease, personality, education, income, spirit, relations and emotions. Just as there are skills to gain in order to manage disease, there are skills to gain that will help us manage these other aspects of patient care. We should seek to improve our performance in these areas through courses, literature and counsel with our mentors. We should develop support systems within our offices, using ancillary personnel to provide the additional time necessary to assist our difficult patients.

"And, as Christian doctors, we need to remind ourselves that Jesus did not die only for nice people. The foundation of our care for difficult patients should be the blood that flowed on Golgotha for difficult people like you and me."

CMDA Ethics Statement: Sharing Faith in Practice

Medical Devices that Dissolve in Your Body

Excerpted from "Scientists Create Tiny Medical Devices that Dissolve in Your Body," Time, by Malcolm Ritter. September 27, 2012--As consumers we want our electronic gadgets to be durable. But as patients, we might want them to dissolve — inside our bodies. Scientists reported Thursday that they succeeded in creating tiny medical devices sealed in silk cocoons that did the work they were designed for, then dissolved in the bodies of lab mice. It’s an early step in a technology that may hold promise, not only for medicine, but also for disposal of electronic waste.

Doctors already use implants that dispense drugs or provide electrical stimulation, but they don’t dissolve. The new work is aimed at making devices that do their jobs as long as needed and then just dissolved, without need for surgical removal or risk of long-term side effects. In the experiment, the devices — which look like tiny computer chips — were designed to generate heat, a potential strategy for fighting infection after surgery by killing germs, said John Rogers of the University of Illinois at Urbana-Champagne, an author of the study.

Someday for people, similar devices might be programmed to monitor the body and release drugs accordingly, or produce electric current to accelerate bone healing, Rogers said. The researchers used the protective cocoon envelope because silk can be processed to stay intact for varying periods of time — from seconds to weeks and potentially for years, he said. The device’s circuitry itself was built from other materials that degrade in the body, such as magnesium and silicon. Click here to read full story
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CMDA Member Thomas Eppes, MD: "The era of nanotechnology is quickly approaching. Studies such as the one discussed above show us that scientist and physicians may do many incredible and wonderful things in the future in the name of health. The future seems bright and endless.

“Where there is potential for good, just around the corner is potential for disaster. Each and every medicine, procedure, surgery and even counseling session has an equal opportunity to go ‘bad.’ One only has to look at the two countries that were leaders of the 1930s eugenics movement to see where misguided physicians can lead society. Whether it was racial purification in Nazi Germany or sterilizing those not worthy of parenting at the Central Virginia Training Center in Lynchburg, Virginia, physicians can do as much harm as good in the name of science.

“Our only hope is to have scientific research and efforts led by physicians who are grounded in ethics. The world believes in the moral neutrality of ethics which we are fortunate to realize is a myth. We are so fortunate that our Lord has given us a guide to ethics in His Scriptures. He has blessed us with an amazing capacity to use our brains in understanding His principles in living and changing this world. We must understand the infinite complexity of His creation, how it at times goes astray due to the sin in this now imperfect world, and what and how we can use our knowledge to do good to His glory, not ours. If we keep our sights set on His way and act as we perceive His will, then we will hear, ‘Well done, good and faithful servant’” (Matthew 25:23, NIV 1984).

CMDA Ethics Statement: Eugenics and Enhancement
History of Eugenics

Trafficking in the USA hits close to home

Excerpted from "Sex trafficking in the USA hits close to home," U.S.A. Today, by Yamiche Alcindor. September 27, 2012--Asia Graves looks straight ahead as she calmly recalls the night a man paid $200 on a Boston street to have sex with her. She was 16, homeless, and desperate for food, shelter and stability. He was the first of dozens of men who would buy her thin cashew-colored body from a human trafficker who exploited her vulnerabilities and made her a prisoner for years. "If we didn't call him daddy, he would slap us, beat us, choke us," said Graves, 24, of the man who organized the deals. "It's about love and thinking you're part of a family and a team. I couldn't leave because I thought he would kill me."

By day, she was a school girl who saw her family occasionally. At night, she became a slave to men who said they loved her and convinced her to trade her beauty for quick cash that they pocketed. Sold from Boston to Miami and back, Graves was one of thousands of young girls sexually exploited across the United States, often in plain sight. A plague more commonly associated with other countries has been taking young victims in the United States, one by one. Though the scope of the problem remains uncertain -- no national statistics for the number of U.S. victims exist -- the National Center for Missing and Exploited Children says at least 100,000 children across the country are trafficked each year.

Globally, the International Labor Organization estimates that about 20.9 million people are trafficked and that 22 percent of them are victims of forced sexual exploitation. The growing number of human trafficking cases handled by U.S. Attorney MacBride's office -- 14 in the last 18 months -- reflects the domestic trend, experts say. The familiar echo of these crimes reaches the other side of the country, too, says Alessandra Serano, an Assistant United States Attorney for the Southern District of California. "You can sell drugs once," she said. "You can sell a girl thousands of times."

Since 2006, the U.S. Department of Education has focused on the problem and worked on training with several schools, said Eve Birge, who works for the agency's Office of Safe and Healthy Students. In doing so, they collaborate with the White House, the FBI, the Departments of State and Justice as well as other agencies. "For a lot of these kids, school can be the only safe place they have," Birge said. Click here to read full article.

CMDA Member and Founder of Gracehaven, Jeff Barrows, DO: “When the average person hears the words ‘human trafficking,’ they first of all think of women and girls being sold for sex in other countries like Thailand or Cambodia. Most individuals don’t realize that trafficking is happening right here in the United States in every major city. The most common form of trafficking in the U.S. is child sex trafficking of minors under the age of 18. The story of Asia in this article is being repeated all across the United States in every state! Like Asia, most of these victims come out of abusive/neglected homes.

“While it is good that President Obama recently drew attention to this horrible plague, the announced $6 million grant program is hardly enough to have a significant impact on the tremendous need for specialized services. Currently there are less than 200 specialized beds for 100,000 victims of child sex trafficking. Physicians and dentists have a major role in identifying these victims while they are being trafficked. Some important identifiers mentioned in the article are:

• Signs of physical abuse
• Truancy
• Homeless youth
• Sudden ability to possess expensive items
• Older boyfriends or girlfriends
• Frequent travel

“In addition, physicians and dentists are needed to provide the medical and dental care these victims need after they are freed. CMDA has a Trafficking in Persons Task Force that is developing a 11-part human trafficking training curriculum that provides continuing education credit and can be found online here."

Human Trafficking Resource Page
Human Trafficking Continuing Education
Human Trafficking - Trade of Innocents Trailer

HHS mandate bypasses parents on contraceptives for children

Excerpted from "HHS mandate allows minors free contraception, sterilization," Catholic News Agency, Sep 25, 2012--Minor children on their parents’ health care plans will have free coverage of sterilization and contraception, including abortion-causing drugs, under the controversial HHS mandate – and depending on the state, they can obtain access without parental consent.

Matt Bowman, senior counsel for the religious liberty legal group Alliance Defending Freedom, said the mandate “tramples parental rights” because it requires them to “pay for and sponsor coverage of abortifacients, sterilization, contraception and education in favor of the same for their own children.”

The Department of Health and Human Services ruled in January 2012 that most employers who have 50 or more employees must provide the coverage as “preventive care” for “all women with reproductive capacity.” The mandate also requires the coverage for beneficiaries, including minors, on the affected health plans, Bowman told CNA Sept. 20. That means that a minor on her parents’ plan could be sterilized if she finds a doctor willing to perform the procedure.

“She can be sterilized at no cost,” Bowman stated. “Whether her parents will know and/or consent might differ by state. But the Guttmacher Institute and other abortion advocates explicitly advocated for this mandated coverage of minors so that access without parental involvement might be able to increase.”
The Guttmacher Institute, in a Sept. 1 briefing on state policies, said that an increase in minors’ access to reproductive health care over the last 30 years shows a broader recognition that “while parental involvement in minors’ health care decisions is desirable, many minors will not avail themselves of important services if they are forced to involve their parents.” The institute, the former research arm of abortion provider Planned Parenthood, said that 26 states and the District of Columbia allow all minors 12 years and older to consent to contraceptive services. At least one state, Oregon, allows 15-year-olds to consent to sterilization.

There are presently 30 lawsuits challenging the HHS mandate in federal court on religious freedom grounds.

Commentary

CMDA Executive Vice President Gene Rudd, MD: “'Beware of Greeks bearing gifts.'
"Sadly, in today’s society, we as parents have to warn our children to avoid adults who try to lure them into doing things that might be dangerous, even deadly. Stereotypically, it is the shady character on the street corner who invites your child to pet his dog or enjoy his candy.

"But what do we do when it is the government or an agency operating with government funds doing this? They also have an agenda, and they wish to entreat our children to take part in that agenda even when we as parents do not approve. And worse, our laws have morphed to make it legal! Yes, there are some differences between their agenda and that of a pedophile, but the outcomes can be just as destructive to the wellbeing of the child and the family.

"So now we must warn our children that adults serving in public positions, those with an element of authority over their lives, might also lure them into behavior contrary to their moral training and dangerous to their health. And as a more definitive step, we must take steps to reverse this social engineering.

"I realize there is an argument to be made for providing care for children in exceptional circumstances, but allowance for the exception has become the rule for all. We must now require our government leaders to scrap the onerous rule that allows for this (included in the Affordable Care Act) and replace it with healthcare reforms that do not undermine the family."