SCOTUS strikes "prostitution pledge" requirement for AIDS, human trafficking grants

Excerpted from "Supreme Court says law can’t dictate anti-AIDS groups’ speech, Washington Post, June 20, 2013 - The Supreme Court ruled Thursday, June 20 that it is a violation of the First Amendment for the federal government to force groups to endorse the government’s views opposing prostitution in order to receive funding to combat AIDS overseas. The justices ruled 6 to 2 that a requirement in a multibillion-dollar anti-AIDS program withholding money from organizations that do not have a policy “explicitly opposing prostitution and sex trafficking” violates their free-speech rights.
 
“This case is not about the government’s ability to enlist the assistance of those with whom it already agrees,” wrote Chief Justice John G. Roberts Jr. “It is about compelling a grant recipient to adopt a particular belief as a condition of funding.”

The provision at the center of the court’s ruling Thursday is of a 2003 law under which the United States is spending $60 billion to combat infectious diseases worldwide. It forbade any of the money being used to “promote or advocate the legalization or practice of prostitution or sex trafficking,” which are ways the diseases can be spread.

Justices Antonin Scalia and Clarence Thomas dissented. Scalia said the government was not coercing speech but simply acquiring partners who share its beliefs.

“The First Amendment does not mandate a viewpoint-neutral government,” Scalia wrote. “The government may enlist the assistance of those who believe in its ideas to carry them to fruition; and it need not enlist for that purpose those who oppose or do not support the ideas. That seems to me a matter of the most common sense.”

Commentary

CMA Vice President for Government Relations Jonathan Imbody: "Some colleagues who focus on religious liberty issues had filed briefs opposing the 'prostitution pledge' provision. They reasoned that its allowance would let the government unconstitutionally dictate the ideological views of any organization that receives government funding. These groups understandably feared strengthening the Obama administration's attacks on religious liberty, buttressing local governments' attacks on pregnancy centers through speech requirements, and squeezing out campus student groups that decline to conform to university dogma on social issues.

"Other religious liberty colleagues, such as the American Center for Law and Justice, reasoned--rightly, in my view--that requiring grantees to supply proof of opposition to prostitution was an eminently reasonable requirement to further the goals of a government health program that hinges on stopping prostitution. The anti-prostitution requirement in this view, does not restrict the free speech of anyone--it just keeps the government from paying for speech opposed to the goals of this particular program, which provides funding on a completely voluntary basis.

"Whatever one might conclude regarding the theoretical impact of this case on religious liberty, what remains undeniable and real are the immediate harms, from a pro-life, anti-trafficking and anti-AIDS perspective, that result from this ruling:

• more money to groups that see prostitution as legitimate 'sex work' rather than as an evil to be eradicated--including pro-abortion and pornography groups (like DKT International, which had filed a similar suit);
  
  
• a blow to efforts to eradicate prostitution, along with prostitution's threat to public health and its degradation of and violence against women and children;
  
  
• the prospect of yet more forced and elective abortions, resulting from relying on condom distribution programs and unionization of prostituted women and children rather than rescuing them out of sex trafficking and other forms of prostitution."

Resources
Read the complete CMA/Freedom2Care blog posting on the decision
Continuing Education for Human Trafficking - A Primer for the Healthcare Professional
Prostitution pledge sign on letter to President Bush

High court rules on two cases on same-sex marriage

Excerpted from "Supreme Court strikes down Defense of Marriage Act," Washington Post, June 26, 2013--The Supreme Court on Wednesday struck down as unconstitutional the 1996 Defense of Marriage Act that denies federal benefits to same-sex couples who are legally married in the states where they reside. The decision was 5 to 4, with Justice Anthony M. Kennedy joining the court’s liberals to form the majority. It did not address the question of whether there was a constitutional right to same-sex marriages.

Excerpted from "Supreme Court clears way for same-sex marriage in California," Washington Post, June 26, 2013 - The Supreme Court cleared the way Wednesday for same-sex marriages in California, declining to rule on the state’s Proposition 8, which defined marriage as between one man and one woman. The court ruled 5 to 4 that those who appealed a decision throwing out the constitutional amendment did not have legal standing to proceed. Thus, the Supreme Court did not rule on the merits of the case.

Commentary

CMDA CEO David Stevens, MD, MA (Ethics): (excerpted from CMA news release): "We as doctors have long recognized that the most important function of marriage is to protect the needs of children--not simply to fulfill the emotional desires of adults.

"The best research shows that children consistently experience the most positive outcomes with a mom and a dad and too often experience negative outcomes in same-sex households¹. When some research has attempted to convince us otherwise, rigorous examination of those studies has uncovered fatal research flaws, most likely the result of presuppositions and political agendas that undermined objectivity².

"Some activists, both in the courts and in public policy, appear intent on forcing people of faith to bow to a new and radical viewpoint that ignores our faith convictions and the testimony of millennia regarding marriage. Such pressure inevitably threatens religious freedom, as same-sex relationship advocates insist that conformity to their ideology trumps First Amendment speech, religious liberty and conscience freedoms.

"The Supreme Court failed to recognize that 'We the people' should decide marriage policy. Activist judges with an agenda have been foisting their views on the people--based not on the original Constitution or the duly registered will of the people--but on what these judges imagine their progressive society should look like. Yet 38 states have affirmed that marriage is between a man and a woman. Regardless of this Court's decision, the debate on marriage will continue.

"We will continue to advocate for marriage and the children protected by marriage."

_______________________________________________

1. Thus, it is not simply the presence of two parents, as some have assumed, but the presence of two biological parents that seems to support child development (Child Trends Research Brief after reviewing the literature, June 2002). “Most researchers now agree that together, these studies support the notion that, on average, children do best when raised by their two married biological parents” (Center for Law and Social Policy, May, 2003).

2. Lerner, Robert, Ph.D and Nagai, Althea K., Ph.D. “No Basis: What the Studies Don’t Tell Us About Same-Sex Parenting.”Marriage Law Project, Washington DC. January 2001. “Lerner and Nagai, professionals in the field of quantitative analysis, evaluated 49 empirical studies on same-sex parenting. Lerner and Nagai found at least one fatal research flaw in all of the 49 studies.

Resources
Read full CMA news release
http://www.scotusblog.com
Supreme Court’s Mixed Decision on Marriage - Heritage Foundation
Marriage Matters - Alliance Defending Freedom
CMDA Ethics Statement: Homosexuality
Same-Sex Marriage--Have the Best Interests of Children Been Considered?

I gave up on healthcare in America

Excerpted from “Doctor: 'I gave up on healthcare in America',” CNN, by Parija Kavilanz. April 26, 2013 -- It was time to quit. On August 19, 2011, Snyder sold his practice to a local hospital 30 miles away. "I gave up on healthcare in America," he said. Later that year, he moved to Australia and took up rural medicine there. The choice was heart-wrenching for Snyder. He didn't want to feel like he was abandoning his nearly 5,000 patients, and he'd been the only family physician in the area for 16 years. "I wasn't just a doctor there, I was part of this community," he said.


Snyder's decision to leave was years in the making, but Snyder wasn't ready to give up being a rural doctor, though. "It's what I loved to do," he said. Disillusioned with how healthcare had evolved, and how stressful and expensive it had become to be in private practice in the U.S., Snyder began to explore opportunities to work abroad as a "locum tenens," or freelance doctor. The work was strenuous and challenging personally and professionally, said Snyder. He traveled a lot and was away from home every other week. He couldn't easily refer patients to specialists, because there weren't many practicing in rural towns around Adelaide. Lack of medical technology was another challenge. "Here you don't have an MRI or CAT scan facility at every corner," he said.

Still, Snyder embraced the experience in a country where he said the locals were welcoming and "loved my accent." "Primary care is highly respected here. That's not the case anymore in America," said Snyder. "In the United States, healthcare has become more about the business of making money. The personal side of medicine is going away." In fact, Snyder said he wouldn't be surprised if more primary care doctors in the U.S. look for opportunities elsewhere. His own contract expires at the end of June but he's renewing it for another two years. Would he consider moving back at some point? If he could get the benefits he does in Australia back at home, he said, "I'd still be working in America." Full story can be found here.

Commentary

Director of CMDA Placement Services Allan Vicars: "Over the last few years, we have witnessed a reduction in the number of independent private practices throughout the U.S. Many of them simply cannot compete with their local hospital systems and eventually sell their practices to larger entities. Due to declining Medicare reimbursements and reporting requirements, healthcare reform, overhead costs, declining patient visits, recruitment and retention of physicians, along with medical liability pressures, many physicians such as Dr. Snyder feel they have no other options.


"While many feel medicine has migrated more towards making a profit, our office still assists many independent practices that are financially stable and thriving. The conservation of private practices in the U.S. is extremely important as they provide physicians autonomy to practice as they choose. From our experience, integration of faith and medicine is much more prevalent in private practices compared to those owned and operated by hospital systems.

"One has the ability to set their own hours, philosophy of care and the amount of time spent with each patient. A constant dilemma for most healthcare providers is the desire to spend more time with patients. Most physicians enter into medicine to be in their own practice and that is what makes them happy. Many seek employed opportunities due to economic factors or heavy debt. Physicians need to look inside themselves and ask if they will be happy and if this is where the Lord is leading them. Physicians should be encouraged to continue in private practice and seek avenues, policies and financially viable options, such as IPAs, that will assist them to remain independent and thriving."

CMDA Placement Services
Medical Opportunities
Dental Opportunities
Administrative Opportunities

Genetic Database and Genetic Privacy

Excerpted from “Accord Aims to Create Trove of Genetic Data,” The New York Times, by Gina Kolata. June 5, 2013 -- More than 70 medical, research and advocacy organizations active in 41 countries and including the National Institutes of Health announced Wednesday that they had agreed to create an organized way to share genetic and clinical information. Their aim is to put the vast and growing trove of data on genetic variations and health into databases — with the consent of the study subjects — that would be open to researchers and doctors all over the world, not just to those who created them. Millions more people are expected to get their genes decoded in coming years, and the fear is that this avalanche of genetic and clinical data about people and how they respond to treatments will be hopelessly fragmented and impede the advance of medical science. This ambitious effort hopes to standardize the data and make them widely available.


In just the past few years, the price of determining the sequence of genetic letters that make up human DNA has dropped a million fold, said Dr. David Altshuler, deputy director and chief academic officer at the Broad Institute of Harvard and M.I.T. As a result, instead of having access to just a few human genomes — the complete genetic material of a person, including genes and regions that control genes — researchers can now study tens of thousands of them, along with clinical data on peoples’ health and how they fared on various treatments. “The question is whether and how we make it possible to learn from these data as they grow, in a manner that respects the autonomy and privacy choices of each participant,” he said. No one wants to put DNA sequences and clinical data on the Internet without the permission of patients, he said, so it also is important to allow people to decide if they want their data — with no names or obvious identifiers attached — to be available to researchers. But there are no agreed-upon standards for representing genetic data or sharing them, experts say. And there are no common procedures for assuring that patients consent to sharing their information.

Dr. Francis Collins said that cancers are so genetically complex that, most of the time, a mutation seen in a cancer patient will be uncommon. To figure out its significance, data from hundreds of thousands of patients — the world’s collected data — on that mutation are needed. Pooled data are also needed to understand mutations that lead to rare diseases in children, Dr. Altshuler said. A disease might occur in one in 1,000 or one in 100,000 babies, he said. A medical center might never see a child with that disease, or might see just one. “Since everyone sees zero or one, no one ever learns,” Dr. Altshuler said.

Over the past couple of years, genetics researchers puzzled over the data-sharing problem, seeing it as central to making progress. On Jan. 28, 50 leading researchers from eight countries met and agreed on the need for a global alliance. The group, which included ethicists and disease advocates, stressed that because individual study subjects had to be able to decide whether to share their genetic and clinical information, the system for data sharing had to include ways to track and manage these permissions. The group wrote a white paper and a letter of intent that has now been endorsed by an ever-growing international group. “For us, this is a gratifying development,” Dr. Collins said. Full story can be found here.

Commentary

CMDA Member and Senior Fellow for Family Research Council David Prentice, PhD: "This is a very promising development in regards to moving ahead in genetic diagnosis and even treatments for a number of conditions, but as researchers move forward, there are significant problems that will be faced in maintaining genetic privacy and providing adequate informed consent. The potential for advances in diagnosis and treatment is tremendous. Large data sets are important for determining many genetic correlations, and rapid access to a large genetic database could speed discoveries. One hurdle to overcome will be development of standard formats for presenting genetic data. But a much bigger and very serious hurdle will be developing standards that maintain genetic privacy and anonymity, as well as providing full informed consent for anyone who agrees to participate in genetic studies and clinical testing.

"Such assurances will also be important in recruiting people for genetic studies, and as more genetic correlations are developed not only for diseases but for non-disease traits. The ability to identify someone based only on their DNA sequence and current public databases has already been demonstrated, so it is critical that privacy standards and even masking protocols be firmly in place before genetic information is made public. It will also be incumbent on those who develop and implement such standards that professionals and the public alike be aware of the real limits of genetics and genetic correlations. We are fearfully and wonderfully made, but that also means we are so much more than merely our DNA!

"Identifying Your Name Using Your DNA, http://frcblog.com/2013/01/identifying-your-name-using-your-dna/."

CMDA Ethics Statement: Use of Genetic Information and Technology
A History of Eugenics
Standards4Life: Human Genome

Senator: International health advances American values and interests

Excerpted from "Sen. Graham Urges Religious Groups to Rally Support for Foreign Aid to Combat AIDS," Christian Post, May 15, 2013 - The U.S. government program that helps treat and prevent AIDS in foreign countries is threatened by budget cuts, Sen. Lindsey Graham (R-S.C.) warned Tuesday. He urged faith-based organizations to increase their efforts at rallying support for the program.

"You're going to have to up your game because pressures exist today unlike any time in politics," Graham said at a Washington, D.C. event co-hosted by a number of organizations that have worked together to fight AIDS around the world, including World Relief, World Vision, Pan African Christian AIDS Network, UNICEF and the United Methodist Church.

Foreign aid is only about 1 percent of the budget and not the cause of the nation's budget woes. For this reason, Graham believes it is important for faith groups to let their congressional representatives know they will stand behind them, or "provide a safety net," if they do not cut foreign aid programs to fight AIDS.

"In my state, the evangelical Christian community, the church community, the faith community is listened to," Graham said.

The primary federal program for AIDS relief is The President's Emergency Plan for AIDS Relief, or PEPFAR. It was first passed under President George W. Bush with bipartisan support and continues under President Barack Obama.

Graham also argued that foreign aid benefits national security by building allies abroad and rooting out the suffering that terrorist organizations use as a recruiting tool. Graham also believes that PEPFAR has used taxpayer dollars wisely; 67,000 people received treatment for AIDS in 2004, Graham said, and now over 5 million people are getting treatment through the program.

"This is a smart investment," Graham said. "We're building friends and allies for the future. We're doing the right thing. God will stand with us as long as we stand with Him."

Commentary

CMA Vice President for Govt. Relations Jonathan Imbody: "CMDA CEO Dr. David Stevens accompanied Senator Graham in 2012 to meet with then-Secretary of State Hillary Clinton to discuss strategies on continuing international health aid in the midst of a struggling economy. I've also been working with Senator Graham on this issue and attended the above-mentioned event at a U.S. Senate office building celebrating 10 years of PEPFAR's success in fighting AIDS and treating patients.

"When the program called for us all to join in singing 'Amazing Grace,' I jokingly wondered to a colleague next to me if the Capitol police might storm the meeting and carry us out in handcuffs, citing an imagined church-state violation. But that didn't happen, and the remarkable coalition of faith community leaders, AIDS activists, Republican politicians and Obama administration officials gathered there focused on the common ground and goals we all share in pursuing healing and hope for AIDS patients.

"Several statistics demonstrate the basis for such co-belligerence ('waging of a war in cooperation against a common enemy without a formal treaty of military alliance')--a phrase applied by Christian philosopher Francis Schaeffer to alliances of Christians and others for a shared purpose.

• The World Health Organization released a report revealing that between 30 percent and 70 percent of the health infrastructure in Africa is currently owned by faith-based organizations.¹
  
  
• The Gallup World Poll asked sub-Saharan Africans in 19 countries about their confidence in eight social and political institutions. Overall across the continent, they were most likely to say they were confident in the religious organizations (76 percent) in their countries.²

"Thankfully, even administrations antagonistic to many of our public policy positions recognize this strength and continue to work with the faith community in the fight to eradicate disease and minister to patients overseas."

1. "Faith-based organizations play a major role in HIV/AIDS care and treatment in sub-Saharan Africa," February 8, 2007: http://www.who.int/mediacentre/news/notes/2007/np05/en/index.html.
2. Gallup Poll, "Africans' Confidence in Institutions -- Which Country Stands Out?" January 18, 2007: http://www.gallupworldpoll.com/content/?ci=26176.

US bill would ban late-term abortions

Excerpted from "GOP Rep. Franks to offer late-term abortion ban following Gosnell case," The Hill, May 17, 2013 - Rep. Trent Franks (R-Ariz.) will offer a bill to ban late-term abortions in response to the gruesome case of Kermit Gosnell, an abortion provider recently convicted of killing three viable infants. Franks announced Friday that he will revise his measure banning late-term procedures in the District of Columbia to apply to the nation as a whole. The bill will criminalize abortion after 20 weeks of pregnancy based on the disputed premise that fetuses can feel pain at that stage.

In a statement, Franks compared late-term abortions to Gosnell's killing of three infants born alive after failed abortion procedures. The conviction took place Monday. The case, notable for its grisly details, received attention from congressional Republicans starting in late April. Greater media coverage followed after the GOP accused journalists of avoiding a difficult story about abortion.

Commentary

Rep. Trent Franks (R-Ariz.): [excerpted from news release]: "I know when the subject is related in any way to abortion, the doors of reason and human compassion in our minds and hearts often close, and the humanity of the unborn can no longer be seen. But I pray we can at least come together to agree that we can and should draw the line at the point that these innocent babies can feel the excruciating pain of these brutal procedures.

"The case of Kermit Gosnell shocked the sensibilities of millions of Americans. However, the crushing fact is that abortions on babies just like the ones killed by Kermit Gosnell have been happening hundreds of times per day, every single day, for the past 40 years. Indeed, let us not forget that, had Kermit Gosnell dismembered these babies before they had traveled down the birth canal only moments earlier, he would have, in many places nationwide, been performing an entirely legal procedure. If America truly understands that horrifying reality, hearts and laws will change.

"To this end, I have re-introduced the D.C. Pain Capable Unborn Protection Act, which will now be amended to broaden its coverage so that its provisions will apply nationwide.

"Knowingly subjecting our innocent unborn children to dismemberment in the womb, particularly when they have developed to the point that they can feel excruciating pain every terrible moment leading up to their undeserved deaths, belies everything America was called to be. This is not who we are."

Action
Use our easy, pre-written form to tell your US Rep. to support the Pain Capable Unborn Child Protection Act” (H.R. 1797).

Congress investigates abortion clinics; Congressman gets personal

Excerpted from "Life Depends on the Choice" National Review Online, May 20, 2013 - "I can’t imagine how scared my mom must have been and how alone she felt,” Marlin Stutzman, a congressman from Indiana, would later comment. After he heard about Dr. Kermit Gosnell, he did what congressmen do: He went to the House floor, where he pleaded with the media to cover the case of the since-convicted Philadelphia abortion doctor, whose filthy clinic has exposed the right to abortion as the right to a dead baby, a right that emanates from the penumbras of Roe v. Wade.
“I went to the floor because innocent life is worth defending,” Stutzman tells me. “A monster in Philadelphia — not halfway around the world — murdered newborn babies, preyed on vulnerable women, and stuffed bodies and body parts into the freezer in boxes, bags, and cat-food tins.” The Gosnell trial “should have been front-page news across the nation,” but the mainstream media were largely ignoring it. “The American people deserved to know the truth about it, and I was seeking to raise awareness,” he says. Abortion is such a grave, ugly reality. We mask it “behind convenient euphemisms like ‘choice’ and ‘safe, legal, and rare’ instead of taking a hard look at what abortion really is,” Stutzman observes. “The Gosnell case stripped away all those euphemisms and showed that abortion isn’t safe and it isn’t rare.”

But that day in April when the second-term congressman went to the House floor to talk about Gosnell, he had no idea how personal an issue this was for him. When he phoned his mother a few days later, he learned that she was trying to figure out how to get to an abortion clinic when she was pregnant with him in 1975.

“I could never imagine how this case would change my own life,” Stutzman tells me. “When my mom told me her story — how her house had just burned down, how she was alone and terrified, and how she wanted to find a way to make it 40 miles to get an abortion but couldn’t — we both cried.”

“I can’t help wondering what would have happened if there was a Gosnell clinic four miles away instead of 40,” he reflects. “How many fathers, wives, teachers, doctors and public servants are missing today because of abortion?”

“We have to stand for life, for babies and for young women like my mom,” Stutzman says. “While Planned Parenthood talks about ‘choice,’ the sad reality is that the abortion business depends on women who feel like they don’t have another option. We need to show compassionate action and offer help to the women who find themselves in an unimaginably hard situation.”

And in the wake of the Gosnell verdict we cannot be satisfied with moving on or even simply knowing that Congress has now sent out fact-finding letters to state attorneys generals and health officials for the purpose of investigating what’s happening in abortion clinics across the nation.

Commentary

CMDA CEO David Stevens, MD, MA (Ethics): "Abortion clinics are the most unregulated industry in the U.S. Most do not have doors wide enough to get a stretcher through in an emergency, lack resuscitation equipment and don’t get true informed consent. The doctors doing the abortions fail to follow up with their patients or take care of their complications. Women have no choice – they put their life in danger when they walk into an abortion clinic. Abortion federations are complicit in what happened at Gosnell’s clinic. They resist and attack anyone who advocates regulating or inspecting abortion clinics. The many red flags over decades should have brought greater scrutiny to Gosnell’s activities.

• The clinic was given approval to open in 1979, but there was no inspection by the Pennsylvania Department of Health until 1989. They found no trained nurses and multiple other violations but left with only Gosnell’s promise to rectify them.
  
• They didn’t visit again for three years and found all the same problems … and again let his practice continue.
  
• In 1993, the Pa. Dept. of Health instituted a policy of no inspection of abortion clinics unless there was a complaint. They feared a reduction in abortion clinics in the state.
  
• In 1996, a complaint was filed due to a perforated uterus. No action taken.
  
• In 1997, Dr. Schwartz, head of adolescent services at Children’s Hospital, hand-delivered a complaint that contended that patients referred to Gosnell’s clinic were contracting Trichomoniasis due to unsterilized instruments. No action taken.
  
• In 2002, a former employee complained of anesthesia administrated by unlicensed personnel, flea-infested cats roaming the clinic, a broken autoclave and re-used disposable instruments. Gosnell also reportedly ate his lunch in the procedure rooms. No action taken.
  
• Later that year, a patient died from a perforated uterus and septicemia, resulting in a $900,000 civil settlement. No action taken.
  
• In 2003, a complaint contended that aborted fetuses were stored in paper bags. No action taken.
  
• A total of 46 lawsuits were filed against Gosnell over 32 years.

"Planned Parenthood abandoned their early tack of defending the indefensible Gosnell and instead claimed he was an aberration and should be punished. The truth is that there are probably replications of Gosnell-like horrors all across the country, but many abortion rights advocates likely do not want them to be revealed. Until such revelations translate into action, one of the most dangerous things a pregnant woman can do is to walk into an abortion clinic."


Resources

• View the acclaimed documentary, "3801 Lancaster," on the Gosnell clinic.
  
• Read CMA-led strategy paper on abortion clinic health and safety regulation (members only).
  
• Read the House Judiciary Committee letter to state attorneys general asking questions about efforts to protect the civil rights of newborns and their mothers. Read related Judiciary Committee press release.
  
• Read the House Energy and Commerce Committee letter to state public health asking questions about the licensing and monitoring of abortion clinics.

Action

1. Write your state representatives and encourage them to introduce women's health and safety clinic regulation bills similar to the Americans United for Life model legislation.
   
2. Consider how you can influence your medical specialty college (if specialty is appropriate) or state medical board to advocate for enactment and enforcement of health and safety standards in abortion clinics. Read and share model legislation.
   
3. To protect your right to decline to participate in abortions, click on our Freedom2Care legislative action alert H.R. 940, the Health Care Conscience Rights Act. You will be provided with an easy-to-use, prewritten editable form letter and also more detail on the bill.