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Tuesday, February 21, 2017

"Donald Trump got elected and now I don't know what to think"

If that statement describes how you feel, you are a member of a large group of Americans who neither enthusiastically support nor disgustedly oppose the new administration. You land somewhere between "Not My President" and "Make America Great Again."
The brief suggestions below aim to help you process what's happened, what's happening and what you can do about it all.

Understanding how Trump got elected

Mr. Trump's campaign also focused on an
electoral college strategy that hinged on
turning red a few key purple states
First, we need to understand that President Trump got elected because his populist message and blunt communication style resonated with a broad swath of Americans who have grown sick and tired of politics as usual and who have felt alienated by the people and policies of Washington, DC.
Mr. Trump's campaign also focused on an electoral college strategy that hinged on turning red a few key purple states (those that vacillate between voting Red Republican and Blue Democrat). To nearly everyone's surprise, that long-shot strategy worked.
The strategy worked in part because Hillary Clinton fatefully considered several swing states "in the bag" and devoted little time there, and in part because Donald Trump appealed to many of the American workers and traditional values citizens of those states.
Anyone who protests that Hillary Clinton's winning the popular vote means that Trump is an illegitimate president either does not appreciate the genius of our democratic republic, which designed the Electoral College to protect smaller states from political domination by larger states, or does not understand that every campaign focuses on the Electoral College--not on the popular vote. Otherwise, every campaign would be fought and won largely in New York City, Chicago and Los Angeles.

Appreciating limited government and checks and balances

Our founders and Constitution
designed government with a small "g."
The day after the election, Americans woke up either with a sense of exhilaration, intense panic or just plain wonder.
Some Trump opponents thought, "Those crazy voters have thrown a living grenade into our government; it's the end of America as we know it!" I suspect that many of these people felt that way because they tend to view government—not the family, not the Church, not the local community--as the primary vehicle for social change. So a political loss in the Government (with a big "G") effectively spells the end of their agenda.
People who look to Government to solve problems probably also tend to prefer a very powerful government, especially at the federal level, to effect sweeping, instantaneous changes. Examples of such change include the Roe v. Wade 1973 abortion Supreme Court decision, the Affordable Care Act (Obamacare), the Obamacare contraceptives mandate and the Obergefell same-sex marriage Supreme Court decision.
Our founders and Constitution, however, designed government with a small "g." They designed a limited government that reserves maximum power to the people, a deliberately cumbersome system that makes sweeping change difficult.
That realization should help hyperventilating Trump opponents breathe a significant sigh of relief. Ironically, the small government system that Big Government advocates have been trying to dismantle is actually the very system that will protect them from any tyranny they now fear.
A few recent examples of how our small government, checks and balances system works to control executive power:
·         President Trump's nominee for Secretary of Labor recent had to withdraw due to a lack of support in the U.S. Senate, which must approve such cabinet selections.
·         Federal courts recently put the kibosh on the executive order on immigration.
·         The future of Obamacare and healthcare will be determined by a compromise of interests and strategies in Congress and the Executive Office.
Any law will be crafted to pass constitutional muster with the courts. The people also will wield tremendous political power of persuasion through First Amendment advocacy, which forbids the government from abridging "freedom of speech, or of the press, or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."

Realizing that thousands of good people will run the new government

The Chief Executive determines broad policies,
but people scattered throughout
federal agencies make the government run
Besides the luminaries you many have seen on TV entering and exiting the golden elevator doors at Trump Tower for interviews for cabinet-level positions, the new administration likely will be filled with thousands of people who share the founder's vision for a limited government, who share the pro-life, pro-family views espoused by the major faiths and who share a dedication to pursue policies that provide for all Americans to prosper personally, economically and socially.
I personally know—perhaps you do, too--some esteemed friends and colleagues who already have taken top slots in the Trump administration. I am working with the administration and other organizations to get other good people into some of the over 4,000 presidentially determined jobs in this administration.
The Chief Executive determines broad policies, but these people scattered throughout federal agencies make the government run. They flesh out laws through detailed regulations. They write the aims and guidelines for grants that fund the work of nonprofit charities and organizations across the country. And they develop the pragmatic policies and programs that help our children learn, ensure that patients receive good healthcare and assist in feeding the poor and housing the homeless.

Watching the Supreme Court

The Gorsuch nomination provides significant reassurance
that the Supreme Court will be guided more by the rule of law.
Currently the Supreme Court appears divided into distinct groups according to judicial philosophy: (a) Justices Breyer, Ginsburg, Sotomayor, Kagan, who tend to see the Constitution as a "living document" that can be shaped and changed according to the Court's modern interpretation and desired outcomes; (b) Justices Thomas, Alito and Roberts, "originalist" judges who see the Constitution as written law to be understood and applied through its original context and wording; and, (c) Justice Kennedy, the swing voter whom the other two groups constantly try to convince to join in their opinions.
Candidate Trump during the campaign wisely proffered a list of 21 potential Supreme Court nominees. The Heritage Foundation and the Federalist Society, two groups favoring the "originalist" judicial philosophy, helped assemble the distinguished list. Possibly more than any other issue, this list of Supreme Court candidates may have convinced enough voters on the fence to cast their vote for and help elect Donald Trump president.
From this list, President Trump has nominated Judge Neil Gorsuch, an originalist in the mold of the late Justice Antonin Scalia, whom Gorsuch would replace. This nomination provides significant reassurance that the Supreme Court will be guided more by the rule of law, which protects everyone equally, than by ideology, which favors only those who support the ideology.

Too early to call, but not too early to help

These three factors should provide great comfort and reassurance to people of faith, to social conservatives and to believers in the American experiment:
1.      The limited government checks and balances built into the American system.
2.      Thousands of pro-life, pro-family individuals who will fill the administration and direct the inner workings of government.
3.      Originalist appointments to the Supreme Court.
As of this writing, the Trump administration is just a month into governing and already has made some strides and some mistakes. The normal course of any administration is a rocky start followed by greater calm and competence. It's too early to call.
The extent to which the administration advances policies and achieves results that better our own lives and the lives of others around the world does not just depend on one man. It depends upon all of us, advocating for good policies, demanding accountability and supporting our elected leaders with respect for their offices and with prayer.
Check out the "Plum Book" for positions in the adminitration:
https://m.gpo.gov/plumbook/
Like it or not, and notwithstanding the rhetoric of rebellion, we're all in this together. So take time to write to your legislators and executives, to talk with your neighbors and colleagues about policy issues and even to consider joining the government on the front lines.

Monday, February 13, 2017

10 reasons to kill DC's assisted suicide law before it kills vulnerable patients

By Jonathan Imbody[i]
Eleven members of the District of Columbia Council decided in November 2016 to legalize assisted suicide, paving the way to providing DC citizens with lethal pills to kill themselves. Because assisted suicide represents a deadly danger to vulnerable patients, to the medical profession and to society, Congress is moving to overturn the DC law through a disapproval measure—a seldom-exercised authority but an imperative action with lives at risk.
The following ten reasons, based upon medical research and the testimony of vulnerable patients, illustrate why governments must focus on compassionate care rather than lethal "solutions."

1.  Patients already have the ability to decline extraordinary measures that only prolong death, and to receive aggressive pain relief and palliative care. 

The law and medical practice have long provided for the ceasing of extraordinary measures for patients that simply prolong death. Much progress has been made in pain control technology and in recognizing the value of aggressive pain control—including when it has the secondary, unintended effect of hastening death. Palliative care offers compassionate and effective comfort to patients in their last days, as well as the support of loved ones.
In fact, such progress in recognizing the time for natural death, in aggressively treating pain and in providing compassionate palliative care is strong evidence that make legalizing assisted suicide even less reasonable. Yet still more progress can be made in the legal arena regarding aggressive pain control; this was in part the impetus for the bipartisan bill introduced in 1999 by Senators Nickles and Lieberman, the Pain Relief Promotion Act.
As the American College of Physicians and American Society of Internal Medicine have observed, “We must solve the real and pressing problems of inadequate care, not avoid them through solutions such as physician-assisted suicide. A broad right to physician-assisted suicide could undermine efforts to marshal the needed resources, and the will, to ensure humane and dignified care for all persons facing terminal illness or severe disability.”[ii]

2.    Doctors cannot accurately predict life expectancy.

The DC assisted suicide measure criteria hinges on a physician's prediction of life expectancy:
"Terminal disease" means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, result in death within 6 months.
Yet research has shown that when it comes to predicting life expectancy, "reasonable medical judgment" is usually wrong.
A 2012 study of such predictions related to prostate cancer patients found, "Overall, respondents were within 1 year of actual life expectancy only 15.9% of the time; on average, respondents were 67.4% inaccurate in relation to actual survival."[iii]
Such dismal prediction rates led researchers to conclude, "Physicians do poorly at predicting life expectancy and tend to underestimate how long patients have left to live. This overall inaccuracy raises the question of whether physicians should refine screening and treatment criteria, find a better proxy or dispose of the criteria altogether."

3.    Doctors all too frequently misdiagnose illnesses.

The DC assisted suicide measure does not require an autopsy, so exactly how many patients choose assisted suicide as a result of a misdiagnosis or inaccurate prediction of how long they have to live will remain uncertain. But research suggests the number will be significant.
A research study published in April 2014 found that doctors' "diagnostic errors affect at least 1 in 20 US adults." [iv]

4.    Assisted suicide encourages judgment of the disabled as "life unworthy of life."

Members of the disability-rights group Not Dead Yet strongly opposes legalizing assisted suicide because it encourages and facilitates the devaluing of their lives:
[I]t cannot be seriously maintained that assisted suicide laws can or do limit assisted suicide to people who are imminently dying, and voluntarily request and consume a lethal dose, free of inappropriate pressures from family or society. Rather, assisted suicide laws ensure legal immunity for physicians who already devalue the lives of older and disabled people and have significant economic incentives to at least agree with their suicides, if not encourage them, or worse.[v]
The idea of ridding society of the vulnerable, including the disabled, has a long and sordid history. One reason why the school of Hippocrates gained ascendancy in ancient times is that before Hippocratic protections, physicians possessed the fearful power of poisoning their patients. Undergirding this poisonous power was the notion, expressed by Plato, that "Mentally and physically ill persons should be left to death; they do not have the right to live."
Centuries later, the Nazis revived this deadly outlook on the disabled, dismissing the values of such individuals as "life unworthy of life" ("Lebensunwertes Leben"). Today this lethal, utilitarian judgment of life as unworthy of life seeks new roots in the capital of the United States, in the process sending a chilling message to the disabled and other vulnerable patient communities. As a national capital that is viewed as a symbol of American values, assisted suicide sends this chilling message worldwide.

5.    Empowering doctors to kill disempowers patients.

Once policy makers in the Netherlands and Belgium discarded the Hippocratic ethic in favor of assisted suicide and euthanasia, the dike of patient protections broke and a sea of medical killing swept in.
A report published in a 2011 edition of the journal Current Oncology,[vi] entitled, “Legalizing Euthanasia or Assisted Suicide: The Illusion of Safeguards and Controls,” revealed that in the Netherlands, “For every five people euthanized, one is euthanized without having given explicit consent.” The report also noted, “In Belgium, the rate of involuntary and non-voluntary euthanasia deaths (that is, without explicit consent) is three times higher than it is in the Netherlands."
Testimony before the US Senate Committee on the Judiciary Subcommittee on the Constitution, Civil Rights and Property Rights included personal stories from the Netherlands that illustrate how doctors can become determined to carry out medical killing regardless of patients' wishes.
The testimony relates how an old Dutch sailor, as a doctor administered a sedative to prepare for his euthanasia, sat up in bed exclaiming, "I don't want to die!" The doctor coolly proceeded with the second lethal shot that took his life away.[vii]

6.    Financial and personal pressures create a "duty to die."

The dangerous power of judging lives as unworthy does not come into effect only when physicians or politicians inflict on victims their power to kill with impunity; it can also insidiously infect patients' self-perception and lead to voluntary deaths. "Maybe my life really is not worth living. Maybe I really am a burden to my loved ones and to society. Maybe I owe it to everyone to kill myself."
The DC assisted suicide measure turns the movie, "It's a Wonderful Life," on its head, by actually facilitating suicide—voluntary or coerced—as a way to cash in on life insurance funds:
The sale, procurement, or issuance of any life, health, accident insurance … may not be conditioned upon or affected by the making or rescinding of a qualified patient's request for a covered medication.
Former US Surgeon General Dr. C. Everett Koop personally observed many, especially elderly, patients who felt a sense of what Dr. Koop came to identify as a "duty to die."
In 1985, Dr. Koop prophetically noted regarding assisted suicide, "Two other forces are now at the crossroads: the decline of medical ethics and the push for health cost containment."[viii]
When cash-strapped governments condone and legalize suicide, it is hard for patients to escape the sense that as far as the government is concerned, suicide is a cost-saving preferred option. Media have reported on instances of government payers favoring assisted suicide over paying for patient care. One such patient, Randy Stroup, found out that Oregon's assisted suicide law provides a powerful incentive for government and other payers to save on end-of-life care:
Since the spread of his prostate cancer, 53-year-old Randy Stroup of Dexter, Ore., has been in a fight for his life. Uninsured and unable to pay for expensive chemotherapy, he applied to Oregon's state-run health plan for help. Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup's request with a letter saying the state would not cover Stroup's pricey treatment, but would pay for the cost of physician-assisted suicide.[ix]
Financial factors contributing to a vulnerable patient's sense of a "duty to die" include insurers and government entities that balk at paying for lifesaving drugs, the prospect of depleting resources that otherwise would pass on to loved ones as an inheritance and even subtle pressure from heirs to accelerate the dying process under a guise of compassion. Even the way a careless or uncaring physician negatively presents a prognosis can influence patients to choose early death.

7.    Distrust inhibits minority healthcare access.

Distrust of physicians who discard patient protections such as the Hippocratic oath adds to distrust long rooted in some minority communities. In research published in the February 2009 Archives of Pediatric and Adolescent Medicine,[x] a cross-sectional survey of parents who accompanied children to a primary care clinic found that 67 percent—over two in three--of African-Americans distrusted the medical establishment. Even after controlling for education, race remained an independent predictor of distrust.
Such distrust traces its roots back to a long history of segregation and abuse, painfully illustrated by the infamous Tuskegee Syphilis Study in which treatment known to be effective was withheld from black patients. Adding a fear of physician as killer to the existing distrust already embedded in minority communities can only further decrease access to healthcare in minority-rich centers such as Washington, DC.

8.    Undiagnosed depressed but treatable patients will choose suicide.

Research shows that nine out of ten people who die by suicide suffer from clinical depression or another diagnosable mental disorder.[xi] The sense of hopelessness that severely depressed patients experience can deter them from seeking the help they desperately need.
Yet the DC assisted suicide measure simply notes that doctors should merely
"Inform the patient of the availability of supportive counseling to address the range of possible psychological and emotional stress involved with the end stages of life."
Instead of making sure that severely depressed patients experiencing hopelessness receive a psychological examination or treatment for depression, the DC measure requires merely a suggestion of help before handing the patient a bottle of lethal pills.
Normally, and especially given the rising epidemic of teen suicides, government and social organizations seek to provide messages and resources to discourage suicide and to maximize interventions and treatment of depressed individuals in order to prevent suicides. The DC government's measure turns that approach on its head, instead facilitating the suicide choice and sending a message, "Depressed and despairing of life? Here's an easy way out."
Consider the impact of such a message on a despairing teenager—a very real scenario under the DC assisted suicide measure, which applies even to 18-year-olds:
"Patient" means a person who has attained 18 years of age….
John Norton, now aged 74, recalls, "When I was eighteen years old and in my first year of college, I was diagnosed with Amyotrophic Lateral Sclerosis (ALS) by the University of Iowa Medical School. I was told that I would get progressively worse (be paralyzed) and die in three to five years. The diagnosis was devastating to me. I became depressed and was treated for my depression. If instead, I had been told that my depression was rational and that I should take an easy way out with a doctor’s prescription and support, I would have taken that opportunity." [xii]

9.    A rise in non-assisted suicides follows legalization of assisted suicide.

What impact does the government's message in legalizing assisted suicide send? What happens to the rate of other suicides after assisted suicide is made legal?
A 2015 study used regression analysis to test the change in rates of non-assisted suicides and total suicides (including assisted suicides). The study found that after legalizing assisted suicide, other suicides increased:
Controlling for various socioeconomic factors, unobservable state and year effects, and state-specific linear trends, we found that legalizing PAS [physician-assisted suicide] was associated with a 6.3% (95% confidence interval 2.70%–9.9%) increase in total suicides (including assisted suicides). This effect was larger in the individuals older than 65 years (14.5%, CI 6.4%–22.7%).[xiii]

10. Home-stored lethal chemicals are unlocked loaded guns.

The DC assisted suicide measure provides for patients to obtain lethal chemicals and then simply store them in their own homes. Storing lethal prescriptions in the home is the equivalent of storing unlocked loaded guns around the house.
A 2016 survey published online in JAMA Internal Medicine found that nearly 60 percent of Americans have leftover narcotics in their homes, 20 percent have shared those with another person and fewer than nine percent kept medications in a location that could be locked.[xiv] Given this pattern, the likelihood of lethal prescriptions falling into the hands of individuals, including children, other than the patient, is dangerously high.
For these reasons and many more, the DC assisted suicide measure represents a severe threat to patients, to the medical profession and to society. Congress must act quickly to protect the lives of vulnerable patients and to restore the integrity of the medical profession as trusted healers.



[i] By Jonathan Imbody, Vice President for Government Relations for the 18,000-member Christian Medical Association (www.cmda.org) and Director of the 30,000-constituent Freedom2Care coalition (www.Freedom2Care.org). Contact: ji@freedom2care.us.
[ii] L. Snyder and D. Sulmasy, “Physician-Assisted Suicide” (Position Paper of the American College of Physicians and American Society of Internal Medicine), 135 Annals of Internal Medicine (2001) 209-16 at 214.
[iii] Kevin M.Y.B. Leung, MD;* Wilma M Hopman, MD;† Jun Kawakami, MD, FRCSC, "Challenging the 10-year rule: The accuracy of patient life expectancy predictions by physicians in relation to prostate cancer management," Can Urol Assoc J 2012;6(5):367-73. http://dx.doi.org/10.5489/cuaj.11161 Abstract.
[iv] Hardeep Singh1, Ashley N D Meyer1, Eric J Thomas, "The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations," BMJ Qual Saf doi:10.1136/bmjqs-2013-002627. Available online at http://qualitysafety.bmj.com/content/early/2014/04/04/bmjqs-2013-002627.abstract.
[v] Diane Coleman, “Assisted Suicide Laws Create Discriminatory Double Standard for Who Gets Suicide Prevention and Who Gets Suicide Assistance: Not Dead Yet Responds to Autonomy, Inc.,” Disability and Health Journal, Vol. 3, No. 1 (January 2010), p. 48. Available online at  http://www.disabilityandhealthjnl.com/article/S1936-6574(09)00089-2/fulltext
[vi] J. Pereira, MBChB MSc, "Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls," Curr Oncol. 2011 Apr; 18(2): e38–e45. PMCID: PMC3070710. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070710/.
[vii] Testimony of Jonathan Imbody, Christian Medical Association, U.S. Senate Committee on the Judiciary Subcommittee on the Constitution, Civil Rights and Property Rights, May 25, 2006. Available online at http://www.judiciary.senate.gov/imo/media/doc/Imbody%20Testimony%20052506.pdf.
[viii]C. Everett Koop, MD, banquet address, National Right to Life Committee, Washington, DC, June 22, 1985. Transcript available online at https://profiles.nlm.nih.gov/ps/access/QQBBFR.ocr.
[ix] "Oregon Offers Terminal Patients Doctor-Assisted Suicide Instead of Medical Care," Fox News, July 28, 2008. Available online at http://www.foxnews.com/story/2008/07/28/oregon-offers-terminal-patients-doctor-assisted-suicide-instead-medical-care.html.
[x] Kumaravel Rajakumar, MD; Stephen B. Thomas, PhD; Donald Musa, DrPH; et al Donna Almario, MPH; Mary A. Garza, PhD, MPH, “Racial Differences in Parents' Distrust of Medicine and Research,” Arch Pediatr Adolesc Med. 2009;163(2):108-114. doi:10.1001/archpediatrics.2008.521. Available online at http://jamanetwork.com/journals/jamapediatrics/fullarticle/380874.
[xi] Keith Hawton, Carolina Casañas i Comabella, Camilla Haw, Kate Saunders, "Risk factors for suicide in individuals with depression: A systematic review," Journal of Affective Disorders Volume 147, Issues 1–3, May 2013, Pages 17–28, http://dx.doi.org/10.1016/j.jad.2013.01.004. Available online at http://www.sciencedirect.com/science/article/pii/S0165032713000360#bib10.
[xii]"Affidavit of John Norton in opposition to assisted suicide and euthanasia," March 2012, Judiciary Committee of the Massachusetts Legislature. Available online at http://www.massagainstassistedsuicide.org/2012/09/john-norton-cautionary-tale.html.
[xiii] David Albert Jones, DPhil, David Paton, PhD, "How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?" Volume: 108 Issue: 10 October, 2015. Available online at http://sma.org/southern-medical-journal/article/how-does-legalization-of-physician-assisted-suicide-affect-rates-of-suicide/.
[xiv] Alene Kennedy-Hendricks, PhD1,2; Andrea Gielen, ScD1,3,4; Eileen McDonald, MS3,4; et al Emma E. McGinty, PhD, MS1,2,4,5; Wendy Shields, MPH1,4; Colleen L. Barry, PhD, MPP1,2,5, “Medication Sharing, Storage, and Disposal Practices for Opioid Medications Among US Adults,” JAMA Intern Med. 2016;176(7):1027-1029. doi:10.1001/jamainternmed.2016.2543. Available online at http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2527388

Tuesday, January 31, 2017

Judge Neil Gorsuch on assisted suicide and euthanasia

Judge Neil Gorsuch, moments ago nominated to serve on the Supreme Court, has written extensively on assisted suicide and euthanasia. His writings will encourage those who value protecting individuals at the end of life from the pressures that can arise by legalizing these deadly practices:
  • "[I]t is the physician’s assessment of the patient’s quality of life as ‘degrading’ or ‘deteriorating’ or ‘hopeless’ that stands as the ultimate justification for killing.”

-- Neil M. Gorsuch, The Future of Assisted Suicide and Euthanasia, p. 111.
  • "Helen was a breast cancer patient in her mid-eighties when the Oregon law went into effect. Helen’s regular physician refused to assist in her suicide; a second doctor was consulted but also refused, on the stated ground that Helen was depressed. At that point, Helen’s husband called Compassion in Dying. The medical director of the group spoke with Helen and later explained that Helen was “frustrated and crying because she felt powerless.” Helen was not, however, bed-ridden or in great pain…. The Compassion in Dying employee recommended a physician to Helen. That physician, in turn, referred Helen to a specialist (whose specialty is unknown), as well as to a psychiatrist who met Helen only once. A lethal prescription was then supplied."

--Gorsuch, The Future of Assisted Suicide and Euthanasia, p. 124.
  • "[I]t is also rather remarkable that, while physicians in Oregon are held to a standard of professional competence in administering all other treatments they provide, the Oregon assisted suicide statute creates an entirely different regime when it comes to administering this 'treatment,' specifically and uniquely immunizing doctors from criminal prosecution, civil liability, or even professional discipline for any actions they take in assisting a suicide, as long as they act in 'good faith.' Thus, while a doctor may be found liable for mere negligence in any other operation or procedure, there is no recourse for family members when a doctor kills a patient even on the basis of gross negligence by misdiagnosing the patient as terminal or by misassessing the patient as competent."

-- Gorsuch, The Future of Assisted Suicide and Euthanasia, p. 119.
  • “How does it serve the putative goal of autonomous patient decision making to set up a regime that allows peo-ple to commit suicide without considering wheth-er they are, in fact, acting freely, competently, and autonomously at the time of suicide?”

-- Gorsuch, The Future of Assisted Suicide and Euthanasia, p. 180.
  • "Many jurisdictions have expressly reconsidered these laws [against assisting suicide and euthanasia] in recent years and reaffirmed them.  In 1980, the American Law Institute conducted a thorough review of state laws on assist[ed] suicide in the United States and acknowledged the continuing widespread support for criminalization. Accordingly, it endorsed two criminal provisions of its own. In the 1990s, both New York and Michigan convened blue-ribbon commissions to consider the possibility of legalizing assisted suicide and euthanasia.  The New York commission issued a thoughtful and detailed report unanimously recommending the retention of existing laws against assisting suicide and euthanasia.  The Michigan panel divided on the issue, but the state legislature subsequently chose to enact a statute strengthening its existing common law ban against assisted suicide.  .  .  . Meanwhile, repeated efforts to legalize the practice—in state legislatures and by popular referenda—have met with near-total failure."

--Neil M. Gorsuch, The Right to Assisted Suicide and Euthanasia, 23 Harv. J. L. & Pub. Pol’y 599, 639-41 (2000).

Thursday, January 19, 2017

No tax dollars for abortion bill moving through new Congress

The House Rules Committee is scheduled to meet next Monday, January 23, to consider the No Taxpayer Funding for Abortion Act (H.R. 7). Text of the bill is available here, and a Washington Times story about the bill is here.
The No Taxpayer Funding for Abortion Act (H.R. 7) introduced by Rep. Chris Smith (NJ-04), seeks to do three things. The bill:
  1. Makes the Hyde Amendment and other current abortion funding prohibitions  permanent and government-wide;
  2. Ensures that the Affordable Care Act (ACA) faithfully conforms to the Hyde Amendment while Congress works to repeal and replace the ACA;
  3. Until a new plan year begins, the bill ensures full disclosure, transparency and the prominent display of the extent to which any health insurance plan on the exchange funds abortion.

Monday, January 16, 2017

Physicians urge Congress to shift health funds toward federal centers and away from abortion industry

The 18,000-member Christian Medical Association today urged Congressional leaders to  shift health funds toward federal centers and away from abortion industry. CMA CEO Dr. David Stevens wrote to House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell the following letter:
Dear Speaker Ryan and Majority Leader McConnell:
Thank you for your strong, principled and common-sense leadership on the issue of preventing American tax dollars from funding abortion on demand. Thank you also for your commitment to providing healthcare access to the poor and other vulnerable patients in need.
On behalf of the over 18,000 members of the Christian Medical Association, we urge you to:
1.      ensure the reallocation of funding currently used by abortion-performing, partisan political organizations such as Planned Parenthood, by directing that funding instead to the over 13,000 Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs); and,
2.      overturn, through the Congressional Review Act, the US Department of Health and Human Services (HHS) rule finalized December 19, 2016, titled "Compliance with Title X Requirements by Project Recipients in Selecting Subrecipients," in order to ensure that states are allowed to take a similar direction in allocating federal funding.
Many of our members serve in federally funded centers that focus on providing care to patients regardless of who the patient is or what the patient's values, orientation, ethnicity or any other qualities may be. As you know well, needy patients depend on these centers and on physicians like our members to provide healthcare when likely no one else would provide healthcare for them. FQHCs provide comprehensive services and a “medical home” for whole families and work in the areas of most critical need.
According to the independent government watchdog (GAO) in 2012, FQHCs served 21 million individuals and provided services including STD testing, cancer screening and contraceptive management, as well as other services including immunizations and general child wellness exams. FQHCs and RHCs often meet patient needs on modest budgets, and those who serve in these centers often do so at great personal financial sacrifice. Unlike Planned Parenthood, which follows an aggressive business plan designed to maximize profits on services such as abortion, these centers exist for the purpose of serving the nation's most needy patients.
Yet some medical groups like the American Congress of Obstetricians and Gynecologists, whose pro-abortion ideology aligns with Planned Parenthood and whose members profit personally from working with Planned Parenthood, decry "political interference in the patient-physician relationship." This cry comes, oddly enough, while applying pressure on politicians to fund political groups like Planned Parenthood. It is also worth observing what sources such as the nonpartisan Center for Responsive Politics and PolitiFact National have confirmed--that Planned Parenthood spends millions of dollars each year for one partisan purpose: to elect Democrats and defeat Republicans.
It's hard to get more political than that, and it's impossible to get more politically partisan than that.
The majority of Americans do not want their tax dollars to subsidize abortion, and they certainly do not want their tax dollars to subsidize an abortion-performing partisan political machine. Because of the strong concern of American taxpayers, existing federal law addresses direct funding of abortion. However, the fungible nature of federal grants to Planned Parenthood means that every American's tax dollars, regardless of their convictions about abortion, are being used to prop up the abortion industry.
Any organization that wishes to avoid political entanglement can do so quite easily--by simply foregoing government funding. Those who seek funding should expect federal and/or state oversight, requirements and standards.
Even the most modest of standards should disqualify from federal funding organizations such as Planned Parenthood, given the recent findings of the Select Investigative Panel on Infant Lives, the list of 15 criminal and regulatory referrals made by the Panel, and the referral by the Senate Committee on the Judiciary to the FBI and the Department of Justice for investigation and potential prosecution.
If any organization can and should do without federal funding, the billion-dollar, corrupt abortion business Planned Parenthood is a prime example.
We respectfully urge you to reallocate American tax dollars away from such profit-centered, divisive and partisan organizations and provide funding instead to patient-centered, non-controversial and nonpartisan Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs). And we urge you to ensure that states can do the same, applying reasonable state standards and requirements to those who seek to use taxpayer funds.
Thank you very much for your consideration of these views.
Sincerely,
David Stevens, MD, MA (Ethics)
CEO

CMA court victory protects doctors on transgender decisions

In the waning days of the Obama administration in 2016, the US Department of Health and Human Services launched a new regulation aimed at conforming all healthcare professionals and facilities to the Obama administration's ideology on transgender issues.
The rule left no room for medical judgment or religious objection regarding treatments and procedures demanded by patients who did not want to remain the biological sex they were born with.
To protect the right of medical professionals to (a) exercise medical judgment based on research and evidence regarding transgender issues and (b) to exercise First Amendment religious freedom based on faith convictions, the Christian Medical Association launched a lawsuit to fight the government's coercion. We enlisted the services of Becket Law, known for its many victories for religious freedom, notably the Hobby Lobby and Little Sisters of the Poor Supreme Court cases.
On New Year's eve, a federal judge issued a favorable ruling, a preliminary judgment to stop enforcement of the aspects of the rule objected to in the CMA lawsuit. Becket Law announced the victory on December 31, 2017:

Court strikes down harmful transgender mandate

Ruling protects children and doctors, hospitals from federal regulation
For Immediate Release: December 31, 2016
Media Contact: Melinda Skea | media@becketfund.org | 202-349-7224
WASHINGTON, D.C. – Moments ago a Texas court protected the rights of families and their doctors to make medical decisions for their child free from government bureaucrats’ interference.
The court ruling comes after eight states, an association of almost 18,000 doctors, and a Catholic hospital system challenged a federal regulation that requires doctors to perform gender transition procedures on children, even if the doctor believes the treatment could harm the child. Doctors who followed their Hippocratic Oath to act in the best interest of their patient would have faced severe consequences, including losing their job.
“This is a common-sense ruling: The government has no business forcing private doctors to perform procedures that the government itself recognizes can be harmful, particularly to children, and that the government exempts its own doctors from performing,” said Lori Windham, senior counsel at Becket Law, which filed a lawsuit against the new federal regulation. “Today’s ruling ensures that doctors’ best medical judgment will not be replaced with political agendas and bureaucratic interference.”  
The new regulation applied to over 900,000 doctors—nearly every doctor in the U.S.—and would have cost healthcare providers and taxpayers nearly $1 billion. The government itself does not require its own military doctors to perform these procedures. It also does not require blanket coverage of gender transition procedures in Medicare or Medicaid—even in adults—because HHS’s experts admitted research is “‘inconclusive’ on whether gender reassignment surgery improves health outcomes,” with some studies demonstrating that these procedures were actually harmful. But a doctor citing the same evidence and using their best medical judgment would have faced potential lawsuits or job loss. 
 A recent website provides leading research on this issue, including guidance the government itself relies on, demonstrating that up to 94 percent of children with gender dysphoria (77 to 94 percent in one set of studies and 73 to 88 percent in another) will grow out of their dysphoria naturally and live healthy lives without the need for surgery or lifelong hormone regimens.
“This court ruling is an across-the-board victory that will ensure that deeply personal medical decisions, such as gender transition procedures, remain between families and their doctor,” said Windham.
Becket Law defended Franciscan Alliance, a religious hospital network sponsored by the Sisters of St. Francis of Perpetual Adoration, and the Christian Medical & Dental Associations from the new government regulation. The States of Texas, Wisconsin, Nebraska, Kentucky, Kansas, Louisiana, Arizona, and Mississippi joined Becket’s legal challenge. More information can be found at www.transgendermandate.org.
For more information or to arrange an interview with a Becket attorney, please contact Melinda Skea at media@becketfund.org or 202-349-7224.  Interviews can be arranged in English, Chinese, French, German, Portuguese, Russian, and Spanish.
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Wednesday, December 14, 2016

Federal 2017 Policy Top Priorities: Right to life and freedom of faith, conscience and speech

Christian Medical Association / Freedom2Care

Federal Policy Top Priorities - 2017

The Washington office of the Christian Medical Association (which hosts Freedom2Care) focuses on the fundamental issues of the right to life and freedom of faith, conscience and speech, which serve as the foundation for all other rights and freedoms. Following are some of the top priorities for the new year:

Freedom of faith and conscience 

1.      Protect conscience rights in healthcare by restoring the conscience protection regulation for healthcare professionals and institutions, along with its educational outreach program.
2.      Prevent government coercion related to abortion by passing conscience-protecting legislation (e.g., Conscience Protection Act - S 2927, H.R.4828; Healthcare Conscience Rights Act - S 1919; Abortion Non-Discrimination Act - S 50).
3.      Overturn  "transgender mandate" regulation, which disallows medical judgment and redefines Congress' biological definition of sex to include LGBT issues, by winning our lawsuit vs. US Dept. of HHS.
4.      Sweep away radical federal regulations by empowering Congress (e.g., through the  Midnight Rules Relief Act - S.3483, HR 5982) to disapprove of federal agency regulations that fall within 60 legislative days of a president's final term.

Right to life

1.      Ban abortions of developing babies at the stage in which they can feel pain (e.g., Pain-Capable Unborn Child Protection Act - S.1670; HR 36-passed).
2.      Redirect tax dollars from abortion businesses like Planned Parenthood to federally qualified health centers (e.g., Title X Abortion Provider Prohibition Act - S 51, HR 217).
3.      Save lives of babies born in an abortion (e.g., Born-Alive Abortion Survivors Protection Act - S2066; HR 3504 passed).

Personnel

Promote and support pro-life, pro-religious freedom individuals for key positions including:
·         Supreme Court: new justices
·         Health and Human Services: Secretary, Deputy Secretary, Assistant Secretary for Health, Surgeon General, Assistant Secretary For Children And Families, Commissioner of Food and Drugs, Director of National Institutes of Health, Director of faith-based office, Office of Civil Rights, Office of Global Health Affairs.
·         White House - Domestic Policy Advisor, director of faith-based office
·         Department of State – AIDS Ambassador (PEPFAR), Office of International Religious Freedom, Office to Monitor and Combat Trafficking in Persons, faith-based office, Office of Religion and Global Affairs.

·         US Agency for International Development – Administrator, Asst. Admin. - Bureau of Global Health, faith-based office.