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Friday, March 16, 2018

Use our ready-made comment form to voice your view on a new healthcare faith and conscience rule

Action: Use this form to voice your view on the new healthcare faith and conscience rule

We have a brief window of opportunity to protect conscience and religious freedom in healthcare.
The U.S. Dept. of Health and Human Resources (HHS) has proposed-and asked for our comments on-a new rule that would strongly protect the religious and conscience rights of health professionals and patients.

Whom does the new rule protect?

The new rule will help protect pro-life, faith-based and morally concerned health professionals and patients from discrimination, loss of physician, coercion, job loss, loss of healthcare access, license revocation, demotions, loss of educational opportunity, forced training and much more.

What if I've experienced discrimination?

The new rule also gives us a defender-the HHS Office of Civil Rights-to  take up complaints of discrimination, educate the health community about conscience and enforce 25 federal laws related to faith and conscience freedom in healthcare.
Also on the Freedom2Care legal hep web page, you also can take legal steps to address the discrimination you experienced.

How do I submit a comment?

The quick action you can take right now is to visit our Freedom2Care web page and follow the very simple steps to submit your comment. You can also learn more there about the proposed rule.
Then just push the button and submit your comment.

Why bother?

By submitting your comment, you will be protecting your God-given, constitutionally asserted rights to choose what to believe and to act on your beliefs. You also will be protecting the rights of other health professionals, patients and all Americans to do the same.

What's the deadline for my comments?

The deadline is March 27.
Important: You can also include in your comment any discrimination in healthcare, because of conscience or faith, that you have experienced or witnessed.
(For legal help and reporting discrimination, click here.)

Thank you for taking advantage of this rare opportunity.

Npte: On the Freedom2Care web page, you can choose a quick and simple response or also a more detailed response to specific questions if you prefer.
Alternatively, you can submit your comment directly to HHS via here.

Thursday, February 22, 2018

New HHS division, conscience freedom laws and policies protect patients and physicians

The new HHS division implements 25 federal conscience laws
Note: This excerpt is the sixth in a series of essays on conscience in healthcare, by Jonathan Imbody, Vice President for Government Relations of the Christian Medical Association and Director of Freedom2Care.
Essay #1: "Choose, you lose" prescription threatens the conscience rights of every professional"
Essay #2: "Autonomy quickly translates to tyranny"
Essay #3: "Medical ethics: Bedrock oaths versus zeitgeist barometers"
Essay #4: "'Patient autonomy' – The Trojan Horse assault on conscience freedom in healthcare"
Essay #5: "Are healthcare conscience laws needed?"

In January 2018, the U.S. Department of Health and Human Services announced the creation of a new division within its Office of Civil Rights—the Conscience and Religious Freedom Division.[i] The new division now serves as a center for information on 25 federal conscience laws, outlined on the division's website, including:[ii]
·       The Church Amendments, enacted in the 1970s "to protect the conscience rights of individuals and entities that object to performing or assisting in the performance of abortion or sterilization procedures if doing so would be contrary to the provider’s religious beliefs or moral convictions."
·       Public Health Service Act § 245, which "prohibits the federal government and any state or local government receiving federal financial assistance from discriminating against any health care entity on the basis that the entity refuses to undergo training in the performance of induced abortions" and related actions.
·       The Weldon Amendment, which prohibits government "discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions."
The HHS division will help victims like nurse Cathy DeCarlo,
forced to participate in an abortion against her conscience.
The new HHS conscience and religious freedom division also serves as a recipient of complaints of discrimination on the basis of conscience.
Dr. David Stevens, CEO of the 19,000-member Christian Medical Association, noted in a news release lauding the new division, "There are already laws on the books, and this proposed rule will help address the injustices that those laws were designed to prevent. Our members have been discriminated against and some have even lost positions for speaking out."
In that CMA news release, I added, "Polling indicates that faith-based physicians will be forced to leave medicine if coerced into violating the faith tenets and medical ethics principles that guide their practice of medicine. These faith-based health professionals do not and cannot separate the faith principles that motivate them to help others and serve the needy from the faith principles that uphold the sanctity of human life.
"So conscience protections like the proposed rule announced today are key to not only protecting American freedoms of faith and conscience; they are also key to protecting patient access to principled healthcare."[iii]
While many lauded the new division as protecting fundamental conscience freedoms and First Amendment rights, some political activists issued "hair-on-fire" statements condemning the division as devaluing humanity and promoting religious bigotry.
"This is the use of religion to hurt people because you disapprove of who they are," asserted Harper Jean Tobin, the National Center for Transgender Equality's director of policy, in a statement published by The Washington Post.[iv]

No one's objecting to treating "particular classes of patients"

Contrary to unsubstantiated claims of conscience freedom
covering bigotry, faith-based professionals often actually
seek out  marginalized and stigmatized patients.
The accusation by some LGBT and abortion activists, that health professionals will use conscience claims to discriminate against certain patients, unfortunately also finds expression in the medical community.
Writing in the New England Journal of Medicine, Obamacare architect Ezekiel Emanuel and Penn Professor Ronit Stahl also equate conscience objections with bigotry, asserting,
"No matter how sincerely held, objections to treating particular classes of patients are indefensible — regardless of whether the objections are based on race, gender, religion, nationality, or sexual orientation."[v]
Well, sure, that would be indefensible—if it were actually happening. But, of course, the authors provide no examples of such insidious discrimination. It's just useful for stirring up an emotional response: " I don't want to be labeled a bigot, so let's get rid of these conscience laws that legalize bigotry!"
When President Obama gutted a two-year-old Bush-era conscience protection regulation, an opponent of conscience rights exclaimed to the Washington Post, "Without the rescission of this regulation, we would see tremendous discrimination against patients based on their behavior and based just on who they are.  We would see real people suffer, and more women could die."[vi]
Of course, no real-life examples were cited, and apparently none occurred in the years after the conscience protections took effect.
The truth is that conscience protections do not allow physicians to refuse to treat "particular class of patients." In fact, faith-based health professionals (who depend on conscience protections against coercion) in particular have gone to great lengths to purposefully reach out to the marginalized, the stigmatized and victims of discrimination.

Health policy will always reflect opinions

Hypocrisy: Abortion advocates agitate to force pro-life physicians
to participate in abortion. Then they accuse conscientious objectors
of forcing their personal opinions on others.
The Washington Post article on the new HHS conscience and religious freedom division also quoted Sarah Warbelow, legal director for the Human Rights Campaign, who asserted that the policy seeks to "devalue the humanity of LGBTQ people. Every American deserves access to medically necessary health care, and that health care should not be determined by the personal opinions of individual health care providers or administrative staff."[vii]
While real-life examples of medical professionals "devaluing the humanity of LGBTQ people" are scarce or nonexistent, examples of personal opinions impacting healthcare are ubiquitous. It's also notable that at the same time that Ms. Warbelow argues to disallow the "personal opinions" of health professionals from influencing healthcare, she argues that her own personal opinion, her group's own ideology, must direct healthcare.
Opponents of conscience protections frequently assert the mantra that conscientious health professionals are forcing their opinions on others. But prolife physicians do not force their patients or anyone else to adopt a prolife view; they simply seek exemption from coercion to kill.
Yet intolerant abortion advocates cannot seem to countenance diversity of opinion in healthcare. They would force prolife physicians to perform or refer for abortions or else sacrifice their careers. Then they complain with straight faces about prolife physicians forcing their opinions on others.
The idea that health professionals must ignore their moral and ethical convictions and perform any and all legal procedures is, in itself, a personal opinion expanded into an ideology—"an orientation that characterizes the thinking of a group or nation."[viii]

The conscience debate will impact the future of healthcare

In a free society, we can and should debate the question: Would eliminating conscience freedoms be good or bad for healthcare, for patients, for health professionals, for the country?  But to assert that health professionals who base their practice of medicine on certain ethical prohibitions are uniquely forcing their "personal opinions" on others is patently hypocritical.
Healthcare policies always reflect opinions; they are conceived and implemented by individuals who have personal opinions and by groups that have ideologies. Our democratic republic is designed to debate opinions freely and then translate the best opinions into laws that benefit society. We elect lawmakers who share our opinions and will translate those opinions into laws and policies.
For example, the law that imposed Obamacare on the nation clearly reflected the opinions and big-government ideology of Democrats. The repeal and replacement of Obamacare clearly reflected the opinions and small-government ideology of Republicans. Even if Congress decided to get out of healthcare altogether, that decision to disengage would be a policy formed by opinions and ideology.
The real question is not whether a policy reflects someone's opinions
but rather which opinion, which policy is best and should prevail?
The real question is not whether a policy reflects someone's opinions but rather which opinion, which policy is best and should prevail?
For millennia, medicine and law have provided room for conscience freedom--differing convictions on controversial issues--among health professionals. Many would continue that long-standing policy of tolerance for reasons both pragmatic and philosophical:
·       Tolerance maximizes healthcare access by enabling a breadth of professionals to practice medicine;
·       Tolerance comports with professionalism and professional judgment (a health professional being one who professes to adhere to an ethical standard that guides his or her practice of medicine);
·       Tolerance offers patients the ability to choose health professionals in line with the patient's own values;
·       Tolerance reflects core American principles of freedom of conscience, faith and speech.
The current debate, then, is not about "imposing opinions"; it is about whether or not our long tradition of tolerance for a range of ethical positions should be continued or discontinued. The result of that debate will significantly impact the future of medicine, healthcare access and religious freedom.

[iii] CMA news release, "Christian Medical Association physicians laud new federal conscience rule as protecting patient access to healthcare," January 19, 2018. Accessed online Feb. 20, 2018 at
[v] Stahl and Emanuel, p. 1383.
[vi] "Obama administration replaces controversial 'conscience' regulation for health-care workers," Washington Post, February 19, 2011. accessed 9/21/17.
[vii] Ibid.
[viii] Advanced English Dictionary definition.

Wednesday, February 7, 2018

Christian Medical Association highlights implementation of new US policy keeping tax dollars from abortion groups overseas

Washington, DC, February 7, 2018—The 19,000-member Christian Medical Association (CMA,, today lauded the administration's implementation of the new Protecting Life in Global Health Assistance policy.
Jonathan Imbody, CMA Vice President for Government Relations, said the policy is "effectively advancing human rights consistent with the values of the American people and the aims of US foreign health aid, by ensuring that all global health assistance tax dollars will be used to save lives and promote health and welfare for all."
The CMA's comments came as the administration at 5 p.m. today rolled out a six-month review of the implementation of the policy, formerly known as the Mexico City Policy. The report indicated a smooth transition to the new policy for most recipients of federal grants: "Nearly all prime partners that have had the opportunity to accept the policy have done so; prime partners declined to sign in only four instances out of 733 awards."
Imbody continued, "Under this administration's new policy, no longer are American values and tax dollars subverted by organizations with contradictory principles and counterproductive programs. The new policy requires and restores consistency with lifesaving programs and American values and also enables and enhances partnerships between the American people and effective, life-honoring organizations overseas.
"For too many years under previous administrations, US global health assistance contradicted our national commitment to universal human rights and dignity, by fueling the work of foreign organizations that perform and/or promote abortion as a method of family planning. Contrary to American principles of inalienable human rights and dignity for all, these foreign organizations treat some human lives as mere property for disposal and destruction at will.
"This life-honoring policy, by contrast, advances a view of human dignity and human rights that honors each and every human being—whether already born or waiting to be born--as invaluable individuals created in God's image and worthy of honor and protection."

Tuesday, January 23, 2018

Are healthcare conscience laws needed?

Note: This excerpt is the fifth in a series of essays on conscience in healthcare, by Jonathan Imbody, Vice President for Government Relations of the Christian Medical Association and Director of Freedom2Care

Someone forwarded to me a Facebook comment about the news that the U.S. Department of Health and Human Services had established a new division to address conscience and religious freedom in healthcare.
"So I just read this article and can't really even wrap my head around this. Perhaps because of my personal and professional opinion I cannot understand how this 'division' was created. I would love to hear the opinions of other professionals. I promise I am not trying to troll or create controversy, but simply attempting to understand how opting out of providing medical care or performing procedures despite the medical need/request can coexist with our professional ethics and obligations."

Conscience laws protect professional ethical decision-making

When a professional follows a code of medical ethics, the professional makes a choice—for example, either to perform or not to perform an abortion. Without legal protections for alternative choices, only one choice is allowed, and the dissenting professional can suffer job loss, license loss and other forms of discrimination. 
Federal conscience laws protect professionals on both sides of ethical issues.
Conscience laws protect both sides of the abortion debate.
For example, if one subscribes to the ethical theory that a medical professional must perform an abortion if the patient wants one, what recourse does that professional have if an employer forbids you from performing an abortion? Federal conscience law (in this case, the Church Amendments) actually protects professionals from discrimination either for performing or for not performing the abortion. (Read more about federal conscience laws here.)
The alternative to federal conscience laws is excluding from medicine all professionals who do not follow a prevailing ethic. 
In the two and a half millennia during which the Hippocratic oath prevailed, that would mean no doctors whose ethic required or permitted assisted suicide or abortion would be allowed to practice medicine. Currently, with fewer doctors taking the Hippocratic oath, an absence of conscience protections could mean that only doctors who do not follow the Hippocratic oath would be allowed to practice medicine.

Conscience laws protect patient access and choice

Some today insist that conscience freedoms end upon entrance to medical school. The result of repealing conscience laws and excluding from medicine all professionals who do not follow the "ethic du jour" would be a massive loss of patient access to healthcare. With pro-life, faith-based and Hippocratic professionals excluded from medicine, far fewer professionals would be left to treat patients. Those allowed to remain in the profession would experience a lack of freedom for professional judgment, since any judgment departing from the current consensus would disqualify them from continuing in medicine.
Our forbears fled to this land because they had experienced discrimination for their beliefs. Our Constitution's First Amendment spells out the priority that Americans place on freedom of belief and the right to conscientiously exercise those beliefs in the public square. 

The source and stability of medical ethics matters

One final question to ask regarding medical ethics is what is the source? Who makes the decisions on what is ethical and what is not? Is the ethic a constant, or does it change? 
The Declaration of Geneva changes every 10 years.
As outlined in previous essays in this series, the original Declaration of Geneva oath published by the World Medical Association unequivocally asserted, "I will maintain the utmost respect for human life from the time of conception." But the same oath later dropped the commitment of respect for human life from the time of conception and now requires simply, "I will maintain the utmost respect for human life."
In contrast to the over two-millennia-old Hippocratic oath, the Declaration of Geneva changes every ten years
What of health professionals who still follow the original oath and decline to perform abortions because they "respect human life from the time of conception"?
Should they now be driven out of medicine because their views no longer reflect the prevailing ethic--an ethic that shifted over a period of a few years?

Conscience freedoms and time-tested ethical standards stabilize medicine

Polling indicates that patients place a high priority on the ability to choose health professionals who share the patient's ethical positions. Polling also indicates that faith-based physicians will leave medicine apart from conscience protections.
Repealing conscience laws would leave patients without care.
Should patients and our healthcare system prepare for massive expulsions of health professionals every decade, as medical ethics shifts from one point to another?
Health professionals who follow faith tenets such as biblical standards do not change their ethical stances from year to year. Their convictions do not and cannot flex with the ever-changing consensus within the medical community; they rest upon an unchanging standard. These faith-driven health professionals rely on conscience protections to continue to practice medicine. 
Their non-religious colleagues, who may for the moment diverge from a consensus ethic that has shifted, also rely upon the same conscience protections that to protect their professional medical and ethical judgment.
Conscience protections serve to stabilize our healthcare system by maximizing the number of professionals able to practice medicine. Such laws also buttress American constitutional freedoms of faith and speech while protecting the rights of patients to associate with like-minded professionals.

Friday, January 19, 2018

House passes Born-Alive Abortion Survivors Protection Act!

This morning the House passed the Born-Alive Abortion Survivors Protection Act (H.R. 4712), by a vote of 241-183. 235 Republican Members and 6 Democratic Members (Cartwright-PA, Cuellar-TX, Langevin-RI, Lipinski-IL, Peterson-MN, Walz-MN ) voted to support HR 4712; No Republicans and 183 Democratic Members voted against.

Rep. Martha Roby (R-AL) managed the debate on the floor; her speech and those of the other Members speaking during the debate are linked below.

Rep. Martha Roby (R-AL), opening and closing

Christian Medical Association physicians laud new federal conscience rule as protecting patient access to healthcare

Washington, DC—January 19, 2018--Today the Christian Medical Association (CMA, the nation's largest faith-based association of physicians and other health professionals, said a new proposed rule announced today by the U.S. Department of Health and Human Services Office of Civil Rights (HHS OCR) will help protect patient access to healthcare.
The rule will enforce 25 existing statutory conscience protections, including major pieces of legislation passed by significant bipartisan majorities over the years since the 1973 Roe V. Wade Supreme Court decision contravened the Hippocratic oath and suddenly made pro-life physicians vulnerable to discrimination and job loss for declining to participate in what suddenly became a legal procedure nationwide.
CMA CEO Dr. David Stevens noted, "There are already laws on the books, and this proposed rule will help address the injustices that those laws were designed to prevent. Our members have been discriminated against and some have even lost positions for speaking out."
CMA Vice President for Government Affairs and Director of Freedom2Care, Jonathan Imbody, explained, "Polling indicates that faith-based physicians will be forced to leave medicine if coerced into violating the faith tenets and medical ethics principles that guide their practice of medicine. These faith-based health professionals do not and cannot separate the faith principles that motivate them to help others and serve the needy from the faith principles that uphold the sanctity of human life.
"So conscience protections like the proposed rule announced today are key to not only protecting American freedoms of faith and conscience; they are also key to protecting patient access to principled healthcare."

Thursday, January 18, 2018

Reforming the federal grants process to ensure the best help to the most people

I recently enjoyed the privilege of meeting with USAID chief Mark Green (center) to discuss how the US govt. can work better with faith-based organizations, to partner with to reach the needy overseas. What's needed IMHO is wholesale reformation of a byzantine grants process that favors huge companies that have extensive financial resources--not necessarily to do the best work or to reach the most in need--but resources to hire staff who write slick grant proposals and schmooze with bureaucrats. By contrast, many faith-based ministries operate on shoestring budgets devoted to direct care rather than to financial development.
USAID under Administrator Green is addressing this challenge, and their dedication promises improvements that will extend more effective aid to more individuals. For example, a Broad Agency Announcement now allows interested organizations to submit a two-page expression of interest for grant projects.
Other practical suggestions for reform include:
  1. Provide training for faith-based organizations by government officials and faith-based grantees on how to navigate the grants process, similar to the New Partners Initiative program.
  2. Use the USAID faith-based office to review all relevant grants for faith-friendliness, and provide the office with legal expertise on religious freedom issues.
  3. Include members of the faith community on grant review panels, which injects a faith perspective into the process and also educates reviewers about the process.
  4. Take a look at the current contractors under the Indefinite Delivery Indefinite Quantity (IDIQ) system, which as far as I can tell has no explicitly faith-friendly contractors, and see how a large faith-based organization might participate and then be in a position to sub-grant to smaller faith-based organizations. 
The goal is not to get money to any particular organization based on size or ideology but simply to keep the doors open to those organizations capable of doing the best work for the most people.