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Thursday, September 29, 2016

What you need to know and do about the new HHS transgender mandate

If you receive federal health funds,
read on...
What do doctors and health institutions need to know about and how can they defend themselves from the Obama administration’s newly enacted transgender mandate?

Action:

If you are a health professional or institution impacted by the HHS transgender mandate, you may use this web page to present your views confidentially (or publicly if you prefer).

What happened when?

The transgender mandate, promulgated by the US Department of Health and Human Services under the assumed authority of the Affordable Care Act (Obamacare), went into effect July 18, 2016.
A new website, www.transgendemandate.org, explains what the mandate requires, why it violates the law and what conscientious objectors can do to protect their rights.

Whom does the rule target?

HHS recently mandated that doctors must perform gender transition procedures on any child referred by a mental health professional, even if the doctor believes the treatment or hormone therapy could harm the child
Doctors who follow their Hippocratic Oath to act in the best interest of their patient instead of this new mandate can face severe consequences, including losing their job.

The Transgender Mandate also requires virtually all private insurance companies and many employers to cover gender transition procedures or face stiff penalties and legal action.

What do they have to do?

No religious exemption
The new rule includes no religious exemption; it will have significant impacts on religious healthcare professionals:

  • It will require healthcare professionals to perform certain gender transition services, including elective hysterectomies or cross-hormone therapy;
  • It will require healthcare professionals to refer individuals for gender transition services;
  • It will require healthcare professionals to provide insurance coverage for gender transition services, some of which include sterilization procedures;
  • It may require healthcare professionals to provide coverage for abortion;
  • It will require healthcare professionals to open facilities, such as showers, bathrooms, or locker rooms, to employees based on gender preference;
  • It will expose healthcare professionals to hostile work environment lawsuits unless healthcare professionals refer to individuals by their preferred name or gender pronoun.

What happens to those who do not comply?

A healthcare professional not in compliance risks:
Liable for lawsuits

  • losing HHS funding
  • being subjected to federal enforcement proceedings
  • being subjected to false claims liability
  • being sued for damages and attorneys’ fees by patients, employees, or their dependents.


What does the evidence show regarding gender transition procedures?

Research shows that there are significant risks with gender transition procedures in childhood.  Again, that is why HHS’s own medical board advised against requiring coverage of gender transition surgical procedures under Medicare and Medicaid. 
Putting children at risk

Along with physical impacts like heart conditions, increased cancer risk, and loss of bone density, the peer-reviewed longitudinal studies of children with gender dysphoria (that HHS accepted as valid) found that fewer than 1-in-4 children referred for gender dysphoria continued to experience that condition into adulthood. Some grew out of it, but many of the children ended up realizing that they were not transgender but instead gay or lesbian. 
The Transgender Mandate virtually guarantees that doctors will be forced—against their medical judgment—to perform procedures aimed at altering the gender of children who are not actually transgender.
Medical science is on the side of any doctor who feels that in a specific case it would be a mistake to begin gender transition procedures on a child.

What about medical judgment?

No medical judgment
The Mandate does not allow space for the doctor’s medical judgment and does not even allow the doctor to refer the child to another doctor, even one more qualified, or for a hospital to find a doctor willing to perform the procedure. Any refusal by a qualified and practicing doctor to perform such a procedure is a violation of the Mandate.
To be clear, this is not a question of access to care but of forcing a political ideology on doctors against their medical judgment.

Is anyone moving to stop this?

In August 2016, the Christian Medical Association; the states of Texas, Wisconsin, Nebraska, Kentucky, and Kansas; North Texas State Hospital; Franciscan Alliance, Inc.; and Specialty Physicians of Illinois, LLC filed a lawsuit against HHS in the US District Court for the Northern District of Texas.
The Becket Fund for Religious Liberty, which boasts an undefeated record in Supreme Court cases, represents the plaintiffs. The lawsuit asks the court to do the following:


  1. Declare that the challenged Regulation is invalid under the Administrative Procedure Act;
  2. Declare that the challenged Regulations is invalid under the Religious Freedom Restoration Act;
  3. Declare that the challenged Regulation is invalid under the First Amendment to the United States Constitution;
  4. Declare that the challenged Regulation is invalid under the Fifth Amendment of the United States Constitution;
  5. Declare that the challenged Regulation is invalid under the Fourteenth Amendment of the United States Constitution;
  6. Issue a permanent injunction enjoining Defendants from enforcing the challenged Regulations against Plaintiffs, those acting in concert with Plaintiffs, and all States;
  7. Award actual damages;
  8. Award nominal damages;
  9. Award Plaintiffs the costs of this action and reasonable attorney’s fees; and
  10. Award such other and further relief as it deems equitable and just.

Action:

If you are a health professional or institution impacted by the HHS transgender mandate, you may use this web page to present your views confidentially (or publicly if you prefer).

Friday, August 26, 2016

The "right to die" quickly morphs into a "duty to die"

Oregon's lethal drug of choice: Secobarbital
Assisted suicide advocates and their media allies would have us believe that taking lethal pills somehow represents the supreme expression of individual choice (see for example, "Deciding to use the end-of-life law," Los Angeles Times, Aug. 16). In reality, however, legalized assisted suicide can lead down a quick and dangerous path to patient abuse and the loss of autonomy.
What happens when government and corporate payers or unscrupulous heirs calculate that your early death spells cost savings? The "right to die" quickly morphs into a "duty to die," complete with subtle and not-so-subtle psychological pressures on vulnerable patients.
Such abuses of elderly, handicapped and other vulnerable patients will never show up in whitewashed, bare-bones bureaucratic reports. Secrecy provisions in the law prevent independent investigations. The only witness is dead.

Palliative care including powerful pain relief, coupled with the unconditional and persevering love of family and friends, offer a priceless alternative to cheap suicide pills and a safeguard of patient choice.

Wednesday, August 24, 2016

Doctors, States challenge new “transgender regulation”

The Christian Medical Association has filed a lawsuit along with others to fight an Obamacare transgender mandate, outlined below in a news release from The Becket Fund for Religious Liberty.
Government orders doctors to perform procedures it admits may harm children
For Immediate Release:  August 23, 2016
Media Contact:  Melinda Skea | media@becketfund.org | 202-349-7224
Washington, D.C. – Doctors, hospitals and five states will file a lawsuit today against a new federal regulation that would force doctors to ignore science and their medical judgment and perform gender transition procedures on children. The government does not even require Medicare and Medicaid to cover these same gender transition procedures because the Health & Human Services’ (HHS) medical experts found the risks were often too high and benefits too unclear. But any doctor citing the same evidence and their judgment in an individual case would be in violation of the new mandate and face potential lawsuits or job loss.
“No doctor should be forced to perform a procedure that he or she believes will harm a child,” said Lori Windham, senior counsel of the Becket Fund for Religious Liberty. “Decisions on a child’s medical treatment should be between families and their doctors, not dictated by politicians and government bureaucrats.”
A new 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 will not need surgery or lifelong hormone regimens. Studies also show that there are numerous negative effects when children undergo hormone regimens, such as increased risk of heart disease, type 2 diabetes, and breast, ovarian, and prostate cancer.
The government itself does not require coverage of gender transition procedures in Medicare or Medicaid — even in adults — because it has acknowledged that such procedures can be harmful. This rule would be the first time a law forces doctors to break their Hippocratic Oath and is also unique in placing mental health professionals as the final decision-makers on what medical care doctors must provide for their patients.
The new regulation applies to 900,000 doctors — virtually every doctor in the U.S., many of whom have chosen the medical profession because they are inspired by their faith to serve those in need and to heal others. They have taken an oath to put the needs of each patient first and do no harm. But this regulation violates doctors’ ability to exercise both their best medical judgment and their religiously-inspired desire to care for society’s most vulnerable. It will also cost healthcare providers and taxpayers nearly $1 billion.
“This regulation is blatantly hypocritical: The government exempts coverage of gender transition procedures from Medicare or Medicaid because it admits that they may be harmful; but it then tries to force private doctors to perform the same procedures on young children,” said Windham.
The Becket Fund for Religious Liberty will file a lawsuit today in federal district court in Wichita Falls, Texas, on behalf of Franciscan Alliance, a religious hospital network sponsored by the Sisters of St. Francis of Perpetual Adoration, and the Christian Medical & Dental Associations, defending them from the new government regulation. The States of Texas, Kansas, Kentucky, Nebraska, and Wisconsin also joined the Becket Fund’s legal challenge. More information can be found at www.transgendermandate.org.
For more information or to arrange an interview with a Becket Fund 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.
Additional Information:

Thursday, July 28, 2016

Dem, GOP platforms contrasted on life issues

Both major political parties recently issued new platforms that communicate contrasting core values to the American people. Following is a breakdown of where each party stands on the life issues of particular concern to readers of this blog: abortion, sex education, embryos and stem cell research and assisted suicide:

Abortion

The Democrat party platform maintains that “that every woman should have access to quality reproductive health care services, including safe and legal abortion” (p. 37).
The Republican party platform focuses on “The Constitution’s guarantee that no one can ‘be deprived of life, liberty or property’ deliberately echoes the Declaration of Independence’s proclamation that ‘all’ are ‘endowed by their Creator’ with the inalienable right to life” (p. 13).
Democrats: “We will continue to stand up to Republican efforts to defund Planned Parenthood health centers, which provide critical health services to millions of people” (p.37).
“We will continue to oppose—and seek to overturn—federal and state laws and policies that impede a woman’s access to abortion, including by repealing the Hyde Amendment [which prohibits most government funding of abortions]” (p. 37).
“We will support sexual and reproductive health and rights around the globe. In addition to expanding the availability of affordable family planning information and contraceptive supplies, we believe that safe abortion must be part of comprehensive maternal and women’s health care and included as part of America’s global health programming. Therefore, we support the repeal of harmful restrictions that obstruct women’s access to health care information and services, including the “global gag rule” and the Helms Amendment that bars American assistance to provide safe, legal abortion throughout the developing world” (p. 46).
Republicans: “We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare” (p. 13).
“We will not fund or subsidize healthcare that includes abortion coverage” (p. 13).
“Because of [Democratic party] opposition to simple abortion clinic safety procedures, support for taxpayer-funded abortion, and rejection of pregnancy resource centers that provide abortion alternatives, the old Clinton mantra of “safe, legal, and rare” has been reduced to just “legal” (p. 14).
“We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics” (p. 14).

Sex education

Democrats: “We recognize that quality, affordable comprehensive health care, evidence-based sex education and a full range of family planning services help reduce the number of unintended pregnancies and thereby also reduce the need for abortions” (p. 37).
Republicans: “We renew our call for replacing ‘family planning’ programs for teens with sexual risk avoidance education that sets abstinence until marriage as the responsible and respected standard of behavior. That approach — the only one always effective against premarital pregnancy and sexually-transmitted disease — empowers teens to achieve optimal health outcomes” (p. 34)

Embryos and stem cell research

Democrats: No mention.
The 2012 platform had noted that “the President issued an executive order repealing the restrictions on embryonic stem cell research.”
The 2008 platform had issued a call to “lift the current Administration's ban on using federal funding for embryonic stem cells– cells that would have otherwise have been discarded and lost forever–for research that could save lives.”
Republicans: “We call for expanded support for the stem cell research that now offers the greatest hope for many afflictions — through adult stem cells, umbilical cord blood, and cells reprogrammed into pluripotent stem cells — without the destruction of embryonic human life. We urge a ban on human cloning for research or reproduction, and a ban on the creation of, or experimentation on, human embryos for research” (pp. 37-38).

Assisted suicide and euthanasia

Democrats: No mention.
Republicans: “We oppose the non-consensual withholding or withdrawal of care or treatment, including food and water, from individuals with disabilities, newborns, the elderly, or the infirm, just as we oppose euthanasia and assisted suicide” (pp. 13-14).


Friday, July 15, 2016

Resources and summary of Planned Parenthood baby parts scandal

Resources from colleagues on Capitol Hill regarding the Planned Parenthood baby parts scandal:
One year ago the first of a series of videos showing Planned Parenthood and fetal tissue brokers discussing harvesting and selling baby body parts was released.  In the months following, the House responded to the information in the videos by voting to defund Planned Parenthood six times. The House also passed a bill to protect babies who survive abortions and established a Select Panel on Infant Lives to investigate. 

 Resources


Executive Summary 

Select Investigative Panel Interim Update to the House

I.                    Congress Created the Select Investigative Panel

a.       Following the release of undercover videos documenting shocking admissions and graphic footage of abortion clinics and so-called “tissue procurement companies,” Congress initiated hearings and subsequently created a Select Investigative Panel to carry out an in-depth investigation into the allegations revealed by the videos. The primary allegation was that abortion clinics received a payment for aborted babies’ body parts from tissue procurement companies who then resold those parts for researchers.

II.                 Formation of the Investigative Plan- Applicable Laws, Regulations, and Commissions

a.       Federal Laws that Address the Treatment of Women and Children

                                                              i.      There are guidelines in place meant to prevent the callous treatment of women and children whose privacy and well-being the Panel’s investigation reveals are being violated. Among them are the Born Alive Protection Act, the Belmont Report, the findings of several Presidential Commissions on bioethics, the HIPAA Privacy Rule, the Common Rule, Institutional Review Board Regulations, and federal statutes. Investigative evidence shows that the motive for disregarding these safeguards is financial gain. Abortion clinics remedy these problems by, among other activities, overbilling the government for Medicaid reimbursements and, more disturbingly, profiting from the sale of the leftover body parts of babies they have just aborted.

b.      Federal Statutes Governing the Transfer of Human Fetal Tissue

                                                              i.      The NIH Revitalization Act of 1993 (42 U.S.C. § 289g-1 and 42 U.S.C. § 289g-2): Rep. Waxman, a Democrat, offered the amendment to the NIH Revitalization Act of 1993 that governs the donation of fetal tissue, specifically §289 g-2(a). It states that “it shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human fetal tissue for valuable consideration if the transfer affects interstate commerce.”

                                                            ii.      The Statute Informed the Panel’s Investigative Plan: The main point of the Panel’s inquiry centered on this question: If fetal tissue is transferred from one entity to another, does the transfer violate the intent of §289 g-2? To answer this question, the Panel has analyzed four business models currently operating in the market sector and one operating in the public sector: 1) The Middleman Model; 2) The University/Clinic Model; 3) The Biotech Company/Clinic Model; 4) The Late-Term Clinic Model; and 5) The Government Funded Research Model.
                                                          iii.      Fetal Tissue Sales and Abortion Clinic Fiscal Problems: Although abortion providers and abortion rights advocates have a long history of stating that “it’s not about the money” but about women’s reproductive health, the Panel’s investigation has produced evidence that financial interests are increasingly driving management and clinical practice decisions.

III.              The Ethics of Fetal Tissue

a.       Amazing scientific and biomedical advances are continuously being discovered and developed. Congress, research institutions, and the medical community must continue to work together to promote medical advancements while simultaneously ensuring that laws and regulations on ethics remain up to date. On March 2, 2016, the Panel held a hearing entitled Bioethics and Fetal Tissue. The hearing focused on ethical issues raised as a result of information recently made public about fetal tissue donations, transfer of fetal tissue, and use of fetal tissue by research institutions.

IV.              Case Studies of the Fetal Tissue Industry

a.       At a hearing on The Pricing of Fetal Tissue, the Panel compared documents produced from StemExpress, LLC, a for-profit business, to the applicable federal statute. StemExpress obtains fetal tissue from abortion clinics and offers it for resale to researchers. The documents show that StemExpress embedded employees within a group of abortion clinics to procure fetal tissue, and those employees then shipped the tissue to customers. StemExpress paid the abortion clinics a per-tissue fee for each tissue its employees procured, plus a per-tissue bonus to StemExpress employees.

V.                Biomedical Research and Fetal Tissue

a.       The Panel’s investigation has produced a fact-based picture of the history, utility, and uses of fetal tissue in biomedical research. The importance of fetal tissue has been mischaracterized by political rhetoric. The Panel continues to seek ethical methods for the conduct of important research to find treatment and cures for injuries and disease.

VI.              Compliance with Congressional Subpoenas


a.       At least four entities from whom the Panel requested documents have failed to fully comply with the Panel’s requests. As a result, the Panel was forced to serve subpoenas on Southwestern Women’s Options, the University of New Mexico, Advanced Bioscience Resources, and StemExpress. However, none of these entities have complied with their subpoenas, making it impossible for the Panel to fully conduct its investigation. In some cases, the Panel has been made aware, through other sources, of documents missing from productions. The absence of these important documents raises the concern that others are missing as well.

Wednesday, July 6, 2016

Despite court losses, pro-life movement presses on

I represented the Christian Medical Association and Freedom2Care  today in Washington, DC for a strategy and prayer summit of leaders of the pro-life movement in the United States. Two stinging Supreme Court losses last week triggered our meeting: an overturning of a Texas law protecting women’s health and safety in abortion clinics, and a decision to refuse to review a lower court ruling allowing Washington state to force pharmacists to peddle potential abortifacients like Plan B. The latter decision portends dark and challenging days ahead for people of conscience in healthcare.
Our mood was both sober and determined.
We felt sobered by the decline in our culture—a decline which, according to 40 Days for Life leader David Bereit, parallels the historic pattern of crumbled civilizations. History has shown that sexual immorality, the disintegration of the family and a loss of respect for human life have marked the end of some of the world’s greatest civilizations.
At the same time, we also felt determined.
No one in that room had entered the pro-life movement with an illusion that building a culture of life would be any easier than the contentious work that Ezra and Nehemiah undertook in biblical days to rebuild the walls around the holy city, Jerusalem. These men and women are culture warriors, not fad followers.
They are motivated, first by a steadfast faith that God has made every human being in His image and calls us to protect the most vulnerable, and second by sheer compassion for the victims of the culture of death—both those who are killed and those who have been deceived into killing.
So we talked about strategically investing in the political process, to ensure that men and women of courage and conviction replace the typical politicians who run at the mention of opposition on pro-life issues.
We talked about influencing the culture, from polling to messaging to winning over millennials, who show encouraging trends toward a pro-life viewpoint.
I noted that our pro-life movement typically begins its outreach at the college age, in contrast to current movements to influence even elementary age students toward all kinds of anti-Chrsitian viewpoints. I suggested that we find out who is reaching children and teenagers with a pro-life message, and that we create new resources and structures to reach that age group.
Such an outreach to children and teenagers could incorporate medical and scientific information regarding fetal development and other evidence related to pro-life issues.
Perhaps you or someone you know is already providing resources to reach children and teenagers from a pro-life perspective? If so, I’d like to hear from you. Simply email me at washington@cmda.org, tell me what’s being done and provide contact information if you have it.
If we can reach the next generation to align themselves with God’s design for life, our laws eventually will reflect a new commitment to life.
Thank you for all you are doing to advanced that cause. God bless you, and keep up the good fight without wavering.

Monday, June 27, 2016

CMA doctors lament Supreme Court decision upending women's health protections in abortion clinics as ensuring "back-alley abortions"

Washington, DC, June 27, 2016—The 17,000-member Christian Medical Association (CMA, www.cmda.org) today lamented the Supreme Court's 5-3 decision to overturn a lower court ruling that upheld a Texas law protecting the health of women in abortion clinics.
CMA CEO Dr. David Stevens declared in a statement, "Given the shocking revelations of abysmal health and safety deficiencies in abortion clinics around the country, the Court's disallowance of health and safety requirements just protects what amount to back-alley abortions.
Kermit Gosnell's house of horrors
"Texas had the courage to require medically appropriate measures to protect women in abortion clinics, where state investigations had uncovered gross negligence and health hazards. The Supreme Court today upended those reasonable, medically necessary safety and health protections in favor of abortion ideology.
"We hear over and over the abortion mantra, 'safe, legal and rare.' But with over a million abortions a year and courts preventing even modest health and safety regulations, abortion is only legal—not at all safe or rare."
An amicus brief filed in  Whole Woman's Health v. Hellerstedt for CMA by Alliance Defending Freedom highlighted the state's interest in protecting women's health by passing reasonable protections that rationally relate to health risks: "Texas' law appropriately expresses Texas's constitutional interest in safeguarding women's health and maintaining medical standards. The Ambulatory surgical center requirements rationally relate to Texas's legitimate interest in upholding consistent standards for outpatient abortion providers. The admitting privileges requirement rationally relates to Texas's legitimate interest in regulating outpatient abortion."
CMA Executive Vice President Dr. Gene Rudd, an obstetrician-gynecologist, added, "Surgical and drug-induced abortion carry significant risks to the mother that require timely care and continuity of care. The way to ensure adequate care when abortion complications occur is to require that the physician who performed the procedure that resulted in the complication be able to assure rapid treatment of the patient. That needs to be done in a medical facility properly equipped to care for these types of surgical emergencies."

As CMA's brief noted, "That is exactly why ambulatory surgical facilities require admitting privileges for physicians performing surgery comparable to elective abortion, and exactly why Texas needs this law to ensure the health and safety of women undergoing both medical and surgical abortion."