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Wednesday, May 24, 2017

Court victory protects Vermont physicians from assisted suicide option counseling mandate

The Christian Medical Association CMA, www.cmda.org) celebrates a court victory, thanks to Alliance Defending Freedom (ADF), that protects Vermont physicians from being forced to violate the Hippocratic oath and participate in assisted suicide. (Which tells you, of course, that doctors who participate in assisted suicide have dismissed a vital patient protection of the Hippocratic oath--so choose your doctor carefully.)
ADF's news release [emphases added] on the victory follows:

Victory for Vermont health professionals after pro-suicide group drops appeal

Compassion & Choices withdraws appeal of court decision that affirmed pro-life physician groups aren’t mandated to counsel, refer for assisted suicide
Tuesday, May 23, 2017
RUTLAND, Vt. – A pro-suicide group has dropped its appeal of a federal court’s decision which affirmed that a Vermont law can’t be interpreted to require pro-life health professionals to counsel or refer patients for assisted suicide. As a result, the U.S. Court of Appeals for the 2nd Circuit officially dismissed the appeal Monday, thus ending the case.
The withdrawal of the appeal by Compassion & Choices leaves in place a consent agreement between physician groups and the Vermont Attorney General’s office, which agreed that the court was correct in deciding that the state’s Act 39 does not force conscientious professionals to ensure all “terminal” patients are informed about the availability of doctor-prescribed death.
ADF's Steve Aden
“Vermont health care workers just want to act consistently with their reasonable and time-honored convictions without fear of government punishment,” said ADF Senior Counsel Steven H. Aden, who argued before the U.S. District Court for the District of Vermont in November of last year in Vermont Alliance for Ethical Healthcare v. Hoser. “Conscientious Vermont healthcare professionals are in agreement with the state that the law doesn’t force them to participate in this heinous process, and they are pleased that the nation’s foremost advocate of assisted suicide, Compassion & Choices, has abandoned its effort to force them to do so.”
Alliance Defending Freedom attorneys and ADF-allied attorney Michael Tierney represent the Vermont Alliance for Ethical Healthcare and the Christian Medical and Dental Association, groups of medical professionals who wish to abide by their oath to “do no harm.”
Act 39, Vermont’s assisted suicide bill, passed with a very limited protection for attending physicians who don’t wish to dispense death-inducing drugs themselves, but state medical licensing authorities construed a separate, existing mandate to counsel and refer for “all options” for palliative care to include a mandate that all patients hear about the “option” of assisted suicide. For that reason, the groups representing pro-life health professionals filed suit.
The court ruled that the groups lacked a legal right to bring the lawsuit because the law actually doesn’t force them to act contrary to their conscience—a finding that Compassion & Choices initially opposed. The dismissal of the appeal leaves Vermont healthcare professionals free to “do no harm” without fear of retaliation for their pro-life views.
Alliance Defending Freedom is an alliance-building, non-profit legal organization that advocates for the right of people to freely live out their faith.
Previous news releases:
  • 2017-04-05: Vt. health professionals planning next legal steps after decision on conscientious objection to providing suicide info
  • 2016-11-07: Health professionals to court: Don’t allow Vermont to force us to help kill patients
  • 2016-09-26: Health professionals ask court to stop Vermont from forcing them to help kill patients
  • 2016-07-20: Vermont health professionals: Don’t force us to help kill our patients

Monday, May 15, 2017

Administration expands policy keeping foreign assistance from funding abortion groups overseas

In a phone briefing this morning originating at the U.S. Department of State, an administration official outlined Secretary of State Rex Tillerson's new plan, effective today, that expands the "Mexico City policy" that Republican presidents have employed to keep our foreign assistance tax dollars from propping up abortion groups overseas.
The Trump administration's presidential memorandum of January 2017 built upon and expanded previous directive by Republican presidents George W. Bush and Ronald Reagan. The Trump memorandum also directed the Secretary of State to develop an implementation plan.
That plan makes clear that the ban on funding related to certain abortion issues (details outlined in the timeline below) will now apply to any entity that receives US government foreign aid funding, including for programs such as HIV/AIDS, maternal and child health, malaria, family planning and reproductive health. Select programs including, for example, programs involving humanitarian assistance or defense, are not affected by this policy.
The State Department official also explained the bottom line for the expansion of the Mexico City policy. Whereas in previous years the abortion-related funding ban impacted roughly $500-$600 million in foreign assistance funds, the Trump policy now will impact $8.8 billion.

"Mexico City Policy" timeline

  1. 1984 - Reagan: At a population conference in Mexico City in 1984, the Reagan Administration announced that the United States would no longer contribute to nongovernmental organizations (NGOs) "which perform or actively promote abortion as a method of family planning in other nations."
  2. 1993 - Clinton: rescinds.
  3. 2001 – George W. Bush
    1. reinstates "in full all of the requirements of the Mexico City Policy in effect on January 19, 1993" and stipulates "no funding re: "perform nor actively promote abortion as a method of family planning in other nations."
    2. applies to State Dept./USAID
  4. 2009 – Obama rescinds.
  5. 2017 – Trump
    1. "reinstates the Presidential Memorandum of January 22, 2001";
    2. directs Sec. State "to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies."
    3. "further directs the Secretary of State to take all necessary actions, to the extent permitted by law, to ensure that U.S. taxpayer dollars do not fund organizations or programs that support or participate in the management of a program of coercive abortion or involuntary sterilization."

Thursday, May 4, 2017

Linking healthcare access to conscience freedoms, Christian Medical Association hails Presidential Executive Order

[The President's Executive Order text follows this press statement]
Washington, DC, May 4, 2017--Citing the link between patient access to healthcare and conscience freedom for health professionals, the 18,000-member Christian Medical Association (CMA, www.cmda.org) today expressed gratitude for President Trump's executive order that begins to provide stronger protections against discrimination against individuals and organizations of faith.
"Protecting religious freedom means protecting the millions of individuals served by organizations and professionals who are motivated and guided by the tenets of their faith," explained Dr. David Stevens, CEO of the 85-year-old nonpartisan organization of Christian doctors and students. "The faith that compels so many health professionals to minister to patients in underserved areas and populations is the same faith that compels us to practice according to moral and ethical guidelines. Conscience freedoms are the foundation of our service.
"When the government refuses to accommodate those faith principles, or--as we experienced in the previous administration's contraceptives and transgender mandates--attempts to coerce people of faith to violate those principles, those who suffer include the poor, the marginalized and the vulnerable."
Represented by Becket Law, the Christian Medical Association recently successfully challenged the Obama administration's transgender mandate. Represented by Americans United for Life, CMA filed an amicus brief in the contraceptives mandate Supreme Court case, Zubik v. Burwell.
CMA also worked to help establish the nation's first health professionals' conscience protection rule, promulgated in 2008 by the U.S. Department of Health and Human Services. The Obama administration subsequently gutted the conscience rule and also attempted to force faith-based organizations to participate in morally objectionable contraceptives such as Plan B and the morning-after pill.

"We are grateful for this executive order that begins to turn the tide back toward freedom of faith and speech, including political speech. Americans do not give up their First Amendment protections when they speak from the pulpit, counsel their patients or minister in a faith-based outreach to help the poor," Dr. Stevens observed. "Threatening the First Amendment freedoms of any one group threatens the First Amendment freedoms of all of us, and protecting those freedoms protects us all." 
-----
EXECUTIVE ORDER
PROMOTING FREE SPEECH AND RELIGIOUS LIBERTY
      By the authority vested in me as President by the Constitution and the laws of the United States of America, in order to guide the executive branch in formulating and implementing policies with implications for the religious liberty of persons and organizations in America, and to further compliance with the Constitution and with applicable statutes and Presidential Directives, it is hereby ordered as follows:

     Section 1Policy.  It shall be the policy of the executive branch to vigorously enforce Federal law's robust protections for religious freedom.  The Founders envisioned a Nation in which religious voices and views were integral to a vibrant public square, and in which religious people and institutions were free to practice their faith without fear of discrimination or retaliation by the Federal Government.  For that reason, the United States Constitution enshrines and protects the fundamental right to religious liberty as Americans' first freedom.  Federal law protects the freedom of Americans and their organizations to exercise religion and participate fully in civic life without undue interference by the Federal Government.  The executive branch will honor and enforce those protections.

     Sec. 2Respecting Religious and Political Speech.  All executive departments and agencies (agencies) shall, to the greatest extent practicable and to the extent permitted by law, respect and protect the freedom of persons and organizations to engage in religious and political speech.  In particular, the Secretary of the Treasury shall ensure, to the extent permitted by law, that the Department of the Treasury does not take any adverse action against any individual, house of worship, or other religious organization on the basis that such individual or organization speaks or has spoken about moral or political issues from a religious perspective, where speech of similar character has, consistent with law, not ordinarily been treated as participation or intervention in a political campaign on behalf of (or in opposition to) a candidate for public office by the Department of the Treasury.  As used in this section, the term "adverse action" means the imposition of any tax or tax penalty; the delay or denial of tax-exempt status; the disallowance of tax deductions for contributions made to entities exempted from taxation under section 501(c)(3) of title 26, United States Code; or any other action that makes unavailable or denies any tax deduction, exemption, credit, or benefit.

     Sec. 3.  Conscience Protections with Respect to Preventive-Care Mandate.  The Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health and Human Services shall consider issuing amended regulations, consistent with applicable law, to address conscience-based objections to the preventive-care mandate promulgated under section 300gg-13(a)(4) of title 42, United States Code.

     Sec. 4Religious Liberty Guidance.  In order to guide all agencies in complying with relevant Federal law, the Attorney General shall, as appropriate, issue guidance interpreting religious liberty protections in Federal law.

     Sec. 5.  Severability.  If any provision of this order, or the application of any provision to any individual or circumstance, is held to be invalid, the remainder of this order and the application of its other provisions to any other individuals or circumstances shall not be affected thereby.  

     Sec. 6General Provisions.  (a)  Nothing in this order shall be construed to impair or otherwise affect:

(i)   the authority granted by law to an executive department or agency, or the head thereof; or

(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

     (b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

     (c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
DONALD J. TRUMP
THE WHITE HOUSE,

May 4, 2017.

Thursday, April 20, 2017

Explaining at the Supreme Court why kids at churches need public safety protection, too

#Fairplay: "Government should not set up a
religious test for which kids get protection on playgrounds."
I spoke yesterday outside the U.S. Supreme Court during oral arguments in a court case over whether the Government can exclude kids who play on church-owned playgrounds from safety programs. The case could have broad implications across the nation for how governments treat faith-based institutions and individuals.
I really appreciated working together with colleagues from groups like Concerned Women for America (CWA) and Alliance Defending Freedom (ADF) to highlight the message that Government should not set up a religious test for which kids get safety protections.

Check out photo and video highlights from CWA and ADF: (see 4/19 ADF video posted at 10:17 a.m. Apr 19). My remarks at the Court are on the ADF video noted above at around the 34:00-minute mark.
Following is text of my presentation:

Wednesday, April 5, 2017

US no longer props up abortion coercion in China

View Reggie Littlejohn's video
My friend Reggie Littlejohn, Founder and President of Women's Rights Without Frontiers, has long advocated for women in China who live under the regime's oppressive child limitation policy, which has included forcible abortions.
Wang Liping
Consider this chilling testimony by Wang Liping*:
At around 6pm on March 31, 2008, I was stopped by a couple of people on the street in Guying Town. They asked me to go with them. They told me they were from Guying Population and Family Planning Office when I asked who they were. However, they didn’t show me their badges. They wanted to take me into their car but I refused to comply. So those people beat me up and dragged me to the Guying Hospital, PLA Air Force Hospital and Litang Hospital, and asked them to do induced labor on me.  But none of those hospitals was willing to do that to me.
At 11:00 p.m., they took me to the Laoyachen Hospital, and forcibly induced labor on me without any examination or my signature. My seven-month unborn child was killed. At that time I was crying out loud for help and those people beat me up. They and some doctors and nurses pushed me onto the ground and took my pants off. Then they injected some medicine at my fetus’ location in my belly, and then they roped me onto a sickbed. I could not resist this and nobody came to help me. I could not imagine that this brutal and bloody behavior could happen in the civilized 21st century
This week the Trump administration acted to stop the US from subsidizing such government coercion, by finally enforcing a law that bars funding to organizations that either carry out or support abortion coercion. The news report from Capitol Hill:
The State Department has made a determination that the United Nations Population Fund (UNFPA) is ineligible to receive global health funds under the Kemp-Kasten Amendment. This longstanding appropriations rider precludes funding for any organizations that “supports or participates in the management of a program of coercive abortion or involuntary sterilization.” Despite the Kemp-Kasten Amendment, the Obama Administration continued to fund UNFPA.
In the memo transmitted to Congress on April 3, the State Department determination explains that China’s National Health and Family Planning Commission (NHFPC) oversees the implementation of China’s “two-child” birth limit law and the NHFPC is listed as a UNFPA partner in Country Program 8. The determination says that “by implementing a portion of its family planning program in partnership with that government entity [NHFPC], UNFPA provides support for NHFPC’s implementation of China’s family planning policies, which includes coercive elements.”
Under this determination UNFPA will no longer receive funding, and those funds that are no longer available to UNFPA will be transferred to the Global Health Programs account for other family planning, maternal, and reproductive health activities. 
Rep. Smith (l), Jonathan Imbody confer at White House
Congressman Chris Smith, Co-Chair of the Congressional Executive Commission on China, said in a statement that “In contrast to the Obama Administration’s silent acceptance of the coercion, suffering, and death of Chinese citizens, I am heartened by the Trump Administration’s early action to apply Kemp-Kasten and end US support for this most egregious human rights violation,” The complete release from Congressman Smith can be viewed here.
*The account of Wang Liping is Case 12 in the report submitted into the Congressional Record by Reggie Littlejohn, entitled, "New Evidence Regarding China’s One-Child Policy -- Forced Abortion, Involuntary Sterilization, Infanticide and Coercive Family Planning." To read this document, click here.

Thursday, March 23, 2017

Shining light on the human trafficker

He sits in the lurking places of the villages;
In the hiding places he kills the innocent;
His eyes stealthily watch for the  unfortunate.
He lurks in a hiding place as a lion in his lair;
He lurks to catch the afflicted;
He catches the afflicted when he draws him into his net.
He crouches, he bows down,
And the unfortunate fall by his mighty ones.
He says to himself, “God has forgotten;
He has hidden His face; He will never see it.”

-- Psalm 10:8-11
Photo by Kay Chernush for the U.S. State Department
The despicable exploiter portrayed in Psalm 10 counts on God "never seeing" his crimes as he lurks in the shadows. Likewise, today's human traffickers count on health professionals "never seeing" their crimes.
Many health professionals will recall seeing patients who raised red flags. Something about the injuries, the patient's affect or the person accompanying the patient didn't seem right.
In fact, a study of rescued victims revealed that nearly nine in ten victims during their captivity had been taken, typically by a pimp or trafficker, to see a health professional. But researchers found no evidence that any health professional had reported a single one of these victims.
Imagine the difference in the life of a victim—think of her as your own daughter--if just one health professional had asked a probing question or made a phone call to authorities.
Thankfully, awareness campaigns and medical curricula are helping professionals learn to spot the signs and take appropriate action. The Christian Medical Association, for example, has developed ten online training modules with continuing medical education credit to equip health professionals with lifesaving skills.
Alert and action-ready health professionals can shine a light to break through the shadows in which the trafficker lurks. The God who remembers the victim and sees the injustice can use you in His plan to rescue, redeem and restore precious individuals.
---

National Human  Trafficking Hotline: 

888-373-7888 

www.acf.hhs.gov/endtrafficking
health and trafficking brochure

Thursday, March 9, 2017

That awkward moment when sex ed research paralleled common sense and parental preference

A Congressional staff briefing today, presented by ASCEND, offered legislators research and common sense reasons to change direction in sex ed program funding.
For years, liberals/progressives/people mad at the Church have been railing against any approach to sex ed that veers off the party line that teens are going to have sex no matter what, so just break out the condoms on bananas instructions and the explicit curricula. If you can't stop them from having sex, might as well teach them how to have all kinds of sex.
Never mind that research shows that to provide a significant measure of protection against certain sexually transmitted infections and diseases, condom use requires not only manufacturing perfection (no breakage or leaks) but also methodological consistency (careful and systematic application every single time).
How many teenagers do you know who might be described as careful and systematic at any time, much less late at night in the heat of passion?
Maybe that's why so many parents prefer the educational approach now known as Sexual Risk Avoidance. They know what their teens are actually like, and besides recognizing the personal and health risks of sexual activity, they also give their teens a lot more credit for the capacity to make good choices than do liberal-leaning sex ed curriculum developers.
Sexual Risk Avoidance education also parallels public health strategies employed in programs designed to prevent smoking and alcohol abuse. Imagine an anti-smoking program that assumed that teens were going to smoke anyway, so let's encourage them to smoke cigarettes with filters.
As with most common-sense, parental-preferred programs, Sexual Risk Avoidance (SRA) education has faced intense opposition in Washington, DC. The Obama crowd insisted that research and SRA were incompatible and instead funneled millions into the controversial, "comprehensive" sex ed approach that pleads agnosticism as to whether or not teen sex is good or bad. The funding disparity between that approach and actually teaching teens how to postpone sexual activity in 2014 reached 20 dollars for "comprehensive" sex ed for every one dollar of Sexual Risk Avoidance sex ed.
Tha turned out to be a terrible gamble.
ASCEND, a terrific organization that courageously has stood strong for Sexual Risk Avoidance education in the face of tremendous opposition, summarizes what happened when the US Government shoveled your tax dollars with reckless abandon into "comprehensive" sex education:

HHS Report Shows Lack of Effectiveness for “Comprehensive” Sex Ed.

Five years and more than a half billion dollars later, it appears that what were promised as effective models for sex education curricula simply are not.  In a blow to the heavily-funded federal Teen Pregnancy Prevention Program (TPP), new research shows dismal results for youth served in the program. Begun in 2010, the TPP program was called “evidence-based” by the US Department of Health and Human Services (HHS) and communities were guaranteed positive results if they implemented one of the curricula on the HHS-approved list, as shown by this quote found on the HHS website: “Evidence-based programs can be expected to produce positive results consistently.“[1] But the findings of the newly released research shows the promise was mostly inaccurate.
According to researchers who worked on the evaluation project, “most of the programs had small or insignificant impacts on adolescent behavior.”[2] A closer look at the research findings reveals that this summary may be a generous assessment of the results, since some youth actually fared worse when they were enrolled in some of the funded projects.
Compared with their peers who were in the program, teens in some TPP-funded projects were more likely to begin having sex, more likely to engage in oral sex, and more likely to get pregnant. In fact, more than 80% of students in these programs fared either worse or no better than their peers who were not in the program.
Valerie Huber, president/CEO of Ascend responded to the TPP results: “For years, we have been concerned that objective research protocols were ignored when making the ‘evidence-based’ promises for TPP.  As a result, school administrators and community stakeholders were led to believe that if they wanted their youth to thrive, they mustimplement curricula from the TPP ‘evidence-based’ list. Many well-intentioned decision makers did just that, but now they learn that this decision may have been ill-advised – and that their students may be at increased risk as a result.”
"This research gives us serious reason to pause – ask the hard questions - and be willing to amend what messages we are giving vulnerable youth. It’s time to bring honesty and transparency to the entire issue of sex education. The fact is that the sexual risk reduction approach, typified in the TPP program, holds no claim on successful models that guarantee sexual health for youth.”
The lessons from public health tell us two things that should inform sex education policies, beginning today:
1. The healthiest message for youth is one that gives youth the skills and information to avoid the risks of teen sex, not merely reduce them. This is a message that is relevant in 2016, since the majority of teens have not had sex, far fewer, in fact, than 20 years ago.[3] Therefore, we need to be more intentional with finding the best ways to help youth achieve this optimal health outcome.
2. TPP programs overwhelmingly normalize teen sex – a message that 1 in 4 teens say makes them feel pressured to have sex.[4] The recently-released TPP research appears to confirm this felt sexual-pressure. As a society, we must normalize sexual delay and make it a realistic expectation.
Huber suggests one more consideration: “Sex education posturing and policies should not be about winning or losing a debate. Policies must be about increasing the chances that all youth can obtain optimal sexual health and a brighter opportunity for a healthy and successful future.  Nothing less is acceptable.”
A summary of the findings from HHS can be found here.
________________________________________
[1] HHS, Office of Adolescent Health (OAH) website. Retrieved October 14, 2016 at http://www.hhs.gov/ash/oah/oah-initiatives/teen_pregnancy/training/curriculum.html
[2] (2016). Special issue of American Journal of Public Health explores impacts of Teen Pregnancy Prevention Program. American Journal of Public Health: September 2016. 106 (S1):S9-S15.
Retrieved on October 14, 2016 at  http://www.news-medical.net/news/20160930/Special-issue-of-American-Journal-of-Public-Health-explores-impacts-of-Teen-Pregnancy-Prevention-Program.aspx
[3] CDC (2016) YRBS. Atlanta: Author. Retrieved October 14, 2016 at
https://nccd.cdc.gov/Youthonline/App/QuestionsOrLocations.aspx?CategoryId=C04
[4] (2015). Teens speak out. Ventura: Barna Research. 

 
 
 
                                                               ###
________________________________________
Ascend (formerly the National Abstinence Education Association) champions youth to make healthy decisions in relationships and life by promoting well being through a primary prevention strategy, and as a national membership and advocacy organization that serves, leads, represents and equips the Sexual Risk Avoidance field.

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