The Point - May 2012
In this edition:
- Your faith and your practice
- Allowing non-physicians to perform abortions?
- California may ban gay teen 'conversion' therapy
Excerpt from "Setting faith aside can make doctors less effective, researchers find," Press Herald. April 7, 2012--Doctors and scholars examine how physicians are discouraged or encouraged from integrating their faith and their practice. As a medical student, Dr. Julie Oyler was told to remove the cross she wore on the lapel of her white coat. As a resident, Dr. Aasim Padela was told he wouldn't have time to recite Islam's five daily prayers. But ignoring God was not an option for Oyler, an evangelical Christian, and Padela, a Muslim. Nor should it be, according to researchers at the University of Chicago, where both doctors now freely practice their medical specialties and religious traditions. After discovering that silence on matters of spirituality left some patients unsatisfied with the care they received at the University of Chicago, two doctors there and four faculty scholars have chosen to examine how some medical schools either encourage or discourage physicians to integrate their faith both in conversations with patients and their own professional lives. Doctors who set their faith aside, they say, can become disillusioned and less effective. "When doctors are dispirited, the care they give to patients is worse," said Dr. Farr Curlin, co-director of the Program on Medicine and Religion. "Patients should be very hopeful that their doctor sees their work as a remarkable privilege, even a holy privilege, that will make the doctor respond to that patient out of joy." Both Curlin and Dr. Daniel Sulmasy, an internist who also serves on the Presidential Commission for the Study of Bioethical Issues, said they believe that as the gap between health care and religion has widened, the quality of care for patients has diminished.
Both men say policymakers and insurers have perpetuated that sense of alienation by treating healthcare as nothing more than a business. That has led some doctors to feel unfulfilled. Many seem to have forgotten the calling that led them to medicine, having been urged to abandon that way of thinking and focus on science, Sulmasy said. For many, that repression of faith begins in basic training when medical students are typically pressured to set their lifelong beliefs aside and focus on objective science. Oyler, a primary care physician at the University of Chicago, said she felt uncomfortable sharing her faith for years after she was reprimanded as a medical student for wearing a cross on the collar of her white coat. While she still doesn't advertise her evangelical Christian faith to patients, she does establish during the initial appointment what role religion plays in her patients' lives, in case that becomes the basis for decisions they make over time. If the person shares her Christian faith, she lets them know they have something in common.
Though the American Medical Association has no policy encouraging or discouraging a separation of church and medicine, the Joint Commission, the accrediting agency for health care institutions, requires medical professionals to receive some training in spiritual care. Still, there are some who believe God talk should be taboo in medicine and religion should play no role in a doctor's bedside manner. Full story can be found here.
CMDA Past President Al Weir, MD: "What role should faith play in our work as Christian doctors? Should it be visible? Should it be shared?
"Dr. Farr Curlin in Chicago and others, like Dr. Tracy Balboni in Boston, have addressed this issue with scientific methodology for many years. Their investigations clearly point to the conclusion that most patients wish for doctors to be open with their faith and to address spiritual issues. In 2005, Dr. Curlin summarized his recommendations for doctors in a beautiful article entitled Strangers or Friends (J Gen Int Med 2005; 20:370-374). He proposed that patients desire a doctor’s wisdom, not competence alone; patients desire respect for their faith issues, not avoidance; and patients desire candor rather than neutrality. Our patients want us to be authentic, especially if we are demonstrating the life God has called us to live.
"And they should. Our faith in Christ is a chisel that fashions us into better doctors. Faith in Christ shapes our character into integrity; knowing Him shapes our motivation into love; His truth defines all patients as persons of value; His presence brings wisdom into whole person care. For the good of our patients, Christians need to be authentic. This alone is enough to keep me on my knees every day.
"In addition, we have a mandate from the Creator of the Universe to share our faith, to bear witness. How we do that is another great story."
Excerpt from "California bill allowing non-physicians to perform abortions falters, Christian Examiner. April 30, 2012--A California Senate committee stalled a bill on Apr. 26 that would allow non-physicians to perform first-trimester suction abortions, shooting it down on a 4-4 vote. SB 1338, sponsored by Sen. Christine Kehoe of San Diego, sought to allow midwives, nurse practitioners and physicians assistants to perform abortions without medical supervision. The Senate Public Safety Committee approved the measure, but amended it so that only 41 non-physicians taking part in an as-yet incomplete five-year pilot training program could perform them. But the 4-4 vote in the Senate Business, Professions and Economic Development Committee didn’t decisively end the matter: The committee granted a reconsideration, which will bring it back for another vote on May 4.
Suction abortions involve inserting a cutting tool into the womb, which dismembers the preborn baby’s body. The remains are then evacuated through a suction tube into a bottle. The pilot program training midwives, nurse practitioners and physicians assistants to perform abortions is led by Tracy Weitz, a professor at the University of California-San Francisco, but underwritten by the John Merck Fund, which has made large donations in the past to the Planned Parenthood Federation of America, the Center for Reproductive Rights and Choice USA. Weitz testified that “nurse practitioners, certified nurse midwives and physician assistants can safely perform aspiration abortions in California.” But because of the risk of perforating the uterus or incompletely evacuating the fetal remains, pro-life advocates say the risks remain high — much higher than the study would lead people to believe.
The California Nurses Association, which usually leans left on abortion issues, called SB 1338 “ill-conceived and unnecessary.” In a letter, the bishops of the California Catholic Conference said that “in the name of enhancing access, convenience and cost-savings, this bill will do nothing to make abortion ‘safe and rare.’ ” “You don’t have to be anti-abortion to oppose this attempt to lower the standard of health care for women and girls based not on completed scientific evidence but on ideology and financial gain,” wrote political watchdog Margaret A. Bengs in an April 21 Sacramento Bee op-ed. Full story can be found here.
CMDA Senior Vice President Gene Rudd, MD: "Having experience in teaching and practicing with certified nurse midwives, I have long advocated for non-physician healthcare professionals. So, while a reasonable concern can be raised about safety issues if non-physicians are licensed to do abortions, that is not my primary concern. My concern is placing non-physician health professionals in the shadowy world of abortion; a world that does not attract the most competent skills or character; a world where institutional quality standards are poorly monitored; a world of inadequate professional accountability; a world willing to place agenda over beneficence.
"Even if pilot studies show nurse practitioners and physician assistants perform abortions with reasonable safety outcomes, we cannot assume that will reflect future reality. The controls of a research environment and the researcher bias common in abortion studies will likely result in more favorable outcomes than will occur if non-physician practitioners are allowed behind the veil of the abortion industry.
"Caveat lawmaker: let the California legislators beware. For if they fail to protect unsuspecting women, I fear the consequences."
Excerpt from "California may ban gay teen 'conversion' therapy ," Associated Press, by Hannah Dreier. March 6, 2012--A first-of-its-kind ban on a controversial form of psychotherapy aimed at making gay people straight is speeding through the California statehouse. Supporters say the legislation, which passed its final Senate committee Tuesday, is necessary because such treatments are ineffective and harmful. "This therapy can be dangerous," said the bill's author Sen. Ted Lieu. The Torrance Democrat added the treatments can "cause extreme depression and guilt" that sometimes leads to suicide. Conservative religious groups emphatically reject that view of sexual orientation therapy and say the ban would interfere with parents' rights to seek appropriate psychological care for their children. The bill would prohibit so-called reparative therapy for minors and obligate adults to sign a release form that states that the counseling is ineffectual and possibly dangerous.
Conversion therapy penetrated the national consciousness last year when former Republican presidential candidate Michele Bachmann was questioned over whether her husband's Christian counseling business provided services that attempted to change gays and lesbians. Interest in the religion-based therapy appears to have surged in recent years, sparking debates about whether sexual orientation is an immutable characteristic.
The American Psychological Association said in 2009 that mental health professionals shouldn't tell gay clients they can become straight through therapy. The American Counseling Association and American Psychiatric Association have also disavowed the therapy. The psychiatric association removed homosexuality from its list of mental disorders nearly 30 years ago. The practice has garnered attention in past years as teens sent by their parents to conversion therapy programs have shared their stories online. Full story can be found here.
CMDA Member and board-certified family physician Andre' Van Mol, MD: "Senator Ted Lieu’s SB1172 is the first legislative effort to ban sexual orientation-change efforts (SOCE) for those under 18 and to require adults seeking such therapy to sign 'informed consent forms.'
"Psychologist Christopher Rosik, President of National Association for Research Therapy of Homosexuality, noted that the only study cited in the bill -- Ryan, et al. (2009), 123, Pediatrics, 346-352 -- examined family rejection and not SOCE; used flawed sampling; showed recruitment bias; was limited to young adults and not youth; and the study itself cautioned against generalizing its results (p.351). The study has no legitimate place as scientific backing for the bill.
'Sen. Lieu erroneously claimed in a press statement, 'Sexual orientation change efforts pose critical health risks to lesbian, gay and bisexual people' up to and including depression, substance abuse and suicide. The senator also claimed there is insufficient evidence that any type of psychotherapy can change a person's sexual orientation.' Dr. Rosik replies by asking why California’s licensing agencies and mental health associations failed to issue licensure revocations or membership suspensions among therapists if SOCE was such a known hazard.
"The truth is the opposite of Sen. Lieu’s assertions. Decades of studies show positive results of SOCE for those who wish it. Homosexual practice itself leads to loss of 25 to 40 percent of life expectancy with higher rates of infectious disease, cancers, substance abuse, depression, anxiety, multiple psychopathologies and suicide. GLBT relationships are shown to be shorter lived, more prone to abuse and not the carbon copy of heterosexuality claimed by the gay and lesbian task forces of several professional guilds so easily maneuvered by the planned political-ideological stacking of key committees. Simply put, gay sex is bad for people, change is possible and many want it.
"SB1172 is ideology masquerading as science and an example of the intolerance, compulsory conformity and bullying tactics by which GLBT activists makes gains, but of which they accuse their opponents."