Christian Medical Association applauds new Tennessee policy to protect vulnerable patients during pandemic

Bristol, TN—June 26, 2020: The Tennessee-based, 18,000-member Christian Medical Association (CMA, www.cmda.org) today applauded a Tennessee patient protection policy announced this afternoon by the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) and developed collaboratively between HHS, the state of Tennessee and disability rights groups.

CMA's Executive Vice President for Bioethics and Public Policy, Dr. Jeffrey Barrows, noted, "Patients with disabilities face even greater challenges than others during a pandemic, and we're thankful that both the federal government and the state of Tennessee are standing in the gap to protect the civil rights of all Americans. No person with a disability should have to fear that a government will assign their lives a lower value simply because they live with physical challenges."

The policy, announced today by HHS, reportedly incorporates crucial protections into the state's Crisis Standards of Care plan, stipulating that factors such as age or disability should not be used as criteria in determining the allocation of scarce resources. The policy also protects vulnerable patients who require additional resources from automatically being assigned a lower priority to receive lifesaving care.

Working with the HHS OCR, the state agreed to remove language permitting the use of a patient's long-term life expectancy as a factor in determining assignment of scarce resources. The policy also stipulates that long-term ventilator users will be protected from having their own ventilators taken from them and given to someone else.

Dr. Barrows, an Obstetrician-Gynecologist, observed, "Every human life is of immeasurable worth at every stage of life, regardless of physical challenges. We congratulate the HHS Office of Civil Rights for ensuring the civil rights of persons with disabilities. We also encourage the Department to ensure that civil rights are extended to vulnerable persons of all ages, including babies born prematurely."

HHS addresses "transgender mandate" in new rule … but Supreme Court redefines "sex discrimination"

The U.S. Department of Health and Human Services (HHS) announced on June 12 that it had "finalized a rule under Section 1557 of the Affordable Care Act (ACA) that maintains vigorous enforcement of federal civil rights laws on the basis of race, color, national origin, disability, age, and sex, and restores the rule of law by revising certain provisions that go beyond the plain meaning of the law as enacted by Congress."

CMA and Becket express optimism

The Christian Medical Association (CMA) expressed optimism that the new HHS rule, which was influenced by a CMA court case and buttressed by CMA polling, will help protect medical judgment and the exercise of conscience in healthcare.

"Health professionals know they must base medical decisions on biology and science, not ideology," said Dr. Jeff Barrows, CMA's Executive Vice President for Bioethics and Public Policy and an Ob-Gyn physician. "Biological gender carries very significant health implications that a physician must be able to recognize in making treatment decisions. The freedom for a health professional to base decisions on the medical science regarding biological gender also carries conscience concerns that should not be overruled by politics or ideology.

"We are hopeful that this rule will help steer consideration of gender issues in healthcare back toward science and away from politics and ideology, back to the protection of professional medical judgment and the freedom to adhere to long-observed ethical and moral standards."

Luke Goodrich, vice president and senior counsel at Becket—the firm that represents CMA in its case against the 'transgender mandate--added, “No doctor should be forced to perform a procedure she believes would harm a patient. The new rule will help ensure that all patients receive top-notch care without forcing doctors to perform potentially harmful procedures in violation of their religious beliefs and medical judgment."

CMA lawsuit and polling influenced new HHS rule

The new HHS rule was influenced by a successful and ongoing CMA and Franciscan Alliance lawsuit aimed at stopping the previous administration's "transgender mandate" that had trampled medical judgment and nixed conscience objections over transgender procedures and prescriptions. The old rule had interpreted "sex discrimination" under Section 1557 of the Affordable Care Act (Obamacare) to include not just biological sex but also termination of pregnancy and gender identity, which the old rule defined as “one’s internal sense of gender, which may be male, female, neither, or a combination of male and female.”

As Roger Severino, Director of the Office for Civil Rights at HHS, explained in announcing the new final rule, "HHS will continue to vigorously enforce federal civil rights laws prohibiting discrimination on the basis of race, color, national origin, disability, age, and sex in healthcare, as Section 1557 provides. HHS respects the dignity of every human being, and as we have shown in our response to the pandemic, we vigorously protect and enforce the civil rights of all to the fullest extent permitted by our laws as passed by Congress. We are unwavering in our commitment to enforcing civil rights in healthcare."

In its announcement, HHS highlighted the impact that CMA's successful lawsuit had on the rules, noting, "On December 31, 2016, a federal court preliminarily enjoined, on a nationwide basis the prior administration’s attempt to redefine sex discrimination in the 2016 Rule, concluding that the provisions were likely contrary to applicable civil rights law, the Religious Freedom Restoration Act, and the Administrative Procedure Act."

HHS also cited as rationale for its new rule CMA's national polling of faith-based health professionals that had been submitted to HHS during the public comment period on the proposed rule.

HHS observed that CMA "commenters, however, cited a survey showing that 97% of responding faith-based medical professionals attest that they 'care for all patients in need, regardless of sexual orientation, gender identification, or family makeup, with sensitivity and compassion, even when [they] cannot validate their choices.' Thus, some commenters argue, the issue is not one of refusing to care for certain patients based on identity, but instead a matter of declining to participate in a discrete set of morally controversial procedures and treatments that are available elsewhere."

CMA's polling also found that 91% said they would stop practicing medicine apart from conscience protection.

Supreme Court redefines "sex discrimination"

While the HHS final rule highlighted the common understanding of the term "sex" as referring to biological male or female, the Supreme Court just a week later issued a decision reinterpreting "sex discrimination" in employment to include discrimination based on sexual orientation and gender identity.

According to the majority opinion, authored by Justice Gorsuch, if any employer “fires an individual for being homosexual or transgender,” then the employer has fired that person “for traits or actions it would not have questioned in members of a different sex.” Thus, the employer has engaged in “sex discrimination” in violation of federal law.

In his dissenting opinion, Justice Alito warned that the ruling “is virtually certain to have far-reaching consequences.” In particular, Justice Alito noted that “[h]ealthcare benefits may emerge as an intense battleground under the Court’s holding,” because the Affordable Care Act “broadly prohibits sex discrimination in the provision of healthcare.”

One example of that issue is CMA's "transgender mandate" lawsuit. Winning the religious freedom aspect of that case now takes on even greater importance.

As Justice Alito noted, “[S]ome employers and healthcare providers have strong religious objections to sex reassignment procedures, and therefore requiring them to pay for or to perform these procedures will have a severe impact on their ability to honor their deeply held religious beliefs.”

Call to courage and spiritual battle

Clearly some of the foundations of our faith, medical science and reality itself are under attack in the courts and in our legislatures. We know from Scripture that spiritual forces lie behind attacks on God's immutable truth and on the design of His creation.

Ultimately our enemy is not deceived legislators, activists or judges but the false ideas and spiritual forces of deception that have blinded eyes to the truth—truth that can set us free to live according to God's design.

Pray for our country, our courts, our lawmakers and CMDA, that we might all conform our lives to God's truth and follow His perfect path to human fulfillment and justice.

Related resources:

•  Freedom2Care - CMA's project focused on freedom of faith, conscience and speech
• CMA/Freedom2Care national polling – on conscience and compassionate care
• Final HHS Rule - PDF
• Factsheet on HHS rule - PDF

Christian Medical Association doctors express hope that HHS gender rule will uphold medical judgment and conscience

Washington, DC, June 12, 2020—The 18,000-member Christian Medical Association (www.cmda.org) today expressed optimism that a just-finalized rule by the U.S. Department of Health and Human Services that deals with gender issues will help protect medical judgment and the exercise of conscience in healthcare.

"Health professionals know they must base medical decisions on biology and science, not ideology," said Dr. Jeff Barrows, CMA's Executive Vice President for Bioethics and Public Policy and an Ob-Gyn physician. "Biological gender carries very significant health implications that a physician must be able to recognize in making treatment decisions. The freedom for a health professional to base decisions on the medical science regarding biological gender also carries conscience concerns that should not be overruled by politics or ideology.

"We are hopeful that this rule will help steer consideration of gender issues in healthcare back toward science and away from politics and ideology, back to the protection of professional medical judgment and the freedom to adhere to long-observed ethical and moral standards."

Responding to anti-Christian animus revealed in the pandemic

The pandemic has revealed much about human nature, sacrificial Christian love and hostility toward followers of Christ.

Activists lobby to banish Christians working to save COVID-19 patients

Samaritan's Purse volunteers risked their lives at their
own expense to save lives in New York City.

In New York City, pronouncements against the volunteer work of the Christian relief group Samaritan's Purse revealed venomous anti-Christian attitudes. Because Samaritan's Purse, led by Franklin Graham, the son of the late evangelist Billy Graham, adheres to a biblical view of marriage, some New Yorkers would have had the group kicked out of the city rather than allowed to help save lives.

According to NBC News, for example, an LGBT activist protestor summed up the sentiment  against the Christian organization by saying, "How was this group ever considered to bring their hatred and their vitriol into our city at a time of crisis when our people are fighting a pandemic?” According to the New York Times, "the Democratic speaker of New York’s City Council urged Samaritan’s Purse to leave the city."

Meanwhile, of course, Samaritan's Purse staff and volunteers risked their lives at their own expense to save the lives of as many New Yorkers as they could. Like virtually all Christian health professionals who participated in national polling by the Christian Medical Association and Freedom2Care, they had committed to "care for all patients regardless of agreement with patients' choices."

Anti-Christian hatred threatens Christian health professionals

A Christian physician who serves in New York City wrote of healthcare colleagues feeling "incensed since day one" and of "enraged emails and faculty meetings that demand 'kicking them out.'" The physician worried that anyone known to associate with Samaritan's Purse staff would be subjected to personal reprisals.

I wrote to this Christian physician:

Thank you for your incredible work and perseverance in the face of tremendous stress. May God bless, strengthen and inspire you and you have inspired us.

It sounds like you are essentially viewing raw human nature apart from God, something akin to what C.S. Lewis paints a picture of in The Great Divorce.

You also seem to be living and experiencing life in a way reminiscent of the early Christians, who shone as lights in pagan darkness and hostility that went beyond words to rocks and lions.

In our times of growing hostility toward the things of God, I suspect He is calling Christian health professionals to make clear decisions along the lines of Daniel, who first “made up his mind that he would not defile himself” (Daniel 1:8) by compromising values under pressure, and with Queen Esther, who finally conquered her fear with faith, determining that “if I perish, I perish” (Esther 4:16).

In other words, if a Christian health professional can stay true to God’s principles by determining beforehand to let it all go and leave career, reputation and future in His hands, then faith can begin to conquer fear and enable one to not only courageously face the hatred of others but to love them as well.

Now, I write this in the comfort of my home while you are facing demanding shifts in the midst of death, so I don’t claim to fully appreciate what you’re facing. But I do think these examples and principles in God’s Word are there for us for just “such a time as this.”

God bless you, protect you and equip you to love as He would. And may He transform the lives of your colleagues.

Government officials discriminate against churches

The pandemic also seems to have provided an invitation, in the minds of some government officials, to restrict believers from meeting while allowing more favored secular groups to meet. The U.S. Department of Justice recently had to weigh in against government officials in Virginia who were penalizing churches while protecting secular businesses and groups for the same activities.

From a U.S. Department of Justice news release:

The Department of Justice today filed a Statement of Interest in a Virginia federal court concerning the First Amendment’s freedom of religion in support of Lighthouse Fellowship Church (Lighthouse), a congregation in Chincoteague Island, Virginia, that serves, among others, recovering drug addicts and former prostitutes.

In response to the COVID-19 pandemic, Virginia’s governor issued executive orders that ban in-person religious services of more than 10 people while permitting such gatherings of workers in any non-retail business and an array of retail businesses, including liquor stores, dry cleaners and department stores. Violations of the orders allow for criminal charges and carry penalties of up to a year in a jail and a $2,500 fine.

As alleged by Lighthouse, on April 5, 2020, the church held a sixteen-person worship service in its 225-seat sanctuary while maintaining rigorous social-distancing and personal-hygiene protocols. At the end of the service, the Chincoteague police department issued Lighthouse’s pastor a criminal citation and summons, based on the governor’s executive orders.

“For many people of faith, exercising religion is essential, especially during a crisis,” said Assistant Attorney General Eric Dreiband for the Civil Rights Division. “The Commonwealth of Virginia has offered no good reason for refusing to trust congregants who promise to use care in worship in the same way it trusts accountants, lawyers, and other workers to do the same. The U.S. Department of Justice will continue to monitor any infringement of the Constitution and other civil liberties, and we will take additional appropriate action if and when necessary.”

We can seize an opportunity in the midst of attacks

Someone has wisely observed that crises do not form character; they reveal character.

As our nation faces this pandemic crisis, we see not only the raw anti-Christian character of some people laid bare; we see also an opportunity to demonstrate supernatural Christ-like character in response. Easier said than done, I fully realize, but the words of our Lord Jesus Christ can inspire and equip us to overcome evil with good:

“If the world hates you, you know that it has hated Me before it hated you. If you were of the world, the world would love its own; but because you are not of the world, but I chose you out of the world, because of this the world hates you. Remember the word that I said to you, ‘A slave is not greater than his master.’ If they persecuted Me, they will also persecute you; if they kept My word, they will keep yours also (John 15:18-20).

“But I say to you who hear, love your enemies, do good to those who hate you, bless those who curse you, pray for those who mistreat you (Luke 6:27-28).

But love your enemies, and do good, and lend, expecting nothing in return; and your reward will be great, and you will be sons of the Most High; for He Himself is kind to ungrateful and evil me (Luke 6:35).

Keep FDA safety requirements and nix telemedicine abortions

Seeing the pandemic as an opportunity to pump up profits from abortions, the abortion industry and its advocates in state governments are lobbying to loosen abortion-related FDA safety requirements.

Twenty-one state attorneys general have written to U.S. Dept. of Health and Human Services Secretary Alex Azar and FDA Commissioner Stephen Hahn, "to request that you increase access to reproductive healthcare, including safe and legal abortion, during this pandemic. Specifically, as the U.S. Food & Drug Administration (FDA) considers policy changes in response to the Coronavirus Disease 2019 (COVID-19) public health emergency, we urge you to waive its Risk Evaluation and Mitigation Strategy (REMS), or use FDA enforcement discretion, to allow certified prescribers to use telehealth for Mifepristone, the medication abortion prescription drug."

Thankfully, pro-life Members of Congress and the Christian Medical and Dental Associations also have written to Azar and Hahn, urging the officials to protect the health of women.

Rep. Bob Latta (R-OH) led 38 Senators and 121 House Members in a bicameral letter that noted,

"Despite claims that medication abortion is safe and easy, research proves that as many as five to seven percent of women who take abortion drugs will require follow-up surgery, and three percent could end up in the emergency room. Self-managed abortions from home are especially dangerous; in fact, half of abortion providers do not consider them safe, according to a 2019 survey published in the journal Contraception. Further, medication abortion becomes even more dangerous in situations where women cannot access emergency medical care. This is especially concerning during the COVID-19 pandemic as emergency rooms are currently being overwhelmed."

Senior VP for Bioethics and Public Policy Jeffrey Barrows, DO, MA, (Ethics) DO MA ACOOG, wrote in CMDA's letter,

"The FDA gave Mifepristone a REMS designation because it is a drug with significant complications if not prescribed correctly. One essential criterion for prescribing Mifepristone is to establish that the pregnancy is less than 71 days in duration. Telemedicine is incapable of correctly ascertaining the gestational length of a pregnancy. Menstrual history is an inaccurate indicator of gestational age, even among reliable patients. If Mifepristone is given inadvertently to a woman beyond 70 days gestation, the potential danger of hemorrhage and its resulting complications rise significantly, thus placing the patient at significant risk of harm."

Abortion is not healthcare, much less essential healthcare during a pandemic.

Besides protecting women's health, we also want to offer alternatives such as pregnancy resource centers and adoption. By loving both mother and baby, and by engaging in public policy with credibility and courage, we can begin to rebuild a culture of life in our nation.