Addressing race in healthcare through the faith and through the law

The Christian Medical Association has tackled race issues in healthcare proactively, gathering members together for prayer and fasting, webinars, public policy statements, articles, discussions, video presentations and more while pledging to "continue seeking to oppose racism in healthcare and society and pursuing justice in access to healthcare and equitable outcomes."

The U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) is likewise tackling race issues in healthcare, by communicating and enforcing federal law. OCR recently issued the following (excerpted) bulletin of guidance "to ensure that recipients of federal financial assistance understand that they must comply with applicable federal civil rights laws and regulations that prohibit discrimination on the basis of race, color, and national origin in HHS-funded programs during COVID-19:

To help ensure Title VI [of the Civil Rights Act of 1964] compliance during the COVID-19 public health emergency, recipients of federal financial assistance, including state and local agencies, hospitals, and other health care providers, should:

·         Adopt policies to prevent and address harassment or other unlawful discrimination on the basis of race, color, or national origin.

·         Ensure – when site selection is determined by a recipient of federal financial assistance from HHS – that Community-Based Testing Sites and Alternate Care Sites are accessible to racial and ethnic minority populations.

·         Confirm that existing policies and procedures with respect to COVID-19 related services (including testing) do not exclude or otherwise deny persons on the basis of race, color, or national origin.

·         Ensure that individuals from racial and ethnic minority groups are not subjected to excessive wait times, rejected for hospital admissions, or denied access to intensive care units compared to similarly situated non-minority individuals.

·         Provide – if part of the program or services offered by the recipient – ambulance service, non-emergency medical transportation, and home health services to all neighborhoods within the recipient's service area, without regard to race, color, or national origin.

My friend and colleague, HHS OCR Director Roger Severino, observed, "HHS is committed to helping populations hardest hit by COVID-19, including African-American, Native American, and Hispanic communities. This guidance reminds providers that unlawful racial discrimination in healthcare will not be tolerated, especially during a pandemic."

Vice Admiral Jerome M. Adams, Surgeon General, MD, MPH added, "Minorities have long experienced disparities related to the medical and social determinants of health – all of the things that contribute to your health and wellbeing. The COVID-19 pandemic has magnified those disparities, but it has also given us the opportunity to acknowledge their existence and impact and deepen our resolve to address them."

As CMDA has demonstrated and encouraged, followers of Christ can use this unique moment in our nation's history to advance principles of the faith regarding race. We can continue to promote the revolutionary biblical truth that every human being--of all races, both genders and at every point along the continuum of life from fertilization to natural death--carry the very image of God and as such merit our deepest respect, protection and love.

Resources

·         Read the new HHS OCR Bulletin: Title VI Bulletin - PDF

·         Learn more about non-discrimination on the basis of race, color, national origin, sex, age, and disability; conscience and religious freedom; and health information privacy laws, or file a complaint with HHS OCR: www.hhs.gov/ocr.

CMA doctors denounce judge's injunction against FDA safety precautions on abortion pill as a "pyrrhic victory" for abortion advocates

July 20, 2020—Bristol, TN: Today the 18,000-member Christian Medical Association (CMA, www.cmda.org) denounced an injunction issued by a federal district court judge that bars the FDA from enforcing health and safety precautions on a chemical abortion pill during the pandemic.

Dr. Jeffrey Barrows, an Ob-Gyn and CMA's Senior Vice President for Bioethics and Public Policy, said, "The judge handed pro-abortion forces a pyrrhic victory at the cost of women’s health and lives. The reason the FDA placed a Risk Evaluation and Mitigation Strategy (REMS) on mifepristone is that since its approval, 24 women have died from various complications including infection and internal hemorrhage.

"Since mifepristone was approved in 2000, 97 women have been documented with a pregnancy outside the womb--a life-threatening situation. I know from personal experience that these abnormal pregnancies are difficult to diagnose and require in-person consultation and examination. Prescription through telemedicine will hamper the ability to diagnose these abnormal pregnancies."

A federal district court judge for the District of Maryland on July 13 issued a preliminary injunction blocking Food and Drug Administration (FDA) enforcement for the “Elements to Assure Safe Use” in the Risk Evaluation Mitigation Strategy (REMS) for the chemical abortion pill mifepristone. The injunction allows mifepristone to be dispensed after telemedicine consult by clinics, medical offices, and hospitals via mail or delivery service and applies until thirty days after the end of the COVID-19 public health emergency.  

This injunction comes after Rep. Bob Latta (R-OH) and Senator Cindy Hyde-Smith (R-MS) led 38 Senators and 121 House Members in a bicameral letter urging FDA Commissioner Stephen Hahn to enforce the REMS.

The letter noted, "Unfortunately, there are some who seek to exploit this time of crisis to push for the weakening or overturning of critical Risk Evaluation and Mitigation Strategy (REMS) associated with medication abortion drugs, which would put women at significant risk."

The Congressional letter also highlighted that "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."

The Members of Congress had urged Hahn "to continue to robustly enforce the REMS for medication abortion....”

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."