Thursday, November 20, 2014

CMDA-affiliated physician dies of Ebola

Editor's note: Dr. Martin Salia was a general surgeon and graduate of CMDA’s Pan-African Academy of Christian Surgeons residency in Cameroon.

Excerpted from "Ebola-infected physician dies in Nebraska," USA Today, November 17, 2014, - A surgeon infected with Ebola while treating patients in Sierra Leone has died in Omaha, Nebraska Medical Center announced Monday. Martin Salia, whose family lives in Maryland, arrived in Omaha on Saturday for treatment at the specialized biocontainment unit. He became ill Nov. 6 and tested positive for Ebola a week ago. Before his dad died, the son of Doctor Martin Salia said treating patients infected with Ebola was his "calling from God."

"It is with an extremely heavy heart that we share this news," Phil Smith, medical director of the Biocontainment Unit at the hospital, said in the statement. "Dr. Salia was extremely critical when he arrived here, and unfortunately, despite our best efforts, we weren't able to save him."

Smith said Salia was suffering from advanced symptoms of Ebola when he arrived, including kidney and respiratory failure. He was placed on dialysis, required a ventilator and received plasma, Smith said. Multiple medications included ZMapp therapy, a new drug that has shown promise in fighting the disease.

Salia is the second person to die of Ebola in the United States. A Liberian man living in Texas, Thomas Eric Duncan, contracted the disease in his native country but was not diagnosed until after his return to Dallas. He died Oct. 8.

Salia's wife, Isatu Salia, has said that her husband believed he had malaria or typhoid when he fell ill Nov. 6. Her husband had two negative tests for Ebola before the third came back positive Nov. 10, she said. Isatu Salia said her husband's voice sounded weak and shaky when they spoke early Friday. But she said he told her, "I love you."

Salia said her husband traveled frequently between the United States and his native Sierra Leone. He never stayed in the U.S. long because he believed people in Africa need him, she said. Ebola has killed more than 5,000 people in West Africa, mostly in Liberia, Sierra Leona and Guinea.

Commentary

Allen H. Roberts II, MD, MDivProfessor of Clinical Medicine at Georgetown University Medical Center and CMDA Campus Advisor Allen H. Roberts II, MD, MDiv: “With heavy hearts the news of Dr. Martin Salia’s death was shared, and with heavy hearts it is received. Most keenly is his death felt by his wife and sons, to whom our hearts and for whom our prayers go out, but it is felt deeply and dearly by his CMDA family as well. We pause in the midst of our daily rounds and of our own Ebola preparations to think about our brother in Christ, the life he lived and the death he died – both in the service of the Lord he loved.

“Martin’s predicament confirms what we are learning about Ebola. Patients who arrive at U.S. medical centers early in the course of the illness and are treated with aggressive fluid and electrolyte administration fare better. Many hospitals are developing protocols and ethics statements reflecting that with appropriate disease-containment interventions, the disease, when treated early, is survivable and containable.

“Dr. Salia’s death also came in the aftermath of an appeal that went out to CMDA members that we pray without ceasing for his recovery, and scores of members did just that. Yet, this dear brother died.

“Now is a good time to remember Jesus at the tomb of Lazarus (John 11:17-44). We may join Martha and Mary in their deep sorrow; we may join Jesus Himself in absolute indignation and anger over the death of a friend.

“And we are invited, then, to listen to Jesus utter these most astonishing words, “I am the resurrection and the life…” (John 11:25, NIV 2011). It was in the certain hope of the resurrection that Martin Salia responded to God’s call to minister to those with Ebola in Sierra Leone. He counted the cost, and he went.

“We know how the story ends for Lazarus and how it will end for Martin Salia and all who are in Christ. It may be in the months ahead that God in His mercy will lead us to an effective treatment for this dreaded disease. We don’t know. But it was on the cross that the fate of Ebola was sealed, along with that of all disease and all death in all history. Jesus’ tomb is empty, and so will be Martin’s.”

Action
Participate in CMDA's End Ebola Project

Resources
Ebola: ‘Beat the fire while it is far’ by Dr. David Stevens Ebola and Medical Missionaries

Pro-life movement makes gains in election

Excerpted from "Polling Shows Impact of Abortion Issue in Mid-Term Election," National Right to Life News, November 6, 2014 - A new post-election poll of actual voters conducted by The Polling Company/ WomanTrend, found that the issue of abortion once again played a key role in the mid-term elections, and that National Right to Life and its state affiliates were key to getting out the pro-life vote for pro-life candidates.

Twenty-three percent of voters said that the abortion issue affected their vote and voted for candidates who oppose abortion. This compares to just 16 percent who said abortion affected their vote and voted for candidates who favor abortion, yielding a 7 percent advantage for pro-life candidates.

These poll results help explain the victories experienced by the right-to-life movement in Tuesday’s elections. Despite being vastly outspent by pro-abortion organizations such as Planned Parenthood and EMILY’s List, pro-life candidates won Tuesday by significant margins. There were 26 races in which a candidate supported by National Right to Life was running against a candidate supported by the pro-abortion PAC EMILY’s List. Nineteen (73 percent) of the National Right to Life-supported candidates won.

“The abortion issue has played a key role in every major election since Ronald Reagan won the presidency in 1980,” said Carol Tobias, National Right to Life president. The poll also found that voters heard and saw the right-to-life message in the days leading up to the election.

Editor's note: As a 501(c)3 organization, CMA educates on issues and legislation but does not endorse candidates for office.

Commentary

Jonathan ImbodyCMA VP for Government Relations Jonathan Imbody: “Activist electioneering is hard but potentially productive work, and this round of advertising, phone calling and one-on-one conversations leading up to the November 4 elections paid off for the pro-life cause. The House of Representatives gained at least seven pro-life members, and the Senate's switch of party control (the GOP will have at least a 53-47 edge, with not all races decided) means that pro-life bills now should at least gain a vote.

“To some followers of Christ, following politics seems at best pointless and at worst counter-productive. Some believers disdain or shrink from the controversies and contention that mark modern politics. Some even decry any public policy involvement including voting, asserting that engaging in worldly politics is beneath heaven-bound Christians.

“Here's a case for robust Christian engagement in public policy:
  1. Scripture (Romans 13) teaches that God has ordained governments for two primary purposes—to punish evil and to reward good.
  2. While God provides everyone with a conscience to subjectively sense right and wrong (Romans 2), God's Word and His Spirit enable believers uniquely to objectively and spiritually discern good and evil (1 Corinthians 2).
  3. In a democratic republic such as the United States, We the People—including We the People of God—possess the power, privilege and duty to guide our government toward truth and justice.
  4. When believers disengage from public policy and refuse to guide their government as political leaders, activists and voters, their government suffers a critical loss of counsel regarding truth and objective standards of justice.
  5. This dereliction of duty by believers, who by the gifts of God's revelation and Spirit know right from wrong most clearly, opens the door to control of the government by power-seeking individuals with a self-concocted, upside-down worldview.
  6. When subjective ideologies and arbitrary assertions replace the Judeo-Christian objective standards that formed the foundations for Western governments and justice, evil becomes good, and good becomes evil.
  7. In the absence of objective standards, ideology replaces the rule of law and justice, and government enforces its ideology with unchecked power. Individuals holding opposing worldviews and the politically powerless suffer most, and no one remains safe from arbitrary autocratic attack."

Action
  1. Join our Freedom2Care coalition Federal Registry on LinkedIn (registration is free) to gain updates on opportunities to advise government officials, serve on federal commissions and secure federal jobs.
  2. Visit our Freedom2Care legislative action website for easy-to-use forms to voice your values to your legislators.

Resources
Defending Life 2014 - a state-by-state legal guide to abortion, bioethics, and the end of life, by CMA legal partner Americans United for Life.
CMDA Abortion Ethics Statement
Remember to Remember: The Modern Implications of Abortion by Dr. John Patrick

Choosing to live

Excerpted from "The Courageously Mundane Faithfulness Of Kara Tippetts," Breakpoint commentary by John Stonestreet, November 7, 2014 - A young Oregon woman with a brain tumor recently made the choice to die. But a Colorado woman facing a terminal disease is choosing to live. What can we learn from their stories?

Oregon allows physician-assisted suicide; California doesn’t. Brittany Maynard chose November 1 as the day she would end her own life, with the help of a doctor. And I’m sad to say she carried through with her plans—despite the enormous outpouring of love and prayers from people across the country who urged her to change her mind.

One of those people was Kara Tippetts, a 38-year-old married mother of four who knows well the fear and pain of a stage 4 cancer diagnosis. Her approach to illness has been to rest on the grace of God and to find power in living faithfully moment by moment, squeezing the goodness out of each day, and exhibiting, no matter what the prognosis, “mundane faithfulness,” which is the name of her blog.

Kara tells a story of mundane faithfulness in her new book, The Hardest Peace.

Kara has used her voice to reach out to Brittany Maynard, asking her to reconsider, gently telling her that there’s more to life than good physical health and the avoidance of suffering. “Suffering is not the absence of goodness,” Kara says in an open letter to Brittany, “it is not the absence of beauty, but perhaps it can be the place where true beauty can be known. ...That last kiss, that last warm touch, that last breath, matters—but it was never intended for us to decide when that last breath is breathed.”

Kara has been learning that lesson on her own journey. Go to her blog and you’ll see that Kara is not throwing around a lot of cheap Christian clich├ęs. Here’s an entry from October 18:

“How do you love when you are at the bottom of yourself? The last gulp of a drink you feel tentative to swallow? How do you swallow that last gulp of life and fight to live it well? I’m struggling today,” she writes, “and I knew it would be a hard one. Chemo brings a low that I struggle with words to describe.”

And then on October 20: “...The hand held, the time spent reading together, the little loves that when faced with death have become the giant important moments in my life. The time praying together, laughing together, cooking together and crying together. They add up to a life well lived. [They] are simply the best of life.”

Friends, let's pray for Kara and for all those facing terminal illness—as well as for their families. And let’s also pray for our culture, that we learn that life is always a gift, without exception.

Commentary

Jonathan ImbodyCMA VP for Government Relations Jonathan Imbody: "Even if moving stories like those of Brittany Maynard prompt some to think we need to legalize assisted suicide, it's crucial to remember that such laws affect many more people and have many more consequences than originally imagined. The elderly, the handicapped and the depressed all become much more vulnerable under assisted suicide laws. You as a health professional know that much can go on behind the curtain that will never show up on a chart or in court. What appears on a document as a voluntary decision may in truth be coerced or otherwise improperly influenced--by an unduly negative presentation of a prognosis, or by family members who want an easy way out for themselves.

"Laws teach principles, and assisted suicide laws teach that suicide is not only good but a right. The right to die too easily becomes the duty to die. How many elderly patients already consider themselves a burden? How many heirs already wish their benefactor would die? What is a severely depressed teen supposed to think when society legalizes suicide?

"I know from conducting on-site research in the Netherlands what happens when the medical community and society make medical killing normal. I spoke to a son whose father, who had chosen euthanasia out of fear and a lack of his wife's support to choose life-extending surgery, told the doctor he didn't want to die after the doctor had administered the first shot to put him to sleep. The doctor ignored his statement and quickly administered the lethal injection. A grandfather asked for help with a painful thrombosis and instead died at the hands of a physician who interpreted his request as one for euthanasia.

"When doctors gain the power to kill, no patient remains safe. Hippocrates helped transform medicine with a proscription against assisting suicide--a measure that for the first time protected patients. Do all in your power to see that your state does not turn the clock back to the days when patients had to fear their physicians."

Action
State Legislative Issues - Physician-Assisted Suicide

Resources
Jonathan Imbody Senate Testimony on Euthanasia
Kara Tippetts, blog
"Small wonders" - Kara Tippetts - World magazine
CDD STAT Interview with Kara Tippetts
Euthanizing Medicine, a presentation on the implications of legalizing physician-assisted suicide
Top Reasons Why Physician-Assisted Suicide Should Not Be Legal

Thursday, November 6, 2014

Terminally ill patient ends her life

Excerpted from Brittany Maynard, right-to-die advocate, ends her life,” USA Today. November 3, 2014 — Brittany Maynard, the 29-year-old face of the controversial right-to-death movement, has died. She captivated millions via social media with her public decision to end her life.

Sean Crowley, spokesman for the non-profit organization Compassion & Choices, confirmed Maynard's death Sunday evening. "She died peacefully on Saturday, Nov. 1 in her Portland home, surrounded by family and friends," according to a statement from Compassion & Choices. The statement said Maynard suffered "increasingly frequent and longer seizures, severe head and neck pain, and stroke-like symptoms." She chose to take the "aid-in-dying medication she received months ago."

Her death brings a new element to the movement in the age of social media because the conversation has included younger people. "She's changed the debate by changing the audience of the debate," Abraham Schwab, an associate professor of philosophy at Indiana University-Purdue University Fort Wayne, told the Associated Press earlier.

Maynard was diagnosed with a stage 4 malignant brain tumor. She moved with her family from California to Oregon, where she could legally die with medication prescribed under the Oregon Death With Dignity Act.

"I understand she may be in great pain, and her treatment options are limited and have their own devastating side effects, but I believe Brittany is missing a critical factor in her formula for death: God," said Joni Eareckson Tada last month in an article for Religion News Service.

Commentary

Dr. David StevensCMDA CEO David Stevens, MD, MA (Ethics): “I’m deeply saddened by Brittany Maynard’s suicide. As far as we know, she had no hope—despite Joni Erickson Tada, Kara Tippets (who is dying with Stage 4 breast cancer) and others pointing her toward God, our real source of hope. I’m saddened because Compassion and Choices used and possibly abused her as their ‘poster child’ for legalizing physician-assisted suicide in a slick media campaign that drew millions of Facebook and YouTube hits, as well as enormous favorable media attention. I can’t help but wonder why she announced she was going to postpone her suicide, only to take her life two days later? Did she feel pressured or obligated to do it?

“I’m even more saddened that many more patients are likely to die because Ms. Maynard glorified suicide as the answer to suffering, and it won’t just be highly controlling, terminally ill patients like her. In the short term, it will be vulnerable teens and the depressed. In the long run, it will be handicapped newborns, Alzheimer’s patients, the chronically sick and the mentally ill, as we have already seen in Europe. It’s inevitable, despite all the so-called safeguards. Who can deny ‘this right to death with dignity’ to anyone who is suffering or is even afraid they may suffer in the future? And if the patient is incompetent, should the physician, exhausted caregiver or the son or daughter set to inherit the estate decide ‘on their behalf?’ Ultimately, it will kill the ethos of healthcare as doctor-patient trust is destroyed.

“It is too late for Brittany, but not for you and me to speak the truth in love to alter the predictable future. I’m heading to New Jersey next week to meet with legislators to urge them to say ‘No’ on an expected physician-assisted suicide vote scheduled for Thursday, November 13. I’m then traveling from one end of Montana to the other, speaking out against physician-assisted suicide in every major city and doing media interviews along the way to hopefully halt their march off the physician-assisted suicide cliff.

“What are you going to do to alter the future—before it is too late?”

Resources

CDD STAT Interview with Kara Tippetts, a stage-four cancer patient
Euthanizing Medicine, a presentation on the implications of legalizing physician-assisted suicide
Top Reasons Why Physician-Assisted Suicide Should Not Be Legal

Action

Physician-assisted suicide legislation is now being attempted in California, Connecticut, Massachusetts, Nevada, New Jersey, New Mexico and Pennsylvania. If you’d like to get involved in the fight against this dangerous legislation, please contact communications@cmda.org.

Tennessee passes abortion amendment

Excerpted from "Tennessee Amendment 1 abortion measure passes," The Tennessean. November 5, 2014 — Tennessee voters by a solid margin backed Amendment 1, a measure that gives state lawmakers more power to restrict and regulate abortions. The measure was perhaps the most closely watched and most contentious Election Day vote in Tennessee's midterm elections. It passed with 53 percent of the vote. Its passage has no immediate effect on abortion policies in Tennessee. But it will give lawmakers far more power in enacting abortion regulations and restrictions in Tennessee.

Backers of the amendment were jubilant, embracing at the offices of Tennessee Right to Life, the campaign headquarters for the effort. "Obviously for those of us who believe life is sacred, this was the necessary first step toward protection not only for the unborn but for women and girls who fall prey to people looking to profit from untimely or unexpected pregnancies," said Brian Harris, president of Tennessee Right to Life and a coordinator for the "Yes on 1" campaign, who has devoted much of the past 14 years fighting for the measure to get on the ballot.

Opponents on Tuesday night called the measure a "dangerous ballot measure that strips away the state's established right to safe and legal abortion" and vowed abortion rights supporters "will not stand for restrictions that serve only to create barriers to service," said Ashley Coffield, president and CEO of Planned Parenthood — Greater Memphis Region.

The abortion measure drew the close attention of national groups on both sides of the abortion divide — and large contributions from abortion rights advocates outside the state concerned not only about the impact in Tennessee, but beyond its borders. One in four abortions in Tennessee is sought by a woman from out of state. Proponents of the measure called on Tennessee voters to end the state's status as an "abortion destination."

Commentary

Dr. Brent BolesCMDA Member and Board Certified Obstetrics and Gynecology C. Brent Boles, MD: “The votes have been counted and Amendment 1 is now part of Tennessee’s Constitution. This amendment corrects the poor decision made by the Tennessee Supreme Court in 2000 in Planned Parenthood v. Sundquist, in which four of five justices decided that Tennessee’s Constitution had stronger protections for abortion than the U.S. Constitution. Since that decision, the Tennessee legislature has been unable to pass meaningful regulation having to do with abortion in our state. As a result, the abortion industry was not accountable to the state’s Department of Health in any significant way. Now, the Tennessee legislature can work to protect vulnerable women from being victimized by the abortion industry and reduce the number of innocent babies lost every year in Tennessee. I hope we will see a restoration of a standard informed consent process and a brief waiting period, as well as the health department’s ability to enforce the same patient safety standards respected by all of legitimate medicine.
“How did the amendment pass? Planned Parenthood poured millions into the state to defeat this amendment because its passage was a threat to the abortion industry’s business model. They outspent the amendment’s supporters 2 to 1. Supporters of Amendment 1 couldn’t outspend Planned Parenthood, but they did outwork Planned Parenthood. A tremendous grassroots effort all over the state resulted in success.

“One of the key pieces resulting in success was the involvement of churches. Success for life and for women in Tennessee shows we can begin to see the tide turn if the church in America will find its voice. How can Christian healthcare professionals play a role? Paul tells us in Romans 12 that we are all parts of Christ’s body and we all have roles to play, and he admonishes us to fulfill our roles with diligence.

“Christian healthcare professionals are in a unique position to make a difference on this issue across the country. We are leaders in our churches and communities. Legislators listen when we call. Pro-abortion forces do not hesitate to use pro-abortion physicians in this fight on both the state and federal levels to promote the abortion industry’s many deceptions. We can do no less. The church has been silent on social issues in America for far too long, and if the church is to truly be salt and light in today’s society, then it is incumbent upon Christian healthcare professionals as members of Christ’s body to take the lead on the issue of life. Successful passage of Amendment 1 is cause for praising our God, but it is not the last chapter in the story of abortion in America. Now is the time to not only stand firm, but to also press forward at every opportunity. It may be that the church is finding its voice once again, and we as Christian healthcare professionals need to be part of the choir.”

Resources

CMDA Abortion Ethics Statement
Remember to Remember: The Modern Implications of Abortion by Dr. John Patrick

Public supports quarantine for Ebola health workers

Excerpted from NBC/WSJ Poll: 71% Back Mandatory Quarantines for Ebola Health Workers,” NBC News. November 2, 2014 — More than seven in 10 Americans support mandatory quarantines for health professionals who have treated Ebola patients in West Africa, even if they have no symptoms, according to a new NBC News/Wall Street Journal poll. The survey shows that 71 percent of those surveyed say the health workers should be subject to a 21-day quarantine, while 24 percent disagree.

The question of mandatory quarantines exploded into the public debate after nurse Kaci Hickox battled with the governors of New Jersey and Maine over the mandated isolation, arguing that she has exhibited no symptoms and tested negative for the virus. Those who oppose the practice – including top health officials and White House administration officials – say that it is unnecessary and discourages health workers from fighting the Ebola outbreak at its source.

Support for the quarantines varies by political party, age and education level. Eighty-five percent of self-described Republicans say they think the quarantines should be enforced, versus 65 percent of Democrats and 60 percent of independents. Ninety-one percent of Tea Party backers also believe the quarantines are necessary.

Older Americans are also more likely to back mandatory isolation for the health workers. A third of those 18-34 years old oppose the requirements, compared with just one in 10 seniors. And those with lower levels of education are more likely to support quarantines (80 percent of those with a high school education or less are in favor) than those with college or post-graduate educations (63 percent are in favor.)

Commentary

Dr. John GreeneCMDA Member and Chief of Infectious Diseases at Moffitt Cancer Center John N. Greene, MD: “The majority of people, including healthcare workers, favor the quarantine of those who care for patients infected with the Ebola virus, both at home and those returning from West Africa. This paradox exists despite the clear scientific evidence pointing to a lack of contagion of the asymptomatic but exposed person. The fear and hysteria created by the Ebola epidemic is unprecedented.

“Just to point out one of many examples: A teacher returning from Kenya (a country with no cases of Ebola) was asked to remain at home for 21 days and bring in a note from a doctor at the end of her home-bound detention stating she is non-contagious before returning to teach children. All this due to parents and faculty being fearful of contagion despite the impossibility of transmitting an endemic virus the teacher was never in contact with.

“The real question is why would rational people, especially those of the Christian faith, believe the unbelievable? I think it is fear, which clouds one’s judgment, and a lack of trust in authorities and experts who have led us astray and do not hold our Christian values. If we believe the Bible commands us to be a beacon of light for unbelievers, then we need to allow perfect love to cast away fear.

“Jesus and the apostle Paul did not fear death but instead entered into dangerous situations that ultimately claimed their lives. Why? They entrusted their lives to Him who judges righteously and did not count their lives as dear to themselves. Why can’t we have the same attitude and encourage those who risk their lives to care for those stricken with Ebola virus disease? Let’s not punish them for their service by placing an unwarranted burden on them and forcing them into quarantine to be shunned and avoided. Rather, let’s tell them, ‘Well done,’ and embrace them with a warm hug for their Christ-like service of those who can’t help themselves. What a testimony for Christ the world would see if we could lead this charge and go against the tide of unreasonableness and a lack of love.”

Resources

Ebola: ‘Beat the fire while it is far’ by Dr. David Stevens
Ebola and Medical Missionaries

Action

Participate in CMDA's End Ebola Project