CMDA Today - Summer 2022

CMDA TODAY

Volume 53 • Number 2 • Summer 2022

THE PATH OF LIFE

Join The Practice Faith-based Direct Primary Care Established in 2010 by CMDA member Dr. Jan Mensink with the vision of providing concierge medicine for the common man, The Practice in Bakersfield, California is the fourth largest direct primary care practice in America.

The direct pay model we work on is a win-win for doctors and patients; it is very financially beneficial for both sides, and because doctors have time to do quality medical care, patients get healthier and doctors have greater job satisfaction. Direct primary care also provides a wonderful work/life balance because of the longer visits, little to no insurance paperwork, smaller patient panels vs. numerous patients for typical insurance taking primary care doctor.

We are seeking a doctor for immediate employment and the unique opportunity of taking over this thriving functional medicine practice when Dr. Mensink retires in a few years.

During full-time employment now, the candidate will work closely with Dr. Mensink to be well prepared to take over as Dr. Mensink phases out. The Practice is continuing to grow at a phenomenal rate, and Dr. Mensink is seeking to reduce his hours and turn the practice over to an associate in the next two to five years.

For more information, contact CMDA Placement Services at placement@cmda.org or visit www.cmda.org/placement.

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From the CMDA President T. Lisle Whitman, MD

T

wo of my partners recently returned from a pilgrimage to the mecca of childhood theme parks—Disney World in Orlando, Florida. I enjoyed hearing of their travails to bring their family joy. It caught my eye a few days later when I found a newspaper article discussing the increasing cost and decreasing amenities of a trip to Disney, even as attendance rates soar.

This caused me to reflect a bit on the value of different things in our lives. Studies show that experiences increase well-being and contentment more than additional possessions. Time and money leveraged to build relationships and cultivate experiences result in a greater perception of value than other uses. That is, we look for value when we plan purchases, but we often find value in our experiences.

This reflection then brought me to CMDA. CMDA is a great value-added organization. Anytime we talk about value, we first must consider cost. Did you know CMDA dues for all types of memberships remain unchanged for the second straight year?

Beyond that, the most expensive dues category has only increased by $24 since 2016. What do I get for this small price? I am glad you asked.

We look for value when we plan purchases, but we often find value in our experiences.

CMDA is all about relationships. Our primary mission is to help you with your most important relationship—your personal relationship with Jesus Christ. We do that by educating, encouraging and equipping you for this journey. Our largest department is Campus & Community Ministries, focused on providing engagement for Christian healthcare professionals and students. Countless numbers of today’s members were introduced to CMDA through Bible studies during training.

Others participated in mission trips, community gatherings, outreach ministry or a variety of ministry groups. As believers, our relationships are our lifeblood ( John 13:35).

Beyond facilitating a community of Christian believers, CMDA provides numerous other valuable resources. Hopefully you have been educated, encouraged and equipped by our publications, social media blogs, podcasts, events, continuing education courses and policy statements. Perhaps you have not had the opportunity to join us for a CMDA National Conven-

tion. I have found our conventions both build relationships and provide experiences that bring great value. The CMDA Learning Center is a hub for valuable information, both spiritual and medical, that comes with built-in continuing education credits.

Oh, and it is FREE to members! Do you find it challenging at times to build your faith into your practice? The Faith Prescriptions on-demand video series is a dynamic, small group-focused opportunity to learn to share Christ in word and deed to patients, colleagues and students.

If all these offerings do not convince you of the VALUE of our organization, consider CMDA’s efforts on the public policy front. CMDA is leveraging our group voice to speak up for the vulnerable among us. We have stood on the steps of the Supreme Court of the United States to give verbal and physical witness to the value of human life. We have dozens of state directors engaged in standing for biblical truth in state houses across our country. We are engaged with fellow stakeholders to fight for a true Hippocratic understanding of medicine through the Alliance for Hippocratic Medicine, the formation of which was led by CMDA. By standing together, CMDA binds our voices into one to be heard loudly in these myriad areas.

As we face a world in which so much has cheapened over time, I hope you value your association with CMDA as much as I do. Over the last 32 years of my membership, I have seen numerous changes and learned more and more about our organization. I continue to be amazed at the depth and breadth of our ministry. If you are excited as I am, I hope you will take the opportunity to do two things. First, tell someone that could benefit from our mission to educate, encourage and equip healthcare professionals to glorify God. Second, let your local, regional, state or national CMDA contact know how much you appreciate their efforts to bring value to the dollars and time you invest with CMDA.

T. Lisle Whitman, MD, is the 2021-2023 CMDA President. He is an orthopedic surgeon in Bristol, Tennessee, and he has practiced with Appalachian Orthopedic Associates since 2000. Lisle and his wife Lauren have three children, one daughter-in-law and three grandchildren. He loves the practice of general orthopedics. He has participated in several overseas mission trips, and he enjoys family trips, the lake and learning new things.

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VOLUME 53 | NUMBER 2 | SUMMER 2022

EDITOR Kim Shattell

EDITORIAL COMMITTEE Gregg Albers, MD John Crouch, MD Autumn Dawn Galbreath, MD Curtis E. Harris, MD, JD Van Haywood, DMD Rebecca Klint-Townsend, MD Debby Read, RN

CMDA TODAY

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CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS P.O. Box 7500, Bristol, TN 37621 888-230-2637 main@cmda.org • www.cmda.org If you are interested in submitting articles to be considered for publication, visit www.cmda.org/publications for submission guidelines and details. Articles and letters published represent the opinions of the authors and do not necessarily reflect the official policy of the Christian Medical & Dental Associations. Acceptance of paid advertising from any source does not necessarily imply the endorsement of a particular program, product or service by CMDA. Any technical information, advice or instruction provided in this publication is for the benefit of our readers, without any guarantee with respect to results they may experience with regard to the same. Implementation of the same is the decision of the reader and at his or her own risk. CMDA cannot be responsible for any untoward results experienced as a result of following or attempting to follow said information, advice or instruction.

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ON THE COVER

The Path of Life: My Journey to Help Rescue the Pre-born Christina Francis, MD

The author’s personal story of discovery

for her calling in the kingdom

18

Training Medical Students to Care for Patients in Spanish Tiffany M. Shin, MD

MDA Ethics Statement on 24 CConscience in Healthcare How to live by conscience with integrity, with pure hearts and transformed minds that seek God’s will and strive to love Him and our neighbor

32

The Dr. John Patrick Bioethics Column

What is Distinctive about Christian Ethics?

John Patrick, MD

A new medical school program that teaches care for the underserved, bilingually

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CMDA Plays Major Humanitarian Role in Russian/ Ukranian War Jim Peipon, MD

The secular, transparent attempt to exclude Christianity from the public square, education and politics

See PAGE 34 for CLASSIFIED LISTINGS

Ukraine CMA (CMDA) coordinates medication and medical supply efforts for the entire country

REGIONAL MINISTRIES

Connecting you with other Christ-followers to help better motivate, equip, disciple and serve within your community Western Region: Michael J. McLaughlin, MDiv • P.O. Box 2169 • Clackamas, OR 97015-2169 • Office: 503-522-1950 • west@cmda.org Midwest Region: Allan J. Harmer, ThM, DMin • 951 East 86th Street, Suite 200A • Indianapolis, IN 46240 • 317-407-0753 • cmdamw@cmda.org Northeast Region: Tom Grosh, DMin • 1844 Cloverleaf Road • Mount Joy, PA 17552 • 609-502-2078 • northeast@cmda.org Southern Region: Grant Hewitt, MDiv • P.O. Box 7500 • Bristol, TN 37621 • 402-677-3252 • south@cmda.org

THE CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS ® Changing Hearts in Healthcare . . . since 1931.

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Ministry News RESOURCES

CMDA Go App Have you downloaded CMDA Go yet? Our mobile app is now available to download on Apple and Android mobile devices. Visit your device’s app store to download it today.

In the CMDA Go app, you can set up your personal CMDA profile, check out the latest news from CMDA, listen to CMDA Matters and other podcasts, renew your membership and make your dues payments, access a variety of downloadable resources, interact with other members through the discussion forms and join group chats.

For more information, visit www.cmda.org/app.

CMDA Learning Center The CMDA Learning Center offers complimentary continuing education courses for CMDA members. This online resource is continuing to grow with new courses to help you in your practice as a Christian healthcare professional.

More than 100 hours of continuing education are now available at NO COST to CMDA members. For more information and to access the CMDA Learning Center, visit www.cmda.org/learning.

CMDA Matters Are you listening to CMDA’s weekly podcast with CEO Dr. Mike Chupp? We’re welcoming new and exciting guests to the podcast this year, so you don’t want to miss it.

CMDA Matters is our popular weekly podcast with the latest news from CMDA and healthcare. A new episode is released each Thursday, and interview topics include bioethics, healthcare missions, financial stewardship, marriage, family, public policy updates and much more. Plus, you’ll get recommendations for new books, conferences and other resources designed to help you as a Christian in healthcare.

Listen to CMDA Matters on your smartphone, your computer, your tablet…wherever you are and whenever you want. For more information, visit www.cmda. org/cmdamatters.

NOW HIRING Inaugural Chair of Psychiatry

Nationally ranked Liberty University College of Osteopathic Medicine (LUCOM) is seeking its Inaugural Chair of Psychiatry. The selected candidate will build upon the recent successes attained to date in behavioral health and psychiatry, and provide academic leadership, expand and build collaborative relationships and grow innovative programs. LUCOM is approaching the 10-year mark since its inception. Many vital programs and faculty have been added, and there is a tremendous opportunity to be on the ground level toward contributing to educational, clinical and research programs that will be in place for many more years to come. Candidates must have a substantial record of leadership and achievements in academic medicine and education; be board certified in psychiatry; be qualified for appointment at the rank of associate professor or full professor; and be eligible for a license in the state of Virginia. Build and develop an innovative academic Department of Psychiatry within a young College of Osteopathic Medicine; LUCOM culture is Christ-centered, faith-based, collegial, cohesive and mission-oriented; Visionary and collaborative leader who can develop and implement a plan to address the shortage of mental health providers; LUCOM’s strong relationships with community partners allow faculty the ability to build robust clinical practices with ample resources and support. Lynchburg, Virginia is a welcoming community energized

by Liberty University College. There’s a charming downtown filled with restaurants and live music among the scenic beauty of the James River and the Blue Ridge Mountain Foothills. The outdoor enthusiast will marvel at the abundance of activities, including hiking, biking, kayaking, fishing, camping and skiing. Please contact Jay Torio at medcareers@merritthawkins.com or at 866-406-0259 and reference PSY-145993.

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Ministry News

Faith Prescriptions One of the newer resources provided

by CMDA is a video series called Faith Prescriptions. This 25-part video series (featuring 10 core sessions) provides training on everything from LGBTQ issues in the healthcare arena, to praying with your patients and sharing your faith in ethical and appropriate ways with colleagues and patients.

Get started today by visiting www.cmda.org/learning.

Upcoming Events Dates and locations are subject to change. For a full list of upcoming CMDA events and further information for each event, visit www.cmda.org/events.

Pre-field Orientation for New Heawlthcare Missionaries August 1-4, 2022 • Boone, North Carolina Critical Conversations on Identity and Gender August 5-6, 2022 • Dallas, Texas Voice of Christian Doctors Media Training August 12-13, 2022 • Bristol, Tennessee

Women Physicians & Dentists in Christ Annual Conference September 15-18, 2022 • Newport Beach, California Trophy Trout Fishing with CMDA September 29-October 2, 2022 • Bristol, Tennessee

Biblical Turkey Tour – In the Footsteps of Paul and John October 15-23, 2022 • Turkey CMDA Northeast Annual Conference October 28-30, 2022 • North East, Maryland CMDA National Convention 2023 April 27-30, 2023 • Cincinnati, Ohio ICMDA World Congress June 20-25, 2023 • Arusha, Tanzania

CMDA is partnering with The Hendricks Center at Dallas Theological Seminary to host an in-person conference called “Critical Conversations on Identity and Gender” on August 5-6, 2022 in Dallas, Texas Cultural norms have rapidly changed, as has our ability to meaningful dialogue about those shifts. Nowhere is this truer than in discussions about gender and sexuality. Medical and pastoral care face a daunting task in the midst of discussions about transgenderism and choices about sexual preference, especially when theological reflections on how we are made are deliberately left to the side. As Christians, how do we speak effectively, truthfully and graciously while giving care in such an environment? Join us for this critical conversation as we consider the theology, science, legal counsel and pastoral care required to serve people well, as individual caregivers and fellow members of society. For more information and to register, visit www.cmda.org/events.

Order this book today!

from littlepeoplebook.com or Amazon “The moral uncertainty and apathy in our society to the plight of unborn children springs from our failure to identify them as real people.”

As a Board Certified Family Practitioner who has delivered 1500 babies, Dr. John Hey provides captivating vignettes from his 50 year-long practice, experiences that brought him to understand that these Little People are precious to God, protected by God, and deserve to be treated with the dignity, care, and legal protections afforded to all those who have already been born.

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Ministry News

CMDA 2022 Member Awards MEMBER NEWS

In Memoriam Our hearts are with the family members of the following CMDA members who have passed in recent months. We thank them for their support of CMDA and their service to Christ.

• •

Marvin C. Culbertson, Jr., MD – Chattanooga, Tennessee Member since 1952 Mark A. Snyder, MD – Cincinnati, Ohio Lifetime member since 1985

Memoriam and Honorarium Gifts Gifts received January through March 2022 Mr. and Mrs. Thomas F. Titkemeier in memory of Anne Walston Mr. and Mrs. Thomas F. Titkemeier in memory of Kathleen A. Pearch Cincinnati VA Medical Center, Dental Clinic Staff in memory of Stella Thompson Dr. Charles and Roena Tandy in memory of Dr. Bill Forbus Dr. and Mrs. Donald Wood in memory of Rev. Ross Bacon For more information about honorarium and memoriam gifts, please contact stewardship@cmda.org.

LEARN MORE The following awards were presented at this year’s National Convention.

These articles are excerpted from the actual award citations which can be viewed at www.cmda.org/awards.

2022 Educator of the Year Award Farr Curlin, MD

Dr. Curlin completed both his bachelor’s degree and his medical degree at the University of North Carolina, where he also met his wife, Kimberly.

Farr and Kimberly spent the first 14 years of their marriage in Chicagoland, and most of those years they ▲ Farr Curlin, MD, with CMDA President Lisle were part of the community surWhitman, MD (right), after receiving the 2022 Educator of the Year Award. rounding the Lawndale Christian Health Center. At the University of Chicago, Farr completed internal medicine residency and fellowships in health services research and clinical ethics. He joined the faculty in 2003 and went on to found and co-direct the University of Chicago’s Program on Medicine and Religion, while also founding, with colleagues, the annual Conference on Medicine and Religion, now in its 11th year. In 2014, Dr. Curlin accepted an offer from Duke University to become the Josiah Trent Professor of Medical Humanities in the Trent Center for Bioethics, Humanities and History of Medicine.

Farr holds joint appointments in the School of Medicine, where he teaches medical ethics and practices hospice and palliative medicine and also the Divinity School, where he co-directs the Theology, Medicine and Culture (TMC) Initiative. The TMC Initiative offers in-depth Christian theological training for those with vocations in healthcare. The initiative has trained more than 70 fellows and now includes a hybrid track for practicing clinicians who want deeper theological training regarding medicine. Dr. Curlin has authored more than 130 articles and book chapters dealing with the moral and spiritual dimensions of medical practice.

2022 Missionaries of the Year Award Get Involved with Advocacy

CMDA’s Advocacy and Communications Team is looking for healthcare professionals who are willing to assist us in advocating against the transgender ideology that is becoming so prevalent in healthcare today. We need expert assistance from physicians just like you in researching and developing resources, speaking in webinars, etc. If you are interested learning more about this and other advocacy efforts, please contact communications@cmda.org.

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Dr. Harry and Mrs. Echo VanderWal Dr. VanderWal trained at Boonshoft School of Medicine in Dayton, Ohio, specializing in internal medicine and pediatrics. Echo trained as a physician assistant at Kettering College of Medical Arts, then joined a surgical practice. In 2004, the VanderWals visited Eswatini, a country of just over one million people in southern Africa, for the first time. Then, as it

▲ CMDA President Lisle Whitman, MD (left), presented the 2022 Missionaries of the Year Award to Dr. Harry and Mrs. Echo VanderWal.

Ministry News still does today, Eswatini had the highest prevalence of HIV/ AIDS in the world. When they returned for a second visit in 2005, God affirmed their call to Eswatini. After Harry completed his medical training in 2006, the VanderWals moved to Eswatini to serve the most isolated and underserved populations. There, they founded The Luke Commission and began growing the team. The name represents a deep conviction to treat both the medical and the spiritual, highlighting the importance of treating the whole person—body, mind and spirit—with compassionate care.

In 2013, God provided an opportunity to purchase a property in central Eswatini, and a year later, an adjacent farm was also purchased to extend access to the largest river in Eswatini. As a constant reminder of God’s faithfulness, The Luke Commission team affectionately named the new property the Miracle Campus.

Since 2013, the team has expanded its reach through the addition of 21 buildings to support increased medical and logistical capacity.

Today, The Luke Commission team serves patients 24/7 at the fixed-site Miracle Campus in central Eswatini and at hundreds of outreaches across the country each year. With more than 650 staff members, 38 departments and multi-disciplinary teams supporting on-site construction, supply chain logistics, meal preparation, medical care, engineering, systems, agriculture and hospitality, the Miracle Campus resembles a small town and serves as a hub of operations and the heartbeat of compassionate care throughout Eswatini, where Harry and Echo served for 16 years.

2022 Servant of Christ Award Alva Weir, III, MD, FACP

Dr. Weir graduated from University of Tennessee Medical School, completed internal medicine residency at both Washington University in St. Louis, Missouri and University of Tennessee in Memphis, and was board certified in internal medi- ▲ Al Weir, MD (center), with his wife Becky cine with certifications in after being awarded the 2022 Servant of Christ Award by CMDA President Lisle hematology and oncology.

Whitman, MD. He married his life-long love, Becky, in medical school. After a few years of practice, God called Al and Becky and their family to international missions. They began serving at Eku Baptist Hospital in Eku, Nigeria in 1983. Their plan for career international missions was cut short by family health issues, so they returned to the U.S. After a few years on the University of Tennessee faculty, Dr. Weir entered private practice, while also continuing as adjunct faculty at the medical school.

After hearing from God with a change in direction for his future, Al became plugged into CMDA as a campus advisor and later as the leader of CMDA’s Memphis local council. In addition, Weir worked with the Albanian Health Fund, an educational evangelism mission. He continued to grow his involvement with CMDA and became a state representative for the House of Representatives, then a member of CMDA’s Board of Trustees, and then he served as president from 2001 to 2003. In 2005, he started as CMDA’s Vice President for Campus & Community Ministries, where he served until 2008. He later served a second term as president from 2017 to 2019, when he also wrote and contributed to several books.

Currently, Dr. Weir serves as professor of medicine at University of Tennessee Health Science Center, section chief for hematology and oncology at the VA Medical Center in Memphis and Program Director for the hematology and oncology fellowship at the University of Tennessee.

2022 President’s Heritage Award Regina Frost, MD

Dr. Frost began her education in 1996 at the University of Michigan in Ann Arbor, receiving a bachelor’s degree in psychology. Subsequently, she earned her medical degree at the Wayne State University School of Medicine in Detroit, Michi- ▲ Regina Frost, MD (center), with her gan, and then she performed husband Darren Clark (left), after receiving the 2022 President’s Heritage Award from her residency in obstetrics CMDA President Lisle Whitman, MD. and gynecology at St. John Hospital and Medical Center also in Detroit. Regina started her own private practice for women’s healthcare, while also teaching part-time at St. John Hospital and Medical Center. Furthering her experience in teaching from 2011 to 2017, Regina was a clinical assistant professor for Michigan State University in the Department of Osteopathic Surgical Specialties. In 2012, she became board certified by the American Board of Obstetrics and Gynecology.

In 2019, Dr. Frost was involved in a federal court case in which she was a named defendant, along with CMDA and the U.S. Department of Health and Human Services who released a new conscience rule enforcing existing laws that allow religious healthcare professionals to continue their important work in caring for patients without having to perform certain procedures that would be inconsistent with their beliefs or their conscience. It went to court and Dr. Frost testified on behalf of religious healthcare professionals, so they can continue

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Ministry News their ministry providing compassionate care to their patients without being forced to compromise their beliefs.

In addition, Dr. Frost has served abroad in mission trips to Jamaica, Brazil, Kenya and Uganda. She is married to Darren Clark, and they look forward to seeing how God will use them together to advance His kingdom. Today, she is an is an OB/Gyn with Ascension St. John Hospital in Detroit, Michigan. Regina has also been an active member of CMDA, where she is the current Chair of CMDA’s Women Physicians and Dentists in Christ.

2022 Recognition for Contributions in Medical Ethics Robert Orr, MD, CM

Dr. Orr and his wife Joyce began their life together in Montreal, Quebec, where Bob studied at McGill University Faculty of Medicine, earning the MD, CM in 1966. Bob joined the U.S. Navy and performed his internship at the U.S. Naval Hospital in Bethesda, Maryland and his family medicine residency at the U.S. Naval Hospital in Jack- ▲ At the 2022 CMDA National Convention, Robert Orr, MD, CM, sonville, Florida. He then served was honored posthumously for his as a general medical officer contributions to the CMDA. community and the field of medical ethics. at the U.S. Naval Hospital in Roosevelt Roads, Puerto Rico.

As a result of his growing interest and involvement in medical ethics, Dr. Orr pursued a postdoctoral fellowship at the Center for Clinical Medical Ethics at the University of Chicago from 1989 to 1990. After completing his postdoctoral studies, he served for 25 years in various professional roles including Professor of Medical Ethics and Director of Clinical Ethics at Loma Linda University Medical Center in Loma Linda, California; Professor of Family Medicine and Director of Clinical Ethics at the University of Vermont College of Medicine in Burlington, Vermont; Professor of Bioethics at Trinity International University in Deerfield, Illinois; and Professor of Bioethics at Union University Graduate School in New York.

Dr. Orr first became active with CMDA in 1968. He served on the Ethics Committee as chairman from 1991 to 1994, traveled and lectured frequently at CMDA events, mentored medical students and participated in several outreach programs on the mission field. He was a vital leader in CMDA’s advocacy efforts, and he was a respected voice while serving on CMDA’s Board of Trustees from 2010 to 2018.

Dr. Robert Orr passed away on May 20, 2021, after a fiveyear battle with cancer. In honor of his esteemed contributions to the CMDA community and the field of medical ethics

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around the world, CMDA has named the annual ethics track at the CMDA National Convention the Robert Orr Lecture Series in Bioethics, in his honor.

The Christian Medical Community Loses a Father MARVIN “CUB” CULBERTSON, JR

Marvin Criddle Culbertson entered this world 94 years ago on August 30, 1927 in Vernon, Texas. He joyfully served his awesome God until he was called home to join his heavenly Father on February 25, 2022. Cub was a member of CMDA since 1952. Cub began his medical journey in 1946 at The University of Texas Medical Branch at Galveston. During the Korean Conflict, he was the physician on a troop transport for the U.S. Navy with the rank of Lieutenant, J.G. He then completed his ENT residency in New York City at Bellevue Hospital. Returning to Dallas in 1956, he started his private and academic practice. In a time of segregation, Cub had the courage to stand against racism by integrating his waiting room. He was the first in Dallas to do so. What Cub enjoyed most in his practice was the immense joy he received from serving people, listening to their personal stories and creating solutions to help them. Cub had a passion for sharing his medical knowledge and skills, both at University of Texas Southwestern Medical School and literally all over the world through medical missions. He authored chapters of medical textbooks and developed innovative surgical instruments. If you knew Cub, you knew that medicine was a love, but not his first love—that was Jesus! No matter where he was or who it was, Cub fearlessly told his audience about his Savior. He was even kicked off a college campus and out of a communist country for telling others about Jesus! This love of Jesus led him to serve on faith-based boards such as Sky Ranch, InterVarsity Christian Fellowship, his local elder board, denominational leadership roles, choirs, mentoring seminary students, mission trips and much more. Cub’s medical career started on a boat and ended on a boat (in his 80s—a boat on the Amazon River, doing surgeries in isolated villages and sleeping in a hammock.

We are thankful for the impact Cub had in bringing the hope and healing of Christ to the world. He will be missed by the entire CMDA family.

“The area suffered a great loss in Cub Culbertson, one of my local heroes. He made every effort to help the area in every way. Everyone that spent evenings at my home met him at some point. One of my favorite things said about him was that, ‘He was the best elevator evangelist I ever met.’ I will miss him.”

—Stan Cobb, Dallas Area Director

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THE PATH OF LIFE My Journey to Help Rescue the Pre-born Christina Francis, MD

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I

stepped out of the door into the crisp, fresh air on the early morning of December 1, 2021 and started the short walk to the U.S. Supreme Court in Washington, D.C. As the sun rose on this historic day, I looked back at the group that accompanied me.

Nearly 80 physicians and other healthcare professionals had traveled to Washington, D.C. from all over the country, in the middle of the week, leaving busy practices, to stand in solidarity for the dignity of our patients. Never had I imagined we would gather so many healthcare professionals on that day, nor that we would be there for what could be the case that finally overturns the travesty of Roe v. Wade. The excitement and anticipation were palpable as we reached the front of the Supreme Court. As I looked out over our small sea of white coats, I couldn’t help but marvel at the journey the Lord has taken me on to bring me to this place.

As I look back on my path, I realize that what God used to guide my steps weren’t earth-shattering events, but rather small moments that probably seemed inconsequential to others. To me, however, those moments brought me to a place where I could see God’s mercy and power in ways I never imagined.

The first small moment occurred with my initial visit to what would eventually be my alma mater, Ball State University in Muncie, Indiana. Growing up, I had dreams of one day being a marine biologist. Though my father had warned me a marine biology career would be more than just “swimming with the dolphins,” I was certain (in a 17-year-old kind of way) that was what I wanted to do. During my campus visit, we met with two encouraging biology professors who listened patiently to all my aspirations. Toward the end of our discussion, they said something that eventually changed my path.

They exhorted me to pursue whatever I was passionate about.

They also proceeded to tell me that I would have to get a doctorate to even have a chance of finding a job in that field, and even then, it wasn’t guaranteed. While their comments may have sounded discouraging, they were illuminating for me and prompted me to consider where my passions truly lie. What I discovered through that process was that, while I did love science and the process of scientific discovery, I wanted to use it to be the hands of Christ. That is what led me to medicine, and I am eternally grateful it did. Now, I can’t imagine choosing a different vocation. How blessed we are as healthcare profes-

sionals to be a part of our patients’ lives, through their joys and sorrows, and to care for them during those times with compassion, excellence and integrity.

A year or so after starting my undergraduate studies, I attended a youth missions conference. The exhibit hall was filled with what seemed like hundreds of organizations that were all there to help young people serve on the mission field. In the midst of numerous organizations with elaborate exhibits, I had my next small moment. An unassuming booth with a simple display of photos of children stopped me in my tracks. The smiles on their dirty little faces and the joy radiating from their eyes tugged at my heart. A few months later, I was headed to Romania to spend five weeks living in an orphanage and ministering to about 75 children. My life and my heart were changed.

Experiencing the love and provision of Christ through ministry to these children helped me understand Him in a way I don’t think would have been possible otherwise. I saw perseverance and joy in the face of such adversity. I experienced the wonder of a well-known scriptural truth through the eyes of a child hearing it for the first time. It was during that time in Romania, while having Bible study with my team and several of the older www.cmda.org | 13

children in the orphanage, I realized this is how God wants me to serve Him with my life—through healthcare missions.

Fast forward to my second year of medical school when my next small moment occurred. My goal of practicing medicine in the developing world was the lens through which I viewed the various medical specialties offered. My initial thought was pursuing family medicine or combined internal medicine and pediatrics in order to have the broadest knowledge base and enable me to take care of as many types of patients as possible.

This all changed in a moment in the delivery room of a woman I didn’t even know. I was shadowing a family medicine physician when he was called to the hospital for a patient who was in labor and nearing delivery. I was so excited to go with him and see what a delivery was like. For reasons I can’t remember, I didn’t take part in the delivery, but I was able to watch the entire process. As I witnessed the miracle of a new life coming into the world (the ex-utero world anyway), tears sprang to my eyes, and I realized this was one of the most amazing things I had ever seen. How remarkable that God made women’s bodies to grow and nurture a child, then deliver that child and continue to sustain him or her! What an amazing picture of the goodness of our Creator.

In that moment of awe, I sensed someone standing close to me. I looked over to see the seasoned labor and delivery nurse

▲ Christina with a local woman requiring an emergency C-section at the Kapsowar Mission Hospital in Kenya.

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who was waiting to receive the baby at the warmer. She leaned over to me and said, “Oh, honey, if this makes you cry, you need to do this for a living!” One sentence, said in the emotion of the moment, spoken to someone she didn’t even know, focused my vision where it needed to be. I realized she was right—my specialty had chosen me. As I progressed through my thirdand fourth-year rotations, nothing inspired me more than being with a woman and her family as they welcomed a new baby or being able to comfort a family through a devastating loss, ensuring they received the compassionate support they needed.

The challenge of caring for two patients at once—one born, one pre-born—still excites me. I feel privileged to do so.

I continued to participate in short-term healthcare mission trips throughout medical school and residency, including trips to Myanmar and Afghanistan, anxiously anticipating the day I could do so full-time. In the final year of my OB/Gyn residency, I was accepted to the Post-Residency Program through Samaritan’s Purse. There were myriad places that desperately needed an OB/Gyn physician to come serve, and I felt overwhelmed trying to choose. Africa had always fascinated me. I had longed to go one day, but Africa is a large continent with countless locations with significant need. After praying and seeking wise counsel, I asked the Lord to somehow make clear where I should go. Then I heard about Kapsowar Mission Hospital in Kenya. It is a rural hospital, with approximately 150 beds, that

had not had an OB/Gyn for more than 20 years, despite serving a population surpassing 300,000.

After spending a month there as a fourth-year resident, I knew I had found my home. The warm welcome I received when I moved there confirmed my decision. Despite the challenges of not always having the necessary resources, or the heartbreak of losing babies that would have survived in the U.S., I loved serving the Marakwet people and learned so much from them. I learned the art of true hospitality and the importance of placing relationships ahead of schedules. I learned patience and that true hope for my patients doesn’t come as a result of my efforts as a physician, but from Jesus Christ, the Great Healer. What a privilege it was to freely pray with my patients in times of joy, uncertainty and sorrow. I was blessed with an amazing support system of other missionaries and Kenyan friends and could not imagine ever living or serving the Lord anywhere else.

After my first two years in Kenya with Samaritan’s Purse, I returned to the U.S. for a planned 18-month break to collect my case lists, take my oral board exam, switch sending agencies and then return to Kenya full-time. Or so I thought. Little did I know how deeply I would come to understand Proverbs 16:9, “The heart of man plans his way, but the Lord establishes his steps” (ESV). My final small moment occurred during a weighty conversation with my best friend. She had recently been encouraged by her pastor, during 40 Days for Life, to watch or read something about abortion daily for 40 days. Never one to back down from a challenge, she did just that. What she discovered lit a fire in her to do more to protect innocent pre-born children.

One day she was telling me about all she had learned, and she said, “Christina—you’re a Christian, you’re an OB/Gyn, you’re a woman and you say that you’re pro-life, but I think you could be doing more.” I was stunned for a moment. I grew up in a Christian home, I’ve always been pro-life, and I’ve never done or recommended an abortion. All the excuses and defenses ran through my head until I realized she was right. I could do more—and I should. As an OB/Gyn, the Lord had uniquely positioned me to be able to speak up for the lives of my preborn patients, and yet, I had been quietly skating by—talking to my patients individually but never speaking out publicly against the atrocity of abortion. She challenged me to consider what practical ways I could speak up for the pre-born.

Thus began my journey to learn more about the reasons I was pro-life. It wasn’t enough to say I was a Christian, though my Christian worldview certainly forms my view of inherent human dignity. I needed to be able to give a reason for my pro-life position to anyone who asked. I was floored the first time I heard Scott Klusendorf from Life Training Institute1 lay out the reason- and logic-based defense of life. It all comes down to what we believe the pre-born are. As Stand to Reason2 Founder Greg Koukl says, “If the unborn are not human beings, then no justi-

F

or nearly 50 years since Roe v. Wade was passed, abortion has been a blight on our country. However, December 1, 2021 was an amazing and historic day for LIFE! CMDA CEO Dr. Mike Chupp and Senior Vice President of Bioethics and Public Policy Dr. Jeff Barrows were joined by a dozen or more CMDA members on the steps of the U.S. Supreme Court as oral arguments were heard on Dobbs v. Jackson Women’s Health Organization.

This case is challenging a law passed in Mississippi in 2018 that bans abortion after 15 weeks’ gestation, except for cases of medical emergency. At the time this article goes to print, we are still waiting for a decision from the court. Nevertheless, more than ever before, we know this case has the opportunity to speak to the value and intrinsic worth of human life, created in the image of God. It is time for the law of our land to catch up with advances in medical science and support the human rights of all of our patients. We know God is hearing our prayers as we petition Him to move mightily and miraculously to protect the unborn.

So what’s next? Will you prayerfully consider getting involved in CMDA’s grassroots advocacy efforts in your individual state? State legislatures responded quickly with a plethora of new bills in response to this abortion case, and we need your help to promote life in all 50 states. As Christians, we have a responsibility from Christ to be defenders of our faith in the public square. To get involved with CMDA’s advocacy efforts, contact communications@ cmda.org.

Please continue to pray for CMDA and for us to always be faithful in our mission to “educate, encourage, and equip Christian healthcare professionals to glorify God.” Obeying the clear biblical instruction to “Speak up for those who cannot speak for themselves; ensure justice for those being crushed” (Proverbs 31:8-9, NLT) is clearly one way that together we can glorify God. In doing so, we protect the lives of the least and littlest of these who are made in His image.

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necologists (AAPLOG), a professional medical organization dedicated to equipping its members—pro-life medical professionals—with the evidence-based rationale for a pro-life position and to defend the practice of Hippocratic medicine. I have been honored to serve on the AAPLOG board for the last seven years and am currently chairman of the board. Through my involvement with AAPLOG, I have learned about the extensive damage caused by abortion procedures and the lies furthered about them to women. Abortion truly is the greatest injustice we face today as a society and as a profession.

fication for elective abortion is needed. However, if the unborn are human beings, then no justification for elective abortion is adequate.” The more I learned and read, the more apparent it became to me that I could no longer be silent. I had to do more.

My “call to arms” occurred during a visit to the United States Holocaust Memorial Museum in Washington, D.C. Surrounded by evidence of the relative lack of response of the U.S. to the bloodshed and suffering of millions of innocent people, I found myself wondering how anyone could have known what was happening and ignored it. In that moment, I knew I had to do more to try to stop the slaughter of millions of pre-born children and the harm inflicted on their mothers due to abortions.

I must admit that path was not a smooth one. My pride took over. I had been telling everyone for years now that I was planning to be a healthcare missionary for the rest of my life. How could I go back on my word? Would I be perceived as taking the easy way out, not able to “hack it” on the mission field? Through praying, seeking wise counsel and struggling with God, I realized I wasn’t going back on my word or abandoning the Lord’s plans.

Pre-born children, who are dependent and vulnerable and labeled disposable by the world, are just as much a mission field as rural Kenya. In addition, the policies and attitudes surrounding abortion in the U.S. influence policies around the globe. So, while my specific mission field is now different than I expected, I am still serving the Lord by caring for the vulnerable and the fatherless and helping others see the value of those whom society discards.

It was during this time of soul searching I was introduced to the American Association of Pro-life Obstetricians and Gy-

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It was this injustice that led us to organize the sea of healthcare professionals in front of the Supreme Court last December, along with amazing partners like CMDA. On the day of oral arguments in the case of Dobbs v. Jackson Women’s Health Organization, we had the privilege of boldly declaring that abortion is not healthcare! It ends the life of at least one of our patients and harms the other, both physically and mentally. We struck a chord that day. Seeing all of us in front of the Supreme Court demonstrated to others that they too can stand up for what’s right—defending the defenseless and speaking for the voiceless.

Never had I imagined myself speaking in front of thousands on the steps of the Supreme Court. It was only by the Lord’s grace and equipping I was able to do so. Each of the small moments in my life led me to that place on the steps. As healthcare professionals, we have a duty and a calling to defend and care for the vulnerable. Be bold in your convictions, be faithful to that duty and know you are not alone!

Endnotes 1. Life Training Institute at prolifetraining.com 2. Stand to Reason at str.org

Christina Francis, MD, is a board-certified OB/Gyn who currently works in Fort Wayne, Indiana as an OB/Gyn hospitalist. Dr. Francis completed medical school at Indiana University in 2005 and completed her OB/Gyn residency at St. Vincent Hospital in Indianapolis, Indiana in 2009. She is Chair of the Board of the American Association of Pro-life Obstetricians and Gynecologists, an associate scholar with the Charlotte Lozier Institute, a board member of Indiana Right to Life and a physician member of the Abortion Pill Reversal Network. As a pro-life speaker, Dr. Francis offers her medical expertise, knowledge of bioethics and pro-life reasoning both here in the U.S and around the globe. She has always had a passion for human rights, spending a significant portion of her life in various countries working tirelessly on behalf of women and children. Dr. Francis worked for three years as the only OB/ Gyn at a mission hospital in rural Kenya until returning to the U.S. in 2014 to work on behalf of women and children, both in the U.S. and internationally, who are often victims of the abortion industry. She has written on issues surrounding women’s health and abortion for publications including the Wall Street Journal, Newsweek and USA Today.

My

C MDA

Story

I don’t stand alone.

“I was called into healthcare from a very young age to ‘speak up for those who cannot speak for themselves, for the rights of all who are destitute’ (Proverbs 31:8-9, NIV 1984).

As a physician assistant, I’ve been able to share with patients the value of life by helping women choose life for their babies and helping families think through hard end-of-life issues. I need CMDA to advocate for me nationally so I can continue to have these rights to practice healthcare according to the dictates of my conscience. As a member of CMDA’s Fellowship of Christian Physician Assistants, my colleagues have come alongside me with advice about tough ethical patient situations and offered prayer and camaraderie. At the CMDA National Convention each year, I hear from ethical experts who also follow Christ. As a CMDA member, I know I am not alone in standing for life, and I would encourage all my physician assistant and nurse practitioner colleagues to consider joining CMDA so we can continue to stand together.”

—Caroline Pilgrim, PA-C

Introduce Your Practice Team to CMDA Is everyone on your team a CMDA member? CMDA membership is beneficial to all healthcare professionals, so we encourage you to introduce the physician assistants, nurse practitioners and others in your practice to CMDA. Together, you can join Caroline and more than 18,000 healthcare professionals across the country who are part of this growing movement of “bringing the hope and healing of Christ to the world through healthcare professionals.”

Visit www.joincmda.org or call 888-230-2637 to join us today.

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Training Medical Students to Care for Patients in Spanish Tiffany M. Shin, MD

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n the United States there are about 57 million Hispanic individuals, and approximately 40 percent of those have limited English proficiency. Research shows that language-discordance, where the patient and the clinician do not speak the same language, results in reduced access to health information, decreased satisfaction with care and worse health outcomes. When Hispanic patients are hospitalized, having limited English proficiency is associated with an increased risk of medical errors and patient harm. On the other hand, when the patient and the clinician speak the same language, health outcomes can be greatly improved. Less obvious is the reality that being able to speak a second language does not necessarily mean a clinician is ready to care for patients in that language. I created the Medical Applied Education in Spanish through Training, Resources and Overlearning (MAESTRO) Program at Wake Forest School of Medicine to teach medical students clinical communication skills in Spanish and the cultural understanding needed to care for Hispanic and Latino patients and to address health inequities.

I joined Wake Forest School of Medicine in 2017 as an assistant professor of pediatrics. As a general pediatrician, I started out teaching pediatrics to medical students and providing bilingual pediatric care to the local Hispanic and Latino community in a hospital-affiliated clinic where more than two-thirds of the patients prefer care in Spanish. It quickly became apparent to me that Wake Forest medical students 18 | CMDA TODAY | SUMMER 2022

wanted formal opportunities to learn medical Spanish and gain skills to become bilingual clinicians. Students frequently asked me how I learned to speak Spanish with patients and how they could do the same to improve their care for patients.

The difference in communication and rapport with patients and families due to speaking the same language was obvious to them while working in our clinic.

One conversation quickly led to many others, and the idea of creating a medical Spanish program was born. I led a needs assessment at the medical school, where it was clear that Wake Forest medical students had a high level of interest in gaining medical Spanish skills. The medical school leadership was keen to support the creation of a formal medical Spanish program— the MAESTRO Program—as such a program aligned with the school’s goals and priorities.

Improving the Care of Spanish-speaking Patients through Medical Education The MAESTRO Program’s goal is to train medical students who are equipped with the skills necessary for providing care in Spanish for the growing number of Hispanic and Latino patients in the U.S. The program is designed to integrate clinical communication skills and cultural understanding with language, not teach language alone. The program is designed for medical students with high-intermediate, advanced or native Spanish language proficiency. Often, students enter medical

school with Spanish language skills from studying in college or semesters abroad but are unsure of how to develop and maintain their abilities during medical school. In fact, many students report that an important factor in choosing what medical school to attend was looking at the opportunities for medical Spanish education. In the MAESTRO Program, students have the opportunity to build on their language skills to become bilingual clinicians prepared to care for diverse communities and healthcare leaders equipped to address health inequities.

A Unique Four-year Program The MAESTRO Program is a longitudinal program that runs concurrently with the traditional medical school curriculum at Wake Forest School of Medicine. It follows students’ 18-month preclinical coursework and the subsequent clinical training through the end of their fourth year of medical school. While students are first introduced to new knowledge and clinical skills in their core medical school classes, the MAESTRO Program teaches them how to use and apply these skills with an understanding of cultural aspects in Spanish. During their clinical rotations, students put their training into practice by working directly with Spanish-speaking patients and individualizing their skills with respect to their professional interests and planned medical specialty. The four-year curriculum is key to ensuring that students do not lose language skills during medical school training and that they graduate having advanced their medical Spanish knowledge and abilities.

The program goes beyond mere Spanish vocabulary and incorporates cultural humility and clinical communication training throughout all four years. Students participate in interactive workshops with faculty instructors where they work on medical Spanish skills during group discussions, partner practice and role-play scenarios. Teaching faculty give direct feedback to students during standardized patient encounters where students role-play patient visits with native Spanishspeaking actors. Another important part of the MAESTRO Program is its community service hours requirement, where students use their language skills to interact directly with the local Spanish-speaking community. Most students complete this requirement by volunteering at the medical school’s student-led free clinic, at the hospital’s mobile health clinic or at other community-based free clinics as a Spanish interpreter.

Students are provided additional opportunities to further integrate and apply their language skills during clinical rotations and through local and global health clinical electives.

The MAESTRO Program benefits from a unique collaboration with the undergraduate Wake Forest campus Spanish department. Carmen Pérez-Muñoz, PhD, is a Spanish professor

who has collaborated on program design and development and who provides essential medical Spanish teaching experience and expertise. Our unique interdisciplinary collaboration has resulted in a learning experience that uses best practices from both language and medicine to present students with a wellrounded education. Students benefit greatly from learning from both Spanish language and clinical experts and tapping into the diverse experiences and knowledge of instructors.

Shaping the Next Generation of Healthcare Professionals

The MAESTRO Program officially launched in 2019, after a successful pilot medical Spanish program in 2018. Our pilot program students are graduating this year, and our first cohort of MAESTRO students will graduate in 2023. Through our program, students gain a community of like-minded individuals who plan to go on to care for Spanish speakers and other underserved communities. They also benefit from close mentoring by peers and faculty from the beginning of medical school through graduation.

Since its onset, the MAESTRO Program has received input from medical students through a student design team. This small team of medical student leaders works with me to ensure the program is learner-centered and effective. The team helps review students’ feedback on the program and provides input on ways to improve the learning experience. This student-faculty collaboration is invaluable and energizing to the process of continual program development. Meanwhile, these students benefit from mentorship and partnership with medical school faculty as they get hands-on learning about medical education, curricular design and leadership.

During clinical rotations, students in our program have demonstrated strong clinical communication and rapport-building www.cmda.org | 19

will be our future generation of healthcare professionals, leaders, advocates and medical educators.

His Ways Are Not Our Ways

skills in general, because they have pushed themselves to develop these skills in two languages. They are quick to ask about social aspects that impact patients’ health, such as food insecurity, transportation issues and other social drivers, as their involvement in our program has deepened their understanding of a holistic approach to the health and well-being of patients.

They often help their medical teams navigate cultural issues and advocate for patients and families who do not speak English.

All the students involved with the MAESTRO Program have commented on how their participation has been influential on their formation as healthcare professionals and on their training in medical school. After entering their clinical rotations, students often tell me they did not fully understand how much difference the ability to communicate in Spanish would make interacting with patients. On the wards, they witness first-hand the health inequities faced by patients who do not speak English. The students experience how they can make a difference by listening well, communicating clearly and advocating for patients. Senior students have shared with me that their involvement in the MAESTRO Program is the most common topic they are asked about during residency interviews.

Students have the opportunity to take the Clinician Cultural and Linguistic Assessment (CCLA) for bilingual clinician certification, which allows them to see Spanish-speaking patients without an interpreter. This third-party assessment tool developed by Kaiser Permanente is used by Wake Forest and other healthcare systems for bilingual certification, and students can carry this certification with them through their clinical rotations, on to residency and beyond in their medical careers.

I look forward to seeing our students’ impact multiply as they use their skills in residency and in practice, and I know some will even go on to teach others best practices in caring for patients who do not speak English. It is such a privilege and joy to work with students who are caring and thoughtful and who

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I started medical school thinking I would end up as a missionary physician somewhere outside of the United States, but for now, God has placed me on a different path. When I joined the faculty at Wake Forest School of Medicine, I did not plan to start a language program, and I never imagined God would place me in this capacity to train future healthcare professionals to care for the marginalized and underserved. Beyond that, I had no idea that studying Spanish in high school and college would be so valuable, nor that the experiences I had studying abroad and participating in a medical Spanish program during medical school were preparing me for this role. Even the meetings and conversations with students, faculty collaborators and school leadership were perfectly timed and positioned. Some might call this “luck,” “chance encounters” or attribute credit elsewhere, but without a doubt, God’s amazing hand orchestrated all of this. He guided my steps to land here at Wake Forest to work for His kingdom in this way.

While I am thankful for the difference I can make as a bilingual pediatrician in my practice, I am also astounded by the way that God is multiplying the seeds planted as I teach students the skills I use day-to-day to communicate and connect with patients. Indeed, His ways are not our ways, and His thoughts are not our thoughts (Isaiah 55:9b) May the Lord also guide you as you take each next step in faith to serve Him with your God-given skills and abilities. As you faithfully follow Him, may He continue to show you ways you can care for the suffering, poor or marginalized in your community.

“He has shown you, O mortal, what is good. And what does the LORD require of you? To act justly and to love mercy and to walk humbly with your God” (Micah 6:8).

Tiffany M. Shin, MD, is a general pediatrician and assistant professor of pediatrics at Wake Forest School of Medicine in Winston-Salem, North Carolina.

She graduated from the University of North Carolina School of Medicine in Chapel Hill and completed residency training in pediatrics at the University of North Carolina. During medical school, she trained in a four-year longitudinal medical Spanish program which fueled her passion to care for underserved Spanish-speaking populations. She provides pediatric care to a large, underserved population of children and families who prefer care in Spanish. Her enthusiasm for medical education is evident in her clinical teaching and work in medical Spanish education.

She has been recognized for clinical teaching and service and is the founder and director of MAESTRO, the Medical Spanish Certificate Program at Wake Forest School of Medicine.

All photo credits Wake Forest University School of Medicine

CMDA Plays Major

HUMANITARIAN ROLE in the Russian/Ukranian War Jim Peipon, MD

All photos from CMA Ukraine

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n a CMDA Matters podcast in March 2022, CEO of International Christian Medical & Dental Associations (ICMDA) Dr. Peter Saunders and Ukraine Medical Outreach (UMO) President Dr. Jim Peipon shared with CMDA CEO Dr. Mike Chupp about how they responded to the medical needs created by the war between Russia and Ukraine. The members of CMDA-USA contributed to the ICMDA Appeal for Ukraine which raised more than $300,000 worldwide. Another $1,000,000 has been given in donations of pharmaceuticals through the Christian Medical Association of Sweden. The Ukrainian people say, “THANK YOU!” It has now been several months since war broke out between Russia and Ukraine. However, the truth is this conflict has been going on for at least eight years. The seeds of conflict were planted and cultivated over a much longer period, perhaps centuries. Biblically, it didn’t take long for a spirit of rebellion to develop in Adam and Eve, throwing the world into turmoil ever since. The turmoil will continue until Jesus returns.

As healthcare professionals, we are dedicated to caring for people with all manner of illness. We often feel overwhelmed when we walk into work and wonder what unexpected emergency awaits us, in addition to all the patients scheduled for that day. When there is a slight break, we reach for our phones to check messages or read a few headlines. Those headlines are filled with sorrow and disappointment. A train station crowded with passengers trying to escape is bombed; the horrors of atrocities committed in Bucha, where men were executed and women and children were raped; and reports of poison gas released in Mariupol, already 90 percent destroyed, and those remaining are without food, water and medicine. In addition, we are handling the care of more than four million Ukrainian refugees who have fled to Poland, Slovakia, Hungary, Romania and Moldova.

When confronted with the reality of life, or should I say death, where do we find hope? As I was asked about 9/11 and again when the COVID-19 pandemic began and continues, “Where is God in all of this? Why does God allow these tragedies to happen?” First, we should remember that during all these events, we must turn to Christ. He is our hope, and He is faithful to keep His promises. His death and resurrection remind us we can have freedom from our sin and guilt. This provides us assurance for our future. We see the faithfulness of God keeping His promises over time. This gives us a constancy to live in the present. Second, we should tell stories of truth to encourage and motivate us toward showing love to God, showing love to our neighbors and resisting apathy. Countless numbers of stories of God’s mercy and grace have emerged in recent months. Let me share a few.

A month or two before this war erupted, President of the Christian Medical Association (CMA) of Ukraine Dr. Rudi 22 | CMDA TODAY | SUMMER 2022

Mihovych called, obviously discouraged. “What am I to do?” he asked, “I am just one person. I don’t have a team.” I began meeting with Rudi regularly to assist him through the disaster.

Two days before the war began, we spoke again. His concern was what would happen if the Russian army attacked and how they would prepare. We exchanged a few basic ideas, such as using the existing network to set up a communications system and using the resources within Ukraine to gather supplies and determine what would be needed.

Dr. Mihovych, a 25-year-old neurology resident, married for only one year and recently became a father, now oversees a warehouse with a staff of 30 volunteers to receive and sort supplies. His team coordinates the transfer of supplies from Poland across the border to their warehouse. When requests are received from churches and hospitals, they are processed; however, not all the needs can be met. Then brave drivers, often using their own cars, drive the supplies to Chernihiv, Kyiv, Kharkiv, Odessa, Dnipro, Zaporizhzha and even Mariupol. This entire team is overwhelmed by the support the worldwide Christian medical community has shown them. Although, Rudi is quick to point out, there is still great need for basic medicines. Hypothyroidism is a major health problem in Ukraine, secondary to illness from the Chernobyl nuclear reactor. Many people have suffered from thyroid cancer and had their thyroids removed.

Other medicines needed include antibiotics, antihypertensives, insulin, metformin, asthma and pain relievers. They have need of basic trauma packs which contain pulse oximeters, bandages and ambu bags. Word has spread about the network and supply chain developed by CMA Ukraine, which is known for being a trustworthy and reliable group. Other Christian groups are providing and sending medicines through them.

Rudi reported, “The generosity of Christian medical organizations around the world, both in prayer and finances, has been a tremendous support.” To date, 40,000 kg or just over 44 tons of medicine has been distributed to more than 70 cities and villages all through Ukraine to 150 organizations, churches, hospitals and Ukrainian military on the frontlines.

Rudi explained, “CMA Ukraine was one of the first groups to coordinate bringing supplies to the frontlines at the beginning of the war.” Those cities were the hardest hit and include Kyiv, Kharkiv, Chernihiv, Zaporizhzha and Mariupol. This has been difficult and dangerous work, at times, with many challenges.

In one city in north central Ukraine, Chernihiv, the only bridge leading into the city from the south was destroyed, and a boat had to be purchased to get the supplies across the river.

Just during the first week of April, CMA of Ukraine was able to supply medicines to the Russian occupied cities of Kherson and Mariupol. When asked why people are driving to obviously dangerous and unfriendly places, Rudi responded, “Our team is

made up of all volunteers. They are not paid and do not want to be paid anything. They do their work for the love of God, the love of their churches and the love of their people.” The situation remains quite fluid, never knowing what will happen or where the next hot spot will be. The stress on the Ukrainian government to meet the needs of both civilians and the military is overwhelming. CMA Ukraine has stepped up to meet some of these challenges. This is possible only through your generosity and prayers.

Take Action!

The question then arises: What is needed now and how can you be of further help?

1. Prayer is our first request. The prayer of a righteous person has great power.

2. The next and easiest request is for you to continue to send money through CMDA-USA. Visit www.cmda.org/ ukraine to make a donation.

3. Another important means of support is the connections CMDA members have with pharmaceutical, medical supply or transport companies.

4. In addition, UMO has organized a group that meets regularly to share information on how to obtain medical supplies, how to transport them efficiently and inexpensively, what documentation is needed and what kind of supplies are needed.

If you would like to be a part of the discussion or can provide help in any way, please contact Jim Peipon at jim@ukrainemedicaloutreach.org.

Dr. Jim Peipon served as a pediatrician for 20 years before becoming involved in medical missions in Ukraine. He and his wife Marianna began Ukraine Medical Outreach. The goal of this organization is to help train the next generation of Christian healthcare workers and provide hope to Ukrainian families and children living with HIV/AIDS and disabilities. He serves as advisor to the International Christian Medical Association of Ukraine, which brings a Christian perspective to the study of medical care. He leads seminars on the role of faith in medicine, trains healthcare professionals on how to become an effective witness for Christ in the medical context and promotes the improvement of care for children with disabilities and those affected by HIV. He has been married to Marianna for 40 years, and they are blessed with three children and five grandchildren.

LEARN MORE Please send your generous gifts to CMA Ukraine to help them continue serving their devasted citizens by visiting cmda.org/ukraine and making a donation today! Thank you for your support!

Do you feel down, depressed or hopeless? Have you lost interest or pleasure in doing things? Do you know someone who might be depressed and want to help?

Are you a Christian healer—healthcare professional, counselor or clergy—and want to expand your knowledge base on depression? If you answer yes to any of these questions, this book may be of help to you.

As a Christian family physician and educator for more than 40 years plus seminary training, Dr. Andrew White has found that treating the whole person with clinical depression is the most likely way to be healed from this dreadful illness. There are now many real helps for those with clinical depression from the medical (including psychiatric), counseling and pastoral care professions, especially from the Bible itself. Dr. White has suffered from seven clinical depressions, so he knows the issues facing those who are depressed. Also included are real-life examples of Christians who have suffered from depression and recovered, plus helpful quotations from Scripture and special prayers for those who are depressed.

Purchase Your Copy Today!

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“A powerful testimony and treatise on the power of prayer, counseling and medical therapy for depression. Andy’s personal lifetime experience with depression makes this book a tremendous labor of love and a mustread for healthcare professionals as well as patients, families, pastors and others engaged in mental healthcare inside and outside the church.”

—Mike Chupp, MD, FACS CEO, Christian Medical & Dental Associations www.cmda.org | 23

CMDA Ethics Statement

CONSCIENCE IN HEALTHCARE INTRODUCTION

Made in the image of God, we are endowed with a conscience that enables us to know and respond to moral truth. To live by conscience is to live with integrity, with pure hearts and transformed minds that seek God’s will and strive to love him and our neighbor. Christians should inform their consciences through Scripture, reason, and evidence, and when matters are uncertain, pray for the Holy Spirit’s guidance. Because moral judgments reflect our best understanding of what is good and right, we should always follow our conscience even as we recognize that our conscience is fallible and ultimately under God’s judgment and grace. Because reason is essential in conscience, Christians should be prepared to engage in moral deliberation and to explain and commend the reasons for their conscientious actions to others.

In clinical practice, Christian healthcare professionals should be in, but not of, the world, striving for what is good and avoiding complicity with evil. We should pray for wisdom to discern what is right when circumstances in our fallen world make it difficult to separate ourselves from associating with the evil actions or intentions of others. Christian healthcare professionals will sometimes need to disagree with patients, colleagues, or institutions over the ethical legitimacy of controversial medical practices. Under such circumstances, Christian healthcare professionals must be prepared to refuse to cooperate with such practices. They should do so with compassion and confidence, knowing that loving our neighbors sometimes means refusing to cooperate with their mistaken wishes. Conscience should be considered a right with profound ethical and religious importance. Therefore, Christian healthcare professionals should encourage colleagues, institutions, and governments to respect this right and to establish policies that accommodate clinicians who exercise it.

A. THE NATURE AND SIGNIFICANCE OF CONSCIENCE

1. Conscience is at the core of our nature as moral persons made in the image of God (Genesis 1:27). It is a gift of God that enables us to understand moral truth based on the moral law God has written on the human heart (Romans 2:15).

2. The full expression of God’s moral truth is revealed in the Bible (Deuteronomy 5:6-21; Deuteronomy 6:5; Psalm 119:111, 144; Mark 12:30-31; 2 Timothy 3:16-17), which also teaches us about conscience. a. I n the Old Testament, conscience is often portrayed by the heart, meaning the innermost place of our moral consciousness as persons ( Job 27:6; Psalm 51:6, 10). b. The New Testament affirms and extends this understanding, describing the need for pure hearts (Matthew 5:8; I Timothy 1:5) and transformed minds (Romans 12:1-2; 2 Corinthians 3:18) that have the wisdom to know God’s will and desire to please God by doing his will (Colossians 1:9-10). c. By following conscience, Christians strive to live with the integrity of undivided hearts (I Kings 9:4; 2 Corinthians

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1:12; Psalm 86:11) in which thoughts, words, and actions harmonize in a unified life that brings glory to God (Matthew 5:16; James 2:14-17; I Peter 2:12).

3. To live according to conscience is a fundamental moral and spiritual obligation for the Christian. We are called to hold on to faith and a good conscience (I Timothy 1:18-19; 3:9).

4. The Christian’s conscience becomes properly formed and perceptive by being conformed to the mind of Christ through the power of the Holy Spirit (I Corinthians 2:16; Romans 9:1; Luke 11:9-13).

5. Conscience should always be motivated by a love for God and our neighbor (I Corinthians 10:23-24; I Timothy 1:5).

6. Conscientious living reflects the Christian’s duty and desire to put God’s kingdom first by pursuing what is true and right. This means living a life of love, fleeing immorality, and enduring suffering that produces perseverance, character, and hope (Matthew 6:33; Acts 5:29; Philippians 4:8; Ephesians 5:1-11; I Timothy 6:11-12; Hebrews 12:1-11; Romans 5:3-5).

B. AUTHORITY AND FALLIBILITY OF CONSCIENCE

1. Because we are fallible and finite, our consciences may not always provide trustworthy moral guidance. We may suffer from limited or mistaken understandings ( Job 42:1-6; Isaiah 55:8-9), weaknesses in our moral character (Proverbs 16:2; I John 1:8), and we may be self-deceived ( Jeremiah 17:9-10). In extreme cases, our consciences may be seared and not function (I Timothy 4:2). Therefore, our consciences need the objective moral illumination provided by God’s Word.

2. Through the power of the Spirit and the guidance of biblical teaching, God uses Scripture to renew our minds to discern his will (Romans 12:1-2). This enables us to respond to ethical challenges with consciences informed by reason and evidence, and with hearts motivated by faith, hope, and love (I Corinthians 13:1-13). a. Rightly understood, conscience engages multiple aspects of our human nature as it involves the dimensions of reason, emotion, and motivation.1,2 Together, these interrelated dimensions allow us to understand, feel, and do what we believe is right and good. b.

Reason is an essential part of conscience. Therefore, conscience is more than a private moral sensibility; it is rational and its claims and conclusions can be communicated to others. c. This ability to communicate allows us to appeal to other persons’ consciences (2 Corinthians 4:2) and to use moral reasoning to inform, advise, or persuade them (2 Corinthians 5:11).

3. Even though conscience is fallible, we must always follow it, because conscience reflects our best moral understanding before God and man (Acts 24:16; 2 Corinthians 1:12; I Timothy 1:19; 3:9; James 4:17).

a. The God-given authority of an individual’s conscience sets it above the judgments of others. b. A clear conscience, however, does not make someone innocent: each person’s conscience remains under the judgment of God and His Word (I Corinthians 4:3-4; Hebrews 4:12-13). c. The unique and universal value of conscience reflects a belief in individual human equality that Christianity introduced to the ancient world. This belief has rightly shaped modern assumptions about the exceptional importance of personal human freedom in matters of ethics and faith.3

C. CONSCIENTIOUS PRACTICE IN HEALTHCARE

1. A Christian healthcare professional’s conscientious practice must be both motivated by the love of God and neighbor (I Corinthians 10:23-24; I Timothy 1:5) and guided by wisdom. a.

Conscientious practice must demonstrate a love that abounds in both knowledge and deep insight to discern what is best, so that God is praised (Philippians 1:9-11). b. We need wisdom in situations where there is tension between our duty to care for a patient with simultaneous obligations to others – to other patients, to family (I Tim 5:8), to the fellowship of faith (Ephesians 4:1-16), to employers (Ephesians 6:5-8), to society (Matthew 22:21) or to be a faithful steward of one’s own body (I Corinthians 6:19-20; Ephesians 5:29; I Timothy 5:23). c. Conscientious practice must follow the ‘order of love,’ directed first to God and then to our neighbors (Mark 12:28-34), in the confidence that what pleases God is also beneficial to our neighbors. d. In all circumstances, we should pray for wisdom to fulfill our multiple responsibilities ( James 1:5) and for strength to do what we know is good ( James 4:17).

2. Moral deliberation is part of conscientious practice and is thus a responsibility of each Christian healthcare professional (Galatians 6:4-5). After we have done our moral best, we must entrust our decisions to Christ’s mercy (Psalm 68:19; Romans 14:4).

D. COMPLICITY WITH EVIL

1. To avoid complicity with evil, we must live by the Spirit (Galatians 5:22-26), reject the desires of our sinful nature (Galatians 5:16-21), not become weary in doing good to all people (Galatians 6:9-10), seek to learn God’s will (Psalm 86:11), and offer ourselves to God as living sacrifices (Romans 12:1-2).

2. Actions and intentions are evil if they go against God’s will as revealed in Scripture, summarized in the command to love God and neighbor (Deuteronomy 5:1-33; Matthew 5-7; Mark 12:28-31; Romans 13:8-10). a. A s Christians we are called to avoid every kind of evil (I Thessalonians 5:22), separate ourselves from evil (2 Corinthians 6:17), hate what is evil (Romans 12:9), pray for deliverance from the evil one (Matthew 6:13), and have nothing to do with deeds of darkness (Ephesians 5:11). b. Christians must never do evil that good may result (Romans 3:8).

3. A person is morally complicit with evil when he or she supports, associates with, or participates in actions or intentions that are evil.

a. Complicity may involve the use of unethical means or the pursuit of corrupt goals. b. Complicity may involve encouraging, assisting, or cooperating with the unethical actions or intentions of patients, other professionals, institutions, or governments. c. Complicity may involve the use of information, technology, or materials previously obtained through unethical means, which may have the further effect of justifying, rewarding, perpetuating, or ignoring past, present, or future evils.

4. Because of the complex ramifications of professional practice requirements and employee-employer relationships, it may sometimes not be possible to completely separate ourselves from associating with the evil actions or intentions of others. a. In such circumstances, Christians should take comfort in knowing that God wants us to be in, but not of, the world ( John 17:15-16; I Corinthians 5:9-10), that He protects us from evil and enemies (Psalm 23), and that He calls us to be salt and light (Matthew 5:13-16) in a world darkened by evil, and yet a world that Christ died to save ( John 3:16-21). b.

No matter how complex our circumstances may be, Christians are always responsible, to the best of our abilities, to rely on God’s Word, the Holy Spirit, and mature Christian counsel to act conscientiously. We must identify courses of action that promote what is good and achieve the needed degree of separation from the evil intentions or actions of others. c. By demonstrating a better way, conscientious refusal enables the Christian health professional to overcome evil with good (Romans 12:21).

5. Sometimes questions of conscience may cause Christians to experience significant uncertainty and profound anxiety. a. In such circumstances, we should not be fearful, no matter how weak we feel. God faithfully upholds us when we are tested (Hebrews 12:1-11) and shows mercy to us in our weakness (2 Corinthians 1:8-9) as we rely on Him and seek His wisdom ( James 1:2-5). b. He knows our condition (Psalm 103:13-18; Matthew 9:12; Matthew 11:28-30; Mark 9:21-26) and wants us to turn to Him in our distress (2 Chronicles 20:12; Psalm 121; Psalm 146; Proverbs 3:5-6). c.

He will be faithful (1 Corinthians 10:13; Hebrews 10:23), shining a light on our path and shielding us with his protection (Psalm 84:11).

6. In seeking discernment about situations involving complicity, Christian healthcare professionals should consider the following: a. Intention: our motivation must always be to do and promote good, not evil. b. Proximity: the closer the association with an evil act, the greater the culpability. c. Seriousness: the evil of some acts is so significant that any association with them is morally unacceptable. d. Clarity: the greater the certainty that an action is evil, the greater the culpability.

7. Frameworks that distinguish between unacceptable and acceptable occasions for “cooperation with evil” may help

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Christian healthcare professionals clarify questions of proximity.4,5,6 Such distinctions rest on reasoning that includes the following: a. Our actions in themselves should never be immoral. b. We should never share in the evil intentions of a person committing an immoral action. c. Even if we do not share in such evil intentions, we should never cooperate in ways immediately or directly connected to the execution of an immoral action. d. The greater the distance between the immoral act and our action, that is, a distant “cooperation”, the more likely our action will be untainted by the original immorality. e. The moral reason for our action, (our distant “cooperation”) should be proportionate to the immoral action at issue: i.e., The greater the seriousness of the immoral act, the more compelling the basis for our refusal to cooperate. Some immoral actions constitute such a grave attack on human life and health that any cooperation, however distant, is morally unacceptable.

8. Concerning the evil actions or intentions of others, moral complicity is absent or morally justified when all of the following conditions are satisfied: a. The healthcare professional intends to do and promote good; b. There is a sufficient distance between the healthcare professional and the evil intention or action; c. The healthcare professional’s action does not justify, reward, perpetuate, or ignore past, present, or future evils.

E. CONSCIENTIOUS REFUSAL IN HEALTHCARE

1. Healthcare professionals who are guided by love and wisdom usually collaborate well with their patients in shared decision-making, based on a shared concept of health and legitimate goals of care.

2. Sometimes, however, healthcare professionals and patients disagree about the ethical legitimacy of certain medical practices based on differing foundational beliefs and values. a. In the face of such disagreements, clinicians may believe that a patient’s intentions are inherently unethical or not directed toward acceptable goals. To avoid complicity, they may need to refuse to cooperate with a patient’s request. b. In such a situation, a clinician should listen with compassion to the patient’s wishes and concerns and respectfully explain why those desires conflict with legitimate concepts of health, goals of care, medical evidence, or ethical principles that the clinician, by conscience, is obligated to respect. c. By practicing conscientiously, clinicians will act in their patient’s best interests by offering alternatives that promote health, based on the clinician’s best understanding and judgment, both ethically and medically. d. Conscientious practice involves judgments about controversial medical practices and goals, and focuses on the patient’s good.7 It should never be a justification for prejudice or discrimination.

3. The contrast between a patient’s request and a patient’s health illustrates how loving our neighbor may sometimes require us to go against his or her wishes for his or her good.8 (Please see CMDA’s Statement on Autonomy.)

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F. TYPES OF CONSCIENTIOUS REFUSAL

1. Healthcare professionals who conscientiously refuse to participate in practices they believe are unethical must decide how to avoid complicity in those practices.

2.

Conscientious healthcare professionals may find some medical practices more objectionable than others. Therefore, the form that conscientious refusal may take will vary.

Depending on the degree of moral objection, conscientious refusal may involve one or more of the following kinds of actions: a. recusal from participation (by stepping away from the process or plan of care, without abandoning the patient); b. disclosure of information (by giving prior notice to patients or employers, by describing alternatives to patients, or by explaining reasons for refusal); c. facilitation of treatment (by referring the patient to another clinician or by transferring care); d. avoidance of work that includes objectionable activities (this may mean avoiding problematic clinical specialties, clinical assignments, or practice environments).

3. Referral practices deserve special consideration. Clinicians may encounter professional policies or social expectations that state or imply that they should always be willing to make a referral for a service that is (1) legal, (2) desired by the patient, (3) within or outside their specialization, and (4) supported by professional bodies.

4. Conscientious clinicians will often judge referrals to be appropriate. But for some controversial practices, they may consider the referrals to be unethical because they represent unacceptable complicity with evil.9 a. Healthcare professionals who refuse to make referrals for controversial practices believe that those practices are contrary to their patients’ best interests. Such referrals would make them responsible contributors to a process aiming at an unethical goal and would thus make them complicit with evil. b. Such clinicians believe referral constitutes a morally serious relationship between intentions, actions, and outcomes that would make them responsible participants in an ethically problematic chain of events. c. When healthcare professionals believe they are morally responsible for their own intentions and actions, they must maintain their moral integrity. They should never be treated as mere channels for the preferences of others. d. Whereas a purely utilitarian calculation may presume to aggregate everyone’s preferences into some notion of the ‘greater good,’ individual integrity is not simply one interest among many. It is a fundamental value that warrants the highest level of moral consideration and respect.

5. Healthcare professionals who refuse to participate in a controversial practice are not abandoning their patients or failing to fulfill their duty to care. a. On the contrary, the controversial practice itself would compromise their duty to care because it would not promote the patient’s health and best interests. b. Conscientious clinicians should always be committed to caring for their patients, as long as they do so through morally legitimate means.

6.

Clinicians who invoke conscience rights should always

respect a patient’s freedom to seek treatment elsewhere.

However, respect for that freedom does not imply an obligation to assist the patient in seeking an ethically objectionable treatment.

G. THE RIGHT OF CONSCIENCE

1. The predominant moral language of the Bible is articulated not in terms of rights but of obligations (Deuteronomy 5:133; Matthew 5-7; Mark 12:28-31; Romans 13:8-10) and virtues (Matt 5-7; Romans 13:8-10; I Corinthians 13:1-13; Galatians 5:22-23; Colossians 3:12-14). a. The use of the word ‘rights’ is infrequent in English translations of the Bible. b. Old Testament references to ‘rights’ serve as reminders of the justice we owe to those who bear the image of God, and particularly to those with less power (Proverbs 31:9; Isaiah 10:2). c. In the New Testament, the few references to ‘rights’ caution against using them for moral justification (I Corinthians 8:9; I Corinthians 9:15).

2. Nevertheless, rights language is prevalent in Western culture, arguably because of Christianity’s historical emphasis on the God-given equality and dignity of every human being.3 a. The concept of rights highlights those things that have great moral value in society. Claiming that something is a right accomplishes three things:10 i It assigns priority to a particular attribute believed to be essential to human flourishing; ii. It serves as a protective capsule surrounding that attribute; and iii. It appeals for deliberate action from others to ensure such protection.

3. The language of rights may seem self-focused because clinicians’ rights may seem to compete with patients’ rights.

But rights and duties should be understood as corollaries, two sides of the same moral coin. Thus, rights language in public and professional contexts may be a potent way of referring to the binding obligations that human beings owe each other. One of these obligations is respect for another’s conscience. a. For Christian healthcare professionals, the right of conscience reflects an awareness of their moral obligation to God to “hold on to faith and a good conscience” (I Timothy 1:19). Patients, colleagues, and society must respect this important obligation. In healthcare, the right of conscience applies to patients and professionals alike.

4. Patient rights of conscience a. Patients with decision-making capacity have the right to refuse treatment, even when such refusal would bring them harm. b. When a patient’s refusal of treatment threatens the lives of others, the patient’s right to refuse treatment should be subordinate to the protection of others and be considered a matter of public interest and responsibility. (i.e., tuberculosis or infectious disease treatments) 5. Healthcare professional rights of conscience a. All healthcare professionals and trainees have the right to refuse to participate in practices they believe to be

unethical. Participating (as noted in Section E) would undermine their integrity by making them contributors towards an unethical goal, causing them to be complicit with evil. b. It is the moral prerogative of each healthcare professional to decide, and to be ready to explain, what constitutes ‘participation.’ c. When a patient requests a service that a conscientious clinician is ethically unable to provide, the patient may seek to transfer care elsewhere. The healthcare professional is obligated to ensure that the patient’s medical records are transferred to the new healthcare professional the patient has chosen. d. When conflicts occur, a professional’s right of conscience should have moral and legal priority over a patient’s request for the professional’s cooperation.

6. Healthcare institution rights of conscience a. Healthcare institutions have the right to refuse to provide or participate in practices that conflict with their foundational beliefs and values. b. Healthcare institutions should be transparent about the services they do and do not provide. c. Healthcare institutions should not be deprived of public or other funding due to exercising their rights of conscience.

7. Healthcare education and rights of conscience a. Educational institutions, educators, and trainees should be permitted to refuse to provide or participate in practices they believe to be unethical. They should be able to do so without the threat of negative repercussions. b. Healthcare professionals at all levels of training should be familiar with their institution’s policies related to the protection of conscientious practice and the expectations of those with conscience-based objections. c. No professional organization, governing body, or government agency should ever mandate participation in medical practices that violate the consciences of healthcare professionals or trainees.

H. CONCLUSIONS

1.

CMDA affirms that Christian healthcare professionals should strive to love God and their neighbors in every aspect of their professional work.

2. CMDA affirms that a Christian healthcare professional’s conscience should be informed by Scripture, reason, and evidence, and should be guided by the Holy Spirit through prayer.

3.

CMDA affirms that Christian healthcare professionals have a fundamental ethical obligation to follow their consciences and to resist pressures that would undermine their integrity, whether in professional work or in any other part of their lives.

4.

CMDA affirms that Christian healthcare professionals should encourage colleagues, institutions, and governments to respect conscience rights and to establish and defend policies that accommodate and protect clinicians who exercise them.

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BIBLE VERSES (ESV) Genesis 1:27 So God created man in his own image, in the image of God he created him; male and female he created them.

Deuteronomy 5:1-33 And Moses summoned all Israel and said to them, “Hear, O Israel, the statutes and the rules that I speak in your hearing today, and you shall learn them and be careful to do them. 2 The LORD our God made a covenant with us in Horeb. 3 Not with our fathers did the LORD make this covenant, but with us, who are all of us here alive today. 4 The LORD spoke with you face to face at the mountain, out of the midst of the fire, 5 while I stood between the LORD and you at that time, to declare to you the word of the LORD. For you were afraid because of the fire, and you did not go up into the mountain. He said: 6 “I am the LORD your God, who brought you out of the land of Egypt, out of the house of slavery. 7 “You shall have no other gods before me. 8 “You shall not make for yourself a carved image, or any likeness of anything that is in heaven above, or that is on the earth beneath, or that is in the water under the earth. 9 You shall not bow down to them or serve them; for I the LORD your God am a jealous God, visiting the iniquity of the fathers on the children to the third and fourth generation of those who hate me, 10 but showing steadfast love to thousands of those who love me and keep my commandments. 11 “You shall not take the name of the LORD your God in vain, for the LORD will not hold him guiltless who takes his name in vain. 12 “Observe the Sabbath day, to keep it holy, as the LORD your God commanded you. 13 Six days you shall labor and do all your work, 14 but the seventh day is a Sabbath to the LORD your God. On it you shall not do any work, you or your son or your daughter or your male servant or your female servant, or your ox or your donkey or any of your livestock, or the sojourner who is within your gates, that your male servant and your female servant may rest as well as you. 15 You shall remember that you were a slave in the land of Egypt, and the LORD your God brought you out from there with a mighty hand and an outstretched arm. Therefore the LORD your God commanded you to keep the Sabbath day. 16 “Honor your father and your mother, as the LORD your God commanded you, that your days may be long, and that it may go well with you in the land that the LORD your God is giving you. 17 “You shall not murder. 18 “And you shall not commit adultery. 19 “And you shall not steal. 20 “And you shall not bear false witness against your neighbor.

21 “And you shall not covet your neighbor’s wife. And you shall not desire your neighbor’s house, his field, or his male servant, or his female servant, his ox, or his donkey, or anything that is your neighbor’s.’ 22 “These words the LORD spoke to all your assembly at the mountain out of the midst of the fire, the cloud, and the thick darkness, with a loud voice; and he added no more. And he wrote them on two tablets of stone and gave them to me. 23 And as soon as you heard the voice out of the midst of the darkness, while the mountain was burning with fire, you came near to me, all the heads of your tribes, and your elders. 24 And you said, ‘Behold, the LORD our God has shown us his glory and greatness, and we have heard his voice out of the midst of the fire. This day we have seen God speak with man, and man still live. 25 Now therefore why should we die? For this great fire will consume us. If we hear the voice of the LORD our God any more, we shall die. 26 For who is there of all flesh, that has heard the voice of the living God speaking out of the midst of fire as we have, and has still lived? 27 Go near and hear all that the LORD our God will say and speak to us all that the LORD our God will speak to you, and we will hear and do it.’ 28 “And the LORD heard your words, when you spoke to me. And

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the LORD said to me, ‘I have heard the words of this people, which they have spoken to you. They are right in all that they have spoken. 29 Oh that they had such a mind as this always, to fear me and to keep all my commandments, that it might go well with them and with their descendants forever! 30 Go and say to them, “Return to your tents.” 31 But you, stand here by me, and I will tell you the whole commandment and the statutes and the rules that you shall teach them, that they may do them in the land that I am giving them to possess.’ 32 You shall be careful therefore to do as the LORD your God has commanded you. You shall not turn aside to the right hand or to the left. 33 You shall walk in all the way that the LORD your God has commanded you, that you may live, and that it may go well with you, and that you may live long in the land that you shall possess.

Deuteronomy 6:5 You shall love the LORD your God with all your heart and with all your soul and with all your might.

I Kings 9:4 And as for you, if you will walk before me, as David your father walked, with integrity of heart and uprightness, doing according to all that I have commanded you, and keeping my statutes and my rules.

2 Chronicles 20:12 O our God, will you not execute judgment on them? For we are powerless against this great horde that is coming against us. We do not know what to do, but our eyes are on you.”

Job 27:6 I hold fast my righteousness and will not let it go; my heart does not reproach me for any of my days.

Job 42:1-6 Then Job answered the LORD and said: 2 “I know that you can do all things, and that no purpose of yours can be thwarted. 3 Who is this that hides counsel without knowledge?’ Therefore I have uttered what I did not understand, things too wonderful for me, which I did not know. 4 ‘Hear, and I will speak; I will question you, and you make it known to me.’ 5 I had heard of you by the hearing of the ear, but now my eye sees you; 6 therefore I despise myself, and repent in dust and ashes.”

Psalm 23 The LORD is my shepherd; I shall not want. 2 He makes me lie down in green pastures. He leads me beside still waters.3 He restores my soul. He leads me in paths of righteousness for his name’s sake. 4 Even though I walk through the valley of the shadow of death, I will fear no evil, for .you are with me; your rod and your staff, they comfort me. 5 You prepare a table before me in the presence of my enemies; you anoint my head with oil; my cup overflows.6 Surely goodness and mercy shall follow me all the days of my life, and I shall dwell in the house of the LORD forever.

Psalm 51:6 Behold, you delight in truth in the inward being, and you teach me wisdom in the secret heart.

Psalm 51:10 Create in me a clean heart, O God, and renew a right spirit within me.

Psalm 68:19 Blessed be the Lord, who daily bears us up; God is our salvation.

Psalm 84:11 For the LORD God is a sun and shield; the LORD bestows favor and honor. No good thing does he withhold from those who walk uprightly.

Psalm 86:11 Teach me your way, O LORD, that I may walk in your truth; unite my heart to fear your name.

Psalm 103:13-18 As a father shows compassion to his children, so the LORD shows compassion to those who fear him.14 For he knows our frame; he remembers that we are dust.15 As for man, his days are like grass; he flourishes like a flower of the field; 16 for the wind passes over it, and it is gone, and its place knows it no more.17 But the steadfast love of the LORD is from everlasting to everlasting on those who fear him, and his righteousness to children’s children, 18 to those who keep his covenant and remember to do his commandments.

Psalm 119:111 Your testimonies are my heritage forever, for they are the joy of my heart.

Psalm 119:144 Your testimonies are righteous forever; give me understanding that I may live.

Psalm 121 I lift up my eyes to the hills. From where does my help come?2 My help comes from the LORD, who made heaven and earth.3 He will not let your foot be moved; he who keeps you will not slumber. 4 Behold, he who keeps Israel will neither slumber nor sleep.5 The LORD is your keeper; the LORD is your shade on your right hand. 6 The sun shall not strike you by day, nor the moon by night.7 The LORD will keep you from all evil; he will keep your life. 8 The LORD will keep your going out and your coming in from this time forth and forevermore.

Psalm 146 Praise the LORD! Praise the LORD, O my soul! 2 I will praise the LORD as long as I live; I will sing praises to my God while I have my being.3 Put not your trust in princes, in a son of man, in whom there is no salvation. 4 When his breath departs, he returns to the earth; on that very day his plans perish.5 Blessed is he whose help is the God of Jacob, whose hope is in the LORD his God, 6 who made heaven and earth, the sea, and all that is in them, who keeps faith forever; 7 who executes justice for the oppressed, who gives food to the hungry. The LORD sets the prisoners free; 8 the LORD opens the eyes of the blind. The LORD lifts up those who are bowed down; the LORD loves the righteous. 9 The LORD watches over the sojourners; he upholds the widow and the fatherless, but the way of the wicked he brings to ruin.10 The LORD will reign forever, your God, O Zion, to all generations.

Praise the LORD! Proverbs 3:5-6 Trust in the LORD with all your heart, and do not lean on your own understanding. 6 In all your ways acknowledge him, and he will make straight your paths.

Proverbs 16:2 All the ways of a man are pure in his own eyes, but the LORD weighs the spirit.

Proverbs 31:9 Open your mouth, judge righteously, defend the rights of the poor and needy.

Isaiah 10:2 to turn aside the needy from justice and to rob the poor of my people of their right, that widows may be their spoil, and that they may make the fatherless their prey!

Isaiah 55:8-9 For my thoughts are not your thoughts, neither are your ways my ways, declares the LORD. 9 For as the heavens are higher than the earth, so are my ways higher than your ways and my thoughts than your thoughts.

Matthew 5 Seeing the crowds, he went up on the mountain, and when he sat down, his disciples came to him. 2 And he opened his mouth and taught them, saying: 3 “Blessed are the poor in spirit, for theirs is the kingdom of heaven. 4 Blessed are those who mourn, for they shall be comforted.

5Blessed are the meek, for they shall inherit the earth. 6 Blessed are those who hunger and thirst for righteousness, for they shall be satisfied. 7 Blessed are the merciful, for they shall receive mercy. 8 Blessed are the pure in heart, for they shall see God. 9 Blessed are the peacemakers, for they shall be called sons of God. 10 Blessed are those who are persecuted for righteousness’ sake, for theirs is the kingdom of heaven. 11 Blessed are you when others revile you and persecute you and utter all kinds of evil against you falsely on my account. 12 Rejoice and be glad, for your reward is great in heaven, for so they persecuted the prophets who were before you. 13 You are the salt of the earth, but if salt has lost its taste, how shall its saltiness be restored? It is no longer good for anything except to be thrown out and trampled under people’s feet. 14 You are the light of the world. A city set on a hill cannot be hidden. 15 Nor do people light a lamp and put it under a basket, but on a stand, and it gives light to all in the house. 16 In the same way, let your light shine

before others, so that they may see your good works and give glory to your Father who is in heaven. 17 Do not think that I have come to abolish the Law or the Prophets; I have not come to abolish them but to fulfill them. 18 For truly, I say to you, until heaven and earth pass away, not an iota, not a dot, will pass from the Law until all is accomplished. 19 Therefore whoever relaxes one of the least of these commandments and teaches others to do the same will be called least in the kingdom of heaven, but whoever does them and teaches them will be called great in the kingdom of heaven. 20 For I tell you, unless your righteousness exceeds that of the scribes and Pharisees, you will never enter the kingdom of heaven. 21 You have heard that it was said to those of old, ‘You shall not murder; and whoever murders will be liable to judgment.’ 22 But I say to you that everyone who is angry with his brother will be liable to judgment; whoever insults his brother will be liable to the council; and whoever says, ‘You fool!’ will be liable to the hell of fire. 23 So if you are offering your gift at the altar and there remember that your brother has something against you, 24 leave your gift there before the altar and go. First be reconciled to your brother, and then come and offer your gift. 25 Come to terms quickly with your accuser while you are going with him to court, lest your accuser hand you over to the judge, and the judge to the guard, and you be put in prison. 26 Truly, I say to you, you will never get out until you have paid the last penny. 27 You have heard that it was said, ‘You shall not commit adultery.

28 But I say to you that everyone who looks at a woman with lustful intent has already committed adultery with her in his heart. 29 If your right eye causes you to sin, tear it out and throw it away. For it is better that you lose one of your members than that your whole body be thrown into hell. 30 And if your right hand causes you to sin, cut it off and throw it away. For it is better that you lose one of your members than that your whole body go into hell. 31 It was also said, ‘Whoever divorces his wife, let him give her a certificate of divorce.’ 32 But I say to you that everyone who divorces his wife, except on the ground of sexual immorality, makes her commit adultery, and whoever marries a divorced woman commits adultery. 33 Again you have heard that it was said to those of old, ‘You shall not swear falsely, but shall perform to the Lord what you have sworn.’ 34 But I say to you, Do not take an oath at all, either by heaven, for it is the throne of God, 35 or by the earth, for it is his footstool, or by Jerusalem, for it is the city of the great King. 36 And do not take an oath by your head, for you cannot make one hair white or black. 37 Let what you say be simply ‘Yes’ or ‘No’; anything more than this comes from evil. 38You have heard that it was said, ‘An eye for an eye and a tooth for a tooth.’ 39 But I say to you, Do not resist the one who is evil. But if anyone slaps you on the right cheek, turn to him the other also. 40 And if anyone would sue you and take your tunic, let him have your cloak as well. 41 And if anyone forces you to go one mile, go with him two miles. 42 Give to the one who begs from you, and do not refuse the one who would borrow from you. 43 You have heard that it was said, ‘You shall love your neighbor and hate your enemy.’ 44 But I say to you, Love your enemies and pray for those who persecute you, 45 so that you may be sons of your Father who is in heaven. For he makes his sun rise on the evil and on the good, and sends rain on the just and on the unjust. 46 For if you love those who love you, what reward do you have? Do not even the tax collectors do the same? 47 And if you greet only your brothers, what more are you doing than others? Do not even the Gentiles do the same? 48 You therefore must be perfect, as your heavenly Father is perfect.

Matthew 6 Beware of practicing your righteousness before other people in order to be seen by them, for then you will

have no reward from your Father who is in heaven. 2 Thus, when you give to the needy, sound no trumpet before you, as the hypocrites do in the synagogues and in the streets, that they may be praised by others. Truly, I say to you, they have received their reward. 3 But when you give to the needy, do not let your left hand know what your right hand is doing, 4 so that your giving may be in secret. And your Father who sees in secret will reward you. 5 And when you pray, you must not be like the hypocrites. For they love to stand and pray in the synagogues and at the street corners, that they may be seen by others. Truly, I say to you, they have received their reward.

6 But when you pray, go into your room and shut the door and pray to your Father who is in secret. And your Father who sees in secret will reward you. 7 And when you pray, do not heap up empty phrases as the Gentiles do, for they think that they will be heard for their many words. 8 Do not be like them, for your Father knows what you need before you ask him. 9 Pray then like this: Our Father in heaven, hallowed be your name. 10 Your kingdom come, your will be done, on earth as it is in heaven. 11 Give us this day our daily bread, 12 and forgive us our debts, as we also have forgiven our debtors. 13 And lead us not into temptation, but deliver us from evil. 14 For if you forgive others their trespasses, your heavenly Father will also forgive you, 15 but if you do not forgive others their trespasses, neither will your Father forgive your trespasses.

16 And when you fast, do not look gloomy like the hypocrites, for they disfigure their faces that their fasting may be seen by others. Truly, I say to you, they have received their reward.

17 But when you fast, anoint your head and wash your face, 18 that your fasting may not be seen by others but by your Father who is in secret. And your Father who sees in secret will reward you. 19 Do not lay up for yourselves treasures on earth, where moth and rust[e] destroy and where thieves break in and steal, 20 but lay up for yourselves treasures in heaven, where neither moth nor rust destroys and where thieves do not break in and steal. 21 For where your treasure is, there your heart will be also. 22 The eye is the lamp of the body. So, if your eye is healthy, your whole body will be full of light, 23 but if your eye is bad, your whole body will be full of darkness. If then the light in you is darkness, how great is the darkness! 24 No one can serve two masters, for either he will hate the one and love the other, or he will be devoted to the one and despise the other. You cannot serve God and money.

25 Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing? 26 Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they? 27 And which of you by being anxious can add a single hour to his span of life? 28 And why are you anxious about clothing?

Consider the lilies of the field, how they grow: they neither toil nor spin, 29 yet I tell you, even Solomon in all his glory was not arrayed like one of these. 30 But if God so clothes the grass of the field, which today is alive and tomorrow is thrown into the oven, will he not much more clothe you, O you of little faith? 31 Therefore do not be anxious, saying, ‘What shall we eat?’ or ‘What shall we drink?’ or ‘What shall we wear?’ 32 For the Gentiles seek after all these things, and your heavenly Father knows that you need them all. 33 But seek first the kingdom of God and his righteousness, and all these things will be added to you. 34 Therefore do not be anxious about tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble.

Matthew 7 Judge not, that you be not judged. 2 For with the judgment you pronounce you will be judged, and with the measure you use it will be measured to you. 3 Why do you

see the speck that is in your brother’s eye, but do not notice the log that is in your own eye? 4 Or how can you say to your brother, ‘Let me take the speck out of your eye,’ when there is the log in your own eye? 5 You hypocrite, first take the log out of your own eye, and then you will see clearly to take the speck out of your brother’s eye. 6 Do not give dogs what is holy, and do not throw your pearls before pigs, lest they trample them underfoot and turn to attack you. 7 Ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you. 8 For everyone who asks receives, and the one who seeks finds, and to the one who knocks it will be opened. 9 Or which one of you, if his son asks him for bread, will give him a stone? 10 Or if he asks for a fish, will give him a serpent? 11 If you then, who are evil, know how to give good gifts to your children, how much more will your Father who is in heaven give good things to those who ask him! 12 So whatever you wish that others would do to you, do also to them, for this is the Law and the Prophets. 13 Enter by the narrow gate. For the gate is wide and the way is easy that leads to destruction, and those who enter by it are many. 14 For the gate is narrow and the way is hard that leads to life, and those who find it are few. 15 Beware of false prophets, who come to you in sheep’s clothing but inwardly are ravenous wolves. 16 You will recognize them by their fruits. Are grapes gathered from thornbushes, or figs from thistles? 17 So, every healthy tree bears good fruit, but the diseased tree bears bad fruit. 18 A healthy tree cannot bear bad fruit, nor can a diseased tree bear good fruit. 19 Every tree that does not bear good fruit is cut down and thrown into the fire. 20 Thus you will recognize them by their fruits. 21 Not everyone who says to me, ‘Lord, Lord,’ will enter the kingdom of heaven, but the one who does the will of my Father who is in heaven. 22 On that day many will say to me, ‘Lord, Lord, did we not prophesy in your name, and cast out demons in your name, and do many mighty works in your name?’ 23 And then will I declare to them, ‘I never knew you; depart from me, you workers of lawlessness.’ 24 Everyone then who hears these words of mine and does them will be like a wise man who built his house on the rock. 25 And the rain fell, and the floods came, and the winds blew and beat on that house, but it did not fall, because it had been founded on the rock.

26 And everyone who hears these words of mine and does not do them will be like a foolish man who built his house on the sand. 27 And the rain fell, and the floods came, and the winds blew and beat against that house, and it fell, and great was the fall of it.” 28 And when Jesus finished these sayings, the crowds were astonished at his teaching, 29 for he was teaching them as one who had authority, and not as their scribes.

Matthew 9:12 But when he heard it, he said, “Those who are well have no need of a physician, but those who are sick.

Matthew 11:28-30 Come to me, all who labor and are heavy laden, and I will give you rest. 29 Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. 30 For my yoke is easy, and my burden is light.”

Matthew 22:21 They said, “Caesar’s.” Then he said to them, “Therefore render to Caesar the things that are Caesar’s, and to God the things that are God’s.”

Mark 9:21-26 And Jesus asked his father, “How long has this been happening to him?” And he said, “From childhood. 22 And it has often cast him into fire and into water, to destroy him. But if you can do anything, have compassion on us and help us.” 23 And Jesus said to him, “If you can’! All things are possible for one who believes.” 24 Immediately the father of the child cried out[d] and said, “I believe; help my unbelief!”

25 And when Jesus saw that a crowd came running together,

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he rebuked the unclean spirit, saying to it, “You mute and deaf spirit, I command you, come out of him and never enter him again.” 26 And after crying out and convulsing him terribly, it came out, and the boy was like a corpse, so that most of them said, “He is dead.”

Mark 12:28-34 And one of the scribes came up and heard them disputing with one another, and seeing that he answered them well, asked him, “Which commandment is the most important of all?” 29 Jesus answered, “The most important is, ‘Hear, O Israel: The Lord our God, the Lord is one. 30 And you shall love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength.’ 31 The second is this: ‘You shall love your neighbor as yourself.’ There is no other commandment greater than these.” 32 And the scribe said to him, “You are right, Teacher. You have truly said that he is one, and there is no other besides him. 33 And to love him with all the heart and with all the understanding and with all the strength, and to love one’s neighbor as oneself, is much more than all whole burnt offerings and sacrifices.” 34 And when Jesus saw that he answered wisely, he said to him, “You are not far from the kingdom of God.” And after that no one dared to ask him any more questions.

Luke 11:9-13 And I tell you, ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you.

10 For everyone who asks receives, and the one who seeks finds, and to the one who knocks it will be opened. 11 What father among you, if his son asks for a fish, will instead of a fish give him a serpent; 12 or if he asks for an egg, will give him a scorpion? 13 If you then, who are evil, know how to give good gifts to your children, how much more will the heavenly Father give the Holy Spirit to those who ask him!”

John 3:16-21 For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life. 1For God did not send his Son into the world to condemn the world, but in order that the world might be saved through him. 1Whoever believes in him is not condemned, but whoever does not believe is condemned already, because he has not believed in the name of the only Son of God. 1And this is the judgment: the light has come into the world, and people loved the darkness rather than the light because their works were evil. 2For everyone who does wicked things hates the light and does not come to the light, lest his works should be exposed. 2But whoever does what is true comes to the light, so that it may be clearly seen that his works have been carried out in God.” John 17:15-16 I do not ask that you take them out of the world, but that you keep them from the evil one. 16 They are not of the world, just as I am not of the world.

Acts 5:29 But Peter and the apostles answered, “We must obey God rather than men.

Acts 24:16 So I always take pains to have a clear conscience toward both God and man.

Romans 2:15 They show that the work of the Law is written on their hearts, while their conscience also bears witness, and their conflicting thoughts accuse or even excuse them.

Romans 3:8 And why not do evil that good may come?— as some people slanderously charge us with saying. Their condemnation is just.

Romans 5:3-5 Not only that, but we rejoice in our sufferings, knowing that suffering produces endurance, 4 and endurance produces character, and character produces hope, 5 and hope does not put us to shame, because God’s love has been poured into our hearts through the Holy Spirit who has been given to us.

Romans 9:1 I am speaking the truth in Christ—I am not lying; my conscience bears me witness in the Holy Spirit—

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Romans 12:1-2 I appeal to you therefore, brothers, by the mercies of God, to present your bodies as a living sacrifice, holy and acceptable to God, which is your spiritual worship. 2 Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

Romans 12:9 Let love be genuine. Abhor what is evil; hold fast to what is good.

Romans 12:21 Do not be overcome by evil, but overcome evil with good.

Romans 13:8-10 Owe no one anything, except to love each other, for the one who loves another has fulfilled the Law. 9 For the commandments, “You shall not commit adultery, You shall not murder, You shall not steal, You shall not covet,” and any other commandment, are summed up in this word: “You shall love your neighbor as yourself.” 10 Love does no wrong to a neighbor; therefore love is the fulfilling of the Law. Romans 14:4 Who are you to pass judgment on the servant of another? It is before his own master that he stands or falls.

And he will be upheld, for the Lord is able to make him stand.

I Corinthians 2:16 “For who has understood the mind of the Lord so as to instruct him?” But we have the mind of Christ.

I Corinthians 4:3-4 But with me it is a very small thing that I should be judged by you or by any human court. In fact, I do not even judge myself. 4 For I am not aware of anything against myself, but I am not thereby acquitted. It is the Lord who judges me.

I Corinthians 5:9-10 I wrote to you in my letter not to associate with sexually immoral people— 10 not at all meaning the sexually immoral of this world, or the greedy and swindlers, or idolaters, since then you would need to go out of the world.

I Corinthians 6:19-20 Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, 20 for you were bought with a price. So glorify God in your body.

I Corinthians 8:9 But take care that this right of yours does not somehow become a stumbling block to the weak.

I Corinthians 9:15 But I have made no use of any of these rights, nor am I writing these things to secure any such provision. For I would rather die than have anyone deprive me of my ground for boasting.

1 Corinthians 10:13 No temptation has overtaken you that is not common to man. God is faithful, and he will not let you be tempted beyond your ability, but with the temptation he will also provide the way of escape, that you may be able to endure it.

I Corinthians 10:23-24 “All things are lawful,” but not all things are helpful. “All things are lawful,” but not all things build up. 24 Let no one seek his own good, but the good of his neighbor.

I Corinthians 13:1-13 If I speak in the tongues of men and of angels, but have not love, I am a noisy gong or a clanging cymbal. 2 And if I have prophetic powers, and understand all mysteries and all knowledge, and if I have all faith, so as to remove mountains, but have not love, I am nothing. 3 If I give away all I have, and if I deliver up my body to be burned,[a] but have not love, I gain nothing.4 Love is patient and kind; love does not envy or boast; it is not arrogant 5 or rude. It does not insist on its own way; it is not irritable or resentful; 6 it does not rejoice at wrongdoing, but rejoices with the truth.

7 Love bears all things, believes all things, hopes all things, endures all things. 8 Love never ends. As for prophecies, they will pass away; as for tongues, they will cease; as for knowledge, it will pass away. 9 For we know in part and we prophesy in part, 10 but when the perfect comes, the partial will pass away. 11 When I was a child, I spoke like a child, I

thought like a child, I reasoned like a child. When I became a man, I gave up childish ways. 12 For now we see in a mirror dimly, but then face to face. Now I know in part; then I shall know fully, even as I have been fully known.13 So now faith, hope, and love abide, these three; but the greatest of these is love.

2 Corinthians 1:8-9 For we do not want you to be unaware, brothers, of the affliction we experienced in Asia. For we were so utterly burdened beyond our strength that we despaired of life itself. 9 Indeed, we felt that we had received the sentence of death. But that was to make us rely not on ourselves but on God who raises the dead.

2 Corinthians 1:12 For our boast is this, the testimony of our conscience, that we behaved in the world with simplicity and godly sincerity, not by earthly wisdom but by the grace of God, and supremely so toward you.

2 Corinthians 3:18 And we all, with unveiled face, beholding the glory of the Lord, are being transformed into the same image from one degree of glory to another. For this comes from the Lord who is the Spirit.

2 Corinthians 4:2 But we have renounced disgraceful, underhanded ways. We refuse to practice cunning or to tamper with God’s word, but by the open statement of the truth we would commend ourselves to everyone’s conscience in the sight of God. 2 Corinthians 5:11 Therefore, knowing the fear of the Lord, we persuade others. But what we are is known to God, and I hope it is known also to your conscience.

2 Corinthians 6:17 Therefore go out from their midst, and be separate from them, says the Lord, and touch no unclean thing; then I will welcome you Galatians 5:16-21 But I say, walk by the Spirit, and you will not gratify the desires of the flesh. 17 For the desires of the flesh are against the Spirit, and the desires of the Spirit are against the flesh, for these are opposed to each other, to keep you from doing the things you want to do. 18 But if you are led by the Spirit, you are not under the Law. 19 Now the works of the flesh are evident: sexual immorality, impurity, sensuality, 20 idolatry, sorcery, enmity, strife, jealousy, fits of anger, rivalries, dissensions, divisions, 21envy, drunkenness, orgies, and things like these. I warn you, as I warned you before, that those who do such things will not inherit the kingdom of God. Galatians 5:22-26 But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness, 23 gentleness, self-control; against such things there is no law. 24 And those who belong to Christ Jesus have crucified the flesh with its passions and desires. 25 If we live by the Spirit, let us also keep in step with the Spirit. 26 Let us not become conceited, provoking one another, envying one another.

Galatians 6:4-5 But let each one test his own work, and then his reason to boast will be in himself alone and not in his neighbor. 5 For each will have to bear his own load.

Galatians 6:9-10 And let us not grow weary of doing good, for in due season we will reap, if we do not give up. 10 So then, as we have opportunity, let us do good to everyone, and especially to those who are of the household of faith.

Ephesians 4:1-16 I therefore, a prisoner for the Lord, urge you to walk in a manner worthy of the calling to which you have been called, 2 with all humility and gentleness, with patience, bearing with one another in love, 3 eager to maintain the unity of the Spirit in the bond of peace. 4 There is one body and one Spirit—just as you were called to the one hope that belongs to your call— 5 one Lord, one faith, one baptism, 6 one God and Father of all, who is over all and through all and in all. 7 But grace was given to each one of us according to the measure of Christ’s gift. 8Therefore it says, “When he ascended on high he led a host of captives, and he gave

gifts to men.” 9 (In saying, “He ascended,” what does it mean but that he had also descended into the lower regions, the earth? 10 He who descended is the one who also ascended far above all the heavens, that he might fill all things.) 11 And he gave the apostles, the prophets, the evangelists, the shepherds and teachers, 12 to equip the saints for the work of ministry, for building up the body of Christ, 13 until we all attain to the unity of the faith and of the knowledge of the Son of God, to mature manhood, to the measure of the stature of the fullness of Christ, 14 so that we may no longer be children, tossed to and fro by the waves and carried about by every wind of doctrine, by human cunning, by craftiness in deceitful schemes. 15 Rather, speaking the truth in love, we are to grow up in every way into him who is the head, into Christ, 16 from whom the whole body, joined and held together by every joint with which it is equipped, when each part is working properly, makes the body grow so that it builds itself up in love.

Ephesians 5:1-11 Therefore be imitators of God, as beloved children. 2 And walk in love, as Christ loved us and gave himself up for us, a fragrant offering and sacrifice to God.3 But sexual immorality and all impurity or covetousness must not even be named among you, as is proper among saints. 4 Let there be no filthiness nor foolish talk nor crude joking, which are out of place, but instead let there be thanksgiving. 5 For you may be sure of this, that everyone who is sexually immoral or impure, or who is covetous (that is, an idolater), has no inheritance in the kingdom of Christ and God. 6 Let no one deceive you with empty words, for because of these things the wrath of God comes upon the sons of disobedience. 7 Therefore do not become partners with them; 8 for at one time you were darkness, but now you are light in the Lord. Walk as children of light 9 (for the fruit of light is found in all that is good and right and true), 10 and try to discern what is pleasing to the Lord. 11 Take no part in the unfruitful works of darkness, but instead expose them.

Ephesians 5:29 For no one ever hated his own flesh, but nourishes and cherishes it, just as Christ does the church.

Ephesians 6:5-8 Bondservants, obey your earthly masters with fear and trembling, with a sincere heart, as you would Christ, 6 not by the way of eye-service, as people-pleasers, but as bondservants of Christ, doing the will of God from the heart, 7 rendering service with a good will as to the Lord and not to man, 8 knowing that whatever good anyone does, this he will receive back from the Lord, whether he is a bondservant or is free.

Philippians 1:9-11 And it is my prayer that your love may abound more and more, with knowledge and all discernment, 10 so that you may approve what is excellent, and so be pure and blameless for the day of Christ, 11 filled with the fruit of righteousness that comes through Jesus Christ, to the glory and praise of God. Philippians 4:8 Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.

Colossians 1:9-10 And so, from the day we heard, we have not ceased to pray for you, asking that you may be filled with the knowledge of his will in all spiritual wisdom and understanding, 10 so as to walk in a manner worthy of the Lord, fully pleasing to him: bearing fruit in every good work and increasing in the knowledge of God. Colossians 3:12-14 Put on then, as God’s chosen ones, holy and beloved, compassionate hearts, kindness, humility, meekness, and patience, 13 bearing with one another and, if one has a complaint against another, forgiving each other; as the Lord has forgiven you, so you also must forgive. 14 And

above all these put on love, which binds everything together in perfect harmony.

I Thessalonians 5:22 Abstain from every form of evil.

I Timothy 1:5 The aim of our charge is love that issues from a pure heart and a good conscience and a sincere faith.

I Timothy 1:18-19 This charge I entrust to you, Timothy, my child, in accordance with the prophecies previously made about you, that by them you may wage the good warfare, 19 holding faith and a good conscience. By rejecting this, some have made shipwreck of their faith I Timothy 3:9 They must hold the mystery of the faith with a clear conscience.

I Timothy 4:2 through the insincerity of liars whose consciences are seared I Timothy 5:23 (No longer drink only water, but use a little wine for the sake of your stomach and your frequent ailments.)

I Timothy 6:11-12 But as for you, O man of God, flee these things. Pursue righteousness, godliness, faith, love, steadfastness, gentleness. 12 Fight the good fight of the faith.

Take hold of the eternal life to which you were called and about which you made the good confession in the presence of many witnesses.

2 Timothy 3:16-17 All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, 17 that the man of God may be complete, equipped for every good work.

Hebrews 4:12-13 For the word of God is living and active, sharper than any two-edged sword, piercing to the division of soul and of spirit, of joints and of marrow, and discerning the thoughts and intentions of the heart. 13 And no creature is hidden from his sight, but all are naked and exposed to the eyes of him to whom we must give account.

Hebrews 10:23 Let us hold fast the confession of our hope without wavering, for he who promised is faithful.

Hebrews 12:1-11 Therefore, since we are surrounded by so great a cloud of witnesses, let us also lay aside every weight, and sin which clings so closely, and let us run with endurance the race that is set before us, 2 looking to Jesus, the founder and perfecter of our faith, who for the joy that was set before him endured the cross, despising the shame, and is seated at the right hand of the throne of God. 3 Consider him who endured from sinners such hostility against himself, so that you may not grow weary or fainthearted. 4 In your struggle against sin you have not yet resisted to the point of shedding your blood. 5 And have you forgotten the exhortation that addresses you as sons? “My son, do not regard lightly the discipline of the Lord, nor be weary when reproved by him.

6 For the Lord disciplines the one he loves, and chastises every son whom he receives.” 7 It is for discipline that you have to endure. God is treating you as sons. For what son is there whom his father does not discipline? 8 If you are left without discipline, in which all have participated, then you are illegitimate children and not sons. 9 Besides this, we have had earthly fathers who disciplined us and we respected them. Shall we not much more be subject to the Father of spirits and live? 10 For they disciplined us for a short time as it seemed best to them, but he disciplines us for our good, that we may share his holiness. 11 For the moment all discipline seems painful rather than pleasant, but later it yields the peaceful fruit of righteousness to those who have been trained by it.

James 1:2-5 Count it all joy, my brothers, when you meet trials of various kinds, 3 for you know that the testing of your faith produces steadfastness. 4 And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing. 5 If any of you lacks wisdom, let him ask God, who

gives generously to all without reproach, and it will be given him.

James 2:14-17 What good is it, my brothers, if someone says he has faith but does not have works? Can that faith save him? 15 If a brother or sister is poorly clothed and lacking in daily food, 16 and one of you says to them, “Go in peace, be warmed and filled,” without giving them the things needed for the body, what good[b] is that? 17 So also faith by itself, if it does not have works, is dead.

James 4:17 So whoever knows the right thing to do and fails to do it, for him it is sin.

I Peter 2:12 Keep your conduct among the Gentiles honorable, so that when they speak against you as evildoers, they may see your good deeds and glorify God on the day of visitation.

I John 1:8 If we say we have no sin, we deceive ourselves, and the truth is not in us.

Approved by the House of Representatives Passed with 52 approvals, 0 opposed, 0 abstention October 30, 2021, virtual

REFERENCES

1 Broad, C., 1940. Conscience and Conscientious Action. Philosophy, 15(58), pp.115-130.

2 Langston, D., 2001. Conscience and Other Virtues: From Bonaventure to MacIntyre. University Park, PA: Pennsylvania State University Press, p.129.

3 Siedentop, L., 2014. Inventing the Individual:The Origins of Western Liberalism. London: Penguin Books Ltd, pp.353-361.

4 Pellegrino ED. 1993. Societal duty and moral complicity: the physician’s dilemma of divided loyalty. Int J Law Psychiatry, 16(34), pp.371-391.

5 Pontifical Academy for Life, 2006. Moral Reflections on Vaccines Prepared from Cells Derived from Aborted Human Fetuses. The National Catholic Bioethics Quarterly, 6(3), pp.541-550.

6 Chausa.org. 2013. The Principles Governing Cooperation and Catholic Health Care: An Overview. [online] Available at: www. chausa.org/publications/health-care-ethics-usa/archives/ issues/winter-2013/the-principles-governing-cooperation-andcatholic-health-care-an-overview. [Accessed 11 March 2021].

7 Pellegrino, E., 2001. The Internal Morality of Clinical Medicine: A Paradigm for the Ethics of the Helping and Healing Professions. The Journal of Medicine and Philosophy, 26(6), pp.559-579.

8 O’Donovan, O., 1986. Resurrection and Moral Order: An Outline for Evangelical Ethics. Leicester, England: Inter-Varsity Press, p.234.

9 Kaldjian, L., 2019. Understanding Conscience as Integrity: Why Some Physicians Will Not Refer Patients for Ethically Controversial Practices. Perspectives in Biology and Medicine, 62(3), pp.383-400.

10 Freeden, Michael. 1991. Rights. Minneapolis, MN: University of Minnesota Press, pp. 7-10.

CMDA’s Ethics Statements like this are designed to provide you with biblical, ethical, social and scientific understanding of today’s issues through concise statements articulated in a compassionate and caring manner. They are needed for the religious freedom battles we are currently facing, so we encourage you to share them with your colleagues, pastors, church leaders and others. Visit www.cmda.org/ethics for more information about CMDA’s Ethics Statements and to review all of the statements.

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Bioethics The Dr. John Patrick Bioethics Column

WHAT IS DISTINCTIVE ABOUT

I

n his journey to faith, my good friend, John Robson1, wrote an opinion piece in the Ottawa Citizen entitled “Why Taking History Seriously Can Make You Very Cross.” I would add that this makes sense if you are a secularist, which he was at the time, but certainly not if you are a Christian. He went on to recognize the world was radically changed by the incarnation, even though the Roman authorities had no inkling or suspicion about it. That piece had a major impact on my thinking.

Early Christians were different, and their neighbors noticed. They stood out, because they did things like caring in a way the world had never seen before (not practicing infanticide, in particular). My question is: Why are we not different now?

Early Christians were frequently martyred, and that is still happening today, of course, particularly in Muslim or secularist countries. Being different can be dangerous, but we are called to be different. Our Lord told us doing so would bring persecution, but through those experiences, He would be with us, and we would be aware of it, and it would produce joy.

Stephen was the first example, but it continues to this day. Marginalization is the benign modern version, seen in attempts in the U.S. made by the liberal elite to replace the right to freedom of religion with freedom of worship—a transparent attempt to exclude Christianity from the public square, education and politics. Similarly, in other areas, of which bioethics is a specific example, marginalization of traditional Christian positions occurs. Originally called medical ethics, it has been taken over by otherwise unemployable philosophers of a skeptical, atheistic bent. A few Christians are allowed and even tolerated, as long as they skate around liberal idols, such as abortion; however, they have no influence on public policy. Meanwhile, the anointed elite use secular ethicists to legitimize bad behavior, as we have seen in Canada. Clearly unethical behavior by politicians has no serious consequences for them, but truckers demanding freedom from vaccine mandates can be scurrilously stigmatized and punished for peaceful protests. There were no smashed windows, no looting, no rioting in these protests, in total contrast to the liberal-approved protests we saw earlier in the pandemic.

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John Patrick, MD

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Ethics courses, sensitivity training, etc. are all recent additions to public life, designed to deny serious attention to history and focus only on our personal feelings. We obsess over pronouns but neglect the bigger issues of freedom and liberty. Maybe the debacle and injustice of Vladimir Putin and Russian forces invading Ukraine will force us to repent and rethink. Given the current state of the world, it is not unreasonable to suggest we should think more seriously about history, particularly the reason America succeeded.

In the 1770s, America did not lead the world in any way—now it does—but everyone knows that all is not well. Thoughtful academics like legal scholar Arthur Leff, philosopher Allan Bloom and Nobel Prize-winning economist Robert Fogel have all pointed to the falling standards of learning and, more importantly, ethics.

Read Fogel’s book, The Fourth Great Awakening, to find out how a deep study of America’s history made the Nobel Laureate reassess the role serious faith has played.

We certainly have grounds to insist on the right to teach explicitly on the differences between Christian and secular ethics. Serious scholarship will lead to a re-ordering of our ethical priorities. Not

all behaviors are equally important. Particularly in healthcare, we have a noble history of not running away from dangerous disease.

First-century Greek physician Galen could not have understood such courage and moral nobility, as he was a pagan rationalist. As I write, the courage of Ukrainians facing the might of Russia is reminding us of our response to Germany and Japan in World War II, which contrasts dramatically with our liberal elite’s fearful response to COVID-19 while, nevertheless, using it as an excuse to increase the intrusive power of the state. How many of us have used the opportunity to remind our friends and colleagues, “…it is appointed unto men once to die, but after this the judgment” (Hebrews 9:27, KJV)? Moral courage is a rational outcome of being true followers of Christ. The secularist has only a vapid consequentialism, which leads to the what’s-in-it-for-me culture. Is it surprising we have weak politicians and suicidal or murderous teenagers?

The elevation of tolerance to the level of a virtue is a good example. We do not tolerate honesty, trustworthiness, courage or love. We honor these virtues. We tolerate bad things, moral slips, a little cheating, white lies, etc. The moral foundations of Western culture can be traced back to the Ten Commandments and the commentaries on them, beginning with the book of Deuteronomy, which is rarely a topic of serious expositional preaching, although frequently quoted by Jesus. The Ten Commandments can easily be rewritten as the ten divine intolerances! A stable society results when those intolerances are written on the heart. We used to know we are required to act justly, love mercy and walk humbly with our God (Micah 6:8). He did not define justice but simply asks us to be just as He is just.

Today, medical ethics are usually taught from the perspective of the Georgetown Mantra of Bioethics—autonomy, justice, beneficence and non-malfeasance—without serious discussion of why these, and not truth, are chosen and whether or not the order matters. C.S. Lewis foresaw the problems when he wrote The Abolition of Man in 1947. If every Christian healthcare professional could and would quote the book, healthcare would change.

Here is a typical example which has been written on my heart, “For the wise man of old, the cardinal problem of human life was to conform the soul to objective reality (God) and the solution is wisdom, self-discipline and virtue. For the modern (man), the cardinal problem is how to conform reality to the wishes of men and the solution is a technique.” Nowadays, it would be the whole of technological science. Sadly, in his book, philosopher Alastair MacIntyre wrote, we are living After Virtue. We no longer know God’s Word as the source of the reasons for bearing our sorrows and performing our duties, as Allan Bloom said in The Closing of the American Mind (1987).

I would order the Georgetown Mantra biblically, which means turning the modern construction upside down, reminiscent of Acts 17. When the commandments are known and respected, at least grudgingly, by all within a community, then doors are not locked, women and children do not walk in fear, divorce is rare and the old are honored. Laws forbidding objective evil, such as murder, theft, etc., can be made, and from that negative base, the positive actions like love, mercy and respect can be understood. Although

not capable of being framed into law, these actions can produce beneficence and provide a framework for justice. (Without a belief in divine judgment, though, there is no rational reason for judges to be impartial.) Autonomy that is not anarchic can be achieved only with these foundations. Nineteenth-century historian and politician Lord Acton wrote, “Liberty is not the power of doing what we like, but the right of being able to do what we ought.” Learning how to live as though we are not bound by sin but have the means to overcome it is Christianity’s gift to civilization.

The ethics of the epistles are simple—love and honor your spouse, care for your children and pay your workers. Each of Paul’s epistles approach a particular ethical problem by first teaching theology followed by injunctions, as above, but always rooted in a renewed mind. Ask your pastor every week which part of your thought processes he is trying to change. We are not quick to apply the idea of all being one in Christ Jesus. We still have a long way to go, but there has been progress over centuries.

Christian ethics are built upon the acknowledgement of being created by God, but we sinned, and God came in the form of Jesus Christ who set us free from the power of sin, so we can be prepared for eternal fellowship with Him. This biblical narrative is the basis for Christian ethics and is not compatible with secular ethics, and we should not pretend it is. Our intellectual elite are allergic to the question: In the beginning what or whom? But premises ultimately control outcomes, so if we get this wrong, the results are predictable. Secular ethics tacitly dismiss God, worship Darwin and, as Lewis vigorously expressed in The Abolition of Man, “We castrate and bid the geldings be fruitful.”

Author’s Note

John Robson is a historian, journalist and political commentator who writes for the National Post, a Canadian conservative daily newspaper, and is unashamedly Christian. He also has a website, climatediscussionnexus.com, and a YouTube channel with the same name. My colleagues and I run a discussion on ethics culture and faith during one week over the summer in Ottawa, Ontario. For details, visit Augustinecollege.org. We also specialize in teaching students how to survive attendance at a university while keeping their faith intact.

John Patrick, MD, studied medicine at Kings College, London and St. George’s Hospital, London in the United Kingdom. He has held appointments in Britain, the West Indies and Canada. At the University of Ottawa, Dr. Patrick was Associate Professor in Clinical Nutrition in the Department of Biochemistry and Pediatrics for 20 years. Today he is President and Professor at Augustine College and speaks to Christian and secular groups around the world, communicating effectively on medical ethics, culture, public policy and the integration of faith and science. Connect with Dr. Patrick at johnpatrick. ca. You can also learn more about his work with Augustine College at augustinecollege.org.

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