Today's Christian Doctor - Fall 2020

Volume 51 No. 3 • Fall 2020

Today’s

Christian Doctor The Journal of the Christian Medical & Dental Associations

Racism in healthcare.

No one is immune.

AftertheCrisiS A Lasting Courage: Stories from the Frontlines

CMDA National Convention April 29 - May 2, 2021 Ridgecrest Conference Center Ridgecrest, North Carolina

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CEO EDITORIAL MIKE CHUPP, MD, FACS

INVISIBLE THREATS AND ENDURING HOPE

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he year 2020 has been full of unexpected and painful realities for our CMDA ministry as well as our members and their families. We are certainly grateful technology has allowed us to continue advancing the ministry of “Changing Hearts in Healthcare” by leveraging new opportunities for educating, encouraging and equipping our members to glorify God. An exciting achievement for us during the pandemic was the launch of the CMDA Learning Center, an online learning management system for our members to earn continuing education credits. Through the CMDA Learning Center, we are able to provide excellent, fully accredited and free educational courses for our members, which is training followers of Christ in healthcare are unlikely to find anywhere else. For more information about the CMDA Learning Center, visit www.cmda.org/learning.

Our hope had been that the summer would bring relief from the COVID-19 disruption. Instead, the heat of summer brought a surge in U.S. Coronavirus cases AND another invisible but chronic plague of our American history and culture: racism. Our cover article in this fall edition of Today’s Christian Doctor tackles the issue of racism in healthcare head on. It is co-written by Dr. Omari Hodge, a family physician from Atlanta, Georgia who serves on CMDA’s Board of Trustees, and our new Director of State Public Policy Nicole Hayes, who has been leading CMDA’s area ministry in Washington, D.C. for the last two years. Nicole helped host the CMDA webinar in early June entitled “Created in His Image: Reversing Racism’s Effect on Health and Healthcare.” I respectfully ask you to read this article while praying David’s prayer in Psalm 139:23-24: “Search me, O God, and know my heart; test me and know my anxious thoughts. Point out anything in me that offends you, and lead me along the path of everlasting life” (NLT). For more information about CMDA’s efforts to combat racism, visit www.cmda.org/racism.

that will likely require CMDA to pursue your freedom and right of conscience in the courts in an even more determined manner.

For this reason, I am thrilled to have Dr. Jeff Barrows on our national CMDA leadership team as our Senior Vice President for Bioethics and Public Policy. We have bolstered our public policy efforts by adding Dr. Barrows, Nicole Hayes and one additional administrative staff to the team this year. In this season of national debate on the kind of government and nation we desire for the future, an admonition from Paul in Titus 3:1-2 has been on my mind: “Remind the believers to submit to the government and its officers. They should be obedient, always ready to do what is good. They must not slander anyone and must avoid quarreling. Instead, they should be gentle and show true humility to everyone” (NLT).

This fall edition also highlights a long awaited and much needed CMDA position statement on the pornography “pandemic” with continuing education credit available.

I find Paul’s words to Titus in the context of Roman rule and a hateful emperor named Nero both remarkable and challenging.

I just finished reading Tried by Fire, a superb history of the first millennium of the church written by acclaimed educator and New York Times bestselling author William J. Bennett. If you enjoy the discovery of important people, places and events that impacted church history like I do, this is a must read. Governments and their officers have often despised the followers of Jesus, and yet Bennett’s tome documents repeatedly that the church of Jesus Christ survives and often thrives under fierce opposition. In Tried

by Fire, Bennett writes that the early Christians, without favor from ruling authorities, “depended on the promise of heaven to get them through what was probably for the most part a miserable existence of hunger, poverty, illness, and early death.”

As we look ahead to the rest of 2020, we face another U.S. presidential election season marked by a partisan political power struggle, the results of which will have a significant impact on Christ followers in healthcare. Our ability to practice conscientiously and with reasoned scientific debate on the controversial healthcare issues of our day, marked by comity and amity, will be impacted. The U.S. Supreme Court handed down decisions in June on the issues of abortion regulation and sex discrimination

We serve a faithful God! No matter the outcome of national elections in November, the U.S. Supreme Court rulings or federal lawsuits, those of us in healthcare who follow Christ have an enduring and empowering hope. As we speak up for those who cannot speak for themselves, including the poor, the marginalized and the helpless, the hope and healing of Christ, with the promise of heaven, will sustain us through any trials and troubles ahead. www.cmda.org 3

TO DAY ’ S C H R I S T I A N D O C TO R

contents

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VO LU M E 5 1 , N O. 3

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The Christian Medical & Dental Associations ®— Changing Hearts in Healthcare . . . since 1931.

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10 Cover Story

Racism in Healthcare: No One

is Immune

by Omari Hodge, MD; and Nicole D. Hayes, MPA

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Facing

the virus of racism within healthcare and our world

At the Heart of the Crisis: Personal Reflections on COVID-19

by Matthew Y. Suh, MD, MPH

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How

the pandemic affected CMDA members in New York City

Redefining Essential in the Midst of a Pandemic

by Travis King, DDS; and Elise Shockley, DDS

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Using

dentistry as an essential way to share God’s love

Learning from History: The Case Against Assisted Suicide

by R. Kelley Myers, MD

A palliative medicine specialist explores the past and the perils of assisted suicide 4 TODAY'S CHRISTIAN DOCTOR Fall 2020

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CMDA Ethics Statement on Pornography and Interactive Sexual Devices

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Earn

Continuing Education credits and learn more about this topic

Classifieds

EDITOR Mandi (Mooney) Morrin EDITORIAL COMMITTEE Gregg Albers, MD; John Crouch, MD; Autumn Dawn Galbreath, MD; Curtis E. Harris, MD, JD; Van Haywood, DMD; Rebecca Klint-Townsend, MD; Robert D. Orr, MD; Debby Read, RN AD SALES Margie Shealy 423-844-1000 DESIGN Ahaa! Design + Production PRINTING Pulp CMDA is a member of the Evangelical Council for Financial Accountability (ECFA).

Today’s Christian Doctor®, registered with the U.S. Patent and Trademark Office. ISSN 0009-546X, Fall 2020, Volume LI, No. 3. Printed in the United States of America. Published four times each year by the Christian Medical & Dental Associations® at 2604 Highway 421, Bristol, TN 37620. Copyright© 2020, Christian Medical & Dental Associations®. All Rights Reserved. Distributed free to CMDA members. Non-doctors (US) are welcome to subscribe at a rate of $35 per year ($40 per year, international). Standard presort postage paid at Bristol, Tennessee.

Undesignated Scripture references are taken from the Holy Bible, New International Version®, Copyright© 1973, 1978, 1984, Biblica. Used by permission

of Zondervan. All rights reserved. Other versions are noted in the text.

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.

TRANSFORMATIONS

CMDA Members Receive Awards Patsy Lawton, BS, PT

Patsy was awarded this year’s Donna Frownfelter Community Achievement Award by the Department of Physical Therapy & Human Movement Sciences at Northwestern University Feinberg School of Medicine. Patsy’s contributions to the community have promoted awareness to the physical therapy profession and provided education and support to underserved communities.

With little support, Patsy began leading the collection of used wheelchairs and other mobility equipment to assist Wheels for the World. With her determination and vision, she collaborated with physical therapy students and faculty from local universities to help bring awareness to people with disabilities and to host wheelchair drives on a yearly basis. Patsy then traveled to many countries to deliver, teach, and fit wheelchairs to recipients.

Along with her late husband Dr. William Lawton, Patsy has also been a key leader in two CMDA ministries: Medical Education International (MEI) and Christian Physical Rehab Professionals (CPRP). Through these ministries, she provides healthcare education and physical therapy consultations in developing nations. Patsy’s contributions to the world are continuous, and her service to others and compassion have impacted so many lives on a global scale.

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

Northeast Region Tom Grosh, DMin 1844 Cloverleaf Road Mount Joy, PA 17552 609-502-2078 northeast@cmda.org

Midwest Region Allan J. Harmer, ThM, DMin 951 East 86th Street, Suite 200A Indianapolis, IN 46240 317-407-0753 cmdamw@cmda.org

Southern Region Grant Hewitt, MDiv P.O. Box 7500 Bristol, TN 37621 402-677-3252 south@cmda.org

Dr. Bruce and Rosemary MacFadyen

The Houston Global Health Collaborative, a collection of individuals from various institutions and organizations throughout the Texas Medical Center and greater Houston area dedicated to realizing the vision of seeing the area as global leader in global health research, service and education, has instituted an annual global health award named the establishment of the eponymous “Bruce and Rosemary MacFadyen Global Health Award.” Dr. Bruce and Rosemary MacFadyen were the inaugural recipients of the award in 2020, and the global health impact of their work spans across the world.

Rosemary earned an bachelor of arts and a master of arts in English literature, and then she subsequently taught in this field and then served as a senior consultant with Birkman International Inc., a testing program that helps people make occupational and career decisions. She has accompanied her husband on countless international endeavors.

Dr. MacFadyen recently retired from the University of Texas McGovern Medical School as Professor of Surgery and had served prior to that as Chairman of the Department of Surgery of the Medical College of Georgia. He is well known in the area of laparoscopic surgery and was the former co-editor of the Journal of Surgical Endoscopy; former editor of Seminars in Laparoscopic Surgery; co-editor of three surgical textbooks; and the author of numerous articles and book chapters. When coming to Houston in 2012, he elected to work part-time so he could devote his time to teaching surgery at mission hospitals.

He is a founding member of the Pan-African Academy of Christian Surgeons (PAACS). Together, Bruce and Rosemary have spent considerable amount of time training surgeons to serve in the neediest areas of the world.

www.cmda.org 5

TRANSFORMATIONS

EVENTS For more information, visit www.cmda.org/events.

Dates and locations are subject to change due to COVID-19.

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.

William B. Anderson, III, MD Cadiz, Kentucky • member since 2000 John D. Dryden, MD Washougal, Washington • member since 1988 Wendy Y. Leu, MD Orange, California • member since 1998 Jack L. Wasinger, PhD, DDS Evergreen, Colorado • member since 2001 John E. Woods, PhD, MD Rochester, Minnesota • member since 1953

The Church and Science in a COVID World

October 1, 2020 1 p.m. Eastern Standard Time A collaboration between Christian Medical & Dental Associations and Dallas Theological Seminary Hendricks Center.

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

6 TODAY'S CHRISTIAN DOCTOR Fall 2020

Women Physicians in Christ Virtual Annual Conference September 17-20, 2020 • Virtual Conference 501 Foundations for Christian Coaching September 28 – November 16, 2020 • Virtual Seminar Global Missions Health Conference November 12-14, 2020 • Virtual Conference Remedy 2021 January 9-10, 2021 • Virtual Conference 2021 Northeast Winter Conference January 15-17, 2021 • North East, Maryland 2021 West Coast Winter Conference January 21-24, 2021 • Cannon Beach, Oregon 2021 CMDA National Convention April 29 – May 2, 2021 • Ridgecrest, North Carolina

MEMORIAM & GIFTS

Gifts received April 2020 through Jiune 2020 Memory Darlene Burns in memory of Margaret Archie Naji Abi-Hashem in memory of Drs. Paul and Margaret Brand Tom and Janet Titkemeier in memory of Delores “Dee” Farmer Patrick Lester in memory of Mayo Gilson Jennifer Brown in memory of Dr. and Mrs. Donald (Bonnie) Graves Joy Hawkins in memory of Dr. Theron C. Hawkins Christopher Jenkins in memory of Dr. and Mrs. Edward (Mary Jane) Jenkins James Kedrow in memory of Rachel and Kimberly Kedrow Patti Palmer in memory of Davis Kelly Pam Smythe in memory of Delma Kopp Anonymous in memory of Dr. Wendy Leu David Levine in memory of Suzanne B. Levine Tom & Janet Titkemeier in memory of Rev. Myron Marenburg Debbie McAlear in memory of Al and Kay McAlear Thomas Warren in memory of Sid (and Ann) McCauley Debra Jihann in memory of Richard Schreiber Ina Sivits Luhring in memory of Ms. Jay Ann Sivits Tonia Skakalski in memory of Scott L. Skakalski, Jr. Anonymous in memory of Dr. David B. Strycker Jon Hill in memory of J. Robert and Morrell Swart Vernon Sneed in memory of Sunny Weir Janet Woods in memory of Dr. John E. Woods Mark Weatherly in memory of Joshua Honor Sujata Malhotra in honor of Carol Baker Keith Dowell in honor of Bruce Bonnell, MD, FACS Matthew Montgomery in honor of Ron and Becky Brown Jeff Anderson in honor of Susan Carter Frank Jan in honor of Dr. Roberto Diaz Tony and Angela Ellis in honor of Ms. Connie Douglas Cynthia Williams in honor of Daniel Epperson Barry Aldridge in honor of Josephine & Paul Glaser Daniel Sutphin in honor of Dr. Jim Koerten Carol Olson in honor of Summer Olson Barbara Snapp in honor of Gene Rudd, MD Richard Raborn in honor of Erik Benson Raborn, DO Susanne Thompson in honor of Dr. Sam Thompson Jeff Owsley in honor of Alva Weir Keith Peevy in honor of his grandchildren John Pike in honor of all GHO staff Scott Raber in honor of all the missionary physicians and their families scattered across the globe Carlotta Rozzi in honor of Evan Nix and Mariana Mickelsen’s wedding Karen Swenson in honor of Evan Nix and Mariana Mickelsen’s wedding Carole Atkison in honor of Evan Nix and Mariana Mickelsen’s wedding Cheri Nix in honor of Evan Nix and Mariana Mickelsen’s wedding John and Debbie Adams in honor of Evan Nix and Mariana Mickelsen’s wedding For more information about honorarium and memoriam gifts, please contact stewardship@cmda.org.

MAKE THE SWITCH And Listen to CMDA Matters Online

C

MDA Matters is our popular weekly podcast with the latest news from CMDA and healthcare. Hosted by CEO Mike Chupp, MD, FACS, a new episode is released each Thursday, and interview topics include COVID-19, bioethics, healthcare missions, financial stewardship, marriage, family and much more. Plus, you’ll get recommendations for new books, conferences and other resources designed to help you as a Christian in healthcare.

How to Make the Switch

Due to high mailing costs, we encourage you to make the switch and begin listening to CMDA Matters electronically.

To update your subscription preferences and stop receiving a physical CD, please visit www.cmda.org/cmdamatters.

WAYS TO LISTEN

Each quarter, you currently receive “The Best of CMDA Matters,” a physical CD with a selection of interviews from the weekly podcast. But did you know you can receive CMDA Matters on your mobile device as soon as it’s released?

Make the switch and start listening to the podcast today!

6 REASONS TO MAKE THE SWITCH 1. It’s fast. You will receive the podcasts as soon as they are

available, instead of waiting for the physical CD to arrive in the mail.

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2. It’s simple. By subscribing to the podcast on iTunes or Google

3. It’s safe. No need to worry about getting a computer virus from any of the ways you can receive CMDA Matters.

4. It’s convenient. You will easily find all of the CMDA Matters

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Play, you will get the interviews automatically. You can also download the CMDA app or visit www.cmda.org/cmdamatters to listen to the interviews.

podcasts in one location.

5. It’s flexible. You can choose to listen to CMDA Matters on your smartphone, your computer, your tablet…wherever you are and whenever you want.

6. It’s more. More interviews are available online versus the physical CD.

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“Create in me a clean heart, O God, and renew a right spirit within me.”

—Psalm 51:10, ESV

Racism in healthcare.

No one is immune.

by Omari Hodge, MD; and Nicole D. Hayes, MPA

10 TODAY'S CHRISTIAN DOCTOR Fall 2020

It must start with us.

Many things have been laid bare this year. In late 2019, a novel Coronavirus referred to as SARS-CoV-2 originating in Wuhan, Hubei, China spread to the United States becoming a global pandemic. By the end of July of this year, there were close to 17 million confirmed COVID-19 cases worldwide, with around six million active cases affecting more than 200 countries.

In the United States, there have been more than four million COVID-19 cases (with more than two million recovered) and more than 150,000 deaths. We would soon learn that African Americans—who make up 13 percent of the U.S. population—disproportionately comprise U.S. COVID-19 fatalities, with many having underlying health conditions such as diabetes, hypertension and asthma. Income and wealth inequalities also tend to create greater disparities within communities of color, making access to adequate healthcare and healthy living an elusive and unaffordable necessity.

While grappling with these unacceptable health disparities, our nation faced something even more horrific but not so new.

Ahmaud Arbery. Breonna Taylor. George Floyd. Three African Americans killed unjustifiably between February and May sparked protests around our nation and world against racism and police violence against Blacks. In particular was the murder of George Floyd at the hands of a Minneapolis police officer kneeling on his neck with his hands tucked in his pockets for eight long minutes and 46 seconds as Mr. Floyd laid on the pavement underneath the weight of the officer’s knee saying, “I can’t breathe.” Captured on video for the entire world to see, within that horrific eight minutes and 46 seconds, as Mr. Floyd cried out for his mother who had passed two years before, we watched a man die. As many times as the video has been replayed, that image is forever burned in our minds and our consciences.

“This means that anyone who belongs to Christ has become a new person. The old life is gone; a new life has begun!”

—2 Corinthians 5:17, NLT Although we did not know George Floyd personally, or all he had or had not done leading up to that moment, none of it justified what we witnessed. What we witnessed was absolutely demonic, a disregard for life, a bankrupt moral

center and a lack of civility. What transpired in Minneapolis, throughout the country and around the world as Blacks, whites, Latinos and other ethnicities rose to their feet and took to the streets in sheer outrage through protests and marches. There seemed to be great unity. The incident also brought many of us collectively and individually to our knees in prayer. It caused us great grief and lament knowing a man’s life was taken. But something else more important was being laid bare in this time: our hearts.

Since facilitating the CMDA webinar, “Created in His Image: Reversing Racism’s Effects on Health and Healthcare” in June (which was providentially planned prior to Mr. Floyd’s death), we’ve engaged in thoughtful, authentic and insightful conversations on the subject of racism and bias with many of our white brothers and sisters. Introspection and questions in a search to understand...from humble dispositions seeking to listen, learn and squirm by what may be revealed through perceptions and ignorance. What we learned is that no one is immune. Whether biases, implicit or explicit, whether blindspots because of our limited view lived out through our own lens of experience, we can all catch this “virus” that skews how we view another created in God’s image. Ultimately, the “virus” is sin—and that could not be more clear, could not be more black and white.

OUR WAY FORWARD AND THE ANTIDOTE

Living in a world that is perishing, ungodly, wicked and operates counter to God’s kingdom principles could make you forget who you are. Even amid darkness, as believers, as those who have been made a new creation in Christ (2 Corinthians 5:17), we also take on Christ’s nature. We seek to no longer conform to the pattern of this world but to be www.cmda.org 11

transformed by the renewing of our minds (Romans 12:2).

As Christians, we are called to love. We love because God first loved us (1 John 4:19-21). This is not a suggestion but a command.

“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 12:2, ESV As members of the Christian Medical & Dental Associations, we are intentionally addressing the sin of racism. This is a time of weeping and lament, a time of introspection and repentance, as we ask Jesus to transform hearts and unify the church. We know the gospel is greater than any division. As we weep together, may we also walk together. Let us not be infected by the world but rather affected by and for the Lord.

In reading Ecclesiastes 3:1-3, verses 2 and 3 tells us there is a “time to plant and a time to uproot…A time to heal; A time to tear down and a time to build up” (NASB). As a call to action, we invite you to pray and consider how the Holy Spirit would lead you to tear down and remove those things unsuitable in our society—that which produce and perpetuate decay. We invite you to pray and consider the godliness you are being led to plant and the godlessness you are being led to uproot in the environments and territories you’ve been placed.

We invite you to pray and replace what was torn down with more suitable and fruitful structures.

“We love each other because he loved us first. If someone says, ‘I love God,’ but hates a fellow believer, that person is a liar; for if we don’t love people we can see, how can we love God, whom we cannot see? And he has given us this command: Those who love God must also love their fellow believers.”

—1 John 4:19-21, NLT Satan’s devices for causing division and strife in the world and even within the body of Christ are being exposed. But we must not be idle or passive. And we must be of one accord in order to foil Satan’s plans. As ambassadors of Christ with 12 TODAY'S CHRISTIAN DOCTOR Fall 2020

the role of advancing God’s kingdom in the earth, we are to be change agents, catalysts who clear out things in a territory that don’t need to be there by retaking that territory for God’s kingdom. But it doesn’t end there—once we tear down, clear out and build, we must transfer this knowledge to others so they know how to hold and maintain this reclaimed and restored territory.

Yes, the issues are real, and so is the solution. Not a movement, not an initiative, not a hashtag can bring about the justice and healing that only the gospel can. Our way forward and the antidote is the gospel and transformed hearts.

RECOGNIZING THE DANGER

I (Dr. Hodge) have always enjoyed watching wildlife. Something about the beautiful background of nature contrasted with the constant struggle for life and death has always fascinated me. One of the creatures that keeps me glued to the screen are snakes and, in particular, the Vipers. King Cobra, Black Mamba (no, not Kobe Bryant RIP), Rattlesnakes, Gaboon vipers, etc. They never fail to fascinate. Watching them hunt and stalk their prey using heat sensors (as snakes are nearly blind) is something of an amazing feat. In an instant we watch the prey fall victim to a quick strike that has to be slowed down many frames per second for us to fully appreciate its awesome power. The thing I have always found most peculiar is that after envenomating its meal, vipers simply wait, and wait, and wait. There is no chase,

no real external struggle between the serpent and its prey. At that point, the struggle is all internal.

The humoral and nervous system are short circuited by the foreign venom that disrupts proper homeostatic flow.

In our society, however, the venom of racism is much more potent. It not only has physically deleterious effects (like the deaths of Ahmaud Arbery, Breonna Taylor and George Floyd), but it also gets into the mind and actually convinces us it’s simply not there. Somehow we have come to believe that we determine whether or not we have been infected or affected by racism. This is a dangerous issue surrounding racism today, and it is also the reason we are having such a difficult time in this country moving forward to a legitimate peace. We must realize that no one is immune to the dangers of racism.

As a family physician, some of the most difficult patients to treat are my newly diagnosed diabetics. The difficulty is not found in developing a strategy but in terms of patient compliance. I usually spend most of the visit convincing them that they are indeed seriously sick and encouraging them not to rely on their physical senses as a measure of wellness but to defer to my physical exam and lab indices. This is no small feat, as we are wired naturally to trust ourselves and believe the signals our bodies are sending us, while at the same time, we have a special knack for rationalizing any irregularities that may manifest itself. For example, I am always thirsty not because glucose is leaching water right out of my system but rather I have been doing too much. That pain in my legs is not diabetic neuropathy but simply my de-conditioned state that can be cured with a few workouts.

There is a sort of built-in arrogance that must be subdued and the disease state seen in its proper context. Part of our jobs as healthcare professionals is to do just that. We try to establish a proper frame of reference bringing light to an otherwise murky situation in which diseases can hide and thrive. A proud heart cannot see racism. In fact, it wills itself not to see it and largely accomplishes this feat by aligning itself with people and friends who all look and think

along the same lines. We all know individuals like this in our practice. They are those people who are seemingly unable to avoid the gauntlet of countless other comorbidities just waiting to partner with our friend’s sweet disposition.

On the other hand, if this person can learn to submit to someone who thinks differently than themselves and has a perspective that can be challenging initially, then there is hope of health and wellness in the future. It is the humble and honest patient who gets an accurate assessment of their health as well as a partner in developing a plan for wellness.

Proverbs 11:14 says, “Where no counsel is, the people fall: but in the multitude of counsellors there is safety” (KJV).

DESPISING THE SHAME

A less often talked about issue that keeps the venom of racism potent and paralyzing is the shame it brings to its victims. In our attempts to keep racism in check and to defang it, we have mandated that its sufferers (all of us) wear a scarlet “R.” It was thought this “R” would bring about a sort of reverential fear and warning to stay away from its effects; however, all it did was drive us underground to silently suffer as the poison had its way in our lives and society as a whole. Romans 3:23 says, “For all have sinned and fall short of the glory of God” (ESV). This Scripture is the key to understanding how to properly position one’s self toward racism. There simply is no chief sin. There are sins that have different levels of natural consequences, but from a righteousness standpoint, none of them bring you closer www.cmda.org 13

LEARN MORE

As an organization, CMDA wants to be part of the solution for healing the divisions of racism, specifically for our profession in healthcare.

CMDA condemns racism in any form, and we believe there is no place for racism in the world, in healthcare or in the lives of our leadership, members or staff. We believe Scripture clearly communicates God’s will for mankind to treat people everywhere in all circumstances with love, humility, kindness, compassion and self-control.

Visit www.cmda.org/racism to find more resources addressing this issue, as well as CMDA’s Public Policy Statement on racism.

to or further away from the Giver of Life. Most of the time when I speak to people about racism, I find that I need to spend time deconstructing the platform on which they have put racism. The aim is to bring racism closer to earth where overeating, cursing and laziness live. Once the dehumanizing component of the disease is removed, then dealing with it becomes an actuality. Confessing to having issues with racism should not have a worse connotation than confessing to having issues with sin in general, so long as these are confessions of a repentant and sincere heart.

HEALING THE WOUND

Recognizing the venom of racism, submitting to godly, reconciliatory leadership and removing any preformed ideas about the stigma of racism puts us in a position to move from a negative peace toward a positive peace. The term “negative peace” first coined by Martin Luther King, Jr. as he wrote from a jail in Birmingham, Alabama during the civil rights movement refers to a society uneasy with injustice but covered with a thin blanket of order that is quickly removed once a sentinel event occurs. Like an abscess, conflict is scary, but left neglected, the consequences can be devastating. Ask any married couple and they will tell you that the argument you had is always better than the one you didn’t. If we can commit ourselves to staying in the true moment, and if we refuse to allow the distractions and divisions of this life (sports, politics, social media) to abort us from the goal of a deep and true reconciliation amongst 14 TODAY'S CHRISTIAN DOCTOR Fall 2020

people of differing races and ethnicities, then we can and will see something that is best described in Psalm 133:1-3: “Behold, how good and how pleasant it is For brothers to dwell together in unity!

It is like the precious oil upon the head, Coming down upon the beard, Even Aaron’s beard, Coming down upon the edge of his robes.

It is like the dew of Hermon Coming down upon the mountains of Zion; For there the Lord commanded the blessing—life

forever” (NASB).

THE DASH SOLUTION

As a young Christian barely 20 years of age, I (Dr. Hodge) remember attending the funeral of my best friend’s mother.

I recall listening to the music and fighting back tears when I saw a sight that left an indelible impression on me. I looked over at the guests in the funeral home and saw a perfectly mixed congregation. Whites, Blacks, Hispanics, Asians and other demographics all converging in this one funeral home to pay their respects. Up to that point it had never occurred to me how rarely this occurred; in fact, outside of a work environment I had never seen this happen at all. As I stood looking at her tombstone, my eyes fixated on the dash in between the years of her birth and death. It was as if I was standing alone in time with the Lord and I felt an emotion

that changed to words welling up in my throat until I finally uttered, “This is what I want my funeral to look like, I want it to resemble heaven.”

Revelation 7:9-10 says: “After this I looked and there before me was a great multitude that no one could count, from every nation, tribe, people and language, standing before the throne and in front of the Lamb. They were wearing white robes and were holding palm branches in their hands. And they cried out in a loud voice: ‘Salvation belongs to our God, who sits on the throne, and to the Lamb.’”

This has become my life’s calling, and it is a banner we believers must rally around, especially in today’s tumultuous time. What I have learned from this end of my dash is that believers must embrace intentionality if we are to avoid the poison and pitfalls of racism. We must kill relational comfort and put our hands to the plow of cultural

cultivation, constantly tilling the fields of life and seeking a harvest comprised of men and women of all hues. We must submit ourselves one to another seeking to hear more than we are heard. We must bear our cross of humility and patience toward other cultures, thereby showing the world the power of unity in diversity that is only possible in Christ.

We must lead by example and refuse to accept any system that continues in racial division, and it must start with the church, your church! We must use our platform and sphere of influence, especially in healthcare, to stand up for truth and love even if it makes us unpopular.

If we do this, if we step up to the call at such a time as this, then we believe we will see what the prophet Amos envisioned, a society where “justice roll(s) down like waters, and righteousness like an ever-flowing stream” (Amos 5:24b, ESV). May we continue His work until the nets are full.

OMARI HODGE, MD, is a board certified family medicine physician. Dr. Hodge’s residency was in family medicine at Self Regional Hospital in South Carolina. Dr. Hodge earned his medical degree at Morehouse School of Medicine. He received his bachelor of science in biology from University of West Georgia. As a primary care physician, Dr. Hodge deals with a wide array of health issues and concerns. Wound management and mental health are some of the common issues he manages daily in the clinics. He serves as an attending physician to the numerous medical students and residents who rotate through the clinic for training. Dr. Hodge is a current member of CMDA and enjoys traveling, mission work and spending time with his wife and four children.

NICOLE D. HAYES, MPA, joined CMDA in August 2018 as the Washington, D.C. Area Director serving healthcare professionals, medical and dental students in the Greater Washington, D.C. area. In addition to this role, as of July 2020, she also serves as the Director of State Public Policy where she helps to advance the life-affirming, biblical principles of CMDA’s ethical positions through legislative advocacy at the state and federal legislative levels through relationship building, communication and education. She resides, works and fellowships in Washington, D.C.

www.cmda.org 15

A hospital worker wearing a face mask walks by a sign supporting healthcare workers outside the entrance of Mount Sinai Hospital in Astoria, Queens. Queens is the largest borough in New York City and one of the hardest hit areas by COVID-19. Signs of support and appreciation popped up all over New York.

AT THE HEART OF THE CRISIS

Personal Reflections on COVID-19

by Matthew Y. Suh, MD, MPH

16 TODAY'S CHRISTIAN DOCTOR Fall 2020

I

t is no exaggeration for me to say CMDA has had an influential impact on my adult spiritual life. Since 1999, I have been active with CMDA in one way or another.

In 2017, my work with the New York City chapter was significantly increasing, and I found myself more interested in ministry activities than even my own private practice in surgery. After a couple years of praying and planning, I officially began my full-time ministry as the NYC Area Director on March 1, 2020. There was no way humanly possible we could have foreseen what would occur in NYC that same month.

The first official case of COVID-19 in New York City was confirmed that same day on March 1, 2020.1 It was a healthcare professional who had just returned from visiting her family in Iran. Two days later, an attorney who commuted to Manhattan was identified as the second case.2 In hindsight, it is clear these two cases were only the initial cases identified, as Coronavirus was already spreading in NYC. A genomic study of 84 early Coronavirus isolates from one NYC hospital system revealed numerous different strains originating from Asia and from Europe, as well as domestic strains from within the U.S., suggesting multiple strains converging as early as January (and possibly earlier).3 This should not be a surprise given the ethnic diversity of NYC, as well as the high traffic volume of its airports. It was a perfect storm in the making.

As the number of cases skyrocketed, anecdotal reports from CMDA members in New York were grim. Emergency departments were overrun with sick patients, intensive care units were overwhelmed by patients requiring ventilators and floor patients were rapidly deteriorating and dying before they could be attended to. Healthcare professionals were running out of masks, at times not even able to get simple surgical masks, let alone N95 masks. Many of them were wearing the same mask for days and weeks at a time. Residents and attendings of all fields were put on “COVID deployments� staffing ICUs and floors, regardless of whether they had any training in adult intensive care or pulmonary care medicine.

Stories from the frontlines were shocking. Even as early as March it was evident healthcare workers would pay a high price due to COVID-19. Countless healthcare professionals became sick with COVID-19 as they took care of the sick and the dying. Some even knew exactly when they contracted Coronavirus because they deliberately chose to care for specific patients who were suspected of or diagnosed with COVID-19 without adequate protection. Many recovered, but they were sick for a significant duration of time, often with high fevers and deep fatigue. www.cmda.org 17

Healthcare workers outside a field test set up at Mount Sinai West Hospital in New York City.

In addition to the physical toll, we anticipated the pandemic would have significant psychological and spiritual impact on healthcare professionals. What we could not anticipate was how significant it would be. Starting on April 19, we started a Zoom meeting called OASIS, a spiritual respite meeting FOR healthcare professionals BY healthcare professionals. The meetings are designed specifically for embattled professionals on the frontlines to find a safe place. We intentionally gathered to worship, share and pray together in Zoom breakout rooms, because where the Spirit of God is, there is freedom and healing. We needed Him more than ever in the midst of these storms. I know these OASIS meetings have been a lifesaver for many of our healthcare workers. We need to be able to share and unburden what lies heavily on our hearts, to cry out to Jesus our Savior to come and rescue us and to lift up one another in prayer knowing He will answer. The OASIS meetings, now occurring twice weekly, are still a spiritual respite for many in New York.4

“

OASIS was refreshing to my weary soul in the middle of a pandemic and expand it at national level for every CMDA member on the COVID-19 frontlines.

—Isaac Alamuri, MD, DO

”

On April 27, we were all shocked to hear in the news of the tragic death of Dr. Lorna Breen.5 I initially heard through emails and texts from friends: “Did you know Lorna?” or “Did you hear about this doctor?” The news of Dr. Breen’s suicide hit New York City like a punch to the gut.

Dr. Lorna Breen was head of the Emergency Department at the Allen Hospital of the New York-Presbyterian Hospital system. Her father is a surgeon, and her mother is a nurse. Most significantly, Dr. Breen was a Christian. I did not know Dr. Breen personally, though her face in the news 18 TODAY'S CHRISTIAN DOCTOR Fall 2020

reports was vaguely familiar. I only found out after her death that Dr. Breen was a fellow member at Redeemer Presbyterian Church, albeit at a different congregation in the city.

While she was not a member of the national CMDA, she had been active with our NYC chapter 10 years ago. Even as we were mourning, many were silently asking, “How could this have happened?” “What could we have done to prevent such suicide?”

A recent follow-up article in the New York Times detailed many thoughts from Dr. Breen’s family and friends, including some of the private conversations they had with Dr. Breen during the height of the COVID-19 crisis.6 I am grateful for the willingness of Dr. Breen’s family and friends to share their intimate conversations with their daughter, sister and friend, because what Dr. Breen experienced is not unique. Lorna’s suicide was NOT an exceptional event of extraordinary circumstances. Her suicide was a sentinel event of what lurked hidden, the proverbial tip of the iceberg.

She texted her Bible study friends and others: “People I work with are so confused by all of the mixed messages and constantly changing instructions. Would appreciate any prayers for safety, wisdom and trust.” “I’m totally lost. Trying to read up and get back to speed.” “Just baffled and overwhelmed.” “Hardest time of my life. Am trying to focus.” “I’m drowning right now.

May be AWOL for a while.” During her last weeks, one of her friends remembered Lorna saying, “I couldn’t help anyone. I couldn’t do anything. I just wanted to help people, and I couldn’t do anything.” Lorna’s feelings of hopelessness, shame and guilt, coupled with the pernicious stigma of mental illness within the medical community, were crippling her. Her sister remembered Lorna kept saying, “I think everybody knows I’m struggling.”

In response to Dr. Breen’s suicide, Redeemer Counseling Service sponsored a psycho-education webinar coupled with small group processing time for healthcare professionals in May, acknowledging that we all have experienced trauma. In July, CMDA NYC, CMDA’s Psychiatry Section and Redeemer Counseling Service co-hosted a followup webinar meeting with Dr. Margaret Yoon (a Christian psychiatrist and CMDA member) for Christian healthcare professionals to explore what we might be experiencing

now that the peak of the COVID-19 crisis has passed in NYC, to understand why we feel what we are feeling and to learn how we can seek help. So many of us in NYC have been holding our breath underwater while the COVID-19 crisis crashed over us. It is time for us to come up for air, to breathe in the life Jesus gives us and to be refreshed and be healed.

During the COVID-19 crisis, we all have learned to do EVERYTHING differently, and in doing so we experienced the power of God in our lives. We learned again what it means to be a neighbor as we shared precious N95 masks with our colleagues and friends. One member testified that as she shared N95 masks with her colleagues, one professed Jesus as her Savior. As we prayed for family members, relatives and friends who were sick, we saw God heal as fevers and symptoms broke within 24 hours of prayer. We also prayed fervently in around-the-clock vigils for family members and grieved when we lost them.

We mourned, lamented and prayed again. We learned to be parents again, as our children’s schools were closed, and we had to be teachers, mentors and friends to our children who were struggling to understand why they could not see their friends and teachers. We learned how to be family again—how to cook dinner at home because all the restaurants were closed, how to have family time and how to enjoy each other’s presence again. Most importantly, we learned how to be church again without church buildings and church programs. With the benefit of online platforms, our living rooms became the center stage of the church. We learned to worship again without fancy sound systems and orchestral backup. We learned how to pray and expect our Heavenly Father to answer prayers because, after all, He is a good Father.

deaths (confirmed and probable).8 Everyone would agree these statistics significantly underestimate the true burden of COVID-19, as many who were sick and recovered at home have not been tested. When we look at COVID-19 mortality statistics for NYC, there is a definite peak on April 7 (with 597 confirmed deaths from COVID-19). Do you remember when the Passover was this year? It started on April 8. Yes, our Heavenly Father answered our prayers and had mercy upon our city!

“

OASIS has become my prayer and praise small group that uplifted me and strengthened me during the rise and uncertainty of COVID-19 in New York. I am so blessed by the regular gathering of this beautiful group!

—Linda L. Huang, DDS

”

Yes, the crisis in NYC is far from over. Many churches are still closed. Many small businesses have not survived and will never return. Many who have the means to flee the city have left NYC, and some are not coming back. While the streets are relatively empty compared to pre-COVID-19 days, many more homeless are now out on the streets. Our young people are restless, protesting on the streets for justice, but no one (including the church) is talking about forgiving one another. Just recently, NYC experienced its deadliest weekend over the Fourth of July holiday, and gun violence (which plagues mostly minority neighborhoods in NYC, primarily due to gang violence) has tripled from just one year ago.9 All these events are what is referred to in Hebrews: “Yet once more I will shake not only the earth but also the heavens” (Hebrews 12:26b, ESV).

As cases and deaths from COVID-19 mounted in NYC, we prayed our Father would have mercy upon our city. As NYC’s peak of COVID-19 passed over us (and we experienced our first day without death from COVID-19 on July 12),7 we are wondering if we will have our second wave of infection. When many in NYC were outside protesting after George Floyd’s senseless death (and NOT social distancing), why did we NOT have a second wave then? As the Coronavirus can be aerosolized and airborne (and we did not universally wear N95 masks nor have similar filters in our apartment buildings while we’ve been indoors for the most part of the last four months), why did COVID-19 cases and deaths abate in NYC and remain low today? How can we explain what we have experienced?

As of July 14, 2020, the official case count for New York City was 216,199, with 55,486 hospitalizations and 23,323

NYC commuters wear protective masks and gloves while riding the downtown 1 Train subway.

www.cmda.org 19

Yet there is hope in NYC, and around our world, because hope has a name. And His name—Y’shua H’messiah ( Jesus Christ)—has the power to rescue us, heal us and save us from our sins and brokenness. We have hope because His kingdom is a kingdom that cannot be shaken (Hebrews 12:28).

“

It’s been an oasis during these dark stormy times. It’s been encouraging to hear from colleagues and share our stories, concerns, thoughts and our prayers about what we’ve been experiencing, as well as to be able to have others who understand us just because they are fellow believers in the healthcare profession.

—Tammy R. Gruenberg, MD

”

On July 2, more than 100 churches and Christian organizations in the greater New York City area (including CMDA NYC) recorded and released our own version of “The Blessing,” a powerful song written by Chris Brown, Cody Carnes, Kari Jobe and Steven Furtick. This song is the blessing Moses proclaimed over Aaron and his sons as commanded by our Heavenly Father in Numbers 6. “The New York Blessing,” released on YouTube, garnered over 300,000 views in less than two weeks.10 More important than the YouTube views is the spiritual impact of singing and releasing the blessing of our Heavenly Father upon our own city. This song is what our families, our children, our friends, our neighbors and our city are aching to hear, even when they do not know what they are crying out for.

“But seek the welfare of the city where I have sent you into exile, and pray to the Lord on its behalf, for in its welfare you will find your welfare…I will visit you, and I will fulfill to you my promise and bring you back to this place.

For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.

Then you will call upon me and come and pray to me, and I will hear you. You will seek me and find me, when you seek me with all your heart” ( Jeremiah 29:7,10-13, ESV).

May it be so, Lord Jesus! Maranatha!

BIBLIOGRAPHY 1 Dyal, Natasha Priya. “First case of COVID-19 in NYC, first death reported in Washington state.” Infectious Disease Advisor. March 3, 2020. https://www.infectiousdiseaseadvisor. com/home/topics/respiratory/first-case-of-covid-19-in-nycfirst-death-reported-in-washington-state/ (accessed July 13, 2020).

2 Ailworth, Erin and Berzon, Alexandra. “How coronavirus

20 TODAY'S CHRISTIAN DOCTOR Fall 2020

invaded one New York community: ‘We weren’t expecting it to be Ground Zero’.” The Wall Street Journal. March 30, 2020. https://www.wsj.com/articles/how-coronavirusinvaded-new-rochelle-we-werent-expecting-it-to-beground-zero-11585583228 (accessed July 13, 2020).

3 Gonzalez-Reiche, AS, et al. “Introductions and early spread of SARS-CoV-2 in the New York City area.” Science. May 29, 2020. https://science.sciencemag.org/content/early/2020/05/28/science.abc1917 (accessed July 13, 2020).

4 Online registration for the OASIS meetings is at https://bit. ly/register4oasis 5 Watkins, A., Rothfeld, M., Rashbaum, WK., and Rosenthal, BM. “Top E.R. doctor who treated virus patients dies by suicide.” New York Times. April 27, 2020. https://www.nytimes. com/2020/04/27/nyregion/new-york-city-doctor-suicidecoronavirus.html?smid=tw-share (accessed July 14, 2020).

6 Knoll, C., Watkins, A., and Rothfeld M. “’I couldn’t do anything’: the virus and an E.R. doctor’s suicide.” New York Times. July 11, 2020. https://www.nytimes.com/2020/07/11/ nyregion/lorna-breen-suicide-coronavirus.html (accessed July 14, 2020).

7 Yang, Yueqi. “New York City reaches milestone with no reported virus deaths.” Bloomberg News. July 12, 2020. https://www.bloomberg.com/news/articles/2020-07-12/newyork-city-reaches-milestone-with-no-reported-virus-deaths (accessed July 14, 2020).

8 New York City Department of Health and Mental Hygiene.

“COVID-19: Data.” NYC.gov. July 14, 2020. https://www1. nyc.gov/site/doh/covid/covid-19-data.page (accessed July 14, 2020).

9 Price, Brian. “9 dead, at least 42 shot in roughly 15 hours as NYC violence rages over weekend.” NBC New York.

July 5, 2020. https://www.nbcnewyork.com/news/local/ bullet-strikes-nypd-patrol-vehicle-misses-officers-sitting-inside/2500243/ (accessed July 14, 2020).

10 The New York Blessing can be viewed at https://bit.ly/nyblessing

MATTHEW Y. SUH, MD, MPH, is the current NYC Area Director for CMDA. He is a graduate of Harvard University and SUNY Downstate College of Medicine. He is a board certified surgeon, trained in general surgery and transplant/hepatobiliary pancreas surgery. Until recently, he was in private practice in Northern New Jersey. He is a MDiv candidate at the Alliance Theological Seminary and is blessed to be married to Margaret. He is proud of be father of Christopher and Trina.

When not in NYC, Matthew may be found in Mongolia, leading Medical Education International’s teams to Mongolia.

A

Redefining Essential in the Midst of a Pandemic

by Travis King, DDS; and Elise Shockley, DDS

m I essential? As general dental professionals, we do not imagine many of you have asked yourselves this question. By choosing dentistry as a profession, it is safe to assume a certain level of job security and financial stability. Though both of those factors may have been initial lures into the field, what inspires us daily to practice dentistry is the impact we have in the lives of our patients, each created in the image of God. As dentists, all that we work to achieve is essential to the health and wellbeing of our respective communities. And yet, in the midst of the Coronavirus global pandemic, it feels like oral healthcare was deemed non-essential. States recommended dentists limit their offices to emergency patients only. No handpieces were running. No cavitrons were cleaning. Some dentists were even finding themselves unemployed! Oral healthcare seemed low on the priority list, and any momentum we had made in terms of advocating prevention felt lost.Â

Regardless, the Lord has continued to reveal His faithful character. He has helped us as a health center, and as a profession, to redefine essential. Christ Community Health Services is a faith-based federally-qualified health center (FQHC) located in Memphis, Tennessee. It is home to the first CMDA Dental Residency [+] Program. The [+] Residency is a three-year discipleship

We recognize these protective measures were made to mitigate the spread of a deadly virus and keep the population safe. We are thankful for local and national leadership that made tough calls with the aim to prevent loss of life.

However, with fewer patients, furloughed staff and empty parking lots, it was easy to believe dentistry was non-essential. Our health center, Christ Community Health Services, has not been exempt from many of these hardships. www.cmda.org 21

her story of how things had been going in the last couple of months and the strain it was causing. The assistant and I prayed for her, and although I don’t remember what was specifically said, I do remember she was deeply moved. She shared that her church had transitioned to online services, but they just were not the same as in person. She even went on to say that by us praying with and for her in person, it was better than church.

I couldn’t believe it! Despite the fact that she was in the dental chair waiting to have a tooth taken out, she felt her visit was better than church because of face-to-face compassion.” and training program for dentists who have a heart for the poor, underserved and unreached communities both domestic and internationally. We have had to quickly adapt to meet the needs of both our residents and our clinicians. Despite COVID-19, there were still procedural requirements to meet for the Advanced Education in General Dentistry (AEGD) program. There were also hourly requirements for National Health Service Corp (NHSC), which provides loan repayment to many of our second and third year residents. One of the solutions we implemented to meet these requirements was teledentistry. Using a web-based platform called doxy.me, we were able to virtually connect with patients at home, minimizing exposure for both the patient and the clinician. Although dental treatment is limited via telehealth, this was an encouraging moment for our health center as we adapted to restrictions and prioritized the needs of our patients. Some restrictions have even had unintentional benefits!

For Dr. Stewart and other dental professionals, experiences like this during this season of the Coronavirus serve as a reminder to see patients as more than a mouth. Our profession is about more than teeth. It is important that we remember each patient interaction is a divine appointment. We have the opportunity to partner with what God is doing in our patient’s life. I am reminded of what is most important, and I find myself no longer asking, “Am I essential?” but, “What is essential?” Nothing in dentistry is forever, but God’s kingdom is an eternal one. When we pray with and for our patients, we usher His kingdom into the operatory. We bring healing in Jesus’ name and oftentimes (literally) restoration! This season has also allowed our dental team to be a part of this healing process both inside and outside of the operatory.

With a lighter schedule, our healthcare professionals have had more time with fewer patients. I’m sure this has been the case for many of you as well! Rather than rushing from room to room, the limited patient care allowed time for more chair-side conversation. With people isolating at home, oftentimes the dentist was one of their only faceto-face interactions. One of our second year residents, Dr. Scott Stewart, recently shared about a patient he was able to care for during the pandemic. A woman had presented to the office in excruciating pain. During the visit, while Dr. Stewart was waiting for profound anesthesia after administering a block, he offered to pray for the patient and inquired about her needs.

As numerous team members were restricted from their normal roles, Christ Community Health Services began implementing free drive-thru COVID-19 testing in partnership with local and state leadership. The first testing event was on a Saturday morning, and 49 people were tested. That next week, our available dental team began staffing daily drive-thru testing, seeing anywhere from 50 to 150 people. As of the writing of this article, we are testing more than 200 people daily at two locations across Memphis.

For the dentists and staff members, it was a sudden shift in responsibility. People had legitimate fears and concerns, but those individuals also expressed a desire to care for the community of Memphis and to help Christ Community be a champion for COVID-19 testing across Tennessee. As we learned about the impact the virus was having among African Americans and people of color, it was easy to see that our testing sites were beacons of hope in our community.

He recounts, “This patient in particular was struggling with isolation and loneliness due to COVID-19. She shared

Our response to the Coronavirus has also allowed our dental department to work in collaboration with our

22 TODAY'S CHRISTIAN DOCTOR Fall 2020

medical team, as well as spiritual and behavioral health. In the past, we have often looked for ways to integrate care.

Keeping our patients safe from the virus has reminded us of our common goal to see healthy communities healed in the name of Jesus. It has been a blessing to work with physicians, physician assistants and nurse practitioners at the drive-thru testing sites. As we transitioned from oropharyngeal to nasopharyngeal swabs, the medical clinicians stepped up to partner with us at the drive-thru sites. We were able to take our experience working in a dental operatory, with assistants who move around the dentist, and create an efficient testing system that emphasized infection control and kept both the patient and staff members safe.

We have also had community partnerships strengthened, as students and faculty from the University of Tennessee Health Science Center have volunteered their time to test patients, collect samples and even direct traffic.

Amidst great fear and loss, we have seen God work through this pandemic to bring about His kingdom. We are stronger dental professionals, and Christ Community is a stronger health center. He is faithful and good, and when He has begun a good work He will carry it unto completion (Philippians 1:6). The pandemic has reminded us that as dental professionals, our identity is not in restorations, prostheses or COVID-19 testing, but rather our identity is in Jesus our Savior. Proclaiming the gospel of Jesus Christ, and thereby helping to usher His kingdom here on earth as it is in heaven, is essential. We, as dentists, partner with

God in bringing about Shalom, the wholeness of His kingdom, to our patients and communities.

WILLIAM “TRAVIS” KING, DDS, is a recent graduate of the CMDA Dental Residency [+] Program. He graduated from the University of Texas School of Dentistry in 2017 and completed a year of Advanced Education in General Dentistry at the University of Tennessee Health Science Center. Travis and his wife Katie live in Memphis, Tennessee and are expecting their first child in early 2021. He currently works at Christ Community Health Services, a faith-based federally qualified health center in Memphis.

ELISE SHOCKLEY, DDS, is a dentist and the current CMDA Dental Residency [+] Program Site Director for the Memphis, Tennessee location.

She graduated from UNC-Chapel Hill School of Dentistry. She then went through the CMDA Dental Residency [+] program. She has worked for Christ Community Health Services for the last five years in Memphis. She is married to Phillip Shockley and is about to give birth to their first child, a daughter. She feels very blessed to be working in public health dentistry and to work with resident dentists.

She is excited to see where and how God uses their family for His work in the future.

www.cmda.org 23

Learning from History:

The Case Against Assisted Suicide

by R. Kelley Myers, MD

I

t has been said that the best way to learn about our future is to look to our past. A historical reflection on the actions of those who have gone before us can both guide us toward monumental successes and deter us from repeating colossal mistakes. A glance to history may reveal progressive social and technological advancements, yet it also affirms that the basic principles of a man’s heart remain unchanged. As Proverbs reminds us, “There is a way that seems right to a man, but in the end it leads to death” (Proverbs 14:12).

One such example of this is physician-assisted suicide. I was first exposed to this controversial issue in my freshman 24 TODAY'S CHRISTIAN DOCTOR Fall 2020

year of college. As a senior in college, I took a class on the Holocaust and saw how this idea was used in the horrible events that occurred leading up to and during World War II. I joined CMDA in 1993 while I was in medical school, and during that time I attended a conference where we learned about ethics in medicine and discussed the topic of euthanasia. It’s a topic that has stayed with me throughout my career, and I’ve been a practicing hospitalist and palliative medicine specialist for the last 20 years. Today, I teach medical students and residents, and I continue to be surprised by how many younger students simply accept

physician-assisted suicide as an alternative aggressive treatment of underlying symptoms.

This subject needs more attention and more discussion among healthcare students and healthcare professionals before more states legalize it and allow physician-assisted suicide to be a legal practice.

one of the fastest growing medical specialties. Much of this growth can be attributed to the significant hospital cost savings usually associated with palliative care consultation programs that reduce a large portion of end-of-life medical expenditures.

While palliative medicine has proven to be the best possible outcome in difficult end-of-life situations, alternatives are being proposed. I attended a lecture entitled

GET INVOLVED

CMDA is a leading voice in the battle against the legalization of physicianassisted suicide. For resources and the latest information about the dangers of physician-assisted suicide to healthcare and your right of conscience, visit www.cmda.org/pas. If you want to get involved fighting against physician-assisted suicide in your state, contact communications@cmda.org.

I made a career shift to palliative medicine after witnessing my father benefit from the end-of-life care he received.

After making this shift, I realized that while many of the treatments I had previously administered as a hospitalist may have prolonged life, they were not increasing the quality of life. The evidence supports this conclusion. Approximately 30 percent of Medicare’s expenditures occur in the patient’s last year of life. Of these expenditures, few improve the quality of life, nor do they extend the duration of life.1 Palliative care stands as an effective way to impact quality of life, and many clinicians in the medical field are taking note. In recent years, palliative medicine has become

“New Treatment Modalities in Difficult Pain Patients” at a recent palliative medicine annual conference. The presenter was a renowned physician and program director at a respected medical institution. I was not expecting a controversial lecture and was actually searching for new interventions to manage symptoms such as severe pain, recurrent nausea and intractable seizures. Early in the lecture I was astonished when physician-assisted suicide was presented as a last resort option for treating several of these symptoms. Our lecturer offered that assisted suicide was generally accepted and was legalized in some states. www.cmda.org 25

system as other forms of homicide. But in January 1939, the German legislature passed a euthanasia decree. This decree streamlined the administration of physician-assisted suicide, requiring only the signatures of two licensed physicians. Initially, morphine administered in high doses was the preferred method to terminate life. Eventually, carbon monoxide was found to be more cost effective and have a higher “success” rate.

Mobile euthanasia unit discovered in Chelmno extermination camp. Exhaust fumes were diverted into the sealed rear compartment where victims were locked in. Though this unit has not yet been modified for that purpose, it offers insight to how these brutal deaths occurred.5

One of the pain management principles I learned in my training and continue to pass on to my palliative medicine and oncology fellows is the use of gradual increases in opioids (such as morphine) as a safe and effective way to manage symptoms. If the opioid is initiated at a low dose and gradually increased, a therapeutic dose is achieved, sans respiratory depression. On the other hand, if you begin with exceedingly high doses of morphine, you may not only control the pain, but you also may “shorten the patient’s hospital length of stay by the principle of double effect,” per the lecturer. He said this in jest, eliciting laughter among the attendees. But it was an upsetting assertion that continues to disturb me today. The shortening of lengths of stay via high dose morphine is no laughing matter, and the principle of taking life in such a way is not a new concept.

In 1938, post-World War I Germany, a country that was already deeply in debt, was experiencing soaring healthcare costs, and thus ensued a desperate search for cost containment in healthcare. At the time, the Nazi Party leaders consisted of physicians, attorneys, professors and scientists.

These intellectual elites possessed a deep love for their country and a desire for a stronger Germany. Joseph Goebbels, a close friend of Adolf Hitler and appointed head of the “Reich Ministry of Public Enlightenment and Propaganda,” utilized media outlets to influence the general public and lawmakers. One such propaganda effort was the publication of an emotional letter from a father pleading for lawmakers to legalize assisted suicide. The letter regarded assisted suicide as an act of compassion that would allow his son to be relieved of his painful terminal illness. This and other propaganda efforts influenced the German legislature. At that time in Germany, assisted suicide was illegal and it brought about the same penalty from the judicial 26 TODAY'S CHRISTIAN DOCTOR Fall 2020

Assisted suicide in pre-World War II Germany initially began with the terminally ill. As government officials recognized the cost savings associated with euthanizing these patients, assisted suicide measures extended to the mentally ill, those with Downs Syndrome and those in the cognitively impaired wards of the state. Such practice brings to mind the cancer research I completed during my undergraduate studies. Prior to removing the spleens of rats to assess their response to chemo, we euthanized our lab rats using the very same gas chamber methods outlined in Hitler’s euthanasia decree.

In two short years, six hospitals installed gas chambers and assisted suicide ended the lives of a documented 70,273 patients. Psychiatry units were closed, and the healthcare budget was significantly reduced.2 Difficulties arose in transporting patients to the euthanasia centers. A plan was proposed to extend “treatment” to patients unable to travel great distances. In December 1941, three mobile vans were transformed into carbon monoxide chambers by the Reich Main Security Office. These mobile units rectified the access problem of stationary gas chambers. As the practice grew, the staff physician was required to see increasing numbers of patients per day. To streamline the process, the covering physician was required to triage each patient with a list of more than 60 fatal diseases to keep their program within its guidelines. A “mercy death” was prescribed for all patients with a diagnosis on the triage list.3 With callous disregard for life, the Nazi leaders sent more than 10 million people to a government-sponsored genocide. I believe that such a disregard for life began with the slippery slope of assisted suicide that placed the containment of healthcare costs ahead of the sanctity of human life. Advocates of physician-assisted suicide assert that it would save millions of dollars in the healthcare budget.4 We find similarities of this today. The Donohue-Levitt hypothesis asserts that the legalization of abortion has made a significant contribution to crime reduction. The hypothesis suggests that unwanted children or those children born to parents who lack the financial means to support them are more likely to become criminals. Abortion advocates promote this data as proof that abortion benefits the

mother as well as society as a whole. This hypothesis has eerie similarities to the gas chambers installed in mental hospitals during pre-WWII Germany.

While the way of a man may seem right, God’s Word tells us the way of the cross will lead to life (Matthew 16:24-25).

While a turn toward history will reveal the way of man, it also reveals the way of the cross. Though the majority of Roman citizens enjoyed the blood sport of the Colosseum games, it was not a fair sport for the marginalized citizens of Rome who were fed to the lions for entertainment. In 402 AD, a young monk named Telemachus went to the Roman Colosseum to see the gladiatorial events and share the gospel with those in Rome. While watching the gladiators fight to the death, Telemachus was sickened and shocked at what he saw and took a stand. He repeatedly yelled, “In the name of Jesus, stop!” He was killed by one of the gladiators for sport as the crowd cheered. As he lay lifeless, the realization of what had happened gripped the crowd as they each left the Colosseum in silence. This was the very last gladiator game at the Colosseum. Shortly afterward, the emperor issued an edict forbidding any future games of war within the Roman Empire.

Protecting the beauty and sanctity of life is the mandate for those of us entrusted to deliver healthcare. The Hippocratic Oath clearly says, “I will never give a deadly drug to anyone if asked for it or will I make a suggestion to that effect.” More than 2,000 years after the writing of this oath, we have the best pain management, symptom control and depression treatments at our disposal. Yet, the desire to decrease the cost of healthcare presents options that place the sanctity of life in peril. As healthcare leaders and healthcare professionals, we must adhere to the foundation that all life is sacred and insist that laws and practices are in place to protect the lives of the vulnerable. May we all be like Telemachus—slow to bend to popular opinion and quick to protect the lives of God’s image bearers.

3 Lifton, R. J. (1986). The Nazi Doctors: Medical Killing and the Psychology of Genocide. New York: Basic Books. ISBN 978-0-465-04904-2. Archived from the original on 3 September 2006.

4 Aaron J. Trachtenberg, MD; Braden Manns, MD (January 2017). Cost Analysis of medical assistance in dying in Canada. CMJA. vol 189, (3), p. 101.

5 World War II Today. 2011. Retrieved April 22, 2013. Source: Office of the United States Chief Counsel for Prosecution of Axis Criminality: Nazi Conspiracy and Aggression – Washington, U.S Govt. Print. Office, 1946, Vol III, p. 418

R. KELLEY MYERS, MD, is an academic hospitalist/palliative medicine specialist who is an Associate Professor at the University of Tennessee and Hospitalist at the VA Medical Center in Memphis, Tennessee. As a medical student, Kelley was involved in CMDA and Medical Campus Outreach in Augusta, Georgia. After completing a family medicine residency in Greenwood, South Carolina, he taught at the Valley Baptist Family Medicine Program in Harlingen, Texas for five years.

After moving to Memphis in 2005, he transitioned his practice into hospitalist medicine and palliative medicine consultation. He is involved in student and resident mentoring and teaching, by focusing on the roles of Christian healthcare professionals in a secular society. Kelley and his wife Julie (an occupational therapist) have two sons and are active in their local CMDA chapter and serve on the local board.

BIBLIOGRAPHY 1 Patrick Alguire, MKSAP16, (Philadelphia, American College of Physicians, 2012), 28.

2 Sandner, Peter (July 1999). Die “Euthanasie”Akten im Bundesarchiv. Zur Geschichte eines lange verschollenen Bestandes [The ‘Euthanasia’ Files in the Federal Archives.

On the History of a Long Lost Existence] (PDF) Vierteljahrschefte für Zeitgeschichte – Institut für Zeitgeschichte. Munich. 47 (3): 385–400. ISSN 0042-5702.

www.cmda.org 27

CMDA Ethics Statement on Pornography and Interactive Sexual Devices

Pornography is any medium that depicts erotic behavior and is intended to entice sexual imagination.

Pornography has no beneficial use but damages human relationships. Mass communication technologies such as the Internet have expanded its reach to an unprecedented degree. Video and virtual reality have intensified its content. The introduction of sex robots that imitate human speech and sexual behaviors and are designed to perform sexual acts with humans are an extreme elaboration of pornography. All of these have dangerous psychological, social, and spiritual consequences.

As of 2016, in the United States, 93% of male and 62% of female university students had viewed internet pornography during adolescence, with 49% of males viewing pornography before age 13.1 64% of young people, ages 13-24 actively pursue viewing pornography weekly or more frequently.1 A study in 2012 showed 93% of boys and 52% of girls aged 16 to 19 had watched a pornographic movie in the 6 months prior to survey.2,3 The world’s most popular pornography website averages 92 million daily visits and ranks #8 among all websites in the world, outranking Wikipedia, Amazon, or Netflix.4,5 One in four internet users view pornography in any given month.1 Pornography is the most common online topic for men, more than any other subject.1 Sexually explicit dialog, dress and actions are increasingly common in regular television programming, even during the purportedly family friendly hours, and the so called “soft” porn or “mommy” porn publishing industry is increasing.

Pornography is also a substantial problem for practicing Christians and clergy in the United States. Among practicing Christians, 2% seek out pornography daily, 5% weekly and 6% once or twice a month. 21% of youth pastors and 14% of senior pastors admitted to using pornography regularly. Among the users of pornography, 56% of the youth pastors and 33% of the senior pastors stated they were addicted.6 In evaluating pornography and counseling those affected by it, the following areas should be considered: 1. Biblical A. Scripture is unequivocal about the necessity for 28 TODAY'S CHRISTIAN DOCTOR Fall 2020

human beings to remain sexually pure, and that sexual activity is to be restricted to monogamous marriage between one man and one woman (Ex 20:14; Ex 22:16-17; Deut 22:13-30; 1 Cor 6:9, 13b-20; Gal 5:19; Eph 5:3-5; 1 Thes 4:3-5; Heb 13:4).

B. God has reserved the most intimate expressions of sexuality, including sexual intercourse, specifically for the marriage relationship. The Bible describes the covenantal relationship of love which God has for His people; the husband-wife relationship reflects the relationship between Christ and the Church and as such is holy. (Song of Songs; Prov 5:15-19; Eph 5:25-31).

C. Scripture also makes it clear that defiling the mind and heart with lust is sinful and the moral and spiritual equivalent of adultery, and may lead to committing adultery (Ex 20:17; 2 Sam 11:2-5; Ps 66:18; Ezek 23:5-10; Matt 5:28; Rom 1:24-28; Col 3:5; 1 Pet 2:11).

D. God sees sin that is done in secret (Ezek 8:7-13; Matt 10:26; 1 Tim 5:24).

E. Christians have a duty to warn when society is faced with moral danger (Ezek 33:1-6).

F. God through Jesus Christ offers forgiveness, no matter how shameful the sin (Hos 3:1, 1 John 1:9).

2. The Human Cost Pornography is extremely harmful, and this harm is done at multiple intertwined levels: biological, psychological, medical, social, and spiritual.

A. Pornography is harmful to individual users; it: 1. Trains them to think that sexual gratification is obtained with images or objects that exist for the user’s pleasure, rather than with an ensouled, thinking and feeling person who bears the image of God.7,8 2. Promotes the myth that the purpose of sex is primarily to take rather than give pleasure. 7 3. Is not a morally neutral substitute for fornication or adultery. There is no honor or virtue in having sex with a thing. 9 4. Defiles their bodies and souls with lust for something illusory and unreal and, in the case of sex robots, further defiles their bodies and souls by physical coupling with an interactive artificial humanoid device.10 5. Supports the sexual revolution’s lie that sexuality is all about orgasm and personal gratification. 8 6. Is addictive. Like a potent drug, pornography releases dopamine in the brain, providing a transitory escape from stress, disappointment, boredom, and facing one’s responsibilities, while over the long term placing the user who desires more and more pornography at risk of becoming socially crippled and emotionally stunted. 7,11-14 7. May lead to employment termination in the case of workplace viewing.15 8. Contributes to loneliness. 8 9. May encourage a variety of sexually deviant behaviors.16-18 10. Leads to estrangement from God.12 B. Pornography is harmful to marriages19; it: 1. Leads to decline in sexual satisfaction within marital relationships.12,20 2.

Leads to destruction of loving relationships.20,21 3. Further separates the goods of love and the potential for generation of life from love and mutual giving.20,22 4.

Encourages a “throw-away” culture of disposable relationships, leading to more singleparent, divorced, and fractured families.19,20,23

5. Diverts finances from legitimate family needs to narcissistic sexual gratification.24 6. Denies the legitimacy of sexuality and family as defined by God.19 C. Pornography is harmful to children: 1. It diverts parental affection to images or objects.8,19 2. It subverts the modeling of genuine love.8,19 3. It fuels the sexual perversion of pedophilia (in the case of child pornography), increasing the risk that children may become victims of molestation.18,25,26 This risks distorting the child’s understanding of God the Father.

4. When sex robots are designed to resemble children, it normalizes sexual gratification with the immature and places children at further risk.27 D. Pornography is harmful to those used in the creation of pornography; it: 1. Reduces them to nameless instruments of unseen strangers who, to gratify their own urges, leer at their nakedness, exploit their vulnerability, and abuse their dignity as people bearing God’s image.

2. Forces sex trafficking victims to engage in unsafe sexual practices of every imaginable form.28 3. Fuels the appetite for and profitability of sex trafficking. Children and many women depicted in pornography frequently have been trafficked into forced prostitution25 (see CMDA statement on Human Trafficking).

4. Spreads sexually transmitted diseases, some of which are potentially deadly, and not all of which are preventable by barrier methods.29,30 5. Suppresses their sense of personal identity and self-worth as they endure the message that their value is nothing more than their bodily appearance.7,8,31 6. Severely shortens the lifespan of those trafficked due to malnutrition, infections, violence, limited access to medical care, and forced drug use (see CMDA statement on Human Trafficking).32,33 E. Pornography is harmful to society; it: 1. Furthers the pernicious tendency in our society of commodifying and denigrating others, particularly women and children.7,26 2. Incentivizes withdrawal from authentic human relationship and community, which contributes to emotional and relational disability.20,23 www.cmda.org 29

3. Is toxic to marriages, contributing to the destruction of stable families.9,20,23 4. Decreases tolerance and acceptance of others.19,20 5. Corrupts and debases the ideal of beauty, which is reduced to only that which is sexual.8,10,20,33 6. Generates inhuman expectations for others, who may feel that they must imitate pornography to be attractive and, through immodest dress or augmentative surgery, become hypersexualized to be loved.31,34 7. Perpetuates or worsens misogyny.22 8.

May increase the incidence of rape as it teaches individuals that they are entitled to have their sexual gratification anytime they want it.22 9. Disseminates exposure to all sorts of sexual deviancies, such as sexting, hookup apps, virtual impersonation, sexual violence, bestiality, and “deepfake” pornographic video manipulations intended to humiliate, manipulate and ruin the reputations of other people.22,25 10. Confuses lust with genuine love, leading to a society that no longer seeks truth and the good, sacrifices for others, or retains its will to survive.

11. Signifies the seeking after a vacuous substitute for being in relationship with God.7 12.

Contributes to cyber-crime, malware and malicious Internet activity.24,26 3. Medical Considerations Use of pornography has been claimed to have potential beneficial effects, such as diffusing sexual aggression.

These claims are, or potentially are, without merit as follows: A. Pornography, including interactive sexual images and devices, has no therapeutic value. Patients who have difficulty interacting with other people would not be trained to deal with real people in a healthy way by interacting with artificial and controllable sex robots.35 B. Interactive sexual technologies do not have potential to treat pedophilia or rehabilitate sex offenders. Retrospective studies have strongly correlated pornography with increased incidence of rape, prostitution, normalization of sexual deviancy, and addiction to sexual activity.35,36 C. If the use of interactive sexual devices leads to increased desire for “real” sexual activity, the in30 TODAY'S CHRISTIAN DOCTOR Fall 2020

dividual may become inclined to engage in risky behavior.35,36 D. Sex robots will likely not promote safer sex. If used in a brothel the potential for sexually transmitted infection between serial users may persist.35 4. Responding to Pornography A. Christians should promote the beauty and benefits of sexual purity.

B. Christians should acknowledge the pervasive and addictive nature of pornography and recognize that its root is ultimately spiritual.

C. Christians who are involved with pornography should confess their sins and demonstrate repentance, and this necessitates a plan of action and accountability to prevent recurrence.

D. Christians should have early and ongoing discussions with their children about the dangers of pornography and consider using filtering technologies to decrease the risk of accidental exposure to Internet pornography.

E. Christian healthcare professionals, because of their duty to respect and protect the dignity of every patient as a bearer of God’s image, have an even higher obligation to abstain from sexual impurity, including pornography.

F. Internet search engines, advertisers, and other custodians of information technology should be required to filter pornographic content so that it is not presented to users who do not request it. At a minimum, the default policy should be filtering of pornographic content.

G. Christians should become aware of the content used in sex education curricula and oppose the use and promotion of sexually explicit material in schools at all levels.

H. Christians should testify that God is just, merciful, loving, and faithful, and that He will, if we ask Him and repent, forgive sexual sins and bring us into a relationship with Him that is far more fulfilling and intimate than the fleeting and false pleasures of pornography. God rejoices when sinners repent (Luke 15:7; John 3:16-17; Jer 2:13).

I. Christians are obligated to welcome with compassion those who are caught up in pornography, which is not to condone the use of pornography (Gal 6:1).

J. Christians should pray for those trapped in this perverse industry: the performers, the users, the victims, and the perpetrators, that they would be released from bondage, and that the industry would fail.

5. Conclusion A. CMDA affirms, with gratitude to God, the beauty of our nature as sexual beings.

B. CMDA acknowledges that while God creates us as sexual beings, our created human nature and flourishing are far more than sexual.

C. CMDA rejects the notion of pornography as a harmless or victimless activity.

D. CMDA condemns the creation, distribution and use of pornography, including extreme forms of pornography such as sex robots. Pornography is an imminent threat to public health, a clear and present danger to all people and to their relationships with others and with God. E. CMDA affirms that Jesus Christ, with open arms, offers the possibility of repentance, spiritual renewal, healing, and hope for all who are afflicted by pornography (1 John 1:9).

REFERENCES

1. National Center on Sexual Exploitation. Pornography and Public Health. 2017.

2. Weber M, Quiring O, Daschmann G. Peers, parents and pornography: exploring adolescents’ exposure to sexually explicit material and its developmental correlates. Sex Cult.

2012. 16:408-427.

3. Peter J, Valkenburg PM. Adolescents and pornography: a review of 20 years of research. J Sex Res. 2016. 53:509-531.

4. Pornhub Insights. 2018 Year in Review. https://www.pornhub.com/insights/2018-year-in-review. Accessed 9-292019.

5. Top Websites Ranking. https://www.similarweb.com/topwebsites. Accessed 9-29-2019.

6. McDowell, Josh. The Porn Phenomenon: A Comprehensive Groundbreaking New Survey on Americans, the Church, and Pornography: Impact of Internet Pornography on American Population and the Church. Barna: New York, 2016.

7. Lim MSC, Carrotte ER, Hellard ME. The impact of pornography on gender-based violence, sexual health and wellbeing: what do we know? J Epidemiol Community Health.

2016. 70:3-5.

8. Tylka TL. No harm in looking, right? Men’s pornography consumption, body image, and well-being. Psychol Med Masculinity. 2015. 97-107.

9. Martins A, Pereira M, Andrade R, et al. Infidelity in dating relationships: gender-specific correlates of face-to-face and online extradyadic involvement. Arch Sex Behav. 2016.

45:193-205.

10. Facchin F, Barbara G, Cigoli V. Sex robots: the irreplaceable value of humanity. BMJ. 2017. 358:3790.

11. Gola M, Wordecha M, Sescousse G, et al. Can pornography be addictive? An fMRI study of men seeking treatment

EARN CONTINUING EDUCATION 2 HOURS NOW AVAILABLE

We are now offering continuing education credits through Today’s Christian Doctor. Two hours of self-instruction are available.

To obtain continuing education credit, you must complete the online test at www.pathlms.com/cmda/ courses/21664.

•T his CE activity is complimentary for CMDA members.

•T he fee for non-CMDA members is $80.00.

If you have any questions, please contact CMDA’s Department of Continuing Education at ce@cmda.org.

Review Date: June 25, 2020 Original Release Date: August 22, 2020 Termination Date: August 22, 2023

EDUCATIONAL OBJECTIVES • Articulate the serious extent of the use of and bondage to pornography in the United States.

• Describe the harms that pornography presents to individuals, to marriages, to children, to those used in the creation of pornographic materials and to society at large.

• List ways that Christians and Christian healthcare professionals can respond to and combat pornography.

ACCREDITATION The Christian Medical & Dental Associations is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

PHYSICIAN CREDIT The Christian Medical & Dental Associations designates this educational activity for a maximum of 2 AMA PRA Category 1 Credit(s)™.

Physicians should only claim credit commensurate with the extent of their participation in the activity.

NURSE PRACTITIONER The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Individuals are responsible for checking with the AANPCP for further guidelines. Nurse practitioners may receive up to 2 credits for completing this activity.

PHYSICIAN ASSISTANT AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit(s)™. by an organization accredited by the ACCME or a recognized state medical society. Physician assistants may receive up to 2 credits for completing this activity.

DENTAL CREDIT CMDA is an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing education programs of this program provider are accepted by AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. The current term of approval extends from 1/1/2018 to 12/31/2022.

Provider ID#218742. 2 Hours Self Instruction Available. No prior level of skill, knowledge, or experience is required (or suggested).

DISCLOSURE None of these authors, planners or faculty have relevant financial relationships.

Chris Hook, MD; Mandi Mooney, CMDA Today’s Christian Doctor Editor; Barbara Snapp, CE Administrator; Sharon Whitmer, EdD, MFT; and CE Committee Members.

CMDA CE Review Committee John Pierce, MD, Chair; Jeff Amstutz, DDS; Trish Burgess, MD; Stan Cobb, DDS; Jon R. Ewig, DDS; Gary Goforth, MD; Elizabeth Heredia, MD; Curtis High, DDS; Bruce MacFadyen, MD; Dale Michels, MD; Shawn Morehead, MD; Michael O’Callaghan, DDS; and Richard Voet, MD THERE IS NO IN-KIND OR COMMERCIAL SUPPORT FOR THIS ACTIVITY.

www.cmda.org 31

for problematic pornography use. Neuropychopharmacology.

2017. 42:2021-2031.

12. Grubbs JB, Exline JJ, Pargarment, et al. Internet pornography use, perceived addiction, and religious/spiritual struggles.

2017. Arch Sex Behav. 46:1733-1745.

13. Grubbs JB and Perry SL. Moral incongruence and pornography use: a critical review and integration. J Sex Res. 2019.

56:29-37.

14. Kuhn S and Gallinat J. Brain structure and functional connectivity associated with pornography consumption: the brain on porn. JAMA Psychiatry. 2014. 71:827-834.

15. Cameron C. Electronic porn in the workplace: a policy examination. Int J Technology Policy Law. 2012. 1:120-124.

16. Klein, J. and Cooper, D. 2018. Deviant Cyber-Sexual Activities in Young Adults: Exploring Prevalence and Predictions Using In-Person Sexual Activities and Social Learning Theory. Archives of Sexual Behavior, 2018. 48: 619-630.

17. Hagen, T., Thompson, M. and Williams, J. Religiosity Reduces Sexual Aggression and Coercion in a Longitudinal Cohort of College Men: Mediating Roles of Peer Norms, Promiscuity, and Pornography. Journal for the Scientific Study of Religion. 2018. 57: 95-108.

18. Babchishin, K., Karl Hanson, R. and Hermann, C.The Characteristics of Online Sex Offenders: A Meta-Analysis. Sexual Abuse: A Journal of Research and Treatment.

2010. 23:92-123.

19.

Perry SL, and Snawder KJ. Pornography, religion and parent-child relationship quality. Arch Sex Behav, 2017.

46:1747-1761.

20. Malcolm M, and Naufal G. Are pornography and marriage substitutes for young men? East Econ J. 2016. 42:317-334.

21. Ley D, Prause N, Finn P. The emperor has no clothes: a review of the ‘pornography addiction’ model. Curr Sex Health Rep. 2014. 6:94-105.

22. Shor E, and Seida K. “Harder and harder”? Is mainstream pornography becoming increasingly violent and do viewers prefer violent content? J Sex Res. 2019. 56:16-28.

23. Perry SL, and Schliefer C. Till porn do us part? A longitudinal examination of pornography use and divorce. J Sex Res. 2018. 55:284-296.

24. Wondracek G, Holz T, Platzer C, et al. Is the internet for porn? An insight into the online adult industry? WEIS. 2010. http://seclab.ccs.neu.edu 25. Klein CA. Digital and divergent: sexual behaviors on the internet. J Am Acad Psychiatry Law. 2014. 42:495-503.

26. Smith PK, Thompson F, Davidson J. Cybersafety for adolescent girls: bullying, harassment, sexting, pornography and solicitation. Curr Opin Obstet Gynecol. 2014. 26:360-365.

27. Danaher J. Regulating child sex robots: restriction or experimentation? Med Law Rev. 2019.

28. Moore JL, Kaplan DM, Barron CE. Sex trafficking or minors. Pediatr Clin N Am. 2017. 64:413-421.

32 TODAY'S CHRISTIAN DOCTOR Fall 2020

29. Abad N, Baack BN, O’Leary A, et al. A systematic review of HIV and STI behavior change interventions for female sex workers in US. AIDS Behav. 2015. 19:1701-1719.

30. Shannon K, Strathdee SA, Goldenberg SM, et al. Global epidemiology of HIV among female sex workers. Lancet.

2015. 385:55-71.

31. Laemmle-Ruff IL, Raggatt M, Wright CJ, et al. Personal and reported partner pornography viewing by Australian women, and association with mental health and body image.

Sexual Health. 2019. 16:75-79.

32. Lederer LJ and Wetzel CA. The health consequences of sex trafficking and their implications for identifying victims in healthcare facilities. Ann Health Law. 2014. 23:61-91.

33. Aldridge RW, Story A, Hwang SW, et al. Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance abuse disorders in high-income countries: a systematic review and meta-analysis. Lancet.

2018. 391:241-250.

34. Dogan O, and Yassa M. Major motivators and sociodemographic features of women undergoing labiaplasty. Aesthet Surg J. 2018.

35. Cox-George C and Bewley S. I, sex robot: the health implications of the sex robot industry. BMJ Sex Reprod Health.

2018. 44:161-164.

36. Maras MH, Shapiro LR. Child sex dolls and robots: more than just an uncanny valley. J Internet Law. 2017.

37. McDowell, Josh. The Porn Phenomenon: A Comprehensive Groundbreaking New Survey on Americans, the Church, and Pornography: Impact of Internet Pornography on American Population and the Church. Barna: New York, 2016.

ADDITIONAL SOURCES AND POSITION PAPERS

•D anaher, John and McArthur, Neil. Robot Sex: Social and Ethical Implications. Cambridge, Massachusetts: The MIT Press. 2017.

•D evlin, Kate. Turned On: Science, Sex and Robots. New York: Bloomsbury Sigma. 2018.

•E berstadt, Mary and Layden, Mary Anne. The Social Costs of Pornography: A Statement of Findings and Recommendations.

The Witherspoon Institute, 2010.

•F agan, Patrick F. “The Effects of Pornography on Individuals, Marriage, Family and Communities; Main Report and Executive Summary.” Marriage & Religion Research Institute. December, 2009.

•F oubert, John D. How Pornography Harms: What Today’s Teens, Young Adults, Parents and Pastors Need to Know.

Bloomington, IN: LifeRich Publishers. 2017.

•F radd, Matthew. The Porn Myth: Exposing the Reality Behind the Fantasy of Pornography. San Francisco: Ignatius Press. 2017.

•G rudem, Wayne. Christian Ethics: An Introduction to Biblical Moral Reasoning. Wheaton, IL: Crossway. 2018. Chapter 31 – Pornography.

•L evy, David. Love+Sex with Robots: The Evolution of HumanRobot Relationships. New York: HarperCollins Publishers.

2007.

•P earcy, Nancy. Love Thy Body. Grand Rapids, MI: Baker Books. 2018.

•R egnerus, Mark. Cheap Sex: The Transformation of Men, Marriage, and Monogamy. New York: Oxford University Press. 2017.

•S harkey, Noel; van Wynsberghe, Aimee; Robbins, Scott; Hancock, Eleanor. Our Sexual Future with Robots: A Foundation for Responsible Robotics Consultation Report. 2017.

•S truthers, William M. Wired for Intimacy: How pornography hijacks the male brain. Downers Grove, IL: IVP Books.

2009.

•W ilson, Gary. Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction. Commonwealth Publishing. 2017.

Unanimously approved by the House of Representatives April 21, 2020 Bristol, Tennessee (and virtual locations)

HELPFUL WEBSITES •C onquer Series https://conquerseries.com •C ovenant Eyes Internet Accountability Service https://www.covenanteyes.com •L iving Without Lust http://www.livingwithoutlust.com •O peration Integrity https://operationintegrity.org •R esponsible Robotics https://www.responsiblerobotics.org •R ich Guidotti https://positiveexposure.org •S haunti Feldhahn https://shaunti.com •Y our Brain on Porn https://www.yourbrainonporn.com

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BRINGING TOGETHER HEALTHCARE PROFESSIONALS TO FURTHER GOD’S KINGDOM We exist to glorify God by placing healthcare professionals and assisting them in finding God’s will for their careers. Our goal is to place healthcare professionals in an environment that will encourage ministry and also be pleasing to God. We make connections across the U.S. for physicians, dentists, other healthcare professionals and practices. We have an established network consisting of hundreds of opportunities in various specialties.

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My

CMDA

Story “I was first introduced to CMDA’s Women Physicians in Christ around 2012 by two friends/colleagues. After reviewing the literature from their annual conference, I knew this was something I wanted to experience for myself.

The following year, I attended the WPC Annual Conference in Texas. I went alone, but felt very welcomed.

I could not believe there was a medical conference that met my spiritual, emotional and intellectual needs all in one place! It was amazing to have the opportunity to worship, pray, laugh and cry together as we shared our stories. Since that time, I have had an opportunity to serve with a phenomenal group of women and develop long lasting friendships.

We have shared joys and hardships.

I am grateful to be surrounded by this caring community of believers, and I look forward to experiencing all that God has in store for us in the future!”

—Regina Frost, MD

Introduce Your Colleagues to CMDA Introduce your colleagues and friends to CMDA like Dr. Frost did, and you can develop lasting friendships with more than 19,000 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.”

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

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