Catholic Physicians Blog

CMA UK Midlands/ Worcs 2011

2011-09-23T14:32:00.001-07:00

Catholic Medical Association Meeting Thurs 20 Oct ‘11

‘Induced Abortion: Its effect on Mental Health’

Speakers: Drs Pravin Thevasathan (CMA Worcs Branch Secretary, Cons Psychiatrist LD) & Greg Gardner (Birmingham GP and protestant ethicist for Midlands Ethics Group)

Chair: Dr Tony Cole
Venue: Newman House Catholic Chaplaincy, 29 Harrisons Rd, Edgbaston, Birmingham

19:30: Mass
20:10: Meeting Followed By Discussion & Light Buffet

To assist with catering, would those wishing to attend please notify (email) John Kelly (kellyj1931@googlemail.com) by 12 Oct.

There is no charge for Buffet

Sirach 38:9,13

2011-08-14T07:22:00.000-07:00

My Child; when you are ill, delay not, but pray to God, who will heal you... There are times when good health depends on doctors, for they in their turn, will pray the Lord to grant them the grace to relieve and to heal, and so prolong your life.

Catholic Embryo adoption?

2011-04-28T16:23:00.001-07:00

Once immorally conceived in a Petri dish, instead of through the loving marital action, should 'surplus' embryos be discarded or would it be morally right to implant an embryo to save it.

Yes: Jo Shaw
Giles
Dr Gerard Nadal

No: John Smeaton
Fr John Fleming (Bioethicist advisor to SPUC) Book
The Vatican(?)

I think this article of Dignitas Personae clarifies in my mind that it is not right and we must not cooperate with evil:

With regard to the large number of frozen embryos already in existence the question becomes: what to do with them? All the answers that have been proposed (use the embryos for research or for the treatment of disease; thaw them without reactivating them and use them for research, as if they were normal cadavers; put them at the disposal of infertile couples as a “treatment for infertility”; allow a form of “prenatal adoption”) present real problems of various kinds. It needs to be recognized “that the thousands of abandoned embryos represent a situation of injustice which in fact cannot be resolved. Therefore, John Paul II made an “appeal to the conscience of the world’s scientific authorities and in particular to doctors, that the production of human embryos be halted, taking into account that there seems to be no morally licit solution regarding the human destiny of the thousands and thousands of ‘frozen’ embryos which are and remain the subjects of essential rights and should therefore be protected by law as human persons” (n. 19).

However, I am very impressed with the 'Yes' arguments and to avoid post conciliar stagnation, i'd welcome lively debate around this issue. From a doctor's point of view, I'd want to know the practicalities eg. Consenting biological mothers for donation rather than just storage. An interesting topic. As John Fleming says regarding Dignitas Personae

It’s as if the church is saying to the secular world: “You created this situation by wantonly and irresponsibly creating human embryos in vitro and you are asking the church to solve the problem. It’s up to you to solve this unjust situation yourself by stopping creating embryos outside the body and freezing them.”

Happy Easter!

2011-04-24T12:09:00.001-07:00

A very medical Palm Sunday

2011-04-17T06:02:00.001-07:00

Forget the 'Passion Sunday' you may hear (that was last week) today is Palm Sunday. A restrained and yet intensified aspect of Lent and Passiontide: the point of entry into Holy Week and the culmination of our Lord's Passion. For that reason in the traditional liturgy the procession would have been clothed Violet, with the Cross veiled, and the Ministers wearing folded chasubles. No Red Vestments for the Mass: The violet colour of Lent and our Lord's royalty is retained. Although modern liturgy gave way to a forward-facing table to distribute palms (a Bugnini innovation which led to the 'table-altar); the traditional form involved a miniature 'mass' with blessing having its own collect and preface, and distribution of blessed palms (corresponding to the consecration of the species at Mass with communion).

Peter Jennings © 2008
The congregation would then join a procession to a stational church, all holding blessed palms signifying the triumphant entry of Christ into Jerusalem.

Glória, laus et honor tibi sit, Rex Christe, Redémptor: Cui pueríle decus prompsit Hosánna pium.
R. Glória, laus et honor tibi sit, Rex Christe, Redémptor: Cui pueríle decus prompsit Hosánna pium.

This quickly turns into sorrow, as arrival in the second church gives way to the Red Vestments and Mass proper, whose chant includes Psalm 21. Then the solemn singing of St Matthew's Passion during the Gospel, sung by coped clerics. This has been set to music by many famous composers.

But today I am sitting in the Doctors mess at a local psychiatric hospital, responding to bleeps and starting some revision for this summer's exam. It is through my own loss of the Mass on this day, as I work the 12-hour shift, that I most sharply experience Lent. My work, a burden at weekends, can be offered up as I watch the Holy Sacrifice on my iPod!

Please remember to make your UK response to the

RCPsych's draft consultation to the DoH's investigation into the effects of Induced abortion on mental health.

Studies vary in their conclusions, and with regards validity; but some find Abortions are harmful, in it's resultant mental health. But other studies find that women have just as many psychological problems following birth of an unwanted pregnancy.

But NONE of them would have the legal effect of justifying the Abortion legislation; 97% cases being performed on the grounds of avoiding mental and physical health problems which continuing to birth would cause. The only kind of evidence the DoH should be satisfied with, is a demonstrable better mental and physical health in the abortion group. This draft publication and literature review clearly do not show this.

Therefore the very basis of the clause in the law should be closely examined and hopefully removed, which would eliminate 'abortion on demand' and at least result in the consent counseling including that any women susceptible to mental health problems are at increased risk of developing 'post-Abortion syndrome'.

This, paradoxically, (perhaps poetic irony) nullifies the rationale of 97% of the use of the 1967 Act.

Sidcup Healthcare Conference

2011-03-19T15:44:00.001-07:00

Our Lady of the Rosary is hosting a spiritual and learning conference built upon faith and clinical excellence for healthcare workers, arranged by the Catholic Medical Association (Kent Branch.)

The Conference will take place on Saturday 19 & Sunday 20 March 2011. for medical professions, this will gain 6 hours of CPD: Certificates of attendance will be available.

Published by Blogpress for my iPhone

Pro-life in the UK

2011-03-09T03:27:00.001-08:00

On Monday night we hit the motorway (freeway) and arrived in a little church hall/church in Tamworth where we never normally would have frequented. Hosted by 'Vic' ( the Vicar):

The meeting: organized by SPUC locally and presented by Mr Doyle (no relation);

National Director Mr J Smeaton (His blog here) explained pro-life issues and the fight against abortion over the last few decades, always flatteringly over-optimistic about the audience's youth! But most worrying, John says, the worst anti-life project of recent months and years: the aggressively secularist teaching of sex to innocent school children, and the obligation not to inform the guardians when serious issues (eg pregnancy) arise.

It was a successful evening with over forty people in attendance from Tamworth and further afield. The talk was faith inspired but not religiously loaded, acknowledging our common belief in the sanctity of human life. It did not stray far into the Catholic teaching against contraception, but always asserted the life of the embryo and it's personhood and dignity from the moment of conception.

Of interest was seeing the beautiful little models which were sent to members of parliament before an important vote. These models were 1:1 scale medical replicas of a 20-week baby in utero, complete with half a uterus. It looked beautiful to us, but was at the time described horrifically by politicians, even accusing SPUC of cruelty against a lady recently having miscarried, who was upset at the contents of her package.

I think that is the point: rather than ignoring this female emotion; to acknowledge the grief at losing a tiny baby. This must be the same grief that a woman feels post abortion, but who have to suppress it because they knew it was their choice.

John compared this revelry from MPs as similar (certainly almost identical in verbiage) to mid 19th century British reaction to sketches of young children manually working in the pits. How is this not worse?!

There is new impetus in Tamworth encouraged by a youthful vision in the Smeaton Family: "Abortion will fall; be repealed." Like the slave-trade, it will be seen as a black day in history.

http://cma-midlands.blogspot.com/

2011-02-22T20:14:00.000-08:00

CMA Midlands Blog (UK)

NHS cuts

2010-06-04T11:53:00.001-07:00

Cross posted from My Blog
"They're starting to get results, [health] Minister!"
"Time to restructure!"

The photo above is from a mug of tea I was drinking at work today. It made me laugh, but also got me thinking about the worrying prospect of NHS cuts in light of the public deficit following the global recession. Quite how our new coalition goverment will handle this I don't know, but my worry is it will impact adversely on Mental Health Services.

Why? Because in this day of public pressure groups and political maneuverings, it is the group of patients with mental health problems who lack a strong and unified voice. It probably stems from stigma, a case which is made worse by the aggressive shift towards community care during '80s conservative days, meaning society has been suddenly and unpreparedly exposed to a fear which they have no idea how to handle or integrate into society. It is a prime target for cuts.

There are very few advocates, people fighting for this vulnerable sector. But politically and socially, think of the huge burden of psychiatric illness: which 1 in 4 people will suffer from sometime in their life. Loss in earnings and taxes. Loss in confidence and stable homes. Worse and untreated physical health. Reduced life expectancy and huge socioeconomic inequalities widening. To not make this a priority, both within specialist services and in primary care when the bulk of illness is treated, would therefore be a huge mistake!

I pray the new goverment can make the correct decisions to cut excess and waste, and prune the health service to make it more efficient, effective, satisfying and above all accessible.

"For El-ahrairah to Cry"

2010-04-03T16:23:00.000-07:00

I wrote a note on my personal blog remembering the death of my son Theodore two years ago. In it I relate how this has affected my work as a physician. It can be found HERE.

Mulier Fortis: Maybe This Is Apocryphal...

2010-03-25T09:11:00.000-07:00

Mulier Fortis: Maybe This Is Apocryphal...

2010-03-23T11:35:00.000-07:00

For those interested, Franciscan University in Steubenville, Ohio has a number of bioethics courses available periodically. You can find the link here.

The next scheduled event is:

Ethical Issues in Suffering and DeathMarch 26-28, 2010

They also have available majors and programs available.

New Member

2010-01-27T16:10:00.000-08:00

Welcome to Michael DePietro, MD to the Catholic Physicians' Blog. Mike, perhaps you can kick start this thing for us. Posting have been slow recently.

Emergent Infant Baptism

2009-09-27T21:24:00.000-07:00

I recently baptized an infant before he died, and the experience made me pull up some of the teachings of the Catholic Church on infant baptism to review in the event anyone questioned me on this incident.

First of all, I asked for the permission of the infant's father beforehand. I was blessed with the opportunity to speak with him shortly before it was obvious that the child would not survive.

The Catechism of the Catholic Church can be accessed online at this website. It has a search engine attached to it, so one can browse the whole document and dive into the text at will.

The Catechism of the Catholic Church(from here on referred to as CCC) discusses baptism in paragraphs 1213 to 1284. The word baptize comes from the Greek word baptizein, which means to "plunge" or "immerse"; the "plunge" into the water symbolizes the catechumen's burial into Christ's death, from which he rises up by resurrection with him, as "a new creature." (CCC 1214)

The CCC gives several examples of the prefigurement of the sacrament of Baptism found in the Old Testament. Noah and the Ark show life starting over after washing away sin, and the Israelites crossing the Red Sea prefigure the liberation from the slavery of sin through baptism. Later, the baptism is prefigured when the Israelites cross over the Jordan to enter the promised land; entering the promised land is symbolic of entry into Heaven. (CCC 1217-1222; they write it far better than I do)

I recall reading somewhere that St. John the Baptist, when he was baptizing in the River Jordan, was baptizing on the 'far' side of the river, so that those who were baptized had to cross back over the Jordan, just as the Israelites did in the Old Testament. This brings up the most important reason for baptism: Jesus Himself insisted on it before starting his ministry.

Baptism of infants is brought up in paragraphs 1250 to 1252, and the main sentences which motivated me are highlighted below. I saw a chance to bring this infant to become a child of God, and I did not think anyone would be able to get to the child before he died.

1250 Born with a fallen human nature and tainted by original sin, children also have need of the new birth in Baptism to be freed from the power of darkness and brought into the realm of the freedom of the children of God, to which all men are called. The sheer gratuitousness of the grace of salvation is particularly manifest in infant Baptism. The Church and the parents would deny a child the priceless grace of becoming a child of God were they not to confer Baptism shortly after birth.

1251 Christian parents will recognize that this practice also accords with their role as nurturers of the life that God has entrusted to them.

1252 The practice of infant Baptism is an immemorial tradition of the Church. There is explicit testimony to this practice from the second century on, and it is quite possible that, from the beginning of the apostolic preaching, when whole "households" received baptism, infants may also have been baptized.

How to Baptize:

There are two things needed for the sacrament: one is water to pour over the head(preferably) of the patient; the other is to say the words of baptism while pouring the water three times over the head of the patient. The words of baptism are: "N., I baptize you in the name of the Father, and of the Son, and of the Holy Spirit."

When I realized that things were going downhill fast, I turned to one of the nurse anesthetists (CRNA) who was working with me, and asked her to get me some water from the scrub sink. She pointed to a small bowl of water on top of the anesthesia cart. "I got you covered, Doc," she said.

As a footnote, by some miracle, we were able to get this child back to his mother and father, and they were able to hold their son as he died. It was heartwrenching and difficult to talk to the young couple, but I did manage to tell them that their son had been baptized. The experience brought back a flood of memories of losing Theodore, and the desolation which accompanied that loss. The pained expression I saw on the face of this young couple reminded me of the way Carolyn looked after Theodore died.

"No Kill" Nursing Homes

2009-07-10T07:39:00.000-07:00

I just discovered that the senator for our region of Pennsylvania, Lisa Boscola, co-sponsored a senate bill 404 that will legalize physician assisted suicide if it is eventually passed. What this will mean is that if grandma is diagnosed with "terminal cancer" and wishes to end her life, she can ask the kind family doctor for a prescription cocktail that will end her life.The Hippocratic Oath which I took in 1985 makes me promise to not give anyone something that would end their life, nor counsel them on how to do it. Most western cultures have prohibited suicide and have laws against it. Both Christian and Jewish theologians have understood suicide to be a grave moral evil. Now in our enlightened age, we are going to change the rules and say it's ok to kill grandma or grandpa. Giving a patient a prescription to end their life is no different than me (a physician) going to K Mart and buying a shotgun and shells, sawing off the barrel for convenience and leaving it at the doorstep of my suffering patient so they can end their life.Does anybody have a problem with this?I am the medical director of two nursing homes and oversee the care of over 200 frail elderly patients. I spend my day attempting to alleviate the pain and suffering that is often experienced in the end stages of life. It is not usually easy, but often labor intensive and emotionally draining at times. However, I view it as my privilege to be entrusted to care for the most vulnerable of our society and would want no other job. But is if this bill becomes law, some will view it as cheaper and more convenient to encourage patients to end their life. The value of a older suffering person's life will drop faster than the stock market as it has in the European countries that have embraced PAS and EuthanasiaI am thinking of asking the administrators of my nursing homes to designate them as "No Kill Nursing Homes" just as they do with dog shelters, so the patients can be assured that they will be cared for and not put out of their misery. How can the hand that heals also be the hand that kills? How will patients trust me?The fact that most people I have spoken to in the medical profession have no idea that this bill was proposed back in March is frightening. This is not unintentional. Will we be the next Oregon or Washington state?In the next several months I am hoping to organize some effort to educate those around us to Physician Assisted Suicide and hopefully, by the time the bill is put up for a vote, or a public referendum, the public should be well-informed of this evil. The trick is to get to the public before the well-oiled and funded euthanasia lobbying machine gets to our legislators. Let your senators and representatives know how you feel about this.If you wish to let SenatorLisa Boscola (Lehigh Valley Region) know about your feelings towards this bill and her co-sponsorship of it, email her at:boscola@pasenate.com

Doctor Poem

2009-05-23T14:11:00.001-07:00

Junior Doctor

Each demand 'top priority' but usually mundane
I'm trying to get through each one in vain
Doing nothing well, making mistakes
Not even taking any breaks
I look worse than ill
Can't I have a pill?

I can't think - Just tell me what to do!
"You're the Doctor - we're supposed to say that to you!
But while you're here; sign here, and here...
We've done it already, have no fear!"
But this D-dimer is a thousand, why did you ask for that?
Now he needs a V/Q and clexane stat.

I need the toilet, but my bleeper sounds
I don't care, I need the sanctuary a cubical allows
Until it shouts from under my pants:
"CARDIAC ARREST: EAST ENTRANCE!"
It turns out to be someone who's slipped in the rain
So I trudge back to the other side of the hospital again

"Doc - where have you been?
There's five patients waiting - none of them seen!"
Who do I start with: the one with gangrene?
Or unconscious? Or whose relatives scream:
"You're a Doctor? You're too young...
Where's the Consultant? He's the important one!"

Someone just died in Sideroom One
Perhaps I could nip in and certify them?
Four minutes of listening for life
Absolute quiet - forgetting the strife.
Pupils fixed and dilated, no furrowed brow
No more demands that life would allow.

I'm wakened from my trance by an alarm
A drip is obstructed - in an oedematous arm
How will I ever get another one in?
Can't we just stop it? Give in?
I'm at my wits end but there's more to come
I'll probably end up examining someone's bum.

My watch says three hours longer, from bad to worse
Till its confiscated by an Infection Control Nurse
"Bare below elbow" they say as they go
A suspendable offence? I do hope so...
"Excuse me, Dr Doyle?" A nurse says all too soon
Yes, I reply, with a sense of impending doom

"Did you prescribe this?" Yes, Co-amoxiclav.
"But the patient's allergic and now has a rash."
Oh, bugger. Incident Report Form. Then Adrenaline IM.
(And if I have time, I should say sorry to them.)
Doing nothing well. Making blunders
Survival overtaking hopes of achieving wonders.

But then from a patient I get a smile and a tear
And suddenly it all seems so clear
"Thank you so much Doctor" they remark
"It's just my job" I retort, but inside there's a spark
I am grinning from ear to ear, its the best
Conscience so clean it could pass the UV test

Obama Lifts Restrictions on Stem Cell Research, "Science" Will Guide

2009-03-09T17:58:00.001-07:00

As expected, President Obama continued to advance the culture of death by removing restrictions of government funding of stem cell research. Despite the fact that there has not been any meaningful advance in this area and given that there is an alternative.

WASHINGTON (AP) - From tiny embryonic cells to the large-scale physics of global warming, President Barrack Obama urged researchers on Monday to follow science and not ideology as he abolished contentious Bush-era restraints on stem-cell research. "Our government has forced what I believe is a false choice between sound science and moral values," Obama declared as he signed documents changing U.S. science policy and removing what some researchers have said were shackles on their work.

"It is about ensuring that scientific data is never distorted or concealed to serve a political agenda - and that we make scientific decisions based on facts, not ideology," Obama said.

You can be sure that the only political agenda that will not be served by the "scientific data" will be conservative, religious or moral. Besides, if Obama really means it, where would this leave AlGore?

A Time for New Martyrs?

2009-02-28T15:17:00.001-08:00

Those of us in the field of health care may come under additional pressure from this pro-abortion administration and congress. According to the New York Times:

WASHINGTON — The Obama administration moved on Friday to undo a last-minute Bush administration rule granting broad protections to health workers who refuse to take part in abortions or provide other health care that goes against their consciences.

The Department of Health and Human Services served notice on Friday, through a message to the White House Office of Management and Budget, that it intends to rescind the regulation, which was originally announced on Dec. 19, 2008, and took effect on the day President Obama took office.

When the administration publishes official notice of its intent, probably next week, a 30-day period for public comment will begin, after which the regulation can be repealed or modified.

The rule prohibits recipients of federal money from discriminating against doctors, nurses and other health care workers who refuse to perform or assist in abortions or sterilization procedures because of their “religious beliefs or moral convictions.” Its supporters included the United States Conference of Catholic Bishops and the Catholic Health Association, which represents Catholic hospitals.

In praising the Bush administration last fall, Sister Carol Keehan, president of the Catholic Health Association, said that in recent years “we have seen a variety of efforts to force Catholic and other health care providers to perform or refer for abortions and sterilizations.”

But opponents of the regulation, including the American Medical Association, the National Association of Chain Drug Stores and Planned Parenthood, said it could have voided state laws requiring insurance plans to cover contraceptives and requiring hospitals to offer emergency contraception to rape victims. It could also allow drugstore employees to refuse to fill prescriptions for contraceptives, critics of the regulation have said.

Fascism comes slowly sometimes. One step at a time. And it must be resisted by decent people of all faiths. Some may have to suffer a "green martyrdom" rather than to submit to this type of intimidation. Catholic hospitals may need to close.

The pro-abortion crowd is pleased.

“Dismantling this dangerous rule is a historic step toward preserving profoundly significant health care rights for women, and vital constitutional rights for all,” Mr. Blumenthal said.

Reaction to the move on Friday made it clear that the issue remains an emotional one. “We are encouraged by the Obama administration’s recent effort towards ensuring that patients have the ability to access necessary, widely used and accepted medical services,” said Mary Jane Gallagher, president and chief executive of the National Planning and Reproductive Health Association.

Fellow Catholics who voted for Obama you have your change, but with little hope for a better America.

Technorati Tags: abortion,Obama,healthcare,conscience

New Member Welcome

2009-02-26T16:41:00.000-08:00

Welcome to our newest member, Paulinus, who blogs from across the pond at http://inhocsigno.blogspot.com/. We look forward to your posts (and given the recent activity, we look forward to any post!)

Best Wishes.

Primum Non Nocere Malevolus

2008-12-09T03:25:00.000-08:00

A Reflective Report on Ethical Issues Facing a House Officer

Being a Foundation Doctor often involves following orders and performing seemingly menial tasks; this experience can be dis-empowering, with ethical decisions left to more experienced clinicians. But occasionally, amongst our frantic duties, we can overlook simple ethical issues. This essay will present examples of these, which I will use to present some basic ethical and moral responsibilities of a doctor, which should underpin all our encounters.

Part 1: Limitations of the modern Principles of Biomedical Ethics

“Principlism” is a theory first published in 1979 by Beauchamp and Childress. According to this methodology, any ethical problem is solved by applying the four principles of respect for patient autonomy, non-maleficence, beneficence, and justice(1). I have found Principlism useful as a ‘check-list’ to ensure several angles of ethical reasoning have been considered, and in my experience this is how Principlism is commonly used in the clinical setting. However, it relies heavily on intuitive decisions once the principles are ‘balanced,’ and there are often a variety of solutions which can be arrived at. Senior clinicians will have their own intuitive ways of doing this, informed by experience, but these processes are often inaccessible to a junior.

Part 2: Two Examples of Ethical Problems

Case One: The Tendency To Overtreat In Hospital Palliative Care
Whilst on-call and covering the medical wards at night, I was asked to see a 78 year old man with pneumonia. He was hypovolaemic and in a drowsy condition. I spent considerable time fumbling over collapsed veins inserting cannulas, administering fluid challenges, and taking samples of blood. I then read his notes and found he had been deteriorating over several days. He had not responded to intravenous antibiotics, and his kidneys were failing. He had been assessed by Critical Care the previous day, who concluded that due to several co-morbidities, he was unsuitable for dialysis on the intensive care unit.

My senior then arrived. He sat the patient’s wife down, explained the situation to her, and agreed to cease non-essential therapy. This allowed the patient a peaceful death and was a more holistic approach.

Case Two: Truth-Telling
During my time on a surgical firm, a 70 year old man was admitted, with altered bowel habits and rectal bleeding, for further investigations. A colonoscopy was performed, revealing an extensive tumour of the large bowel. The impression was invasive cancer. However, I was told by my seniors not to discuss this with the patient, but rather to wait until further reports and investigations had been performed.

Later that morning I was confronted by the patient, and later the relatives, and asked directly what the test had shown. On this occasion I described some basic appearances of the tumour within the limits of my expertise, but that I was not experienced enough to report more fully. I also discussed the possible diagnoses and which tests would be required. I was therefore honest without conveying the full impression of my seniors.

Part 3: Applying Ethical Principles

Principlism alone hasn’t helped me in these situations. In the first example I lacked the intuitive ability to engage in the Principlist framework at all. In the second example I feel my actions were appropriate, and could easily use Principlism to justify them. However, Principlism could also be used to argue the converse, depending on the moral agent. I propose a simple but crucial Hippocratic basis for ethical decisions, involving true harm avoidance. I will then elaborate on the Hippocratic principle of helping the patient, using moral rationale of similar antiquity.

The Problem of Harm
The maxim Primum non nocere, meaning “first do no harm” is popularly thought of as an essential Hippocratic approach to medicine. However, such a succinct phrase is not found in Hippocrates’ writings, which were originally written in Greek, casting doubt on whether the Latin phrase can be considered Hippocratic. More likely it is a mid-nineteenth century formulation, departing from true Hippocratic tradition(2).

In the 4th century BC, Hippocrates wrote:

“As to diseases, make a habit of two things - to help, or at least to do no harm.”

[A Latin translation of the above: “si subvenire alicui non vales, saltem noli eum nocere” isn’t nearly as concise as the ancient language usually allows!] This truly Hippocratic phrase implies the first principle of a physician is to do good, rather than avoid harm altogether. In the Hippocratic Oath, this ordering of priorities is maintained:

“to help the sick for the good of my patients according to my ability and my judgement, and never do harm to anyone.”

Beauchamp and Childress seem to follow the opposite order, placing autonomy and non-maleficience before beneficience. It is possible that this departure from tradition has led to a more risk-averse practice of medicine. To prohibit ‘nocere’ is rather wasted if it will shackle the physician from practicing their art. I believe the confusion lies with the definition of “harm.”

To clarify the situation, I propose that two types of harm are considered, following these two Hippocratic quotations. The first I will term “Collateral Harm.” By this I refer to physical damage. For instance, almost every intervention has side-effects, which are a necessary but inadvertent harm to the patient, and always to be balanced against the benefits of an intervention.

The second type I will term “Malicious Harm.” This is an injustice, a wrong or evil inflicted intentionally upon the patient. This type of harm is absolutely prohibited. An example of this is given in the Hippocratic Oath immediately after mentioning avoiding harm; the prohibition of giving a deadly poison, even when requested. Malicious Harm is at odds with the aims of medicine. Therefore Primum non Nocere Malevolus would be a better clarification on the maxim for harm avoidance.

One way to distinguish between these types of harm is by looking at the disposition of the physician, and the intention of his actions. For example, a dying person can be given morphine as pain relief, which may hasten death in large doses. But unless a drug has been given to intentionally injure the patient, then the physician has done no Malicious Harm in prescribing it.

In Case One, the harm of over-treating was not Malicious, because I had good intentions. What I had not taken into account was minimising Collateral Harm, which is essential in Palliative Care; to quote Hippocrates “... at least to do no harm.”

In Case Two, I had caused worry to the patient (Collateral Harm) by discussing the provisional diagnosis. However, to withhold this would be Malicious Harm, by neglecting my duty of care (E.g. GMC good practice of respecting the patient’s right to information).

Now that I have applied a correct understanding of harm avoidance, how can I enhance the true Hippocratic principle of ‘doing good’? To do this I will look at the disposition of the physician and the intention of his actions, in a similar way to how Malicious Harm can be differentiated:

Doing Good
Virtue Ethics is an excellent way of preserving and fostering the intention of helping patients. It is an ancient ethical system first developed by Greek philosophers Socrates, Plato and Aristotle(3). They proposed that the moral character of the agent is important in finding the right solution to a problem. Put simply, good people are more likely to do good things. By exploring how a virtuous character can be developed by habitual practice, one can find the qualities which will lead to being a good doctor. The classically defined virtues are courage, prudence, temperance and justice. These are termed ‘cardinal’ virtues, after the Latin cardo or hinge, since they are the hinges upon which the door of the moral life swings.

Virtue Ethics considers the motivation behind the action to be of crucial importance. To have dealt best with Case One, the way my senior did, requires a virtuous character with elements of compassion, prudence and temperance. In Case Two, withholding truth would be excluded, since a virtuous doctor has qualities of trustworthiness and integrity. Good virtues guide a doctor in discerning the best way to give information to the patient. Ultimately, a virtuous doctor will put their patients first, thus avoiding Malicious Harm.

Part 4: Conclusion

Medical ethics is not merely a checklist produced when common ‘ethical issues’ arise; it is a necessary daily tool to inform practice. My clarified maxim Primum non Nocere Malevolus provides a better foundation of the most basic aims of medicine, and Virtue Ethics helps avoid this malicious intent by exhorting virtue. I have begun to appreciate that there is a need to develop an informed conscience, and for a desire to do the best for one’s patients. I encourage a more holistic implementation of medical ethics, guided by the great moral philosophers of the past.

REFERENCES

1. Beauchamp T, Childress J. Principles of Biomedical Ethics [5th ed]. Oxford: Oxford University Press, 2001
2. Jones DA. The Hippocratic Oath III: Do no harm, withdrawal of treatment, and the mental capacity act. CMQ 2007;57(2):15-23
3. Gardiner P. A Virtue Ethics Approach to Moral Dilemmas in Medicine. J Med Ethics 2003;29:297-302

Welcome

2008-10-15T14:36:00.000-07:00

Richard A. Watson, M.D. is our newest member. Although Richard did not indicate a website or blog ulr, I'll list it if he sends it along.

He did send a tag to an interesting article linked here. Another "bioethicist" of the Peter Singer model. Wonderful.

If you thought Peter Singer, now a professor at Princeton University, was Australia’s gift to world bioethics, then I have news for you. One of his PhD students, now a professor at Oxford, Julian Savulescu, is leaving him in the dust.

His postal address may be an ivory tower but he gets down and dirty with “practical ethics”. He argues trenchantly for performance enhancing drugs in sport, genetic screening, early abortion, late-term abortion, sex-selective abortion, embryonic stem cell research, hybrid embryos, saviour siblings, therapeutic cloning, reproductive cloning, genetic engineering of children for higher IQs, eugenics, and organ markets. For starters.

Welcome, Richard. Your invitation to post to this blog is in the (e-)mail.

The Cost of Eliminating Down's Syndrome

2008-09-19T05:29:00.000-07:00

Aborting children with Down's Syndrome will not raise an eyebrow in some crowds. Hell, some might condemn anyone who would choose to bring these little monsters into the world. But the cost of perfecting humanity may cost a few "normal" children. Eugenics is a messy affair and always has been. According to The Telegraph:

Two healthy babies are miscarried for every three Down's Syndrome babies that are detected and prevented from being born, research has suggested.

The losses are down to the invasive methods used to test for the condition, which affects approximately one in every 1,000 babies conceived, the researchers claim.

They also cast doubt on the advice and risk assessment given to the 6,000 women each year who are offered screening and subsequent testing to assess the health of their unborn baby.

If an expectant mother is deemed to be at risk of carrying a Down's baby following a blood test, she will then go on to undergo an amniocentesis and chorionic villus sampling (CVS) test, which involves inserting a fine needle through the abdomen to either withdraw amniotic fluid or take a tissue sample.

The NHS cites a miscarriage rate of between one and two per cent following the tests, but the researchers, from the charity Down's Syndrome Education International, point out that only the number of Down's babies terminated, miscarried or born are recorded, not the number of healthy babies lost.

Creating liberal utopias will always cost innocent lives. It's hard work and occasionally someone will get in the way.

Technorati Tags: Down's Syndrome,abortion,chorionic villus sampling,CVS,amniocentesis,eugenics,utopia

Disability on Display

2008-09-13T15:15:00.001-07:00

If nothing else, Sara Palin's nomination as Republican VP candidate has brought matters of disabled children to the forefront in this political season. Palin and her husband have welcomed a child with Down's Syndrome into their family.

Unfortunately not all are willing to accept children as they are rather than as they might be. Wesley Smith at SHS blog has a disturbing post about a mother who murdered her disabled child.

Joanne Hill, 32, planned the murder after her husband refused to allow their daughter, Naomi, to be adopted, it was alleged.
A jury heard how Mrs Hill struggled to cope caring for the youngster, who suffered with cerebral palsy. She wore callipers to help her walk and had poor hearing.
Opening the case for the prosecution Michael Chambers QC told Chester Crown Court that Mrs Hill was "ashamed and embarrassed" of her daughter's condition and murdered her in a "determined and planned act".
"Joanne Hill could not come to terms with the fact that her daughter Naomi was disabled," he said.
"Instead of seeking help from the social services, she quite deliberately and consciously acted to kill Naomi."
Mrs Hill allegedly planned the murder for the afternoon of November 26 last year knowing her husband Simon would not be home until 5.30pm.
After picking up Naomi from the childminder she drove them to the family home in Deeside, Flintshire, north Wales, poured herself a glass of wine then ran a bath.
Mr Chambers said: "When the bath was full she told Naomi she was having a bath, but Naomi didn't want one. The defendant carried her upstairs and undressed her.
"The defendant put her in the bath and drowned her by holding her head under the water for a long time until she was dead."

Smith writes:

Princeton University's Peter Singer and some other bioethicists argue that killing unwanted babies is perfectly fine since babies aren't persons. Babies born with disabilities and terminal illnesses are already being subjected to infanticide in the Netherlands--acts of murder under Dutch law that go unpunished, and which have been supported by prestigious medical and bioethics journals such as in an article published in the prestigious Hastings Center Report. Here in America, 90% of fetuses testing with genetic anomalies such as Down or dwarfism are not allowed to be born--a eugenics action sometimes encouraged by doctors and genetic counselors. In Canada, Robert Latimer murders his daughter Tracy because she had cerebral palsy and is embraced by many there as a loving and compassionate father. Meanwhile, some people savage the Palins because they are affronted by Trig's presence in the world and a Canadian medical official worries that it could mean more parents deciding not to abort their disabled babies.

We as physicians have wonderful opportunity to affirm life from conception until natural death. Our patients respect us and we can influence the debate. Our actions and words are noted. Set the example and frame the debate in a life affirming way.

Technorati Tags: Down's Syndrome,disability,ethanasia,suffering,Catholic,physician,cerebral palsy,infanticide

Welcome to a New Member

2008-09-13T14:51:00.001-07:00

Catholic Physicians Blog is pleased to welcome a new member. Richard Kim blogs at http://catholicpsychiatrist.blogspot.com/. Great to have you onboard!

Psychiatry

2008-08-29T13:33:00.000-07:00

I have recently finished a four-month rotation in Psychiatry. I wanted to impart some of the things I learned from this, which have inspired me towards a career in this noble art. The specific area of work was a community based outreach service called 'Early Intervention'. This service is basically aimed at young people (16-35) who are experiencing psychotic symptoms for the first time. These kind of symptoms are common features of Schizophrenia, which is a syndrome prominent in the public conscious. However, not everyone understands this devastating illness, or how it can be managed, so I was privileged to be able to gain an insight.

Schizophrenia was a term first coined by Eugen Bleuler (1857-1939) in 1908. Prior to this, the condition was called 'Dementia Praecox', as assigned by the German Psychiatrist Emil Kraepelin (1856-1926) who introduced a distinctly clinical outlook to Psychiatry. Bleuler correctly realised that it was not a dementia, and also not exclusively confined to young people. His new term, 'Schizophrenia', was derived from the Greek term meaning 'Split mind'. There is a common misconception, perhaps stemming from this etymology, that it is a syndrome of split personality. This is false, and not to be confused with Dissociative Identity Disorder.

The sort of symptoms which Schizophrenia involves are hallucinations and delusions. Typically an individual will hear voices, talking in a derogatory manner about or to the subject. Sometimes the voices will give a running commentary on what the person is doing. Less commonly hallucinations can be visual, or in other modalities.

An individual with Schizophrenia will often feel that their thoughts are not their own. They may believe that thoughts are being physically inserted into their head, or taken away, or that their thoughts are being broadcast for all to hear. Delusions often develop from these symptoms and can be quite complex, and reflect a fragmentation of their experience of reality. To be a delusion it has to be a false, unshakable belief which is out of keeping with their cultural context. Often these seem to be related to popular constructs around them. Sometimes they may have a religious content, other times about aliens, and quite commonly at the moment about government conspiracies. Particular to Schizophrenia, these delusions often contain contradictions, with a lack of logical consistency, and have an unpredictable series of actions which may flow from it. The Oxford textbook of Psychiatry(1), in relation to this, quotes Eugen Bleuler thus

"Kings, Emperors, Popes, and Redeemers engage for the most part, in quite banal work, provided they still have any energy at all for activity".

The result of these is that affected individuals display bizarre, erratic behaviour. Their speech often becomes rambling and incoherent, as they exhibit a 'loosening of associations' in their thought processes. Negative symptoms, like depression, withdrawal and a lack of motivation often predominate. People around them become increasingly baffled and worried. Fortunately current anti-psychotic medication, and services to improve social functioning, can return people to a normal and fulfilling life. The diagnosis 'Schizophrenia' is less commonly used, especially early on, since it is difficult to predict the course of the illness, and patients do not necessarily benefit from having a stigmatising label applied to them.

This can all obviously be incredibly distressing. I write the above because I find it all very fascinating, and because it is so poorly understood, even within the medical profession. My work with Early Intervention has brought me in touch with all kinds of people from a wide range of demographics, but in this case all young, often around the age of 17 and going through stressful life adjustments.

Perhaps another similarity with these young people is that many of them have smoked Cannabis heavily. It is difficult for people to understand what a serious problem this is, especially since it is a drug so commonly consumed at schools, colleges and universities. An initial study(2) suggested that those with a strong history of Cannabis use, especially in early adolescence, are up to 6 times more likely to develop the illness. Since about 1% of the population will suffer from psychosis at some point in their life, this is not a negligible risk. More importantly, those with the illness can relapse suddenly upon exposure to Cannabis, and it is often a factor in delayed recovery. This should come as no surprise, since Cannabis increases levels of Dopamine in the brain, which is the biochemical process believed to be most associated with Schizophrenia, and the target of most therapeutic drugs (which incidentally have much fewer side-effects than was previously the case).

It always astonishes me the sort of social pressures which impede the practice of Psychiatry. Rather than a noble and respected profession, it is often seen by outsiders as a threatening and arrogant speciality. In my experience Psychiatrists are the most thoughtful, friendly, and intuitive doctors around. Their communication skills are superb, and indeed have to be, since they are the only real diagnostic tools available. I see two social pressures to predominate: anti-Paternalism (and accompanying medical consumerism) and so-called human rights arguments. Perhaps I will expand upon these observations another time, but for now I just wanted to focus on the experience of mental illness, in particular one as devastating as psychosis. There is a tendency for people to view these patients with suspicion and apprehension, and to alienate them further. However, what they really need is to be valued and loved in the way Jesus instructed us. A great saint summed it up thus:

When her mother reproached her for caring for the poor and sick at home, Saint Rose of Lima said to her: "When we serve the poor and the sick, we serve Jesus. We must not fail to help our neighbours, because in them we serve Jesus."
Catechism of the Catholic Church 2449

We can therefore see in our brethren Christ himself, and be moved to compassion by hearing Christ say: "As long as you did it to one of these my least brethren, you did it to me." (St Matthew's Gospel 25:40)

Mental illnesses are like any other disease in that they have physical and psychological aetiology; we must not think they are due purely to social or spiritual factors, as important these are in any illness. We must certainly not think that something like psychosis is a manifestation of demonic activity; I hope very much that this sort of opinion is cast firmly aside. Yes, demonic possession does exist - but mental illness is something discrete and always to be excluded by a diocesan investigation. Ultimately though, amongst the indispensable drug treatment and psychological interventions, spiritual remedies will always be welcome. In a sense, Psychiatry is the one area of medicine where all components of the human being meet, and the scope is thus endless.

References:
1. Gelder M et al. Oxford Textbook of Psychiatry. Oxford University Press: 2000
2. Zammit S, Allebeck P et al. Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. BMJ 2002;325:1199

HHS Proposed Regulations to Protect the Conscience Rights of Health Care Providers

2008-08-26T18:12:00.001-07:00

This is from the Priest for Life website.

The United States Department of Health and Human Services has publicized new proposed regulations to protect the conscience rights of health care providers. They are inviting comments from the public from now through September 19, and we ask you to do so today!

The HHS press release announcing this is at http://www.hhs.gov/news/press/2008pres/08/20080821a.html

Comments can be submitted at http://www.Regulations.gov or via e-mail to consciencecomment@hhs.gov.

“Many health care providers routinely face pressure to change their medical practice – often in direct opposition to their personal convictions,” said HHS Assistant Secretary of Health, Admiral Joxel Garcia, M.D. “During my practice as an OB-GYN, I witnessed this first-hand. But health care providers shouldn’t have to check their conscience at the hospital door. This proposed rule will help ensure that doesn’t happen.”

Be sure to register your comments with HHS.

Welcome!

2008-08-20T11:36:00.000-07:00

Catholic Physicians' Blog welcomes Matthew Doyle who blogs at http://www.lacrimarum-valle.blogspot.com/. Welcome Matthew. Love your blog!

The Saint Song

2008-07-18T14:51:00.000-07:00

As a child of the 60's, 70's, and beyond, I remember hearing Tom Lehrer belt out tunes on albums from "Wehrner von Braun" to "The Vatican Rag" to "National Brotherhood Week." One of those memorable ditties was "The Elements Song," in which Tom went through all of the known elements up to that time sung to the tune of Gilbert & Sullivan's, "I am the very model of a Modern Major General."

The trials and tribulations of the Saints and how they sought and achieved holiness has been an interest of mine for quite some time, especially those Saints that we as physicians look to for patronage - Luke, Cosmas and Damien, Pantaleone, etc. I thought of a way recently to introduce others to the Saints, in a "Lehrer-esque" manner. This is the result. Hope you like it.

2008-05-21T18:41:00.001-07:00

The Path to Euthanasia

2008-02-27T16:24:00.000-08:00

A recent medical study cast doubt on whether antibiotics should be administered to patients in the advanced stages of dementia. The argument is that it doesn't improve the "quality of life" and that it increases the likelihood of creating super- resistant bacteria which the nursing home resident then brings to the hospital when they get admitted.
As a geriatrician with a practice in skilled nursing facilities, I am concerned about what message this study sends to physicians and the lay community. It is fairly clear to most physicians when a patient is dying and antibiotics are futile. It is not always clear if a patient develops a fever that this will be their terminal event. A dementia patient who spikes a temp is not necessarily moribund and a simple once a day parenteral antibiotic may help them turn the corner, if indeed it is not yet their time to go. By us witholding antibiotics are we "stacking the deck" in a way that will increase the likelihood of their dying? To me this is erring on the side of death and not life! If we are to err, let it be on the side of life, regardless of what someone determines is the "quality of life."
I see this as the tip of the iceberg and we are going to start seeing more "studies" that show the futility of medical treatments for patients with dementia and other "poor quality of life" diseases. We already have a small body of literature that suggests feeding tubes do not prolong the quality of life and as a result, ethics committees in hospitals cite these studies to deny PEG tubes to patients with advanced dementia. Now we will have ethics committees recommending the withdrawl of antibiotics if a patient with urosepsis and dementia presents to the ER with a change in mental status. Perhaps I am being an alarmist, but I don't think so. This is just another brick being layed down on the road to Euthanasia.

Holy Father: "Science Cannot Understand the Mystery of Man."

2008-01-29T17:04:00.001-08:00

Pope Benedict XVI addressed academics gathered in Rome to study the human person. The Holy Father told those in attendance:

"...the exact sciences, both natural and human, have made prodigious advances in their understanding of man and his universe". However at the same time "there is a strong temptation to circumscribe human identity and enclose it with the limits of what is known.”

“In order to avoid going down this path,” the Pontiff said, “it is important not to ignore anthropological, philosophical and theological research, which highlight and maintain the mystery of human beings, because no science can say who they are, where they come from and where they go. The knowledge of human beings is then, the most important of all forms of knowledge".

"Human beings always stand beyond what can be scientifically seen or perceived", the Pope affirmed. This failure manifests itself today in “an incapacity to recognize the foundation upon which human dignity rests, from the embryo until natural death," said the Pope.

"Starting from the question of the new being, who is produced by a fusion of cells and who bears a new and specific genetic heritage", the Holy Father told his audience, "you have highlighted certain essential elements in the mystery of man". Man, said the Pope is "characterized by his otherness. He is a being created by God, a being in the image of God, a being who is loved and is made to love. As a human he is never closed within himself. He is always a bearer of otherness and, from his origins, is in interaction with other human beings".

For those whose of you who read Italian (Paul), find the speech here (and for the rest of us an article about the speech here.)

Technorati Tags: Pope,Benedict,XVI,science,human,man,humanity

The American College of Obstetricians and Gynecologists and Medical "Ethics"

2008-01-16T17:44:00.000-08:00

A rather disappointing position from another professional organization. According to Renew America:

The political effort to protect so-called reproductive medicine has led ACOG to the conclusion, according to its Committee on Ethics, that even when healthcare providers have moral concerns about a decision a patient has made, they may not allow those concerns to translate into a refusal to provide a "service" or a prescription to that patient.

If one examines this premise and the committee's language, it becomes painfully clear that the target for the statement is the Christian medical community. For example, in the ACOG statement, we find the following:

When conscientious refusals conflict with moral obligations that are central to the ethical practice of medicine, ethical care requires either that the physician provide care despite reservations or that there be resources in place to allow the patient to gain access to care in the presence of conscientious refusal.

Unfortunately this is yet one more example of a professional organization
which has become so politicized and "PC" that it is but a shadow of its
historical self and mission. I would suggest that one would be hard pressed to
justify membership in the ACOG if one is serious about one's Catholic
faith.

Welcome to Sabin

2008-01-15T18:57:00.000-08:00

Welcome to Sabin, our newest member. If you have a blog or web site, Sabin, send me the address and I will blogroll it. We're glad that you are with us and look forward to your posts.

Peace.

More on Being a Burdon

2007-12-29T18:12:00.001-08:00

For some reason, the "comments" function is not working and I'd like to make a few comments on John's thoughtful post.

Many patients who voice this kind concern with being a "burden" are, in my view, suffering from depression and I am quick to recommend these patients for consultation for depression.
However many are really saying that they do not want to suffer. They do not want to suffer loneliness or suffer dependence on others for their needs. They may fear physical pain.

It may be difficult, but if I know a patient is Catholic (and I will inquire about my patients' faith when they voice such a comment) it is useful to remind them that they can unite their suffering with that of Christ and share in His redemptive suffering. Salvifici Doloris, JPII's wonderful encyclical on suffering, is helpful in this regard (and well worth re-reading occasionally.)

I will generally also discuss why it may be important for the patient to "allow" the family to care for them. How this submission to dependency may be an opportunity to teach love to one's children and grandchildren. My mother, with her own eight children, welcomed her father and her mother-in-law into our modest home and provided to us, her children, an example of what it means to love. I am much richer because my grandparents "allowed" themselves to "burden" my mother. They were able to temper pride in order to become dependant.

I once had an old nun tell me that the engine of the Church, the spiritual energy of the Church, was the millions of old people continuously praying--praying the rosary, praying the Divine Chaplet, praying the hours, praying the daily Mass. Remind your patients that they can use this station in their life to enrich the Body of Christ through their prayers.

On Being a Burden

2007-12-19T15:47:00.000-08:00

"Doc, I just don't want to be a burden to my family."

The patient was in his 80's and suffering from the usual mixture of heart disease, arthritis, prostate cancer, etc. He lives with his wife--both very proud, independent Yankees. Over the years, as I have served as his family physician, Tom (not his real name) has often expressed anxiety about growing old and being unable to care for himself. He is a nominal Christian with no firm faith in life after death, no hope in heaven or fear of hell--"A loving God could never send anyone to hell forever."

As I listened to Tom talk, I thought to myself, "You are not a burden, but a blessing!" I tried to explain, but Tom replied, "I just sit around all day--I don't have the energy to do anything useful." How could I open a window to another perspective on his situation?

This idea that the aged, the infirm, the disabled, the unborn could be a burden is so pernicious in our society. Tom is thoroughly convinced that as he becomes less and less productive, he becomes more and more ready for the rubbish pile. What effect could my few words have against such an onslaught from the Culture of Death? We all seem to judge our value by what we do, by our productivity. The notion that a person has inherent value as a human being has slipped away. We have become "human doings" rather than "human beings".

Tom, "Do you have any children?"--I knew he had several children and grandchildren, but asked anyway. "What did you think about your newborn son, Samuel, when you first saw him?" "Why, I thought he was the most wonderful thing I had ever laid eyes on!" replied Tom with enthusiasm. Gently I asked, "That first day, could Samuel do anything useful?" Tom smiled and for an instant I think a window opened. I pray the Lord will hold that window open as the days and infirmity of age progresses.

As Catholic physicians we've all heard someone say, "Doc, I just don't want to be a burden." What would you say? Have you found any useful ways to respond to this dark perspective on the life we have all been given?

"Catholic Church must withdraw from involvement in frontline healthcare here in the UK"

2007-12-11T16:26:00.001-08:00

Catholic moral teaching is again butting heads with human secularist in the UK. Cormac Cardinal Murphy O'Connor, head of the Catholic church in England and Wales, has insisted that Catholic hospitals (can you believe) abide by Catholic teaching in certain medical situations. From LifeSite:

Two members of the board of directors of a London Catholic hospital have resigned in the face of the hospital's decision to adopt a Catholic code of ethics. After an investigation, instigated at the request of the Vatican, it was revealed that the hospital violated Catholic moral principles by referring for abortions, dispensing contraceptives and performing sterilizations. The hospital was also suspected of carrying out the surgical and chemical mutilations known popularly as "sex-change" operations.

And of course there is no tolerance from the left where the "right" to abortion and sexual license are stake.

Last month, Dr. Scurr reiterated his stand that, because of its dedication to classical medical ethics and refusal to adopt the utilitarian pro-abortion mentality, the Church should abandon its centuries-long dedication to health care in Britain.

"As I have said repeatedly," he said, "we are now in an era where the Catholic Church must withdraw from involvement in frontline healthcare here in the UK, as it appears to be unable to reach the degree of tolerance that has been reached elsewhere in the world."

Saying the adoption of the Catholic ethics code placed "Catholic values" above patient care, Scurr said, "In the matter of modern medical care the cardinal has chosen to listen to individuals who have no specific expertise in that arena. The damage to the church will be worse if the hospital closes, unless he chooses to withdraw his patronage."

Expect increasing pressure from secularists against Catholic social institutions that refuse to cooperate with the secularist agenda. Case in point; the Boston Archdiocese has opted out of providing adoptive services because they refuse to place children in homes of homosexual couples.

The intolerance of the left is staggering.

Vaccines and the Catholic Physician

2007-12-06T18:54:00.000-08:00

Lately I have been approached by a few patients who are questioning my use of vaccines which are "made from cells from aborted babies." When I was first approached about this, I immediately sought the wisdom of Holy Mother Church as to what my responsibility as an orthodox Catholic physician was. I think the people disseminating information about the use of vaccines should research what "descendant cells" are before they start shouting that certain vaccines "come from aborted babies."

Information on what the Church teaches about the morally acceptable use of vaccines produced in descendant cells can be found here.

British Catholic Hospitals Take Moral Stand

2007-11-29T18:03:00.001-08:00

From the other side of the pond:

London, Nov 28, 2007 / 12:00 pm (CNA).- A Catholic hospital favored by British celebrities has barred its doctors from making abortion referrals or providing contraceptives, the Daily Telegraph reports.

The board of the private St. John and St. Elizabeth Hospital voted to implement a new code of ethics advocated by Cardinal Cormac Murphy-O'Connor, the Archbishop of Westminster.

In a letter to the hospital earlier this year, the cardinal said: "There must be clarity that the hospital, being a Catholic hospital with a distinct vision of what is truly in the interests of human persons, cannot offer its patients, non-Catholic or Catholic, the whole range of services routinely accepted by many in modern secular society as being in a patient's best interest."

Of course taking a righteous stand in the secular world usually results in various intimidations and threats.

Hospital insiders claim staff who opposed the code may resign. The hospital could face financial troubles if it must abandon plans to lease part of its site to National Health Service physicians, who are obligated by contract to offer contraceptive services.

On Human Life

2007-11-26T18:00:00.000-08:00

In flipping through this blog I notice that there is nothing from Archbishop Chaput. Here's a wonderful pastoral letter he wrote on Humanae vitae some years ago. Thank God for the Archbishop--his faithfulness has been a real encouragement. Here's a snippet:

Sooner or later, every pastor counsels someone struggling with an addiction. Usually the problem is alcohol or drugs. And usually the scenario is the same. The addict will acknowledge the problem but claim to be powerless against it. Or, alternately, the addict will deny having any problem at all, even if the addiction is destroying his or her health and wrecking job and family. No matter how much sense the pastor makes; no matter how true and persuasive his arguments; and no matter how life-threatening the situation, the addict simply cannot understand -- or cannot act on -- the counsel. The addiction, like a thick pane of glass, divides the addict from anything or anyone that might help.

One way to understand the history of Humanae Vitae is to examine the past three decades through this metaphor of addiction. I believe the developed world finds this encyclical so hard to accept not because of any defect in Paul VI's reasoning, but because of the addictions and contradictions it has inflicted upon itself, exactly as the Holy Father warned.

Profile of the Catholic Teacher of Medicine

2007-11-25T14:34:00.001-08:00

by Cardinal Javier Lozano Barragan

President of the Pontifical Council for Health Care MinistryReally [an excerpt--for the full article see www.catholicculture.org/library/view.cfm?recnum=7816]

Consequently, the physician should realize that health is complexive and bodily health should not be talked about as something radically different from the complete health that we call eternal health or salvation. The physician's ministry is therefore an ecclesiastic ministry which is directed toward the salvation of man from his body, but which involves other aspects.

We thus describe health as a dynamic tension toward physical, mental, social and spiritual harmony and not just the absence of disease, which prepares men to carry out the mission with which God has entrusted them, in accordance with the stage of life at which they are.
The physician's mission is therefore to ensure that this dynamic tension toward complete harmony exists, as required at each stage of the life of this specific man who is their patient, so that they can carry out the mission with which God has entrusted them. Thus, the contradiction of reducing the medical function to the single physical and chemical aspect of the disease. This function is complete and moreover cannot be static, but rather should be inserted within the dynamism of the patients who tend toward their own harmony.

In this context, death is not a frustration for the physician, but rather a triumph, as they have accompanied their patient in such a way that they have been able to use their talents to the full at each stage of their life. When it has reached its end, the medical function ends, not with a cry of impotence, but rather with the satisfaction of a mission fulfilled, both by the patient and by the physician.

Thus, the physician truly is with Christ and their profession is identified in this communion with Christ, and then the physician joins together with our Father God like a son with his father, and their professional love becomes the action of the Love of God in himself, which is the Holy Spirit. A Christian physician is therefore one who is always guided by the Holy Spirit. From the Holy Spirit and with the Holy Spirit is all the sympathy that must exist between the physician and the patient, all the due humanization of medicine and all the demand for updating and lifelong learning, as the Love of the Holy Spirit makes the physician an essentially open person for the rest, as they are obliged to do so before God because of their profession of Faith represented by their medical profession.

[Many thanks to Rich for starting this blog. As a Catholic family physician it's great to have such a forum. I am posting this excerpt from an article I ran across recently. Cardinal Barragan's comments are very challenging and inspiring. He reminds me that we can only pursue this vocation, and vocation it is, with Christ. Would that I were more consistent and faithful in walking "with Him" into the exam room and the hospital bedside! I would welcome your comments/feedback.]

Welcome

2007-11-25T06:42:00.000-08:00

Welcome to our newest Catholic Physician blogger, John. We look forward to your posts! John, if you have a website or blog, let me know and we can add it to the Blogroll.

I once had privileges here:

2007-11-19T19:16:00.000-08:00

Cross-posted at Scorpion Stalking Duck

MD's Poorly Trained in God Therapy

2007-11-17T14:06:00.001-08:00

According to the UPI:

Almost half of the pediatric physicians surveyed at 13 elite U.S. hospitals see themselves as very or moderately spiritual or religious.

Researchers at Brandeis University in Waltham, Mass., and the University at Buffalo conclude these doctors are open to connecting with patients and their families but lack the professional training on how to do so.

The survey of 74 pediatric hematologists and oncologists at "honor roll hospitals" ranked by U.S. News & World Report found 47.3 percent described themselves as very or moderately spiritual and only 13.5 said they were not at all spiritual. However, only 40 percent thought their spiritual or religious beliefs had any influence on their interactions with families, patients and colleagues.

Thirty-one percent of those surveyed said they were raised Protestant; 25.7 percent Catholic; 25.7 Jewish, and 10.8 percent other.

Humorous Journal Article

2007-10-31T21:33:00.000-07:00

Here is a link to another blog of mine, which then links you to an article from the British Medical Journal. The article applies the concept of evidence based medicine to what appears to be a 'no-brainer' intervention.

Enjoy....

Pope Calls for Conscientious Objection by Pharmacists

2007-10-31T16:23:00.001-07:00

The Holy Father has weighed in on the controversy concerning Catholic pharmacists dispensing contraceptives and abortifacients.

Vatican, Oct. 29, 2007 (CWNews.com) - Catholic pharmacists should not be involved in the distribution of drugs designed to cause abortion or euthanasia, Pope Benedict XVI (bio - news) said on October 29.

In a short talk to members of the International Federation of Catholic Pharmacists, the Holy Father urged the group to be sensitive to "the ethical implications of the use of particular drugs."

Specifically, the Pope said, "we cannot anesthetize consciences as regards, for example, the effect of certain molecules that have the goal of preventing the implantation of the embryo or shortening a person's life."

Catholic Physicians Encouraged To Apply Their Faith

2007-10-28T08:21:00.000-07:00

From Archbishop Wilton D. Gregory in Atlanta:

ATLANTA—Archbishop Wilton D. Gregory reminded Catholic physicians and healthcare workers attending the 76th annual Catholic Medical Association conference that they should strive to be “Catholic first” in a profession that often challenges church wisdom.

Long-held classical and biblical ideals of reason and freedom have been “trumped” by modern notions of “self-determination” and “self-creation,” “deeply invad(ing) the medical profession in our culture,” explained Archbishop Gregory in closing remarks to about 300 doctors, nurses and other healthcare professionals from the United States, Canada, Chile and Zimbabwe gathered in Atlanta for the conference held Oct. 3-6 at the JW Marriott Hotel in Buckhead.

From the Catholic perspective, “our freedom finds itself in surrender to the objectivity of the values that God has placed within the body and within nature,” he said.

Womens' Conference Assailed for Pro-abortion Tilt

2007-10-23T11:27:00.000-07:00

From EWTN News:

The global conference Women Deliver failed in its objective of finding ways to reduce maternal mortality and morbidity, reported various participating humanitarian organizations dedicated to the woman, family and the protection of life.

Several participating agencies objected to the pro-abortion agenda:

The letter's signatories noted that numerous U.N. reports, such as "The World's Women 2005: Progress in Statistics," "have concluded that accurate data about maternal mortality, including abortion, are not available, especially for the developing world. Therefore, the presentation of unsubstantiated and unreliable data on illegal abortion as fact can only be seen as a deliberate attempt to mislead the conferees and the international community."

"To assert that 'unsafe abortions' are only those that are illegal, and to subsequently imply that legal abortion is therefore safe, is both disingenuous and scientifically flawed," they wrote. "The consistent assertions that improvements in the maternal mortality rate are dependent on the promotion of legal abortion not only diverts attention from the urgent need for basic heath care, skilled birth attendants and emergency obstetrics, it threatens to undermine the field of obstetrics and gynecology if implemented on a wide scale."

The letter concludes with a call to "the conference partners to focus on basic health care, skilled attendants and emergency obstetrics, which have been the key to decreasing maternal mortality in the developed world, instead of exploiting the tragedy of maternal mortality to promote abortion rights."

Failure of Sex Ed in California

2007-10-20T12:17:00.000-07:00

According to EWTN News:

According to a study published last month in the Californian Journal of Health Promotion, there were 1.1 million new cases of sexually transmitted infections (STIs) among young Californians in 2005, the California Catholic reports.

The figure is ten times higher than previously believed. If the study is accurate, diseases such as chlamydia, gonorrhea, syphilis, HPV, and HIV now infect almost one out of four Californians in the 15-24 age group.

The authors believe that their figures are underestimated because of incomplete screening of sexually active young people and failures in follow-up testing.

The California Department of Education reports that 96 percent of California school districts provide comprehensive sexual health education. All California schools have been required to teach HIV/AIDS prevention since 1992.

Linda Klepacki, sexual health analyst for Focus on the Family Action, thought the dramatic increase was unsurprising. "California has insisted on teaching contraceptive-based sex education in their schools all along. They expect teens to be sexually active. They don’t raise the health standard to abstinence… It's clear California supports sexually active teens, and STI rates will naturally explode with these policies," she wrote in an on-line press release.

Plan B, the so-called "morning-after pill," could be another factor contributing to the increase in STIs. Sexually transmitted infections soared in the British Isles when Plan B was made available without prescription in 2000. California was one of the first states to permit the sale of Plan B over-the-counter without an age limit.

More on Connecticut and Plan B

2007-10-06T13:56:00.000-07:00

The National Catholic Bioethics Center has issued a statement regarding the Connecticut bishops' decision regarding "Plan B" in Catholic hospitals.

NCBC Statement on Connecticut Legislation
Regarding Treatment for Victims of Sexual Assault

October 3, 2007

Recently the Bishops of Connecticut permitted a protocol in Catholic hospitals for the treatment of victims of sexual assault. This action on the part of the Connecticut bishops received national attention and requires some commentary. This is a complex moral matter and does not lend itself to brief explanation. This difficulty was rendered all the worse by inaccurate reporting and inappropriate, indeed misleading, terminology.

Catholic hospitals have always provided contraception for the victims of sexual assault. This was usually done with a medication or medications which would prevent ovulation. If an egg is not released from the ovary, the victim cannot become pregnant. There was a difficulty here, however, because some medications appear to have a negative effect on the lining of the womb that might prevent an implantation of a new human embryo if one is engendered as a result of the assault. This would amount to an early medical abortion that would not be allowed.

In light of these facts, two protocols were generally developed and approved by bishops. One protocol allowed for no use of a medication for contraceptive purposes because it might have an abortive effect.

Another more commonly used protocol tried to take into account the variety of circumstances surrounding a sexual assault in such a way as to allow the use of a contraceptive medication – if it truly worked as a contraceptive.

The document concludes:

In matters that have not yet been decided definitively by the Holy See, The National Catholic Bioethics Center has refrained from adopting one or another position on a disputed question. However, in the matter of protocols for sexual assault, there is virtual unanimity that an ovulation test should be administered before giving an anovulant medication. The protocol the NCBC has supported requires the ovulation test because it provides greater medical and moral certitude that the intervention will have its desired anovulatory effect. The NCBC objects strongly to state mandates, such as those passed by Connecticut and Massachusetts, that do not allow health care professionals and facilities to exercise their best medical judgment and which do not protect the consciences of all parties. We also object to state mandates that do not allow the victim of sexual assault to have all the information necessary for a medical intervention so that she might make an informed judgment. However, the NCBC understands the judgment of the Connecticut bishops that the administration of a contraceptive medication in the absence of an ovulation test is not an intrinsically evil act. However, it is immoral to violate one’s conscience, including the corporate consciences of health care agencies, and the unwillingness of the state to allow an exemption of conscience makes the law unjust and onerous.

Did You Take The Hippocratic Oath?

2007-10-03T18:40:00.000-07:00

You may have taken the unadulterated oath when you graduated, but medical school graduates today may opt to "improve" upon the ancient wisdom. According to Second Hand Smoke, today the oath has been watered down to accommodate today's medical "ethics."

When I tell lay audiences that most doctors no longer take the Hippocratic Oath, which clears the way to permit some to engage in (now formerly) unprofessional acts (e.g., sex with patients) and still call themselves ethical, they are stunned and appalled. They know that the Oath was one of their best protections against abuse. Too bad Conis can't understand that simple truth and apparently embraces the ongoing deconstruction of professionalism that is afflicting our society in medicine, science, law, journalism, academia, and other areas of important endeavor.

More on Connecticut Bishops and "Plan B"

2007-10-02T15:52:00.000-07:00

From LifeNews.com:

In an interview with LifeSiteNews.com Feldman [spokesman for the bishops] displayed a fundamental error in thinking around Plan B. He suggested that the "morning after pill" which was condemned by the Pontifical Academy for Life in 2000 was entirely different from "emergency contraception" such as Plan B which was now being permitted in Catholic hospitals for rape victims after the administration of a pregnancy test.

Asked if he was familiar with the Vatican document issued in the year 2000 on the Morning After Pill, Feldman responded, "Yes I am."

That document available from the Vatican website ( here: http://www.vatican.va/roman_curia/pontifical_academies/acdli...; ) refers to the morning after pill as "a well-known chemical product (of the hormonal type) which has frequently - even in the past week - been presented by many in the field and by the mass media as a mere contraceptive or, more precisely, as an 'emergency contraceptive', which can be used within a short time after a presumably fertile act of sexual intercourse."

The Pontifical Academy for Life voiced a clear prohibition on the use of the morning after pill. "Consequently, from the ethical standpoint the same absolute unlawfulness of abortifacient procedures also applies to distributing, prescribing and taking the morning-after pill," said the document. "All who, whether sharing the intention or not, directly co-operate with this procedure are also morally responsible for it."

Seems to me that if the bishops believe that they are correct on this issue, they should be out front addressing the "flock." Gentleman, with all due respect, get a spine.

Catholic hospitals to follow Plan B law

2007-09-28T08:49:00.000-07:00

From the newsobserver.com:

HARTFORD, Conn. - Roman Catholic bishops in Connecticut have agreed to let hospital personnel give emergency contraception to all rape victims, reversing their decision days before a new state law requires it.
The church, which runs four of the state's 30 hospitals, had fought the state law requiring medical personnel to give rape victims emergency contraception, sold as Plan B, even if the women are ovulating.

Church officials had said the treatment was tantamount to abortion and had been considering legal action, but they took a step away from that position Thursday, in a joint statement by the Catholic Bishops of Connecticut and leaders of the Catholic hospitals.

The hospitals will be allowed to provide Plan B without ovulation tests "since the teaching authority of the church has not definitively resolved this matter and since there is serious doubt about how Plan B pills work," the statement reads. "To administer Plan B without an ovulation test is not an intrinsically evil act."

Bad news. I'm afraid that this is the thin edge of a wedge.

Notice of posts elsewhere

2007-09-27T18:26:00.000-07:00

Here is a post where I talk about Saints Cosmas and Damian. I also comment on the modern physician.

In the previous post, I commented on why I would not recommend that my daughters go into medicine.

Have a great night!

EU Court Rules Poland Must Pay For Not Aborting Child

2007-09-27T14:37:00.000-07:00

Poland, a country where the Catholic Church plays a major role in social policies, has been forced to pay a woman who could not receive an abortion and suffered and "eye hemorrhage." From the KaiserNetwork:

The European Court of Human Rights on Monday upheld a ruling that ordered the Polish government to award damages to a Polish woman who says that in 2000 she was denied an abortion despite warnings from physicians that she could become blind if she continued the pregnancy, the Irish Times reports (Irish Times, 9/25).

Alicja Tysiac alleges that Poland's abortion law violated her rights under Article 8 and Article 14 of the European Convention for the Protection of Human Rights and Fundamental Freedoms, which guarantee "respect for privacy and family life" and "prohibition of discrimination," respectively. Polish law allows abortion only if a woman has been raped, if there is danger to the life of the woman or if the fetus will have birth defects. Three ophthalmologists in February 2000 told Tysiac she would go blind if she were to give birth to a third child. None of the doctors would refer her for an abortion procedure.

In April 2000, Tysiac had an appointment at a public hospital in Warsaw, Poland, where a gynecologist said there was no medical reason to have the procedure. Tysiac gave birth via caesarean section in November 2000. After her c-section, Tysiac experienced a retinal hemorrhage. Since then, "a panel of doctors concluded that her condition required treatment and daily assistance and declared her to be significantly disabled," court documents said.

Kids Medical "Rights" in the UK

2007-09-27T13:32:00.000-07:00

Yet another example of governmental efforts to separate children from their parents:

Parents taking their children to the doctor could be asked to let them be seen alone under guidelines issued today.

For the first time doctors have been ordered to "respect the rights" of children to make decisions for themselves and refuse treatment if they wish.

Official guidance from the General Medical Council says doctors should treat children confidentially and inform them of their right to a private consultation.

It applies to all 240,000 doctors - not just GPs - and is aimed at improving medical care for children and teenagers.

Sts. Cosmas and Damian

2007-09-26T15:50:00.000-07:00

Sts. Cosmas and Damian were twin brothers who were physicians from Arabia. As Christians they practiced medicine with great kindness and charity and never accepted money for their services. They were martyred about the year 287 during the persecution of Diocletian. In the eastern Church they are called the Holy Unmercenaries. They are patrons of physicians and surgeons as well as pharmacists.

Grant, we beseech thee, Almighty God that we, who observe the heavenly birthday of blessed Cosmas and Damian, thy Martyrs, may by their intercession be delivered from all evils that beset us. Through our Lord Jesus Christ, Thy Son, Who liveth and reigneth with Thee in the unity of the Holy Spirit, one God forever and ever. Amen.

Sts. Cosmas and Damian, ora pro nobis.

Physicians View Religiosity as Factor in Patients' Health

2007-09-26T15:49:00.000-07:00

You can influence the suffering of your patients. From Medical News:

CHICAGO, April 10 -- A majority of physicians in a large survey declared that religion and spirituality, including divine intervention, affect their patients' health.

The survey of more than a thousand practicing physicians found that 56% believe religion and spirituality have a significant effect on health, researchers reported in the April 9 issue of the Archives of Internal Medicine.

It goes on:

Compared with those with low religiosity, highly religious physicians were substantially more likely to report that patients often mention spiritual issues (36% versus 11%; P<0.001).

They were also more likely to believe that religion and spirituality strongly influence health (82% versus 16%; P<0.001), and to interpret the influence of religion and spirituality in positive rather than negative ways, the researchers found.

These associations persisted in multivariate analyses that controlled for religious affiliation, region of practice, age, sex, ethnicity, and specialty.

Catholic Teachers in Medicine

2007-09-26T15:42:00.000-07:00

Here is the text of an message written by Cardinal Javier Lozano Barragán, the president of the Pontifical Council for Health Care Ministry on the profile of the Catholic teacher of medicine. In part:

If the professor of medicine is a Catholic, then this transcendence and this victory over death are not merely beautiful desires which, for many, in our secularized culture, do not go beyond good intentions and palliatives for the failure of death, but rather they are based on the same reality of an irrefutable historical event, the resurrection of our Lord Jesus Christ.

On professing this faith, the teacher of medicine becomes a triumphant professor. He and his students advance toward medical culture with the certainty and the joy of knowing that the progress in health science is a foretaste of the full health that they will find for themselves and for their patients in the resurrected Christ.

It is obvious that this is incomprehensible for those who do not profess this faith. For a physician who does not have faith in Christ and in his Church, nothing here means anything, and rather it is something absurd which would appear to be for ignorant and mad people as it goes against the biological experimental knowledge which they believe to be the only one valid in medicine: "evidence-based medicine." However, here is another type of evidence, even stronger than laboratory evidence, the evidence of a faith based on an irrefutable fact which is reached for the same reason, but which arises from a free and firm decision of the will of each person. St Paul already said that the announcement of a crucified Messiah was offensive for the Jews and madness for the Gentiles, but it is much wiser than all human wisdom, and what may seem to be weakness in God, is stronger than all human strength (1 Corinthians 1:23-25).

Catholic Physicians Stand as Targets

2007-09-18T18:11:00.000-07:00

Here's a bit from the California Catholic Daily regarding physicians who practice medicine in a way consistent with their faith. And they have become targets of those who promote pagan values.

Nationwide, "doctors are becoming more assertive in refusing to treat patients for religious reasons,” said an Aug. 2 USA Today story. Even in California, where two doctors face a lawsuit from a lesbian refused fertility treatment, some doctors are taking a stand for conscience.

But one doctor, George Delgado, is concerned about the future of medical practice for physicians who have such convictions. Delgado, a Family Practice/OB Gyn physician, is the Medical Director at Culture of Life Family Services, a non-profit medical clinic devoted to offering medical help with a Catholic perspective. It is located in San Diego’s Hillcrest neighborhood – a name synonymous with the homosexual lifestyle.

Delgado has practiced for 16 years and has never performed an abortion, although he admits that he once prescribed artificial contraceptives. He says a deeper conversion to his own Catholic faith led him to stop prescribing them: “After reading Humanae Vitae, I was resolved to always practice according to the Church’s teachings.”

Physicians in California and elsewhere may soon lose the right to practice according to their ideals. Two such doctors, Christine Brody and Douglas Fenton, both OB/Gyns at North Coast Women’s Care in Vista, California, are being sued by a former patient who is angry that Brody would not artificially inseminate her because she was a lesbian. The case is yet to be heard by the state Supreme Court. In 2003, the fourth district state appeals court ruled against the physicians

Here's the agenda. Accept, embrace and promote our values over yours or we'll sue you too. Yes, the left is clearly the "tolerant" ideology, isn't it. (Sorry, couldn't help the rant.)

Additional Vatican Commentary Concerning Care of Those in a "Vegetative State"

2007-09-18T08:49:00.000-07:00

Here is additional commentary from the Congregation for the Doctrine of the Faith in regard to USCCB inquiries regarding the treatment of those in a "vegetative state." In part:

2) In response to those who doubt the “human quality” of patients in a “permanent vegetative state”, it is necessary to reaffirm that “the intrinsic value and personal dignity of every human being do not change, no matter what the concrete circumstances of his or her life. A man, even if seriously ill or disabled in the exercise of his highest functions, is and always will be a man, and he will never become a ‘vegetable’ or an ‘animal’” (no. 3).

3) “The sick person in a vegetative state, awaiting recovery or a natural end, still has the right to basic health care (nutrition, hydration, cleanliness, warmth, etc.), and to the prevention of complications related to his confinement to bed. He also has the right to appropriate rehabilitative care and to be monitored for clinical signs of possible recovery. I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, to the extent to which, and for as long as, it is shown to accomplish its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering” (no. 4).

Concerning the Care of Patients in a "Vegetative State"

2007-09-15T15:00:00.000-07:00

The Congregation for the Doctrine of the Faith has responded to certain questions that have arisen regarding the care of patients in a "vegetative state."

RESPONSES TO CERTAIN QUESTIONS
OF THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS
CONCERNING ARTIFICIAL NUTRITION AND HYDRATION

First question: Is the administration of food and water (whether by natural or artificial means) to a patient in a “vegetative state” morally obligatory except when they cannot be assimilated by the patient’s body or cannot be administered to the patient without causing significant physical discomfort?

Response: Yes. The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented.

Second question: When nutrition and hydration are being supplied by artificial means to a patient in a “permanent vegetative state”, may they be discontinued when competent physicians judge with moral certainty that the patient will never recover consciousness?

Response: No. A patient in a “permanent vegetative state” is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means.

The Supreme Pontiff Benedict XVI, at the Audience granted to the undersigned Cardinal Prefect of the Congregation for the Doctrine of the Faith, approved these Responses, adopted in the Ordinary Session of the Congregation, and ordered their publication.

Rome, from the Offices of the Congregation for the Doctrine of the Faith, August 1, 2007.

William Cardinal Levada
Prefect

Angelo Amato, S.D.B.
Titular Archbishop of Sila
Secretary

Welcome!

2007-09-13T05:36:00.000-07:00

Catholic Physicians Blog welcomes Paul, who podcasts at Saint Cast. Welcome and we look forward to your contributions.

Psychiatrists and God

2007-09-11T17:48:00.000-07:00

From MSNBC:

Psychiatrists are the least religious of all physicians, a nationwide survey reveals.

The study, published in the September issue of the journal Psychiatric Services, also found that religious physicians are more likely to refer patients to a clergy person than a psychiatrist or psychologist.

"Something about psychiatry, perhaps its historical ties to psychoanalysis and the anti-religious views of the early analysts such as Sigmund Freud, seems to dissuade religious medical students from choosing to specialize in this field," said lead study author Farr Curlin, an assistant professor of medicine at the University of Chicago.

Organ Donation

2007-09-11T17:40:00.000-07:00

Here's and interesting piece by a physican concerning the ethics and practice of organ donation and the Church's call for the ethical harvest of organs. Dr. John B. Shea, MD, FRCP(C) writes:

Organs are obtained from an unconscious patient after he or she has been called “brain dead” using clinical and technologically acquired information, regarded as diagnostic. The public in general is not aware of the following serious criticisms of
this kind of organ harvesting.
The theory of brain death is highly controversial and can be used for utilitarian purposes.4 The Pontifical Academy of Sciences declared brain death to be “the true criterion for death” in 1985 and again in 1989. However, in February of 2005, Pope John Paul II called for more precise means of establishing that the donor is dead before vital organs are removed. Organ transplants, he continued, are acceptable only when they are conducted in a manner “so as to guarantee respect for life and for the human person.”5
The concept that whole brain death (irreversible loss of function of the cerebrum, cerebellum and brain stem) means the loss of integrated organic unity in a human being has been subjected to a powerful critique by neurologist Alan Shewmon.6 Some physicians question whether we can be sure the entire brain is really dead in patients declared dead in the U.S. by “whole brain,” or in the U.K. by “brain stem,” criteria.7
Neurological criteria are not sufficient for declaration of death when an intact cardio-respiratory system is functioning. These criteria test for the absence of some specific brain reflexes. Functions of the brain that are not considered are temperature control, blood pressure, cardiac rate and salt and water balance. When a patient is declared brain dead, these functions are not only still present, but also frequently active.

There is no consensus on diagnostic criteria for brain death. They are the subject of intense international debate. Various sets of neurological criteria for the diagnosis of brain death are used. A person could be diagnosed as brain dead if one set is used and not be diagnosed as brain dead if another is used.8,9,10,11

A diagnosis of death by neurological criteria is theory, not scientific fact. Also, irreversibility of neurological function is a prognosis, not a medically observable fact. There is also evidence of poor compliance with accepted guidelines of brain death.12

It's worth a read.

Digoxin for Abortion

2007-08-14T15:26:00.000-07:00

Here is some very disturbing news. Abortionists are using digoxin to induce fetal death and "miscarriage" in their rush to abort children.

Detroit, MI (LifeNews.com) -- After the Supreme Court upheld the national ban on partial-birth abortions, some abortion businesses are so desperate to continue doing legal second-trimester abortions that they are willing to put women's health at risk by misusing a drug for heart conditions to do the abortions.

The partial-birth abortion ban made it clear that abortion practitioners can't mostly deliver an unborn child before doing the abortion and killing her.

To get around the ban, they are using the drug digoxin to kill the baby inside the mother's womb and then cause the mother to miscarry the dead baby's body.

Digoxin is widely used in the treatment of various heart conditions such as atrial fibrillation, atrial flutter and congestive heart failure.

But abortion practitioners admitted to the Detroit News in various interviews that they are misusing the drug in off-label use to do the second-trimester abortions.

Renee Chelian, executive director of Northland Family Planning Centers, said the three Michigan abortion centers under that name use digoxin.

And the abortion apologist continues (blaming prolife groups for there immoral and dangerous practices):

"The woman's health has taken a back seat [because of the partial-birth abortion ban]," Chelian claimed in comments to the Detroit News. "The fetus is given an equal status as the woman. It's a horrible precedent that the woman's health and safety is not paramount."

"We have to cause fetal death," Chelian added. It is not necessary, but it is the Supreme Court telling doctors, 'This is how you do surgery.' It's really scary that the fetus has as much weight as the woman."

Good News From Illinois

2007-08-08T14:06:00.000-07:00

From LifeNews.com:

Springfield, IL (LifeNews.com) -- An Illinois pharmacist has won the first battle against Wal-Mart over whether he has to be forced to distribute the morning after pill, which can cause an abortion in limited circumstances. Beardstown pharmacist Ethan Vandersand rejected a request to fill a prescription for the drug last year.
That refusal led to disciplinary action from Wal-Mart and a civil rights lawsuit from Vandersand.

Vandersand was the only pharmacist on duty at the Wal-Mart store when a Planned Parenthood staff member seeking the Plan B drugs presented the script. The staffer eventually went to another pharmacy in town.

The lawsuit has gone before U.S. District Judge Jeanne Scott and she issued a statement this week saying that state pharmacists should have the right to refuse to dispense the Plan B drug on moral or religious grounds.

She also denied a request by Wal-Mart to dismiss the lawsuit. Scott also said she agreed with Vandersand that he is legally protected by the Illinois Health Care Right of Conscience Act which protects the conscience rights of medical professionals.

Concerning Care of the Suffering

2007-07-26T11:47:00.000-07:00

The words and writings of John Paul II provide a map for living. I love to search online libraries for the various letters and writings of the former pope. Here is a talk to a group of Catholic physicians given in 2000.

The world of suffering and pain is vast and complex. Yet it can be for the human being an opportunity for spiritual growth, opening up horizons beyond the confines of a precarious physical condition. When he is properly supported, the sick person, although aware of his own physical frailty, is often led to discover a dimension that goes beyond his own corporeity. This is why, in the medical and nursing care of patients, as well as on the boundaries of research, it is important always to keep in mind the centrality of the person, regardless of race or religion. We must bend over every sick person with loving care, following the example of the Good Samaritan.

We must never lose sight of the finality of the true good of the person; we must never yield to the temptation of a medicine and scientific progress that are without norms and values, that could be transformed into a dangerous form of "technological control" over life.

Science and Religion

2007-07-25T17:28:00.000-07:00

Here's a link to an article from Commentary Magazine by Leon Kass, former advisor to President GW Bush and one of my favorite philosophers, regarding the nature of science and its relationship to religion.

The substantive limits of science follow from certain fundamental aspects of scientific knowledge and from science’s assumptions about what sorts of things are scientifically knowable. They stem from science’s own self-proclaimed conceptual limitations—limitations to which neither religious nor philosophical thought is subject. This is not because,science being rational, it is incapable of dealing with the passionate or sub-rational or spiritual or supernatural aspects of being. It is, on the contrary, because the rationality of science is but a partial and highly specialized rationality, concocted for the purpose of gaining only that kind of knowledge for which it was devised, and applied to only those aspects of the world that can be captured by such rationalized notions. The peculiar reason of science is not the natural reason of everyday life captured in ordinary speech, and it is also not the reason of philosophy or religious thought, both of which are tied to—even as they seek to take us beyond—the world as we experience it.
Cross posted at EyeHackerBlog

The Dark Side of "Universal Healthcare"

2007-07-20T18:15:00.000-07:00

Here's a bit from across the pond:

Laura Price, 30, who worked on shows such as Big Brother and Strictly Come Dancing, was found dead in her home just hours after she had been discharged from casualty.

The evening before she died, Miss Price, from Notting Hill,
west London, had begged a junior A&E doctor for anti-seizure drugs but had been told they could only be prescribed by a neurologist. Two days earlier she had visited a specialist at Charing Cross hospital and was told she would have to wait six weeks for a brain scan. She had felt "concerned and afraid" at having to wait that length of time for a test before being treated for a recurrence of childhood epilepsy, Westminster coroner's court heard.

For all the faults of our system, can you imagine how bad things will be if there is socialized medicine in this country?

'Ethics' in End of Life Care

2007-07-15T13:32:00.000-07:00

I am new to the blog here, thanks so much for having me. I work as a geriatrician for a large hospital system in eastern Pennsylvania and am an associate professor of medicine at Penn State Medical School. I work part-time, meaning 35 hours a week, vs full time 70+ when I was in solo private practice. I am also a musician and have been performing acoustic music for most of my life. I have my own blog at Crossed The Tiber.
I had been an evangelical Christian for the past 33 years having left the Catholic Church as a young teenager not knowing who I was leaving. (Jesus in the Eucharist) I am in daily wonder of the beauty of Catholicism and in particular the wonderful tools Holy Mother Church equips us with to live out the gospel in our professional and personal lives. Regarding ethics and making end of life decisions as an evangelical physician, I flew by the seat of my pants adopting the "quality of life" mantra that had been shoved down our throats since medical school. Through the medical ethics of the Church, God is teaching me that life itself is "a good" because He has created it and quality has nothing to do with the decisions when caring for people at the end of life. 60 years ago, the Nazis were very big on the *quality of life* paradigm and started exterminating the retarded, crippled and disabled of their own race which opened the door for the final solution. My first post on this blog deals with the palliative care committees which are springing up in many hospitals including my own. Initially it seems like a positive idea, trying to guide the appropriateness of care, but in my experience they have acted as a unwelcome force to remove basic care from patients who are deemed "low quality of life."

The "futile care theory" is spawning the creation of "ethics" committees in hospitals which may be more accurately called "Auschwitz Welcome Wagons." When the doctors perceive that the patient's quality of life is poor they now consult these "Welcome Wagons" to badger the families into relenting and letting them stop care. I understand the need to stop aggressive measures when death is imminent and the treatment is over-burdensome, however, I have seen fluids and feedings stopped because a person with dementia was judged to not "measure up," to use Dr. Kevorkian's terminology.Once we start killing life at the beginning, it becomes so much easier to hasten death at the end.Germany still has the graveyards where the elderly and disabled were interred after being euthanized. Let's face it, elderly and embryos don't look good in two piece bathing suits nor do they contribute to the GNP. So where's the quality there? God have mercy on us. Lord Jesus, Give us understanding of the inviolability of life.

Welcome to a new member!

2007-07-15T13:19:00.000-07:00

Welcome to Russ, "a revert and geriatrician,internist" who has joined us here. Russ blogs at http://www.crossed-the-tiber.blogspot.com/ Russ we're looking forward to your participation.

The Oath

2007-06-25T19:09:00.000-07:00

Hat tip to Michael R. Denton who blogs at For the Greater Glory on this MSNBC article on doctors who refuse to prescribe treatments which are contrary their moral or religious beliefs. Of note was one particular sentence in the article (by an attorney):

"Doctors swear an oath to serve their patients."

Oh really? I must have missed that part of the Hippocratic Oath. I swore to first do no harm. Not quite the same thing as swearing an oath to serve my patients.

Most Sacred Heart of Jesus, have mercy on us!

Abortion May Increase Risk for Suicide

2007-06-21T14:39:00.000-07:00

From across "the pond:"

At a press conference called by Ms Winterton in the House of Commons, Dr Stammers said that in 26 years in medical practice, he had treated many women suffering from depression relating to previous abortions.

And consultant gynaecologist Dr Robert Balfour cited a study of 5,000 women in Finland between 1987 and 2000, which found those who had an abortion were six times more likely to commit suicide than those who had given birth in the past year.

Dr Balfour said that statistics from his home area of south Wales suggested that there were more psychiatric admissions and suicides among women who had abortions than those who gave birth.

Gay Adoption Paper Flawed

2007-06-21T14:24:00.000-07:00

Medical societies and organizations are coming under increased pressure by the gay and lesbian communities to adopt certain positions on social issues which are favorable to homosexuals. As these pressures and influences increase, look for objective scientific reporting to become increasingly agenda driven. As an example, consider the issue of gay adoption.

"Conclusive" Report by American Academy of Pediatrics on Homosexual Adoption Shown to be Full of Holes
Said to contain "major quotation and interpretive errors that ... invalidate the conclusions in the article."

By Elizabeth O'Brien

IOWA, 1 June 2007 ( LifeSiteNews.com) - Over the past five years, Dr. Sharon Quick, a member of the American Society of Anesthesiologists and retired Clinical Assistant Professor from the Washington School of Medicine, has analyzed all of the major scientific literature that was used in the 2002 American Academy of Pediatrics (AAP) Technical Report on Same-Sex "Marriage" Adoptions. The final report was printed in the highly influential Pediatrics journal and concludes by supporting the adoption of children by Gay and Lesbian Couples.

In an Iowa court-case in late May, Dr. Quick gave her official testimony that the Technical Report "contains major quotation and interpretive errors that, irrespective of the quality of the studies cited, invalidate the conclusions in the article."

Many medical societies trust the accuracy of the AAP's investigations and base their policies upon its reports. The report influenced the American Medical association, for example, to support the adoption of children by same-sex parents. The Report was also as evidence in the Massachusetts legal battle over same-sex union and in United States Supreme Court cases as well.

Dr. Sharon Quick discovered that the report inaccurately references an unprecedented 57 percent of its scientific literature. The list of grossly misgathered and misrepresented information reveals the bias and inaccuracy in the Technical Report.

Many other examples of flawed research can be found. But it is very dangerous and harmful to society when political correctness trump sound medical research.

Cardinal Pell Will Not Be Silenced

2007-06-20T12:12:00.001-07:00

One of the more courageous of the Catholic Church refuses to be bullied by liberals who would like to see embryonic stem cells used for medical research. George Cardinal Pell, of Australia, has come under fire for refusing to remain silent on the issue.

Last month, Archbishop of Sydney, George Pell, threatened to deny communion to them because the bill would fund the destruction of human life as scientists obtain the cells from days-old unborn children.

Since then, he has come under fire for the comments and some members of the province's parliament have indicated they think its wrong for a top religious official to speak out on political issues.

Pell called those elected officials "intolerant parliamentarians" for trying to silence him. They have asked the State Parliament's privileges committee to determine whether his comments about Catholic politicians was in contempt of Parliament.

So much for the myth of liberal "tolerance."

An exercise of choice

2007-06-07T16:54:00.000-07:00

From the Great Falls Tribune online:

"A Great Falls pharmacy's decision to phase out the sale of prescription birth control pills for moral reasons is stirring a small firestorm of controversy locally and a buzz of criticism nationwide on women's health Web sites."

The rest of the story is here.

When did contraception become basic health care for women?

Just one more piece of evidence that the only choices that matter to those who define themselves as "pro-choice" are those which support their cause.

Physician Assisted Suicide

2007-05-31T09:38:00.000-07:00

There is a recent piece on public opinion regarding physician assisted suicide which suggests that a significant portion of the American population support physicians in this role.

New York - More than two-thirds of Americans believe there are circumstances in which a patient should be allowed to die, but they are closely divided on whether it should be legal for a doctor to help terminally ill patients end their own lives by prescribing fatal drugs, a new AP-Ipsos poll finds.

The results were released Tuesday, just days before euthanasia advocate Dr. Jack Kevorkian is freed from a Michigan prison after serving more than eight years for second-degree murder in the poisoning of a man with Lou Gehrig's disease.

And now California is considering a bill which permit, as in Oregon, physicians to assist in the suicide of their patients.

California's Legislature is advancing a proposal modeled after Oregon's law permitting patients diagnosed with six months or less to live to take lethal pills prescribed by their doctor.

The issue has stirred emotion from the Capitol to the pulpits, with supporters casting it as a matter of personal choice and opponents saying it is an immoral compromise of the sanctity of life and a doctors' oath to do no harm.

The two sides agree on this much: If California legalizes physician-assisted suicide, it will prompt many other states to follow suit and perhaps even prepare the way for a national law.

At the root of the efforts are misguided attempts to help the terminally ill. Under treated pain, depression, the feeling of abandonment, loss of dignity and the loss of a joyful existence lead many to consider suicide. Clearly all of these conditions are manageable and a truly compassionate response from family, friends and caregivers would be aimed at alleviating physical and psychological suffering. Physicians have a responsibility to resist attempts at legalizing suicide and work to educate the public about truly charitable care of the terminally ill.

Eugenics: Alive and Well

2007-05-23T15:07:00.000-07:00

There was a time before Hitler and the Nazis euthanized the mentally retarded and the disabled in Germany when prominent Americans advocated draconian policies for similar unfortunates in the United States. No less the jurist than Oliver Wendell Holmes advocated forced sterilization of disabled in this country. Although eugenics was eventually turned back at the time, it seems to be making a resurgence in mainstream academic circles. An excellent editorial details the risks to the disabled in this country today.

This month marked the 80th anniversary of the disgraceful Supreme Court decision in Buck v. Bell, which upheld Virginia's involuntary sterilization laws. In his majority opinion, Holmes declared: "It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind . . . Three generations of imbeciles is enough."

Though society may be inclined to regard Holmes's detestable opinion in Buck v. Bell as a relic of a time past, eerie similarities exist in contemporary remarks of the well-respected.

Justifying the sterilization of "genetically unfit" individuals, Holmes wrote that Carrie Buck was "the probable potential parent of socially inadequate offspring."

Some 72 years later, renowned embryologist Bob Edwards said, "Soon it will be a sin for parents to have a child that carries the heavy burden of genetic disease. We are entering a world where we have to consider the quality of our children."

In recent years, Peter Singer, a professor of bioethics at Princeton University, has said, "It does not seem quite wise to increase any further draining of limited resources by increasing the number of children with impairments."

In January, the American College of Obstetricians and Gynecologists urged all women regardless of age to undergo prenatal screening for Down syndrome, aware of statistics that greater than 85 percent of pregnancies diagnosed with Down syndrome end in abortion.

Last fall, Britain's Royal College of Obstetricians and Gynecologists argued for "active euthanasia" of significantly disabled newborns to spare parents emotional and financial burden.

Two years earlier, the Groningen Protocol emerged in the Netherlands; it proposed selection criteria for euthanizing babies and children with disabilities.

Tell the little girls above that one of them is unworthy of life. Tell them that only those deemed "unimpaired" deserve the protection and resources of society. Go ahead. Tell them.

The depravity of men, many of whom enjoy respect of their social and academic peers, is truly unlimited when there is no recognition of the dignity each human life enjoys because of being...well, human, and created in the image of God himself.

Cross-posted at www.eyehackerblog.com.

Pediatricians Oppose Embryonic Stem Cell Research

2007-05-23T14:16:00.000-07:00

An official from the American College of Pediatricians is calling for more funding of adult stem cells and elimination of embryonic stem cell studies.

The American College of Pediatricians recommends that public officials considersupporting adult stem cells exclusively.

Michelle Cretella, MD, a fellow of the American College of Pediatricians, told LifeNews.com that "Not only does embryonic research require taking the life of human embryos, it also prolongs needless suffering by delaying the development of more promising adult stem cell treatments and cures."

Dr. Cretella said that using non-embryo sources of stem cells, including amniotic fluid, umbilical cord blood, placenta and adult blood, fat and various organs, has yielded impressive results.

Adult stem cells are now routinely used in certain forms of cancer therapy,Cretella explained.

Over the last decade, these cells have been used to successfully treat spinal cord injuries, heart failure, Parkinson's disease, diabetes and dozens of other conditions in human trials."This has not been the case with any embryonic stem cell trial," the pediatricians' group's spokeswoman said. "Instead, there have been catastrophic results with these cells producing the wrong tissue, forming tumors and triggering immune rejection."

"Every dollar spent on the failed and unnecessary process of embryonic stem cell research steals resources away from the established utility and potential of adult stem cell research," Cretella concluded. "This is fiscally irresponsible and medically unconscionable."

Additionally:

In April, scientists in Brazil showed that adult stem cell treatments can help patients with diabetes to be insulin free.
However, leading diabetes groups in the U.S., which heavily funded lobbying efforts to get the Congress to approve a bill to force taxpayers to fund embryonic stem cell research, wouldn't put money behind the study.
Publishing their findings in the most recent issue of the Journal of the American Medical Association, the scientists found that adult stem cell treatments helped 14 of 15 patients became insulin free.

Dr. Richard Burt of Northwestern University's Feinberg School of Medicine in Chicago, worked with the scientists.

"It's the first time in the history of Type 1 diabetes where people have gone with no treatment whatsoever ... no medications at all, with normal blood sugars," he says of the groundbreaking study.

Adult stem cell research continues to expand and continues to bring hope for cure of many chronic and deadly disease. Clearly the efforts and resources should be prioritized to adult and away from embryonic stem cell research.

Another Physician as intercessor

2007-05-22T16:27:00.000-07:00

http://www.abcparma.it/english/eng_rast_esempio.htm

I had studied the Rastelli procedure during my ICU rotations as a resident, and I regret that I wasn't aware of Dr. Rastelli's great faith which has led the bishop of the diocese of Parma in Italy to lead the cause for his beatification. I will certainly keep his name among my list of intercessors.

An Invitation

2007-05-21T04:51:00.000-07:00

For those Catholic physicians that may be popping in to read this blog, why not register and contribute? We'd love to have you join us.

Crossing the line

2007-05-20T08:05:00.000-07:00

http://www.theindiancatholic.com/newsread.asp?nid=7636

The secularization of the modern world has led to a false understanding of the principle of freedom. It is not being able to simply do whatever we want because we can. We need to re-learn something inherent to true freedom: knowing which line you should not cross.

A Brave New World Is Being Created

2007-05-15T15:07:00.000-07:00

As incredible as it seems to me, main stream medicine continues it slide into a Brave New World. From the destruction of human embryos to the killing of millions of unborn children and now to this:

Embryos are to be screened for a cosmetic defect for the first time in a British clinic.

Doctors have been given permission to create a baby free from a genetic disorder which would have caused the child to have a severe squint.

The Bridge Centre family clinic, in London, has been licensed to treat a businessman and his wife to create the baby. Both the businessman and his father suffer from the condition, which causes the eyes only to look downwards or sideways.

Slippery slope? What slippery slope.

He [Prof Gedis Grudzinskas] said: "We will increasingly see the use of embryo screening for severe cosmetic conditions."

He added that he would seek to screen for any genetic factor at all that would cause a family severe distress. [This is the escape hatch through which ANY undesired characteristic can be claim for embryonic destruction. This is the "health of the mother" provision which will provide limitless destruction.]

When asked if he would screen embryos for factors like hair colour, he said: "If there is a cosmetic aspect to an individual case I would assess it on its merits.

"[Hair colour] can be a cause of bullying which can lead to suicide. With the agreement of the HFEA, I would do it.

"If a parent suffered from asthma, and it was possible to detect the genetic factor for this, I would do it.

"It all depends on the family's distress."

Amazing and amazingly evil.

Cross posted at eyehackerblog.com.

The dilemma which was Gardasil

2007-05-14T22:25:00.000-07:00

Vaccines are wonderful gifts from God to the human race. I recall my parents telling me stories of dealing with whooping cough and of knowing kids with polio complete with stories of the "iron lung". I am amazed at the recollections of my colleagues who diagnosed Haemophilus influenzae meningitis numerous times a year during their training. I have never seen a case of it because I began my training several years after an effective vaccine was introduced.

There is now a vaccine on the market called Gardasil which protects against human papillomavirus (HPV), a leading cause of cervical cancer, and suddenly I find myself questioning moral and ethical decisions related to this vaccine. I do not have an issue with the vaccine per se since its use may be lifesaving for some women. The issue I have stems from Merck pharmaceuticals (the manufacturer) and its advertising methods and lobbying efforts. This vaccine was being advertised in numerous magazines (including some full page ads) and on television before I had been detailed about the vaccine by Merck. I received telephone calls from parents requesting the vaccine before I had even considered using the vaccine. Then I heard of Merck lobbying state governments in Virginia and Texas into mandating Gardasil use for school aged girls, and I had still never been detailed by the company. The doctors who would be administering the vaccine were skipped over, and the vaccine was directly marketed to consumers and the government.

The vaccine is recommended for girls and women ages 9 to 26. This means I am going to have to counsel pre-teen girls that they are getting a vaccine which protects against a virus that is transmitted through sexual intercourse. Did Merck consider this while they were lobbying the governors of Texas and Virginia to mandate this vaccine's use? Did they consider the parents who might just not be ready to open that discussion with their pre-teen daughters?

Ultimately I believe Gardasil is a good thing. Unfortunately its manufacturers crossed the fine line between altruism in medicine and profit. Thankfully, the company has finally detailed me on the use of Gardasil and given me the opportunity to voice my concerns. They assure me the lobbying efforts have stopped, but trust has been compromised between me and my colleagues and the company which provides the vaccine. When push comes to shove, I will and must put the concerns and needs of my patients and their families above the financial interests of pharmaceutical companies.

New Member

2007-05-14T18:53:00.000-07:00

Catholic Physicians Blog welcomes William who blogs at vocemea.blogspot.com. We look forward to your posts!

Culture of Life Survey

2007-05-12T20:48:00.000-07:00

I have received this survey three times now - this last time by the Catholic Medical Association, and I thought I would pass it on to this blog. This link is to the 'White Paper' which explains what the underwriters are trying to ascertain.

Here is a quote:

"K&B Underwriters hypothesize that physicians and healthcare entities which focus on best practices in a Culture of Life framework for their patients from conception through natural death have lower incidents of litigation and cause fewer health problems that unnecessarily burden the healthcare industry and insurance companies."

I invite you to take the survey.

DISCLOSURE: dadwithnoisykids has no affiliation with this company, nor does he own any stock or any other interest in the company. He DOES have an interest in seeing lower malpractice insurance rates.

The New Eugenics Movement

2007-05-10T18:37:00.000-07:00

The American College of Obstetricians and Gynecologists (ACOG) has issued recommendations regarding the prenatal testing of women in the first trimester for Down's Syndrome in utero. The press release can be viewed here. It reads in part:

All pregnant women, regardless of their age, should be offered screening for Down syndrome, according to a new Practice Bulletin issued today by The American College of Obstetricians and Gynecologists (ACOG). Previously, women were automatically offered genetic counseling and diagnostic testing for Down syndrome by amniocentesis or chorionic villus sampling (CVS) if they were 35 years and older.

The new ACOG guidelines recommend that all pregnant women consider less invasive screening options for assessing their risk for Down syndrome, a common disorder that is caused by an extra chromosome and can result in congenital heart defects and mental retardation. Screening for Down syndrome should occur before the 20th week of pregnancy.

Obviously such tests can be helpful in the identification of children which will require special care immediately or soon after birth. But such tests also provide for the occasion of many abortions in the search for "perfect" children. A very high percentage of mothers who find that their child has Down's Syndrome will abort the child.

George Will, a well known commentator weighs in:

Nothing—nothing—in the professional qualifications of obstetricians and gynecologists gives them standing to adopt policies that predictably will have, and seem intended to have, the effect of increasing abortions in the service of an especially repulsive manifestation of today's entitlement mentality—every parent's "right" to a perfect baby. Happily, that mentality is not yet universal: 214 American families are looking for Down syndrome children to adopt.

And a neonatologist, the father of a Down's child has some comments:

The obsession with “perfection” in pregnancies is, in my view, a result of many factors. To be fair to obstetrical providers, some of it has to do with legal considerations. More important, however, is that we have lost the ability to see the value in imperfection. Only perfection matters. Most of us deny our own imperfections (we are human) and cannot appreciate that a child, no matter how “different”, is a gift. In an age in which many children are raised by day cares, nannies or public schools, children have become a possession, albeit an important one, but a possession nonetheless. Why shouldn’t “it” be perfect?

As humans, decisions such as abortion are accompanied by a significant amount of emotional baggage, namely guilt. Society, including the obstetrical community, has gone to great lengths to mitigate this distasteful feeling. We assuage these feelings by the knowledge that “we are saving the unborn child from a life of suffering and pain.” Counselors made available to families with difficult diagnoses have great expertise in the pathology that accompanies a multitude of syndromes and genetic disorders. These counseling sessions invariably include the topics of mental retardation, cerebral palsy, and quality of life. Rarely in my experience are these potential parents ever exposed to families who have recognized the gift given them in an “imperfect child”, families who have made the decision to keep their child. You mention CF, Dean, and it is a great illustration of this conundrum. Let me mention another in more detail - Down Syndrome - as another great example of a potential diagnosis in which parents are often counseled without exposure to sources who can describe what life is like with a child with Down Syndrome.

It is physicians who guide the population in issues of health. We must always seek to bring truth and goodness to those that we seek to heal. As Catholics, we are called to bring Christ with us to the office, the operating room and the laboratory. We must bring light to the darkness of utilitarian and misguided policies of those professional organizations to which we belong.

St. Gianna Beretta Molla, pray for us physicians and for all mothers that they will see their children as a blessing regardless of their condition.

New Member

2007-05-08T12:42:00.000-07:00

Pyro, a friend from Catholic Dads Blog and a medico is now on the blogroll. Welcome Pyro. Pyro blogs at http://theantisophist.blogspot.com/.

More Embryonic Stem Cell Hype

2007-05-07T18:08:00.000-07:00

Here is the latest in the MSM (HT drudgereport.com) in support of stem cell research. This time we are all to become teary eyed with hope for grandma with macular degeneration. The headline is: Embryonic stem cells can repair eyes, company says. The article begins:

WASHINGTON (Reuters) - Stem cells made from human embryos can home in on damaged eyes, hearts and arteries of mice and rats, and appear to start repairs, a U.S. company said on Monday.
Massachusetts-based Advanced Cell Technology said it had devised a straightforward way to make blood vessel precursor cells out of the stem cells and plans to test them in humans.

"We figured out how to produce literally billions of so-called 'hemangioblasts' -- the mythical cell in the embryo that gives rise to our entire blood and immune system as well as to the blood vessels in our body," Dr. Robert Lanza, vice president of research and scientific development at ACT, said in an e-mail.

OK, so the company feels that they can make hemangioblasts, which may be helpful in some ocular (and non-ocular) disorders. The article continues:

They directed the stem cells into becoming what they believe are hemangioblasts, the blood vessel precursor cells, although other teams will have to replicate this for it to be accepted.

So now there is doubt that these are in fact the cells promoted in the early paragraphs. And it is unclear how the studies will translate into healing human disease.

The researchers killed the mice to check the cells' progress, so they do not know the long-term effects.

"The cells also showed remarkable reparative capacity in animals with heart attacks and ischemic (blocked by a blood clot) limbs. The cells reduce the mortality rate by 50 percent after a massive heart attack," Lanza said.

"If the same thing works in humans (these would be the same human cells we would probably use), you might be able to prevent patients from having legs and other limbs amputated by simply injecting some cells."

Sounds so simple. No long term animal data, not yet one human study, but we have a cure promoted. And of course no pro-embryonic stem cell article would be complete without taking a shot at conservatives and Bush in particular.

The U.S. Congress has passed several bills that would expand federal funding of
human embryonic stem cell research but President George W. Bush vetoed one and
has said he will veto any more.

How this is promoted as a breakthrough in the treatment of eye disease is beyond me. There is no mention of the many successes of adult stem cell research. The agenda is clear; promote embryonic stem cell research as miraculous even at its earliest stage and bury anything positive concerning non-embryonic stem cell successes. Amazing!

Salvifici Doloris

2007-05-04T20:11:00.000-07:00

Here is a great Apostolic Letter for physicians to read: Salvifici Doloris . This is a brief review I wrote a while ago and put on my blog.

Sometimes it is a good idea to take a step away from our work, to call a time out, and to take some stock of what we are doing in our lives. This is true for whatever our vocation is, or whatever our profession. In my case, I recommend this letter from Pope John Paul II as a good aide for doctors to use. Reading it has reminded me of the reasons why I chose medicine as a career so many years ago. It also will, hopefully, make me treat my patients as if I were caring for Our Lord instead of Yet Another Patient with An Abscess Somewhere That Needs To Be Drained.

Pope John Paul II makes the point that those who care for the sick are like the Good Samaritan, and the the good we do for others in our work is as if we were doing it for Him(whatsoever you do….etc.).

It is also a good idea to remember that our livelihood, for all specialties, is made possible by the sorrow and pain of others: fallout from the Fall of Adam.

Pope John Paul II published this letter in February 1984, approximately two and a half years after he was shot. My guess is that this letter was inspired by his experience as a patient.

George Weigel’s book, Witness to Hope covers this part of his pontificate very well. Pope John Paul II seemed to be very active in the decision making process of his medical care.

Catholic Bioethic Resources

2007-05-03T10:21:00.000-07:00

The National Catholic Bioethics Center has prepared a collection of materials regarding a number of moral issues facing physicians and their patients. These materials are available for downloading here. Topics include subjects from abortion to vaccines.

Jesus, Physician and Healer

2007-05-03T10:09:00.000-07:00

From the Angelus 2/9/1997

JOHN PAUL II
ANGELUS
Sunday, 9 February 1997

Dear Brothers and Sisters,

1. The Gospel often speaks of the cures worked by Jesus. The sick crowded round him and sought to touch him “for power came forth from him and healed them all” (Lk 6:19). I like to remember this shortly before the fifth World Day of the Sick, which will be celebrated this coming 11 February, the feast of Our Lady of Lourdes.

By healing the sick, Jesus shows that his gift of salvation is offered to the whole person, since he is the physician of soul and body. His compassion for those who are suffering spurs him to identify with them, as we read in the passage on the last judgement: “I was sick and you visited me” (Mt 25:36). It is this deep sharing that he asks of his disciples, when he entrusts them with the task of “healing the sick” (cf. Mt 10:8).
If we pray with faith, the Lord will not fail to work miracles of healing even today. His Providence, however, usually works through our responsible efforts and requires us to combat illness with all the resources of intellect, science and appropriate medical and social assistance.

2. Jesus’ love for the sick encourages us especially to put the resources of our heart into action. We know from experience that, when we are ill, we not only need adequate treatment, but human warmth. Unfortunately in contemporary society we often risk losing genuine contact with others. The pace of work, stress or family crisis makes it increasingly difficult for us to give one another fraternal support. It is the weakest who pay the price. Thus it can happen that the elderly who are no longer self-sufficient, defenceless children, the disabled, the severely handicapped and the terminally ill are sometimes seen as a burden and even an obstacle to be removed. On the other hand, walking at their side, dear brothers and sisters, helps build a society with a human face, enlivened by a deep sense of solidarity, where there is room and respect for all, especially the weakest.

3. Looking to Christ, physician of souls and bodies, we also meet the caring gaze of Mary, invoked by Christians as “Health of the sick”, Salus infirmorum. May the Blessed Virgin help us touch the healing hand of her divine Son, welcome the saving power of the Gospel and become ourselves a concrete witness to all who need us.
-----------------------------------------------------------------------
After greeting the pilgrims in various languages, the Holy Father added extemporaneously:
I wish you all a pleasant Sunday and good week, in which we will already begin Lent. The liturgy of ashes will be celebrated on Wednesday. Praised be Jesus Christ!

May Christ be our example in our efforts to heal those entrusted to our care. May we work to heal them physically and by our compassion, may those that we treat see the face of Christ in us.

Religion and Medicine

2007-05-02T05:32:00.000-07:00

There is a recently published article in Archives of Internal Medicine (Arch Intern Med. 2007 Apr 9;167(7):649-54) which surveyed physicians and their impressions of religion and spirituality (R/S) in medicine. Some of the findings include:

63% of (physician) respondents characterize themselves as moderately (27%) or highly (36%) spiritual.

How often does illness increase patient awareness of R/S?

Often/Always 64%, Sometimes 34%

How often have your patients mentioned R/S, God, etc?

Often/Always 25%, Sometimes 51%

Overall how does R/S influence patients' health?

Much/Very Much 56%, Some 35%

Is the R/S influence positive or negative?

Positive 85%

R/S helps patients cope

Often/Always 76%

R/S gives positive hopeful state of mind

Often/Always 74%

Overall, physicians are religious and find that religion and spirituality plays and important and positive role in the health of their patients. I would recommend the article as an insight as to physician attitudes concerning spiritual matters in their own and their patients' lives.

New Member

2007-05-02T04:56:00.000-07:00

Welcome to dadwithnoisykids, a friend from Catholic Dads' Blog. Dadwithnoisykids also blogs at scorpionstalkingduck.blogspot.com.

Register Catholic Physicians Blog

2007-04-30T18:42:00.000-07:00

Welcome to Catholic Physicians Blog. Please register and contribute.

Limits on Biology

2007-04-29T16:22:00.000-07:00

Dr. Leon Kass is President Bush's former advisor on bioethics and the author of "The Beginning of Wisdom." He is a thoughtful man who understands that science is not limitless in its understanding of man because science cannot answer questions which involve the soul. He writes a recent piece on just this limitation of biology.

According to many a prophet in the temple of science, biology has no permanent limitations. Instead, it faces an endless frontier — eagerly, gladly, confidently. Firmly founded on the concepts and methods of objective science, supported by the century-old doctrine of evolution, and armed with new discoveries and techniques in biochemistry and molecular genetics, biology and medicine go forward into a golden age. They promise, among other things, a full understanding of those age-old “mysteries” of embryogenesis and differentiation; an unlocking of the “secrets” of perception, memory, imagination and desire; new biotechnologies and new cures for disease; the provision of psychic peace through a true psychophysics; and perhaps even the conquest of mortality through mastery of the genetically determined processes of aging.
Though it is commonplace to distinguish applied from pure science — and it makes some sense to do so — it is important to grasp the essentially practical, social and technical character of modern science as such, modem biology included. Ancient biology had sought knowledge of what living things are, to be contemplated as an end in itself, satisfying to the knower. In contrast, modern biology seeks knowledge of how they work, to be used as a means for the relief and comfort of all humanity, knowers and non-knowers alike. Though the benefits were at first slow in coming, this practical intention has been at the heart of all of modern science right from the start. In order to make thought useful for meeting human needs, Descartes (in his Discourse on Method) proposed a new kind of thinking. He permanently turned his — and science’s — back on the speculative or theoretical questions, questions about the being or nature or goodness of things, questions also about first or ultimate causes. Instead, in order to become practical, science will study nature-at-work, nature-as-craftsman; a new kind of physics, solving problems about force and action, will yield power and will ultimately lead to human mastery and ownership of nature.
The purposes of a science-based mastery are humanitarian, served by a boundless medicine capable of curing “an infinitude of maladies both of body and mind,” capable perhaps of conquering aging, and even mortality itself. Moreover, because the new medicine will know precisely the mind’s dependence on the disposition of the bodily organs, it will be able to provide psychic peace and new mental powers, including a new kind of practical wisdom. Physics, here meaning “natural science,” will issue in mastery of nature (phusis), via a new physick, an omnicompetent and comprehensive medicine of body and mind.
The new biology that brings us these dilemmas can, by its very value-neutral self-definition, provide us neither knowledge nor guidance for dealing with them. Worse, the scientific teachings themselves challenge and embarrass the existing prescientific or religious notions of better and worse, and of human life more generally, on the basis of which we have made — and still make — moral judgments; on the basis of which we have lived — and still live — our lives. The project for the mastery of nature, even as it provides limitless powers, leaves the “master” lost at sea. Lacking knowledge of ends and goals, lacking standards of good and bad, right and wrong, we know not who we are nor where we are going. Yet we travel fast and freely, progressively achieving our own estrangement — from our communities, from our nature, from our very selves.
Despite these obvious practical and moral threats to our humanity, scientists and others often refuse to recognize the danger, and even object to the term “dehumanization.” For how, they ask, can science or technology be dehumanizing when these activities are themselves the expression of our highest humanity — of our curiosity and courage, our cleverness and dexterity, our energy and industry, our rationality and perfectibility? But not everything of human origin is humanizing in effect. Man does not live by rationality alone. Indeed, the foundations of our humanity — our sentiments, loves, attitudes, mores and character, as well as the familial, social, religious and political institutions that nourish and are nourished by them — are not laid by scientific reason or rational technique, and may, in truth, be undermined by them, especially if our much-vaunted scientific rationality is — as I hope next to show — philosophically unsound and finally unreasonable.

This is a wonderful piece, a shade so to speak in the hot sunlight of a scientific world.

NCBC Postion on Upcoming Stem Cell Legislation

2007-04-25T18:37:00.000-07:00

Here is an excerpt from the National Catholic Bioethics Center letter sent to members of the US Congress recently:

I am writing, on behalf of the National Catholic Bioethics Center, to request
that you oppose proposed legislation S. 5, which would provide tax payer
money for the destruction of human embryos for research purposes.
Furthermore, I am asking that you support S. 30 which would accelerate federal
research on pluripotent stem cells without destroying human embryos.

Basic embryology makes it clear that from fertilization a new human being
exists, as a composite unity, with his or her own internal principle directed
toward continuing organismic development and growth towards adulthood. From the
moment the human zygote is formed a new human being exists, separate from
his/her father or mother. Thus, he/she is a bearer of human rights. Each of us
has as our origin that small cluster of cells we call an embryo. Each human
being has immeasurable value and intrinsic dignity, which outweighs any
utilitarian consideration. Providing public funding to support research on cells
obtained through the destruction of human beings, especially at their most
vulnerable stages, is an affront to the dignity of all persons.

As physicians, we are in a unique position to enter the debate on stem cell research and technology. How often are we asked by our patients "when will stem cells cure my disease, doctor?" Such questions offer the opportunity to introduce the difference in embryonic and non-embryonic research and de-homogenize the rhetoric on the subject. Given the successes of non-embryonic stem cell research and the paucity of progress from embryonic stem cells, we have an opportunity to move opinion away from the sacrifice of embryonic human life.

Welcome to Catholic Physicians Blog

2007-04-23T18:26:00.000-07:00

I thought that it might be helpful and informative to create a blog relevant to Roman Catholic Physicians (and yes dentists.) This is meant to be a place where Catholic doctors can post and comment on issues of medicine and faith. A place where we can explore the issues of faith in the setting of our profession as healers and a place to link to medical news and issues relative to our profession. Comment freely and if you are interested in posting to the blog and would like to be included in the blogroll, email me at retina_md at yahoo.com.