Tuesday, October 11, 2011

Talk Given at Franciscan University of Steubenville: "Being Catholic in Medical School"

This talk was given by Brian J Burke at Franciscan University of Steubenville on October 7th, 2011.  Mr. Burke is a fourth year medical student at the University of Toledo College of Medicine, and has served as the Vice President of the CMA-SS for the past year and a half.  He will be pursuing a career as a family physician, and will begin his training this coming summer.  Mr. Burke graduated from Franciscan University of Steubenville in 2007 with a degree in biology and theology.

Good morning to all of you.  It is a real honor to be able to return and speak before you.  It was not too long ago that I sat in those very seats, contemplating my future and all that lay before me.  At that time, I never imagined the journey the Lord would take me on, particularly in regards to medical school and the like.  My journey since I graduated in 2007 has been filled with many joys and some sorrows.  I have felt lifted up and torn down.  But through it all the Lord has guided me, and as I stand before you and reflect on that journey, I feel that I am a stronger man for it, and without a doubt, it has drawn me closer to the Lord.  Today I wanted to take the time to talk to you a little bit about this journey. Namely, I will outline some of the challenges I have personally faced being Catholic in medical school, as well as other issues my Catholic colleagues have faced.  But being Catholic in med school is more than just about being on the defensive, and so I want to also spend some time on how being a Catholic medical student has brought me greater skill and joy when caring for my patients.  Throughout the talk, I will touch upon a subject I feel is extremely important for all of us, and that is the need for every Catholic professional to seek to be both technically and spiritually competent in their field, and I will explain more of this at that time.  I will also discuss the ways that you can both find support in medicine as well as work to make a difference.

Challenges Faced
Being Catholic surely does not make medical school or any other healthcare related job any easier.  In fact, it makes it harder.  The easy way is to go with the flow, and simply accept what mainstream medicine and our culture says is “okay” and the “appropriate thing to do for our patients.”  But of course, all of you probably realize this and recognize that what the culture tells us does not make it the right thing to do.  Going back to healthcare, those challenges and difficulties begin the moment you leave this campus and enter any job dealing with the care of the sick.  For the sake of time, I will focus on medical school in this talk, but the ideas and challenges can be applied to any healthcare worker, especially nurses and pharmacists.
So Let us begin with the process of getting into medical school.
Dr. Kuebler just recently publish an excellent article in the National Catholic Register.  I hope all of you have had the opportunity read it, because it is the truth.  This article is entitled “The Case Against Pro-Life Physicians: Bias Begins at Med School Interview.”  
Here are two short paragraphs I wish to quote:
“It is routine for medical-school admission interviews to include open-ended questions on ethical issues. Primarily, these questions are included in the process to see if students can articulate clearly and defend adequately their thoughts on complex issues. If this were the sole reason for their inclusion, questions about abortion and abortion access could play a legitimate role in the interview process. But that is often not the intent of such questions.
The reality is that many schools are using abortion-related questions to screen out pro-life candidates. This is despite the fact that federal law prohibits medical schools that receive federal funding from discriminating against candidates based upon their views on abortion. While the law prohibits explicit discrimination against pro-life candidates, it does not prohibit schools from inquiring about abortion during the interviewing process. Unfortunately, this situation creates a loophole big enough to drive a truck through.”
Getting into medical school is not easy for pro-life students.  And this becomes even more difficult for faithful Catholics because not only can questions of abortion arise, but a pernicious interviewer could easily raise questions concerning contraception, sterilization, and end-of-life care.
How do we face these types of situations?  I think this is particularly pertinent for those of you who will be in this situation sooner than later.  First of all, and this will be repeated in other situations, you must be knowledgeable.  Why do you believe what you do?  Know it.  And not just what the Church teaches us.   Of course this is extremely important for us to know, and to know well.  But I am going to tell you a little secret about the people who do not want you to succeed: They do not care what the Catholic Church teaches.  If your main argument against abortion, contraception, sterilization, etc is because it is against my faith, then I am telling you now, you will lose the fight.  The best overall strategy I can offer you is two part: 1) Stay calm and maintain a respectful attitude.  Losing your cool will only help the other person succeed in preventing you from entering medical school.  2) Be able to explain your position using only medical and ethical, NOT religious, reasoning.  I will tell you now that I try to never bring in the fact that I am Catholic as a reason for not participating in a procedure or action.  The problem is that once you use that argument, the other party, even if they are Christian, will typically zone out and not listen to any subsequent defenses.  I can expostulate eloquently on the medical risks and complications of abortion or contraception, but if I had first said that “it is because I am Catholic”, all of that will not be heard.  In many cases, simply the fact that people know I am a faithful Catholic has hindered me.  I don’t even say a word about it in these situations, but they already have preconceived misconceptions about why I will not prescribe contraception or perform/assist in abortions.  In those cases my work is twice as hard.   Now, I want to clarify that I do not mean that we hide our faith, but rather that we don’t hide BEHIND our faith.  The wonderful thing about our Faith is that all that Holy Mother Church teaches on these medical issues is confirmed in the natural world.
Now going back to the interview.  What I just said is extremely important to remember.  Now, as Dr. Kuebler talked about in his article, it isn’t as much about religion as the position of pro-life versus pro-abortion.  However, as it stands, there is little we can do until our rights are better enshrined in law. What we CAN do is to speak eloquently and with love.  Even if the interviewer disagrees with you and seems to be out to get you, it is extremely important that you stay calm.  I know of several individuals who antagonized the interviewer as much as they were antagonized, and let’s just say that it did not end well.  We must be different than our aggressors.  When we show we are willing to hold our temper, to continue to be respectful, and still intelligently defend our position, we are more likely to succeed in softening their hearts, and possibly convincing them that we would ‘not be a threat’ or could ‘have our mind changed’.    Now is this always going to work? No, but it has a much better of success than allowing yourself to become enraged at their provocations. 
Once in medical school, the challenges you face become different.  Life in medical school can be a bit challenging when faced with the variety of ethical and moral issues that come up.
During the first two years, you really are not in true clinical scenarios.  This does not mean, however that you do not have challenges to face.  Many schools now have lectures or even classes on medical ethics or related topics, in which you may find yourself in a bit of a pickle.  Or you may be in lectures where abortion or contraception or even euthanasia is being touted as something good.  So the question becomes, what do you do?  You could simply keep your head down, telling yourself that once you are through med school, you can practice how you want to practice.  This is one way.  But there is another. I can remember a couple of different scenarios that came up.  One was during my first year of medical school, during the behavioral science block.  The lecture was on adulthood, and the instructor had touched up the progression of adult relationships, and had made the comment on how cohabitation was healthy step in a relationship, and that some couples may or may not progress to marriage, and then on to divorce (almost as if it were a given).  Now, I took issue with this a bit, and so I raised my hand to ask if the instructor was familiar with the research that indicated that those who cohabitate prior to marriage have a higher incidence of divorce.  The instructor basically brushed me off and ridiculed me saying he knew of no studies showing such a thing.  Having my laptop handy, I did a quick lit search on pub med (an extremely important skill!) and found dozens of articles on this topic, and not just about the correlation of cohabitation and divorce, but of cohabitation and poverty, abuse, murder, and other issues.  At the break, I went and talked to the instructor about this and when the class returned, he put me on the spot to share what I told him.  I told the class that a simple lit search did in fact show cohabitation to be unhealthy for the relationship.  Now, this was a very difficult thing to do. It exposed me to all of my classmates, and in fact upset several of them because, lo and behold, they were cohabitating with their significant other and felt ‘attacked and judged’ by me.  This was an unfortunate consequence, this straining of the relationship with some of my classmates.  But it was important to do. This instructor was spreading false information to future physicians who would then influence multitudes of others.  Another situation I encountered was during my second year, during the reproductive physiology lecture.  Now, being a Natural Family Planning instructor, I was quite curious to see how the topic of contraception and NFP would be approached.  I had access to the previous year’s PowerPoint presentation and was able to scout things out.  To my expectation, natural family planning was treated rather poorly, using the typical (and false) statistic of a 25% failure rate.  Since I had a heads up this time, I actually emailed the individual giving the lecture to ask him about this in light of several articles I cited to him, which showed the success rate of 99%.  After discussing this issue and the efficacy of lacational amenorrhea (and providing him with solid sources) he actually changed his presentation to be more NFP friendly.
These are just a couple of the times that I had to stand up and say “This is not right.”  But when I did rise up, I tried to do it in the most respectful way possible.  Did I get angry and upset at times? Absolutely! But I knew I needed to cool off before responding.  And then I made sure that I knew what I was talking about.  One of the worst things we can do, other than losing our cool, is to be caught with a bad or defenseless argument.  So before you respond, if you are able, take the time to do a little reading, now what you want to say and have the sources to back it up.
Now, you need to take these same steps during your clinical years.  Only now, you will find yourself in situations where you are unable to say ‘I will get back to you on that’, but you will need to make a split second decision about how you will act.  So the best way to handle this is to know what you will do and why you are doing it ahead of time.  Let’s take a few examples.
One of the most commonly encountered issues for Catholic medical students is contraception.  Our culture accepts it as a given, and medicine is obviously no different.  Many of you probably know that the only organized group of individuals that vocally rejects contraception is the Roman Catholic Church. That being said, you need to know why the Church teaches what she does.   Be familiar withHumanae Vitae, read up on the commentaries and instructions given by individuals like Janet Smith (her Contraception Why not?).  But you also need to be up to date on the medical reasons why you would not prescribe contraception.  This includes the risks associated, the side effects, the long term consequences on a woman’s health like breast cancer and infertility.  You also need to know the ethical reasons.  My main response is that I am not comfortable with causing a major, healthy, functioning organ to stop working. Basically I am causing a disease state in an otherwise healthy woman.  This, too me, goes against the basic tenets of medicine.
I have found myself in these situations on several occasions.  Most of the time I was able to avoid having to deal with it, but when I was unable to avoid a visit that was specifically about obtaining birth control, I had to calmly tell the physician I was working with that I was going to not go in on the visit because I was not comfortable with prescribing birth control.  Most of the time the physician looked a bit confused, but would shrug his shoulders and go into the room without me.  Other times I would see the eyes narrow, and the lips purse, and the physician ask, in a bit of a menacing way, “Why not?” And so I would have to explain myself, mainly with the reason I stated above.   Sometimes this would turn into a more in depth discussion and I could venture into natural family planning as an alternative, and other times it ended there.  I praise the Lord that I was never put in situation where I felt my grade was in jeopardy, but I know it has happened to others.  Surprisingly, the people from whom I received the most flak about my stance on contraception were my fellow classmates.  They were more cruel and intolerable than many of the physicians I have worked with, and some of the harder ones to respond to.  And yet you do what you can in the way I have already outlined.
One of my strengths in this area is the fact that I am a Natural Family Planning instructor.  This was something I was able to offer as an alternative, if not to my patients in the clinic, then at least to the physician who questioned why I would not prescribe.  Having a skill like this can be invaluable, not only because it is a tool to offer but because of the knowledge that you have because you took the time to learn about NFP. 
Another issue, related to the contraception issue is sterilization.  There are two forms of sterilization you will encounter in medicine, tubal ligation and vasectomy.  Sterilization is one of the most common forms of birth control used in the United States.  As such, you will undoubtedly find yourself having to make a moral choice about your participation in the sterilization of a patient.  I have been faced with both tubals and vasectomies.  I had an interesting experience in dealing with the vasectomy issue.
Early in my third year I was on my surgery rotation.  It was a Friday afternoon of the first week with this particular surgeon, Dr. B.  I had already rotated with the trauma service and the neurosurgeon at the University Hospital, and now I was assigned to small, community hospital.  The week had gone great, with a variety of general surgery cases and now we were wrapping up the week with a few hours seeing patients in the office.  As I reviewed the list of patients for the afternoon, I saw something that made my heart sink.  The last patient of the day was scheduled to have a vasectomy performed.  I had not anticipated this being a problem on surgery.  In retrospect, I should not be too surprised, since a vasectomy is a surgical procedure.  I suppose that since the male reproductive issues do not come up as often, I simply wasn't thinking about it.  However, that quickly changed.  After all of this came to my attention, I mentioned to my preceptor that I saw the last patient of the day was a vasectomy.  I started to say "I hope you don't mind, but-", then I was interrupted by my preceptor saying "You would like to sit this one out?  Not a problem."  I said thank you, and we went on to see the next patient.  When we returned to his office, he related to me that since coming to this hospital about 15 years ago he has done the majority of the vasectomies because the urologist in the hospital was a Catholic and would not do vasectomies.  I again gave him my gratitude for understanding, and we left it at that.
Now I tell you this story, because I want you to realize the importance of standing up for your beliefs. Thanks to this urologist, I did not have to “deal” with that issue in this case.  I have in other times, but in this situation, because someone had come before me and set the example, my life was a bit easier and my beliefs were already accepted.  This is why I am here today, to encourage you and show you that a path has been laid out.  It is not necessarily easy, but with each passing student, and each success we make a little headway in regaining our freedom to practice as Catholic physicians.  We will come back to this later. 
Though I dodged this bullet, I did not dodge the bullet on tubal ligations.  One night on labor and delivery, there was a tubal ligation scheduled for after the C-section I was assisting on.  So I told the physician I would be stepping out of the room after the baby was born because I could not assist in the tubal.  The physician turned to me with a bit of an antagonistic look and said “What do you mean by stepping out? Out of the room? Off the floor? Out of the hospital? Off the world?”  I calmly replied that I would be stepping out of the room.  He said “Fine”.  So that is what I did, and despite the hard time he gave me, later in the evening he let me deliver the baby of one of his other patients and we had a fairly decent conversation.  But that was a hard trial, because I was forced to go up against a well established OB/GYN.  Here was a man who could make my life miserable, but I needed to follow my conscience and my beliefs.  If I was willing to violate it now, how could I live with myself and know that in the future I would continue to do what is right by my patients?  This is the challenge each of us faces in these situations.
I have spoken of contraception and sterilization first because it has been my experience that these will be two areas in which you will be most challenged in clinical practice.  As I said before, Catholics are the only unified voice that still speaks out against these practices, and so you will even find yourself unpopular on these topics with your protestant, pro-life colleagues.  So you need to be well versed in why these actions are attacks on the human person and attacks on love. 
Next let me turn to the issue of abortion.  A recent Guttmacher Institute study showed that 54% of abortions occur because another form of birth control failed.  You will not learn this in medical school. No, you don’t learn a lot of things about abortion in medical school.  Like the fact that women have greater risk of mental health issues after an abortion, or that it leads to increased rates of pre-term labor and other neonatal complications. Not to mention the surgical risk associated with the procedure.  What you do learn is that this is a “Safe, healthy procedure that is legal in the United States and that it carries less risk than bringing a pregnancy to term.”  For those of you active in the prolife movement, you may have heard some of these lies about how safe abortion is.  Well, I am sad to say they are perpetuated at the highest level in medical school.  So you may find yourself coming up against classmates and instructors on this issue.  Again, know your stats, know your studies, know why the pro-abortion people are wrong in their science.  When it comes to Ob/Gyn and embryology, you may need to do some extra reading in order to get a real education in this area, in order to get beyond the lies and falsities.  I know I had to.  Now, in regards to participation in abortion during your clinical years.  This, praise the Lord, I have not been faced with, and I believe it is safe to say most medical schools are not going to put you into that position.  If you go into OB/GYN and do a residency, the situation changes, but as of now, most schools will not force medical students to participate in abortions in any way.  Now, that doesn’t mean there are not opportunities and you may here of classmates who do special electives or work with certain doctors who train them to do abortions.  So, for now, you have some safeguards, but there is an area you need to consider, and that is the treatment of ectopic pregnancies.  Ectopic pregnancies are rare, and difficult cases.  Some treatments are morally acceptable and others are not. It is your responsibility as a medical student or nurse to know what the treatment is going to be on a given case.  You do not want to be unwittingly assisting in a direct abortion.
Unfortunately, the pro-abortion, pro-death ideology is alive and well in medical school.  I think you would be hard pressed to find a place where abortion, contraception, sterilization are not accepted as every day, good things.  You will be taught in such a way to try and justify these procedures and drugs, and you will be taught that what the patient wants you should give.  This is the tyranny of autonomy, the idea that whatever the patient wants, as long as it is legal, the patient should have access to.  And this is why we end up fighting so many of our battles.  Our medical education system continues to try to destroy any philosophical basis for our ethics, and replace it with an ethics based upon the legal system.  As such, when we are faced with a situation where a patient is requesting something that is legal, but against our moral code, we are viewed by our colleagues as withholding a reasonable medical treatment from our patient, and thus violating the rights of our patients.  Obviously we are not violating the rights of our patients in respecting our consciences, but this is what our culture is trying to paint us as doing.  And so, even if you are never faced with an actual abortion, you will be challenged by those around you on why you would withhold a legal service from a patient.  So be prepared to have these conversations, and to find yourself quite frustrated in them.  But know that it is important to remain strong.
A few other areas that you may encounter, mostly on the theoretical level unless you pursue certain fields of practice, are IVF and other reproductive technologies.  I mention them to you because the conversations will arise, and you will be on the unpopular side if you stand with the Church, and so it is again important that you be well studied on these issues.
At the other end of the spectrum on ethical issues is death and dying.  Euthanasia is legal in three states, and appears to be gaining ground in other states.  But euthanasia occurs more often than we think. Consider the issue of artificial nutrition and hydration.  This is where a person receives food through a feeding tube and water through an IV line.  Now, mainstream medicine has said that this is extraordinary care for an individual and so can be withdrawn at any time at the discretion of the physician and family.  Yet the Church has emphatically stated that ANH is NOT extraordinary, but ordinary means of care and should never be withdrawn unless it is burdensome or harmful to the patient.  I have encountered some situations where the very fine line on this has been very, very gray. So it is important for you to have a firm grasp of the Church’s understanding on the caveats surrounding ANH.
Joys Encountered
So I have spoken for quite awhile on the challenges of being Catholic in medical school.  But there are many, many joys that come too.  I look back at the past three years in awe at the way the Lord has lead me, and helped me grow stronger and closer to Him.  I have found that my faith has been transformative in my understanding and practice of medicine.  From the beginning of medicine, my views on suffering have been very different than my colleagues.  Because of this, I am able to approach my patients not by viewing them as a disease process to be fixed, but rather an individual who has been given the gift of suffering, and it is my role to either alleviate that suffering and in doing so show the power of God, or to help the patient better understand their suffering so that they can grow in virtue and holiness because of it.  Now I do not necessarily do this with overt words, but rather through my actions.  If I take the idea that my suffering neighbor is Christ, and I love them in that way, so much good can come from that relationship, both for the patient and for myself.  Another great joy comes from the struggles I talked of earlier.  I am not speaking of joy begotten from strife with others, but of knowledge of the Truth.  While your classmates may struggle with ethical issues, there is joy and peace that comes from have drawn your line in the sand and standing by it.  That joy comes from trusting in the Lord and in the Church.  You of course do your part to gain the knowledge necessary, but you can take solace in the Authority of the Magisterium, unlike many of your classmates, who in their relativism, are lost in these ethical conundrums.
Another great joy comes from finding fellow Catholics.  This is not always an easy task, but now there are a growing number of Catholic groups on medical school campuses.  And there is now a national group for Catholic medical students called the Catholic Medical Association Student Section.  This is the group I have helped to start and been a part of the past two years.  Even if you feel you are the only Catholic medical student who remains faithful to Catholic teaching at your school, this is a group where you can be in contact with other faithful Catholics from around the country.  We also work to connect students with Catholic physicians who are members of the Catholic Medical Association, a national group of faithful Catholic physicians. 
Other joys come to. Maybe they are better known as solaces, like I mentioned earlier.  But many of us go into medicine, not because of the money, but because it is our calling, our vocation.  And when you have an understanding and commitment to that idea, your whole outlook changes.  The way you approach your studies, your exams, your patients, the long hours in the hospital, all of this has a new meaning because you know that what you are doing is in the service of the Lord.
Achieving Excellence
This brings me to my next point I want to discuss:  The need for excellence.  As we move forward as Catholics, the pressure upon us to conform to the culture is only increasing.  When I look around, I recognize that the easier way is to conform, to give in and do what my professors and colleagues, and the culture want me to do.  But I know this is not what I must do.  I know that the Lord is calling me to remain faithful to Him.  But you know, it is not enough to just get by, to quietly keep my head down and ‘wait until I am established in practice to be a Catholic doctor.’  I talked a little bit about an experience of having the way made easier because another Catholic had set the example.  Imagine if all the Catholics out there made their voices heard and set the example?  Perhaps we could shift the tide in medical ethics, and we would no longer have to fight these battles.  But it isn’t that easy.  Consider yourselves for a moment.  Would you listen to someone who didn’t know what they were talking about?  Would you have much respect for them if you knew that half the things they said were wrong? Probably not.  The same goes for you and me.  Do you think the world is going to listen to you on issues of faith and morals or good medical practice if you play the fool?  Even if you have the most theologically sound mind and the tongue of Chrysostom, if you don’t have the technical knowledge in medicine, you will not have the respect, and no one will listen.  We must have competence, both theologically/morally and technically (in our respective fields of medicine).  We must rise up as the top students in our class, as the best residents in our program, and the best doctors in our communities. When you have technical authority, your voice gains greater strength, and the respect for you grows. It makes sense doesn’t it? If you are an incompetent physician who tends to lose the trust of your patients medically, how will people trust you when you speak on things like NFP, contraception, sterilization, abortion?  So, your job begins now. 
In order to even get into medical school, you need to be competitive when it comes to grades, experience, research, and the like.  But more than just getting accepted, the classes at FUS will prepare you and make med school easier. So pay attention!  Work hard!  Get good grades now, so that in med school, the pressure is a little less.  I found that I was extremely well prepared for the first year of med school because I had already been through Cell phys, biochem, immuno, developmental, neuro, and the like.  And do research! When you have papers published (I have three in scientific journals, and one in bioethics), it increases your clout.  And you know what else you need to do? Study theology.  This is the best place on the planet to study both theology and biology, so don’t waste that opportunity.  You need more than just Intro and Christian moral principles.  Take advantage so that you can use your knowledge TO your advantage later on.  I have never regretted my theology degree.  It has been immensely helpful in my medical decision making, my conversations, and my general spiritual life.
Once in med school, you need to be on top of your game and to do as well as you can.  Now I throw in a caveat.  I do not recommend you study so hard, and so much, that you do not have time for a life or for the other work the Lord places in your path.  Balance is key.  It is hard to find, and is very individual, but you must be both competent academically and socially.
For my part, I am married.  And this has helped a lot in that regard.  My bride is a FUS grad, we met here, courted here, and were married at St. Peter’s.  We now have a 2 ½ year old son and another coming in December.  As an aside, I encourage anyone in a serious relationship to consider marriage before med school (without rushing things of course).  It has its challenges, but all in all, the married ones make better students and better physicians and it is very doable.  Let me know at the end of the talk if you have more questions.
Back to competence.  So I talked about doing well in your studies, both now and in med school.  It requires a lot of reading, but it is well worth it.  Now, just to be clear, when I say be competent and top of your class, I do not mean you turn into what we call the “gunner”.  That guy who always answers the questions and tries to make others look bad.  You also need to have a life.  So find the balance.  Practice that now, and remember those tricks in med school.  Most importantly, take it seriously.  This is the rest of your life, it is your calling, your vocation, and you may very well answer before the Lord on how you used your time.
There are things you will not learn in med school that are very pertinent to medicine.  Things like natural family planning.  You will be questions by your family and friends on things like vaccines, and end of life care.  You will need to do extra reading to be able to have some authority in these areas. Moreover, certifications are great.  Going through programs like Creighton or the couple to couple league (for those who are married) to become NFP instructors.  Just recently I was able to use my certification as a NFP instructor to give a lecture to the family medicine residents at a local, secular hospital on natural family planning.  
Finding Support
You also need support.  This is not a journey you can make alone, no matter how strong you are or how hard you try.  I have witnessed students, good people, break trying to do so.  It is important to find community, even if it is outside of the medical school.  Look for parishes, look around in your class. See who responds when you say something, or who comes to pro-life events.  It is a slow process, but eventually you might find someone who shares your beliefs.  I know that over the course of 6 months I found two other men in my class who wanted to know more about their Catholic faith, and they came to me because I spoke out in discussions.  Beyond just your med school, which may or may not have a decent Catholic students group, there is the Catholic Medical Association Student Section, which I mentioned earlier.  Become an active Catholic.  Be active in your school, your parish, and your community.  It is amazing the opportunities and gifts the lord will give.  I never imagined that during med school I would be here giving this talk, or giving the other talks I have given back in Toledo, or traveling to Rome for medical conferences at the Vatican, or being an advisor on medical ethics to several priests in my diocese.  The Lord has opened doors because I responded to His call, and He will do the same for you when you pursue your vocation with prayer and willingness.
I have tried to talk to you all about several different issues.  I wanted to first make you aware of what challenges lay in your path, and also what joys you might be able to expect.  I want to reemphasize that you need to know your stuff.  This means extra studying in areas beyond what you might be tested on, but it will serve you and the Church well.  And remember, you are not alone.  There are organizations, like the CMA-Student Section where you can find others for support.  You can also check out the CMA-SS blog, which has many posts about some of these experiences and ways to become stronger Catholic physicians.  Also, reach out to other pro-life students in groups like Med Students For Life.  And most of all, do not be afraid to live out your faith.  You never know when the battle you fight now may change the life of another person who comes after you.  

Wednesday, August 31, 2011

MaterCare Conference Day 1

The Lord be praised! I write to you all from the Vatican after the first evening session of the MaterCare International 8th annual meeting.  This year the conference is focusing on “The Dignity of Mothers and Obstetricians: Who on Earth Cares!”  That last part may be a bit jarring for most, and rightly so.  In the words of Bogdan Chazan, chairman of the Matercare International Advisory Council,

This dramatic question is to wake us.  To make us aware of the range and size of the world epidemic of perinatal deaths of mothers and children….we have the right – and even the duty – to draw our attention to the drama of the situation of societies, families and children, where mothers die.  An improvement of the care for mothers and their children is not only an issue for governments and non-government organizations.  Doctors, midwives, and nurses should treat their duties in obstetrics not only through the narrow lens of maternal-fetal medicine.  We should treat this beautiful medical specialty more broadly, rather as medicine of maternity.
This meeting is designed to bring about that paradigm shift and for the participants to learn the facts concerning OB/GYN care around the world, and to learn concrete steps that can be taken to help make this a reality.

Now, I am sure many are wondering, who is MaterCare International? MCI is a group of Catholic obstetricians and gynecologists who have adopted a preferential option for mothers and babies.  MCI’s mission is to carry out the work of Evangelium Vitae by supporting their colleagues and improving the lives and health of mothers and babies both born and unborn. They seek to do this through new initiatives in service, training, research, and advocacy designed to reduce the tragic levels of abortion worldwide and maternal and perinatal mortality and morbidity in developing nations.  MCI is also the obstetric and gynecologic arm of the World Federation of Catholic Medical Associations (FIACM). 

This conference has drawn quite a group of speakers and participants, and I look forward to sharing more of the conference.  Just a few names you might recognize: Father Frank Pavone of Priests for Life, Dr. Donna Harrison, of AAPLOG, Mike O’Dea of Christus Medicus, and many others from around the world. So please, continue to check back and don’t forget to follow live updates on twitter @Cathmedstudents and on Facebook at www.facebook.comcatholicmedicalstudents

Monday, July 18, 2011

Why Natural Family Planning should be Mandatory in Marriage Preparation

With Natural Family Planning (NFP) Awareness Week coming up (July 24-July 30), we wanted to share a few thoughts on NFP.  As a teaching couple, we have heard many arguments for and against NFP and whether or not it should be a mandatory part of marriage preparation.  One of the great misunderstandings concerning NFP is that many individuals consider its purpose to be only a natural method to avoid pregnancy.  Now, NFP is extremely useful and efficient in this regard, but in reality, learning about NFP and Fertility Awareness is so much more than simply learning how to avoid pregnancy.  So let us look at a few reasons why learning NFP is so important in our day and age.

Medical Benefits
The simple act of charting can have immense medical benefits for the woman.  Both in our medical experience and in our Natural Family Planning course, we have seen many women who have experienced tremendous paybacks as a result of recording their fertility signs.  And this experience is not simply ours alone.  One only needs to talk to all of the women who have been helped by Dr. Hilgers at the Pope Paul VI Institute to find out how the act of charting opened the doors to cures and solutions of their cycle and pregnancy related medical issues.  Whether using the Creighton Model, the Symptothermal or any other method, a couple who is charting can detect hormonal imbalances, infertility, nutritional deficiencies, cancers, and a variety of cycle issues.  These same couples, through charting, can reduce their need for unnecessary interventions during an infertility workup, or during pregnancy.  Consider that if a couple knows the date of conception through charting, a very accurate due date can be determined.  This saves the couple from needing an ultrasound to determine the due date, and can save many dangerous interventions at the end of the pregnancy since the parents and physician can know with great accuracy when to expect the baby.  If a couple who had a history of charting,  were to consult a physician due to difficulties with either the woman’s menstrual cycle or achieving pregnancy, so much more information can be made available to the doctor.  Without this information, the doctor may not be able to offer as much assistance, or require the woman to undergo many invasive procedures in order to ascertain the root cause of the problem.

Formation of the Lost Sheep
It is obvious that the knowledge of NFP can be truly helpful to many couples experiencing medical difficulties. This is not the only reason, however that we feel that the message of NFP is so badly needed.  The sad reality of today is that, out of those couples who wish to be married in the Church, an overwhelming majority of them are already cohabitating and on the pill. There has been a huge gap in the moral formation of the past two generations and their views on sexuality have been largely formed by the secular culture. The results of this influence have been disastrous. During the morality sections of our class, we have a unique opportunity in reaching out to these couples to educate them in the truth and beauty of human sexuality and to encourage them to embrace God’s design for marriage. Once they understand their dignity as human persons and the nature of love, they begin to see children as a much desired blessing rather than a terrible burden. As in any type of conversion, changing a person’s view on sexuality is a process. We have seen time and again how the Holy Spirit does work in miraculous ways on the hardest of hearts through the message of NFP and watched as relationships have transformed before our very eyes. Many couples have even expressed outrage that no one had ever told them these things before. Through our students we have recognized a burning desire for this message, and a readiness to challenge the unsatisfying lies of the world.  For the majority of those couples, they never would have been exposed to the fullness of the teaching of the Church, had their pastor not required it for their marriage preparation.  

Achieving Pregnancy
Recent studies have shown that 80% of couples who use a fertility awareness method to time intercourse will conceive within 6 months of trying, and over 90% by 12 months.  Dr. Hilgers has shown in his work that 98% of couples in one study were pregnant within one year.  Studies have also shown that at the end of 3 years, over 60% of couples with subfertility will conceive if they use a fertility awareness method.   This has a better efficacy (and lower cost) than IVF and many of the other assisted reproductive technologies.

In today’s society, where children are viewed to be more a burden than blessing, where the majority of physicians do not respect a moral approach to reproduction, and where so many women experience cycle issues, how can we not expose couples to this information?  Even if they choose not to use NFP at that time, they might face a situation in which they may need to turn to it later in their marriage.  A course in NFP may be one of the greatest opportunities a couple has to learn about the beauty of married life and the marital act, and the blessing that children truly are.  By requiring a course in NFP, those being prepared for marriage are being given a great gift of knowledge that they will be able to carry with them for their entire lives.

Brian and Johanna Burke are a certified teaching couple in the Symptothermal Method for the Couple to Couple League and teach in the Diocese of Toledo.  Brian is a fourth year medical student at the University of Toledo, planning a career in family medicine, and is also the Vice President of the Catholic Medical Association Student Section.

Tuesday, June 14, 2011

The Medicinal Gifts of the Holy Spirit

We are currently in the Octave of Pentecost, a time of celebrating the descent of the Holy Spirit and the wonderful gifts the Spirit gives to us.  These gifts are so important to the physician in caring for a patient, and as caregivers, we must take a moment and pray that the Holy Spirit will come upon us.  Let us reflect on how the gifts of the Holy Spirit are pertinent to our profession:

1. Wisdom:  is the first and highest gift of the Holy Spirit, because it is the perfection of faith. Through wisdom, we come to value properly those things which we believe through faith. The truths of Christian belief are more important than the things of this world, and wisdom helps us to order our relationship to the created world properly, loving Creation for the sake of God, rather than for its own sake.  We must pray for wisdom so that our faith may be deepened and our actions towards our patients reflective of the love of Christ given to us through our faith.

2. Understanding: In understanding, we comprehend how we need to live as a follower of Christ. A person with understanding is not confused by all the conflicting messages in our culture about the right way to live. The gift of understanding perfects a person's speculative reason in the apprehension of truth. It is the gift whereby self-evident principles are known, Aquinas writes.  As physicians, we must continue to pray for deeper understanding of the will of God and His Truths.  We must continue to seek a deeper understanding of how, through all of the ethical dilemmas and conflicts we encounter, we are to continue to live out God's will and be a beacon of love and Truth to our patients.
3. Counsel: With the gift of counsel/right judgment, we know the difference between right and wrong, and we choose to do what is right. A person with right judgment avoids sin and lives out the values taught by Jesus. This gift is so important for us as we make decisions that impact both our moral lives and the moral lives of our patients.  We must be able to clearly see and choose the Good in each situation, even when the path is unclear.  This is a gift we must constantly seek from the Spirit.

4. Fortitude: With the gift of fortitude/courage, we overcome our fear and are willing to take risks as a follower of Jesus Christ. A person with courage is willing to stand up for what is right in the sight of God, even if it means accepting rejection, verbal abuse, or even physical harm and death. The gift of courage allows people the firmness of mind that is required both in doing good and in enduring evil, especially with regard to goods or evils that are difficult.  Again, this is a gift that we constantly are in need of in our every day practice.  We must have courage to take the risks involved with standing for the Truth and telling our patients and colleagues what is Right and Good.

5. Knowledge: With the gift of knowledge, we understand the meaning of God. This gift is more than just the accumulation of facts (something physicians are pretty good at).  It is seeing in this accumulation of facts the deeper truth evident in this world and coming to know how these facts fit into the grander picture that Lord has painted for us.  We must pray that the Spirit will help us to know not only the medical facts to care for the patient, but also the personal and spiritual knowledge we need in order to fully heal this person and help them return or come to know the Lord.
6. Piety: With the gift of reverence, sometimes called piety, we have a deep sense of respect for God and the church. A person with reverence recognizes our total reliance on God and comes before God with humility, trust, and love. Piety is the gift whereby, at the Holy Spirit's instigation, we pay worship and duty to God as our Father, Aquinas writes.  As physicians, we must continue to show reverence to the Lord not only in our worship, but in our everdya life, knowning that God is the one who has placed us in our position of healing, and that all of this comes from Him.

7. Fear of the Lord: With the gift of fear of the Lord we are aware of the glory and majesty of God. A person with wonder and awe knows that God is the perfection of all we desire: perfect knowledge, perfect goodness, perfect power, and perfect love. Through this gift, the Spirit can help us to recognize with wonder and amazement the beauty of the human person.  We must approach our patients with this awe, recognizing them as creations of our most perfect Lord, and as such, worthy of our utmost care and respect.

I hope these brief reflections will help us all seek the gifts of the Spirit as we approach our patients and continue to be witnesses of the Lord's love and truth in our profession.

Tuesday, May 10, 2011

Right Place At the Right Time

On my way home from work, I just happened to be in the right place at the right time.  I was nearly home when I saw that there was an accident up ahead.  As I passed by, I saw that there was a man lying in the turn lane, and a mangled bike further down the road, and an SUV with a smashed in windshield.  Seeing that no EMS or Firemen had arrived yet, I pulled into my street, grabbed my stethescope and bag and ran back to the scene of the accident.  The man was lying on the ground, awake and agitated, so I quickly started talking to him in order to check his airway, then I listened to his lungs to make sure he had decent breath sounds and heart sounds, then I looked him over for any major bleeding.  Next I started to do a quick assessment of his neuro status. I wanted to make sure he was coherent and to find out if he had any major deficits (he was wearing a helment and complained of back pain).  Around this point, I heard the sirens of the fire department headed our way.  The firemen and then EMS arrived, took over, and brought him to the University Hospital just around the corner.  In the end, the man will be okay and just had some scrapes and bruises.
This whole incident really made me think twice.  When I made the decision to go help, everything went very fast.  My medical training, my time spent working on the trauma team, everything kicked in and I just started to automatically go through the routine in stabilizing this patient until help could arrive.  I was very grateful that I could be in just the right place at the right time.  I could see the Lord's hand in this.  He was giving me the opportunity to help this man, this complete stranger.  I think of a combination of the teachings of our Lord which brings together the idea of using the talents the Lord has given us with the story of the good samaritan.  We ought to be ready at any moment to give aid when it is needed, to friends and strangers alike.  This is especially true of those who have training that is more than the general public might have.  In my case, the man was okay, but he could have easily broken his back, or punctured a rib, or been bleeding profusely and I may have had to call upon more of my knowledge in order to preserve his life until the medics could get him to the hospital.  But not every life saving action requires a man hit by a car.  In our everyday life, a simple word or act of kindness may mean the difference between real life and death, between heaven and hell for an individual.  You have a special talent, one that is more important than any medical knowledge at the scene of the accident, you have the gift of the knowledge of Christ and His love.  Be sure to use this gift and do not squander it.  In thie everyday actions of life, you just might become a lifesaver.

Monday, March 07, 2011

Full Circle

The Lord is constantly moving in our lives, and He has made that evident to me once again.  This past Friday, I finished up my time on the inpatient general medicine service, I had an experience that I am still contemplating and praying about.  It concerns a patient that I saw, but Friday was not the first time I had encountered this individual.  Last November, when I was doing a general surgery rotation at a community hospital outside of Toledo, I encountered Mr. L during an office visit.  Several months prior, he had a neuroendocrine tumor removed from his left forearm.  It apparently was not very large and seemed to be the only spot of cancer.  When I saw him in the office, he was complaining of a very large mass in his left axilla.  The mass had developed rapidly over the course of a couple of days and he and his wife had become quite concerned.  The surgeon, being a surgeon, took a tissue sample and sent it off.  On the last day of my rotation with this doctor, we recieved the pathology report stating that mass was neuroendocrine tissue.  We were both very surprised because this was unusual behavior for this type of tumor.  In any case, the surgeon stated he would be referring the patient to the University Hospital due to its location, size, and type of tissue.  I thought nothing more of the case as I moved on to my next clerkship.  
Fast forward three full months.  I am now on my last day of inpatient general medicine at the local Catholic hospital (I will use the term Catholic loosely in this case), and we are just starting rounds with the attending.  He tells the team that he has a private patient in the neuro intesive care unit, and that we may either join him or meet him on the wing where our first teaching patient is residing.  We all decided to go ahead and follow our attending upstairs to the ICU.  A fateful decision this would be.  When we arrived in the unit, I followed the doctor to see his patient.  The brief history I gathered from our attending was that several days prior, the patient had gone to bed perfectly normal, and awoke the next morning unable to move his legs or his right arm.  The patient was understandably very distressed and he was taken to his local hospital where an MRI was done.  The MRI showed a mass in the cervical spine compressing the spinal cord.  He was rapidly transferred to the Catholic hospital, a major hospital in my city, for more specialized care.  As I come to discover, this was Mr. L whom I had seen 3 months prior for a mass in his axilla.  As it was related to me, Mr. L had the mass removed by a University physician shortly after I had seen him.  I do not know the interim history, but in the end the cancer had come back very aggressively.  
I was shocked by all of this.  I told my attending that I had seen this patient before, and he made the remark 'Now you have seen him full circle.'  It is this remark that I have been contemplating.  Through all of this I can see the Lord's hand at work, placing me in just the right place at just the right time in order for this series of events to occur.  But I ask myself, what is the Lord showing me?  Why does he want me to see this man go from being very functional to being confined to an ICU bed, scared and in pain?  The answer is one that I think will take a long time to fully realize, but I believe that the Lord has started to show me something very profound and important: Man will suffer and sometimes there is very little that we can do physically for him.  
This may seem like a 'Of course!' type of statement, but I think it is much more difficult to grasp than we realize.  For those who have been in situations of extreme physical or mental suffering, we can think of those moments where we wanted nothing else than for that pain to be gone.  For some, they would give anything for a moment of relief.  And for others, they have given everything, including their soul, seeking escape from suffering, yet only to find themselves in even more dire circumstances.
Suffering is the paramount problem of man’s existence.  “Illness and suffering have always been among the graves problems confronted in human life.  In illness, man experiences his powerlessness, his limitations, and his finitude.  Every illness can make us glimpse death." (CCC 1500)  It is through the action of Adam and Eve that sin was brought into the world, and with it, suffering and death.  The story of man’s attempt to evade both suffering and death is the stuff of ageless legends and the impetus to seek both the ancient and modern remedies that might stave off such a fate. 
And yet, what does suffering do for man? Consider the word's of St. Paul in his letter to the Colossians of the relationship of suffering and the Cross.  He says, “I fill up in my body what is wanting to the sufferings of Christ, for the sake of his body which is the Church.”1  This reflects the new meaning of the suffering of man.  No longer is it simply the curse, but now it is the blessing of God.  Just as the doctor takes part of the salvific mission of the Church through the ministry to the sick, those who are sick and suffering take part in the redeeming mission of Christ.  In the words of John Paul II, “On the cross, Christ made his own all the weight of evil and took away the sin of the world (Jn 1:29), of which sickness is but a consequence.  By his passion and death on the cross, Christ has given new meaning to suffering: now it can configure us to him and unit us with his redemptive passion.”2  By his death and resurrection, Christ has redeemed the world.  In that action he has allowed the suffering man to partake in that redemption and within this new meaning of suffering for the Christian, there is a threefold salvific attitude that exists:
an ‘awareness’ of its reality ‘without minimizing it or exaggerating it’; ‘acceptance,’ ‘not with a more or less blind resignation’ but in the serene knowledge that ‘the Lord can and wishes to draw a good from evil’; ‘the oblation,’ ‘made out of love for the Lord and one’s brothers and sisters.’3 
To consider these three points in another way, one can use the words knowledge, trust, and action.  In that awareness there is knowledge of the nature of the illness and suffering and of the cross which is to be borne.  This is critical, because as Pope John Paul II (from whom this threefold salvific attitude comes) said, the patient neither wants to minimize or exaggerate it, but rather embrace it as it truly is. Through the acceptance there must be a trust in the Lord.  The patient must realize that the Lord came “so that they might have life and have it more abundantly.”4  Suffering is not a cruel punishment but a means of salvation, and so the patient must rejoice in the opportunity to suffer because it is from the Lord, from whom all good things come.  The third part of this attitude is action.  The oblation of which John Paul speaks requires that action must be taken.  It may only be an interior movement of the will, but nonetheless it is essential for this suffering to be fruitful.  The patient needs to consciously make the decision to offer up this suffering on behalf of the body of Christ.  In this way, not only will the graces be obtained, but the psychological affect will be greater.  Through his suffering, the patient has entered into the redemptive act of Christ and it is the physician’s role to help orientate the patient towards this end.

1 Col 1:24
Discourse in Lourdes, August 15, 1983, n.4 found in The Charter for Health Care Workers, p. 59, also found in CCC 1505.
The Charter for Health Care Workers, 54.
4 John 10:10

Saturday, February 19, 2011

Obama Administration Rescinds Bush Era Conscience Protection

"The Obama administration on Friday rescinded most of a 2008 rule that granted sweeping protections to health care providers who opposed abortion, sterilization and other medical procedures on religious or moral grounds. Kathleen Sebelius, the secretary of health and human services, said the rule, issued in the last days of the Bush administration, could 'negatively impact patient access to contraception and certain other medical services.'"
These are the words of the NY Times article detailing the Obama administration's latest action concerning the Bush Era conscience protection measures that finally gave teeth to the Church and Weldon amendments that specifically protected health care workers from being forced to assist or perform abortions.  Previoulsy the commentary on the HHS regulations had read:

The ability of patients to access health-care services, including abortion and reproductive health services, is long established and is not changed in this rule. Instead, this rule implements federal laws protecting healthcare workers and institutions from being compelled to participate in, or from being discriminated against for refusal to participate in, health services or research activities that may violate their consciences, including abortion and sterilization, by entities that receive certain funding from the department. (It also implements the provisions of federal law which protect health-care personnel from being discriminated against for their participation in any lawful health service or research activity, including abortion and sterilization, by entities that receive certain funding from the department.)

This is quite contrary to the tune that Kathleen Sebelius, the current director of HHS is singing.  The new rule will maintain an office for complaints to be filed, but given that the Obama administration has effectively ignored the the Bush Rule that was in place for the past 2 years, it is doubtful that this office will do much of anything when a nurse, student, or physician is pressured by an employer or school to assist or perform in an abortion.  The Vanderbilt Case is a good example.  More and more pressure is being applied to health care providers to simple 'go with the flow' and do whatever the patient desires in regard to abortion and contraception.  We are losing our rights, and in losing our rights, the patient is losing theirs.

The doctor-patient relationship is founded upontrust. The patient must trust the doctor to keep confidentiality, to respect his autonomy, and to do the patient good. The doctor must trust that the patient is telling him the complete information and will follow the treatment plan. Without trust, effective health care is not going to occur. How does the conscience fit in with trust? Take, for example, an individual who is a Jehovah’s Witness. The patient is in a situation where the doctor is recommending a blood transfusion, but the doctor also knows that this individual will not take a blood transfusion because it would be a violation of their conscience. The patient must trust the doctor to respect their conscience and thus their autonomy. If the patient does not feel that a doctor would respect their autonomy, then an effective relationship will not be established and the patient will be in fear of what the doctor may do. However, one key way that a patient can know that a doctor will respect their conscience and autonomy is by seeing that the doctor respects and adheres to his own conscience. How could a patient trust a doctor to respect his own wishes if the doctor is willing to violate that very faculty that is supposed to help him recognize truth and act according to it? It would seem that most patients may have a difficult time fully trusting this doctor to act in their best interest. To brush these concerns aside is to ignore a reality of human nature and to put at risk the foundation of the principle of autonomy in medicine.
This step of the Obama Administration is another attack on not only health care providers, but also on patients themselves.  The continuing erosion of the rights of the provider will only continue until the rights of the patient to make medical decisions for themselves has been eliminated as well.  We must continue to fight for our right to practice medicine as our faith and our conscience directs us, it is the only way that the true Art of Medicine will be saved.

Saturday, November 13, 2010

The New Catholic Medical Association Students Section

The past three months have been very busy.  The Catholic Medical Students Association official no longer exists, but is now become the Catholic Medical Association- Students Section.  Prior to this change, the CMSA was a loose, independent affiliation of individuals around the country.  We had many struggles in maintaining our structure and continuity. However, all of that is changing now.

With the creation of the Catholic Medical Association-Students Section, we will now be officially a part of the CMA and have administrative and monetary support for our mission.  The CMA is extremely happy to have us as a part of their organization and have gone to great lengths to support the CMA-SS.

This is going to be a great opportunity for medical students around the country who are looking to be a part of a group who has national voice in the defense of Catholic medicine.  By joining the CMA-SS, students will also have access to a database of other members and guilds in their area or in places they may be looking at for residency.  The students will also receive the Linacare Quarterly, an great Catholic bioethics journal, and they will also be eligible for scholarships to the yearly meetings.

As a group, the CMA-SS is striving to help form Catholic medical students as strong and faithful doctors.  We hope to do this by facilitating relationships between Catholic physicians and students and by giving the support that each student needs to be a faithful Catholic physician.

If you know of a Catholic medical student, please direct them to our website:

and please check out our latest blog post:

If you have any other inquiries, please email us at

Thursday, August 05, 2010

The Fight Is Still On Against Abortions in the Military

As a future Navy physician (and current Navy officer) I am appalled that Senator Burris would try and force the military to provide abortions.  Despite what the media would have you believe most Americans are against abortion, and that goes for military members as well.  This is an all out assault on the unborn.  We have attacks coming through Obamacare, stem-cell research, govt funding to Planned Parenthood, and now the attempts to force it upon the military.

Abortion and the military is an interesting situation, but one that reflects the greater society.  The so-called need for abortion in the military arises primarily because if a woman becomes pregnant, her ability for advancement disappears.  If she is overseas, she will quickly be sent home and her career will stall out.  (Read more in a June 2010 NY Times article about this).  So in the eyes of the liberals, the answer is to allow these women to abort their children rather than to call upon them, and the men involved, to exhibit the self discipline we would expect from our service men and women.

We ought to be focusing on to points in all of this.  The first is the need to instil the idea of the dignity of human life.  It would seem this would be very challenging in light of the profession of a service member, but it is necessary even in light of this. We need our service men and women to recognize the idea of self defense, but also the idea of mercy when encountering the enemy.  The same for the unborn.  We must show them that this is a life that they have taken an oath to protect, just as they are protecting the rest of us.   The second point is self discipline.  A standard of self control and chastity should be instilled in these men and women (just like the rest of America needs it).  If any group of people should be able to do this, it should be those who have dedicated their lives to the idea of discipline and sacrifice.

So we need to continue the fight against this Amendment:

Over 200 Military Physicians Petition for No Abortion on Military Bases
WASHINGTON, DC, August 3, 2010 ( -- Over 200 active and retired military physicians have signed a letterorganized by the 16,000-member Christian Medical Association (CMA), in which they ask Senators to vote against the FY 2011 National Defense Authorization Act, unless an amendment permitting abortions to be performed on military bases is stripped from the bill.
"In addition to facilitating further destruction of unborn life, the provision will place military physicians with life-honoring convictions in the unenviable position of either disobeying orders, abandoning their conscience, or seeking objector status," said CMA Senior Vice President Gene Rudd, MD, who has received the Gorgas Award for distinguished service in the American military. 
Current law prohibits the performance of abortion by Department of Defense (DoD) medical personnel or using DoD medical facilities, except in case of rape, incest, and a threat to the life of the mother.  An amendment added to the Defense Authorization Act by the outgoing Senator Roland Burris (D-IL), however, would permit abortion on both domestic and overseas military bases.

"Such a drastic and controversial change in longstanding federal policy could disrupt military medicine in a time of war and also undermine military physician retention and recruitment," the letter says.
When President Clinton instituted a policy in 1993 permitting abortions on military bases, most military physicians refused to participate in them.  The letter warns that the efforts of those holding to "partisan abortion ideology" in attempting to diminish conscience rights, combined with pro-abortion policies such as the Burris amendment, could "drastically reduce the number of physicians, thus reducing patient access."
"Reducing physicians and patient access during two wars and at a time of a growing and severe national shortage of physicians - especially in the fields of obstetrics and gynecology and family medicine - is hardly wise policy, regardless of one's views on abortion, " the letter states.
Abortion has been prohibited on military bases since a 1996 law overturned Clinton's policy.  That law "has enabled military physicians to practice medicine according to the life-honoring principles expressed in the Hippocratic oath and Judeo-Christian ethics," according to the letter.
CMA Director of Global Health Outreach Col. Donald Thompson, MD, who recently retired from the Air Force, said that "this provision would put conscientious military medics on the losing side of the Uniformed Code of Military Justice (UCMJ) in key areas crucial to good order and discipline in the military.”
"Our military exists to fight our nation's wars, not to be a ideological playground. If this provision stays in the NDAA, it will drive out of the military those who are most likely to serve their nation by going in harm's way."
The FY 2011 Defense Authorization act would also end the "Don't Ask, Don't Tell," (DADT) policy and permit homosexuals to serve openly in the military.
You may find contact information for your Senator here.

See related stories on

U.S. Senate Committee Oks Amendment Ditching Military Abortion Ban

Rep. Smith Vows to Oppose Military Abortions in Defense Bill