Sunday, January 4, 2009

The Tyranny of an Undisclosed Conscience

Displacing professional standards by an undisclosed conscience can only result in tyranny – and other undesirable unintended consequences of a new Federal rule are also inevitable!

Beginning January 19, you can go to a hospital that says it provides family guidance services yet be denied legitimate healthcare information without your knowledge or consent simply because of the conscientious beliefs of the clinician serving you that day.  For example, “for more than 30 years, federal law has dictated that doctors and nurses may refuse to perform abortions. The new rule would go further by making clear that healthcare workers also may refuse to provide information or advice to patients who might want an abortion.” (Los Angeles Times, 12/2/08)  

The BIG difference between the old and the new scenarios, as we will see below, is that when using a hospital that objects to certain services such as abortion, you used to know what to expect; but under this new rule you no longer know what to expect since what information you receive will depend on each clinician’s personal conscience. It really does NOT matter what the published literature of the hospital says anymore.  The conscience of the individual clinician prevails in every case.


Since this is a federal rule, it trumps local laws:

Many states currently have laws requiring that rape victims treated in hospital emergency rooms be offered the option of taking emergency contraceptive pills to prevent pregnancy. But she [president of Planned Parenthood] said that because providers who don’t believe in emergency contraception could now simply opt not to tell women about that option, “under this rule, we believe that in fact now women who are the victim of sexual assault either would not be guaranteed either information or health care access to emergency contraception.”(NPR, 1/3/09)


This rule has severe penalties:

The far-reaching regulation cuts off federal funding for any state or local government, hospital, health plan, clinic or other entity that does not accommodate doctors, nurses, pharmacists and other employees who refuse to participate in care they find ethically, morally or religiously objectionable. It was sought by conservative groups, abortion opponents and others to safeguard workers from being fired, disciplined or penalized in other way. (Washington Post, 12/19/08)


This rule extends to a wide network of healthcare workers:

The Bush administration announced its “conscience protection” rule for the healthcare industry Thursday, giving doctorshospitals, and even receptionists and volunteers in medical experiments the right to refuse to participate in medical care they find morally objectionable.  (Los Angeles Times, 12/19/08)

The final rule, however, affects a far broader array of services, protecting [pharmacy] workers who do not wish to dispense birth control pills, Plan B emergency contraceptives and other forms of contraception they consider equivalent to abortion, or to inform patients where they might obtain such care….  While primarily aimed at doctors and nurses, it offers protection to anyone with a “reasonable” connection to objectionable care — including ultrasound techniciansnurses aidessecretaries and even janitors who might have to clean equipment used in procedures they deem objectionable. (Washington Post, 12/19/08)

No More Basis for Trust

When you go to a healthcare organization such as a Catholic hospital that clearly states its ethical position, you know what to expect, and you know you will be served professionally within the bioethical beliefs of that organization.  So, for example, they will not offer you abortion services, though they are required to offer alternative options.

Rules already are in place to protect any person, doctor or pharmacist from going against their conscience by providing abortion or contraception information or services to patients or clients. But current practice requires people to inform people that other options are available elsewhere. (Pittsburgh Post-Gazette, 1/3/09)

As we have noted above, however, this new rule does not allow you to know you are not being denied certain services, which means you will not know what to expect.  “The provider can deny information and services to their clients without their knowing it is being denied.”  (PittsburghPost-Gazette, 1/3/09)

You will be under the total control of each clinician’s conscience regardless of their ethnic or religious background, or even any misguided confusion of a partially developed or guilty conscience they may be experiencing at the moment.  Some warn that “As written, the rule also would protect health care providers opposed to vaccinations or other medical procedures.”  (Pittsburgh Post-Gazette, 1/3/09)  It will take a long time to sort out because no one will know when it is being employed because clinicians who take advantage of it are not legally accountable for their actions.  This rule does not require anything from them; rather, it permits them NOT to do what other laws, professional codes, and ethical codes DO require them to do.  It is truly antinomian.  

When I think how many healthcare organizations are turning over ever more of their clinical functions to nurses and much less educated providers; when I think how narrowly educated these specialized medical technicians are; and then when I think how the mass media has made almost all of us highly vulnerable to every wave of pop culture thinking and current fads, I wonder what kind of conscience we are turning our future medical care over to?  Whatever the current movies are promoting?  What kind of social strategizing does the Bush administration have in mind?  Certainly not the good of the unborn – that is plain to see, since there have been no commensurate increases in social services to support the increased birth rate this rule is intended to accomplish.

This rule seems bound to create moral chaos. There is no basis for trusting one’s clinician since they legally do not have to tell you anything that offends their conscience. They are not compelled to give you as much respect as God gave Adam and Eve. They may even deny you your own right to refuse treatment by denying you the right to even know about it. If there ever was a place where the “house of cards” imagery applied, this is it. You can’t just say conscience takes priority in one clinical area but not in another. If it applies to bioethical issues, why should the underlying principle not also apply to alternative medicine, mental heath, and controversial medical treatments? It makes no sense to view this rule as limited in scope: the legal basis for justifying this one area must surely apply to other areas as well.  But my bet is that the whole thing will collapse because it makes no practical sense. 

 

Unintended Consequences?

No one can fully predict the legal implications of this rule if it stays in place since it supersedes other related laws and seems to sanction a kind of libertarianism in medical ethics as far as denying medical treatment is concerned.  As noted above, some are concerned about medical procedures not mentioned in the rule being included as matters of conscience for some clinicians. There are all kinds of matters of conscience that this rule will undoubdedly bring to light.  This rule is not simply a regulation – if it continues it will create a new ethical  paradigm – the belief that personal ethics trump responsibility to clients in the professional relationship.

From all reports, the creators of this law seem to presume a traditionally Christian-based bioethical stance as either the legal heritage of the USA and/or the proper direction which the USA should take.  It appears that they have their own minds made up since they have not adapted the rule based on widespread public input. (Huffington Post, 12/19/08)  They seem unconcerned about the need for people of various viewpoints to live together amicably in a multicultural society, and in a society that does not reflect their common moral viewpoint.

And curiously and in contradiction to the Christian tradition which they seem to represent, this rule appears to be another example of the Bush administration’s nietzschean approach to create social change. In more genteel new age terms, this tactic could also be characterized as an attempt to create their own reality.  This from a president who said Jesus was the most influential political thinker in his life!  Jesus, the one who said “the truth will set you free” (John 8:32).  Yet President Bush wants to be known as a president who promoted a culture based on hiding the truth? 


 


Posted by Jim Johnson at 04:50:32 | Permalink | Comments (2)

Sunday, October 5, 2008

Joe Biden’s Pastoral Advice to the Republican Party

John McCain is known for his black and white simplistic stance towards many issues, and Sarah Palin cloned him perfectly in the vice-presidential debates by saying if she had to carry on as president in the event of McCain’s demise she would continue to “get rid of the greed and the corruption on Wall Street and in Washington.

Comments such as these which invoke holy war imagery in response to recent social and economic trends have endeared Sarah Palin to angry Americans, and especially to conservatives associated with the Republican right wing. They forget that self-interest is at the heart of capitalism and that “greed” in the housing market on which our economy is so heavily based is spread throughout all levels, including the consumer level.

Conservative commentator David Brooks follows the Republican Party and is perplexed that they selected Palin knowing she only appeals to a relatively small percentage of the population. Republicans are engaging in planned obsolescence.

…the Republican Party has become a small-town party, running against — as Sarah Palin did last night — against big cities, against the East Coast, to some extent, against newspaper readers.

I understand why they’re doing it, running against Washington. This is the way Republicans do populism. But in the long run, it’s poisonous and self-destructive. You cannot be a majority party in this country if the coasts don’t like you and people who read newspapers don’t like you.

And they have narrowed themselves. … And with Sarah Palin, short-term gain last night, but long-term turning people off. (David Brooks, Online News Hour,10/3/08)

It seems to me Joe Biden gave what could be considered pastoral advice to the Republican Party – actually it was grandfatherly advice to any listener — a few minutes after Sarah Palin’s holy war comments cited above, in his response to the last question about how to lead in Washington, about how to bring about a spirit of bipartisan cooperation.

Joe Biden shared what he had learned in the Senate, a principle he learned the hard way because he violated it first and then was taught by Mike Mansfield to see why the principle is important. Listen to this segment of the debate to hear Biden’s account. We only have space for the principle here.

This is the principle: Don’t question other people’s motives. Question their judgment.

Underlying this principle is the fact that each representative is sent to Congress because other people see something they like in those representatives. Biden left it up to us to meditate on the implications of this fact; but it does not take much time to realize that in a democracy each person must allow their opinion to be one among many. Our leaders should not see themselves as being at war with each other, but rather as representing people who elected them to work for the common good. They must then work with other community and business leaders on the same respectful basis to have any hope of enlisting their support and accomplishing anything worthwhile.

Without making any accusations, and in a gracious manner that admitted he was a sinner as much as any one else, Joe Biden shared this principle as he had received it.

By closing the vice-presidential debate on this note, I think Joe Biden achieved an intellectual triumph that no one has yet acknowledged.

In this one principle he undermined most of Sarah Palin’s appeal as John McCain’s running mate.

Most people recognize she is not yet ready for presidential level office. Her role is simply to draw right-wing voters to John McCain. She is a gamble for the Republican Party. And she is a gamble for the USA.

Joe Biden held up a mirror for the Republican Party to examine its own soul. The problem with all principles, however, is that it is much easier to hear them than to put them into practice.



Posted by Jim Johnson at 21:08:22 | Permalink | No Comments »

Saturday, September 27, 2008

The McCain David Brooks knows — The Obama I know

David Brooks is one of my favorite columnists because of his thought-provoking social insights. He seems more a sociologist than a journalist. You could probably entitle a collection of his most important columns “Popular Sociology.”

On the Jim Lehrer News Hour, he has often expressed his fondness for John McCain, and now he has formalized his endorsement in a piece entitled The McCain I Know.

In it he attempts to demonstrate that although John McCain is not a sophisticated conceptual thinker, his long experience in the Senate forced him to take on issues one at a time in an inconsistent manner: “One day he’s a small-government Western conservative; the next he’s a Bull Moose progressive.”

Brooks argues that McCain has successfully established “a half-century of evidence” as a “good judge of character” and as “a serious man prone to serious things.”

David Brooks believes that if John McCain is elected “he will run the least partisan administration in recent times.” He believes that although he is not able to express himself well and is inconsistent, McCain will prove to be a man of character who will seek to work with a wide constituency.

The biggest problem with Brooks’ argument is its own internal incoherence — that is, since McCain is inconsistent, he cannot be counted on in any given circumstance. What Brooks therefore must actually mean is, experience teaches us we can usually count on McCain. That does not mean we can count on McCain for the big decisions! For example, David Brooks does not think Sarah Palin was a wise VP choice because she is not ready to step into the presidency — that is a major blunder. So even by Brooks’ own standards, McCain is not a dependable decision-maker.

The McCain David Brooks knows is a man of character who is not guided by thoughtful principles and who makes inconsistent decisions on a case by case basis.

The Obama I Know

We all have been so saturated by this presidential campaign that many of us feel we know these candidates and have images of them in our minds based on what we have read and seen over these months. I have written about Obama in several blog entries ( 1234 ) .

For me, the Obama I know can be summarized in this sentence:

Obama is a leader with character who is guided by liberal beliefs, which include not imposing his will on those he leads, but rather seeking their participation in an inclusive democratic government.

What this means is that all people have to do is get involved and their voice will count and they will have an effect on the outcome of any given decision. This is what he has been encouraging: participatory democracy from the grassroots upwards as the only way to save our nation. It is not enough to leave leadership to Washington. But when Washington must be involved, it should hear from everybody!

In terms of staffing his administration, it might look very similar to McCain’s. In many ways Obama and McCain seem quite similar on many fronts. But on the interior they are quite different. Although they both appear to be men of sincere Christian faith and character, McCain is more volatile and temperamental, while Obama is more steady and thoughtful. The difference between the two men is that simple.

The biggest thing about being president is making decisions.

Whose temperament is better suited for the presidency?

Who made the best call on whether to go into the war in Iraq?

Who should be the next president if the one who is elected in 2008 dies in office?

Answering these questions will tell you a lot about which way you should vote in November

.

Posted by Jim Johnson at 20:15:33 | Permalink | No Comments »

Thursday, September 4, 2008

Pro-Choice Bella


Bella is not a perfect movie; but I think it’s an important one, and just about everything you would want in a film.

It is a bit choppy in its use of a creative mix of flashbacks and foreword-shots to force the viewer to discover what is happening a little bit at a time. This necessitates that the plot be kept simple so the viewer can figure it out, so the challenge is never overwhelming and more like putting a puzzle together. Just like the way you hear neighborhood gossip, in bits and pieces a little bit at a time in no special order.

Bella is the story of a young single waitress who gets fired because of a few absences caused by pregnancy related illness, and about how the restaurant’s chef is attracted to her and eventually adopts her baby. The plot is actually a good deal more complicated as it portrays the emotional and ethical struggles over abortion in their broader social context.

Many have seen this as a pro-life movie ( 1234 ), because it takes a stand against the abortion trend; and in the positive sense of promoting the better option for choosing life it is indeed pro-life, since it illustrates how real human life is not some isolated existence – not the mere fact of existence as an embryo or as another body count statistic – but rather the quality of the interconnectedness of caring relationships that sustains us all, and which we each need.

But I would argue Bella is actually a pro-choice presentation when it comes to the politics of abortion.

The story works because it respectfully leaves the ultimate choice of whether to have an abortion in the hands of the mother; and it only works because someone was motivated to help the mother find a hopeful future for her baby. The rights of the fetus are not in focus, and quite properly, an emphasis on preventing abortion is not presented as the pro-life message.

Bella emphasizes that for a human being to thrive a child should have a loving family – a baby should be wanted. Social conditions need to exist where families and neighborhoods characterized by positive relationships can thrive. The mother had nothing to offer her child. The chef had all the connections for a rich family life.

Bella is pro-life in a positive sense. It is against abortion when you have an option to provide a viable family for your baby, an option the film recognizes not everyone has, though perhaps every pregnant mother wants it for her unborn child. And it demonstrates that it will take a lot of interpersonal love and caring outreach to unwed mothers to really address the challenge of unplanned, unwanted pregnancies.

I wonder how many pro-lifers really understand the social implications of this film. Or if they can still think their main responsibility is to protest abortion and just get laws against it passed? There really is a big difference between simply being against something and taking action to reduce the need for it.

How can we help reduce the pressures that lead people to see abortion as the solution to their problems? There are a wide range of preventive and alternative measures that could reduce the abortion rate, and there is also a need for more preschool options to support working families as children grow older and young families continue to need support at the most vulnerable time of a child’s development.

Pro-choice does not mean pro-abortion.

Pro-choice means allowing mothers to choose a real life for their child.

Supporting pro-choice means promoting a social environment where children will be wanted, cared for, and where they can thrive.

Posted by Jim Johnson at 01:28:29 | Permalink | No Comments »

Wednesday, August 20, 2008

The Medium Distorts the Message at Saddleback

Everybody seems to be impressed with how evangelicals have become so much more socially conscious nowadays; but as someone who grew up in this tradition, I am as distressed as ever about what went on at Saddleback Church this past weekend.

What is so great about presidential candidates meeting in a church? The kind of religious group candidates meet with should not be an issue.

What horrifies me is the report card format used to measure the candidates, particularly when the issues are as significant and complicated as abortion. There really is a sense in which the medium becomes the message. The message must adapt to the medium, and therefore becomes shaped by it. In effect, moral questions become variations of asking for the meaning of life in 25 words or less.

The warts of the report card method for measuring political candidates are highlighted on the Jim Lehrer Online News Hour video excerpts which highlight the abortion portion of the proceedings at Saddleback Church.

To me it plays like a cartoon that creates the humor of grief — not the humor we usually think of as comedy.


Warren: At what point does a baby get human rights in your view?

Obama: “I think that whether you’re looking at it from a theological perspective or a scientific perspective, answering that question with specificity is above my pay grade. One thing that I’m absolutely convinced of is that there is I a moral and ethical element to this issue. And so I think anybody who tries to deny the moral difficulties and gravity of the abortion issue, I think, is not paying attention.”

Warren: At what point is a baby entitled to human rights?

McCain: “At the moment of conception,” he answers promptly, with a slight “did I get it right?” inflection we can all recall from school days. Then the crowd claps as if he has just won a prize. McCain goes on to tell a touching personal story of his own adopted daughter; but this is irrelevant to answering a question about when human rights should be legally compelled in every case, which is what “getting human rights” is all about. But the crowd has been induced to produce more applause, and we are left here with a little vignette of the irrationalism that can be fostered in churches.


Shaping the Message

Notice there is a slight difference in these questions. The first question asks for a thoughtful opinion (“in your view”). The second one asks for a straightforward answer (“what… is”). In each case the requested answer was supplied. Perhaps this was because Pastor Rick Warren just responded to each man naturally because he really knew each one fairly well and wanted to make him feel comfortable. But the fact is that each one was “set up” to produce a different kind of response, and they produced it.

Much more significant, though, is the response of the crowd to Senator McCain’s precise and absolutist answer, which stands in sharp contrast to Senator Obama’s nuanced response. The crowd wanted the easy answer. Who cares about difficult cases? Let those people suffer in silence. The law of the land should enforce the right of a not yet implanted ovum to survive (since fertilization happens before implantation).

I suppose it would have been impolitic for either candidate to answer that “babies” should have human rights from the moment they are defined as “babies.” That would have been the Solomon-like answer; but we would not have accepted this response in our day. This answer would have pushed the issue into the kind of discussion it deserved, and the format did not allow for this kind of dialogue.

Ultimately such snippets of moral opinion by political leaders may have extremely little to do with their policy decisions. Only a more extensive discussion could have determined that. Apparently, from all reports I’ve seen, NOTHING was actually learned about how either candidate would actually lead the country on the abortion issue.

I did not see the complete televised discussion; but most Americans will not see it either. Most will not even see this News Hour excerpt. Those that care about the abortion issue will just erroneously hear that McCain does not believe in abortion and Obama does. There was no significant discussion of the abortion issue in this venue. When we read about the Lincoln-Douglas debates that focused on the moral issue of slavery in their era of American history, we see the candidates themselves conducted extended public discussions of this issue.

Now all we want to know is whether someone is Pro or Con.

Christians know Jesus said “If you are not on my side, you are against me. If you don’t gather in the harvest with me, you scatter it.” (Matthew 12:30) So we know that Jesus has drawn a line between faithful followers and those who are not.

But judging by how some Christians are reacting to the abortion issue it seems like some of us have let Jesus’ teaching form a paradigm in our mind for a host of other issues. This makes it easy, without even thinking about it, to identify following Jesus with following a political leader. If Obama is for abortion, then he must be against Jesus. We don’t even care if he really is following Jesus.

That really seems to be the template set in the brains of some Christians. Give credit to Rick Warren for trying to dispel that notion, even if at the same time he pandered to the majority that pays his salary.

Unfortunately this type of staging does not play well in the minds of many young people outside the Christian camp. They see these snippets and the mindless clapping in the name Christ, and they push further away. It’s hard for them to tell whether this is a scene from Saturday Night Live or if is it real.

Social action, yes. But social action characterized by love that draws people to Christ — not actions that push them away from him.

I think the message got distorted by the medium in this venue.


Posted by Jim Johnson at 04:02:20 | Permalink | No Comments »

Saturday, August 16, 2008

What’s Good about it?

HHS Moves to Define Contraception as Abortion

In what it must consider an act of Wilberforcian moral leadership, the Bush administration seems to want to force an increase in the American birth rate and remove freedoms Americans currently enjoy in the name of freedom of choice for health care providers.


They propose to do this with the kind of superficial logic that manipulates thoughts the way someone first learning a foreign language manipulates words in a dictionary. Government officials transferred the reasoning they deciphered from public polling data into legal arguments as if the public has a consistent and logically held medical and ethical position on fertilization and abortion issues. They translated generic polling data into precise legal arguments.


You will have to read the logic for yourself as documented in this source; only the barest outline can be afforded in this post.


Here are key excerpts from this source:


There are two commonly held views on the question of when a pregnancy begins. Some consider a pregnancy to begin at conception (that is, the fertilization of the egg by the sperm), while others consider it to begin with implantation (when the embryo implants in the lining of the uterus).


Up until now, the federal government followed the definition of pregnancy accepted by the American Medical Association and … the American College of Obstetricians and Gynecologists, which is: pregnancy begins at implantation.


So [now] HHS proposes that anyone can enforce his or her own definition of abortion “within the bounds of reason.”


The practical outcome of this logic led to the next step in the following headline:

Redefining abortion

Federal officials considering a rule allowing health care workers to refuse to provide contraceptives

Already “an existing regulation allows health care providers with objections to abortion to abstain from providing it to patients.”


By extending the definition of abortion to cover contraceptives, the new rule being promoted at HHS “would allow health care workers who object to abortion on moral or religious grounds to refuse to counsel women on their birth control options or supply contraceptives.”

Who’s “Good” does this new rule serve?

1. Obviously this rule is not for the good of unwanted babies who will be born, since many providers may opt out. Nor is it for the good of poor people who will be channeled into less than healthy options for dealing with the resulting consequences of unwanted pregnancies or alternative attempts to avoid them. Given the state of the economy, we can be fairly sure that there is no intent to ensure that other providers will be made available in every situation.


2. The rule that exempted health care providers with objections to abortion from providing it to patients was good because it allows them to avoid the direct act of what they perceive as killing. But indirect acts such as providing supplies cannot so simply and so arbitrarily be prescribed because this is a far more complicated issue. Do everyday store clerks have the right to refuse to sell condoms? One can at least imagine a host of legal controversies and more business for the legal profession as a result. One can even imagine a backlash against the original exemption.


3. According to the Houston Chronicle, this federal administrative rule would probably void a great many state laws. This rule is obviously not for the good of democracy, because it does not reflect a democratic decision-making process nor does it come close to reflecting decisions made by that process in the past.


4. Instead, this rule is widely viewed as payback to the Christian and religious right for its support of the Bush administration. Perhaps it is a cynical concession to the belief that the Democrats will win in November and immediately overturn it. But what if they don’t win? After all, John McCain has sided with the religious right on abortion. Real leaders do not play with fire like this. One has to wonder whether tainted hiring practices have also affected this area of the Bush administration.


Fanaticism takes what is good to an extreme. As we pointed out above, exempting conscientious objectors from providing abortions was good. But sneaking in exemptions for indirect contributions, however defined, without extensive debate and democratic decision-making is fanaticism.


Avoiding fanaticism involves a bit of relativistic thinking. A truly Christian approach to social change is not absolutist. Following the Apostle Paul’s example, one does not simply appeal to God’s revelation, but also recognizes the importance of social mores, because the objective of God’s law is love and peace. The goal of such social action is always to gain voluntary agreement.

What is Good about this Rule?

Absolutely nothing as far as I can see, for reasons already cited above.


Then why is it proposed?


The stated reason based on public opinion polls cited and refuted above is also invalid. A professional philosopher could provide a better explanation and the Bush administration would have done well to consult one. Even research specialists would be able to spot some of the errors in this approach since they would recognize the limitations of interpreting social surveys.


The underlying rationale for the rule is patent, however. The rule extends the likelihood of denial of abortions by giving high status to the definition of pregnancy as simply fertilization (apart from implantation) and by allowing providers such as pharmacists who contribute indirectly to opt out of providing.


In giving “equal” status to such a narrow ethical stance it allows that view to dominate the broader approach much like having a significant number of non-drinkers in a church tends to mean that alcohol may not be served on church property even though there are also a significant number of drinkers, who may actually be in the majority. The strong must accept the weak, but the weak do not have to accept the strong, because the weak think they are right. A teaching that was intended to express mutual concern becomes a tool for domination of others in express violation of Jesus’ commands to the contrary. Christians who deny Jesus’ paradigm as they contend for the “kingdom” in the civil arena are doing no better than those Jesus condemned for their practice of Corban.


Incidents like these help us begin to understand why Jesus predicted that both the sheep and the goats will be surprised about the verdicts on judgment day!


I’ve already expressed my view on the fertilization issue in a previous post. It boils down to the belief that human beings are called to be more than mere physical matter, including even the aspects of soul that the Bible always associates with the body (which is everything that fertilization represents). We must be “called” in some sense to become human. In a Christian theological sense, we are all are born spiritually dead. To have any spark of life and a chance of making it, individuals have to be wanted. My mother-in-law used to tell my children they used to be “a gleam in your father’s eye.” For communities to survive, older members need to reproduce and draw younger members into them. There are no stand-alone human beings.


Our responsibility is to draw individuals into human relationships and into relationship with God. It is not an isolatable responsibility to protect fertilized eggs. You can’t ethically fulfill the duty of protecting a fertilized egg without also fulfilling the duty to draw that being into the human family. A commitment of our country to a higher birth rate given our history and current economic conditions must be accompanied by a correspondingly huge investment in relevant social services supporting this commitment. It is the very fact that this rule is being introduced in such a backdoor manner that demonstrates that it does not reflect the high moral caliber that its backers would like to claim for it.


I do not believe that the “fertilized” ovum that do not implant are human beings that will some day be resurrected like everyone else. But that is what you as a Christian believe if you believe what the Bush administration is promoting to take precedent over other established laws.


Does that sound “good” to you?

 


Posted by Jim Johnson at 07:42:03 | Permalink | No Comments »

Friday, June 27, 2008

Turning the other cheek

Dobson picks a fight with Obama

 


After a long silence politically, James Dobson just recently decided it was worth fighting over how Barack Obama interpreted the Bible and the U.S. Constitution in his Call to Renewal speech back in 2006.

That prompted my son-in-law to write a response to
my analysis of Obama’s speech, and I am publishing a specially edited version of his response for this blog entry as follows –

It is unfortunate that James Dobson has started a quarrel with Barrack Obama over his accusation that Obama does not know how to interpret the Bible and has a “fruitcake” interpretation of the constitution.

There are two points that you make about Obama’s Call to Renewal speech of 2006 that I think are important for Christians to consider as Obama will now be the Democratic candidate for President.

1. Obama is sharing a personal testimony of how he has come to a saving faith in Jesus Christ and how he has processed (and I assume he continues to reflect on) his understanding of how to reconcile faith and politics.

2. The temptation is for us to usurp the authority of God rather than to speak humbly as fellow citizens and as believers in the New Testament, which says,

 

Don’t have anything to do with foolish and stupid arguments, because you know they produce quarrels. And the Lord’s servant must not quarrel; instead, he must be kind to everyone, able to teach, not resentful. Those who oppose him he must gently instruct, in the hope that God will grant them repentance leading them to a knowledge of the truth, and that they will come to their senses and escape from the trap of the devil, who has taken them captive to do his will. (2 Timothy 2:23-26)


Dobson’s accusations do not represent a reading or interpretation of the entire Bible. What exactly is a biblical world view? Is it absolute and concrete? It seems that a lot of interpretation has to go into determining a biblical worldview — and then comes the real tough part of applying the worldview.

Almost immediately, Obama responded to Dobson by acknowledging Dobson, disagreeing on the key point of contention, and then he moved on. Obama took the high ground and applied the dictum in Proverbs: “Do not answer a fool according to his folly, or you will be like him yourself.”

As a believer in the Gospel of Jesus Christ, I will be voting for Obama this November because he is a reflective fellow believer who wrestles with his faith and how he should apply the calling God has given him.

Obama’s life in the political arena might be one conservative Christians would do well to learn from. They may do more good for the cause of the kingdom than they are now with a single minded agenda focused only on rolling back Roe v. Wade.

– Andrew Hains, Bettendorf, Iowa

I have only two specific observations to add:

(1) Dobson has apparently driven up readership of Obama’s Call to Renewal speech. The link to it changed since my original blog post, and the new links shown above could not at first be reached, apparently because of the heavy traffic. I think as more people actually read the speech, more will be drawn to Obama’s point of view.


(2) If you listen to the
CNN video recording, you will notice indeed that Dobson does grossly distort Obama’s main point since Obama says quite the opposite: Dobson claims that Obama says that “unless everybody agrees, we have no right to fight for what we believe.” But what Obama actually said in the Call to Renewal speech was,


“Democracy demands that the religiously motivated translate their concerns into universal, rather than religion-specific, values. It requires that their proposals be subject to argument, and amenable to reason. I may be opposed to abortion for religious reasons, but if I seek to pass a law banning the practice, I cannot simply point to the teachings of my church or evoke God’s will. I have to explain why abortion violates some principle that is accessible to people of all faiths, including those with no faith at all.”


Obama is saying we should translate what we believe into language accessible to everyone and that we should fight for our beliefs. He is advocating a basic principle of communication, akin to learning another person’s language in order to communicate with them.




Posted by Jim Johnson at 02:54:20 | Permalink | No Comments »

Saturday, May 31, 2008

You say, “I am rich”

 

A Biblical Perspective on the American Healthcare System

 

The obsession of the American psyche is that we should only get the health care we earn.

You should only get the healthcare you pay for.  That seems to explain why we have the healthcare system we have, and why health insurance is connected to work.  It’s a reflection of the Protestant work ethic, and reflects the belief that if you don’t work, you don’t eat We reap what we sow.  So obviously, if you won’t work, you shouldn’t get healthcare either.

There is no right to healthcare in the United States like there is in most other countries.  Americans have a right to attend public schools; receive government brokered public services such as utilities, mail, and police protection; and use public spaces such as parks and roadways. But healthcare is construed differently.  Like obtaining food, Americans get it in proportion to what they earn.  We are each pretty much on own when it comes to obtaining healthcare.

No individual can afford all the high costs that will eventually confront the average individual or family in a lifetime.  So healthcare insurance programs connected to work (or paid for by the individual from earned income) are the answer to this need.  Healthcare insurance shares the cost by spreading the risk over large groups of people who contribute to the fund over time and withdraw from it when needed.  Which insurance group a person gets to join is largely outside their control since that is determined by their employer’s business administrators and insurance agents.

If Americans don’t work they don’t eat, and they don’t get healthcare either.  It’s a straightforward system, and it even sounds biblical, since the Bible lays down these same principles.


Jesus as Interpreter of the Biblical Tradition

Unfortunately the traditional American approach to healthcare insurance is no longer consistent with biblical teaching, if it ever was.

One of the main reasons is that when Jesus said “the laborer is worthy of his wages” he seemed to ultimately suggest a principle that people should be paid what today would be called a “living wage“- the amount it takes to meet one’s basic survival needs, which would include such things as food, clothing, transportation, communications, education, and healthcare. 

Initially Jesus was just sending out disciples on a short term mission trip.  Only room and board was involved on that first trip.  But the early church understood the principle as the basis for a new category of paid leadership which would eventually evolve into the group we now call the clergy.

Wage earners were the “poor” in biblical society, although even within that group there could be those who were especially needy.  The people who owned real estate were the wealthy people, the ones who were given all those biblical warnings about paying their workers properly and promptly.  (It seems that eventually the nomads were crowded out by the settlers, and that the birthrights of the first born - who inherited the real estate - eventually resulted in many of the remaining males seeking their fortunes in other endeavors as land became scarcer.)

Businesses primarily serving the needs of property owners developed in towns and cities. Political leaders represented the needs of property owners and relied on militaries to protect and develop these emerging systems as larger political entities also emerged, degraded, and re-emerged.  With the post New Testament era rise of the clergy class, we recognize what came to be known as the “estates of the realm” in Middle Age Europe.

Jesus’ story known as “The Parable of the Workers in the Vineyard” seems to have had a particularly strong influence on popular discussion of American capitalist thought.  In it, workers hired at different times during the day are still paid the same amount at the end of the day.  Those who worked all day are offended that they received the same pay as those who only worked for an hour; but the owner is most remembered for saying, “Don’t I have the right to do what I want with my own money?”  He is less remembered for saying, “Didn’t you agree to work for a denarius?” and “Are you envious because I am generous?”

Many people have used this parable to defend the right to private property and to support both laissez-faire economic theory and libertarianism.

But this parable considers both the property owner and laborer as equal bargaining partners.  The key to the entire story is that the owner and laborers must agree to the terms of their service.  The terms are not forced on the laborers.  Furthermore, in this story, the owner is generous because Jesus wants him to model God’s character.  Extending the paradigm of this parable into economic theory, as tradition has already established, means that both owners and laborers may have representatives negotiate for them on a bi-partisan basis.  

When business leaders and politicians work together to obstruct negotiations with labor unions, they are not treating labor as equal partners. Likewise, when labor does not realistically consider the cost implications of their demands, they have no right to claim privileged bargaining status.  Owners may look elsewhere. The sticking point in all such negotiations is the degree of honesty involved and the willingness to put aside greed.  Goodwill is needed on both sides.  And both sides have mutual responsibilities.

Since there is no way to avoid dishonesty or sinful passions by legal means, care always needs to be taken to preserve the balance of power in these negotiations.  The traditional doctrine of the separation of powers has developed uniquely in the United States in a way that ebbs and flows to serve this need as long as the population (primarily through voting) responds to circumstances as they arise. Even political parties have tended to trend one way or the other in their tendencies to represent either labor or owners; but biblically speaking, both sides need to be fairly represented.   As long as the population consists of a healthy mix of both constituents, though, in theory, the electoral process should address this need.

The Rise of the Uninsured/Underinsured Working Class

Healthcare costs have now so skyrocketed that adequate health insurance is no longer available to a large number of working families and to individuals with previously existing health conditions ( 1 - 2 - 3 - 4 - 5 ).  This has created a dissonant situation in which we have some fairly well off families (especially in comparison to third world countries) yet because their healthcare needs are not met, they are significantly in need.  Their health is significantly endangered.  They do not receive preventive care or seek treatment when needed for financial reasons. In some cases they are dying for lack of treatment.

This means that capitalism as we know it has created a new category of “poor” people in our country - people who do not have their basic needs met even though they work for a living - the uninsured/underinsured working class.  Some are part of the group whose healthcare benefits have been decreased.  Others who had coverage at work have lost healthcare benefits even though they still work. Many have remained continuously uninsured for long periods of time for various reasons. I believe this class is directly analogous to the working poor so frequently referred to in the Old Testament prophets.

These uninsured people may well earn reasonably high incomes based on a minimal poverty scale.  But that does not mean their basic needs are met.  The American poverty scale is not the biblical standard of living from which traditional work ethics are derived.  The biblical standard expects that a worker will be able to fully support his family if he works, and that the rich will share with him when he is needy.  So often the American standard of need expects the person or family to be without a job before really thinking of them as needy.

Just as the rich promote their own interests, they also need to work with the state to address the healthcare needs of the working class.  It is in America’s interest to have a working class that can go to where the jobs are, and that is not anchored to dead-end markets because of the current draconian healthcare system that drains personal resources to pay healthcare costs and then ties welfare to residency, creating a non-productive, overly conservative labor force, afraid to take risks. 

It is no wonder that illegal immigrants are able to come in with a degree of flexibility not seen in the average American worker, although for many of them, it must be kept in mind that their home base is not in America, since their primary function in coming here is to send money “back home” and they simply go to wherever they can obtain jobs.  If Americans had universal healthcare, it seems reasonable to suppose that they could more easily move to wherever the jobs were, as well, and they would be in much better position to accept jobs at the lower end of the pay scale.


Recognizing the Uninsured/Underinsured as “Poor and Needy”

We should include the uninsured/underinsured working people when we think of what the Bible calls the “poor and needy” because although they work (just as those in the Bible did), they do not have their basic needs met by means of that work.  Society needs them to perform their work and takes advantage of their services, but does not adequately compensate them. 

Jeremiah spoke to the problem of disproportionate distribution of wealth, where those who own the major capital assets use various excuses to justify inadequate remuneration for laborers.  The situation he describes is easy enough to discern and the principles he enunciates are still applicable (Jeremiah 22:13-17).

Although there are many reasons for why we are in our current economic situation, and why so many are without healthcare, the disproportionate income distribution in the corporate workforce, in which the top executives get so much more than the first line workers, testifies that the moral corruption of Jeremiah’s day still continues.  Although many of these corporations provide healthcare insurance for all the employees on their books, many of them also contract out many functions to avoid paying these benefits, and have also transferred many manufacturing jobs oversees where  the issue of employee benefits is dwarfed by such concerns as use of child labor.  And as already noted, many employers are also cutting back on the health insurance benefits that they do offer.

We do not know how to recognize these neuvo poor people due to inadequate healthcare in our country because they look like us and we mainly think of the poor as street beggars.  The traditional image of the poor as visibly “different’ has been true since ancient times, as witnessed by this passage from the New Testament book of James….

My brothers, as believers in our glorious Lord Jesus Christ, don’t show favoritism. Suppose a man comes into your meeting wearing a gold ring and fine clothes, and a poor man in shabby clothes also comes in. If you show special attention to the man wearing fine clothes and say, “Here’s a good seat for you,” but say to the poor man, “You stand there” or “Sit on the floor by my feet,” have you not discriminated among yourselves and become judges with evil thoughts? (James 2:1-4)

For us, Charles Dickens, among others, was so successful in communicating the social conditions of the 19th century slums that we are not able to imagine what impoverishment due to the lack of healthcare in America looks like in the 21st century. 

But those without medical insurance (or with inadequate insurance) in our day may look like most other people in our neighborhoods, except for that one major deficit.  One free clinic, for example, reported: “The clinic staff was surprised at some of the people who have no health insurance, including many part-time nurses and part-time postal workers.”  Another clinic reports that “Frustration comes in and patients give up” - many primarily need medical guidance and assistance navigating through the maize of government programs.

Most of us may only learn of their situation if a noticeable problem arises, and then there may be some sort of raffle or other fund raising event to try to help them out.  This kind of local support is meaningful; but it is also fairly frustrating since it can’t usually come near to meeting the total need, and we know that this person is only one of many other needy ones who have no friends to solicit for them.

For those who have seen it, Michael Moore’s Sicko has helped raise awareness of how the American healthcare system is adversely affecting people’s lives, and has even been complimented for this by his critics.

Does the rise of this new impoverished class mean capitalism is suspect or that America is inherently flawed?  Not necessarily.  Everything depends on our response to the situation.

Jesus said, The poor you will always have with you….” (Mark 14:7; cf. Deut 15:11)

I take this to suggest that the human social condition apart from divine intervention will always result in some deprived social class.  And based on God’s revelation in the Old Testament, we know that God identifies with the poor in a particularly emphatic way and expects his people to do the same, to help them and to meet their needs.  As modeled in the Bible, this has meant not only individual actions of charity, but also national laws when appropriate for the time and place.  God has shown us what is good and expects us to continue with him in his ways.

When Jesus said that he came to bring good news to the poor … and recovery of sight for the blind” perhaps some kind of universal healthcare insurance was eventually going to be part of that plan.  The church has always included medical ministries as part of the Christian mission since they are so directly related to Christ’s healing ministry. It is not a big stretch to now support universal health insurance.

It is time to think more comprehensively and accept responsibility to use wealth for the common good.

Posted by Jim Johnson at 04:08:57 | Permalink | No Comments »

Saturday, April 12, 2008

Ministry of Truth?

 

Health Database Was Set Up to Ignore ‘Abortion’

By Robert Pear

NEW YORK TIMES

April 5, 2008


This report lets everyone outside the specialized world of medical librarianship know that the world’s largest database on reproductive health - Popline - with more than 360,000 records and articles on family planning, fertility and sexually transmitted diseases, had stopped allowing researchers to find articles by using the word abortion as a search term.

Why in the world did they do this? 

The New York Times and other news sources have made preliminary investigations (e.g. 1, 2, 3); but perhaps none have presented the results better than the noted British medical journal BMJ.  I have labeled the essential elements of their presentation below to highlight the main points.

WHAT HAPPENED:  The world’s largest database for reproductive health, which is funded by the US Agency for International Development (USAID), last week made it impossible to search its contents for the word “abortion.”

WHY IT HAPPENED:  The explanation given for the ban by the administrator of the website, which is called Popline (population information online) was that because the project was funded by federal money it was thought “best for now.”

BACKGROUND:  Under the US president, George Bush, USAID has been banned from giving funds to any foreign organisation that performs, refers, or counsels on abortion, regardless of whether abortion is legal in their country.

ANALYSIS:  Critics were quick to assume that the decision to ban the word “abortion” as a search term was political.

US federal funded website bans “abortion” as search term, by Bob Roehr;  BMJ  2008;336:792-793 (12 April), doi:10.1136/bmj.39545.500833.DB

Once this ban had created a large public outcry among medical librarians and others, it was quickly reversed by a top administrator of the program.

Most likely nobody will ever be able to prove that political motives led to this policy.  It might simply be that a few influential people who were so inclined had their own way in a small out-of-the-way office that affects the overall operation.  Unless others notice and speak up when these kinds of changes are made, the changes tend to become permanent because after a while people say it’s always been done this way.

A change as radical as this will not be accepted if it is noticed and enough people say something because George Orwell has already alerted us to the dangers of governments attempting to determine truth. But people who want changes such as this try to sneak them in because they hope no one will notice in time to make a difference.  

This case is an example of how government can abuse power.  It may seem like a small issue; but worlds of information are uncovered by a single word, or hidden by the absence of a word; and therefore what we discover and learn can be affected by one word.  As a government agency, USAID made a decision to restrict information access by not allowing researchers to use a very commonly accepted search term.  In an online environment, there was no practical reason for making such a restriction since it did not offer any financial savings or improvement to the system.

This case is also an example of how the public must respond in order to get government to change. Medical librarians and others responded en masse individually and through their professional organizations to this issue. It is sometimes said that there are three branches of government to serve as checks and balances on each other’s powers; and we therefore view governmental power as divided between those three branches. 

That’s fine when we consider that all three branches get their power from the people. But since the delegation of power from the people primarily occurs when they vote, more often than not, it is more helpful to think of government as four powers that should be balanced: executive, legislative, judiciary, and the people. 

We the people need to be supporting or in some cases pushing back against our government when it is making mistakes, in order to keep it in line with what we believe are constitutional principles.  We are still the power on which our republic rests even when we are not in the ballot box.  We should take care how we exercise that power at all times.

Posted by Jim Johnson at 02:59:04 | Permalink | No Comments »

Friday, February 29, 2008

Respecting Bodies and People

 

Lawmaker targets exhibits like ‘Bodies’

Tuesday, February 26, 2008

By Sally Kalson, Pittsburgh Post-Gazette

At last people are coming up with a common sense approach to this complicated moral issue.

According to this Post-Gazette report, Pennsylvania state Representative Michael E. Fleck is preparing a bill that will govern exhibits of human corpses and body parts, including Bodies … The Exhibition, now showing at Carnegie Science Center. 

The bill would ban the commercial exhibition of human cadavers without written consent from the deceased or their next of kin that clearly states the person’s intent to be used in a profit-making enterprise.

This bill would apparently be similar to one just approved in California.

The plastinated human body display at the Science Center which has been making the rounds from city to city has created quite a stir here in Pittsburgh.  Elaine Catz quit her job at the Science Center in protest because there was no significant documentation to confirm that the bodies on display were there as donations freely offered or otherwise legitimately obtained.  They came from China and there is concern that at least some of them were executed prisoners whose bodies may have been used against their will. 

There has been a fair degree of local discussion about the display; but local dignitaries, including the Catholic Diocese of Pittsburgh, have approved the display for its considerable educational values.  One cannot help but wonder whether commercial interests have had the upper hand, however, and whether this might actually be a more complicated issue than one might have assumed at first glance.

Some Second Thoughts

Michael J. Lewis wrote a review of the Body Worlds exhibit for Commentary in January 2007 (“Body and Soul“).  Bodies…the Exhibition is just one of a number of other similar exhibits since Body Worlds first appeared in 1995.  Ken Meyers discussed the Commentary article and the broader topic with Mr. Lewis in the Mars Hill Audio Journal, Volume 88 (November/December 2007).

One of the points Mr. Lewis makes is that our culture basically accepts a mechanistic worldview.  Ultimately, the display of human bodies as mechanisms without any sense of reverence for the human beings they represent, and the overwhelming easy-going acceptance of these bodies as mere physical apparatuses by the audiences, as if they really are just plastic models, just goes to show how far our society has gone in accepting a purely mechanistic worldview, argues Mr. Lewis. 

Another one of the points Mr. Lewis makes is that our society tends to be horrified by the realities of decay and suffering.  By presenting bodies highlighted in bright colors and with an antiseptically clean appearance, there is almost a cartoonish quality to these displays that cannot elicit a holistic human response to the reality of the human body.  The irony is that violence may have been the cause of death for some of these people, yet the horror of that fact will be either disguised or eliminated, satisfying our desire to tune out suffering.  

When I led youth groups for the YMCA in the 1960’s, a favorite trip was to the Wister Institute anatomical museum in Philadelphia to view their collection of selected body parts.  This unique environment created memorable teachable moments.  Education is not just what you see but the interaction that occurs between the participants.  In those moments of viewing real flesh, there was a sense of contact with the real people represented by those specimens, and sometimes an inclination towards identification with them.  And there was a sense of reverence for those people, somewhat like at a typical viewing in a funeral home: we were outgoing and alert, but also with a quiet demeanor. 

I may be wrong, but I do not think this sense of respect for real people is fostered by the plastinated body displays.  But do we need to burden ourselves with a sense of guilt and try to make ourselves think we really ought to feel differently about these bodies?  Perhaps we should just consider that these bodies have been transformed to the point where they have been objectified and dehumanized and therefore are more like model airplanes than flesh and blood human beings. 

If you had the opportunity to see an embalmed Egyptian mummy when you were a child, how did you feel about it?  Did you sense that the embalmed body was a human body to be treated with special respect, or simply an object like any other object in the display?

Don’t our minds see these preserved bodies as something different than human bodies?  From one perspective they could be considered bodies embalmed in plastic. But from another perspective we might well say that with so much plastic they have ceased to be human bodies and have become manikins.  When a body is so transformed by embalming technology that it loses the ability to evoke an empathetic response - a response that enables you to see yourself in their position, a sense of identification with them - I think that body has taken on an objective quality that means it serves primarily for education or entertainment. 

Here’s how one lighthearted blogger put it after viewing the Body Worlds exhibit with her husband:


But the bodies… oh the bodies. I expected to be slightly grossed out. I expected The Mr. to turn pale but they just looked… like models? I guess plastination makes people look like (wait for it) plastic. So, I felt like I was just looking at fake models of bodies. I mean, if I took a second to think that its an actual human body then I kind of got the heebie jeebies.


Yes, the origins of these bodies is a serious concern.  But the level of respect for the actual human body can also serve as a barometer of the moral and spiritual health of our society.  

Some of the questions we ought to ask are:

Are these plastinated bodies human bodies, or are they more like manikins?

Does it make any difference? 

What should we do about it?

I think Representative Fleck has made a reasonable proposal for dealing with this complicated issue: Let each individual decide the fate of their own body.  We are deciding the kind of future society we will pass on to our heirs by the choices we make today.  We should welcome the opportunity to share in that process and accept the burden of making those decisions.

Human bodies can and will be used for all kinds of entertainment and artistic possibilities in the future.  We should not underestimate the human imagination.   

We need to regulate how commercial enterprises are going to develop this new arena, including how much documentation they will be required to supply for the human bodies they use in their displays.  It is a matter of common sense to require appropriate documentation.

We sign permission forms for everything else.  It is not too much to require that we must give our permission if we want to allow our own body to be used in commercial enterprises after we are dead.  Don’t we already have to do that if we want to leave our body for medical uses such as organ donation?  

 

More Pittsburgh coverage just after this post was first published
 

Pittsburgh Post-Gazette: Panel debates ethics of ‘Bodies’ exhibit

Pittsburgh Tribune-Review: ‘Bodies’ exhibit called ‘unethical,’ educational

Posted by Jim Johnson at 03:37:48 | Permalink | Comments Off