Mark William Olson '68 MDiv
Richard a. Bard '68 MA
Frederick A. Smith '66 MD
Stephen Brobeck '66 PhD

The signatories above do not necessarily affirm all of
the content or language of the following essay. It is added (1) to illuminate
the way in which Muslims and Christians refer to the same God, while differing
dramatically in their theology; and (2) to illustrate the potentially negative
consequences Wheaton's action toward Dr. Hawkins may have for the global Church,
as Christians seek to dialogue with Muslims about the Gospel.

_____________________

POCKET-SIZED
GODS?  by Vinoth Ramachandra

Posted by vinoth-ifes on December
30, 2015, at:  https://vinothramachandra.wordpress.com/

The
Malaysian Church, in recent decades, was engaged in a prolonged legal battle
with their Islamist-influenced government which prohibited non-Muslims from
using the word Allah to refer to the supreme God and
creator. Church leaders received directives stating that several words of
Arabic origin, including Allah,
Nabi (prophet) and Al Kitab (Bible) were not to be used by
non-Muslims as Arabic was the language of Muslims. Usage by Christians would
sow the seeds of "confusion". The import of Malay Bibles printed in Indonesia
(which used Allah) was
effectively banned.

Christians
countered by pointing out that Allah was the common term used to refer to
the supreme God long before Islam came into existence in North Africa. Arab
Christians continue to worship God as Allah and Malay-speaking Christians have
also been using Allah for centuries. Far from sowing
"confusion", it has facilitated communication and promoted mutual understanding
between Christians and Muslims.

Clearly this
was more than a matter of official historical ignorance. Islamists fearful of
the conversion of Muslims sought to deter the latter from reading the Bible by
claiming that Christians and Muslims worship different Gods. They have been
successful. Christians lost the legal battle, with dire consequences for the
future of social justice and religious harmony in Malaysia.

How ironic,
then, to find these Islamist arguments flourishing among conservative Christians
in the so-called American Bible Belt.

Earlier this
month, the authorities at Wheaton College, a prominent "evangelical" liberal
arts college aligned themselves with the Islamists. They suspended a tenured
professor for referring to Jews and Muslims as "people of the book" (a common
Qur'anic expression, distinguishing Jews and Christians from polytheistic
pagans), and stating that "Christians and Muslims worship the same God". In the
statement of suspension, the professor was accused of not "upholding
theological clarity". The obsession with "clarity" and fear of "confusion" -  at the expense of other intellectual virtues
such as desiring truth and tolerance of different theological opinions - have
long been hallmarks of religious fundamentalisms.

The eminent
logician Gottlob Frege (1848-1925) famously drew an important distinction
between the referent of a word/phrase and its sense or meaning. He took the
example of the planet Venus which is, paradoxically, described as both the
"Evening Star" and the "Morning Star". The two expressions have different
senses or meanings, but they have the same referent, namely the planet Venus.

The earliest
Christians, most of them Jews, found themselves worshiping Jesus as Lord and
ascribing to him all the titles and functions that applied to Yahweh, the God
of the Hebrew Bible. They were not bi-theists. Nor were they rejecting Yahweh.
As they reflected more deeply on their experience, they eventually came to
articulate a deeper and fuller understanding of who Yahweh is. They became
Trinitarian monotheists.

Arab
Christians share many beliefs in common with their Muslim neighbours. Not only
do they both worship Allah as the unique creator and sustainer of
the universe, but Christians accept most of the 99 Beautiful Names for Allah in
the Qur'an. The differences, of course, are crucial and decisive. Belief in God
as Trinity, as Incarnate as the person Jesus of Nazareth, as crucified for the
salvation of the world … these are foundational to all Christian believing and
living. It grieves Christians that these are misunderstood and rejected by
Muslims (and Jews). Therein lies the great challenge to communication.
Christians ascribe a different narrative identity to Allah and Yahweh. But if
there were no overlapping areas of agreement, no dialogue between Christians
and Muslims (and Jews) would be possible. (Indeed, even argument would be
impossible because argument presupposes that we are arguing about the same
subject matter). And Christians, Muslims and Jews have engaged in mutually
fruitful dialogue for centuries in Europe, Africa and Asia (along with
monotheist Hindus and Sikhs).

All the
distinctive Christian truths are paradoxical. Christians, therefore, should be
at home with paradoxical thinking and not shun it.

So, do
Christians and Muslims worship the same God? Yes and No. To use Frege's
terminology, the same referent but different senses.

But why is
this question not raised in conservative American circles in relation to Jews
and Judaism? (This is what makes many suspect that underlying this debate is
fear or even animosity towards Muslims. If so, it would be deeply disturbing.)

The actions
of the Wheaton College authorities, like much of what is done in the U.S.,
reach a global audience. I can imagine how they will be seized upon by
Islamists around the world as ammunition to deploy against Christians. And how
betrayed Malaysian Christians must feel.

American
Christians- especially those studying and working in colleges and universities-
cannot remain complacent with theological, historical or political naiveté. Wilful
ignorance is inexcusable. Americans have ready access to a wide range of
scholarly literature and the latest information technologies that the rest of
us envy. They don't have to watch Fox News or listen to the
latest chauvinist or demagogue. Some of the finest biblical scholars,
theologians, philosophers and historians are found in the American Church
(sadly, it is not their works that are exported to the rest of
the world).

Moreover,
every American city is multi-cultural and multi-religious. You can meet
Christians from all over the world, as well as thoughtful Muslims from every
Muslim sect, Jews, Sikhs, Jains or Buddhists. You can have your prejudices
dispelled, your viewpoints and worldviews enlarged through such encounters and
friendships.

If American
Christians do not avail themselves of the resources and opportunities on their
doorstep, they will remain culturally marginal, intellectually lightweight,
politically reactionary, and a deep source of embarrassment to the rest of the
global Church.

_____________________

The author, Vinoth
Ramachandra, was
born in Colombo, Sri Lanka. He earned bachelors and doctoral degrees in nuclear
engineering from the University of London. Instead of pursuing an academic
career, he returned to Sri Lanka in 1980 and helped to develop a Christian
university ministry in that country. From 1987 until 2001 he served as the
South Asian Regional Secretary for the International Fellowship of Evangelical
Students (IFES).

He currently serves on the IFES Senior
Leadership Team as Secretary for Dialogue & Social Engagement. His ministry
aims to promote holistic engagement and dialogue within the university among
students and professors, and to encourage Christian students and graduates to
think and respond as Christians to some of the social, cultural and political
challenges they face in their national contexts throughout the world.

Vinoth lives in Sri Lanka with his Danish
wife, Karin, a trained counselor and also a Bible teacher. They often travel
and minster together at student and graduate conferences. Vinoth has also been
involved for many years with the Civil Rights Movement in Sri
Lanka, as well as with the global Micah Network and A Rocha (a world-wide biodiversity
conservation organization). He is the author of several essays, articles and
books including The Message of
Mission (2003), Subverting
Global Myths: Theology and the Public Issues that Shape Our World (2008) and Church
and Mission in the New Asia (2009).

Dr. Philip Ryken, President, Wheaton College alumni@wheaton.edu via email.imodules.com
Reply-to: alumni@wheaton.edu
Date: Fri, Jul 20, 2012 at 10:00 PM
Subject: Responding to your feedback regarding HHS Mandate

Thank you for your thoughtful comments about Wheaton's decision to file a lawsuit against the HHS Health Insurance Mandate. While I am gratified by the many responses of support, I also take seriously every expression of concern or even dissent. Please know that I have read your message and will share it with Dr. David Gieser, who serves as Chairman of our Board of Trustees.
I hope you will take time to read and consider the rest of this message, especially since many of the concerns I have heard so far come from a lack of full knowledge about our case.
The Department of Health and Human Services recognizes that, for religious reasons, certain provisions in its mandate violate the conscience of some employers. For this reason, the HHS has provided a full exemption for churches and other houses of worship.
To date the HHS has not extended a similar exemption to other religious institutions, such as Christian colleges and universities. This is our primary concern: if allowed to stand, the HHS mandate allows the government to declare that Wheaton College no longer qualifies as a religious institution, effectively stripping us of our First Amendment freedom of religion. We believe that we too have religious liberties that are fully protected by the United States Constitution.
Please know that Wheaton College is not:
* filing this lawsuit for political purposes,
* opposing the Affordable Care Act or trying to block it,
* opposing or preventing access to most forms of contraception, or
* funding this lawsuit from our own limited resources.
By way of fuller explanation, here I will answer some common questions and correct some misconceptions by listing objections to the filing and offering a brief response.
+ Wheaton is filing this lawsuit for political purposes-either in response to the pressure of special interest groups or to further the agenda of a political party. Wheaton College is a non-partisan institution. The Trustees-who are affiliated with multiple political parties-properly regard religious liberty as a non-partisan issue.
+ The College has been hasty in filing a lawsuit without attempting to resolve their concerns directly with the HHS. Wheaton's Administration first raised its concerns quietly and directly with the HHS shortly after the mandate was handed down last August. Our hope all along has been that the HHS would grant the exemption we believe that we are entitled to receive. When this exemption was not forthcoming by May, the Trustees voted unanimously-yet reluctantly, as a last resort-to proceed with a lawsuit.
+ The lawsuit is politically motivated and has been timed to influence the upcoming elections. Political considerations played no part in the deliberations or decision of the Trustees. They decided to wait for filing until after the Supreme Court published its decision on the Affordable Care Act at the end of June, in case that decision might provide any relief for Wheaton's First Amendment concerns. With the mandate scheduled to take effect on August 1, and with punitive fines accruing from January 1, they believed that the College could not afford to wait any longer.
+ It is morally wrong for Wheaton College to oppose the Affordable Care Act. As a non-partisan institution, Wheaton neither supports nor opposes the Affordable Care Act, which remains substantially unaffected by our lawsuit. Our objection is to a specific requirement of the HHS Insurance Mandate, namely, the mandatory provision of abortion-inducing drugs. The relief we seek is an exemption, not a repeal.
+ The drugs that are required by the HHS mandate are contraceptives, not abortifacients. The mandate includes drugs that, although categorized by the government as contraceptives, can cause an early abortion. For example, the Food and Drug Administration, the National Institutes of Health, and the Department of Health and Human Services are all on record as stating that the "week after" pill (ella) can have an abortive effect on a fertilized egg.
+ In filing this lawsuit, Wheaton College is limiting the access of women to vital health services. Wheaton supports nearly every preventative service required by the HHS mandate and provides comprehensive health coverage to all of its employees, women included. Our objection is to a service we do not presently provide, so there is no question here of taking away any choices or services from women in the Wheaton community (or elsewhere). On the contrary, filing this lawsuit is a principled way for Wheaton to continue to provide excellent health care to all its employees.
+ Contraception is an individual decision that ought to be a woman's personal choice. While Wheaton College respects the views of Roman Catholics and other Christians who reject contraception outright, neither our Statement of Faith nor our Community Covenant take this position. Thus we provide certain forms of contraception in our health coverage. By their own free choice, in signing the Community Covenant, Wheaton's women and men promise to "uphold the God-given worth of human beings, from conception to death"-a voluntary commitment that rules out any form of abortion.
+ Pursuing this lawsuit is a waste of Wheaton's financial resources. Wheaton College is grateful for the legal representation of The Becket Fund, which is provided pro bono. Becket was chosen in part because of its clearly-established track record as a non-partisan, non-sectarian law firm that has successfully defended the religious liberty of Jews, Muslims, Christians, Hindus, and clients from other faith communities.
+ Wheaton should focus on more important matters that are more central to the gospel. We agree. Many "weightier matters of the law," as Jesus called them, remain at the forefront of a Wheaton education, such as mercy and evangelism. Yet we also need to give appropriate attention to the one place where the government is acting to deny our freedom to carry out our mission-a conflict we would not choose, but cannot ignore.
+ The College should simply accept the HHS mandate, recognizing that its faculty and staff do not have to utilize the services that their insurance must provide. We believe that it is morally inconsistent to provide services that go against our conscience and violate the standards of our Community Covenant. This is a matter of religious principle, which it is unconstitutional for the government to force us to violate. Just as importantly, in denying us the exemption it has provided to churches, the mandate allows the government to declare that we are not entitled to First Amendment protection for our freedom of religion-a dangerous precedent.
For more information about the HHS Health Insurance Mandate and the College's lawsuit, please visit the Wheaton College website.

Sincerely,

Philip Graham Ryken
President

1  .

Old Colonial

Texas, now

August 11th, 2011

1:10 pm

What is critical here is the concept of long-term relationships between doctors and their patients, which most states are now destroying, espeically this one we have moved to - Texas. Never shrink from talking to your doctor about what you want, when, and if - if they brush you aside, never go back to them.

The bottom line, when faced with death is having the knowledge that one's doctor know what you want, and is wholly trusted for his/her competence, expertiese, ethical standards and that special internal spirit that directs their dedicated efforts.

When those things are in place, one can "let go" and either be healed, or pass on. I've been 'there,' twice.

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2  .

SKV

NYCer

August 11th, 2011

1:10 pm

Can't a family say, "Doctor, we'd prefer to leave the decision to your best judgment"? I know that used to be the only choice, or at least the default, but why can't it continue to be an option? If I trust my doctor, that's what I'd prefer.

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3  .

trader

NY

August 11th, 2011

3:09 pm

We do ultimately make the finally decision to stop.

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4  .

Cate

midwest

August 11th, 2011

3:09 pm

Wow, this is beautiful and a wonderful piece. I agree! I guess I can best illustrate this with an example involving our dog (sorry, I don't have any people examples):

Three years ago, our dog was dying after an internal injury, but to us he looked fine. Propped up by pain meds and externally normal, he wagged his tail and was lying still but eager to see us. He was subdued, but his eyes were clear.

His initial repair surgery had failed; they thought there was additional internal bleeding. Our decision was whether to continue with an exploratory surgery or to put him down.

The vet tech who came in with us gently explained that they thought his internal organs too perforated and infected to repair and that he might not make it through the second surgery, based on his current condition. She said everyone at the office felt our dog was not going to make it, but it was up to us as to what to do. She added that dying was not like going to sleep, but could be hard work lasting hours or days, with gasping for breath and pain.

So very sadly, we elected to put our dog down, but we were grateful for an honest response from the medical team. How could we know what to do? We thought, they regularly see these things, they could estimate likelihoods better. What do we know? We did not want our dog to suffer through additional procedures for no reason.

So it was very, very hard to do, but we had our dog put down.

I'm not saying people should be put down (that's a separate discussion), but we did get an honest discussion and OPINION from the medical people in this situation. I think that's all patients want. We can make our own decisions. But don't be afraid to tell us what you really think, even if we are a 90 year old who is stubborn and contrary, or an 60 yo that doesn't seem to think for herself...or whatever. Make it clear what you think.

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5  .

MB

CT

August 11th, 2011

3:09 pm

A nice point; but back to the case, I find the dialectic offered by the young doctor as being unrealistic. And, the indecision is not a weakness: committees can't make such a tough choice. That is why a proxy is needed.

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6  .

Dan Urbach

Portland

August 11th, 2011

3:09 pm

I've been in primary care practice as an internist for 19 years. I've been in this position as the doctor many times. A long term relationship with a patient makes a huge difference. However, like it or not, this type of practice is going out of business, and many patients who die in the hospital are being seen by hospitalists who don't know them. I don't think there's one answer to this problem. The situations are as various as are patients, families, doctors, nurses, and anyone else involved. I do have one suggestion that I think is very important: we need to teach patients and the public at large that death is a natural phenomenon, inevitable, often not a failure. Delaying death is often the wrong choice.

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7  .

Mark

Evanston, IL

August 11th, 2011

3:09 pm

For a number of years I have done ethics consultations in the Chicago area. I am not an MD but a PhD in Philosophy. I have found that patients' families are often surprised by three things when they talk with the physician. First, they are surprised by the complexity of the situation. Second, they are surprised by the uncertainty that often attends the situation (particularly in light of the advertising that exists promoting the wonderful solutions offered at major medical institutions). And, third, they are surprised that they are being asked to make the decision. Particularly in light of the three things by which they are surprised. What I have found is that the most useful thing to do is engage the family in a thorough discussion not only of the possible options in relation to treatment, but also in relation to the possible options of who, when and who the decisions should be made. But I have also found that these discussions can take a very, very long time, and can be very, very frustrating for all involved. The Obama administration recognized the need for such discussions (with no agenda) and the Republicans turned the concept into "Death Panels." I am still incredulous as to what happened. The whole thing was absolutely beyond my comprehension.

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8  .

jay pattelle

NY

August 11th, 2011

3:09 pm

Patient empowerment is a very healthy development. Ultimately we are accountable to our own selves for our health. As long as a doctor properly explains options, with pros and cons, we need to take responsibility for our own choices. We are free to choose to tell the doctor "Doc, please give me your preferred choice, and I will follow it." In earlier days, patient's destinies were in the hands of a doctor who may or may not have made the correct diagnosis.

A close friend overseas lost a relative because his doctor made a wrong diagnosis, and then proceeded to ram it down everyone's throat. The doctor was offended when, seeing no improvement, my friend calling in another specialist for a second opinion. The second doctor immediately corrected the diagnosis, but it was too late. If the patient had been empowered, he could have been saved.

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9  .

Muriel

London

August 11th, 2011

3:09 pm

There was no mention in this article of the legal implications for the doctor who fails to seek permission.

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10  .

Sherry Reynolds

Seattle, WA

August 11th, 2011

3:09 pm

We all know that informed and involved patients lead to better outcomes, higher quality, better RIO and higher patient satisfaction levels. Shared decision making vs the old style of paternalism is the goal for many if not all patients but very few providers and staff are trained or have the tools to provide it.

Studies also show that when patients are informed of their choices and educated about the risks and rewards they are much more comfortable making decisions so I would question the 2 out of 3 want their providers to make the decision since it might simply reflect a lack of time to educate the patient enough for them to make an informed decision.

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11  .

Lynn

New York, NY

August 11th, 2011

3:09 pm

We had a case when a demented patient came in from a nursing home. Her next of kin was 1000 miles away in Florida. We called him up and asked what he wanted us to do. The poor guy was completely blind sided he said do every thing. We hung up and called him back 20 minutes later. We said if we do everything she'd die in about a week, and if we did nothing but pain relief she would die that night, and that we wanted to do nothing. He agreed and was relieved to get permission to make this tough choice at the end of life for an Aunt that he had not seen in a number of years.

As a doc, I like to talk to my patients ahead of time without the stressors of pain and intubation. That way the family KNOWS they are doing what the patient wants, and not trying to guess. Does that mean I am in favor of death panels? I guess so.

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12  .

K S Venkataraman

Murrysville, PA

August 11th, 2011

3:09 pm

The doctor-patient relationship is more sacred than the one between the pastor (or priest) and the lay worshippers. Mercifully, in the non-Christian faiths, the relationship between the laity and the religious leaders is very tenuous, at best.

Very often, in serious cases, patients are given all the options and the pros and cons, and yet do not know how to go about making the choice. The belief system of the patients and the physicians also need to be considered.

Fortunately, most healthcare professionals -- I am not one of them -- are able to interact with patients coming from diverse faiths with great sensitivity.

I can understand the doctors' reluctance to participating in making the decision for the patients and their families, and live with the consequences of the decision. It is a terrible dilemma.

But that is why people treated doctors with so much respect... ... till we ended up a system driven by malpractice insurance companies and lawyers (some with medical degrees) suing doctors for "pain and suffereing" in addition to the other quantifiable medical errors.

This is, indeed, a complicated question with pharmaceutical industries and toerhs making medical gizmos making huge profits, while not willing to bear the responsibilities for their mistakes.

But still, I prefer to trust my doctor's sense of judgment and compassion.

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13  .

Jim Rosenthal

Annapolis, Md.

August 11th, 2011

3:09 pm

It's still a huge improvement over the time when no one told patients anything and they went to their deathbeds wondering why they felt so badly and were losing all that weight, if they were just fine, like everyone kept telling them they were.....

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14  .

Phil Rubin

Florida

August 11th, 2011

3:09 pm

Though not possible for everyone, an even better option is to use the internet to learn as much as you can about your condition. There are technical articles for doctors as well as lots of information laymen. Then you can have an intelligent conversation with your doctor instead of a one sided one.
http://www.youtube.com/watch?v=skqwaYPIc-Y

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15  .

Ted D

Providence, RI

August 11th, 2011

3:09 pm

Physicians need some legal cover to be willing to make the decision. Usually these are not life-or-death decisions but rather die now or die later after spending a lot of the tax payer's money. Non professionals rarely feel qualified to evaluate the value of further treatment and most welcome firm guidance from the MD (or RN)

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16  .

Bob

Maryland

August 11th, 2011

3:09 pm

I have watched 2 parents die both in NYC, both in acclaimed hospitals. Actually my mother essentially died in NY but I moved her to NJ, and a much better truly patient care centered hospital for the actual last breath. My father died of complications following colon cancer surgery in 1985. The doctors either didn't talk to each other or chose to offer us their conflicting opinions fully knowing that they didn't agree. I had to ask them all to convene in one room and explain it all to me, my brother and mother. It was complicated medical stuff and none of us had any medical background but eventually we came to understand - but only after we pulled the teeth. My mom died 24 years later. There were complications following her heart surgery but that wasn't what killed her. The NYC hospital told us not to worry about the fluid around her lungs because it was just routine post-op and she should get out of the hospital to avoid infection/complications and that she was ready for rehab. Not. After 2 or 3 days of suffering in rehab I moved mom to Morristown Memorial Hospital, One of the the first things the ER doc said was that I was right in bringing her in because she was very sick. And then their team mobilized. One doc was assigned just to coordinate. They had a patient liaison who gave new meaning to caring. It took a couple of days of tests but finally they concluded that mom was dying because her tricuspid valve was leaking and could only be fixed by surgery that she could not withstand. Thing was the NY hospital knew the tricuspid was leaking but thought it wasn't leaking so bad when they replaced the mitral valve. But when her breathing problems persisted t he NY hospital never looked back at the tricuspid. They never mentioned the possibility that her breathing problem, which was getting worse and worse, wasn't due to typical post op fluid but to a problem they'd forgotten about, a problem that Morristown quickly found.

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17  .

mauricioboteromd

stuart,fl

August 11th, 2011

3:09 pm

As a nephrologist, kidney doctor, many times i have had these discussions about end of life issues with families. It is always quite difficult but I would like to share things I have leard through the years.

First is a physician dealing with a terminal patient is treating not just the sick one but the family too. Dealing with a dying patient can leave scars in a family. Second, these discussions are self fulfilling, we are not discussing actions outside our control, we are discussing and modifying the situation at the same time. Third, one can never rush these decisions, hospitals have a team of nurses, social workers, trained to rush families into these discussions because it is in the hospital financial interest. Fourth, use the recent history of the patient, when somebody keeps being discharged and coming back to the hospital with acute illness it is a good signal that we have used all our resources and it is time to quit.

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18  .

tough old bird

Virginia

August 11th, 2011

3:09 pm

I can't understand why people can't face the fact that someday they're going to die and have wills, powers of attorney, medical directives and living wills done when they're young. They can always change them should their attitudes change.

I was able to convince my mother to write all of the above documents by doing it for myself at the same time when we were going to take a trip together. A good time to talk to your parents about having their papers in order so that their wishes are followed when something happens. They feel more comfortable if you are doing it for yourself at the same time.

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19  .

Josh Hill

New London, Conn.

August 11th, 2011

3:09 pm

When we had to decide whether to put my grandmother back on a respirator or let her die, I asked the doctor what he would do if it were his grandmother. He said unequivocally that he would let her die. And that's what we did.

In a situation like that, I am grateful for a doctor's clinical experience and expertise. Such decisions must ultimately be up to the patient and family -- within legal and ethical bounds, no one has a right to tell them what to do, unless they cede authority to the doctor. But in my experience anyway, a doctor's opinion is welcome.

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20  .

Craig

Jersey City

August 11th, 2011

3:09 pm

I think what often happens is that doctors and patients and families--in times of great stress--naturally blur the line between science and ethics. A doctor is in no position to make an ethical decision regarding what is good, or bad, for a patient. Likewise, most families are in no position to form a scientific assessment of a loved one. Out of an abundance of caution, doctors sometimes do not provide families and patients with a truthful assessment of the patient and his or her likely response to treatment, for fear that this will be "telling the family and the patient what to do." This is not, though, telling the family what to do. It is only, one hopes, the truth, within a reasonable degree of error. And whatever the truth, it is then up to the family or patient to decide what to do with that information.

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21  .

DrSam

Philadelphia

August 11th, 2011

3:09 pm

Times New Rom

ECONOMICS & UNINSURED

An individual's lack of health insurance affects everyone in the country economically, so requiring it is constitutional.  When the uninsured person goes to the ER, the hospital bill is passed on to everyone (possibly including people from other states) through higher costs.  If she becomes disabled because of lack of preventive care, her Medicaid or SSI are paid for by everyone else's taxes and contributions (and we lose her contribution to taxes if she could work). 

If our insured's eventual disability&poverty allow her to get Medicaid - & she has a long, lingering dying process in an ICU & then a vent-capable nursing facility - this could contribute $100K-$1M to everyone's bills (across state lines, since Medicaid is supported by both state & federal revenues). An ounce of insured prevention is worth many pounds of high-tech remittive or end-of-life care.  Just one reason why 'Obamacare' saves billions over the long haul.  (fs- MD,FACP- int’l,geri& palliative med; bioethics)

A TRAGIC TRAVESTY: INSURER DENIES COVERAGE FOR A 22-Y.O. WOMAN'S RHEUMATOID ARTHRITIS AS A "PRE-EXISTING CONDITION"

    20 years ago I had an unforgettable patient experience that could have been true one year ago. A 22-yo woman who had just graduated college came to Washington DC to work for a non-governmental organization, with a new health insurance plan. She had been having some hand and wrist swelling which a prior provider in her home town had trivialized, without a diagnosis.
    The wrist swelling pointed to an auto-immune process, and she proved to have rheumatoid arthritis.  Her health insurance company refused to treat her RA after they obtained old records from the previous doctor which documented the joint swelling - even though he had made no diagnosis.  The insurer stuck with its "pre-existing condition denial" in spite of my letter of appeal.
     I often wonder what happened to this earnest, idealistic young woman and her family.  Did she ever receive effective treatment for RA?  Did treatment bankrupt her family? Is she still living (she would be only 42yo now)?  How could this travesty occur in America?

Frederick A. Smith, MD, FACP - General Internal, Geriatric, & Palliative Mediicne, and Bioethics, Garden City, NY

6-WORD MEMOIR - 2010  - suggested by Bishop Savas Zembillas - see his Facebook page at http://www.facebook.com/home.php#!/bishopsavas.  He was inspired by Smith Magazine (no relation!) - http://www.smithmag.net/sixwords/. 

Mine (fas): "Serendipity, grace, perplexity, unknowing, learning forgiveness."

The insistence of conservative leaders that patriotism be defined by a believe that the US is INTRINSICALLY EXCEPTIONAL strikes me as the very form of IDOLATRY attacked by both Hebrew prophets and Jesus - who pointed out that God's chosen Israel was guilty of many wrongs (social injustice and spiritual pride & hypocrisy). The prophesies about the fall of Jerusalem and Temple - and the insistence that God preferred merciful hearts and justice toward the poor over orthodox beliefs, rituals and nationalism - were seen at the time as anti-religious and unpatriotic, and resulted in persecution. But the protests of political leadership and "false prophets" ("Calamity won't come upon you!" - Jer. 23:17) did not prevent the ACTUAL destruction of the Temple,& political entity, in both the 6th C. BCE & the 1st C. CE.
America has many great things to its credit: its Constitution, its guarantee of civil liberties including religious freedom, its traditional welcome of immigrants & prohibition of discrimination against them (14th Amendment!), the Civil Rights movement. But the Constitution came at the expense of legitimizing chattel slavery; & reconciliation of the South after the Civil War came at the expense of segregation, loss of black voting rights and KKK terror. Much of what some citizens have seen as exceptional - expansion to the Pacific (much of it through a questionable war with Mexico, and slaveholding occupation of much of the Louisiana Purchase, addition of territories through deceptive use of force against Spain in 1898, Hawaii's rulers in 1899 and Colombia in 1903 (to obtain Panama Canal) - as well as violent suppression of Philippines independence movement in first decade of 20th C.) - can hardly be things that God facilitated.
If we want to be "exceptional" in a good way (competition isn't always bad, when it doesn't hurt the Other, and when it strives for excellence), shouldn't it be through our VALUES and how we PRACTICE them? - for instance, opposition to violence as a first resort for solving disputes and our efforts at genuine peace-making, our push for civil rights abroad as well as at home (think Jimmy Carter), our valuing of each other as fellow citizens (instead of trying to "take back 'OUR' country" from people of the party who are almost demonized as near-traitors), our willingness to compromise for the sake of the overall, long-term good of the country? The Republican insistence on sticking to ideological purity, to seeing as Obama's defeat as their primary goal (therefore, non-compromise on most substantive legislation) represents the kind of idolatrous, exclusive nationalism Jeremiah faced in 600 BCE and Jesus did about 30 CE.
I fear that the US WILL decline as a nation - relative to China, for instance - primarily because the thinking of one of its 2 major parties (one essential to cooperative good governance) has ossified and is consumed only with the idea of power, and to exclude the Other (which our half-African President seems to emblemize for them) from any influence.
We have been blessed as a country, but I am convinced God did not ordain us to be THE exceptional nation. Only Israel has any Scriptural claim to that title, and much of their example as a "light to the Gentiles" has been in how the Jewish people have suffered (Isaiah's original "suffering servant": the very role Jesus took on himself as the Christ: humility, mercy & inclusion - not pride and a harsh exclusive attitude.)
What is the definition of idolatry? To worship at the altar of ANY human construct - whether thing or idea - rather than to bow to God's mystery - in Micah's words: "God has told you, O mortal, what is good; and what does the LORD require of you but to do justice, and to love kindness, and to walk humbly with your God?" ( Micah 6:8)

On 8/3, my good friend and much-admired fellow physician Patrick Cavanaugh brought up a relevant question - asking, "Would a Japanese history museum be appropriate at the Arizona memorial [at Pearl Harbor]?"
(1) Japan is a distinct, relatively homogeneous NATION that, like al-Qaeda, launched an unprovoked attack on the US, bringing the US into a conventional war between states that lasted nearly 4 years.
(2) Islam is a WORLDWIDE, UNIVERSAL RELIGION with between 1.0 and 1.5 billion adherents on all inhabited continents - including probably 5-7 million legally resident in the United States (approaching the size of the Jewish population).
(3) At least one-fourth of US Muslims are of African-American ancestry, with a stake in this nation that goes back 2 to 4 centuries, longer than that of most people of European descent now in the United States (excepting those whose ancestors were already here in the 17th-18th centuries: Protestants from the British Isles; Catholics in the then-Spanish Southwest; displaced Catholic French-Canadians; and a sprinkling of mostly Protestant immigrants from Holland, Germany, France and a few other western European countries).
(4) ONLY A VERY SMALL PROPORTION OF THE WORLD'S BILLION+ MUSLIMS APPROVE MASS-KILLING of the innocent to further their understanding of Islamic objectives is very small - certainly no larger than the proportion of the populations of Protestants or Catholics in Northern Ireland, or of Orthodox Serbs, who were willing to do the same at the height of their recent local conflicts.
(5) Apart, AT LEAST 58 INNOCENT MUSLIMS DIED AT "GROUND ZERO" ON 9/11 (NOT INCLUDING the 10 mostly-Saudi Muslim terrorists who commandeered the 2 planes). Their survivors are among "the 9/11 families," so often described as a monolith. These included a young Muslim couple on AA Flight#11: Rahma Salie, age 27 and 7 months pregnant, and her husband Michael Theodoridis, age 32 and a convert to Islam. Another Muslim victim from NYC described at http://islam.about.com/blvictims.htm:
"Imagine being the family of Salman Hamdani. The 23-year-old New York City police cadet was a part-time ambulance driver, incoming medical student, and devout Muslim. When he disappeared on September 11, law enforcement officials came to his family, seeking him for questioning in relation to the terrorist attacks. They allegedly believed he was somehow involved. His whereabouts were undetermined for over six months, until his remains were finally identified. He was found near the North Tower, with his EMT medical bag beside him, presumably doing everything he could to help those in need. His family could finally rest, knowing that he died the hero they always knew him to be."
(6) THE GROUP BUILDING THE MOSQUE IS CORDOBA HOUSE: A GROUP OF MODERATE MUSLIMS ABSOLUTELY DEDICATED TO OPPOSING THE MUSLIM extremism that does exist, to de-legitimizing extremist interpretations of the Qur'an, and to deepening the bonds of American Muslims both to the United States and to its citizens of other faiths. Obviously, they wish also to win the understanding and respect of non-Muslim Americans for Islam's fundamental nature as a RELIGION (not a justification for a particular political or cultural creature, although all religions are intertwined with cultural traditions that are hard to disentangle, and have been susceptible to nationalistic/ethnic co-opting - see the US's Michelle Bachmann, Sarah Palin and other Tea-Partiers in the Christian-right). Islam is a religion that - at its best (like Christianity, Judaism, Buddhism and Hinduism at their best) - fosters peace, tolerance and humble submission to the Ultimate Reality/Mystery whom religious adherents - at their best - bow to during their brief lives on this earth (God in the religions that trace their roots to the call of Abraham; Allah in Arabic). They chose the name Cordoba after the one medieval European nation that exemplified this ideal: the Spanish kingdom of Cordoba, ruled by Muslim Umayyad caliphs who nourished a vibrant, harmonious and creative community of Muslims, Christians and Jews during the 10th century - so unusual that a German nun (traveling on diplomatic duties) called Cordoba "the jewel of the world."
(7) SOME "9/11 FAMILIES" (although admittedly not most) SUPPORT THE EXISTING PLANS FOR THE MOSQUE (although most, admittedly, oppose it). Donna Marsh O'Connor, spokesperson for an organization representing 200 families), stated:
"SEPTEMBER 11TH FAMILIES FOR PEACEFUL TOMORROWS strongly supports efforts to bring an Islamic Cultural Center to lower Manhattan, near the Ground Zero site. We believe that welcoming the Center, which is intended to promote interfaith tolerance and respect, is consistent with fundamental American values of freedom and justice for all. We believe, too, that this building will serve as an emblem for the rest of the world that Americans stand against violence, intolerance and overt acts of racism and that we recognize that the evil acts of a few must never damn the innocent."
On 8/14 "MyFoxNY" - quoted Bronx resident Colleen Kelly (a Catholic who lost her brother Bill in the WTC) that "Obama's statements Friday are in line with America's values," and that
"the mosque [is] 'in many ways a fitting tribute. . . . This is the voice of Islam that I believe needs a wider audience. This is what moderate Islam is all about.'"
(See (http://www.myfoxny.com/dpp/news/local_news/manhattan/911-Family-Members-Divided-Over-Mosque-Near-WTC-20100814-apx.)
(8) DESPITE THE DARK INSINUATIONS OF DEMAGOGIC POLITICIANS AND PROFESSIONAL MUSLIM-HATERS, THERE IS ABSOLUTELY NO EVIDENCE OF ANY NEFARIOUS FUNDING OF CORDOBA HOUSE BY GROUPS THAT SUPPORT ISLAMIC EXTREMISTS.
(9) GETTING BACK TO JAPAN, consider these facts:
(a) In 1941, about 150,000 HAWAIIANS (about 1/3 of the population) WERE OF JAPANESE ANCESTRY - they, like American Muslims, were also victims of their ancestral country's militaristic government.
(b) 110,000 US JAPANESE-AMERICANSLOST THEIR PROPERTY AND WERE INTERNED IN SHABBY CAMPS surrounded by barbed wire (62% of them citizens). In 1988 President Reagan and Congress apologized for a wrong which they acknowledged originated in "race prejudice, war hysteria, and failure of political leadership." In 1999, a Republican Congress voted $1.6 billion in reparations to surviving Japanese-American victims of internship.
(c) The 1945 A-BOMBING OF HIROSHIMA AND NAGASAKI KILLED UP TO 175,000 PEOPLE instantly, with another 200,000 dying from radiation effects over the following years). Nagasaki was the center of Japanese Catholicism, and its Urakami (St Mary's ) Cathedral - which was ground-zero for the "Fat-Man" A-bomb, killed a churchfull of worshippers attending Mass.
(d) See "The Catholic Holocaust" by Anthony Josemaria (a Franciscan Brother) at http://www.hprweb.com/index.php?option=com_content&view=article&id=250:the-catholic-holocaust-of-nagasaki-august-9-1945why-lord&catid=34:current-issue. Brother Anthony movingly describes the efforts of radiologist and radiation victim Dr. Takashi Nagai to encourage his fellow Nagasaki Catholics (in the face of their protests not to "dignify with pious words the atrocity perpetrated on their families") to seek peace and providential meaning in the holocaust they had suffered. (Dr. Nagai, the author of The Bells of Nagasaki and subject of Kinosita's film Children of Nagasaki," died in 1951.)
(10) Given the suffering of American Japanese and of the A-bomb victims in Hiroshima and Nagasaki, would we really find it unfathomable if, in 1950, pacifist representatives of these 2 groups wished to build a memorial dedicated to peace near the Pearl Harbor war memorials where Japan had attacked 9 years earlier? I don't know if such an idea was ever advanced, but had there been such an initiative, couldn't we see this as a step towards strengthening bonds of peace, and a commitment to avoid the devastation and terror of war as much as possible? Would it really be an insult to the sailors who died on the Arizona?
(11) Given the above facts, mustn't one see the objection to a Cordoba House initiative to build near Ground Zero as stemming, not from thoughtful Constitutional and ethical reasoning, but essentially from raw emotion? - inevitable grief causing understandable anger, which may become attached (isn't it true?) to a non-rational dimension of undiscriminating xenophobia and even vengeful hatred? And aren't the last 2 emotions incompatible with the deepest religious ideals of the faiths most of those opposed to the mosque appear to profess? Although ALL these feelings are understandable, should they be the basis for public policy in a secular, pluralistic democracy which seeks to protect the rights of ALL its citizens? - including those of vulnerable minorities which may be under attack by a majority which may momentarily try to bend the laws to accommodate certain reactive, discriminatory emotions?

Americans' Break for Coffee: "Let's wake up, smell the coffee,
and converse civilly about America's ABCs" (Incomplete write-up-2/14/10)
A. Our Government is Paralyzed
Americans Break for Coffee poses an alternative to the Tea Party movement. It reaffirms the Founders' assertion that American government was intended to "form a more perfect union," despite competing interests and beliefs about the shape of that union.(1)
Our system of checks and balances was intended to avoid tyrannical rule and to protect the rights of minorities, and at the same time to ensure that lawful majority rule ultimately prevailed (in a republican legislature representing all citizens, and elected according to constitutional protocols). Although the Founders were conservatives who did not mind slowing down the legislative process, they certainly did not intend to set up a process in which a determined minority could prevent new legislation that did not have unanimous consent.
(1) Today there is justifiable anger among voters that the legislative process is not working the way it is supposed to work. In an unprecedented way, the minority party appears determined to use every available parliamentary maneuver to prevent the lawfully elected majority to claim any success in implementing the platform which it presented to the voters in the last elections.
The Senate filibuster - a internal parliamentary rule allowing indefinite prolongation of debate, and thus veto power to 40% of senators - was used infrequently until recently. During the last 2 years of George W. Bush's presidency, from 2006-2008, minority Democrats "threatened or used filibusters on a wide variety of issues, including legislation affecting campaign finance, abortion, war spending, the Patriot Act, and the nominations of Samuel Alito to the Supreme Court and Dirk Kempthorne as Interior Secretary"
However, continues David Lightman of McClatchy Newspapers, 'Republicans appear to be taking the filibuster to a new level. They've filibustered 15 nominees to mid-level jobs that formerly got routine approval,' even though all but one were ultimately confirmed. ' "Being unable to stop filibusters can make the party in power look ineffective,' said Julian Zelizer , a professor of history and public affairs at Princeton University, who's written extensively on the filibuster. 'The Republican goal now is to make Obama look like an ineffective leader.' " (2)
(2) Many are also justifiably concerned about the excessive influence of corporations and wealthy private interests on government, as compared to the influence of individual citizens. Saving financiers on Wall Street has seemed to take precedence over saving the jobs and homes of Main Street voters - even if saving the world financial system was a rational precondition for avoiding another Great Depression. The Supreme Court has used this occasion to overturn past congressional legislation and has ruled that corporations' entitlement to "free speech" allows them to spend as many dollars from their coffers as they want to bankroll political parties and movements - even if that money overwhelms the amount of money that individual voters may be able or willing to spend to make their candidates' ideas known within "the public square."

B. China and Europe Are Pulling Ahead of America, As We Dither on Huge Challenges
Former Republican Commerce Secretary Peter G. Peterson summed it up: "Our country faces structural challenges that are undeniable but, politically speaking, untouchable." (3) If we continue to delay in meeting them, these problems will only grow in their scope and in the cost to fix them.
Democrats, Republicans and Independents should be able to agree with Peterson when he cites 2 "elephants in the room":
* A burden of growing, unfunded Federal liabilities - especially related to Medicare and Social Security -"could destroy the quality of life of future generations."(3)
(Yes, there is a "Social Security Trust Fund," but it constantly leaks into payment of the Federal government's general expenses. One presidential candidate in 2000 did recommend putting then-existing government surpluses into a "Social Security lock box" that could not be raided; but he was just ridiculed for the way he said "lock-box." [4] )
* A nationally low savings rate [and excessive consumption of imported goods] makes us "dangerously dependent on foreign lenders."
If these lenders pull the plug on lending, they could "trigger a true crisis: a plummeting dollar, soaring interest rates, and runaway inflation." (3)
I'm sure we could agree on other marauding mammoths that threaten our children's future:
* China and Europe are ahead of us in "green technology" using solar and wind and "clean coal" power as alternatives to fossil fuels like oil. (5)
Our own oil supplies are limited. We have lots of coal, but have done little to minimize the environmental impact of mining and burning it. Our dependence on oil from politically unstable, often hostile foreign countries makes us very vulnerable to disruptions caused by enemy violence or natural disaster. (It also adds further to our foreign debt, so long as imports exceed exports.)
* Our leading Wall Street bankers and financiers have developed a habit of looking for short-term personal profit instead of the national good.
They hired math-whizz specialists to develop and sell extremely risky financial instruments (like mortgage-backed derivatives), while disguising the house of cards they erected with investors' retirement funds. Much of the 2008 financial crisis might have been prevented if, a decade earlier, Republicans and Democrats hadn't repealed the Glass-Steagall Act, which was passed after the 1929 stock market crash precipitated the Great Depression and kept banks from speculating with, in Louis Brandeis's words, "other people's money." (6)
* We fiddle while we watch the crumbling of our infrastructure - highways and bridges; bus, train and air terminals; dams and water-supply and sewer systems.
At the same time our politicians refuse to invest in renovation that only governments can coordinate, citing the public's opposition to new taxes and "too much government."
* Speaking of travel innovation, China and Europe are ahead of us in developing high-speed long-distance rail service.
This would be one way to decongest (and reduce demand for more) highways and airports, reduce energy consumption, and create jobs.
________________________
1. Preamble to the United States Constitution, 1787: "We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America."

2. David Lightman, "Senate Republicans: Filibuster everything and win in November?" McClatchy Newspapers, 2/12/2010 - http://news.yahoo.com/s/mcclatchy/20100212/pl_mcclatchy/3425660.
3. Peter G. Peterson [Secretary of Commerce under President Richard M. Nixon], "How Business Can Rescue the U.S. Economy," Business Week, 11/5/09 - http://www.businessweek.com/magazine/content/09_46/b4155102865997.htm. Peterson doesn't just blame government or citizens. He is disturbed by the silence of business leaders, calling them "MIAs" in the battle to solve national problems (as New York Times columnist Thomas L. Friedman has described them). He calls for "a private-sector Marshall Plan to rescue our own economy-a vast effort in which business leaders, including CEOs and their boards, organize to be heard on the issues and not just lobby for favors. It's time to create a new nonpartisan organization, a public movement to which business leaders lend their names in order to speak out about our long-term structural problems and their potential solutions. "[We must] lead by example. That means any call to sacrifice begins with us. To take just one example: At a time when soaring health-care costs threaten U.S. competitiveness, do we fat cats really think we should get our Cadillac health benefits tax-free? It's time to get off our butts, cure ourselves of an aggravated case of short term-itis, and create a movement that makes it safe for our politicians to opt for the hard choices and unsafe for them to continue to do nothing-to deny the undeniable and pretend we can sustain the unsustainable. "
4. Don Luskin, "Social Security: There is No Trust Fund, Only IOU's, Capitalism Magazine, April 11, 2005 - http://www.capmag.com/article.asp?ID=4190.
5. Bob Herbert, " Watching China Run," The New York Times, 2/13/2010 - http://www.nytimes.com/2010/02/13/opinion/13herbert.html?scp=1&sq=china%20and%20green%20technology&st=Search. "Covering a conference on the importance of energy and infrastructure for the next American economy," Herbert reflects: "China has nothing comparable to the research, industrial and economic resources of the United States. Yet the Chinese are blowing us away in the technology race to the future. . . . What's at stake is the future of the American economy. The low-carbon era is coming. We can be dragged into that newer, greener world by leading countries like China; or we can take up the challenge and become the world's leader ourselves."
6. Melvin I. Urofsky, "The Value of Other People's Money, Op-Ed, The New York Times, 2/6/2009 - http://www.nytimes.com/2009/02/07/opinion/07urofsky.html. "Some things never change. . . . In 1914 Louis D. Brandeis. Brandeis, a commercial lawyer and future Supreme Court justice, described a dangerous combination of avarice, lack of accountability and poor oversight in "Other People's Money, and How the Bankers Use It," one of the best-known exposés of the Progressive era. . . .
Our current crisis, after all, was in part fueled by bankers making big gambles with other people's cash. They bundled and sold sub-prime mortgages, took their profits, and then left others holding portfolios full of worthless, even toxic, paper. This was exactly the kind of behavior that Brandeis despised. He believed that it was one thing for an individual to put up capital in risky ventures, playing to win but prepared for failure. But he saw the bankers of his time dodging failure by manipulating the marketplace at the expense of smaller entrepreneurs and consumers.
For Brandeis, regulation was not supposed to be a restraint on innovation or the entrepreneurial spirit, but rather a check on unbridled greed. He believed in a free market, but one in which the government enforced rules of fair competition so that the most talented could succeed. Clear rules would help ensure that business was conducted fairly and openly."
7. Keith Bradsher, "China Sees Growth Engine in a Web of Fast Trains," The New York Times, 2/12/2010 - http://www.nytimes.com/2010/02/13/business/global/13rail.html?scp=1&sq=china,%20high%20speed%20trains&st=cse. "In China, 42 high-speed rail lines have opened or are set to open by 2012; the U.S. hopes to build its first high-speed line by 2014. . . . The Chinese bullet train, which has the world's fastest average speed, travels 664 miles" from coastal Guangzhouon to Wuhan, deep in the interior in a little more than three hours. Although this is the same distance from Boston to southern Virginia, the train takes less time than Amtrak's fastest train, the Acela, takes to go from Boston to New York. By comparison, the United States' first high-speed rail line will, by 2014, link only the 84 miles between Tampa and Orlando, Fla."

Total opposition appears to be the only relationship between science and religion admissible by "militant atheists" like Sam Harris, Richard Dawkins, Caniel Dennett and Christopher Hitchens.

Last summer Robert Wright - the non-theistic author of The Evolution of God, - wrote an interesting NYTimes Op-Ed column arguing that the science and the great religious traditions in no way displace each other as ways of understanding reality: see http://www.nytimes.com/2009/08/23/opinion/23wright.html.
The Times was kind enough to publish my letter in response to Wright's column, on 8/25/09. (To my delight, it directly rubbed print with a letter above by the afore-mentioned D.Dennett):

To the Editor: My middle-age recommitment to the theistic paradigm of my youth answered years of unhappy experience (echoing Paul of Tarsus): "I do not do what I want, but I do the very thing I hate."
Most religions aim to help human beings address our own moral failings. They provide stories, symbols and disciplines - reflecting a higher, transcendent order - which seem to work in rescuing many from illusion, malice, self-created suffering and self-righteousness.
When I joined Pascal in a leap of faith, my own gamble centered not on a postmortem heaven or hell, but on the desire to live a more consistently purposeful, altruistic and peaceful life in the days that are left to me.
My faith is based on moral (and aesthetic), not cosmological or ontological, reasoning. I thank Robert Wright for explaining why it does not fly in the face of the science I serve in my daily work as a physician.
Frederick A. Smith, 8/24/09

Francis Collins - evangelical biologist, identifier of the genes for cystic fibrosis and Huntington's chorea, director of NIH's Human Genome project, and now Obama-appointed Director of the entire National Institutes of Health (to the great dismay of Sam Harris, author of The End of Faith) - has made a well-reasoned theistic affirmation of this non-opposition between science and religion in his 2006 book, The Language of God: A Scientist Presents Evidence for Belief. (He does not resort to the current formal theory labeled "Intelligent Design," which he sees as untenable in the face of known evolutionary genetics.)

The interface between science and religion interests me greatly, since I define myself both as a devout Christian and as a world citizen who is deeply grateful for the scientific method and its enormous contributions, not only to medical and other technology, but also to the understanding of people's relationships to each other - an understanding that religious communities have, in recent centuries been unable to ignore in their own ethical formulations: biblically-derived justifications of slavery and racial segregation, divine right of kings, and female subservience seem to have few Western adherents today. (Barack Obama and Sarah Palin should be proof enough)

ARGUABLY THE POST-RENAISSANCE TURN TO FREE EMPIRICAL OBSERVATION AND PUBLICALLY REVIEWABLE, REPRODUCIBLE SCIENTIFIC TESTING OF HYPOTHESES HAS ARGUABLY PLAYED AT LEAST AN INDIRECT ROLE IN THIS PROGRESS. (It may also be argued that certain rational, unitive streams within the Abrahamic traditions (Islam, Christianity and Judaism) contributed to the rise of empirical science with its faith that the material world is one and can be understood with the proper rational, non-magical, experimental approach.)

What is the next stretching of the mental envelope the Spirit will ask us to make? It seems pretty clear to me that a science (and experience) point to (if not yet conclusively prove that) HOMOSEXUALITY IS A GENETICALLY IMPRINTED PREFERENCE, with all the libidinous power that suggestion implies. (Recall the apostle Paul's allowance for heterosexual union over the celibacy he preferred: "It is better to marry than to burn" (I Corinthians 7:9 - KJV). DOES NOT A GENETIC UNDERSTANDING OF HOMO-SEXUAL PREFERENCE IMPLY A SIMILAR EQUALIZATION OF RIGHTS, INCLUDING MARRIAGE [with the same understanding about fidelity that religious and other ethical people hold about heterosexual commitments], for our gay brothers and sisters? This is the position my own Episcopal national church is taking on this issue, and I believe it is the right one.

The push in this direction presently seems a hurdle too high for most American Christians (although with no more supporting Scripture than the previous hurdles mentioned above) - as well as for other religious people and Christians in other cultures. (See the 1/4/10 NY Times report on the proposal by Ugandan Christian politicians to make homosexuality a capital crime - perhaps fueled in part by a visit from U.S. anti-gay evangelicals outlining the purported "evil agenda" of homosexuals, although these teachers deny any intent to criminalize gayness so severely: http://www.nytimes.com/2010/01/04/world/africa/04uganda.html?scp=1&sq=uganda,%20homosexuals&st=cse.)

To my unpersuaded Christian relatives and friends, I encourage a re-reading of Acts chapters10 and 15 (New Testament), which describe the quandary mid-1st-century Torah-observing Jewish Christians faced with respect to Gentile converts who were clueless to Torah requirements, and who were deemed "unclean" and therefore inadmissible to the religious community - unless they gave up their culture, became circumcised and began observing stringent Jewish religious laws.

See particularly the following words (to and by the apostle Peter) which seem to me to apply equally, in our time, to fellow Christians whom I know, who happen to be gay, and whose only agenda is to live in peace and harmony - without prejudice or persecution - within the larger community, with all the rights and responsibilities granted/expected for other citizens

* "What God has cleansed, no longer consider unholy." (Acts 10:15)
* "Surely no one can refuse the water for these to be baptized who have received the Holy Spirit just as we did" [in the face of their manifesting obvious "gifts of the Spirit"]. (Acts 10:47-48)
* "God, who knows the heart, bore witness to them, giving them the Holy Spirit, just as He also did to us; and he made no distinction between us and them, cleansing their hearts by faith. Now therefore why do you put God to the test by placing upon the neck of the disciples a yoke which neither our fathers nor we have been able to bear? But we believe that we are saved through the grace of the Lord Jesus, in the same way as they also are." (Acts 15:8-11)
(all references are from the New American Standard Bible Translation - ASBT):

Health care reform is an issue that has been on the political front burner for me this year - as it has been for so many others, now and in 1993-4, if not earlier. (The comments below draw in part from an email I sent to some 1st-cousins who are nurses and are no more of one mind than I and all my siblings.) I sent the following letter to the NY Times on health-care reform; it was published in the 12/19/09 edition:

To the Editor: Re: "Health Care Talks Show Sharp Democratic Divide" (news article, Dec. 15): In an August 2009 Washington Post column, Clinton advisor Paul Begala lamented the absolutist position on health insurance reform he encouraged the Democratic President to take in 1994.
Now advocating incremental reform, Begala noted that the 1935 Social Security Act excluded surviving spouses, agricultural and domestic workers, and employees of government, railroads and non-profit organizations - all later piecemeal additions, like disability benefits and inflation-adjusted cost-of-living increases legislated in 1956 and 1974.
As a physician who prefers single-payer insurance and would settle for a "public option," I am willing to stomach even this imperfect bill. Democrats are unlikely to have the 60-vote majority needed to pass any comparable health reform after the 2010 elections.
It would be tragic to forgo extending access to life-saving medical care to tens of millions, while prohibiting insurers' abusive coverage exclusions, limiting their non-medical administrative costs (including profits), and providing mechanisms to constrain Medicare costs. Frederick A. Smith, 12/16/09

 The doctor-patient relationship: There is a lot of talk about government's role in health care interfering with "the doctor-patient relationship," and - among some - an assumption that doctors oppose health care reform. Actually, the majority of physicians back the Senate bill. American Medical Association delegates recently voted to support the Senate bill (against determined opposition within the ranks).

Doctors want change, in part, because of painful experiences with private insurers - like the great frustration I felt a number of years ago when I evaluated a 22-year-old woman who had just been employed by a small non-profit. After I diagnosed systemic lupus, the insurer refused to pay for treatment because she had had "swollen, painful joints" before she was insured. My written protests did no good. I have often wondered what happened to that young lady, whose only hope to pay for treatment was to get a job with government or a large corporation whose insurance plan did not exclude pre-existing conditions.

 The decline of primary care: Among physicians, primary care doctors tend to like the parts of the bill that increase Medicare reimbursement and loan-forgiveness for doctors who choose to go into primary care (internal medicine, pediatrics or family practice), as well as help with obtaining (now prohibitively expensive) electronic medical records and incentives to manage a "medical home" that includes more ancillary staff as "physician extenders."

Without such Federally imposed changes, the practice of office primary care will likely continue dying a slow death as a specialty choice. The following all play a role:

* Primary care doctors have a particularly large paperwork burdens imposed both by commercial insurers and by public and private regulators. Beyond writing or dictating detailed notes about office visits and telephone communication with patients, they do a lot of duplicate writing in their manually updated charts, as they maintain separate lists of medical diagnoses, medications, preventive interventions and lab results - all of which an electronic medical record (EMR) could update automatically.

* Primary care docs do not earn enough to hire the extra ancillary staff who might help keep up with the huge "retail" burden of phone calls and duplicate writing in charts. I burned out, in my 25th year of medical practice, from 12- to 14-hour days making phone calls & updating charts until 9 or 10 at night.

* Doctors (especially in primary care) have mostly been unable to afford the huge up-front expense of EMR. Fortunately the current Federal stimulus plan includes money to help doctors acquire EMR.

* On average, current medical students will graduate with $150,000 in debt. There's no way to readily repay that as a primary care doc. So their increasing tendency is to go into higher-paying subspecialties (cardiology, etc.), especially those with the highest pay and the easiest hours (taking the "ROAD" to radiology, ophthalmology, anesthesia, dermatology, or going into orthopedics or ear-nose-throat).

 Health care priorities: Health care is so important to our well-being as a society that I believe the entire society (through our elected representatives) does have to help decide about our healthcare priorities. Such decisions include:

* What kinds of health care we place priority on: For instance, do we agree that all children and adults (regardless of ability to pay) should be able to receive proven preventive vaccines before we think about replacing the aortic valve in a frail 94-year-old? (One NY-metro insurer does not cover adult flu and Pneumococcal vaccines; yet very expensive and high-risk operations on the frail elderly often raise no questions about payment.)

* How doctors are reimbursed: The entire society may have to agree on a decrease in the reimbursement for doctors whose high pay is inversely related to ease of lifestyle (and only tenuously related to length and intensity of training or malpractice insurance). In my view, this pay has been hiked too high over the years via a "usual, customary & reasonable" insurance philosophy that has kept primary care underpaid (despite the more cognitively- and labor-intense nature of primary care practice ).

 Health care rationing: Another objection to broader governmental/societal involvement in how the health care system is managed is that healthcare will, for the first time, be "rationed." The truth is that OUR CURRENT SYSTEM DOES RATION HEALTH CARE, BUT WITH THE WRONG CRITERIA: Did you have swollen wrists before you got insured and the doctor diagnosed your lupus? Are you employed (recession or not)? And, if employed, do you have the right job, or are you of an age, which automatically confers good health insurance? The wrong answer means "Use the ER, try to pay the bills afterward, and go bankrupt if you can't." Is this a legitimate way to "keep our costs down," with health care distributed primarily to the lucky, those working for large corporations, those aged 65 or above, the very wealthy or the extremely poor (Medicaid)?

We are the only highly developed country in the world with such an irrational system. Even countries like Switzerland that rely entirely on private health insurers have strict rules that prevent the abuses & gaps - and the unconscionable profits for insurers' CEOs and shareholders - that exist in our country.

No society can allow unlimited use of/payment for medical resources (like repeated, duplicative CTs and MRIs and other imaging tests) for inappropriate reasons and at inappropriate intervals. (Primary care docs are those most disciplined about appropriate testing; many studies have demonstrated that they produce "better outcomes at lower costs.") U.S. health care consumes so much of GDP (we are approaching 20% - almost twice that of other developed countries, which all have better health outcomes) - that our best businesses are having increasing difficulty competing in the world economy.

It's time for a substantial change in how we organize health care in the U.S. (I haven't even talked about the morally unjustifiable position of having 40,000,000+ uninsured, with 45,000 deaths/year attributed to lack of insurance and early access to medical care) in a wealthy country, when other developed countries have shown how universal insurance and access can be obtained at a lower cost.)

Service-Politics, Universal Spirituality, Inclusive/Diverse, Embracing Science
SERPOLUSIDES (http://groups.diigo.com/groups/ser_polus_ides)
 SerPol: Politics in Service to the greater human community - rather than for self-aggrandizing power or narrowly acquisitive interests - on behalf of our equal fellow citizens/neighbors in the larger human community, rather than to narrow interests or power for its own sake:
* As a chosen human duty - whether as a private citizen participating in local or national advocacy groups or party, or as one actually employed as a public servant in a governmental or in a non-governmental organization that aims to further the public good;
* Aiming at equal justice, opportunity, and essential civil amenities - including (but not limited to]) rights to decent housing, clothing, food, medical care, judicial process, respect, & freedoms of thought/speech/assembly for redress of grievances, etc. - regardless of gender, ethnicity, class, nationality, religion, sexual preference, etc.
 US: Universal Spirituality: I would hope that political engagement and service look to a set of universal spiritual/ethical values derived (both deductively and empirically) from the world's great religious wisdom traditions and from non-religious ethical thinkers - values that impose a duty to seek the kind of equal treatment for all people that is described above.
* I prefer the term "spiritual" to "ethical" because (based in part on my observation as a palliativist helping patients and families in their grief) I think "spiritual" better describes certain human virtues, like the impulse to ask for and offer forgiveness that so often arises when a loved one is dying: a process that springs not from rational ethics or psychiatric/social-work ministration; but from love, from a new soulful sight resulting from the removal of blinders, and from a humility in the face of death that may best be labeled numinous (the experience of imminent transcendence that Rudolph Otto described in The Idea of the Holy, later so appreciated by the atheist evolutionary biologist Julian Huxley in his book Religion without Revelation). I believe that the impulses to compassion and service arise from the same wellspring of the spirit, the "soul" which best defines our humanity, and identifies even the most anti-religious person as a spiritual being with spiritual concerns.
* In their condemnations of the blatant injustices and inequalities of the society of their day, the Hebrew prophets (beginning with Amos in the 8th century BCE) made clear that social justice is an essential [if not the sole] dimension to the "righteousness" which is a central standard and goal in the entire Hebrew and Christian scripture:
"With what shall I come to the LORD, and bow myself before the God on high? Shall I come to Him with burnt offerings . . .? Does the LORD take delight in thousands of rams . . . ? He has told you, O man, what is good. And what does the LORD require of you, but to do justice, to love kindness, and to walk humbly with your God?" (Micah 6:8, ASBT)
* For anyone who may think his religion has no need of ideas from outside sources, consider the early Christians' rapid adoption of "the Word" [logos] from contemporary Hellenistic pagan and Jewish thinkers. In the mid-2nd century CE, Justin Martyr referred to the pre-existing philosophical and ethical ideas Christians used for communication as "seeds of the Word" (logoi spermatokoi) already planted in fertile ground by the divine Spirit, so that the Gospel could be better understood. A century before Justin, the apostle Paul told the Stoic and Epicurean philosophers who heard him in Athens:
"God made from one every nation of mankind . . . that they should seek God, . . .grope for him and find him, though he is not far from us - for in him we live and move and exist, as even some of your own poets have said, "For we also are his offspring." Acts 17:26-27, ASBT )
Pope John Paul II confirmed Justin Martyr's view, in his 1979 encyclical, Redemptor Hominis, 11:
"The Fathers of the Church rightly saw in the various religions as it were so many reflections of the one truth, 'seeds of the Word', attesting that, though the routes taken may be different, there is but a single goal to which is directed the deepest aspiration of the human spirit . . ." (see http://www.diigo.com/user/fsfasmith/%22religion+%26+philosophy%22 - item on "Cullan")
 ID: Inclusive and Diverse: Hopefully such a "spirituality" will aim to cooperate closely with all non-destructive/non-exploitative human traditions that point to ways of practicing "the good;"
* This doesn't mean trying to homogenize them into one or even declaring them "equal. (Presumably one who is exposed to the multicultural smorgasbord sticks with one's own religious or ethical tradition, not only from comfort but because it seems to "speak" and work better for oneself.) A universal sense of human oneness (described so eloquently above by the apostle Paul) can celebrate human multiplicity and recognize that human cultures draw strength and creativity from diversity (the "melting pot" that is the United States being a prime example),. In the words of another Abrahamic religion's scripture, the Holy Qur'an:
"O people, we have created you from a male and a female and made you into races and tribes SO THAT YOU MAY KNOW EACH OTHER. Surely the most honored of you in the sight of God is the one who is the most righteous of you" (49:13).
 ES: Embracing Science: To some, adding this notion may seem a distinct oddity in 2010 CE. Nevertheless, the role of science and support of its endeavors by society are very important issues in the United States today (broad public support being perhaps more seriously threatened than ever before). Conversely, especially since 9/11/01, there have been loud assertions from very articulate scientists and other prominent individuals (including the four "militant atheists" named above) that religion (at least of the Abrahamic-theist variety) is intrinsically and inherently harmful to modern democratic society, and should not be at all coddled or tolerated by intelligent people, even in its more liberal and tolerant forms.
I hope that we can agree to understand that science is a method of observing, experimenting, and knowing that is not inherently opposed to religion, theism or a spiritual ethic. It may inform these more transcendent disciplines, and affect how they formulate their in-the-world ethics over time; but science in itself cannot be disprove their validity, nor is science sufficient in itself to provide guidance for ethical conduct.

Here are a couple of perhaps quirky references to classical thought with mnemonic value for this long acronym:
 PolUS recalls for me the Greek polis: the ideal of egalitarian community at its best - this time around without slaves, and now hopefully eliminating bias related to gender, class or place/culture/religion of origin.
 IDES brings me (via Google and Wikipedia, after requesting a search on the soothsayer's warning in Shakespeare's Julius Caesar to "beware the Ides of March") to the Latin word IDUS or "mid-division" day, occurring on the middle/full-moon-day of certain lunar months (March, May, July & October). So it reminds me of Buddha's "Middle Path" or Aristotle's moderation (no extremes: "don't make [your conception of] the perfect become the enemy of the best"). Or I can imagine the moon's fullest reflection of sunlight into our relative darkness and unknowing, as we ourselves may hope to reflect (from our own being - however feebly through the clouds we ourselves cannot escape) compassionate Christ- or Buddha-consciousness, or humanism, toward others who live in distress. (This was a metaphor my Dad used in describing a 1942 early-morning horseback ride down a treacherous Colombian mountain trail in full-moonlight, relating it to his and Mom's desire to reflect the light of Christ as the source sun/Son of light-and-righteousness. His own words are in the bio on their memorial website [till October, 2010]: http://memorialwebsites.legacy.com/Rev-Fred-and-Della-Smith/Homepage.aspx).