The issues facing physicians are numerous, covering a broad spectrum. From the nuts and bolts of managing daily practice, providing great care as we stay up to date, dealing with the ethical dilemmas facing our patients and communities—it can be overwhelming. Our communities expect us to be leaders. To have a balanced life spiritually, physically, professionally and with our families, decisions must be made.

 

I have a burden to be involved professionally. My father taught me to have that desire. Plus, my local general practitioner told me before I went to medical school that I was to follow his example as a country doctor who became president of the Medical Society of Virginia. Once I established my foundation with family, practice and local church, I began the long climb up the ladder. Along the way, my practice benefited with insights, contacts and opportunities to further our practice as well as making an impact statewide. I became president of the Medical Society of Virginia from 2008 to 2009. That led to becoming a delegate in the American Medical Association (AMA) in 2010. I was elected chair of the Integrated Physician Practice Section of the AMA. CMDA played a big role in preparing me to lead in a secular organization with speaker training and the resources we are blessed with on an ongoing basis through CMDA membership.

 

My first “calling” to speak at the AMA was in the conscience freedoms debate when the AMA wanted to tell pharmacists they had to fill abortion pills no matter their beliefs. Calling on someone smarter than me, I asked Dr. David Stevens, who served as CMDA’s CEO at the time, for help. He helped me speak more eloquently than ever before in helping the proper verbiage become reality in the AMA Code of Ethics. The focus changed from telling others what to do and instead how we should act ethically as professionals.

 

My second gap to step in was the effort by the Oregon delegation to change the AMA’s clear stance against assisted suicide in the AMA Code of Ethics. For three years, the meetings, speaking engagements, debates and eventual reaffirmation of the code was a slog. I learned about building coalitions and allies. I really appreciated my Catholic colleagues who are so well grounded on life issues.

 

I thought I was going to quietly disappear from the delegation until 2021 when I was “volunteered” to step into a leadership gap as chair of the delegation. At the same time, the leaked decision from the Dobbs v. Jackson Women’s Health Organization case from the U.S. Supreme Court led to a strident response to the anticipated reversal of Roe v. Wade by an extremely vocal group of physicians. The AMA adopted a new policy in standing for a woman’s right to totally control her healthcare, including the unrestricted right to abortion at all stages of pregnancy. The coalition of strong support cheered when this passed. I had personally encouraged a more thoughtful slower response in the reference committee testimony after a lengthy discussion with the eight women physicians and students in the Virginia delegation. These women respected my beliefs as we hammered out a reasonable stance. As I presented this, I could feel the negative response. A Catholic friend said, “You are the most courageous physician I know,” after gaging the response.

 

In the winter of 2022-2023, I had a gnawing in my gut about the preborn and the way the supporters of the adopted policy celebrated. One Sunday three months later, I prayerfully concluded that, if I was going to get His peace, I needed to do something. I called one of my Catholic friends in the AMA who felt the same tug that day while leaving Mass. That friend guided the process and mechanics of introducing resolutions. I wrote three resolutions. Previous experience with the legislatures and other resolution writing made me realize not to tackle all abortions but focus of the point of viability of the fetus. The first proposed resolution was emphasis on factual data about the number of abortions that is published by the U.S. Centers for Disease Control and Prevention and Guttmacher Institute. The second was a call for the Code of Ethics to do a study on the rights of the viable preborn. The third was a call for advanced neonatal care for the viable aborted born. CMDA Senior Vice President of Bioethics and Public Policy Dr. Jeff Barrows helped immeasurably with the creation of the resolutions.

 

Preparation is the key. I hired a coach to help narrow reference committee talking points. Testimony is restricted, giving you only 90 to 120 seconds to make your points. Thick skin at the reference committee is needed, for many will not like your position. I noted that the opponents of my resolutions never talked about the viable preborn, just women’s rights. The desire to debate the issue was zero. The resolutions failed by 20 to 80 percent vote.

 

After the loss, I was dumbfounded by what happened next. Numerous physicians quietly said, “Thank you,” “You are right” and “I do not have the courage to do and say what you stood up for.” I was invisible as an AMA delegate. No more. This was our Lord’s affirmation that what I did was correct. His peace in this endeavor increased all spring. The fight is not over yet, for I have learned a great deal, and the issue has not gone away.

 

An Instant replay for assisted suicide started again in November. Students and residents decided that the assisted suicide policy reaffirmation that was passed by a two-thirds vote in 2019 needed to be resurfaced. We had learned from 2016 to 2019 that a larger coalition including students and residents was invaluable. The policy was upheld, but a piece was sent back to the Council for Ethical and Judicial Affairs. The struggle to deal with the states that have assisted suicide versus those that do not want assisted suicide at all will continue as values are different. How the AMA board and probably the Council on Ethical and Judicial Affairs choose to address this narrow issue or expand its scope remains to be seen.

 

The biggest lesson is that if you are not there, then things might get passed that you find abhorrent. You can quit the organization or, as I and many others have done, you can get in the trenches. We need many more, not a few. The voice the AMA, state and specialty societies have is just too large for society to ignore. WE are the vanguards of our profession. The students and residents who attended the last meeting realized their voices can be heard. They left with a charge to get involved at the ground level and start up the leadership ladder. They lived the lesson that you cannot win the war unless you are in the trenches. We must make the effort to be ready and armed to protect and fight for what we believe our Lord would have us do.