Michael Morgan , founder and Executive Director of the African American Music Foundation, visited my church this week to celebrate Black History Month . During morning service his thrilling bass voice highlighted an inspiring memorial to Paul Robeson. That afternoon he delivered a recital and lecture on spirituals to an overflow crowd. I’ve been humming these spirituals and mulling their words ever since. Mr. Morgan is charismatic and riveting and he adores spirituals. As he explained, this is not only African American music. It is American music — never composed, but arising organically from...

This election season is extracting an enormous toll from candidates and citizens alike. Pressure is always intense in a Presidential year, but this year is different. Airwaves and Internet hammer away with news of poll after poll, minute campaign details and endless tit for tat. The presidential race, Senate and House races — even local campaigns — all occupy space in national media. Twenty e-mails appear in my inbox by noon each day, all URGENT and all pleading for funds. The money flow is mind boggling. According to followthemoney.org , state races alone have raised almost $1.2 Billion...

Expansion in Oregon Tests whether it’s a Distinction without a Difference As I previously blogged, the Catholic hospital brand is no longer desirable in the marketplace for mergers and acquisitions of healthcare entities. This realization led Catholic Healthcare West , the nation’s fifth largest healthcare conglomerate, to give up its status as a ministry of the Catholic Church. In doing so the corporation exempted itself from obedience to the Ethical and Religious Directives for Catholic Healthcare (ERDs) and released its secular hospitals from control by their local bishops. Local bishops...

Why is it so difficult for doctors to confront the truth when a patient is dying, and almost impossible for most to talk about it openly with the patient and loved ones? Last week I shared a hunch. A journalist asked me the question, “Why do doctors find these conversations so hard?” I said I could only speculate. But I would base my guess on decades of practice as a nurse and physician assistant, and watching doctors from the vantage points of those allied professions. My guess was that doctors are among the people in our society most frightened by death. Their fear reinforces our society’s...

How do we get doctors to honor our wishes at the end of life? Most recommend preparing an advance directive , and I'm no exception. These documents are not infallible, but they are the best things we've got going for us when we can't speak for ourselves. However, one popular advance directive could actually subvert your wishes with its stealth anti-choice language. It's called "Five Wishes." There are two general kinds of advance directive . One is called a "health care proxy" or "power of attorney for health care" and it delegates a person to make decisions on your behalf. The other is a "...

A study published this month paints a troubling picture. Imagine palliative care doctors, working to deliver the best possible comfort care to their patients. Yet even as they meet the recognized best practices of their profession, their colleagues are judging their covert intentions and moral fiber. Over half of the physicians who responded to the survey, published in the Journal of Palliative Medicine (JPM), reported they had been accused of “murder” or “killing” at least once in the past five years. Most often, their accusers were fellow members of the healthcare team. Accusations came...

After years of gains and setbacks, the national movement for same-sex marriage is enjoying a period of remarkable success. Massachusetts and Connecticut became first adopters in 2004 and 2005 and that came after twenty years of advocacy. Turmoil followed, especially in California. But in 2009 three states (Iowa, Vermont, New Hampshire) approved same-sex marriage. New York followed last June , and now the Washington and Maryland legislatures have acted in quick succession. Delaware’s governor predicts his state is not far behind. It’s making me think about similarities between the movement for...

Over and over we see the U.S. Conference of Catholic Bishops confuse the right to exercise their religion with a right to impose their religion on Americans who don’t share it. This is not a subtle difference. And, as Bill Moyers points out in the context of their intransigence on access to birth control, the bishops aren’t content with an exception from the rule that, like other employers, they provide birth control coverage to workers in their hospitals and universities . They also want to be able to keep their employees from obtaining birth control pills from a third-party insurer, at no...

In November Dr. Ken Murray published a blog on Zocalo Public Square called “How Doctors Die.” It’s been reverberating through the Web ever since, prompting a continuous stream of comments and inspiring others to offer their own essays and input. What struck a chord was the assertion that doctors with terminal illness often reject the long-shot technology that traps other people in cycles of hospitalizations, surgeries, procedures and chemicals, and ensures their final days will be in intensive-care lockdown. Do the same doctors who personally reject such misery recommend miserable, intrusive...