ASIAN FEDERATION OF CATHOLIC MEDICAL ASSOCIATIONS

Thursday, October 03, 2013

Advanced Directives & Related Bio-ethical Issues in Asia

Introduction:This article will try to discuss issues related to Advance directives with particular reference to the situation in Asia.In terms of numbers the Chinese, Muslims and Indians form the majority of the population in Asia.The religion of most Chinese including the Japanese and Korean is Buddhism .On the other hand the Muslims led by the Indonesians practice Islam while the Indians practice Hiduism.All religions teach us to do good and "Thou Shalt Not Kill". Most countries in Asia except for the Phillippines have less than 10% Catholics. In Malaysia which has a population of more than 28 million the percentage of Catholics is only 4%. Advance Directives are relatively unknown in Asia. What is an Advanced Directive?. An Advanced Directive is defined as a document with written instructions made by a person before he/she reaches the terminal phase of a terminal illness or a persistent vegetative state and incapable of asking decision about medical treatment when the question of administering the treatment arises. It is preferably a duly notarised document executed by a person of legal age and of sound mind upon consultation with a physician and family members.It directs healthcare providers to administer terminal care when the person executing such directive reaches the terminal phase of his terminal illness. Before I delve further into Advance directives it is important also to mention death/brain death, euthanasia, dysthanasia, orthothanasia, ordinary and extraordinary care and DNR or Do Not Resuscitate as they are all interrelated with Advance Directives. Death/Brain Death From the medical point of view Death can be diagnosed and certified when the heart stops and spontaneous breathing stops (conventional definition) or when the brain including the brain stem stops functioning (Brain Death definition). With the advance in Resuscitation and setting up of Intensive Care Wards some patients whose hearts had stopped or failed and whose breathing was stopping or had ceased were successfully resuscitated. A small percentage of the successfully restarted heart beating 'survivors' could not be taken off life supports.This group was actually 'dead' (by the old definition)because if there were no artificial supports(breathing machines, etc.)or if they were taken off these supports, the heart and breathing would stop..Medical advance(efficient Resuscitation and Intensive Care Units) created this problem of supporting the 'dead' and not as many erroneously refer to as supporting 'life'. The concept of Brain death evolved and intensive care spread and became universally established from the 1960's.It is now accepted that a patient in the intensive care ward requiring artificial supports (breathing machines,supportive drugs,etc.)to maintain heart/breathing functions can be diagnosed as 'dead' if assessment and testing of the total brain function(including Brain Stem function)shows absence of such functions that is Brain Death. The concept of Brain death has to be accepted in hospitals that run Intensive Care Units/Wards.If one does not accept Brain death as a medical entity the situation can arise whereby the ICU beds are occupied by 'dead' people (cadavers) on artificial supports. This is a constant dilemma faced by doctors who run ICU wards if the concept of Brain death is not understood and accepted.To diagnose brain death two specialists run through bed side tests/testing the brain stem function independently and repeat the test after a specific interval before the final conclusion is made.In countries where Organ Transplantation Programmes have been started brain death must be accepted as otherwise the only Organs for successful transplantation will only be available from living donors. Euthanasia :By Euthanasia is meant any action or ommision which of itself and by intention causes death with the purpose of eliminating all suffering. The pity aroused by the pain and suffering of of terminally ill patients, abnormal babies,the mentally ill, the elderly and those suffering from incurable disease does not justify any form of Euthanasia either active or Passive.It is not a question of helping a sick person but the intentional killing of a person.Healthcare Personnel should always remain faithful to the task of giving service to the service of life and assisting it to the end. Human life is sacred--all men must recognize that fact (HUMANAE VITAE). Dysthanasia is meant as the undue prolongation of life by futile therapy which ends in an undignified death.It is an abusive use of extraordinary or inappropriate technological means to prolong life and is usually costly and is done for fear of a malpractice suit. Ordinary and Extraordinary Care ANH or Artificial Nutrition and Hydration is regarded as ordinary care and cannot be legitimately withheld even if death is imminent.In 2004 Pope John Paul 2nd during an International Congress on the Vegetative State stated that " 'The administartion of water and food even when provided by artificial means always represents a natural means of preserving life,not a medical act.Its use furthermore should be considered in principle ordinary and proportionate and as such morally obliggatory insofar as and until it is seen to have obtained its proper finality, which in the present case consist in providing nourishment to the patient and alleviation of his suffering. DNR or a Do Not resuscitate Order is usually executed when death is imminent. Life sustaining treatment is withdrawn from a patient in a terminal condition or in a permanently unconscious state when a medical practitioner signs a do-not-resuscitate order on the request of the patient or his representative if the patient lacks capacity to do so. The life sustaining treatment typically withdrawn is cardiopulmonary resuscitation (CPR). A DNR is morally permissible only if one can judge that CPR is excessively burdensome for the patient taking into account his or her situation and physical and moral resources or that CPR imposes excessive financial burden on the family and community. POLST or Physician Orders for Life Sustaining Treatment is causing alarm in Catholic Healthcare circles. POLST orders include a DNR order (do not resuscitate) and an AND Order (Allow Natural Death)which is to withhold assisted nutrition and hydration and another Order to withhold antibiotics. The POLST ensures that the patient's wishes are followed.A patient can choose any one of the three following measures: a/ First Choice--'Comfort Measures only' which means providing care to relieve pain and suffering b/Second Choice---'Limited Additional Interventions' which includes comfort care but may also include IV fluids and antibiotics.c/Third Choice--'Full Treatment' which includes comfort care,IV fluids, antibiotics,CPR,the type of breathing support, artificially administered nutrition and all other intensive medical care measures including transfer to a hospital. On the surface POLST appears to be a sincere effort to encourage individuals to plan and address their end of life care needs. However POLST has a detrimental effect on Catholic Moral teaching. It makes patient autonomy an enforceable right and gives all patients whether terminally ill or not total control of their end-of-life issues.It attacks the sacred value of human life by allowing individuals to hasten their own deaths on the basis of their personal intentions .exerted independently of Catholic healthcare ethical values. History of Advance Directives : Advance Directives began to be developed in the US in the late 1960's.In 1976 Barry Keene introduced the Bill in California and the latter became the first US state to legally sanction Living Wills. In 1992 all the 50 US States had passed legislation to legalize some form of Advance Directive. Advance Directives generally fall into 3 categories: Living Will. Power of Attorney and Health Care Proxy. Living Will: This is a written document that specifies what type of medical treatment are desired should the individual become incapacitated.A Living Will can be general or specific. the most common statement in a Living Will is to the effect that:- If I suffer from an incurable irreversible illness, disease or condition and my attending physician determines that my condition is terminal, I direct that life sustaining measures that only serve to prolong my life be withheld or discontinued. More specific Living Wills may include information regarding an individual's desire for such service as analgesia (pain relief), antibiotics, hydration,feeding, CPR (cardiopulmonary resuscitation) and the use of life support equipment including ventilation. Health Care Proxy :This is a legal document in which an individual delegates another person to make health care decisions if he or she is incapable of making his/her wishes known.The health care proxy in essence has the same rights to request or refuse treatment that the individual would have if capable of making and communicating decisions. Power of Attorney: Through this type of Advance Directive an individual executes legal documents which provide the power of attorney to others in the case of an incapacitating medical condition. The Durable Power of Attorney allows an individual to make bank transactions,sick social security checks,apply for disability or simply sign cheques to pay the utility bill while an individual is medically incapacitated. Advance Directives in Asia:While the Western Countries like the US has legalized some form of Advance Directives, the latter is relatively unknown in Asia. Up to date only Singapore has passed its Advance Medical Directive Act (Chapter4A) on July 1997.This is an Act to provide for and give legal effect to Advance Directives to medical practitioners against artificial prolongation of the dying process and for matters connected therewith.The Act permits only natural death and not euthanasia or abbetment of suicide.The Advance Directive does not affect palliative care.Any Person who makes a Directive shall register his Directive with the registrar of Advance Medical Directives.Also any person who has made a Directive may in the presence of a witness revoke the Directive in writing, orally or in any other way in which the patient can communicate.The Medical Practitioner responsible for the treatment of the person who has been certified terminally ill shall obtain the opinion of 2 other medical specialists as to whether they agree to with the determination that the patient is terminally ill. Terminal illness means an incurable condition caused by injury or disease from which there is no reasonable prospect of a temporary or permanent recovery where a/death would within a reasonable medical judgement be imminent regardless of the application of life sustaining treatment and b/the application of extraordinary life sustaining treatment would only serve to postphone the moment of death of the patient. A few other countries in Asia are presently trying to promote Advance Directives in their country. In Hong Kong in 2006 the Law Reform Commission released their final report on 'Substitute Decision making and Advance Directives in relation to Medical treatment' and recommended the promotion of Advance Directives but not Legislation.Chinese family members often play a very influential role in relation to end-of-life decisions.The Chinese often view overt reference to death as taboo and would like to talk about death. A Wong et al study showed that 6%of those not engaging in Advance Directives did so because of family objections. In Japan terminally ill patients also rely on Family Members and Physicians for making end-of-life decisions (Kinoshita 2007). These cultural differences are common in Asian countries and may result in patient's medical directive preferences be override. Current Korean Medical Law does not include categories for end -of-life care but the Law concerning emergency medical care states that "Physicians are not allowed to discontinue emergency care without appropriate reasons. Therefor if ill patients are transferred to ICU they must be kept on ventilators until death, brain death or a judicial decision from a court of law (YS LEE 2009). In The Phillippines in July 2004 an Act was presented to their House of Representatives to be passed. This Act was introduced by Rodriguez D. Davidas Declaring the Rights and Obligations of Patients and Establishing a grievance mechanism for Violation thereof and for other purposes.This Act shall be known as the Magna Carta of Patient's Rights and Obligations.Advance Directive is included in this Act---Any Person of legal age and of sound mind may make an Advance directive for physicians to administer terminal care when he suffers from the terminal phase of a terminal illness. Conclusion: Advance directives and the interrelated bio-ethical issues like Euthanasia and Brain Death have been described. Whilst Advance Directives are commonly used in the Western countries like US and are legalized, in Asia only Singapore has legalized it.Due to our cultural differences Advance Directives may not be popular in Asian countries as the Family Bond is very strong amongst Asian Families.Finally Advance Directives attacks the sacred value of human life by allowing individuals to control their own end-of-life issues independent of Catholic Healthcare Ethical Values. Prepared by Dr. Freddie Loh Immediate Past President of AFCMA and Asian Representative to FIAMC.

Saturday, June 08, 2013

POPE AND MEDICAL DOCTOR Church for the Poor : What Pope Francis teaches us Catholic Doctors The Argentinian Jesuit Jorge Mario Bergoglio was just elected Pope a few weeks ago, just before Easter, taking the regnal name Francis. Nevertheless, through his nature and character, he has established his own style of Papacy, much to the admiration of a lot of us. As Catholic doctors, there is a lot we can learn from Pope Francis, and we should actually look up to him as a role model in serving the people. Inspired by St. Francis of Assisi, he is a figure who is humble and very concerned about the poor and disadvantaged. When we identify ourselves as Catholic doctors, we are not mere doctors who happen to believe in the Catholic faith, but we are medical professionals who incorporate Catholic teachings into our daily activities. Do we base our actions on the honest intention to improve the general well-being of people or is making money our sole reason of carrying out our duties? Have we shown humility as doctors and provide the most sincere care to our patients, or do we just consider them as objects? In treating our patients, do we consider all of them equal? Or do we turn a blind eye on our patients who are struggling financially? It is important to acknowledge the reality that a lot of the world’s 7 billion people are living under the poverty line. In line with this, we have to also appreciate that a lot of these impoverished people have trouble accessing the appropriate healthcare they deserve, particularly in the developing countries in Asia, Africa, South America, and Eastern Europe. In my opinion, the first point we have fully grasp is that we could become who we are now as medical professionals not only because of our talents and efforts, but also because of God’s will. Through His grace and with His blessings, we develop our talents and skills to become experts in our respective medical fields, such as cardiology, surgery, gynaecology, and so on. Using this expertise to serve the patients with sincerity and humility, especially those who are financially disadvantaged, is our noble way to thank God for the privileges He has given us. We have to remember Jesus’ message to us when He talked about the kingdom of heaven and the last judgment (Matthew 25:31-46). There He emphasised that whatever we do to the least of his brethren, we do it to Him. It is through these lowly and poor people that we could see the face of Jesus. Furthermore, as we recall, from the parable of the good Samaritan, the two greatest commandments Jesus gave us are to love God unconditionally and to love others as ourselves (Luke 10:25-37, Deuteronomy 6:5, Leviticus 19:18). Combining this with our oath, is it important to always realise that it should be our nature to serve people without discrimination. Pope Francis has called us all, including us medical professionals, to care for and serve the poor. It is one of the, if not the, central theme of his Papacy. He has said that he wants the Church to be the Church for the poor. There are a number of inspirational people we can view as examples to serve the lowly. Saint Damien of Molokai SS.CC., despite not being a medical professional himself, devoted his life to care for the physical, spiritual, and emotional needs of those in the leper colony in Hawaii. We then also have Blessed Mother Teresa of Calcutta, who showed great devotion to care for the disadvantaged people from the slums of India. More recently, we have Fr. John Lee Tae-Soek SDB, a Korean medical doctor who dedicated his life to the services of the poor people with leprosy in war-ravaged Southern Sudan. Pope Francis also reminded us to put more emphasis on human life and dignity on top of other material matters. The pro-life movements should focus their actions not only to prevent abortion, but also to save people’s lives and prevent euthanasia. On the other hand, in the recent times, we have witnessed the advances of medical technology which are able to provide the best treatment for various diseases and illnesses. Unfortunately, a lot of these technologies are only accessible to very few people who have significant financial advantage to afford them. If we flash back to a quarter of century ago, when these technologies were not invented, doctors were still able to utilise purely their talents and skills to accurately diagnose and provide the appropriate and acceptable treatment for the same diseases and illnesses. A lot of doctors in the recent times rely heavily on these very expensive technologies, although they might not provide significant advantage over the conventional techniques employed decades ago. Even worse, these doctors are often pressured by the medical institution (e.g. the hospital) to utilise these cutting-edge technologies, albeit unnecessary, to pay off the debt for purchasing the equipment. The point to highlight here is to warn us Catholic doctors not to fall into the traps of commercialisation of our services. Again, it is imperative to constantly remind ourselves that we should put more focus of our duties on the patients and not the institutions we work for. I recall my own personal experience a couple of years ago when a young boy from a Muslim family diagnosed with tetanus and required immediate hospital treatment was unable to do so because of his parents’ financial difficulties. When I learned about his background story, I decided to donate some money for his treatment. The boy was eventually cured, and a week later his mum came to thank me. One sentence which touched my heart was, “You must be a Christian, as you have been very kind.” May this thought empower us Catholic doctors to serve with our sincere heart, providing the healthcare to all patients regardless of their background, especially their financial situations. Remember, with His love, God has given us talents and privileges. Thus, it is only appropriate to share the love to others, especially to those who earnestly need our help; those who are poor and disadvantaged. Caring for the least of His brethren is our way to glorify His name. Let us pray so that God bless us in all our duties to serve Him and others. Ignatius H. Widjaja, President of AFCMA (Asian Federation of Catholic Medical Associations)

Tuesday, January 01, 2013

Sanctity of Life

Reproduced here is an article on the Sanctity of Life with reference to Asia posted on the FIAMC website by Dr Freddie Loh, Immediate Past President of AFCMA: Introduction: This article tries to sum up the various bioethical issues affecting life with particular reference to the situation in Asia. Bioethics is defined as the application of moral principles to the life sciences,to the many problems in relation to human life that has resulted from the rapid advancement in science and technology. Asia consists of more than 12 countries of various sizes and each with different races, cultures and religions eg. the main religion in Malaysia and Indonesia is Muslim, in Phillipines is Catholicism, in Japan and China is Buddhism, etc..The Catholic population in these countries with the the exception of the Phillipines is very small eg.the percentage of Catholics in Japan is 0.4%,in Thailand <1%,Indonesia 2’7% and Malaysia 4%. The issues confronting the Catholic Church in Asia are the same as those in Europe and the advanced countries and can be divided into (A) Beginning of life issues and (B) End of life issues.Due to limited space only those issues which are common will be discussed in some detail. Our catholic Church teaches us that life begins at conception and is inviolable and should be protected until its natural end ((Charter for Health Care Workers).Also Human Life is Sacred–all men must recognise that fact (Humanae Vitae). A. Beginning of Life Issues: (1)Abortion: The inviolability of the human person from conception prohibits abortion as it is the supprssion of prenatal life. This is a direct violation of the fundamental right to life of the human being and is an abominable crime.(Holy See, Charter in the rights of the family).Unfortunately although most faiths do not condone abortion considering it as a vicious crime of murder,some countries have legalised abortion due to pressure from individuals in their own country.In Malaysia and Indonesia abortion is legal under certain vital conditions when the pregnancy itself may endanger the lives of the mother. (2) Stem cell research: Stem cells can be divided into embryonic, umbilical and adult types. Stem cells are undifferentiated cells which own the potential to grow into various types of cells in the body.Embryonic Stem Cell Research should not be allowed because they are harvested from embryos which are then destroyed. Stem cells can be used to treat Alzeimer’s disease, Parkinsonisn,repair damaged tissues in knee and myocardium,etc..Stem cell therapy has been used in Singapore for sometime. (3) Assisted Reproduction: Procedures which assist the marital act to achieve its purpose are morally permissible but those which substituted for it are not.These procedures include IVF (in vitro fertilisation), FIVET (fertilisation in vitro with embryonic transfer),IVM (in vitro maturation) where the ovum is allowed to mature in the lab before it is fertilised, ICSI (intra cytoplasmic injection),GIFT (gamette intra fallopian tube transfer) and LTOT (lower tubal ovum transfer).GIFT involves tranferring the gamettes (oocyte and sperm) collected and then transferred by laparoscopy for fertilisation to take place. Some consider this method as illicit.LTOT involves transferring the ovum that cannot get into the blocked fallopian tube to a lower position in the tube or the womb so as to make fertilisation possible.It may be considered morally acceptable as long as the sperm is collected by methods not contrary to nature. With regards to IVF a recent survey on 118 Indonesian Catholic Doctors from Jakarta and Surabaya showed that 52.5% of catholic doctors knew before hand that the Catholic Church has taught about the immorality of IVF. However 73.7% did not agree with this Teaching.IVF is immoral because it does not respect the unitative aspect of the conjugal act (Charter for Health Care workers).However IVF is widely acceptable in Indonesia within its own target market and has recently made inroads into Malaysia. (4) Contraception:This is defined as a means to avoid conception with the help of drugs or devices.Types of contraception include condom, diaphram,spermicide,contraceptive pills, contraceptive injections like depo provera, implants, intra uterine devices, vastectomy. tubectomy,etc..Different countries prefer using different methods. Unfortunately in the Phillipines a staunch Catholic country of late contraception has been legalised with the passing of the RH (Reproductive Health) Bill. To counter the negative effect of contraception Natural Family Planning Methods are used and are accepted by the Church.Their success depend on regulating sexual activity to the wife’s immediate fertile state, to postphone or to even to achieve pregnancy.The Billing’s Ovulation Method (BOM)is widely practised in Asia and has a high success rate. Another Method is the Creighton Model System and Napro Technology discovered by Dr. Hilgers at St. Paul VI Institute in the U.S.. It is being used in Taiwan and Japan.Both Methods involve examination of the cervical mucus by the woman herself feeling its changes from cloudy and sticky to stringy and slippery.This slipperiness is used as a marker for ovulation. In the Creighton and Napro Method the couples are taught that whilst genital contact is to avoided during the days of fertility, sexual contact(activity) should never be avoided as this will lead to a respect for the dignity of woman and marriage. (5) Cloning: Cloning is a technique of creating offspring with the same genetic code as its parent. It duplicates the same genetics as an organism and replace the nucleus of the ovum with the nucleus of another cell. Life begins at the time of fertilisation and interventions such as abortion,IVF,embryonic stem cell research and cloning in some way or other interfere with this process. (6) Prenatal diagnosis: The ever expanding knowledge of intrauterine life and the developement of instruments granting access to it has made it possible to diagnose prenatal life thus opening the way for more timely and effective interventions. Its purpose should always be for the benefit for the Child and the Mother and to make possible therapeutic interventions,to bring assurance and peace to women who are tortured by doubts about foetal abnormalities and tempted to have an abortion.If the prognosis is an unhappy one the mother should be given proper counselling so as to prepare for the welcoming of the handicapped child. (B) End of Life Issues:What is Euthanasia? By Euthanasia is meant an act or ommission which by its nature or intention causes death in order that all suffering may be eliminated.The pity aroused by the pain and suffering of terminally ill patients, abnormal babies, the mentally ill, the elderly and those suffering from incurable disease does not authorise any form of Euthanasia either active or passive.It is not a question of helping a sick person but rather the intentional killing of a person.Health Care personnel should always remain faithful to the task of giving service to the service of life and assisting it to the end. Dysthanasia is defined as the undue prolongationof life which ends in an undignified death. It is an abusive use of extraordinary or inappropriate technological means to prolong life and is usually costly and done for fear of a malpractice lawsuit. Orthothanasia: means correct dying.The patient is allowed to die in a dignified way.Human life must be protected and even dutifully prolonged but should not be unduly or uselessly prolonged.It is not a form of passive euthanasia.Jt is important to differentiate between allowing death to occur and intending death to occur. Ordinary and Extraordinary Care:ANH or Artificial Nutrition and Hydrdration is regarded as ordinary care and cannot be legitimately withheld even if death is imminent. For a dying patient in severe pain eg. prostate cancer it is licit to administer to relieve the pain even when the result is decreased consciousness and shorthening of life. A DNR (do not resuscitate) order is usually given when death is imminent.Life sustaining treatment is withdrawn from a patient either in a terminal condition or a permanently unconscious state when a medical practitioner sign a DNR order on the request of the patient or his representative if the patient lacks capacity. Th life sustaining treatment typically withheld is cardiopulmonary resuscitation (CPR). (C)Organ Transplant: Organ transplant for the purpose of transplantation is good and is to be encouraged as it can save lives. However all risks and harm to the donor and the recipient must be kept to a minimum. Buying and selling an organ is wrong and is against the dignity and worth of a person.It is a known fact tha kidneys are sold in India for a price. (D) Death Penalty: In certain Asian countries including Malaysia the death penalty is given to murderers and drug traffickers by hanging.However I understand that Malaysians and Indonesians are trying to convince their respective Pariaments to abolish the Death penalty for drug trffickers and replace it with one of life imprisonment. Conclusion :Different issues concerning Beginning of Life and End of Life with reference to the situation in asia has been briefly discussed.With the exception of the Phillipines, the Catholic population of the Asian countries are small and relatively insignificant. However with the help of the other communities i.e.our Muslim, Buddhist, Hinddu Brothers and sisters we hope to influence our respective Governments to give added value to life from its beginning to its end. It is the duty of the Catholic Doctors from our various Catholic Doctors Associations to teach their fellow members as well as the other Catholic Health Care Workers including priests, nurses and medical students to update them on the various bioethical issues confronting the Catholic Fraternity and respond to them according to the Teachings of the Magisterium. INTERESTED READERS may also wish to access our archives for other related articles: AUGUST 2010(Billings Ovulation) MAY 2009 (Stem Cells) October 2007 (Bioethics)

Saturday, December 15, 2012

New AFCMA OFFICE BEARERS

AT THE 15th AFCMA CONGRESS IN BALI,the following were elected as office bearers: President : Dr. Ignatius Widjaja – Indonesia Proposed by: Dr. Freddie Loh Seconded by : Dr. John Lee Immediate Past President : Dr. Freddie Loh – Malaysia. Vice president : Dr. Peter Au Yeong – Hong Kong Proposed by : Rev. Fr. Gino Seconded by : Dr. Edna Monzon Dr. Edna Monzon – Philippines Proposed by: Rev. Fr. Gino Seconded by : Dr.Peter Au Yeong Dr. Anthonysamy – Malaysia Proposed by: Rev. Fr. Gino Seconded by: Dr.Ignatius Dr. Joon Ki Kang - Korea Proposed by: Dr.John Lee Seconded by: Dr. Freddie Loh Secretary: Dr.Angela Abidin – Indonesia Proposed by: Dr.Ignatius Widjaja Seconded by: Dr. Albert Hendarta Treasurer: Dr.Buichi Ishijima – Japan Proposed by: Dr. John Lee Seconded by: Dr. Albert Hendarta Medical Mission : Dr. John Lee - Singapore Dr. Hon Kwong Ma - Taiwan Membership Committee : Dr. Keong Lyon Jo – Korea FIAMC Representative : Dr. Sis Mary Lou Dr.Freddie Loh Ecclesiastical Advisor : Rev. Fr. Gino Henrigues The VENUE FOR THE 16th AFCMA CONGRESS will be hosted by Japan and will be held in Kyoto, Japan in 2016.

Thursday, October 04, 2012

Important Announcement

Dear Presidents, Rev. Fathers and Respected Members of Member Countries of AFCMA, I have a few Important Announcements to make before our 15th AFCMA Congress starts in Bali, Indonesia 18-21Oct.2012 viz.:- (1) Dr. Albert Hendarta Organising Chairman and his 15th AFCMA Congress Organising Committee has asked me to inform you that the Final Announcement of the 15th AFCMA Congress is ready . Please look at our AFCMA Congress Website www.afcma2012.com for full details. Credit Card payment for Online Registration is also now available in addition to the Paypal and Direct bank Transfer Methods of payment. Overseas Delegates who have Registered Online and given their Flight Details to the AFCMA Congress Secretariat will be greeted by a Member of the AFCMA Congress Organising Committee at the Bali Airport and taken to their respective Hotels.That welcoming person will be carrying an AFCMA placard for easy identification. (2) Annual Dues. This is the Membership Fee due to be paid by a Member Country of AFCMA for the period 2008-2012. Article L of the Statutes and Bylaws of AFCMA states that "the Annual Dues are assesed according to the number of Members in each Association as follows:- 50 USD(per year) for Associations with less than 100 members and 100 USD(per year) for Associations with 100 or more members". This money is the only source of income that AFCMA gets and is used for the Associations Expenditure and Activities.One of the Aims of AFCMA is to encourage the development of Catholic Medical associations in all countries of Asia in order to assist the Catholic Physician in his moral and spiritual development as well as in his technical advancement. That is why AFCMA is sponsoring the Delegates from the poorer countries of Asia who would otherwise be unable to attend the Congress.We hope that these Delegates will help to form and run their own Associations, Evangelise their own members and help their fellow country men when they return home from the Congress. I am glad that to date Japan, Korea, Oman and Malaysia have paid up their Annual dues. For those Member Countries who have not paid up yet can we request them to please pay to our AFCMA Hon. treasurer Dr. Chong Khin Yam at the AFCMA Congress in Bali? For convenience please pay your Annual dues in USD. Poorer Member Countries of AFCMA can pay a token sum to show their support for AFCMA. (3)I am glad to inform you the the Guild of St. Luke Hong Kong had their AGM recently and that Dr. Ambrose Leung has been elected as their new Master of the Guild. Dr. Ambrose Leung's e-mail is ambroseleung@hotmail.com. Please send him a congratulatory message. Finally as this will probably be my last message to you as President of AFCMA as my tenure of office will be over soon I would like to leave you with the following Bible Passages.Please remember that"Everything you do, you are doing it for the Glory of God!" and also"You shall love the Lord your God with all your heart, with all your soul,with all your strength and with all your mind and your neighbour as yourself---Luke 10:27". Thank you for your support to me and our AFCMA Council throughout these last four years(2008-2012). Please forgive me for my shortcomings and if I had unintentially had offended someone I am indeed truly sorry. Thank you and may Almighty God Bless us and shower His abundant Graces upon us. See you all in Bali, Indonesia for the 15th AFCMA Congress 18-21 Oct.2012. In Jesus Christ, Dr. Freddie Loh, President AFCMA.

Saturday, April 21, 2012

Happy Easter & UPDATE

Dear Respected Presidents of AFCMA Member Countries, Rev. Fathers and Brothers and Sisters in Christ from AFCMA, Christ has Risen, Allelulia! I wish you all a Happy and Blessed Easter! I must apologise for this belated Greeting to you all. I could not do so earlier as I was admitted to Hospital for an operation. Thank God the worse is over and I am back to do HIS WILL as long as HE wants me to. I must now update you on two important events that is happening in AFCMA now viz. (1) As you know we are having our 15th AFCMA Congress in Bali, Indonesia from 18-21 Oct.2012. The Theme is "The Challenges of Catholic Doctors in the Changing World". Dr. Albert Hendarta is the Organising Chairman whilst Dr. Ignatius Widjaja is the President of the International Catholic Medical Community(ICMC) which is co-hosting the Congress with Perdhaki. Registration online is now available via the Secretariat's Website www.afcma2012.com. The Organising Committee has employed Ms Yanita Fajar as its Secretary. Her e-mail is the Secretariat's e-mail i.e. secretariat@afcma2012.com. We would like to remind you to Register early. Also we wish to remind the Presidents of the Member Countries to kindly prepare their Country Report for presentation at the Congress during the AFCMA Country Report Session on Sat. 20 Oct.2012. (2) Please note that AFCMA is in the midst of producing our own Hand Book on Bioethics for Catholic Healthcare Workers. We decided to produce our own Hand Book because of our local Asian values and beliefs and understanding may be different from that of our European counterparts. Dr. Edna Monzon(Phillipines) Chair Person of our AFCMA Bioethics Committee assisted by her Committee consisting of Dr. Peter Au Yeong(Hong Kong), Dr. Chong Khin Yam (Malaysia), Dr. John Hui (Singapore), Dr. Buichi Ishijima(Japan) and Prof. Yeh (Taiwan) are busily preparing the draft so that we can get the Hand Book ready for presentation at the 15th AFCMA Congress in Bali in Oct.2012.If necessary we will co-opt others in to help in this important project. This Hand Book will be most useful to help Catholic Healthcare Givers decide what is permissible according to the Teachings of the Magisterium in their daily lives at home and in their work place. Therefor please help us to pray that the Holy Spirit will guide Dr. Edna and her Bioethics Committee to succeed in producing our AFCMA's Hand Book on Bioethics for Catholic Healthcare Workers in time before our AFCMA Congress inOct.2012 in Bali. Thank you very much for your kind attention and co-operation. In Jesus Christ, Dr. Freddie Loh, President AFCMA.

Sunday, January 01, 2012

Christmas Message from Dr Loh

My Dear Brothers and sisters in Christ,
May the peace and Love of Christ be with you all.Today is indeed a happy day for us christians as we are celebrating the birth of Our Lord and Saviour Jesus Christ. This will be my last christmas message to you as my tenure of office will be over in oct.2012 at the 15th AFCMA congress in Bali, Indonesia.
As I reflect on the past events of the year the most significant event was the triple disasters of earthquake, tsunami and radiation leakage that affected the North East coast of Japan. Our Japanese colleagues from the Japan Association Catholic Medical Association led by Dr. buichi did a wonderful job in helping the victims of the tragedies. Our AFCMA member countries viz. Korea, Hong Kong, Malaysia, Taiwan and Singapore responded magnificently to the call for help by our Brothers and sisters from JCMA by contributing generously to the JCMA Fund for Tsunami Disaster of Japan. This augurs well for AFCMA and shows the excellent co-operation and compassion that our fellow AFCMA member countries have for each other.
I would now like to remind you to attend the 15th AFCMA Congress in Bali, Indonesia which is co-hosted by the Indonesian Catholic Medical Community (ICMC whose President is Dr. Ignatius Harjadi) and PERDHAKI (Dr. Felix Gunawan is the Executixe Director).The Congress will be held from 18-21 Oct.2012 and the theme is "The Challenges of Catholic Doctors in the Changing World".The Organising Committee led by Dr. Albert Hendarta is working very hard to ensure the success of the Congress. They hope to have a total of 600 participants.
Year 2011 has not been a good year for us all as torrential rain and floods have played havoc to most of our Asian countries especially Thailand, Phillipines, Malaysia, etc resulting in loss of lives and damage to properties.
At the last AFCMA Congress in Hong Kong HE Cardinal Javier Lozano Barragan exhorted us to reach out to those Asian countries which are not yet members of AFCMA.Actually India, Pakistan and Sri Lanka used to be members of AFCMA but unfortunately we have lost contact with their representatives. The previous contact from Pakistan Dr. Waris Khan has migrated. Fortunaetely God has Blessed us with two new countries viz. Vietnam and Cambodia. We look foward to seeing the Catholic Healthcare Workers Association of Ho Chi Minh City, Vietnam (led by Dr. Pham Chi Lan and Rev. Father John Toai) and the Cambodian Catholic Healthcare Workers Association (led by Nurse Paola and soon to be Dr. Savoeun)at our 15th AFCMA Congress in Bali in Oct.2012.Dr. Jang Sang Park was elected to be in charge of memberships at the AFCMA Congress in 2008.We hope to get some more representatives from the Asian countries. So if you have any contact please let us know.
Another matter that I need to bring to your attention is the Bioethics Booklet. Dr. Edna Monzon Chair Person of our AFCMA Bioethics Committee has pledged to complete writing this important Booklet and hand it to us before the next Congress in Oct.2012. Meanwhile Dr. Edna is busily compiling all the relevant information together with the other Members of the Bioethics Committee. This is the Handbook on Bioethics for Catholic Healthcare Workers. It will be very useful for us Catholic Healthcare Givers as it will teach/remind us to follow the Teachings of the Magisterium and apply it to our daily lives.So please help us to pray for for the succesful completion of this Bioethics Booklet.
The above are two challenges that our AFCMA have to face with before the 15th AFCMA Congress in Bali in Oct.2012 viz. (1) to get more Asian countries to join AFCMA and
(2) the production of the Bioethics Booklet for Catholic Healthcare Workers. We sincerely hope that we will be able to achieve our targets.
Finally I conclude with St. Paul's Letter to the Phillipians 4:13----" I have the power to face all conditions by the power that Christ gives me". This is to remind ourselves that if we have faith in Christ then nothing is impossible as He lives in us.
Thank you and God Bless and have a Blessed Christmas everyone!
In Jesus Christ,
Dr. Freddie Loh
President AFCMA

Monday, December 12, 2011

Visit to VIETNAM

Dear Brothers and Sisters in Christ,
I have recently just came back from Ho Chi Minh City, Vietnam where I was fortunate to meet up with our Brothers and Sisters from the Catholic Healthcare Workers Association of Ho Chi Minh City to advise them to join AFCMA/FIAMC and also invited them to attend our 15th AFCMA Congress in Bali, Indonesia from 18-21 Oct.2012. The Catholic Healthcare Workers Association of Ho Chi Minh City has already been formed and Rev. Father John Toai is the Association's chaplain. Dr. Pham thi Chi Lan and Dr. Nhuyen Dang Phan are the Association's President and Vice-President respectively.
I am enclosing some of the photos that we took together in Ho Chi Minh City. Please note these two places with the signboards viz. (1) Phong Kham Mai Khoi. This is the New Mai Khoi Clinic that The Japan catholic Medical Association (JCMA) led by Dr. Buichi, Catholic Doctors Association of Western Australia led by Dr. Lennard Chan and Catholic Doctors Association of Malaysia (CDAM) represented by me helped to relocate. The old Mai Khoi Clinic was situated in an old shophouse and the owner wanted to take it back. This New Mai Khoi Clinic is situated in a Church compound in HCMC and treats both normal patients and HIV patients. The signboard depicting "Phong Kham Mai Khoi" means Mai Khoi Clinic or Our Lady of the Rosary Clinic. I am indeed glad that I was able to visit the clinic with the Members of the Catholic Healthcare Association of Ho Chi Minh City and took the photo together with them to show it to our other members from AFCMA.
(2)Another place that I visited was Mai Am Mai Tam which is the Sheltered Home for abandoned children from 3 to 16 years old children whose parents have died of HIV. This place is situated in the Thu Duc District and is about 20 minutes from the HCMC centre. It houses 30 children and belongs to the Archdiocese of HCMC and under the pastoral care of Rev. Father John Toai. There are altogether 75 children housed in 3 separate Homes as each building can take in only 30 children. The children are divided into groups where 5 children are under the care of a "Mother" who herself had been treated for HIV.The "Mother" is paid a nominal salary to look after the children. Dr. Chi Lan informs me that it costs about USD4,000 per month to run the Mai Am Mai Tam Shelter or Shelter of Hope. The words Mai Am Mai Tam means Mary Immaculate Heart Shelter.
The members of the Catholic Healthcare Association of Ho Chi Minh City under the care of Dr. Chi Lan And Dr. Phan are a vibrant and enthusiastic group dedicated to doing God's work. They will be an asset to AFCMA/FIAMC. They have said that they wish to attend our 15th AFCMA Congress in Bali in Oct.2012 but will need some partial subsidy. We certainly look foward to welcoming them in Bali where Dr. Chi Lan can present the Country Report to tell us what and how their Association is doing to help the unfortunate and underprivileged members of their beloved country of Vietnam.
In Jesus Christ,
Dr. Freddie Loh,
President AFCMA


Please paste the following website to your browser to assess the photographs taken in Vietnam:
https://picasaweb.google.com/lh/sredir?uname=112571512937068420327&target=ALBUM&id=5678903661388350225&authkey=Gv1sRgCM3L3aa_o7ataw&invite=CK_o1bMH&feat=email

Monday, November 21, 2011

CDAM Council

We would like to congratulate the Catholic Doctors Association of Malaysia on their new Council which was recently elected at their Annual General Meeting:-

President: Dr David Kumar
Vice President: Dr Melvin Raj
Secretary: Dr Juliet Matthew
Treasurer: Dr Beulah Rasan
Committee Members: Dr Freddie Loh
Dr Anthony Samy
Dr Raj
Auditors: Dr Francis Lopez & Dr Gnanapragasam

We give the new council our best wishes on their new appointments and may Gob bless them and guide them in their mission.

Thursday, October 06, 2011

15th AFCMA Congress, 18th -21st Oct 2012, Bali, Indonesia

Official Congress website:

www.afcma2012.com

Please visit the above website if you need to register for the Congress.

For further information please contact Dr Albert Hendarta at following Email:

hendarta@hcm-excellence.com

Tuesday, September 27, 2011

15th AFCMA Congress, Bali

Dear Colleagues, Presidents of AFCMA member countries,

Dear Fathers, Brothers and Sisters in Christ,



On behalf of the committee, it is my pleasure to announce that the 15th AFCMA Congress will be held on 18 – 21 October 2012, in Sanur Paradise Plaza Hotel in Bali, Indonesia. As you perhaps know, Indonesia was appointed as the host for the next AFCMA Congress. Please see attached the first announcement. The congress website is www.afcma2012.com, which will be updated from time to time.

I do hope that all of you, Board and Members of AFCMA will make a note in your calendar for this important date, so that you can schedule your presence at the congress from now on. I would also urge Board and Members in other regions within FIAMC to come and attend the Congress.

The Organizing Committee has chosen Bali as the location of this congress, to attract more participants. Most of you would have heard of Bali as one of the favorite tourist destinations in the world. We assure you that aside from the interesting topics that will be discussed in the congress, there will also be opportunity for you to see the beauty of the Paradise Island of Bali.

Please go through the following pages in this announcement, especially the Congress Programme. There are still some vacancies for congress speakers that you may be able to fill. The topic can be related to the main theme, subtheme or as free papers. Please let me know if you are interested to be one of the speakers.

With this announcement I would like to welcome you to the 15th AFCMA Congress in Bali, and encourage you to register early.

With my warmest regards,

In Christ,



Albert Hendarta, MD, MPH.

Mobile: +62 811 21 9515

Email: hendarta@hcm-excellence.com; hcm.alberthendarta@gmail.com

Sunday, July 17, 2011

Update from the President

Dear Friends from other member countries of FIAMC,
Allow me to update you on two important happenings in Asia one recent and the other in Oct.2012.
In March 2011 North East Japan was struck with the triple disasters of Earthquake, Tsunami and RadiationLeakage from the Fukushima power plant. According to Dr. Buichi Ishijima President of the Japan Catholic Medical association (JCMA) thousands of people were dead or missing and 25 towns and villages along the North East coast of Japan were swept away. Tha JCMA responded magnificently by sending its members to help in the affected areas but were overwhelmed by the magnitude of the triple disasters.JCMA then appealed to the international community for help by sending donations to the "JCMA Fund For Tsunami Disaster of Japan".The money would be used to purchase drugs and other medical necessities fot those affected by the disasters. Our own member countries of AFCMA were shocked and distressed and chipped in by asking their members to help our Dear Japanese Brothers and Sisters by donating to the"JCMA Fund...".Korea, Hong Kong, Malaysia, Taiwan and Singapore were among the countries which responded. Besides these our Asian countries also sent donations via Caritas from our local Churches raised from the parishioners..Due to the magnitude of the disasters Divine Intervention was essential. Therefor all of us offerred special prayers to ask our Lord Jesus to put a stop to the holocaust and comfort those affected by the disasters and help them to relive their lives again.
We are glad to say that the worse is over now and that Japan is on the road to recovery although the problem with the radiation leakage at the Fukushima power plants is not entirely over. The Japanese people and JCMA must be congratulated for their resilience in overcoming the grief and sufferings caused by the triple disasters.
I would now like to inform you that the 15th AFCMA Congress will be held in Bali Indonesia from 18-21 Oct.2011. The theme of the Congress is "The Challenges of Catholic Doctors in the Changing World".The Indonesian Catholic Medical Community (ICMC) and Perdhaki are jointly organising this important event. Some of the members of the Organising Committee are (1) Dr.Albert Hendarta-- Organising Chairman (2)Dr. Ignatius Widjaja-- President of ICMC and(3) Dr. Felix Gunawan-- Scientific Chairman.
Bali is a beautilful island with tropical forests, sandy beaches, coral reefs and fantastic shopping outlets. It will be a wonderful opportunity for those of you who have not been to Bali to come and join us in our 15th AFCMA Congress from 18-21 Oct.2012.On behalf of Dr. Albert Hendarta and the Organising Committee I would like to invite you to come for an Update on the many challenges that we Catholic Doctors are facing in the Changing World. After the Congress you can extend your stay in Bali to enjoy the many interesting facets that beautiful Bali has to offer.
Finally the Organising Committee will be sending out the First Announcement in the near future and we look foward to seeing some of you in Bali in from 18-21Oct.2012.Please keep those dates free.
Thank you and God Bless!
In Jesus,
Dr. Freddie Loh,
President AFCMA.

Wednesday, May 04, 2011

Easter Greetings from Dr Freddie Loh

Dear Brothers and Sisters in Christ,
On Good Friday Jesus's last 3 words before he gave up his spirit was "It is finished" John 19.30 i.e. his mission on earth was accomplished. He came and died on the Cross in order to redeem our sins so that we can have eternal life!
On the 3rd day i.e. Easter Sunday He rose from the dead to show that He has conquered death and sin. All Praise and Glory go to our Lord Jesus Christ!
Today is Easter Sunday. Jesus Christ is risen. Hallellulia! We too have risen with Him. Let us all celebrate this joyous occassion together. Happy Easter everyone!
In Jesus Christ,
Dr. Freddie Loh.

Monday, January 24, 2011

Christmas Message from Dr Loh

Dear Brothers and Sisters in Christ,
It is time that once again we sit down and spend time together with our loved ones to celebrate the birth of our lord Jesus Christ. We are called to behave like the Holy Family i.e. like Joseph,Mother Mary and Jesus. While we celebrate Christmas we must thank God for giving us the wonderful things that he has given us and we must not forget that there are people out there who are marginalised, living in fear of the authorities and barely have enough food to eat for sustenance.
I wish to now inform you that I have just come back from Phnom Ponh Cambodia after a Medical mission Trip to Cambodia with Dr. John Lee and his Singapore group of Catholic Doctors and Dentists , Medical and Dental students and the Parishioners from different parishes of Singapore. I must thank John for allowing me to join in his Medical Mission to Cambodia called ACTS or Advent Cambodian Trips which have been an eye opener for me. I am sure that John and the Singapore Catholic Doctors Association (Dr. Sally Ho) will be describing to you more in detail at our next AFCMA Congress in Bali under Singapore's Country report.
For those of you who wish to come to Cambodia you must visit the Tuol Sleng Genocide Museum. This was a former school converted into a prison by the Pol Pot Regime designed for the detention, interrogation, inhuman torture and killing of the detainees after their confession were received and documented. Altogether about 20,000 prisoners were killed. The Cambodian people had been living through a nightmare in the nineteen seventies. It is hoped that by making the crimes of the inhuman regime public it will prevent new Pol Pot from emerging anywhere on earth!
Different well meaning groups have come to help the people of Cambodia and to rebuild their lives. That is why John and Priscilla Lee's mission here is very welcome by the Cambodian people. The Don Bosco Salesian Sisters have set up schools to helpto educate the young childrenwho have to walk a few kilometers barefeet to school as there is no transport whilst the Missionaries of Mercy (Mother Teresa's) have a Home for the sick.
Dr. John Lee and myself met up with His Grace Bishop Olivier and he was very keen to my suggestion of setting up a Cambodian Catholic Health Care Association so that they will be more organised in their work. The Association can then apply to join AFCMA as a temporary affiliate member and join in our activities. Presently they have about 10 members mainly medical students which Savouen graduating next year.I sincerely hope that as promised by Ms Paola and Mr. Savouen that their Association will be formed within 6 months.
Finally I wish to remind those member countries who wish to help our Indonesian colleagues in Organising the15th AFCMA Congress to pay up their donation towards the AFCMA Sponsorship Fund now. Please pay to Perdhaki whose Banking details I have already given to you earlier. So far the Catholic Doctors Association of Malaysia (CDAM) have donated USD 500 whislt AFCMA itself contributed USD1,000.Please let me and Dr. Chong Khin Yam and myself know once your Association have donated so that it will be recorded in AFCMA's Treasurer's Report in 2012.
Thank you, God Bless Everyone and have a Blessed Christmas.
In Jesus Christ,
Dr. Freddie Loh,
President AFCMA.

Tuesday, November 02, 2010

Antidepressants and the Dying

Here is a question on bioethics asked by a ZENIT reader and answered by the fellows of the Culture of Life Foundation.


Q: What are some ethical issues surrounding the taking of anti-depressants? Does their mood-altering effect raise moral problems for people preparing their consciences for death? -- K.N., Augusta, USA.

E. Christian Brugger offers the following response.

A: There are many brands of antidepressants on the market today divided over several drug categories (or classes). An older class known as tricyclics came into widespread use in the 1950s and 60s. Common brand names include Elavil and Pamelor. A newer class known as selective serotonin reuptake inhibitors (SSRIs) came into common use in the late 1980s and 1990s and are still widely prescribed (including the famous drugs Prosac and Zoloft). One of the newest classes of the last 10 years, called selective serotonin norepinephrine reuptake inhibitors (SSNRIs), includes the popular brands Cymbalta and Effexor. In addition to depression, antidepressant drugs are also prescribed for anxiety, bipolar disease, eating disorders and chronic pain.

All three classes work at the cellular level of the brain blocking the absorption of brain chemicals known as neurotransmitters, believed to be involved in mood. The two most common neurotransmitters targeted by these meds are serotonin and norepinephrine.

Some fear that because they are involved in the altering of a person's mood, taking antidepressants is morally analogous to the taking of illicit mood-altering drugs.

I believe this is incorrect. Neurotransmitter medications, at least for depression and anxiety, when effective -- and they often are ineffective even when medically indicated -- ordinarily do not induce a "high," but work rather by restoring mood to a measure of statistical normality in one whose mood has grown flat and darkened, or has been shadowed by anxiety.

Whether or not antidepressants are advisable or promise symptomatic relief for certain individuals is a clinical question; and nobody reading this article should take what I say as clinical advice. My purpose here is to address moral questions surrounding the legitimacy of taking antidepressants for clinically indicated conditions.

The principal purpose of legitimately prescribed medications is therapeutic, that is, ordered toward the restoration of health. People suffering from major depression, dysthymia (low level chronic depression), chronic anxiety, panic attacks or bipolar disease are suffering from real health disorders. Medicine has demonstrated beyond reasonable doubt that these conditions have a distinct biological dimension. Data indicates that that dimension can be positively benefited by antidepressant medications.

These conditions might also have what clinical psychology calls a behavioral dimension. And I firmly believe that one's voluntary choosing and thinking can contribute to the exacerbation or minimization of the effects of many psychic disorders. It is unquestionably the case that for persons diagnosed with these types of disorders, some behavioral changes will be necessary to restoring long-term therapeutic health. But antidepressants can and should sometimes be part of a comprehensive therapeutic plan.

That said, antidepressants can cause significant side effects that burden one's life, affect one's relationships and limit one's range of activity. Moreover, similar to wearing glasses, one's neurochemistry after taking antidepressants for extended periods can establish new levels of normality on the medication. And so people who cease taking the meds will sometimes feel worse than before going on them. Finally, the newer classes of antidepressants are very expensive and can burden one's budget especially during economic downturns such as our own.

In making a good morally informed decision about beginning or continuing treatment with one of these drugs, consideration of these possible burdens should be factored in.

The question above asks specifically about the use of anti-depressants for persons preparing for death. The only uses of the meds for which I am familiar in end-of-life care are for treating the psychic states of those with terminal conditions. Those conditions, involving as they do bodily deterioration, can precipitate or exacerbate the types of neurochemical imbalances that correspond to states such as depression. In other words, as one's biology deteriorates, the biological basis for depression will often increase. Fear of dying might also play a role in one's mental state.

If such persons exhibit signs of depression, not only is it legitimate to treat them with antidepressant medications, it can be, in my opinion, a requisite part of palliative care (i.e., relieving distress involved in the dying process). Studies consistently illustrate that those patients most vulnerable to euthanasia are suffering from (among other things) treatable depression. For persons consigned to a bed because of incapacitating illness, behavioral options may be limited, so medications may be one of the few options available.

If health care workers appear unconcerned about the mood of the dying, then family members and other caregivers should insist that the patient's mood be taken seriously.

If the administration of antidepressants causes severe side effects that inhibit a person from conscientiously preparing himself or herself for death, then patients might rightly forgo their use as "excessively burdensome."

But if a patient is suffering from psychological distress of some sort as a (biological and/or environmental) result of a terminal condition, or if they have a history of mood disorders, and antidepressant medications can promise some relief, then treating them with these medications is no more morally suspect than treating them for chronic pain.

Tuesday, September 28, 2010

Following is a reprint of the letter sent by our president to the Catholic Newspaper in Malaysia(HERALD):
I am enclosing the text of my letter addressed to the Editor of the Malaysian Herald Catholic Weekly News letter dated 19Sept.2010 issuefor your perusal and ? comments. This was written is in response to the letter written by a concerned Parishioner who was disturbed by the news that Japanese Medical scientists disposed of human embryos at the end of stem cell manoeuvers.
"Dear Editor,
I refer to Bobby George's article on 'Defenceless embryos cannot cry: Time to act'. We wish to assure him that we Catholic doctors also firmly believe that life begins at conception and is inviolable and must be respected.'Thou shall not kill' is one of our main Commandments and 'I have come that they may have life and have it abundantly'
(John 10:10) are repeatedly mentioned in our Holy Father John Paul II's 'The Gospel of Life' reminding us of the sacredness of humanlife.
The Japan Catholic Medical Association (JCMA) together with the Central Bishops' Association of Japan had in July 2008 already sent their protests against their Government's draft proposal to create human embryos for 'research purposes' in Japan but their protests were ignored. This is the second time that the Ministry of Education and Science have again called for the final public opinion regarding their proposal to create human embryos for 'research purposes' as it is aware of the ethical considerations involved. Let us pray that the Japanese Government will listen to their own people and act wisely.
Recently the Catholic Doctors' Association of Taiwan R.O.C. was involved in opposing their Government's views on surrogate mothers.An Artificial Act on Reproduction passed in 2007 had regarded a woman's body and the foetus as tools which are dehumanising to the mother-child relationship. The Taiwanese doctors pointed out that the Catholic Church in Taiwan instead supported the natural way of promoting impregnation called Natural Procreative Technology or NAPRO. By using treatments that work together with the women's menstrual and fertility cycles at the Cardinal Tien Hospital, they have helped many couples to give birth succesfully. Many of these couples have been unsuccesful previously when they used artificial reproductive technology. Both NAPRO and BOM (Billings Ovulation Method) are accepted by the Catholic Church as natural family planning methods and have helped many sub-fertile women to conceive.
In conclusion we doctors including the Catholic Doctors Association of Malaysia (CDAM) are doing what we can to defend our Church's teachings in our daily lives at home and at work. We look froward to working closely with other health care workers in this respect as we are part of the team.
Dr. Freddie Loh,
President,
Asian Federation of Catholic Medical Associations (AFCMA)"

Wednesday, August 11, 2010

Update on Billings Ovulation Method

Study on the Billings Ovulation Method™ and the Achievement of Pregnancy
1/1/1999 – 31/12/2003
Study conducted by Research Team of Ovulation Method Research and
Reference Centre of Australia Ltd

Summary of Results
Study involved all couples who expressed a desire to achieve a pregnancy and
who attended 17 Australian Billings Ovulation Method™ clinics within the required
time frame.

Total Participants 449
Outcome known 358
Outcome unknown 91

Total pregnancies 278 of 358
Pregnancy Rate 78%
Known Live Birth rate 61%
Possible Live Birth rate*
*14 still pregnant at end of study;
outcome of pregnancy unknown for 62 couples.
88%
Average months trying to achieve for all couples in study
before coming to Billings Ovulation Method™ clinic 15 months
Average months from initial instruction in Billings Ovulation Method™ to conception 4.7 months
Couples who were childless 60%
Prior knowledge of signs of fertility 18%

207 women in the study were classified as sub-fertile – trying to achieve a pregnancy for more than 12 months
(e.g. 20 couples had been unsuccessful with IVF/AI – 7 achieved pregnancy with Billings Ovulation Method™) Outcome known for 172:

Known pregnancy rate for this sub-fertile group 111/172 65%
65 subjects over 38 yrs old - known pregnancy rate 32/48 66%
93% stated they were satisfied and would recommend Billings Ovulation Method™ to others.

95% stated that the Billings Ovulation Method™ gave an understanding of fertility and infertility




From: Marian Corkill

Tuesday, May 25, 2010

FIAMC Lourdes Congress 6th to 9th May 2010

Following is an account of Dr Freddie Loh's sharing of the FIAMC Congress at Lourdes recently.

Dear Brothers and Sisters in Christ,
Here is a brief summary of the 23rd FIAMC's Lourdes Congress that was recently successfully concluded. Prior to the Congress the FIAMC Exco. Committee meeting was held and Dr. Peter Au-Yeong and Dr. Edna Monzon graciously agreed to represent Dr. Buichi Ishijima and myself at short notice as we were unable to attend in time.Dr. Peter Au-Yeong read the AFCMA's President report prepared by me.
AFCMA was well represented at the Congress. The following show the country and their no. of representatives:
(1) Indonesia 24 headed by Dr. Ignatius and Dr. Albert Hendarta(the Organising Chairman of the 15th AFCMA Congress in Bali in 2012)
(2)Malaysia 13 headed by Dr. Frederick Yap
(3)Singapore 11 headed by Dr. John Lee and Father Gino
(4)Hong Kong 4 headed by Dr. Peter Au-yeong
(5)Phillipines 2 headed by Dr. Edna Monzon and
(6) India 4 headed by Father Dr. Stephen Fernandes
(7)Vietnam 1 rep.by Dr. Pham Chi Lan
(8)Myanmar by Dr. May Thu Lynn (our new AFCMA member)
Also present was Dr. Eamonn from Australia who represented Oceana.
The Theme of the Congress was "Our Faith As Physicians" with 4 sub-themes viz. God the Creator, Jesus Christ Suffering and Healing, the Spirit of Life, and The Church, The Body of Christ.There was also a session on Pro-Life.
The Congress was officially declared open by His Excellency Mgr. Zymunt ZIMOWSKI President of the Pontifical Council for Pastoral Health Care on 6 May 2010.
Besides the Scientific Program we also had other activities as this was also our pilgrimage to Lourdes. We had masses at the Grotto (where our Lady appeared to St. Bernadette),Rosary Basilica and the underground Basilica St. Pius X.We walked along with the others at the Marian Procession carrying candles at night and also the Eucharistic Procession,Adoration and Blessing of the Sick. We drank the holy water from the "Taps" of Lourdes and carriedthe water home in bottles in the figurine of our Lady to be given to our relatives and friends. Some members were fortunate to be able to have their "Bath".
Here are some excerpts from a few of the speakers during the Congress:
(1)Dr. Richard Watson(USA)who spoke on 'Should Christian Physicians incorporate prayer as part of therapy?'said that prayer must be for the truly Catholic Doctor at the very core of the doctor-patient relationship.Every time we come into contact with a patient the interface reflects, 'Chritus Medicus'-Christ the Divine Physician our Healer and Savior interfaces with 'Christus Patiens'Christ the Patient, our Redeemer who sufferred for us and saved us by His wounds.
(2) Father Dr. Stephen Fernandez(India) spoke on 'Life in the Spirit and the Challenging Mission of Medical Professionals'. He said that evetyoneis called to meet the Lord in a life experience and bear witness to Him through personal testimony and through their works of faith and justice.We can never live a full Christian Life without experiencing the presence and power of the Holy Spirit.The Holy Spirit descended upon the apostles at Pentecost and transformed their lives.Dr. Stephen then spoke onthe many challengesthat medical professionals are facing in Asia and esp. in India viz. 3.1 million people in India are living with Aids/Hiv, the resurgence of tuberculosis,etc..
(3) Dr. Nicola NAPOLI (Rome) spoke on new therapeutic approacheswith adult stem cells for regenerative medicine.He said that a major task of contemporary medicine is restoration of human tissues and organs lost to diseaseand trauma.Many approaches to tissue engineering have been hindered by factors such as rejectionby the immune system, limited blood supply or morbidity of the donor site. An interesting development has been the discovery of harvesting adipose derived stem cells. This brings new hope as adipose tissue can be easily harvested in adults and can represent an abundant source of therapeutic cells.
Finally at the General Assembly Dr. Simon Castellvi was re-elected as President of FIAMC. Our own Dr. John Lee (Singapore) was also re-elected as Vice- President of FIAMC for another term of 4 years. Bombay has been selected to host the next FIAMC Congress.
In Jesue Christ,
Dr. Freddie Loh
President AFCMA.

Saturday, February 13, 2010

Doctor say many are cured in LOURDES

The former head of the Lourdes Medical Bureau is affirming that all people can receive a cure at Our Lady's shrine if they pray and hope for it with perseverance.

Doctor Patrick Theillier, who retired from leadership of the Lourdes Medical bureau last year, stated this in an interview with France Catholique.

The cure, he explained, "might not be as spectacular as to be considered a miracle."

However, the physician added, it can affect "in a profound and lasting way the person who experiences it, in all his being, body, soul and spirit."

Doctor Theillier affirmed that "these cures are truly innumerable."

The bureau is a medical organization run by doctors that operates within the Sanctuary of Our Lady of Lourdes, which, among other things, is responsible for the medical investigation of cures associated with the shrine.

The doctor noted that there are, of course, miraculous cures as well in Lourdes, and 67 have been officially recognized as such.

He affirmed that these miracles are sometimes "necessary," such as at the beginning of the Church. "For faith to increase, it must be supported by miracles," Doctor Theillier said.

Moral sufferings

Yet today, he continued, perhaps more than a century ago, we have a need "to be relieved from moral sufferings and the wounds of life, of a psychological-spiritual order, which goes beyond medicine."

"Here is where Lourdes responds to a very present need, which undoubtedly corresponds more to its original message," the physician stated.

He asserted that these types of "miracles" are "much greater" than the bodily cures, as souls are "regenerated." These miracles, he said, can take place if you desire them, hope with faith, and pray to God.

"Extraordinary physical cures have become rare," Doctor Theillier observed, given that "God acts in the first place through human mediation, through medicine and doctors."

This year, Lourdes will be the site of the international congress for the World Federation for the Catholic Medical Associations. The theme for this May 6-7 event will be "Medicine and Faith."

Doctor Theillier issued an invitation for all doctors worldwide to go to Lourdes on this occasion in order to network with colleagues, hear addresses on the application of faith to medicine, and make a pilgrimage as an "occasion to experience the cure that we all need."

"My hope at this time is that numerous Catholic doctors who suffer much at present because of their faith […] will come to find by Our Lady's side consolation and cure," he said.

He invited all Catholics, "Speak with your doctor!"

The physician concluded, "As those who have come to previous congresses have shown, the doctors who attend will be able to experience God's mercy in this place of graces."

Saturday, January 02, 2010

Christmas Message from Dr Freddie Loh

Dear Brothers and Sisters in Christ,
The Peace of our Risen Christ be with you!
It has been one year that your New AFCMA Council took office. I will give you a brief outline of some of our activities for the past year.
(1) Relocation of MAI KHOI CLINIC in HCMC, Vietnam. I am glad to inform you that The Catholic Doctors Association of Malaysia (CDAM), Japan Catholic Medical Association (JCMA) led by Dr. Buichi Ishijima together with the Catholic Doctors of Western Australia represented by Dr. Leonard Chan and Dr. Michael Shanahan we managed to raise sufficient funds for our Vietnamese colleagues led by Father John Toai for the latter to relocate their HIV Clinic to new premises in Ho Chi Minh City, Vietnam.
(2)Year 2009 was not a good year for our Asian countries.
a) first of all we were all affected by the HINI flu epidemic. Some countries were badly affected resulting in numerous deaths. Our members helped their own countries by giving vaccinations, Tamiflu treatment and advising their Church authorities and the public on preventive measures.
b)Natural disasters also affectedour countries and especially Typhoon Ketsana in the Phillipines and Padang earthquake caused massive damage and loss of lives to the affected countries. CDAM and CHAK (Catholic Health Associations of Korea including the KFCMA (Korean Federation of Catholic Medical Associations) responded magnificently by donating cash to the Catholic Physicians Guild of the Phillipines (CPGP) led by Dr. Edna Monzon and Perdhaki (Association of Catholic Hospitals in Indonesia) led by Dr. Felix Gunawan for them to use for emergency relief work for their countrymen.
c) We are pleased to inform you that we have prepared our own AFCMA letterhead (by courtesy of Dr. K. Y. Chong) which will be used for official functions.
Future Events: a) I must remind you to attend the Lourdes Congress Organised by FIAMC from 6-9 May 2010. The theme for the Congress is "Medicine and Faith". This will be a wonderful opportunity forus go to Lourdes for our Pilgrimage besides attending the scientific sessions. Registration fee is only Euro 350. Closing date for registration is Mid. March 2010. Please register online:
http://pagesperso-orange.fr/theillier/index.htm.
b) the 15th AFCMA Congress will be held in Bali, Indonesia in 2012. ICMC(Indonesian Catholic Medical Community) headed by Dr. Ignatius Widjaja and Perdhaki will be co-hosting the event. Dr. Albert Hendarta is the Organising chairman. Proposed theme is "The Challenges of Catholic Doctors in the Changing World".
Challenges: We need to get more member countries/members to join us. Unfortunately we have lost touch with our members from India, Thailand, Pakistan and Sri Lanka. We hope that you can help Dr. Jang Sang Park (Korea) and myself on this matter.
c) Code of Ethics for Catholic Physicians and other Health Care Workers. Dr. Edna Monzon and her Bioethical Committee will be preparing this important booklet for us to prepare us and advise us on bioethical issues involving the Church's Teachings.
Finally iI hope that you will inform us on any important matters involving your country and share it with us eg. The Guild of St. Luke, St. Cosmos and St. Damian organised a sccesful Medical Outreach Program "The Myanmar Missionary Trip 2009". Sister Mary Lou is busy with her Hamdan project in China. Dr. John Lee the Head of our Medical Missions Overseas has finally completed the building of FIAMC's Hospital in Aceh, Indonesia, etc..
Have a Blessed and Joyous Christmas and may HE guide us to do HIS WILL so that others will recognise us by our words and actions.
With love from Christ,
Dr. Freddie Loh,
President AFCMA.