ࡱ> %` ybjbj"x"x <@@h' TTTFT4UUU,UTpTpTp8p|qL,U`q`q`q`q`qrrr$|hh+Uzrrzz+UU`q`qH@}}}zU`qU`q}z}} |UU!`qTq m@Tp{`>V0ô^L||L|!!\LU}r|$u}vlVxrrr++b}drrrzzzz,U,U,U$Pn,U,U,UPn,U,U,UUUUUUU CHRISTIAN SCIENCE COMMITTEE ON PUBLICATION Federal Representative for Australia ABOUT THE SUBMITTER The Christian Science Committees on Publication worldwide provide a resource to governments and the media for accurate information on Christian Science. In that regard they also support public awareness of the practical, effective and responsible use of this proven prayer-based method of healthcare. In Australia and elsewhere, these Committees work with lawmakers at every level in state and national governments to ensure public access to this spiritual care is maintained for those members of the public who seek it for themselves or their families. EXECUTIVE SUMMARY The submission will address a number of issues which should be considered when reporting on this discussion of freedom of religion and belief to encourage recommendations to governments about future legislative codes and policies that factor acceptance and allowance of responsible prayer-based healing methods into those codes. The main focus of the submission addresses the second and third areas of the discussion paper in the following respects: Religion and the State the Constitution, roles and responsibilities, regarding how freedom of religion and belief should be codified in the law and whether the current constitutional provision is adequate. Religion and the State - practice and expression, regarding how religious practices may be inhibited by law, procedural practice or policy (i.e. education or health). As part of this discussion, we address the following areas of concern as they relate to current legal requirements which have the potential to limit the publics access to spiritual care, and which deserve consideration by lawmakers and policymakers: 1. Access to spiritual care in lieu of medical treatment and testing a. Common Law and the 1998 Article 18 HREOC Report b. Prayer-based healing for elders and vulnerable adults c. Emergencies d. Employment physical examinations and medical certificates e. Vaccinations f. Public and private health insurance cover 2. Clergy status a. Clergy privilege b. Jury duty Our intent in this submission would be to ensure that in the discussions on religion and belief issues in the 21st century, researchers and others in the conversation might bring to the ensuing reports and recommendations that inform governments the following points: Religious practice utilizing a responsible and effective prayerbased healthcare method should find acceptance in federal and state government health agendas to ensure its availability without discrimination to any competent individual who chooses it responsibly. Health systems should not function in ways that may cause coercion of individuals preference for responsible prayer-based healthcare, especially those of senior years who may have relied over a lifetime on a prayer-based method of healing. Health professionals should be encouraged to take a more thoughtful view of what is in the best interests of a patient, including patient preferences for spiritual care, which if not thoughtfully considered, could negatively impact the health and well-being of the patient. The confidentiality of the Christian Science practitioner/patient relationship should be acknowledged in the practice of prayerbased healing as it is in other clergy and healthcare relationships. We note too, in conjunction with the Christian Science Committee on Publication for Victoria we have also made a brief joint submission to the related discussion co-sponsored by the 鱨վ and The Victorian Health Promotion Foundation How does freedom of religion and belief affect health and wellbeing. In that narrower context we specifically address the effectiveness of prayer-based healing in Christian Science as a core factor to better heath and wellbeing. A copy of that submission is appended here to serve as Appendix B for context. DISCUSSION Significantly, considerations about effective prayer-based healing have not been part of most discussions on religious belief and practice in Australia. Although the subject was briefly included in the May 1998 HREOC Article 18, The report of the inquiry into freedom of religion and belief in Australia, we did not take advantage of the opportunity to make submission to that inquiry. We appreciate this opportunity to make submission to the current discussion paper, as we have with a range of more recent inquiries and discussions papers on freedom of religion and belief. In response to the seven areas under exploration by the current discussion paper, we feel submission would be helpful on the second and third areas concerning the codification of freedom of religion issues in the law, and how such practices currently are inhibited. In particular, we feel it is important that laws be written in a manner that does not preclude public access to, or otherwise infringe upon, responsible religious beliefs and practices, particularly as they relate to those who rely on spiritual prayer for their health and well-being. The measure of constitutional protection in the Australian Constitution (S. 116) is recognized and appreciated. This of course generally allows freedom to establish and practice a religion in Australia without government interference at the federal level, though one would expect the spirit of this section is respected in general terms across the States. We also note that Tasmania is the only State to provide for religious freedom in its constitution even if with somewhat limited scope. It is assuring too that some States have enacted legislation which prohibits discrimination on religious grounds in certain situations. No major issues of intolerance to members of the Church of Christ, Scientist (often referred to as the Christian Science church) are known. Nor are we aware of any to those who may not be members of a church but profess Christian Science as their religious belief, all of whom choose to rely on the practice of Christian Science as a way of life and for healing. However, there is always room for greater understanding and respect of religious differences. We note there is growing evidence of a search for, and wide use of, alternate healing methods apart from the traditional medical system by large numbers of Australians. However, there is only limited awareness of religious communities that offer spiritual healing as a component of their traditional worship, and the evidence of effective prayer-based healing. Such healing is not new, and in the Christian Science community, has been an effective, viable part of the practice of Christian Science healing since the late 19th century in Australia and throughout the world. For these reasons we will address a number of issues which should be considered when reporting on this discussion of freedom of religion and belief so that recommendations might be made to governments about future legislative codes and policies that factor understanding and acceptance of responsible prayer-based healing methods into those codes. SPECIFIC ISSUES IN THE LAW REGARDING PRAYER-BASED HEALING A. Access to Spiritual Care In Lieu of Medical Examination and Treatment We address a number of circumstances herein where those in the community who choose prayer-based healing in Christian Science are presented with situations where it is considered essential to submit to medical examination, testing, procedures, or treatment, either in specific situations or on an ongoing basis. While these situations mostly occur due to ignorance of the practice of Christian Science prayer-based healing, in some cases it results from direct opposition, or refusal to accept, that there is an effective alternative to medical practice. 1. Comments Concerning the 1998 Article 18 HREOC Report: The Article 18 report made brief reference to the common laws recognition of an individuals ability to refuse medical treatment as follows: The common law has long recognized the right to bodily integrity. This means in essence that a person who enters into physical contact with or uses force against another person, without the consent of that person, commits an assault against that person and may be subject to criminal charges as well as a civil claim for trespass. In the medical area, this means that practitioners are not entitled to impose treatment on an unwilling patient. Though the common law position might appear clear, there are nevertheless situations known and which we reference, where persons have relied on Christian Science prayer-based healthcare or perhaps other responsible prayer-based systems - for many years or even a lifetime, yet find their individual choice for that care is often not understood or respected. This calls for greater recognition throughout Australia in understanding and respecting such choices, and greater strength and consistency of advance directive and enduring power of attorney laws through which such choices can be clearly designated. In advocating for better understanding of, and access to, the prayer-based method of health care used in Christian Science, the intent is never to convert others or to encourage others not to use medicine, nor to advocate for a sectarian preference for healthcare through prayer. Great respect is afforded the many health professionals in our communities who serve the public with dedication and who are thinking deeply and courageously about ways to improve existing healthcare systems everywhere. 2. Prayer-based healing for Elders and Vulnerable Adults: One of the circumstances in which an individuals preference for spiritual care is not understood or respected often occurs with elder members of the community, especially when in residential care. Well intentioned considerations are often made which are said to be in the best interest of the person. Absence of living wills or other advance health directives may be partially responsible for this confusion given those useful tools are still less widely known and used. However, even the use of clear directives are not always respected, leading to cases when medical intervention without consent occurs or coercion despite an individuals capacity to refuse consent, thus usurping the common law principle, and causing the person further distress and suffering. These are issues to be considered for further research. Elders and vulnerable adults should be afforded access to effective spiritual care options. Such individuals who voluntarily choose to rely on spiritual means through prayer, such as Christian Science treatment, for their health care, even if chosen through a previous directive or through someone familiar with the individuals health care preferences, should not be construed under the law as being abused or neglected. Such an understanding is an important aspect of protecting a vulnerable adult from abusive environments, including any environment that would impose a form of care contrary to the wishes, preferences and religious beliefs of the individual. Attached at Appendix B is a document entitled Christian Science and Caring for Christian Scientists, which provides a brief summary of some underlying principles that will help ensure that individuals desiring Christian Science care are receiving the care they prefer in settings such as retirement hostels, nursing homes, or hospitals should occasions arise suggesting traditional medical care and treatment is needed. It should be noted too, that individuals desiring a spiritual approach to healing in Christian Science are not generally assisted by discussions, testing, or diagnoses of illness which often accompany interactions with medical personnel. In many nursing homes, and hostels for elders, residents are required to attend a regular medical checkup, at least every 3 months, for a health assessment. While society generally may deem this as beneficial, assessment of adverse health conditions of individuals who are accustomed to choosing prayer-based healing in Christian Science can adversely impact and infringe upon their ability to effectively practice their preferred method of care. Such assessments can also lead to the prescription of medications and further medical intervention, often coercing an individual into accepting medical treatment despite their preferences for prayer-based healing. Coercion also comes in the form of pressure to receive medical examination to avoid investigations of abuse or neglect if an individual ultimately passes away outside of the care of a medical professional. No law or person should presume abuse or neglect simply on the ground that someone is relying on spiritual care in lieu of medical care, or was unattended by a medical professional prior to death. It is particularly important in these health care settings that facilities are acclimated to, and respect, the health care preferences of patients, and maintain clear records reflecting the patients desired choice of care. 3. Emergencies: Similar to the discussion above, when any person is taken to a hospital following an accident or other emergency, a request for Christian Science treatment through prayer alone is sometimes questioned, and even resisted, by staff. Great respect and flexibility must be extended to those caring for such individuals in emergency rooms, often in times of heavy work-loads. However, the same respect and flexibility must be afforded to individuals whose preferred method of care is probably the most single important aspect of their road to healing. 4. Employment physical examinations and medical certificates: Though a common practice in government and some private industry, for entry into the armed forces, for workers' compensation insurance claims, and validation of extended absences from work for health reasons, there is no general accommodation for an individual who prefers Christian Science treatment for illness or other health matters. However, recent changes to Commonwealth workplace laws may provide more latitude for employers to accept statutory declarations for short term absences, in lieu of a doctors certificate, from individuals who utilize prayer-based healing. As with the discussion above concerning elder care, those of all ages choosing prayer-based healing in Christian Science, in circumstances where medical certification is required, may find such examinations to be an infringement on their spiritual beliefs and practices which relate to their understanding of health and how it is best experienced. Most would prefer to maintain an environment free from medical oversight that would tend to interfere with their prayer-based method of care and treatment. In the case of a health issue that prevents attendance from normal work duties, most individuals relying on Christian Science for their care would prefer the option of being able to validate the legitimate need for leave through a Christian Science practitioner, and be allowed a reasonable time frame to achieve healing through prayer-based treatment, relative to the time allowed in cases where medical treatment is used. This office is aware of a few cases where employers have accepted signed statements from a Christian Science practitioner that the individual was receiving Christian Science treatment by them during the period of absence, and clarifying that they do not diagnose any illness but were aware of the persons inability to attend work for a certain period while under their care. A respect for prayer-based healing for those who choose such forms of treatment will usually be more conducive to the individual achieving full healing. Although there always will be situations where a legitimate need to confirm that the public health or safety will not be at risk by permitting an individual to work takes precedence, care and respect for the treatment preferences of individuals should always be a consideration by employers. 5. Vaccinations: While vaccination is not usually compulsory in Australia for children or adults, except in rare widespread contagious outbreaks, those who utilize prayer-based healing in Christian Science are free to choose whether to use vaccinations for themselves and their families. We are appreciative of a religious accommodation that was added to the law in 1998 under Commonwealth legislation, which allowed payments for childcare benefit to be made to parents or guardians who could produce written evidence from their local Christian Science church that they were practicing members of that church, without evidence of staged immunization, and for the maternity immunization allowance under similar arrangements. Those parents are now able to claim benefits without being required to attend interviews with a doctor or other health professional to discuss the risks and benefits of childhood immunization which contravene their religious beliefs and practices. All parents so exempted under that provision understand clearly that should an outbreak of a particular immunization-preventable disease occur in the school or childcare centre, they agree to withdraw any unimmunized child until the principal determines the child may return. Though state schools generally accept the exercise of the religious accommodation for immunization requirements, some private schools and childcare centres are not so accepting of children who are not immunized on the basis of religious objection. This is an issue that should be explored further. 6. Public and Private Health Insurance Cover: To date, in Australia there is no cover in private health insurance plans, nor under Medicare, for prayer-based healing of any type. Individuals choosing to engage a Christian Science practitioner or Christian Science nurse for healing and support must pay for such service out-of-pocket. As such, this can be a barrier to access to efficient and cost effective care. Moreover, it becomes a matter of fairness when individuals are charged the higher Medicare levy unless they hold private health insurance cover which doesnt cover the form of care they prefer, and which otherwise has little or no value to them. In the United States, the federal government has reimbursed for religious Non-medical nursing for seniors and individuals with financial needs under its Medicare program for over 40 years since the programs inception. In addition, many government employee health plans at the federal and state level also cover spiritual care, and private insurance companies have covered Christian Science care and treatment dating back to 1917. B. Clergy Status: There are several issues related to the extension of clergy status to Christian Science practitioners that deserve consideration so as not to unfairly discriminate against such individuals that provide a professional spiritual support function to the public, parallel to that provided by other traditional clergy. This includes the extension of evidentiary privileges and occupational preferences that are available to clergy, such as jury service waivers, that would inhibit the publics access to needed spiritual resources. These are discussed more fully below. 1. Clergy Privilege: Although the Christian Science church has no ordained ministers, there are some important parallels which may not be understood between the role of the Christian Science practitioner and the well known role of clergy in many Protestant churches. Not understanding these parallels may lead to confusion or failure to extend the clergy privilege to Christian Science practitioners and their patients. Confidentiality between clergy and penitent is a sacred and essential aspect in many faith traditions. It is likewise essential for the ministry of Christian Science, which acknowledges the need for confidential sacred communication between those individuals desiring a prayer-based method of healing and Christian Science practitioners who are professionally available full-time to offer this service. The worldwide governing document of The First Church of Christ, Scientist - the Church Manual of The First Church of Christ, Scientist in Boston, Massachusetts authored by church Founder Mary Baker Eddy, clearly provides for this sacred relationship which applies to Christian Science Practitioners world-wide. Practitioners and Patients. Sect. 22. Members of this Church shall hold in sacred confidence all private communications made to them by their patients; also such information as may come to them by reason of their relation of practitioner to patient. A failure to do this shall subject the offender to Church discipline. This privilege is recognized by the majority of states in the United States which extend confidentiality of sacred communications between clergy and penitent expressly to Christian Science practitioners, or more generally, to religious practitioners. Some Evidence Acts throughout Australian States and the Commonwealth (see Evidence Act 1995 No.2 of 1995 Section 127) make provision for clergy privilege and a few allow individuals to apply for confidentiality privilege on certain grounds which may or may not be granted. None however recognize the role of a Christian Science practitioner in the way a member of the clergy is recognized as able to protect the confidence of information they receive from sacred communications in the patient/practitioner relationship. Because Christian Science practitioners are not automatically recognised in the same way as clergy or ministers of religion of other denominations, such individuals must prove their right to exercise the clergy privilege in each case. To deny this privilege would cause those persons to contravene the sacred confidentiality of the practitioner/patient relationship and subject them to church discipline. Moreover, it may serve to deter individuals from coming forward to seek needed healing through prayer out of concern that their conversations may not be treated as confidential. For these reasons, it is important that the traditional clergy privilege is extended to this sacred relationship in prayer-based healing communities such as Christian Science. 2. Jury Duty: Those who seek prayer-based healing from a Christian Science practitioner expect to have access on a regular daily basis with that practitioner and would be unable to do so should that person be empanelled on a jury for a lengthy period. Moreover, another important aspect to practicing ones religion and belief in the prayer-based system of Christian Science relates to an annual class of instruction by an authorized teacher of Christian Science (who also is a Christian Science practitioner). An ongoing aspect of that teaching is attendance at an annual meeting with all students of that teacher where continued spiritual teaching occurs. Individuals make plans to attend many months ahead, frequently from other states or overseas. Without jury duty accommodation, students could be prevented from participating in those important classes should a teacher be called for jury duty. Under the Church Manual, no other person may conduct those classes on behalf of the Christian Science teacher. Exemption from jury duty by Christian Science practitioners and Christian Science teachers has been uncertain due to lack of understanding of their distinctive ministerial roles by officials in Sheriff offices. It would be helpful if the accommodation extended to clergy could be so extended to Christian Science practitioners and Christian Science teachers serving in prayer-based ministries. SUMMARY It may be easy to overlook a yearning in society for a more effective and economically reliable healthcare system when all the talk is about the successes and the failures in the medical system. In a pluralistic society such as we have in Australia, a society based on multi-faceted religious beliefs and practices, it is vital to ensure the door is not closed to acceptance of other than a traditional (medical) system, provided of course that the system is safe and effective for those in the community who make that choice. That safety and effectiveness is found not through testing in the traditional evidence-based way, but by reviewing verified proofs through lives healed and changed through the results of prayer-based healing in Christian Science. We do not advocate an anti-status quo approach to traditional healthcare. But it often appears that the status quo stands for only a medical approach to health care, when in fact, it should stand for what the patient really desires -- the freedom to practice their religion and belief as a proven and effective form of healthcare. There has been noticeable evidence in Australia that the status quo doesnt always feel comfortable with alternatives to mainstream medicine. But more important than comfort level, one has to ask: Whether individuals will be able to decide for themselves in every situation where competent choice can be made the type of healthcare they wish to have? To what extent should others be allowed to decide what methods of care work best for an individual? To what extent should the choices for our healthcare in the future be determined by the status quo? Being comfortable and united in a desire for freedom of religion and belief requires recognition in law that those who choose a wholly prayerbased system of healthcare, such as Christian Science, can do so freely and without discrimination or coercion when that choice is competently known and made. Unless a particular method of health care is applied in a manner that demonstrates complete effectiveness, no such method should be presumed to be the only answer. In considering issues surrounding freedoms of religion and belief are well maintained through this 21st century, it is important not only to ensure that the less discussed area of religious, prayer-based healthcare is not overlooked in these discussion in our community, but that reasonably established laws are in place to ensure that occurs without discrimination or failure to recognize those practices are safe and effective to those who make that choice. We sincerely appreciate the opportunity to share these ideas in the context of the discussion on freedom of religion and belief in the 21st century in Australia. Margaret Clark Christian Science Federal Representative for Australia February 28, 2009 Appendices Attached: - Appendix A Description of Christian Science Practitioner and Christian Science Nurse Services - Appendix B Submission: How does freedom of religion and belief affect health and wellbeing - Appendix C Christian Science and Caring for Christian Scientists  Mary Baker Eddy founded Christian Science, which teachings include a prayer-based healing system based on the Biblical method of healing demonstrated and taught by Christ Jesus. See www.marybakereddylibrary.org for further information on the life and work of Eddy. We note that Christian Science is not Scientology.  Christian Science practitioners are available full time to pray for any member of the public seeking spiritual solutions to the challenges of daily living, including illness or injury. The services of a Christian Science practitioner are purely spiritual and religious in nature. See http://www.tfccs.com/aboutchristianscience/practitioners.jhtml) and Appendix A concerning a description of services of a Christian Science practitioner.  See, Article 18,The report of the inquiry into freedom of religion and belief in Australia Section 3.7 Medical Interventions.  See, Cth Joint Standing Committee on Foreign Affairs, Defence and Trade. Human Rights Sub-Committee Submission no. 55 Inquiry into Freedom of Religion and Belief. Australian Multicultural Foundation: Religion, Diversity, and Social Cohesion in Contemporary Australia April 2002.  This office holds many published accounts on file. One recent example -- United prayers fight pain: A new partnership by five Macedon Ranges churches aims to heal the sick with prayer. Sunbury/Macedon Ranges Leader. 10 February 2009.  Article 18, Report of the inquiry into freedom of religion and belief in Australia, Section 3.7 Medical Interventions.  See Appendix B, Christian Science and Caring for Christian Scientists, which summarizes the underlying principles that will help health care professionals ensure such individuals receive the care they prefer.  Commonwealth Of Australian Gazette - 2 June 2000 - Family Assistance (Immunization Requirements Exemption) Determination 2000  See footnote 2 above for more information about the services of Christian Science practitioners.  Christian Science nurses are available full time to carry out an important role in supporting patients by providing religious non-medical Christian Science nursing care. (See http://www.tfccs.com/aboutchristianscience/nurses.jhtml) and Appendix A concerning a description of services of a Christian Science nurse.  ARTICLE VIII, Section 22 (Practitioners and Patients).     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