What’s the data about special needs and abortion?

shutterstock_268726070Here at Key Ministry, we think facts matter. As we follow the one who declares himself to be the way, the truth, and the life, we hold ourselves to a standard of truth as well. When it comes to statistics, that means we refuse to regurgitate oft-quoted figures until we can find the source. Steve has already done that with special needs and divorce, and I’m setting out to do the same today with special needs and abortion.

The number we hear often is that 90% of babies with Down syndrome are aborted. But is that true? Not quite.

That figure comes from an article published in 1999[i] based on studies from the US and 11 other countries. The researchers, Mansfield et al, reviewed rates of pregnancy termination following prenatal diagnosis of Down syndrome and four other conditions. The findings? On average, 92% of babies with Down syndrome were aborted when the diagnosis was made early enough in pregnancy for that to be an option. The range was 71% from a small study in France published in 1990 to 100% in four separate studies in the UK (2 studies), France, and New Zealand in 1990, 1982, 1995, and 1992 respectively. The largest study was done in the UK in 1998 and included 4,824 diagnoses of Down syndrome; out of those, 4,438 – or 92% – ended in abortion. The research review included termination rates for four other conditions when diagnosed prenatally: for spina bifida, 64%; for anencephaly, 84%; for Turner syndrome, 72%; and for Klinefelter syndrome, 58%.

But none of that data is the most complete or current, so we shouldn’t repeat the findings without caution. For starters, this only includes decisions made by women who received a prenatal diagnosis for the conditions, a group which only includes a small fraction of all mothers ever pregnant with a baby with the disability. But most pregnant women don’t pursue invasive testing – like amniocentesis – to confirm a prenatal diagnosis for their unborn child. Furthermore, writing from my context in the US, the studies relevant to Down syndrome reviewed from this country were from 1980, 1985, and 1988, so they were outdated before the oft-cited article was even published in 1999.

Based on this study, at best, could we say something like “one study indicates that as many as 90% of unborn babies diagnosed in utero with Down syndrome are aborted?” No. The wording lacks integrity. Why? Because any good researcher (which we who strive for excellence in Christ should become if we aim to share statistics in truth) doesn’t rely on just one study, especially an outdated one rife with other shortcomings. So what do others say?

Thankfully, we can turn to two more reliable studies than the Mansfield paper. First, a more recent research review[ii] by Natoli et al has been published using more recent data, solely from the US. The termination rates following prenatal diagnoses of Down syndrome were still heartbreaking in that paper, but they were lower. The three kinds of studies they analyzed showed the following averages of those rates: 67% in population-based studies, 85% in hospital-based studies, and 50% in anomaly-based studies.

Is this good news? Yes and no. Yes, because fewer abortions are good news. No, because any abortions – especially 50-85% of babies in these studies – are sad news.

Why the different findings for the Natoli study than the Mansfield one? From the conclusion of the study itself,

“Evidence also suggests that termination rates have decreased in recent years, which may reflect progress in medical management for individuals with Down syndrome and advances in educational, social, and financial support for their families. Importantly, the range of termination rates observed across studies suggests that a single summary termination rate may not be applicable to the entire US population and would not adequately address regional and demographic differences among pregnant women.” (emphasis mine)

In other words, not only is the 90% figure not the accurate one to use, there isn’t a golden stat to cite when we’re talking about disability and abortion. But it does appear that rates of abortion of babies with Down syndrome are dropping. Why? In remarks to The Atlantic[iii], Natoli explained further:

“Families have significantly more educational, social, and financial support than they had in the past. For example, from a social standpoint, women of childbearing age are from perhaps the first generation who grew up in an era where individuals with Down syndrome were in their schools or daycare centers — perhaps not the mainstream integration that we see today, but still a level of exposure that was very different than in generations prior. They grew up watching kids with Down syndrome on Sesame Street.”

And I would add they are starting to see more and more people with Down syndrome in their churches. What different might that make?

The next study[iv] approaches the question in a different way. Instead of asking how many babies with Down syndrome have been aborted, these researchers asked how many more children with Down syndrome would be alive in the absence of abortion. They found “an estimated 30% of fetuses with DS were selectively terminated in recent years.” As a comparison point, CDC data indicates that 17.9% of pregnancies end in abortion, including both those with prenatal diagnoses and those without.[v]

So what should we say?

  1. With regard to the first study, STOP using the 90% figure. It’s not accurate, as indicated by more recent US-based research.
  2. In sharing the results of the second study, stop saying “50-85% of babies with Down syndrome are aborted.” That’s not true. Instead, let’s say something like “according to one comprehensive review of existing research, 50-85% of babies with a prenatal diagnosis of Down syndrome were aborted.” When the majority of pregnant women decline invasive testing and those already considering abortion are more likely to pursue prenatal confirmation of a potential diagnosis, we can’t speak like these figures represent the outcomes for all pregnancies of children with Down syndrome.
  3. In talking about the third study, I do think we can say that babies with a prenatal diagnosis of Down syndrome are nearly twice more likely to be aborted than others. That’s tragic.
  4. Finally, we need to know that populated-based research changes over time but the word of God never changes. Yes, let’s use statistics to describe what’s happening in our fallen world. But let’s be mindful that God is our reason for championing life, not any compelling papers in a peer-reviewed journal.

I know this post was more dense than my usual writing, so thank you for bearing with me if you’ve made it this far. In future posts, we’ll look at practical implications. Does the Bible really support a pro-life stance? Historically, how have we devalued the lives of those living with disabilities? How does this relate to disability ministry? What about adoption? And, most importantly, how can the church respond? I hope you’ll join me for those topics!


[i] Mansfield, C., Hopfer, S. and Marteau, T. M. (1999), Termination rates after prenatal diagnosis of Down syndrome, spina bifida, anencephaly, and Turner and Klinefelter syndromes: a systematic literature review. Prenat. Diagn., 19: 808–812

[ii] Natoli, J. L., Ackerman, D. L., McDermott, S. and Edwards, J. G. (2012), Prenatal diagnosis of Down syndrome: a systematic review of termination rates (1995–2011). Prenat. Diagn., 32: 142–153.

[iii] Wolfberg, Adam. 2 Apr 2012. Why Are So Many Babies Still Being Born With Down Syndrome? The Atlantic. http://www.theatlantic.com/health/archive/2012/04/why-so-many-babies-are-still-being-born-with-down-syndrome/254869/

[iv] de Graaf G, Buckley F, Skotko BG. 2015. Estimates of the live births, natural losses, and elective terminations with down syndrome in the United States. Am J Med Genet Part A 167A:756–767.

[v] I derived that figure from the CDC’s research found at http://www.cdc.gov/reproductivehealth/data_stats/, stating that “the abortion ratio was 219 abortions per 1,000 live births.” Dividing 1,219 – the 1,000 pregnancies ending in live births plus the 219 ending in abortion – by 219 – the number of legally induced terminations – results in an abortion rate of 17.9%. This estimated rate isn’t perfect because some of those 219 terminated pregnancies would have ended by other means, like miscarriage or still birth, but it’s the most accurate figure I could find.

In addition to serving as a Key Ministry Church Consultant, Shannon Dingle is a co-founder of the Access Ministry at Providence Baptist Church in Raleigh, NC.


Indiana Wesleyan University EventOur Key Ministry team will be fanning out across the country this fall at training events in Indiana, North Carolina, Tennessee and Kentucky. Interested in coming to a live event? Click here for more information and to register for any ministry event our people are attending in October and November. Hope to see you soon!

Posted in Advocacy, Controversies, Intellectual Disabilities, Key Ministry, Shannon Dingle | Tagged , , , , , , | Leave a comment

Our Gospel call to support a culture of life

shutterstock_270972401Over the last few months, our blog followers have likely noticed a number of posts I’ve written on the topic of physician-assisted suicide and how the expanded availability of professional assistance for terminating one’s life is likely to impact the disability community, the mental health community and the medical profession. We’ve also discussed an argument for “after-birth abortion” circulating in the medical ethics community and discussed the impact of the video series detailing the investigation of the Center for Medical Progress into allegations that Planned Parenthood is violating Federal laws by trafficking in the sale of organs and body parts following abortions at their clinics across the U.S.

ShannonShannon Dingle is going to launch a blog series this coming Tuesday on the topic of disability and abortion. I’ve read the first couple of posts in Shannon’s series and I think she’ll do a great job in addressing this topic with the grace and sensitivity required by a topic that impacts as many as one in three women in the U.S. and the men who contributed to unplanned or unwanted pregnancies.

I want to address why we’re speaking into these topics when the mission of our organization is to promote meaningful connection between churches and families impacted by disability for the purpose of making disciples of Jesus Christ.

  • Our willingness to publicly acknowledge God as the Giver of all life and proclaim the extraordinary value God places upon each and every human life is foundational to the faith we promote.
  • The respect that we demonstrate for human life…especially the lives of those seen to be of less value to society…is an essential component of our Christian witness.
  • Experience suggests that churches that fail to embrace this understanding of life are unlikely to embrace kids with disabilities and their families.

Russell Moore reinforces why this understanding is so critical…

The gospel tells us that human life is of infinite value and importance. Human beings are created in the image of God himself. (Gen. 1:27). Not only that, but human life was joined to God forever in the incarnation of the Lord Jesus Christ. That means that human life matters infinitely. And it also means that the demonic powers of hell wage constant war against it. Whether through Pharaoh’s order to cast babies into the Nile, Herod’s jealous genocide against Bethlehem’s infant boys, or the pristine floors and shiny signage of a Planned Parenthood clinic, Satan has always sought to attack human life at its most vulnerable.

The value of human life isn’t just an issue for Congress or activists or ethics professors. It’s an issue for every single Christian and every single local church. The church is the embassy of the Kingdom of Christ, and the Kingdom is where the unborn are prayed over, where the widows are visited, where the orphan is adopted, and where the disabled and the “unwanted” are made heirs with Christ of the universe. The church must speak a prophetic, gospel word to our culture of death. The cause of life is not a liberal vs conservative or red state vs blue state issue. It’s a Kingdom issue, and children of the King must stand up in defense of all human life.

Shannon has been invited to represent us on January 21st and 22nd at Evangelicals for Life, where she is scheduled to speak along with our friend, Emily Colson, David Platt and an outstanding lineup of influencers from across the Christian community. Evangelicals from across the country will gather in Washington DC to be inspired and equipped by top speakers including Russell Moore and Jim Daly. The conference is being co-organized by Focus on the Family and the Ethics and Religious Liberty Commission of the Southern Baptist Convention. Shannon will be on a panel with Emily discussing the topic Disabilities, Special Needs and the Sanctity of Life.

Upon the conclusion of the conference on Friday the 22nd, speakers and attendees will be participating in the 2016 March for Life, starting from the grounds of the Washington Monument and ending on Capitol Hill.

We honor God by acknowledging that He and He alone has the authority to give and to take life, and by seeking to model the value He places upon all human life – especially those lives valued less highly by the standards of the world.

Evangelicals for Life

Posted in Advocacy, Culture of Life, Key Ministry, Shannon Dingle, Training Events | Tagged , , , , , , , , , , , , , , | Leave a comment

Why the Spotlight Is on PTSD in Children

shutterstock_125301275Thank you for stopping by for the sixth post in Jolene Philo’s weekly series about post-traumatic stress disorder (PTSD) in children. Last week’s post discussed what happens when a person, child or adult, responds to a perceived threat. The Instinctual Trauma Response (ITR) model explained the seven responses the brain makes when a person goes through a traumatic event.

The ITR model made a great deal of sense to me when at age 26, our son was diagnosed with PTSD caused by frequent, invasive, and lifesaving medical treatment he experienced from birth to age 5. At the same time, the answers provided by the model led to several more questions. How do therapists know what goes on in the brain during trauma? How are successful treatment models developed? What had happened in the years between our son’s birth in 1982 and his treatment in 2008 that moved awareness of PTSD in children and adults from relative obscurity into the spotlight?

From Soldier’s Heart to PTSD

To answer those questions, I began to research to find out when PTSD was first identified as a mental illness. I discovered that thousands of years ago, an ancient Egyptian combat vet described the condition in his journal. Descriptions of it can also be found in medieval literature and by physicians in the 1600s and 1700s. PTSD is first mentioned in this country after the Civil War when it was called “soldier’s heart.” The condition is discussed and renamed in every subsequent American war through the 1950s. In 1952, it was called stress response syndrome in the first Diagnostic and Statistical Manual of Mental Disorders (DSM-I). In 1982, DSM-III settled on the current terminology, post-traumatic stress disorder.

The Perfect Storm of Breakthroughs about PTSD in Children

As you can see, the field of adult onset PTSD has been around for years. But PTSD in children didn’t land in the spotlight until a series of events occurred in the 1980s and 1990s.

Breakthrough #1: These events began, strangely enough, in 1989 with the collapse of communism in Eastern Europe. As countries fell, government orphanages was discovered. Families around the world were moved by the terrible conditions in the orphanages and rushed to adopt neglected infants, toddlers, and older children. Everyone involved believed that love would be enough to heal the ill effects of early neglect and that the children would thrive. In some cases, they did. But some children experienced a host of issues: developmental delays, language delays, behavioral issues, and an inability to bond with their new family members. Parents turned to mental health counselors, child psychiatrists, and child psychologists for help. This large influx of families seeking mental health care moved therapists to find answers for their clients.

Breakthrough #2: The second event came in 1990 with the publication of Dr. Lenore Terr‘s groundbreaking book, Too Scared to Cry. The book details the longitudinal study she began in 1976. The study examines the responses of twenty-six California children and their bus driver who escaped after being kidnapped from a bus after a school-sponsored day camp and buried in a rock quarry for sixteen hours. Terr interviewed the victims soon after their escape and periodically thereafter. In doing so, she discovered patterns of behavior that are now recognized as symptoms of childhood developmental trauma.

Breakthrough #3: During the 1990s, child psychiatrist Dr. Bruce Perry began studying and treating traumatized children. His work continues to this day and is described in greater detail at the ChildTrauma Academy website (www.childtrauma.org). If you want to learn more about PTSD in children, many of his books are fascinating and accessible reads about the subject.

Breakthrough #4: While Terr and Perry were conducting their groundbreaking work, medical imaging technology was making rapid advances.CAT scans were introduced in the 1980s. MRIs came into being at about the same time. In the 1990s, functional magnetic resonance imaging (fMRI), used to create maps showing which parts of the brain are involved in different mental tasks, entered the picture. Thanks to those technologies, doctors, researchers, and therapists could use images to make connections between brain activity and outward behaviors.

The Perfect Storm Is Not Abating

Thanks to this perfect storm of events, a new field of study came into being: childhood developmental trauma. The storm shows no signs of abating as research about trauma in children continues. Monthly, sometimes weekly, study results are released that improve understanding and treatment of childhood trauma. That’s hopeful news for parents who witness the imperfect storms raging in their traumatized children.

Future posts in this series will delve into what new research has revealed about PTSD in children: how to recognize symptoms, as well as how the condition is diagnosed, treated, and can be prevented. All of which I hope will encourage parents to persevere as you raise traumatized kids and help them heal.

Jolene_Blue_dressCongratulations to Jolene Philo for receiving a “starred” review in Publisher’s Weekly (the top review publication in the U.S.) for Does My Child Have PTSD? A starred review means the book should get a second look from libraries, book stores, and other entities that can get it into the hands of families who need it. This is a truly special honor…this is the first such honor ever received by her publisher (Families). Available  at Amazon.

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The Pope’s stop was a pro-life gesture

In this photo provided by World Meeting of Families, Pope Francis kisses and blesses Michael Keating, 10, of Elverson, Pa after arriving in Philadelphia and exiting his car when he saw the boy, Saturday, Sept. 26, 2015, at Philadelphia International Airport. Keating has cerebral palsy and is the son of Chuck Keating, director of the Bishop Shanahan High School band that performed at Pope Francis' airport arrival. (Joseph Gidjunis/World Meeting of Families via AP) MANDATORY CREDIT

In this photo provided by World Meeting of Families, Pope Francis kisses and blesses Michael Keating, 10, of Elverson, Pa after arriving in Philadelphia and exiting his car when he saw the boy, Saturday, Sept. 26, 2015, at Philadelphia International Airport. Keating has cerebral palsy and is the son of Chuck Keating, director of the Bishop Shanahan High School band that performed at Pope Francis’ airport arrival. (Joseph Gidjunis/World Meeting of Families via AP) MANDATORY CREDIT

I’m not Catholic, but I’m a fan of the current Pope. I know I’m not alone in that. I’ve cheered as he’s proclaimed the gospel on the floor of Congress and before the United Nations in the past week.

And when he stopped to intentionally greet and bless a child with cerebral palsy and his family near an airport in Philadelphia? My heart cheered not only at his act but at the number of positive comments on each news post about the event.

(One language note, though: Some news outlets, unfortunately, chose to describe the child as “suffering from” cerebral palsy. My youngest child also has cerebral palsy. She doesn’t exist in a perpetual state of suffering from it, though it does create some limitations. Please, journalists, choose your words wisely. If you adhere to any of the style books regularly used by media outlets, you’ll find that the preferred wording is “child with cerebral palsy” or “child who has cerebral palsy” not “child suffering from cerebral palsy.)

Meanwhile, that same positivity does not extend to the comments section of any post about the Pope’s pro-life stances on abortion. When he spoke before the United Nations last week, he said, “The Golden Rule also reminds us of our responsibility to protect and defend human life at every stage of development.” Previously he has spoken even more powerfully and explicitly against abortion (though he has also spoken with great compassion for those who have had abortions). The response to those remarks is almost always divisive.

As for me, I am pro-life. I’ll be writing more here in the coming weeks about why I am and how disability issues intersect with abortion. For now, I want to make the distinction that I am pro-life like the Pope is pro-life – every stage of development, from womb to the tomb.

What many of those cheering the Pope’s response to the boy with cerebral palsy missed is this: his stop was a pro-life action. Being pro-life, after all, isn’t (or shouldn’t be) simply about being anti-abortion. Yes, that’s part of it, but being pro-life extends after birth as well, both for the child and the mother and everyone else involved.

That’s why I consider special needs ministry to be a pro-life ministry, especially in a world that is surprised when a religious celebrity stops to engage with a child with a disability. May we all follow Christ so well that we and the world expect nothing less from Christians than not just taking note of those with disabilities but living in community with them as friends and fellow image bearers of God. Here’s to changed hearts!

Photo credit: Joseph Gidjunis / AP

In addition to serving as a Key Ministry Church Consultant, Shannon Dingle is a co-founder of the Access Ministry at Providence Baptist Church in Raleigh, NC.


Kids Ministry ConferenceOur Key Ministry team will be fanning out across the country this fall at training events in Indiana, North Carolina, Tennessee and Kentucky. Interested in coming to a live event? Click here for more information and to register for any ministry event our people are attending in October and November. Hope to see you soon!

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Ryan Wolfe…Keeping the Disabled Connected

shutterstock_229624522Several years ago I asked our County Board Superintendent what the #1 problem was facing the disability community. Without hesitation he said it is the problem of isolation.

Isolation is a universal experience for those in the disability community. It is not unique to our community. People affected by disabilities are isolated in various. Sometimes isolation is a result of cultural attitudes and worldviews. Other times isolation is a result of physical barriers. Even if physical barriers are not present people affected by disabilities can feel isolated by circumstances.

Isolation is also not a new problem. Isolation is an age old problem. Look back to Genesis Chapter 3. Here we find the beginning of isolation when we the human race are cut off from God. We are separated from Him as a result of our sin. The enemy see how affective isolation can be and I believe he uses that discourage us as humans.

Isolation is not what God intended. The Garden of Eden is evidence of that. God intended for us to be together united as one. We are only complete when we are all together (see 1 Corinthians 1:22). Ever since our separation in Genesis Chapter 3 things have gone terribly wrong.

Hope in the Midst of SufferingHow can we overcome isolation? How can we keep the body connected? These are all questions that I will answer at The Hope Conference in Indiana next month.

To give you a glimpse of how we can overcome isolation I’d like for you to think about a mat. Yes think about any old mat that you have in the floor of your home. Large or small it doesn’t matter. Maybe you remember a time when your children used a mat in your home to drag each other around on it. Maybe they even used one to pick each other up on one. Depending on your creativity and or craziness a mat can be used for a lot of different things including a sled to ride down a set of stairs. That’s a story for another day.

Now let’s remember how a set of friends used a mat to carry their friend in Luke 5. Their friend who was affected by a disability was isolated from others. He was physically separated from the presence of Jesus because of his disability. Luckily he had a determined and creative group of friends. They used an ordinary mat as an adaptive item that removed the barrier of isolation from his life. The mat was simply a tool that they used to help their friend get connected to Jesus. The group ran into many obstacles in their quest to overcome isolation, but they never gave up. They were both determined and creative using what was available to them. There is a lesson to be learned from these friends.

I will unpack how I believe “the mat” in this story for us is an illustration for technology in our current day story. I am convinced that with the same level of determination and creativity we can help our friends overcome the problem of isolation by using different forms of technology that are available to us. I also do not believe that you have to a tech wizard that works for the Geek Squad to be able to use technology to connect people. Sometimes things are simpler than we make them out to be. Believe it or not?

Come to the Hope Conference and find out how to use technology available to you to overcome isolation.

Ryan Wolfe ColorIn addition to serving as a church consultant for Key Ministry, Ryan Wolfe is the Disability Ministry Pastor at First Christian Church in Canton, OH. He blogs at DisabilityMinistry.com. Ryan believes believe that all persons with disabilities have the right to participate in a faith community and feel valued as a community member.


Indiana Wesleyan University EventOur Key Ministry team will be fanning out across the country this fall at training events in Indiana, North Carolina, Tennessee and Kentucky. Interested in coming to a live event? Click here for more information and to register for any ministry event our people are attending in October and November. Hope to see you soon!

Posted in Inclusion, Intellectual Disabilities, Training Events | Tagged , , , , , , | 1 Comment

Why we can’t acknowledge the presence of evil

Photo by Wayno Guerrini

The shooting that took place yesterday at Umpqua Community College. The TV reporter and her cameraman who were shot last month in Virginia in the middle of an interview they were doing for the morning news. The school shootings we experienced here in our local community several years ago. The six month old girl who was shot through the chest and killed here in Cleveland last night while riding down the street in a car with her family… in the same month as a five year old and three year old in the city were killed in drive-by shootings. What do they have in common?


Evil is the cause of incidents like this one…evil and profound spiritual poverty. Not guns. Not the absence of mental health services. Evil.

We have one group of people arguing that access to guns is the cause of events such as yesterday’s massacre. If we only had more laws controlling access to guns, events like yesterday wouldn’t occur. I’d argue that someone who doesn’t care about the laws on the books about murder isn’t going to care about laws on possessing or obtaining guns.

Gabby_returns_to_house_8_1_11Another group of people argues that our problems with violence result from a lack of mental health services. Media reports about yesterday’s perpetrator include descriptions of him having been quiet, withdrawn, socially awkward and quoting witnesses who report his mother believed he had mental health issues. It’s true that in many of these shootings, the perpetrators had significant issues with social interaction and communication. In the cases of the Colorado theater shooter and the Arizona gunman who shot congresswoman Gabby Giffords, the perpetrators appeared to be experiencing psychotic illness. But we have MILLIONS of people with social anxiety, high-functioning autism and serious mental illness who don’t go out and randomly kill strangers.

I’d also add that as a psychiatrist, mental health treatment has little to offer someone who purposefully and intentionally plans to kill others. We have treatments that can help when people lose touch with reality or have diminished capacity for self-control as a result of mood disorders or problems with executive functioning. When someone has the ability to execute a plan in which they acquire four guns (and the ammunition for the guns), identify a school to target, drive to that school, walk to a classroom, take the time to ask people (by some reports) whether they’re Christians and chooses to shoot them in the head if they answer yes, we have NO PILL and NO TREATMENT to stop them from doing so.

We live in a bad world with a lot of really bad people.

Too many of us don’t want to admit it because to do so, we’d have to acknowledge that there are absolute standards of right and wrong established by God and that’s not acceptable in a world in which everyone thinks they can decide that for themselves. We very much want to be in control…be the masters of our own universe.

The search for a solution through gun control or mental health intervention represents a desperate attempt to temporarily relieve our fears while maintaining our sense that we can keep everything under control without having to submit to a reality larger than our own wants and desires.

We don’t have a gun problem. We have a SIN problem. And all the laws in the world won’t fix it. Go read the first 70% of your Bible. God handed down Ten Commandments to the people of Israel, and the people sought to keep hundreds of laws governing religious practice and everyday life. How’d that work out?

Why was yesterday’s shooting wrong? Doesn’t everybody have the “autonomy” or “dignity” to decide right and wrong for themselves? Obviously, the perpetrator didn’t think it was wrong. Who are we to judge?

We know in our hearts what is right and wrong because God created us with a conscience. But if we repeatedly ignore the warnings of our conscience and refuse to acknowledge and give the proper honor to the One who created us with a conscience, God allows us to continue to pursue the path we choose.

Romans 1:18-32 is one of the most tragic passages in the Bible I can imagine. It describes the outcome when we choose to turn away from God. It’s also an extraordinarily accurate description of our dominant culture…

For the wrath of God is revealed from heaven against all ungodliness and unrighteousness of men, who by their unrighteousness suppress the truth. For what can be known about God is plain to them, because God has shown it to them. For his invisible attributes, namely, his eternal power and divine nature, have been clearly perceived, ever since the creation of the world, in the things that have been made. So they are without excuse. For although they knew God, they did not honor him as God or give thanks to him, but they became futile in their thinking, and their foolish hearts were darkened. Claiming to be wise, they became fools, and exchanged the glory of the immortal God for images resembling mortal man and birds and animals and creeping things.

Therefore God gave them up in the lusts of their hearts to impurity, to the dishonoring of their bodies among themselves, because they exchanged the truth about God for a lie and worshiped and served the creature rather than the Creator, who is blessed forever! Amen.

For this reason God gave them up to dishonorable passions. For their women exchanged natural relations for those that are contrary to nature; and the men likewise gave up natural relations with women and were consumed with passion for one another, men committing shameless acts with men and receiving in themselves the due penalty for their error.

And since they did not see fit to acknowledge God, God gave them up to a debased mind to do what ought not to be done.  They were filled with all manner of unrighteousness, evil, covetousness, malice. They are full of envy, murder, strife, deceit, maliciousness. They are gossips, slanderers, haters of God, insolent, haughty, boastful, inventors of evil, disobedient to parents, foolish, faithless, heartless, ruthless. Though they know God’s righteous decree that those who practice such things deserve to die, they not only do them but give approval to those who practice them.

Romans 1:18-32 (ESV)

shutterstock_139126682We can’t acknowledge the true reason behind the mass shootings that have become increasingly commonplace in our country because if we do so, we activate the consciences of the politicians, financiers, academics, thought leaders and media people who shape the culture and their followers who have rejected God and His truth as revealed through the life and person of Jesus. We’ve seen how angry they can become when the fallacies of their ways come to light and how determined they are to protect their supporters from “microaggressions” that might challenge their to rethink their worldview or lifestyle.

I would hope that God would give me the courage to speak the truth if I’m ever in a situation similar to those in Oregon who were asked if they were Christians after seeing others shot in the head for answering affirmatively. But if we can’t acknowledge Jesus and seek to live in submission to his truth in our daily lives, we’re living a lie of our own creation and denying our families and loved ones a witness to the only truth that really matters.

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The instinctual trauma response

Child's Brain PTSD shutterstock_114591085

Editor’s note: On behalf of the staff and Board of Key Ministry, we’d like to extend our congratulations to Jolene Philo for having received a “starred” review in Publisher’s Weekly (the top review publication in the U.S.) for Does My Child Have PTSD? A starred review means the book should get a second look from libraries, book stores, and other entities that can get it into the hands of families who need it. This is a truly special honor…this is the first such honor ever received by her publisher (Familius). Here’s Jolene…

Welcome to the fifth post in an ongoing series about childhood trauma and PTSD. So far, the series has explained why I write about PTSD in children, what words like childhood developmental trauma and PTSD mean, myths about this mental illness, and what causes childhood trauma.

The Instinctual Trauma Response (ITR) Model

Today’s post takes a look at how the brain responds to perceived danger. Many models exist about the brain’s instinctive response to threat. The one that makes the most sense to me–and I hope will make sense to you, too–is called the Instinctual Trauma Response (ITR) model. It was developed by Dr. Louis Tinnin and Linda Gantt, the founders of Intensive Trauma Therapy, Inc. (ITT) in Morgantown, West Virginia.

ITR’s Seven Stages

In the 1990s Tinnin and Gantt identified a consistent pattern of response to threatening events. The pattern is common in both children and adults and consists of seven stages. Here is a brief look at each stage.

Startle: A quick, intense response which puts the body on high alert.

Thwarted intention: After the initial startle, the body releases a surge of hormones to prepare for fight or flight. When fight or flight aren’t possible, the thwarted intention response kicks in.

Freeze: The body enters a frozen state of numbness and immobility, at least for a moment or two, when intentions are thwarted and there is no hope of escape.

Altered state of consciousness: If the freeze state lasts for more than a few moments, many people enter an altered state of consciousness. Adults often describe this state as watching a movie of themselves or that they feel themselves shrink deep inside their bodies and their bodies seem to become shells.

Body sensations: A variety of sensations, such as pain, can experienced during different stages in the ITR model. All of the sensations are stored as non-verbal memories (in both children and adults) and are stored in the right brain. They remain there as non-verbal memories—bodily sensations that can’t be put it into words.

Automatic obedience: This instinctual response causes a threatened person to automatically obey a perpetrator’s demands in order to survive the immediate threat.

Self-repair: After the threat passes, a person tends to the emotional and physical wounds of trauma. Sleeping, eating, rocking, going to a quiet place, and washing are all forms of self-repair.

How the ITR Stages Look During Childhood Trauma

As has been mentioned before in this series, the best way to understand what happens during childhood trauma is to consider everything from a child’s point of view. So let’s re-examine each of the seven stages through child-colored glasses again.

Startle. Babies are startled by little things like a light being flipped, a pan crashing to the kitchen floor, or by unfamiliar people coming into the room. Baby fingers splay, arms go rigid, and the babies cry. Babies who have a secure primary caregiver startle less often as time goes on. Even so, toddlers and preschoolers tend to jump, gasp, or cry at things adults shake off. Their lives are a continual replay of Dorothy, the Scarecrow, and the Tin Man entering the haunted forest: “Lions and tigers and bears! Oh, my!”

Thwarted intention. Fight and flight options are nonexistent for babies. They have no way to fight or flee. Eventually, kids grow strong enough to hide from perceived danger or to pitch magnificent fits. But for the vast majority of little people, life is a series of thwarted intentions. Therefore, we should not be surprised when kids consider the world to be a more traumatic place than do adults.

Freeze. Children tend to move very quickly from thwarted intentions into the freeze state. Children who experience similar, repeated traumas go through the two previous steps so quickly and automatically may appear to have skipped themcompletely. They may freeze at the slightest hint of threat. No jump. No gasp. No attempt to fight or run. They simply freeze. Their brains may go offline for a while. If they’re young enough, they may squeeze their eyes shut because they think that when they can’t see the threat, it can’t see them either.

Altered state of consciousness. Gaze aversion may be the baby version of an altered state of consciousness. When overstimulated or threatened, they tend to disengage and shut out the stimuli. Older children enter this stage by telling themselves, “This can’t be happening. It must be a dream.” Children also flee threats through daydreaming. They hide in a world of their own making, a world they can control.

Body sensations. This step in the process can pose a great risk for infants and young children because from birth to age three, children are nonverbal. They have no words, so all their bodily sensations are recorded as nonverbal memories. The memories are like terrifying movies playing over and over inside the brain. As children get older, their rational mind can’t explain these sensations. It is no wonder that adults living with unresolved childhood trauma often think they’re going crazy.

Automatic obedience. Though it is uncomfortable to think about any child being in the situation where they reach this stage of the ITR model, it is important to understand traumas that can impact children profoundly. For children in life and death situations, automatic obedience is an appropriate survival response. Also, they live in a society that expects children to obey adults. So babies undergoing hospital procedures learn to lie quietly when people hurt them. Toddlers surrender when grown-ups touch their private parts. Young children do whatever their parents say to avoid a beating or verbal abuse. Automatic obedience is often the only survival weapon children have until their old enough or big enough to fight back.

Self-repair. Children are relieved when a traumatic situation ends. They instinctually seek out people they trust to comfort them. (Think about a baby reaching for Mommy’s arms after immunizations.) Children without a trustworthy comforters may snuggle up to their favorite blankie or a stuffed animal. They may regress and suck their thumbs again or insist on a bottle instead of a sippy cup. Older children may revert to baby talk or demand a nightlight at bedtime. These behaviors are attempts to return to a safer, more comfortable time before the trauma happened.

Hope for Those Who Have Experienced Childhood Trauma

Learning about how a child’s brain perceives and responds to danger can be disturbing unless we keep a few things in mind. First, though all children face perceived threats and go through the stages of ITR, the majority experience no long term traumatic effects. Second, children dealing with unresolved trauma or PTSD that develops from it can be successfully treated. They may recover completely if treated early enough. Even those who receive therapy years later can learn to successfully manage and cope with the residual effects. The next post in this series will discuss symptoms in children of different ages that indicate the need to seek treatment. Until then, remember much hope exists for children living with unresolved trauma or PTSD.


JoleneGreenSweater.jpgDoes My Child Have PTSD? is designed for readers looking for answers about the puzzling, disturbing behaviors of childen in their care. With years of research and personal expererience, Jolene Philo provides critical information to help people understand causes, symptoms, prevention, and effective diagnosis, treatment, and care for any child struggling with PTSD. Available for pre-order at Amazon.

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What if the church destroyed the foster care system as we know it?

shutterstock_58760644Recently the AP reported that for the first time in more than 10 years, foster care numbers rose slightly in 2013 and more sharply last year. We should be unsettled by this news, which you can read in full here. But how can we respond?

First, these numbers should break our hearts. More than 415,000 children are in limbo, waiting to see where their future will go. Of those, 108,000 are available for adoption and waiting for a family to say yes to them as a son or daughter. Yet for more than 22,000 kids in 2013, that day never came as they aged out of foster care as adults without a family of their own. If those numbers weren’t hard enough, 14% of children in foster care live in group homes instead of foster family. And 4,500+ foster children are unaccounted for as runaways, unable to deal with life in foster care but who knows what they are going through now that they are on their own and particularly vulnerable to child trafficking and other dangers.

But more than breaking our hearts, these numbers should move us to action. If one family from every three churches committed to adopt one child and those three churches committed to support that family, there wouldn’t be children waiting to be adopted in foster care. Sure, there would still be temporary placements and other similar constructs, but the foster care system as we know it would be destroyed.

By the church.

Imagine that. Imagine if the church was known more for reflecting Christ like that instead of reflecting hate or intolerance. Imagine if we called families to adopt or foster and rallied around them as they say yes, with the support of one or more area churches, knowing they may need reinforcements and respite as they do battle with their children against previous traumas and fear triggers. Imagine that.

Better than just imagining, though, engage with ministries who are working to make that a reality. Some include The Forgotten Initiative, ALL IN Orphan Care, Tapestry, and The Hope & Healing Institute. If you know of others, no matter how large or small scale or how local or global the efforts, please leave a comment on this post or our Facebook page to share who they are and what they do. We’d love to share the good work being done by others in the kingdom of God!


In addition to serving as a Key Ministry Church Consultant, Shannon Dingle is a co-founder of the Access Ministry at Providence Baptist Church in Raleigh, NC.


© 2014 Rebecca Keller PhotographyCheck out Shannon Dingle’s blog series on adoption, disability and the church. In the series, Shannon looked at the four different kinds of special needs in adoptive and foster families and shared five ways churches can love their adoptive and foster families. Shannon’s series is a must-read for any church considering adoption or foster care initiatives. Shannon’s series is available here.

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A great training opportunity for our friends in the Midwest…

12003393_1064530726904492_5394694705345638286_nOur crew at Key Ministry is very pleased to be involved with an excellent training opportunities next month for our friends in the Midwest.

On October 16-17, we’re delighted that Ryan Wolfe will be joining Joni Eareckson Tada, Steve Bundy and the crew from Joni and Friends for their Hope in the Midst of Suffering Conference at Indiana Wesleyan University in Marion, IN.

Joni September 2015Joni will be speaking at the Opening and Closing Plenaries.  Her Opening Plenary talk is titled Jesus Beside Bethesda and the Closing Plenary will focus on Accelerating Ministry to the Marginalized at the End.

Steve and Joni will participate in a panel discussion, Following the Path of the Crucified Christ on the Path of Leadership and Ministry, while Steve offers a plenary discussion of Luke 14, the Church and Marginalized People and a workshop on Global Perspectives on Pastoral Care for Excluded People.

Ryan will be presenting a workshop on Keeping the Disabled Connected, in which he’ll be looking at ways in which personal technologies can be used to keep people with disabilities connected to the global community.

Hope in the Midst of SufferingOther outstanding speakers attending the conference include Kathy McReynolds and Ben Rhodes from Joni and Friends along with numerous members of the Indiana Wesleyan faculty.

Registration for the conference is $150.00. One-day rates and a reduced rate for groups of four or more are available. Click here to register for the Hope in the Midst of Suffering Conference.


shutterstock_118324816Key Ministry has put together a resource page for pastors, church staff, volunteers and parents with interest in the subject of depression and teens. Available on the resource page are…

  • Links to all the posts from our recent blog series on depression
  • Links to other outstanding blog posts on the topic from leaders in the disability ministry community
  • Links to educational resources on the web, including excellent resources from the American Academy of Child and Adolescent Psychiatry (AACAP), a parent medication guide, and excellent information from Mental Health Grace Alliance.
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What happens when the Christians are driven out of medicine?

shutterstock_191114072From the time my older daughter was in middle school, she appeared destined for a career in medicine. She used the editor’s comments from one of my research papers as part of her eighth grade career project. She spent two summers in high school in paid research positions at Cleveland Clinic. Thanksgiving morning of her senior year in high school was spent observing a heart transplant with one of her research mentors. She completed her certification as an emergency medical technician this past summer because she wanted experience in caring for patients prior to applying to medical school.

IMG_1118She hopes to start med school in 2017 or 2018, graduate in 2022 and finish her residency and fellowship sometime between 2027 and 2030…given her research interests and temperament, she’s likely to end up in cardiology, cardiovascular surgery or cardiovascular anesthesia. While I’m confident that God is guiding her path, as her dad, I fear she’ll be required to do something that wasn’t required of me…violate the sixth commandment in order to practice as a physician in the United States.

Two weeks ago (on September 11), the California Legislature approved a bill to legalize physician-assisted suicide, following a precedent established by Oregon, Washington, Montana and Vermont.

Leaders of the “death with dignity” movement said they hoped the passage of the California law could be a turning point.

“It allows for individual liberty and freedom, freedom of choice,” said Mark Leno, a state senator from San Francisco who compared the issue to gay marriage.

The California legislator quoted by the New York Times is spot-on. The very same arguments made in the same sex marriage debate – arguments for individual dignity and personal autonomy are being used to advance a right to physician-assisted suicide. Given the widespread popularity of physician-assisted suicide (according to the most recent Gallup poll, 68% of Americans – and 81% of 18-34 year-olds approve), and the reality that nearly 20% of Americans may reside in states where physician-assisted suicide is legal, the time when the “right to die”

Bruce Abramson wrote an essay (highly recommended) in last month’s Mosaic Magazine titled How Jews Can Help Christians Learn to Succeed as a Minority in which he describes the evolution of how our leaders view the concept of religious freedom…

Berkowitz rightly casts religious freedom as but one front in the philosophical—and political—battle between liberalism and progressivism. A clear line of difference, beginning with the classical liberal preference for freedom and the rule of law versus the progressive preference for equality and justice, and continuing to manifest itself in the classical liberal preference for “negative” rights that no government may legitimately infringe (as in the U.S. Bill of Rights) versus the progressive preference for “positive” rights like housing, food, and health care that someone must provide (as in many European constitutions), has fed into the practical debate between the liberal view of government as protector (emphasizing military, policing, and the courts) and the progressive view of government as provider (emphasizing entitlements and the welfare state).

Peter Berkowitz, writing in the same magazine, supported the observation made by the California legislator that pertains to our discussion of Christians in medicine…

The larger truth is that we have reached a watershed moment in American law, society, and culture: for the first time, avoiding participation in a given event or activity can now be construed as violating someone else’s civil (or human) rights—and can be actionable as such—even when the avoidance has been dictated by a religious conviction.

Physician-assisted suicide was mandated last year in Canada by a decision of their Supreme Court. The response of the Canadian Medical Association to attempts to enact conscience protections for physicians unwilling to assist their patients in ending their lives was consistent with the new paradigm that religious conviction is a secondary consideration to the rights of others to demand a service…

Conscientious objection was a contentious issue, with 79% of delegates voting against a motion to support conscientious objectors who refuse to refer patients for medical aid in dying.

“What we expect from physicians, at a minimum, is that they provide further information to patients on all the options including the spectrum of end-of-life care and … how to access those services,” CMA Vice President of Medical Professionalism Dr. Jeff Blackmer told reporters at a press conference Aug. 26.

shutterstock_1515432Given two converging trends in society…the perspective that individual conscience must take a back seat to the desires of persons demanding a product or service made available to the public and the determination among activists that accommodations not be made available to public employees, the right-of-conscience exceptions present in assisted suicide laws in the U.S. won’t be in place for long.

Kim Davis has been in the news for her refusal to sign marriage licenses in her position as an elected county clerk in Kentucky. Because she is a public employee in a state where the legislature has not been in session to approve accommodations for employees who cannot comply with the recent Supreme Court decision addressing same-sex marriage, she has been sent to jail and become the target of a very public #DoYourJob Twitter campaign.

All practicing physicians in the United States are required to maintain a medical license in each state in which they practice. The vast majority of physicians (and essentially all hospitals) receive government payment for services provided from Medicare and/or Medicaid. What will happen when activists insist that willingness to provide assistance with suicide is a precondition for licensure or the ability to participate in government-funded healthcare programs?

Our existing religious freedom laws require a “balancing test” in which the government is required to demonstrate a “compelling interest” in enforcing laws that might result in religious believers violating their consciences. What hope do physicians have from maintaining a right to object to assist patients in committing suicide when the “compelling interest” of the government would appear to be far stronger than the interest in forcing bakers and florists to provide goods and services for same-sex marriages?

Right of conscience objections in medicine have primarily been a concern to this point for OB/GYNs and medical students and residents required to rotate through OB/GYN as part of their required training. A mandate for physicians to assist patients demanding help in ending their lives would potentially impact most physicians involved with direct patient care. Lest we think pediatricians and psychiatrists will be exempt, physician-assisted suicide for children was legalized in Belgium last year, and a clinic specializing in assisting psychiatric patients who want to die opened in the Netherlands in 2012. For that matter, here’s a news story published yesterday in which a doctor in the Netherlands was reported to the Medical Board for the equivalent of malpractice for refusing to help a 19 year-old woman with depression and lupus to end her life.

But what about the Hippocratic Oath? All but one U.S. medical school has stopped using the traditional oath (that prohibits abortion and physician-assisted suicide). The reasons why the Oath is no longer used are summarized by the Chief of Medical Ethics at Cornell…

“Do you want to impose an oath on students that probably half of them could not agree to?

“The prescriptive oath, in a sense, is one that purports to have all the answers,” he added. “This breaches the notion of a community. What should mark the professional community today is the willingness to engage ideas and be reflective, all in the service of advocating for patients.”

Consider the consequences when requirements imposed upon physicians to assist patients requesting help in committing suicide become incompatible with an understanding of the sanctity of life as understood from traditional Biblical teaching and principles…

  • What happens when all the Christians are gone from medical school and hospital ethics committees?
  • What happens when all the Christians are gone from government agencies and insurance bureaucracies that determine what medical treatments will and won’t be paid for?
  • What happens when the Christian hospitals close their doors because the faith precludes them from assisting patients who demand help in committing suicide or referring patients to physicians or hospitals that will help them?
  • Who will stand up to defend the dignity and value of persons with disabilities, the elderly, or those in need of expensive medical treatments who aren’t well-connected politically when the cost competes with other societal priorities?

Shannon will be sharing a series of posts in October on the topic of abortion as it relates to our work in disability ministry. The horror of the recent videos describing practices at Planned Parenthood in which organs were being harvested from pre-born children (and in a few instances, children who had been born alive) and being sold for profit has led to many in the Christian community to consider more carefully what it means to be “pro-life.” But sooner than many of us would like, we’ll need to consider the costs of championing the sanctity of life among those with chronic or painful illnesses when society offers the “right to die” …followed inevitably by the duty to die.

God loves my daughter immeasurably more than my wife and I will ever be able to and I’ll have to trust that He’s in control if the doors are opened for her to practice medicine in the fields for which she has interest and passion. I hope she won’t have to choose between violating her conscience or relocating to another state or country if she is to pursue her calling with the gifts, talents and training God plans to give her.


shutterstock_24510829Key Ministry is pleased to make available our FREE consultation service to pastors, church leaders and ministry volunteers. Got questions about launching a ministry that you can’t answer…here we are! Have a kid you’re struggling to serve? Contact us! Want to kick around a problem with someone who’s “been there and done that?” Click here to submit a request!

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