Winners of the 2025 CMA Annual Education Conference Poster Contest

An Exodus Framework for Overcoming Dry Drunkenness by Davis Varghese

Dry drunkenness describes a state in which a person has ceased substance use yet continues to experience the emotional and psychological turbulence of active addiction, leaving the individual in a psychological and spiritual limbo. While existing psychiatric and psychological models recognize that rediscovering meaning is essential for lasting recovery, there remains a gap in holistic frameworks that show how the functional aspects of addiction itself can be redirected toward healing rather than suppressed or discarded.

Because dry drunkenness arises from unresolved internal dynamics, a more psychodynamic and symbolic approach may offer deeper insight. Interpreting addiction through the lens of the Exodus narrative provides a framework for understanding and addressing this state. In particular, the story highlights the “valuables” carried out of Egypt. In recovery terms, this gold symbolizes the functional elements of addiction. When taken as an end in itself, these aspects can re-enslave; when reoriented, they can serve as the foundation of a new life ordered toward meaning.

The pattern unfolds in three stages. First, in the despoiling of Egypt, the Israelites depart from slavery, but take with them the valuables of their oppressors. Similarly, an important component of addiction recovery is both abstinence/departure from the substance while also extracting/isolating the functional components of the addiction.

Next, in the wilderness, absent the clear presence of God and in the throes of uncertainty, the people melt down their gold to fashion an idol. This parallels dry drunkenness. Having left the substance, the person turns back to the valuable components of addiction—comfort, stimulation, control—and begins to worship them in isolation. Without a higher framework, these fragments of function become all-consuming, and the individual risks possession by the very energies that once enslaved them.

Finally, these valuables are integrated, offered freely, and fashioned into a sacred vessel—not to be worshiped itself, but to host the presence of God. Here lies the path through dry drunkenness: integrating the functional aspects of addiction into a life structure that serves meaning and Being. The intensity once bound to substance can be redirected toward service, discipline, creativity, or prayer. In freedom from slavery/addiction, one must recognize the functionality within the dysfunction and attempt to restructure one's life to regain it healthily. Recovery is about building an ark strong enough to contain and sanctify desire.

Some may question whether such symbolic interpretation is useful for clinical care. Yet both Catholic pastoral theology and modern psychodynamic or narrative therapies affirm the power of symbol to reorganize the inner life. Scripture offers a living map for transformation that complements clinical interventions.

Dry drunkenness represents partial liberation: the external bonds are broken, but the internal slavery persists. The Exodus sequence—despoiling Egypt, Golden Calf, Ark of the Covenant—shows how the very capacities once bound to addiction can be transformed into a vessel for greater Being. This framework brings together psychiatry's attention to function, psychology's emphasis on integration, and theology's call to sanctification, offering a recovery model that is both spiritually and clinically resonant.

Built to Coerce: Ethics of Imposed Euthanasia (MAiD) Provision in a Catholic Hospital Space by Yuriko Ryan, DBe, MA, HEC-C

Catholic hospitals in Canada face intensifying pressure to offer euthanasia (Medical Assistance in Dying—MAiD) on-site, often through spatial arrangements that compromise conscience, freedom, and moral clarity. In Vancouver, a legal case launched by the family of a deceased patient, an MAiD advocacy group, and a physician challenged the provincial government and Providence Health Care (PHC) for denying the patient's original request for onsite MAiD access at St. Paul's Hospital, a publicly financed tertiary care hospital operated by PHC. The human rights complaint resulted in arrangements that forced the integration of an MAiD clinic—Shoreline Space—operated by a regional health authority, into the corridor system of St. Paul's Hospital.

Case Study: Shoreline Space

This poster presents an ethical and spatial analysis of Shoreline Space. Architectural and design features—secured entrances, smoky glass, an ambiguous sign, and its location beside a major entrance and high-traffic clinical zones—act as moral coercion. These spatial elements shape perception and behavior, blurring boundaries between normalization of on-site access to MAiD and complicity.

Architecture becomes a silent agent of pressure, influencing ethical experience without explicit dialogue. Planning is in progress for an additional euthanasia facility to be managed by the regional health authority at the new St. Paul's Hospital site, which is presently under construction. These concerns extend beyond acute care. With the scheduled rollout on March 17, 2027, of MAiD for mental illness as the sole underlying condition—and lobbying for expansion to mature minors, advance directives, and other vulnerable populations—the spatial and ethical risks escalate across Christian hospices, hospitals, long-term care homes, pediatric hospitals, and mental health programs.

Analytical Frameworks

The analysis begins with Kahana's Person-Environment Fit theory to establish the importance of environmental congruence. It then expands into spatial ethics rooted in Environmental Psychology, Theory of Planned Behavior. These frameworks clarify how proximity, aesthetics, and institutional layout affect moral reasoning, autonomy, and institutional witness. Catholic moral theology—especially cooperation with evil, double effect, subsidiarity, and the preferential option for the vulnerable—provides the normative lens for evaluating these spatial dynamics.

Conclusion

Spaces built to coerce cannot be defended by neutrality or silence. Catholic healthcare must pursue architectural ethical integrity—designing environments that protect conscience, honor Gospel values, and safeguard the vulnerable. Without intentional design, institutions risk scandal, mission drift, and erosion of Catholic identity in an increasingly normalized view of euthanasia (MAiD) as medical care.

Limitations and Future Directions

This study focuses on one urban Catholic hospital in Canada. Future research should examine similar cases across community care sites. To help Catholic institutions respond, this poster proposes three tools: a moral spatial index to assess ethical exposure based on layout, visibility, staffing, and public interpretation; a Catholic architectural design ethics checklist to identify and prevent coercive spatial features; and a Charrette Engagement Model to surface conscience-related concerns early in planning, with wider stakeholder groups.

FACTS Medical School Elective: Transforming Medical Students' Perceptions of the Effectiveness of FABMs by Kristin Strosnider, BA; Elaine Pope, BA; Mary Benedicta Obikili; Marguerite Duane, MD, MHA, MSPH, FAAFP; Talia Caridi; C. Mary-Angel Ekezie

Physicians have limited knowledge about modern fertility awareness-based methods (FABMs) and are less likely to offer these options to women for health monitoring or family planning purposes. To address this knowledge gap, FACTS has created a two-part online course for students and residents to learn the science underlying FABMs and the role they play in women's health. This course, offered to students and residents via synchronous and asynchronous online activities, is an innovative way to deliver medical education using technology and telemedicine. The purpose of this study is to evaluate the effectiveness of the course by answering the questions: how does this course impact knowledge of FABMs, confidence in explaining and offering FABMs, and the students’ anticipated behaviors in future practice?

Fertility Awareness-Based Methods (FABMs) are natural systems that help women gain knowledge of their fertility patterns through observation of biomarkers, including cervical fluid, basal body temperature, and urinary hormone levels. FABMs have been scientifically proven as an effective means of achieving or preventing pregnancy [1]. Unfortunately, FABMs are often misrepresented or not even addressed in medical school curricula. In one study from 2016 to 2019, FABMs comprised only 4% of all family planning mentions [2]. FACTS offers a 4-week online elective course, divided into two, 2-week parts: FABMs for Family Planning and Fertility Awareness for Women's Health.

We hypothesized that by participating in the FACTS’ Medical Elective, students are as follows: (1) more likely to perceive FABMs to be an effective means for patients to avoid or achieve pregnancy, and (2) more likely to seek additional training in FABMs to facilitate discussions or provision of these methods to their future patients.

To evaluate these hypotheses, pre- and post-course surveys were administered to the elective participants for the years 2022–2023 and 2023–2024. Of the 426 participants, 345 participants completed both surveys and gave consent to use their responses for research. Results related to how students perceived the typical- and perfect-use effectiveness rates of select FABMs with published research were analyzed using a Wilcoxon Signed-Rank test for dependent outcomes and a skewed distribution of differences.

Additionally, results describing whether course participants would offer FABMs for family planning options were analyzed using a paired t-test for dependent outcomes and a normal distribution of differences. Lastly, results regarding whether participants would offer family planning services to future patients were analyzed using a binomial McNemar's test to evaluate differences between “yes” and “no” responses on the pre- and post-surveys. All results had a p-value < .0001.

Overall, we found that after participating in the FACTS Elective, students are significantly more likely to perceive FABMs as effective for avoiding or achieving pregnancy. Students are significantly more likely to either “somewhat” or “almost certainly” offer FABMs to their future patients for family planning. Creighton, Billings, Marquette, STM, FEMM, LAM, and NeoFertility were the FABMs that students were most likely to offer. Finally, participating in the FACTS elective equips medical students to seek additional training in these methods and may empower them to spark conversations with their medical schools to include FABMs in the curriculum.

Spiritual Care in Medicine-Perspectives, Practices and Training Gaps: A Survey of Catholic Medical Association Members by James F. Bathon, BS; Molly A. Bingham, BS; Jackson W. Appelt, BS; Kossivi L. A. Mignondje, BS; James L. Rogers, BS; Keith Meador, MD, ThM, MPH; Linda Donnelly; Carolyn M. Gretzinger, MA; E. Wesley Ely, MD, MPH

Background: A patient's spirituality can lie at the core of how they navigate their healthcare - from decision making to personal coping strategies. Open communication and inquiry into spiritual beliefs have been shown to improve patient outcomes and are frequently welcomed by patients. However, studies show that few physicians routinely engage in spiritual history taking for various reasons, including insufficient time, lack of training, and social discomfort. This study aimed to assess the perspectives and practices of members of the Catholic Medical Association (CMA)—an anticipated strongly religious cohort—regarding spiritual history taking, with the goal of identifying areas for future educational initiatives and policy improvement that promote holistic patient-centered health care.

Methods: This cross-sectional study analyzed survey data from CMA members (449 responses total, 292 responses analyzed), including physicians, fellows, residents, medical students, nurses, advanced practice providers, clergy, and other associated healthcare professionals. Responses were gathered from September 4, 2024, to December 31, 2024. Through multiple question modalities, participants were asked about their attitudes, practices, and education regarding spiritual history taking.

Results: All respondents reported their faith was important to them. Of the responses analyzed, 90% perceive knowledge of their patients’ faith as important, yet 31.5% report knowing this information only “sometimes.” Comfort in taking a spiritual history varied among respondents, but was generally lower among trainees, with 57.7% of residents/fellows and 77.8% of medical students feeling “less than comfortable,” compared to 40% of active and retired physicians. More than 70% of respondents across all levels reported receiving insufficient training in taking a spiritual history, despite 94% agreeing or somewhat agreeing that such training in medical school is important. Furthermore, more than 50% of respondents found it appropriate to share their own faith or pray with a patient if asked. Qualitative responses emphasized the importance of patient consent, receptivity, and clinical context when praying with patients or discussing spiritual history. Physicians noted that prayer was most appropriate when initiated by the patient or offered with permission, and that spiritual history taking should be guided by its relevance to care, emotional distress, or ethical decision-making.

Conclusion: This survey reveals a disconnect between the recognized importance of spirituality in patient care and the comfort and preparedness of CMA members to engage in spiritual history taking. Despite strong personal faith and positive attitudes toward integrating spirituality into clinical practice, many respondents reported limited formal education in this area and similarly limited integration of spiritual care into their practice. These findings underscore the need for structured, early educational initiatives that equip clinicians to address spiritual concerns ethically and effectively. Emphasizing the role of spiritual history in improving patient outcomes and satisfaction will be essential in advancing holistic care.