Source: ForeignAffairs4

Source: The Conversation – USA (3) – By Lloyd Hitoshi Mayer, Professor of Law, University of Notre Dame

Churches and other houses of worship can endorse political candidates without risking the loss of their tax-exempt status, the Internal Revenue Service said in a legal document the tax-collection agency filed on July 7, 2025. This guidance is at odds with a law Congress passed more than 70 years ago that’s known as the Johnson Amendment and applies to all charitable nonprofits, whether they are secular or religious.

The Conversation U.S. asked Lloyd Hitoshi Mayer, a law professor who has studied the regulation of churches’ political activities, to explain what this statute is, how the IRS seeks to change its purview and why this matters.

What’s the Johnson Amendment?

The Johnson Amendment is a provision that Lyndon B. Johnson added to a tax bill passed by Congress in 1954, when he was a senator. It says that any charity that wants to be tax-exempt under section 501(c)(3) of the Internal Revenue Code cannot “participate in, or intervene in … any political campaign on behalf of … any candidate for public office.” In the U.S., all houses of worship are designated as charities by the IRS.

The IRS has interpreted the Johnson Amendment for more than 70 years to mean that charities cannot speak in favor of political candidates or take any other action that supports or opposes them.

The IRS is prohibited from publicly disclosing audits of specific tax-exempt nonprofits under taxpayer privacy laws, so there’s no way to know the extent to which the law has been enforced. The public only learns about audits tied to possible Johnson Amendment violations if the nonprofit discloses that information or the IRS revoked their tax-exempt status.

However, the IRS did conduct a broad enforcement campaign in the 2000s known as the Political Activity Compliance Initiative. The reports it issued for 2004 and 2006 stated that it had audited hundreds of charities, including churches, for possible Johnson Amendment violations. The IRS generally found that most violations were minor and often inadvertent – warranting no more than a warning letter.

It’s unknown whether any nonprofits lost their tax-exempt status as a result of this initiative, which the IRS appears to have ended in 2008.

There’s only one known instance of a church losing its tax-exempt status because it violated the Johnson Amendment. In that case, a church in Binghamton, New York, published full-page newspaper ads criticizing Bill Clinton during his 1992 presidential campaign.

Why does the Trump administration want to change its enforcement?

The National Religious Broadcasters, two churches and another religious nonprofit sued the IRS in 2024, challenging the constitutionality of the Johnson Amendment on First Amendment free speech and free exercise of religion grounds and on Fifth Amendment due process grounds. The plaintiffs also argued that applying the Johnson Amendment to religious nonprofits violated the federal Religious Freedom Restoration Act.

The plaintiffs and the IRS filed a joint motion on July 7 to settle the case. They asked the U.S. District Court for the Eastern District of Texas to order the IRS not to enforce the Johnson Amendment against the two church plaintiffs. They also asked the court to incorporate in its order a statement that the Johnson Amendment does not apply to “speech by a house of worship to its congregation, in connection with religious services through its customary channels of communication on matters of faith, concerning electoral politics viewed through the lens of religious faith.”

This represents the first time the IRS has said there’s an exception to the Johnson Amendment for houses of worship. While lawmakers have periodically sought to repeal or modify the statute, neither chamber of Congress has ever passed such legislation.

President Donald Trump asserted during his first term that he had “gotten rid of” the Johnson Amendment. But that referred to his 2017 executive order that directed the Treasury Department – to which the IRS belongs – to respect freedom of religion with respect to religious organizations speaking about political issues as “consistent with law.”

Under the IRS interpretation of the Johnson Amendment at the time, it would not have been consistent with law for churches or other religious nonprofits to support or oppose candidates for elected public office.

How might the IRS treat religious political activity differently?

If the court approves this new joint motion, that order will only apply to the two churches that are plaintiffs in the case – not other religious nonprofits or the National Religious Broadcasters that joined them in suing the IRS. But the filing tells other houses of worship that the IRS will not enforce the Johnson Amendment against them for speech to their congregations, at least not during the Trump administration.

I think that the government may have a hard time applying this exception for several reasons.

The IRS will have to determine when a charity is a “church,” the term the IRS uses for a house of worship of any faith. That has become increasingly difficult in recent years, as some organizations that stretch the conventional definition of a church have won IRS recognition as such.

The IRS will also have to clarify what constitutes speech made “in connection with religious services” and what are “customary channels of communication.” For example, it’s unclear whether inviting a political candidate to address the congregation about how their religious faith relates to their candidacy falls within the exception.

Will only conservative politicians benefit?

Establishing this exception does not necessarily give conservative politicians any advantages.

It is true that recent attempts to repeal or modify the Johnson Amendment are associated with conservative Christian groups such as the Alliance Defending Freedom, which represented the plaintiffs in this lawsuit.

But historically, many progressive houses of worship have also pushed against the Johnson Amendment, including Black churches that often serve as political as well as religious centers for their communities.

A Texas Tribune and ProPublica investigation documented apparent violations of the Johnson Amendment in the 2022 midterm elections by almost 20 churches in Texas from across the political spectrum. Interestingly, most of the church leaders involved were aware of the amendment.

Many said they were not violating it because they avoided explicitly endorsing candidates, while at the same time clearly expressing their support for specific candidates by, for example, praying for an individual who was identified to the congregation as a candidate.

How could this new guidance change political campaigning?

Americans generally don’t want to see churches get involved in politics, including majorities in most denominations. Nonetheless, church leaders of all stripes who were already inclined to support particular candidates will probably feel emboldened to explicitly endorse candidates when preaching to their congregations.

There are two ways that this new exception could do more than that.

First, it isn’t limited to sermons by pastors, priests, rabbis, imams and other religious leaders. It extends to any speech to a house of worship’s congregation “in connection with religious services through its customary channels of communication on matters of faith.” It therefore almost certainly includes church bulletins and other written materials distributed as part of a religious service.

What’s less clear is whether “customary channels of communication” includes people who watch religious services streamed over the internet or on TV, rather than just those who attend services in person.

Second, the change will increase pressure on church leaders to support candidates.

For example, George W. Bush’s 2004 campaign reportedly sought to recruit thousands of congregations to distribute campaign information. It’s natural to expect such efforts to multiply and become more direct for both Democratic and Republican candidates from now on.

And church leaders will also likely face pressure from politically active congregants to endorse candidates, and have a harder time resisting it.

Lloyd Hitoshi Mayer previously worked at the law firm of Caplin & Drysdale, Chartered, including when the firm represented All Saints Episcopal Church of Pasadena, California with respect to an IRS audit of the church for allegedly violating the Johnson Amendment. He was not personally involved in this representation.

– ref. IRS says churches may endorse political candidates despite a decades-old federal statute barring them from doing that – https://theconversation.com/irs-says-churches-may-endorse-political-candidates-despite-a-decades-old-federal-statute-barring-them-from-doing-that-260854

Source: ForeignAffairs4

Source: The Conversation – USA (3) – By Jalees Rehman, Department Chair and Professor of Biochemistry and Molecular Genetics, University of Illinois Chicago

Tumors can destroy the blood vessels of muscles even when the muscles are nowhere close to the tumor. That is the key finding of a new study that my colleagues and I recently published in the journal Nature Cancer.

Muscle loss in cancer patients is a major health problem, but the exact causes of how precisely tumors affect muscles remain an active area of research.

Scientists in my lab were curious whether one explanation for the muscle loss in cancer patients could be that the cancer impairs the blood vessels that are necessary to supply nutrients and oxygen to muscles. Healthy blood vessels ensure that blood containing oxygen and nutrients is transported from the heart to all tissues and organs in the body, and then circulates back to the heart. Unhealthy blood vessels lose the ability to circulate sufficient blood and develop leaks, with nutrients seeping into the tissue prematurely and thereby cutting off the supply of nutrients to tissues that are further downstream.

To tackle this question, my colleagues and I worked with several other scientific research teams with expertise in advanced microscopy, cancer research and metabolism. We used animal models to study several kinds of tumors – lung cancer, skin cancer, colon cancer and pancreatic cancer. We consistently observed that the blood vessels in the muscles became fewer and leakier even before the muscle weakness set in.

We also found that tumors release a protein called Activin-A, which acts on blood vessels to cause the leakiness and, ultimately, loss of blood vessels in the muscle. When we used a gene therapy to restore blood vessel health by counteracting the effects of Activin-A, we were able to prevent the muscle loss.

So we examined the muscles of patients who had passed away because of cancer and found that the muscles of cancer patients contained fewer blood vessels than expected.

Why Activin-A matters

Millions of cancer survivors struggle with muscle weakness, which can be so profound that they may have difficulties walking up a couple of flights of stairs or going shopping for groceries on their own.

Severe muscle weakness and muscle loss during cancer is called cancer cachexia, which occurs in up to 80% of patients with advanced cancer.

Recent research indicates that cachexia is far more common among cancer patients than previously suspected, with approximately half the patients who see their cancer doctor for the first time already showing signs of muscle weakness.

Importantly, cachexia can persist even after the cancer is successfully treated and cured. This can have a devastating impact on the quality of life for cancer survivors.

Our discovery that the loss of blood vessel function in the muscles occurs early on during the progression of the cancer suggests that fixing blood vessels in cancer patients and cancer survivors could be a new way to prevent or reverse cachexia.

The reasons for the muscle loss in cancer are complicated and involve poor nutrition due to loss of appetite and inflammation, which are initially caused by the tumor but persist even when the tumor is removed.

What other research is being done

There are currently no treatments approved by the Food and Drug Administration for cachexia, but new therapies are on the horizon.

One such therapy is an antibody drug that targets the molecule GDF-15, a protein that is thought to suppress appetite.

Other studies are using a combination of targeted nutrition and exercise programs to help patients with cancer cachexia regain muscle mass and muscle strength.

All these studies suggest that we will need a combination of approaches to enhance exercise, nutrition, appetite, muscle regeneration and – as we propose – blood vessel health.

What’s next

We are now evaluating drugs and exercise programs that are known to improve blood vessel health. Repurposing these treatments that are traditionally designed for cardiovascular patients could be a rapid way to help cancer patients regain muscle strength.

We hope that our work highlights how important it is for cancer patients to receive comprehensive medical care, which includes improving cardiovascular health and overall quality of life.

The Research Brief is a short take on interesting academic work.

Jalees Rehman receives funding from the National Institutes of Health.

– ref. Muscle weakness in cancer survivors may be caused by treatable weakness in blood vessels – new research – https://theconversation.com/muscle-weakness-in-cancer-survivors-may-be-caused-by-treatable-weakness-in-blood-vessels-new-research-259765

Source: ForeignAffairs4

Source: The Conversation – USA (3) – By Turgay Ayer, Professor of Industrial and Systems Engineering, Georgia Institute of Technology

Imagine walking into your doctor’s office feeling sick – and rather than flipping through pages of your medical history or running tests that take days, your doctor instantly pulls together data from your health records, genetic profile and wearable devices to help decipher what’s wrong.

This kind of rapid diagnosis is one of the big promises of artificial intelligence for use in health care. Proponents of the technology say that over the coming decades, AI has the potential to save hundreds of thousands, even millions of lives.

What’s more, a 2023 study found that if the health care industry significantly increased its use of AI, up to US$360 billion annually could be saved.

But though artificial intelligence has become nearly ubiquitous, from smartphones to chatbots to self-driving cars, its impact on health care so far has been relatively low.

A 2024 American Medical Association survey found that 66% of U.S. physicians had used AI tools in some capacity, up from 38% in 2023. But most of it was for administrative or low-risk support. And although 43% of U.S. health care organizations had added or expanded AI use in 2024, many implementations are still exploratory, particularly when it comes to medical decisions and diagnoses.

I’m a professor and researcher who studies AI and health care analytics. I’ll try to explain why AI’s growth will be gradual, and how technical limitations and ethical concerns stand in the way of AI’s widespread adoption by the medical industry.

Inaccurate diagnoses, racial bias

Artificial intelligence excels at finding patterns in large sets of data. In medicine, these patterns could signal early signs of disease that a human physician might overlook – or indicate the best treatment option, based on how other patients with similar symptoms and backgrounds responded. Ultimately, this will lead to faster, more accurate diagnoses and more personalized care.

AI can also help hospitals run more efficiently by analyzing workflows, predicting staffing needs and scheduling surgeries so that precious resources, such as operating rooms, are used most effectively. By streamlining tasks that take hours of human effort, AI can let health care professionals focus more on direct patient care.

But for all its power, AI can make mistakes. Although these systems are trained on data from real patients, they can struggle when encountering something unusual, or when data doesn’t perfectly match the patient in front of them.

As a result, AI doesn’t always give an accurate diagnosis. This problem is called algorithmic drift – when AI systems perform well in controlled settings but lose accuracy in real-world situations.

Racial and ethnic bias is another issue. If data includes bias because it doesn’t include enough patients of certain racial or ethnic groups, then AI might give inaccurate recommendations for them, leading to misdiagnoses. Some evidence suggests this has already happened.

Data-sharing concerns, unrealistic expectations

Health care systems are labyrinthian in their complexity. The prospect of integrating artificial intelligence into existing workflows is daunting; introducing a new technology like AI disrupts daily routines. Staff will need extra training to use AI tools effectively. Many hospitals, clinics and doctor’s offices simply don’t have the time, personnel, money or will to implement AI.

Also, many cutting-edge AI systems operate as opaque “black boxes.” They churn out recommendations, but even its developers might struggle to fully explain how. This opacity clashes with the needs of medicine, where decisions demand justification.

But developers are often reluctant to disclose their proprietary algorithms or data sources, both to protect intellectual property and because the complexity can be hard to distill. The lack of transparency feeds skepticism among practitioners, which then slows regulatory approval and erodes trust in AI outputs. Many experts argue that transparency is not just an ethical nicety but a practical necessity for adoption in health care settings.

There are also privacy concerns; data sharing could threaten patient confidentiality. To train algorithms or make predictions, medical AI systems often require huge amounts of patient data. If not handled properly, AI could expose sensitive health information, whether through data breaches or unintended use of patient records.

For instance, a clinician using a cloud-based AI assistant to draft a note must ensure no unauthorized party can access that patient’s data. U.S. regulations such as the HIPAA law impose strict rules on health data sharing, which means AI developers need robust safeguards.

Privacy concerns also extend to patients’ trust: If people fear their medical data might be misused by an algorithm, they may be less forthcoming or even refuse AI-guided care.

The grand promise of AI is a formidable barrier in itself. Expectations are tremendous. AI is often portrayed as a magical solution that can diagnose any disease and revolutionize the health care industry overnight. Unrealistic assumptions like that often lead to disappointment. AI may not immediately deliver on its promises.

Finally, developing an AI system that works well involves a lot of trial and error. AI systems must go through rigorous testing to make certain they’re safe and effective. This takes years, and even after a system is approved, adjustments may be needed as it encounters new types of data and real-world situations.

Incremental change

Today, hospitals are rapidly adopting AI scribes that listen during patient visits and automatically draft clinical notes, reducing paperwork and letting physicians spend more time with patients. Surveys show over 20% of physicians now use AI for writing progress notes or discharge summaries. AI is also becoming a quiet force in administrative work. Hospitals deploy AI chatbots to handle appointment scheduling, triage common patient questions and translate languages in real time.

Clinical uses of AI exist but are more limited. At some hospitals, AI is a second eye for radiologists looking for early signs of disease. But physicians are still reluctant to hand decisions over to machines; only about 12% of them currently rely on AI for diagnostic help.

Suffice to say that health care’s transition to AI will be incremental. Emerging technologies need time to mature, and the short-term needs of health care still outweigh long-term gains. In the meantime, AI’s potential to treat millions and save trillions awaits.

Turgay Ayer owns shares in Value Analytics Labs, a healthcare technology company. He received funding from government agencies, including NSF, NIH, and CDC.

– ref. AI in health care could save lives and money − but change won’t happen overnight – https://theconversation.com/ai-in-health-care-could-save-lives-and-money-but-change-wont-happen-overnight-241551