Good afternoon. My name is Tommy Perkins and I am from Pasquotank County. I am here to speak about the Board’s policy of requiring certain members of the North Carolina nursing community to attend meetings of the 12-step programs of Alcoholics Anonymous and Narcotics Anonymous as a condition for keeping their nursing licenses. The 12-step programs are religious programs, and as such, the Constitution of the United States forbids any state agency from coercing any person to attend them. Furthermore, by requiring people to attend meetings of a religious organization, the Board is promoting that religious organization and is thus violating the religious liberty of every taxpayer in the state.

The following is from Justice Blackmun’s concurring opinion in Lee v Weisman:

“JUSTICE BLACKMUN, with whom JUSTICE STEVENS and JUSTICE O'CONNOR join, concurring. Nearly half a century of review and refinement of Establishment Clause jurisprudence has distilled one clear understanding: Government may neither promote nor affiliate itself with any religious doctrine or organization, nor may it obtrude itself in the internal affairs of any religious institution. The application of these principles to the present case mandates the decision reached today by the Court.”

The following is taken from the NC Board of Nursing
web site:

“How the Alternative Program Works… Monitoring of the individual's recovery includes submission of self reports; counselor reports; AA/NA sponsor reports; log of AA/NA meetings attended;”

I will be reading selected quotes from U.S. Supreme Court rulings, federal appeals court rulings, and among other publications an article published in the Duke Law Journal specifically addressing this issue.

First I would like to give you a very brief historical background on this constitutional principle and how it came to be. Perhaps a good place to start is with the words of the late Senator Sam Ervin of North Carolina. Was there ever a finer constitutional scholar than the great Senator Sam?

Senator Ervin began chapter 17, “The Constitution and Religion” of his autobiography, “Preserving the Constitution” with the following words:

“The most heart-rending story of history is that of man’s struggle against civil and ecclesiastical tyranny for the simple right to bow his own knees before his own God in his own way. This is so because the story constitutes plenary proof of the truth of the observation of the French Mathematician and philosopher, Blaise Pascal, who said: ‘Men never do evil so completely and cheerfully as when they do it from religious conviction’”

During the early colonial period many people came to America seeking religious freedom. Many did not find it and the struggle Senator Ervin spoke of was a long and arduous struggle. In 1654 Roger Williams, the grandfather of religious freedom in America, wrote the following. He had already been banned from the colony of Massachusetts for voicing such opinions:

"There goes many a ship to sea, with many hundred souls in one ship, whose weal and woe is common, and is a true picture of a commonwealth, or a human combination or society. It hath fallen out sometimes, that both papists and protestants, Jews and Turks, may be embarked in one ship; upon which supposal I affirm, that all the liberty of conscience, that ever I pleaded for, turns upon these two hinges--that none of the papists, protestants, Jews, or Turks be forced to come to the ship's prayers or worship, if they practice any. I further add, that I never denied, that not- withstanding this liberty, the commander of this ship ought to command the ship's course, yea, and also command that justice, peace and sobriety, be kept and practiced, both among the seamen and all the passengers."

Under the leadership of Mr. Williams the colony of Rhode Island became a model for religious freedom, but such was not the case in the other colonies where the government established religions. The established church in Virginia was the Church of England, and religious oppression and persecution continued throughout the colonial period. From this state would emerge Thomas Jefferson, the father of religious liberty in America. A year after he penned the Declaration of Independence he also penned what would later become the Act for Establishing Religious Freedom.
In it he wrote, “Be it enacted by the General assembly, that no man shall be compelled to frequent or support any religious worship, place, or ministry whatsoever” and also “that to compel a man to furnish contributions of money for the propagation of opinions which he disbelieves, is sinful and tyrannical”, but the act would not become law for almost another ten years when it was pushed through the Virginia General Assembly by his good friend, James Madison. But first there was a war to be won to secure such liberty. While serving as wartime governor of Virginia Jefferson wrote “Notes on the State of Virginia”
and dedicated an entire chapter to religious freedom. Of coercion he wrote:

“Subject opinion to coercion: whom will you make your inquisitors? Fallible men; men governed by bad passions, by private as well as public reasons. And why subject it to coercion? To produce uniformity. But is uniformity of opinion desirable? No more than of face and stature…Is uniformity attainable? Millions of innocent men, women, and children, since the introduction of Christianity, have been burnt, tortured, fined, imprisoned; yet we have not advanced one inch towards uniformity. What has been the effect of coercion? To make one half the world fools, and the other half hypocrites. To support roguery and error all over the earth.”

Now I’ll address the religious nature of the 12-step programs of AA and NA. Six years ago the Duke Law Journal published “Religion and Rehabilitation: The Requisition of God by the State”
by Derek P. Apanovitch. The following is taken from that article:

“To determine whether AA is a religion under the Establishment Clause, courts cannot defer to AA's definition of itself. Instead, courts must examine the nature of the organization in practice. Participation in the AA system entails participation in activity that under Supreme Court precedent must be characterized as religious. Further, an examination of AA literature reveals that its dominant theme reflects elements common to most theistic religions. Thus, despite AA's assertions of secular allegiances and its disavowal of any intent to impose a particular concept of God on participants, courts should conclude that AA is a religion. And several prominent courts have done so, including the United States Courts of Appeals for the Second and Seventh Circuits and the New York Court of Appeals. AA, monotheistic in its creed and dogmatic in its practice, shares those traits which characterize organized religion today.“

Now I’ll quote from the court opinions mentioned in the article which have determined 12-step coercion to be unconstitutional:

From the U.S. Court of Appeals for the Second Circuit’s opinion in Warner v Orange County Department of Probation:

“The County also argues that forcing Warner to attend Alcoholics Anonymous did not violate the First Amendment's Establishment Clause. We disagree. The Supreme Court has repeatedly made clear that "at a minimum, the Constitution guarantees that government may not coerce anyone to support or participate in religion or its exercise, or otherwise act in a way which 'establishes a [state] religion or religious faith, or tends to do so.'" Lee v. Weisman”

“The A.A. program to which Warner was exposed had a substantial religious component. Participants were told to pray to God for help in overcoming their affliction. Meetings opened and closed with group prayer. The trial judge reasonably found that it "placed a heavy emphasis on spirituality and prayer, in both conception and in practice." We have no doubt that the meetings Warner attended were intensely religious events.”

“Group prayer was a common occurrence at the meetings Warner attended. They frequently began with a religious invocation, and always ended with a Christian prayer. The district court found that the program "placed a heavy emphasis on spirituality and prayer, in both conception and in practice."

From the supreme court of the state of New York’s opinion in Griffin v Coughlin:

“A fair reading of the fundamental A.A. doctrinal writings discloses that their dominant theme is unequivocally religious, certainly in the broad definitional sense as ‘manifesting faithful devotion to an acknowledged ultimate reality or deity’ Indeed, the A.A. basic literature most reasonably would be characterized as reflecting the traditional elements common to most theistic religions. Thus, God is named or referred to in five of the 12 steps. ‘Working’ the 12 steps includes confessing to God the 'nature of our wrongs’ (Step 5), appealing to God 'to remove our shortcomings’ (Step 7) and seeking 'through prayer and meditation’ to make 'contact' with God and achieve ‘knowledge of His Will' (Step 11). The 12 Traditions include a profession of belief that "there is one ultimate authority -- a loving God as He may express Himself in our group conscience."

"While A.A. literature declares an openness and tolerance for each participant's personal vision of God ("as we understood Him" [Steps 3 end 11] [emphasis in the original]), the writings demonstrably express an aspiration that each member of the movement will ultimately commit to a belief in the existence of a Supreme Being of independent higher reality then humankind…. As we have demonstrated, these texts are unequivocally religious in theme and proselytizing in content.”

From the supreme court of the state of Tennessee’s opinion in Evans v Tennessee Board of Paroles:

“While the Supreme Court has wrestled with questions of whether a certain policy or practice favors or establishes a religion, there is no debate that a government policy that requires participation in a religious activity violates the Establishment Clause.”

From the U.S. Court of Appeals for the Seventh Circuit’s opinion in Kerr v Farrey:

“C. Qualified Immunity

Kerr's claim for damages against the prison officials leads us directly to the question of qualified immunity, which the prison officials have urged as an alternate ground for affirmance on appeal. Qualified immunity is available to shield government officials who are performing discretionary functions from liability for civil damages "insofar as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known." Harlow v. Fitzgerald, 457 U.S. 800, 817 (1982). Recognizing that the question of the level of generality at which the relevant "legal right" is to be identified is often dispositive, the Supreme Court cautioned against imposing an unrealistic burden on public officials in Anderson v. Creighton, 483 U.S. 635, 639 (1987). The appropriate question is whether reasonable public officials in their position would have understood that what they were doing was unlawful. Id. at 640. Concretely, we must decide whether a reasonable prison official would have known, at the time Kerr was forced to "observe" the NA program, that this requirement violated the Establishment Clause.

Although it has been clear for many years that the state may not coerce people to participate in religious programs, see Barnette (1943), Torcaso (1961), and Engel (1962), the particular application of this principle to prisons has arisen only recently in the courts. See Matter of David Griffin, Warner, and O'Connor, supra. One district court, considering a similar case against officials regarding the operation of an alcohol rehabilitation program at a correctional facility, found that a reasonable official might have concluded that the program satisfied the Lemon test, and thus concluded that qualified immunity was appropriate. Scarpino v. Grosshiem, 852 F. Supp. 798 (S.D. Iowa 1994). The district judge here as well concluded that the program survived scrutiny under Lemon. While we conclude that the facts on the summary judgment record do not support that conclusion, under Anderson we cannot say that a reasonable prison official should have known that her actions were unlawful. We conclude that Farrey and Lind were entitled to qualified immunity on Kerr's damages claims against them and that those claims should be dismissed on remand.”

Now you know.

Not only has the Duke Law Journal published a fifty-plus page article addressing this issue, but an entire book has been written on it. In 2000 attorney Stanton Peele, Archie Brodsky of Harvard Medical School, and author Charles Bufe published “Resisting 12-Step Coercion: How to Fight Forced Participation in AA, NA or 12-Step Treatment”:
The entire book is available online.

One reviewer
from the International Journal of Drug Policy wrote:

“ The book's in-depth examination of the U.S. treatment industry, its history, methods, and current status, as well as a thorough debunking of the research which supposedly supports the treatment paradigm, should open the eyes of many to what is surely an impending disaster.” —Peter Webster, International Journal of Drug Policy

The publisher describes the book as follows:

“This book is a guide for the one million-plus Americans per year who face coerced religious indoctrination in the guise of alcohol or drug treatment. It outlines legal strategies and existing court decisions and shows how useless and sometimes harmful 12-step treatment can be. It also contains a considerable amount of material on the routine violation of standard medical ethics by addiction treatment providers, and examples of such violations.

Stanton Peele is a psychologist, attorney, and distinguished critic of the addiction treatment industry. He is the author of Diseasing of America and coauthor of Love and Addiction and The Truth About Addiction and Recovery. Charles Bufe is the author of Alcoholics Anonymous: Cult or Cure? Archie Brodsky is senior research associate in the Program in Psychiatry and the Law, Harvard Medical School. He is the co-author of Clinical Supervision in Alcohol and Drug Abuse Counseling.”

On Dr. Peele’s web site the authors answer questions about the book. Here are just a few of them:

“Q. What is the key element in AA's approach to alcoholism?

A. It's basically a religious program, and its key element is that individuals are powerless to deal with their drinking problems through their own efforts and that, in order to do so, they must turn their "lives and will over to God."

Q. If it doesn't work very well, why is it so universally employed?

A. The 12-step industry has been receiving rivers of government and insurance industry cash for decades, and 12-step treatment providers have every financial reason to keep things as they are. In addition, a great many people within the treatment industry are 12-step true believers, and they don't care about the scientific evidence that their approach doesn't work very well. Beyond this, 12-step advocates have largely managed to suppress alternative approaches.

Q. What are some of the ways in which people are coerced into 12-step groups and treatment?

A. Today the court system forces people into treatment in lieu of or in addition to criminal penalties, such as for drunk driving. In nearly all states, treatment systems have grown to handle DUIs and a number of other lower-level criminal activities in which a defendant has been drinking or using drugs. Family courts also frequently force people into treatment, for example when one spouse complains that the other drinks too much. Parents are often forced into treatment by state family service agencies to retain custody of a child. Employers also coerce a lot of people into treatment, along with state bar and medical associations. There are other ways, too, but these probably account for the bulk of the coercion.

Q. Is it legal for the government to force people to attend 12-step groups or treatment?

A. No. It's a violation of the First Amendment's "Establishment Clause." Four appeal-level courts (the 2nd and 7th Federal Circuit Courts, and the Tennessee and New York Supreme Courts) have ruled on this, and they have uniformly found that AA and other 12-step treatments are religious in nature and that the state may not force individuals into them without offering non-religious alternatives.

Q. Doesn't AA successfully evade the designation "religious" with statements like "it's spiritual, not religious"; "God as we understand Him"; "whatever `higher power' means to you"; or "take what you want and leave the rest"?

A. The appeals courts have uniformly ruled that AA is religious, and specifically Christian, in nature. Our book traces the very much religious and Christian origins of the group. Beyond that, forcing people to pray, even telling people that they can conceive of God any way they like, is impermissible under the U.S. Constitution. Think about this: no one can force you to attend a Catholic church or Jewish synagogue service just by saying "When they mention God, you can think of whatever you want."”