Modelling Christian ethics in the public square
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The ability of a Christian hospital to maintain its Christian ethic is now facing a legal challenge in British Columbia.
Providing medical care is a consistent characteristic of Christian expression throughout Church history. In Medicine and Health Care in Early Christianity (Johns Hopkins, 2009), historian Gary Ferngren concludes that when a church was planted in the Roman Empire, medical care immediately followed.
This led to the establishment of hospitals, originally focused on providing care for the poor since those with wealth could afford to be treated in their homes. Although Greek and Roman culture sometimes saw disease or disability as a sign of divine punishment, within a Christian world view those who were sick were not blamed. Christians provided care as an expression of the love of God displayed in Christ’s incarnation and the belief that everyone bears the image of God and is deserving of care.
The establishment of medical care by Christians is also a defining feature of Canada’s history. Many of our hospitals still bear religious names and some are still guided by their founding Christian mission, though largely relying on government funding.
Over the past decades, as governments have assumed responsibility in providing services, the ability of hospitals to continue to provide Christian-centred care consistent with the founding vision and mission of the facility is being challenged. Sadly, a distinctively Christian ethic is no longer the governing force at many such hospitals, which have become indistinguishable from their secular counterparts.
The establishment of medical care by Christians is also a defining feature of Canada’s history.
The government of B.C. recognizes the distinctive norms and ethos of faith-based care institutions and developed an agreement with a group of them that “preserves the respective religious missions and values of the founding owners and sponsors of their health care facilities in the province.” The Denominational Health Association in B.C. represents 44 facilities of 12 different religious groups including Baptist, Mennonite, Pentecostal, Salvation Army and Roman Catholic.
However, hospitals maintaining a Christian vision are sometimes pressured to compromise their beliefs over which on-site services they provide, such as requests for abortion and now euthanasia.
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Providence Health Care in B.C. is being taken to court by a family and some advocates for euthanasia who have launched a legal challenge against the government policy which allows faith-based facilities to decline to provide euthanasia. They contend the ability of a patient to receive euthanasia on-site should trump the Christian ethic of the facility.
One member of Providence is St. Paul’s. It will transfer the care of a patient requesting MAiD to another facility, thereby protecting the integrity of the facility as well as staff, who also have the freedom to decline participation in the provision of treatment they believe is not consistent with their religious beliefs, and what they believe constitutes good medical care.
Patients, facilities, and their staff are all guided by their respective consciences and beliefs. A truly public system welcomes this provision of health care that reflects the religious diversity of the province and the provision of care animated by religious communities.
When the ethos and practices of faith-based institutions conflict with the beliefs and aspirations of patients, the onus is on the government system which provides health care to find an alternative facility. The burden to accommodate diversity is properly on the system, not the facility.
This significant case is about the religious freedom of Christian hospitals to act with integrity when providing services in a religiously, ideologically and culturally plural society. In a free society it is vital the freedom of conscience and religion of all individuals and communities is affirmed, and the contribution of diverse communities and associations in the provision of health care is respected and welcomed.
To compel on-site compliance threatens the important contribution religious institutions make and, more broadly, challenges the freedom not to comply with practices that conflict with deeply held beliefs. Without a robust commitment to freedom of religion democracies erode, and other freedoms are threatened.
Upholding a Christian-centred facility’s distinctive witness and ethos in serving the public is a significant threshold in a free and democratic society.
Bruce J. Clemenger is senior ambassador and president emeritus of The Evangelical Fellowship of Canada, and author of The New Orthodoxy: Canada’s Emerging Civil Religion (Castle Quay, 2022).