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Transatlantic Blog

National healthcare is driving Christian doctors out of medicine

    Proponents of a national health care system often describe the program as “all-inclusive.” However, a Canadian court ruling and a new U.S. congressional report show that single-payer health care could permanently exclude faithful Christians.

    Health care workers in Canada’s national health service must participate in abortion and physician-assisted suicide because they receive government funding, a Canadian provincial court ruled. Wesley J. Smith highlighted the Canadian case at National Review.

    Physicians argued in court that their constitutional right to conscience is violated by professional guidelines that force them to aid patients seeking to end a human life. The Ontario Court of Appeals described the plaintiffs’ core convictions:

    [T]heir religion is central to their lives. It informs everything they do, including their practice of medicine. They care deeply for their patients and strive to honour their legal and ethical duties to their patients. They also believe in the sanctity of human life.

    Nonetheless, the court ruled that these physicians must make an “effective referral”: They must direct a patient to a “non-objecting, available, and accessible physician,” who will perform the life-ending procedure. One can only imagine the pain this would inflict on a healer with the kind of conscience the appeals court described (much less on the victims).

    Furthermore, the court advised anyone who would not participate in medical actions that take human life to get into another line of work:

    [In] the following areas of medicine … physicians are unlikely to encounter requests for referrals for MAiD or reproductive health concerns, and which may not require specialty retraining or certification: sleep medicine, hair restoration, sport and exercise medicine, hernia repair, skin disorders for general practitioners, obesity medicine, aviation examinations, travel medicine, and practice as a medical officer of health.

    The Canadian legal system essentially told any doctor who will not facilitate abortion or assisted suicide to try working for the Hair Club for Men.

    Indeed, the justices make explicit that these doctors have no right to act in accordance with their deepest-held convictions specifically because Canada has a taxpayer-subsidized national health care system:

    The appellants have no common law, proprietary or constitutional right to practice medicine. As members of a regulated and publicly-funded profession, they are subject to requirements that focus on the public interest, rather than their interests. (Emphasis added.)

    The court stated in the starkest terms that anyone who receives public funding must follow the government's decrees, even if that means committing innumerable mortal sins. “[T]he fiduciary nature of the physician-patient relationship requires” physician compliance, it held.

    The court stated in the starkest terms that anyone who receives public funding must follow the government's decrees, even if that means committing innumerable mortal sins.

    This ruling on the Canadian system (which Canadians call “Medicare”) took on new significance for U.S. readers, as it nearly coincided with a House hearing on the “Medicare for All” proposal, introduced by Senator Bernie Sanders and endorsed by numerous Democratic presidential hopefuls.

    The legislation would require doctors to provide “comprehensive reproductive” care, which includes abortion. It removes any restriction on taxpayer funding and adds that “[i]tems and services to eligible persons shall be furnished by the provider without discrimination.”

    “Medicare for All” has all the contours of a system that could read faithful Christians out of U.S. medical profession. The Congressional Budget Office showed how in a report last month titled “Key Design Components and Considerations for Establishing a Single-Payer Health Care System.”

    The CBO noted a “key decision for a single-payer system is whether it would allow people to opt out … for moral or religious reasons.” Even those who refuse to use services that violate their religion maybe compelled to “contribute” to them “through existing automatic payroll withholdings and taxes,” as in Canada and much of Europe.

    Massive government is a jealous god.

    But doctors may also be compelled to perform them or leave the medical field. “Another key question is whether the single-payer plan would allow participating providers to offer services that the plan covered to private-pay patients and, if so, under what conditions,” it added. It is certainly conceivable the U.S. may follow Canada’s lead in denying the right to practice medicine to someone who refuses to participate in an abortion or physician-assisted suicide.

    The government could complete its control by denying doctors the right to care for “private-pay patients,” the CBO added. “By owning and operating hospitals and employing physicians, the government would have more control over the health care delivery system,” it said, clearly having deliberated deeply on the matter:

    In one scenario, the government could own the hospitals and employ the physicians, as it currently does in most of the VHA system. A greater government role could also include converting for-profit hospitals to nonprofit hospitals or quasi-public providers. In quasi-public organizations, the government or its appointees would oversee or manage daily operations.

    Taken together, the prognosis is clear: “Medicare for All” could create a government takeover of health care, mandate that everyone in the healing profession take part in actions they deem sinful, and then hermetically seal the occupation to systematically exclude conscientious objectors.

    The justification for this intrusion on conscience is public funding. Private enterprise allows people to act - or refuse to act - according to the dictates of their conscience. Government control circumscribes freedom and eventually threatens religious liberty. National health care systems pose a threat to all religions, as reflected by the Canadian case’s diverse coalition of plaintiffs and supporters which spans from the Evangelical Fellowship of Canada to B'nai B'rith.

    Taxpayer-funded health care has grim consequences for conscience. And it drives home a reality all people of faith must remember.

    Massive government is a jealous god. Granting it greater power and authority over economic matters places the actions of our lives, and the end of others', into its hands.


    Rev. Ben Johnson (@therightswriter) is an Eastern Orthodox priest and served as executive editor of the Acton Institute from 2016 to 2021. Previously, he worked for LifeSiteNews and FrontPageMag.com, where he wrote three books, including Party of Defeat (with David Horowitz, 2008). His work has appeared in National Review, the American Spectator, and The Guardian, among other outlets. His personal websites are therightswriter.com and RevBenJohnson.com.