Religious-based health care raises questions

Covenants create ethical, moral, legal and social issues, says Catherine Ford.

Health care should be blind to race, religion, ethnicity, wealth and status. Turns out, none of that is true and nowhere is it more obvious than in our hospitals.

Those who work in the system, especially in hospitals run by the Roman Catholic Church, are frequently fiercely dedicated to their God and their job.

It is not them who should be questioned, examined or criticized, but a system that uses public money to run health-care facilities and permits religious principles to override public health.

It is a conundrum centred on the concept of freedom of religion. If all that mattered was whether Alberta should continue to have two publicly funded school systems — a guarantee enshrined by the British North America Act — there could be a long, involved and bloodless conversation that could continue for as long as the participants wanted. But we are not talking about education.

We are talking about health care and, in that conversation, there is always urgency.

Nobody is prepared to have a philosophical conversation while a patient is in need of care. But when that patient requests access to medical care that violates some religious tenet, is it right that he or she either be denied outright or forced to seek an alternative facility?

This problem arose recently with the Supreme Court of Canada’s 2015 ruling and the federal government’s 2016 passage of the bill that permits doctor-assisted death.

Many of us do not stop to think about the religion of our health providers.

But with the advent of physician-assisted dying, and the always-challenging questions of abortion, birth control and tubal ligations, it behooves us to ask why.

Why are some hospitals in Alberta permitted to dispense only those select services mandated by what is referred to as a covenant? (“A covenant,” says the Rocky Mountain Civil Liberties Association, is a contract between an employer and employee that restricts the types of actions which the employee may undertake.)

At least 23 hospitals and clinics in Alberta insist on covenants. Covenant Health is the name of the board that runs those facilities.

As Dr. Ryan Hoskins wrote in Alberta Views last spring: “The Catholic bishops of Alberta lead Covenant Health, a separate board,” within Alberta Health Services. (Not to be ignored is the double layer of administration and oversight such a separate board mandates, all supported with public money.)

Let’s be clear: There is no reason to question the efficacy, commitment or historical fact of health care delivered by religious orders. It was the missionaries who brought health care to Alberta, and for those without means, those who were Indigenous, immigrants who came to settle at the end of the railway line, Catholic missionaries were the only source of medical care.

To this day, that spirit of serving others remains a cornerstone of treatment.

“This is not an argument about the overall quality of health care provided by faithbased institutions,” writes Ailsa M. Watkinson, a professor in the faculty of social work at the Saskatoon campus of the University of Regina, “but rather the recognition that health care is a right to be provided without discrimination and free from the restrictive doctrines of one’s faith.”

The conversation about access to health care in Alberta — particularly in smaller centres, where the only provider is run under religious principles — needs to start.

To that end, the Rocky Mountain Civil Liberties Association, in conjunction with the Alberta Civil Liberties Research Centre, is holding a free public forum in the Bennett Jones Lecture Theatre (Murray Fraser Hall 2370) at the University of Calgary on Jan. 13, from noon to 4 p.m. to launch just such a public consultation.

Three panels will discuss the many questions arising from covenants with ample time for audience participation. The first panel will focus on the social and moral issues, the second will deal with philosophical and ethical issues and covenants in health care, and the third will deal with legal issues and covenants.

A list of the panellists and their expertise is available at rmcla.ca, as is the registration form.