I've enjoyed the rare opportunity to advise both presidential campaigns this election season, and in each instance I have highlighted the link between First Amendment freedoms and patient access to healthcare.
Freedom of faith, conscience and speech in healthcare has come under fire domestically and internationally in recent years, as politicians pander to special interest groups by mandating ideological conformity on issues such as homosexuality and abortion.
Regardless of one's stance on controversial social issues, sound practical considerations and compassion for needy patients should quell cries to coerce health professionals — particularly those professionals motivated by their faith — into ideological conformity.
According to a World Health Organization (WHO) survey of sub-Saharan African countries, between 30 percent and 70 percent of the healthcare institutions in each country are faith-based. Gallup found that people in this region trust faith-based institutions more than any other institutions.
That means that if the U.S. government wants to accomplish virtually any healthcare goal overseas, instead of focusing on bullying and browbeating dissenters into ideological conformity, U.S. officials instead should focus on learning how to understand and work with the faith-based organizations and individuals who have built the network and earned the trust of the people.
Even those who disdain faith, perhaps because religious principles counter their own ideological proclivities, can appreciate the fact that people of faith for centuries have been serving where no one else will serve and serving people whom no one else will serve. Impelled to do so by the principles of their faith, these servant-ambassadors serve anyone and everyone and especially seek out the poor, the vulnerable and the marginalized.
The same faith principles that motivate sacrificial service also impel faith-based health professionals and institutions to serve according to moral and ethical principles. The faith motivation to serve the needy cannot be severed from the faith motivation to serve according to moral and ethical principles. The motivations are one and the same — to glorify God by loving others according to His principles.
This inseparability of motivation explains why 91 percent of faith-based physicians surveyed say they will leave medicine if forced to choose between their careers and their conscience. When a physician is forced to leave, every patient served by that physician loses her doctor. When a faith-based institution is forced to close, in some cases a whole region loses healthcare.
So when government officials contemplate policies to force faith-based health professionals to follow an ideology that the faith community does not embrace, they must consider the punishing impact those policies will have on patients.
Cultural battles need not endanger patients in the crossfire.
In one exceptional instance during the Obama administration, U.S. Agency for International Development (USAID) officials wisely responded to the concerns of faith-based organizations being shut out from AIDS grants that required them to do morally objectionable activities. To keep the valuable networks and trustworthiness provided by faith-based organizations, USAID developed a religious freedom accommodation policy for faith-based grantees.
The result was that more patients were reached for AIDS care than if officials had continued to restrict its grants to only those in complete ideological agreement with the government.
More often however, the Obama administration has insisted that ideology trump both science and faith. The drive for ideological conformity translates into coercion of conscientious objectors while ironically violating supposed goals of toleration and diversity.
Notably, the Obama administration:
gutted the federal conscience regulation protecting health professionals from abortion-related coercion;
denied federal funds to a well-qualified ministry to human trafficking victims because the ministry declined to participate in abortions
attempted (but lost in a unanimous Supreme Court ruling) to restrict the hiring rights of faith-based organizations
tried to force companies like Hobby Lobby and ministries like Little Sisters of the Poor to participate in morally controversial contraceptives
is now trying to force physicians to do sex change operations and hormone therapy for transgender patients, regardless of medical or moral concerns.
Government officials may relish the raw power to dictate that every doctor, every health institution bow to the administration's ideology. But if they continue down this perilous path, pretty soon there won’t be enough doctors and health institutions left to coerce.
Try explaining that to all the patients who lose their access to healthcare because the government refused to accommodate the faith motivations of conscientious objectors.
Accommodating conscience may challenge government officials bent on wielding power and ideological bureaucrats who despise competing faith principles. But without such conscience accommodations to insure true toleration and inclusivity, the resulting loss of patient access to healthcare may prove an uncompromising administration’s undoing.
Presidential aspirants take note.
Jonathan Imbody is the VP for Govt. Relations, Christian Medical Association
The views expressed by contributors are their own and not the views of The Hill.