COVID-19 Pandemic Exposes Great Need for Delivering Care Based on Conscience and Compassion
COMMENTARY: The pandemic has shed a light on over-use of medical technology, resource scarcity and limited access, an epidemic of loneliness, the use of euphemisms like “medical aid in dying,” and a growing inability within our culture to deal with suffering.
Since March 2020, responding to the COVID-19 pandemic has led millions of “ordinary” people to moments, sometimes weeks and months, of heroism. But heroes are not formed in a moment, a week, or a month. They are often formed by the variety of religious traditions that the right to religious freedom defends.
In the modern era, it has also become “ordinary” for medical technology to cure many diseases and eliminate many pains, but the sick still need deeply human responses, not merely technical solutions. We have come to expect ingenious therapies, increasing wealth and well-being, and more effective data analysis and communications. But we also find the over-use of medical technology, resource scarcity and limited access, an epidemic of loneliness, the use of euphemisms like “medical aid in dying,” and a growing inability within our culture to deal with suffering.
COVID-19 has spotlighted these human problems. Throughout much of the pandemic, patients admitted into hospitals were frequently isolated from their families until they were discharged. For many who did not survive, the day they were admitted to the hospital was the last day they saw their loved ones.
While most COVID patients have survived, their hospital experience often inflicted a loneliness they never expected. Countless families have received medical bills they cannot pay. We have debated vaccine mandates in our clinics, board rooms and homes. Doctors have confronted unexpected scarcity and chaos in a culture prone to over-use life support, on the one hand, and to practice physician-assisted suicide on the other.
When the COVID-19 pandemic is fully over, those in the medical profession will still wrestle with these perennial human problems, but in our era’s unprecedented forms.
Decades ago, the U.S. Supreme Court’s decision in Griswold v. Connecticut opened access to contraception for everyone. Roe v Wade’s legacy allows doctors to perform elective abortions. Lower courts today examine issues raised by artificial reproduction, embryo destruction and transgender surgery. Regardless of what anyone thinks about the morality of these issues, they are problems that require deeply human responses, not merely medical remedies and legal interventions. Further complicating matters, economic scarcity will remain challenging in whatever health care system we create, even for those forms of treatment and care on which there is utter consensus.
The American Founders’ doctrine of religious freedom ensured that no single religion would dominate political society and that each community of faith could worship and live according to conscience. Today, we need this doctrine so that those who sincerely hold religious convictions may bring their tradition’s wisdom to deeply human problems in a secularized, technology-rich culture. Like the philosophical traditions informing the consciences of non-religious people, religious traditions preserve wise understanding and action on the most important human concerns.
The rhetoric attacking religious freedom pales in comparison. It leads people to believe that religion teaches self-interest at others’ expense, mean-spiritedness towards any group who thinks differently, and opposition to activities everyone else leaves to personal choice. Many who craft, administer and interpret civil law have begun to view religious freedom as if it were an accommodation from, or exception to, what is normal — that it confers special permission not to perform abortion or transgender surgery or to refuse to dispense contraception or hormone blockers, thereby denying forms of care to which others are entitled.
But this view of religious freedom is wrong. Rather, it is normal for people to wonder if God exists, and if so whether God cares about humanity or is mischievous, distant or impersonal, and to live according to what one discovers in that wonder, not only in the quiet of a church but in the running of a business, medical practice or hospital.
Religious freedom is the right of all people to wonder about God, share with others what they think about this ultimate question, associate into communities and institutions of shared conviction, learn from a young age what their tradition teaches about God, and bring the wisdom of their faith into every sphere of their life and work.
No one needs a law to be passed to do these things. No church, synagogue, mosque or free-thinking association needs legal accommodation to teach these things. No religiously affiliated health care facility needs legal exceptions to practice these things.
Legal exceptions and accommodations look like respect for religious freedom only when government edicts force medical professionals to perform medical procedures against their consciences.
By contrast, just laws protecting religious freedom prevent citizens from coercing each other to act against their religiously informed consciences. The purpose of these laws is not to pretend to show respect for religious people by (temporarily) accommodating their (increasingly outmoded) beliefs. It is really to enable people of every religion, and no religion at all, to marshal the wisdom of their traditions to address the problems of the day.
These difficult problems demand both a reckoning with reality as well as a deeply informed ethical perspective.
For example, when facing difficult decisions in an ICU, medical professionals bring medical knowledge and clinical experience, families bring their understanding and love of the patient and hospital ethics committees can broaden both family and professional perspectives. But each person, regardless of their role, brings whatever wisdom they have acquired, often from their religious tradition. In these difficult cases, there are often a range of possible good solutions, and some that are morally and unequivocally wrong.
That’s reality. All beliefs and ideas are not equal. Whether God exists does not depend on anyone’s beliefs. Sound moral judgments do not depend on how many people assent to them.
If certain actions are wrong — for example, killing a human being in the womb, conducting embryonic stem-cell research, the practice of physician-assisted suicide or medically altering a female body for a masculine appearance or vice versa — then believing otherwise will not change the reality. There will be disagreement, and some are closer than others to the truth about human beings and about God.
But even in the midst of sharp disagreements over such fundamental things, we ought to be able to say collectively that compelling doctors, nurses and other health care professionals to participate against their consciences in these highly contested procedures is profoundly wrong.
Reality is complicated. People of various religions, and no religion, need each other. Some believers hold very inaccurate ideas about who God is, and some atheists very accurate ideas about who God is not. Some believers deeply understand the implications if God does not exist better than some atheists. Similarly, people need each other to handle contentious medical issues involving the dying process and the difficulties of unwanted pregnancies.
It’s tempting for disagreement to breed contempt rather than foster the mutual understanding that religious freedom supports. Progressives dislike condemnations of surrogacy, abortion, euthanasia and transgender surgery, and the refusal to provide or fund them. They judge these practices to be necessary options for every human being and view opposition to them as deleterious to society.
Those opposed, who are often religious, dislike being accused of discrimination. Their consciences, often informed by religious traditions, judge those practices to be always harmful, both to providers and patients, and they oppose them as a means to advance the common good. Their views, thus, are not discriminatory and do not deserve legal attack.
It may seem impossible today to replace political invective with reasoned debate by sound political, philosophical and, yes, even theological thinking. But the American Founders pointed the way — through the Declaration of Independence and the U.S. Constitution, particularly in its First Amendment — by protecting freedom of religion and conscience for all. These fundamental freedoms continue to help medical providers address the challenges of COVID-19 and other medical crises with careful thought, ethical judgment, and above all, human compassion.
Grattan Brown is a Catholic theologian and academic dean of Thales College in Raleigh, North Carolina. The views he expresses are his own and not those of any organization with which he is affiliated.
This is the fifth installment in a series of articles from the Religious Freedom Institute.