A few years ago, I helped write a book, How to Be a Christian in a Brave New World, about the bioethical challenges in the 21st century. Today, one of our foremost ethical challenges is how to accomplish health care reform in a way that respects most Americans' traditional religious values.

As a quadriplegic for the past 43 years, I have had more than my fair share of doctors' visits and medical treatments. I know the difference between good care and bad care, and I can tell when a physician has my best interests at heart. I am thankful that, for the most part, my doctors have always treated me as the individual I am rather than just another patient in a wheelchair.

For these reasons—my faith and my experience with medical care—I am very concerned about two specific items that currently exist in proposed health care legislation:
—Federal funding of abortions
—Rationing of care.

Proposals in the current House and Senate health care bills would set up a health insurance marketplace to benefit small businesses and people buying coverage on their own, with the promise of some subsidies to keep premiums affordable. The difference, however, is that the House bill would prohibit government-subsidized health plans from covering abortions, and the Senate bill would not.

Anyone watching the drama unfold in Washington this week knows that House Speaker Nancy Pelosi is trying to round up the votes to pass the Senate version of the bill through the House.

The House-approved version would prevent the American people from being forced to pay for abortions, and it closely follows existing law (the so-called Hyde Amendment) that prohibits most federal funding of abortions.

Another major concern I have is the $11 billion that President Obama has earmarked for community health centers to serve low-income people and the uninsured. Providing access to medical care for the poor is a good thing. However, as the bills are currently written, those funds are not covered by the Hyde Amendment.

Why is this issue of abortion important to me? Given my experience with quadriplegia and other forms of disability, I have a special concern to protect and value life in every aspect. I know of countless individuals who have been injured far more gravely than I was when I took that fateful dive back in 1967. For those whose disabilities keep them bedridden or unable to communicate, is their life of any less value than mine? I should say not!

The infant who is developing inside its mother's womb, and who at just a few weeks' gestation already has more mobility than I do, is a human life and a real person, and therefore we must give our all to protect that life.

On the question of rationing care, I understand that all health care systems ration care to some extent, but the real question is whether health care decisions are made by the government using ethical criteria, or by insurance plans where limitations would be based on ability to pay. If decisions are made by government-created Comparative Effectiveness Research boards, decisions on who gets treatment (and who doesn't) could mean life or death for many, especially the elderly and those with disabilities.

The proposed Comparative Effectiveness Research program could put the government in the position of determining how to implement the boards' decisions, and such boards could review quality of care based on providing for those who will benefit most. Unfortunately, this could leave those who require specialized, long-term care—people like me—way down on the list of priorities.

These issues recently led me to join other Christians in signing the Manhattan Declaration, which supports the sanctity of life and the rights of conscience and religious freedom. "Although the protection of the weak and vulnerable is the first obligation of government," the document says, "the power of government is today often enlisted in the cause of promoting what Pope John Paul II called `the culture of death."'

Let me be clear: there are some positive aspects about health care reform, such as prohibiting insurance companies' discrimination against pre-existing conditions, and revamping the Medicaid program to offer community-based alternatives to institutionalization.

But there are concerns—not just for disabled people like me, but for all who care about and uphold the value of human life. Health care reform cannot, and must not, be allowed to negatively affect the least among us.

Joni Eareckson Tada is an author, disability advocate and the founder of Joni and Friends International Disability Center. Injured in a diving accident in 1967, she is one of the longest living quadriplegics on record.