Rendering Treatment, Refusing Transformation (and Destruction): Preserving Medical Conscience Rights

The basic creed of the medical community is “Do no harm!” Today, this foundational principle, derived from the ancient Hippocratic oath, is under assault. Radical voices not only demand extreme individual autonomy in matters of life, death, and mutilation of healthy bodies, but also insist that medical professionals be willing to participate in these procedures without exception.

The Biden administration is leading the charge against faith-inspired doctors, nurses, and medical institutions. Its approach is to use the anti-discrimination provisions of the Affordable Care Act (ACA, also known as Obamacare) to redefine biological “sex” to encompass the full range of LGBTQI+ categories. Legislation like the Equality Act would twist the principles of anti-discrimination even further to require the federal funding of abortion.

Doctors, nurses, and other health professionals have an obligation to preserve and protect human life. For many, this obligation aligns with their religiously informed vocations to serve God and fellow human beings through the healing arts. Especially during the COVID-19 pandemic, we have witnessed the courageous, compassionate service of medical professionals.

But religious individuals and religious organizations may lose the opportunity to serve entirely if they refuse to participate in the controversial procedures to which they conscientiously object. Not only does this destroy the foundation of service that supports our healthcare system, it degrades the religious and moral protections necessary for the functioning of society. This bludgeoning of faith and conscience happens at the hands of employers, professional associations, universities, and state and local governments.

There are three major medical conscience areas where people of faith will face increasing pressure to violate their principles in the years to come: matters of life (and death), gender transition treatments and therapies, and emerging issues associated with the willful transformation of the human body (“transhumanism”).

The Beginning and End of Life

The past decade has seen an alarming trend: the use of intimidation and coercion to compel participation in procedures that voluntarily end life. The Washington Post recently reported that the new Biden-era approach is to target medical providers, healthcare organizations, and insurance plans offered under the ACA exchange.

Consider the recent case of a nurse in Vermont who was deliberately misled to assist with an elective abortion, even though she had placed her name on an objector list. She faced potential disciplinary action if she refused to participate. In another case, a university required nurses applying to a residency program to sign a form agreeing to assist in abortion procedures. Such coercion is immoral and inconsistent with the principles of the American constitutional order.

The United States must fight against the rising tide of euthanasia worldwide. Physician-assisted suicide laws in Belgium, New Zealand, Canada, the Netherlands, and now in Oregon, make elective death an on-demand service. These laws not only authorize the self-solicited destruction of a few individuals. They may also force doctors and nurses to enable the suicide of a child, or, at the behest of family members, the demise of aging relatives whom they find “inconvenient.” Indeed, such scenarios are possible even in jurisdictions with alleged “conscience provisions,” where those who object to participating are often still required to be complicit in the process by referring patients to providers who will carry out the objectionable procedure.

Pope Francis has repeatedly decried a “throwaway culture” that sees human beings as disposable, “readily sacrificed for the sake of others considered worthy of a carefree existence.” This is especially true for those who are “poor and disabled, not yet useful—like the unborn, or no longer needed—like the elderly.” Some human beings are considered unworthy of life, such as disabled children in the womb. Iceland’s chilling 2017 announcement that it had “eliminated Down syndrome,” should make us pause: 100 percent of Iceland’s women who receive a positive prenatal test for Down syndrome terminate their pregnancies. In China, dissenters and minorities are useful for their parts, as China’s state-sponsored organ harvesting industry demonstrates.

We should unreservedly stand against unjust and inhumane laws and policies; but when they are enacted, we must protect medical professionals—those who have a moral and religious conviction on these matters—from being forced to violate their convictions. Consider, for example, efforts by New York and other states to block a federal rule that would allow OB-GYNs like Regina Frost to continue their medical practice without performing procedures, such as abortion, that their consciences forbid.

Gender Dysphoria

A second challenge to medical conscience comes from medical procedures related to gender transitioning, such as hormone treatments, gender reassignment surgery, or “transition” counseling. Many medical and mental health professionals, whether religious or not, cannot condone radical changes that impair healthy human body parts. For people of faith, a commitment to honoring God’s design for the body and God’s purpose in creating and distinguishing male and female makes it impossible to sanction such procedures. Moreover, integrity and compassion demand careful attention to the scientific data, which document a host of mental health problems and high suicide rates for those who undergo such procedures.

What is particularly insidious is the bullying of religious medical and mental health providers. The message is clear: support transgender ideology or get out of the profession. This reveals the radical nature of the transgender medical agenda. It is not enough for some practitioners to support such policies and procedures. No: all must either offer their support or leave the profession. Americans must stand up for the religiously informed conscience rights of health professionals so they can make the best decisions for patients, consonant with their religious convictions.

The so-called Equality Act, recently passed by the U.S. House of Representatives, illuminates how federal law is being manipulated to crush religious liberty and the conscience rights of medical professionals. The law would expand federal civil rights law from the traditional understanding of “sex” as male or female to “sexual orientation and gender identity.” In practice, this means that parents may not be able to halt gender transformation procedures performed on their own children. A helpful overview of actual cases targeting parents, educators, and medical professionals can be found here. And, as the Alliance Defending Freedom has argued, the Equality Act deliberately strips religious exemptions from non-discrimination law, thus effectively nullifying the Religious Freedom Restoration Act. It puts at risk every doctor or nurse who does not want to participate in gender transition therapies or abortions.

Moreover, experts at the U.S. Conference of Catholic Bishops observe that the Equality Act’s definition of “sex” includes “pregnancy, childbirth, or a related medical condition.” Procedures for these “related medical conditions” “shall not receive less favorable treatment than other physical conditions.” Experts say this could undercut current restrictions on federal funding for abortions as well as conscience protections that would protect doctors and nurses from participating in abortions. The Equality Act explicitly states that the Religious Freedom Restoration Act (RFRA), which protects the free exercise of religion including in conscience cases, cannot override its policies.

Transhumanism

The third area of medical controversy will increasingly be the radical augmentation and transformation of the human body and its systems. This is sometimes associated with the philosophy of transhumanism or posthumanism.

There is a difference between restoration and transformation of the body. Restoration is the principle of healing and recovery, and it may include procedures such as organ transplant or prostheses following illness or injury. The transhuman imperative, in contrast, is the conceit to advance humanity—to forcefully evolve the human race—through technology. This is not the ethical development of technology that improves the human condition; it is a departure that disregards the fundamental nature of a human being. Although such technology is commonly condemned for its historical association with eugenics, or caricatured as merely the stuff of science fiction, medically induced human transfiguration has arrived.

We are seeing a move beyond cosmetics and restoration to revolutionary, unethical changes wrought in the lab. When it comes to genetic research, revolutionary technologies have already started down the slippery slope: in 2019, a Chinese scientist announced he had used CRISPR to edit the genes of twin girls with the intention of reducing the risk of AIDS. The procedure, however, opened the girls up to an unknown number of future health risks. Elsewhere in China, researchers have merged human and animal DNA to form “chimeras,” ostensibly with the purpose of growing organs. We will see many more individuals and organizations attempt to “improve” themselves or others through “radical technological modifications to our brains and bodies,” surgical implantation of computer chips, genetic “upgrades,” or age-delaying tactics such as cryogenics, artificial intelligence, and repeated organ replacement.

The methods of developing these technologies are no more ethical than their goal. Scientists employed by government-owned labs, perhaps working behind the walls of classified security, should not face pressure to conform with objectionable experimentation. Doctors and scientists must be able to avoid participation lest it violate their faith.

Religion and Conscience in the Public Square

Religious people must be able to criticize the transformationist agenda in the public square. We live in a highly religious world, and America’s roots are in the Judeo-Christian tradition. Our society has also been enriched by religious diasporas from around the globe, bringing people who seek religious and other freedoms to our shores. It is wrong to force religious individuals who are highly skilled medical and mental health professionals to violate their core religious convictions by compelling them to support and participate in terminating life, or in elective therapies that seek fundamentally to alter the human person, whether to achieve transgender ends or transhumanist ones. Forcing religious institutions to violate the tenets of their faith in the treatments and procedures performed on their premises is similarly repugnant.

Religious professionals are not seeking an exemption just for themselves. Protecting the religiously informed conscience rights of medical professionals is a bulwark for protecting the conscience rights of all medical professionals, such as the agnostic doctor who argues that data suggest many dangers associated with gender reassignment surgery. Moreover, protecting conscience rights spans professions. Religiously informed beliefs are not just under assault in hospitals and clinics. Businesspeople, teachers, lawyers, and others have moral convictions rooted in the traditions and sacred scriptures of their religions. These convictions, and the individuals and institutions holding to them, should not be trampled by new orthodoxies of death, gender reassignment, or medically induced transformation.