The importance of protections in Christian healthcare

A reflection from the Christian Medical & Dental Association

March 14, 2023

Until the end of World War II, Christian healthcare professionals faced few threats to their ability to practice their profession according to their sincerely held beliefs. Several reasons contributed to this cultural harmony, the most prominent of which is that most of the population identified nominally with the Christian faith. However, this began changing in the 1950s as peace and prosperity grew in the United States, and then it accelerated significantly in the 1960s with the introduction of the birth control pill and the subsequent sexual revolution. 

The sexual revolution brought an increasing demand for individual sexual autonomy, unmasking those subscribing to a pretended Christianity who voiced increasing petitions for sexual liberty. With advances in healthcare, such as safer anesthesia and wide-spectrum antibiotics, it was inevitable these demands would eventually include access to “safe” abortion. 

The 1973 U.S. Supreme Court Roe v. Wade decision legalizing abortion in all 50 states presented Christian healthcare professionals with a major challenge to their ability to practice medicine according to their sincerely held Christian beliefs. While it took time for some Christian denominations to formalize their opposition to abortion, countless healthcare professionals instinctively knew that destroying preborn life inside the uterus was against God’s law. 

Fortunately, several federal statutes protecting conscientious healthcare professionals from being forced into performing or referring for abortions were initially passed in the mid-70s and have been maintained in the following decades. These statutes included the Church Amendments, the Public Health Service Act or the Coats-Snowe Amendment and the Weldon Amendment. These provisions provided healthcare professionals and healthcare entities protection from being coerced into abortion provision by threatening the withdrawal of federal funding.

This is important, because enforcement of these provisions requires the action of the U.S. Department of Health and Human Services (HHS) to investigate and initiate the withdrawal of federal funds. If HHS is inclined toward promoting abortion, they are less inclined to enforcement of these federal statutes. Just recently, the Biden administration has proposed a new rule that weakens the enforcement mechanisms available for HHS to investigate violations of these protections. 

The new problem posed by chemical abortions

With the approval of mifepristone (trade name mifeprex) by the U.S. Food and Drug Administration (FDA) in September 2000, the era of chemical abortion began in the U.S., adding a new threat to the conscience freedoms of Christian healthcare professionals. The initial prescribing and dispensing of mifepristone were highly regulated. Only certified physicians were able to prescribe the medication after an in-person evaluation of the patient, and they directly dispensed and administered the medications during those visits.

These initial safety precautions have been progressively relaxed over the last 22+ years, so that chemical abortion drugs are now available by virtual appointment and subsequent mail delivery. Recently, the FDA also relaxed its dispensing requirements, allowing certified pharmacies to dispense the potent drugs that cause chemical abortion. 

This exceptionally relaxed prescribing environment for such potent drugs has increased pressure on Christian healthcare professionals to not only prescribe but also dispense this tragic regimen. This increasingly hostile environment created by our secular culture forced Christian Medical & Dental Associations (CMDA) to turn to the courts to protect its members from these increasing threats to their ability to practice medicine according to their God-given conscience. For example, HHS initiated a rule change with profound consequences in 2016 under the Obama administration. They proposed and successfully changed the traditional definition of sex discrimination within what is known as section 1557 of the Affordable Care Act (ACA) to include pregnancy and gender identity. 

CMDA immediately recognized the implications of this radical change, which meant that any member who refused to refer for or perform an abortion could be accused and found guilty of sex discrimination with its consequent penalties. Furthermore, the rule change could also force CMDA members to engage in the prescribing of puberty blockers and/or cross-sex hormones as well as conducting surgeries assisting a patient who desires to change their secondary sexual characteristics. 

This deceptively small but radical change in terminology changed the concept of discrimination from prejudice against a whole person, something CMDA adamantly opposes, to the refusal to engage in certain procedures. CMDA filed suit in federal court against this unjust attack upon the conscience freedoms of conscientious healthcare professionals. It took six years and several court decisions for us to finally achieve victory through the provision of a permanent injunction protecting CMDA’s current and future members against direct HHS action based on Section 1557. 

This protection comes just in time, as HHS recently used the new Section 1557 rule to demand that pharmacists across the country provide certain abortifacient drugs such as the morning-after pill. 

CMDA is thankful that our pharmacist members are now protected from this new HHS “guidance” and won’t have to worry about HHS attempts to enforce this regulation. While this legal protection is limited to current and future CMDA members because of how our legal system works, we mourn the overall increase in threats to the conscience freedoms of all conscientious healthcare professionals who seek to practice according to Hippocratic values. Healthcare is transitioning from being a profession practiced by highly trained, conscientious practitioners into training providers who acquiesce to the autonomous desires of patients without concern for their overall spiritual and emotional health.

While CMDA is extremely thankful for the current protection achieved by this recent court victory, we know it does not protect our members from all attacks against their conscience freedoms. Previous surveys of our membership have revealed that more than 90% are likely or very likely to leave the healthcare profession if they are put into a position of having to perform or refer for a procedure that they morally oppose. So, this is a battle not only for the souls of Christian healthcare professionals but also for the soul of healthcare itself. 

Let us not grow weary in doing good, but let us successfully recruit the next generation to continue to stand in the gap protecting traditional Christian principles in healthcare. Our culture and the dignity of every life deserves nothing less. 

Jeffrey J. Barrows

Jeffrey J. Barrows, DO, MA (Ethics), serves as senior vice president of Bioethics and Public Policy for Christian Medical & Dental Associations. Dr. Barrows is an obstetrician/gynecologist, author, educator, medical ethicist, and speaker. He completed his medical degree at the Des Moines College of Osteopathic Medicine and Surgery in 1978 and … Read More

Article 12: The Future of AI

We affirm that AI will continue to be developed in ways that we cannot currently imagine or understand, including AI that will far surpass many human abilities. God alone has the power to create life, and no future advancements in AI will usurp Him as the Creator of life. The church has a unique role in proclaiming human dignity for all and calling for the humane use of AI in all aspects of society.

We deny that AI will make us more or less human, or that AI will ever obtain a coequal level of worth, dignity, or value to image-bearers. Future advancements in AI will not ultimately fulfill our longings for a perfect world. While we are not able to comprehend or know the future, we do not fear what is to come because we know that God is omniscient and that nothing we create will be able to thwart His redemptive plan for creation or to supplant humanity as His image-bearers.

Genesis 1; Isaiah 42:8; Romans 1:20-21; 5:2; Ephesians 1:4-6; 2 Timothy 1:7-9; Revelation 5:9-10

Article 11: Public Policy

We affirm that the fundamental purposes of government are to protect human beings from harm, punish those who do evil, uphold civil liberties, and to commend those who do good. The public has a role in shaping and crafting policies concerning the use of AI in society, and these decisions should not be left to those who develop these technologies or to governments to set norms.

We deny that AI should be used by governments, corporations, or any entity to infringe upon God-given human rights. AI, even in a highly advanced state, should never be delegated the governing authority that has been granted by an all-sovereign God to human beings alone. 

Romans 13:1-7; Acts 10:35; 1 Peter 2:13-14

Article 10: War

We affirm that the use of AI in warfare should be governed by love of neighbor and the principles of just war. The use of AI may mitigate the loss of human life, provide greater protection of non-combatants, and inform better policymaking. Any lethal action conducted or substantially enabled by AI must employ 5 human oversight or review. All defense-related AI applications, such as underlying data and decision-making processes, must be subject to continual review by legitimate authorities. When these systems are deployed, human agents bear full moral responsibility for any actions taken by the system.

We deny that human agency or moral culpability in war can be delegated to AI. No nation or group has the right to use AI to carry out genocide, terrorism, torture, or other war crimes.

Genesis 4:10; Isaiah 1:16-17; Psalm 37:28; Matthew 5:44; 22:37-39; Romans 13:4

Article 9: Security

We affirm that AI has legitimate applications in policing, intelligence, surveillance, investigation, and other uses supporting the government’s responsibility to respect human rights, to protect and preserve human life, and to pursue justice in a flourishing society.

We deny that AI should be employed for safety and security applications in ways that seek to dehumanize, depersonalize, or harm our fellow human beings. We condemn the use of AI to suppress free expression or other basic human rights granted by God to all human beings.

Romans 13:1-7; 1 Peter 2:13-14

Article 8: Data & Privacy

We affirm that privacy and personal property are intertwined individual rights and choices that should not be violated by governments, corporations, nation-states, and other groups, even in the pursuit of the common good. While God knows all things, it is neither wise nor obligatory to have every detail of one’s life open to society.

We deny the manipulative and coercive uses of data and AI in ways that are inconsistent with the love of God and love of neighbor. Data collection practices should conform to ethical guidelines that uphold the dignity of all people. We further deny that consent, even informed consent, although requisite, is the only necessary ethical standard for the collection, manipulation, or exploitation of personal data—individually or in the aggregate. AI should not be employed in ways that distort truth through the use of generative applications. Data should not be mishandled, misused, or abused for sinful purposes to reinforce bias, strengthen the powerful, or demean the weak.

Exodus 20:15, Psalm 147:5; Isaiah 40:13-14; Matthew 10:16 Galatians 6:2; Hebrews 4:12-13; 1 John 1:7 

Article 7: Work

We affirm that work is part of God’s plan for human beings participating in the cultivation and stewardship of creation. The divine pattern is one of labor and rest in healthy proportion to each other. Our view of work should not be confined to commercial activity; it must also include the many ways that human beings serve each other through their efforts. AI can be used in ways that aid our work or allow us to make fuller use of our gifts. The church has a Spirit-empowered responsibility to help care for those who lose jobs and to encourage individuals, communities, employers, and governments to find ways to invest in the development of human beings and continue making vocational contributions to our lives together.

We deny that human worth and dignity is reducible to an individual’s economic contributions to society alone. Humanity should not use AI and other technological innovations as a reason to move toward lives of pure leisure even if greater social wealth creates such possibilities.

Genesis 1:27; 2:5; 2:15; Isaiah 65:21-24; Romans 12:6-8; Ephesians 4:11-16

Article 6: Sexuality

We affirm the goodness of God’s design for human sexuality which prescribes the sexual union to be an exclusive relationship between a man and a woman in the lifelong covenant of marriage.

We deny that the pursuit of sexual pleasure is a justification for the development or use of AI, and we condemn the objectification of humans that results from employing AI for sexual purposes. AI should not intrude upon or substitute for the biblical expression of sexuality between a husband and wife according to God’s design for human marriage.

Genesis 1:26-29; 2:18-25; Matthew 5:27-30; 1 Thess 4:3-4

Article 5: Bias

We affirm that, as a tool created by humans, AI will be inherently subject to bias and that these biases must be accounted for, minimized, or removed through continual human oversight and discretion. AI should be designed and used in such ways that treat all human beings as having equal worth and dignity. AI should be utilized as a tool to identify and eliminate bias inherent in human decision-making.

We deny that AI should be designed or used in ways that violate the fundamental principle of human dignity for all people. Neither should AI be used in ways that reinforce or further any ideology or agenda, seeking to subjugate human autonomy under the power of the state.

Micah 6:8; John 13:34; Galatians 3:28-29; 5:13-14; Philippians 2:3-4; Romans 12:10

Article 4: Medicine

We affirm that AI-related advances in medical technologies are expressions of God’s common grace through and for people created in His image and that these advances will increase our capacity to provide enhanced medical diagnostics and therapeutic interventions as we seek to care for all people. These advances should be guided by basic principles of medical ethics, including beneficence, non-maleficence, autonomy, and justice, which are all consistent with the biblical principle of loving our neighbor.

We deny that death and disease—effects of the Fall—can ultimately be eradicated apart from Jesus Christ. Utilitarian applications regarding healthcare distribution should not override the dignity of human life. Fur- 3 thermore, we reject the materialist and consequentialist worldview that understands medical applications of AI as a means of improving, changing, or completing human beings.

Matthew 5:45; John 11:25-26; 1 Corinthians 15:55-57; Galatians 6:2; Philippians 2:4

Article 3: Relationship of AI & Humanity

We affirm the use of AI to inform and aid human reasoning and moral decision-making because it is a tool that excels at processing data and making determinations, which often mimics or exceeds human ability. While AI excels in data-based computation, technology is incapable of possessing the capacity for moral agency or responsibility.

We deny that humans can or should cede our moral accountability or responsibilities to any form of AI that will ever be created. Only humanity will be judged by God on the basis of our actions and that of the tools we create. While technology can be created with a moral use in view, it is not a moral agent. Humans alone bear the responsibility for moral decision making.

Romans 2:6-8; Galatians 5:19-21; 2 Peter 1:5-8; 1 John 2:1

Article 2: AI as Technology

We affirm that the development of AI is a demonstration of the unique creative abilities of human beings. When AI is employed in accordance with God’s moral will, it is an example of man’s obedience to the divine command to steward creation and to honor Him. We believe in innovation for the glory of God, the sake of human flourishing, and the love of neighbor. While we acknowledge the reality of the Fall and its consequences on human nature and human innovation, technology can be used in society to uphold human dignity. As a part of our God-given creative nature, human beings should develop and harness technology in ways that lead to greater flourishing and the alleviation of human suffering.

We deny that the use of AI is morally neutral. It is not worthy of man’s hope, worship, or love. Since the Lord Jesus alone can atone for sin and reconcile humanity to its Creator, technology such as AI cannot fulfill humanity’s ultimate needs. We further deny the goodness and benefit of any application of AI that devalues or degrades the dignity and worth of another human being. 

Genesis 2:25; Exodus 20:3; 31:1-11; Proverbs 16:4; Matthew 22:37-40; Romans 3:23

Article 1: Image of God

We affirm that God created each human being in His image with intrinsic and equal worth, dignity, and moral agency, distinct from all creation, and that humanity’s creativity is intended to reflect God’s creative pattern.

We deny that any part of creation, including any form of technology, should ever be used to usurp or subvert the dominion and stewardship which has been entrusted solely to humanity by God; nor should technology be assigned a level of human identity, worth, dignity, or moral agency.

Genesis 1:26-28; 5:1-2; Isaiah 43:6-7; Jeremiah 1:5; John 13:34; Colossians 1:16; 3:10; Ephesians 4:24