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.