WASHINGTON — Christian physicians in the U.S. military are concerned that Congress may soon vote to require them and their colleagues to participate in elective abortions at U.S. military bases domestically and overseas.

The highly controversial provision is included in the annual bill that directs spending for the Department of Defense.

The bill, which was rejected by all 41 Republican senators in September due to concerns over the military abortion provision and other controversial items it included, will be brought up for another vote after the midterm elections.

So Christian physicians and their pro-life allies are gearing up for another fight.

Dr. David Stevens, CEO of the Christian Medical and Dental Associations, a group of 17,000 clinicians, launched a renewed outreach and educational effort toward senators in late September after Democratic leaders revealed they planned another vote on the defense bill during the so-called lame-duck session following the Nov. 2 election. Among their chief concerns is the fact that the abortion provision, which would roll back a 1996 law that banned the use of military facilities and personnel for elective abortions, is that it lacks conscience protections for physicians who morally object to abortion.

“In the military, when you get an order, you follow it,” Stevens said. “It’s very difficult to opt out of the abortion process in a military setting.”

More than 250 active-duty physician members of the Christian Medical and Dental Associations wrote to senators in August stating that the elective-abortion provision would endanger their ability to follow both their Hippocratic Oath and Judeo-Christian ethics.

“It’s just a situation they shouldn’t have to be placed in,” said Mary Harned, counsel at Americans United for Life. “These are clinicians and facilities that are intended to save the lives of members of the military, not perform abortions.”

Although the military does offer conscience protections for military doctors, the possibility of politically driven repercussions for those who refused was raised the last time the issue came up under a president who supported abortion.

In 1993, President Bill Clinton required the military to offer elective abortions in all of its facilities and thousands of military physicians signed a petition stating that they would not participate in those “procedures.”

Some pro-abortion Democratic leaders in Congress viewed this as insubordination and were considering action when the 1994 elections swept Republicans into control of Congress, recalled pro-life advocates.

Supporters of the measure counter that the existing conscience protections in the military code offer sufficient protection for military clinicians who do not want to participate in abortions. For them, the primary issue is one of access.

“Women in the military should have access to the same quality care available to women in our country,” said Nancy Keenan, president of NARAL Pro-Choice America, in a written statement. “Signing up to serve in the armed forces shouldn’t cause women to lose health-care options if they’re stationed overseas.”

Election Impact Possible

The next Senate vote on the measure is expected to be a party-line vote — just as the first vote was — unless the majority leader, Sen. Harry Reid, D-Nev., accedes to Republican requests to drop the abortion language and other controversial provisions.

The outcome of that vote also could be affected by close Senate races in Delaware, Illinois and Colorado, where the winner will be seated immediately after the election, instead of the following January. All of those seats are held by Democrats, and any Republican wins would expand their one-vote margin to maintain a filibuster majority.

Filibustering the entire bill is the best hope to block the abortion provision, according to pro-life advocates, because a pro-abortion majority in the Senate is expected to block any votes to remove the abortion language.

The critical nature of such votes on the overall bill led Americans United for Life to base its annual score on a member of Congress’ pro-life record, in part, on that vote. Sen. Robert Casey Jr. of Pennsylvania, who is Catholic and considered the leading pro-life Democrat in the upper chamber, fell short on that pro-life score by joining all Democrats in voting to advance the defense bill.

“Senator Casey opposes the military-facilities provision,” noted Larry Smar, communications director for Casey. “As a pro-life senator, he does not believe that elective abortions should be performed on military bases that are entirely taxpayer-funded.”

Smar would not say whether Casey would support it if the abortion language remained. National Right to Life gives Casey a 42% pro-life score on its website.

Meanwhile, pro-life advocates both inside and outside the Senate are pushing for Reid to drop the abortion language before bringing the measure back after the election.

“The pro-life position is to not approve the bill until the abortion provision is taken out,” said Douglas Johnson, legislative director at the National Right to Life Committee. “If [Casey] would say to Reid that he was withholding his support until this provision was taken out, then that would make a big difference.”

As a stopgap, pro-life advocates are holding out hope that any bill that passed the Senate containing the abortion mandate would be changed when melded with the House-passed version, which does not contain any such language. Any meeting to combine the two defense bills would be led by Rep. Ike Skelton, D-Mo., chairman of the Armed Services Committee, whose spokeswoman described him as “very pro-life.” National Right to Life gives Skelton a 66% pro-life rating.

Rich Daly writes from Washington.