Hospitals’ Case for Conscience Protection

COMMENTARY: Should medical professionals be required to perform procedures that they disagree with, ethically, morally or due to religious reasons?

Conscience protections are key for Catholic health care and patient welfare.
Conscience protections are key for Catholic health care and patient welfare. (photo: Shutterstock)
“First, do no harm.” — from the Hippocratic Oath

When we hear these words, most of us think of doctors and their moral obligation as medical professionals to provide care. However, these words are also important because of their effect on patients, the actual object of medical care. The very reason doctors have been historically prohibited from doing harm is to protect the well-being of their patients. Therefore, when we think about medical care and how doctors practice medicine, we must remember to prioritize the good of patients. We prioritize their good by ensuring that medical professionals can follow the foundational principle of doing no harm.

Today, there is a battle raging over whether doctors and other medical professionals should have conscience rights and be able to follow this principle. That is, should medical professionals be able to provide care in accord with what they believe is the authentic good of their patients? Or should they be required to perform procedures that they disagree with, ethically, morally or due to religious reasons? 

In other words, should medical professionals be forced to violate their moral obligation to do no harm, as they understand it, and possibly their religious convictions, and be coerced into potentially harming their patients, physically and spiritually? 

This question is becoming ever more important, for two reasons. First, there is growing disagreement regarding what types of procedures qualify as health care. Catholics, for example, do not believe that abortion, contraception or euthanasia are health care, but others do. Second, the federal government is taking an even more active role in health care. In doing so, the government is creating requirements that medical professionals and hospitals must follow, and these requirements often reinforce procedures that Catholics cannot condone, much less perform. 

Many Catholic and other faith-based hospitals either receive government funding or have affiliations with government-run health-care systems. These relationships often increase health-care access for local populations and ensure the financial stability of the hospitals, thereby helping patients receive the best possible care. However, the requirements attached to government funding may include performance of unethical procedures. These requirements may unjustly pressure faith-based hospitals, while, for small faith-based clinics, that funding may be necessary just to exist. 

If hospitals or medical professionals try to maintain their religious mission and identity and receive this funding, they may become vulnerable to litigation. Two lawsuits in Maryland and California exemplify this point, as both involve Catholic hospitals being sued for refusing to remove healthy uteri from individuals experiencing gender dysphoria. 

Catholic and other faith-based hospitals and professionals face an unwinnable dilemma: Either cease receiving government funds to avoid legal conditions that require them to betray their faith, thereby imperiling their capacity to serve those in need, or face legal repercussions for remaining faithful to their religious mission, which could drive them out of existence. Regardless, patients will suffer because they will lose their ability to receive care from these hospitals and professionals. 

Funding-related issues are not the only threats to the rights of conscience, religious liberty and health-care access.  Another is the much-discussed Equality Act, which passed the House of Representatives in late February. The Equality Act would make it a civil-rights violation for Catholic or other faith-based hospitals or medical professionals to refuse to be involved in “gender-reassignment procedures,” and likely abortions, as well. The legislation also explicitly repeals the Religious Freedom Restoration Act in cases involving Equality Act claims. Other proposed legislation, like Medicare for All, includes mandated abortion and contraception with no exceptions. Catholic doctors, nurses and medical institutions would struggle to exist in the United States under such legislation. 

Beyond federal legislation, some states and secular health systems are considering cutting ties with Catholic hospitals. There has been a push in recent years within the University of California to sever its ties with Catholic hospitals due to their Catholicity. Despite the university maintaining those ties (or perhaps because of it,) a bill was introduced into the California Senate that would outright prohibit the university from contracting with Catholic hospitals. 

These developments further endanger the civil right of medical conscience and Catholic health care and will limit access to care and put patient welfare at risk. The loss of access would not only affect Catholic patients looking to receive care in line with their beliefs, but non-Catholic patients, as well. 

Catholic hospital systems, in the aggregate, are the largest nongovernmental health-care providers in the country. About one in seven hospital beds in our country are in Catholic hospitals, and in many Midwestern states, Catholic hospitals make up 30%-40% of available hospitals. Closing Catholic hospitals would be disastrous and should be unthinkable, particularly considering the events of the past year.

These disastrous outcomes for patients are all tied to the current lack of conscience protection for medical professionals and health-care institutions. The irrational push to enact policies that would destroy Catholic and other faith-based health care will harm millions of patients by greatly limiting their ability to receive care. State and national health-care policies should firmly respect and promote the conscience rights of doctors, nurses, other medical professionals and health-care institutions, not only to protect the professionals themselves, but also the public they serve.

Millions of vulnerable patients in the months and years ahead will need faith-based hospitals and medical professionals to provide them with care. To undermine the conscience rights of doctors, nurses and other medical professionals would undermine their vital contributions to the common good and would, in direct contradiction to the purpose of medicine, unnecessarily exact great harm on patients in need of care. 


Jordan Buzza serves as the director of CMF CURO for the Christ Medicus Foundation.

This is the sixth article in a series from the Religious Freedom Institute. Previous parts from the series can be found below and also here, here, here, here and here.