By Nathan Berkeley

Health reporter, Rachana Pradhan, wrote an important piece in The Washington Post this week on “Why hospitals in many states with legal abortion may refuse to perform them.” In it, RFI Interim President David Trimble spoke to why medical conscience rights matter and provided a vital counter-balance to voices that wrongly frame the religious freedom of healthcare providers as pitted against the well-being of patients.

Pradhan writes about the nature and limits of medical conscience rights, and how they apply to institutions like religious hospitals. She begins by observing that “State laws often protect hospitals that refuse to perform abortions — even where it’s legal.” Of course, in states where abortion is highly restricted, hospitals that refuse to allow it on their premises are not in much need of conscience protections since their policy substantially aligns with the law. It is precisely in those states where abortion has little restriction that medical conscience rights become so critical, and contested. Pradhan turns to states like California, Michigan, and Pennsylvania where the abortion license is expansive, and notes that these states also have “little-noticed laws on the books protecting hospitals that refuse to provide [abortion].” 

Characterizing medical conscience protections with some unease, Pradhan writes:

The laws shield at least some hospitals from liability for not providing care they object to on religious grounds, leaving little recourse for patients. The providers — many of them Catholic hospitals — generally refuse to perform abortions and sterilizations because the services run contrary to their religious beliefs, but their objections can extend to other kinds of care.

These state conscience laws, Pradhan continues, “carry significant consequences for patients.” To elaborate the point, she turns to Elizabeth Sepper, a legal expert who focuses on religious liberty and health law. “It’s one thing to say that a health-care provider can refrain from providing certain care because of their sincerely held religious beliefs. It’s another thing altogether to say because you have these beliefs you can harm people and face no repercussions for it,” said Sepper, a law professor at the University of Texas at Austin.

A brief response to Sepper is in order. The harm to which she refers is unclear. Does she mean the harm of medical conscience protections that result in the denial of emergency medical care to patients? If yes, as RFI’s David Trimble explains later in the article, the newer medical conscience laws that have passed in recent years in Arkansas, Florida, Montana, Ohio, and South Carolina do not permit such emergency denials. 

Perhaps, however, she means the refusal to perform abortion is itself a form of harm to women being denied it. But this meaning of harm ignores the harm of abortion itself — to the unborn child, the mother, and possibly others.

Whatever one’s view of abortion, there’s yet another problem. Sepper might also be suggesting that a state’s abortion license carries within it a corresponding right to demand the fulfillment of that license at a particular hospital. No such corresponding right exists. In other words, the state’s stamp of approval on a given activity does not empower a person to coerce a non-state institution to participate in that activity. 

To conclude the article, Pradhan quotes Trimble on why medical conscience rights are so vital in America today — to religious practitioners, faith-based clinics and hospitals, and the healthcare system as a whole: 

‘Faith is meant to be lived out, and it’s meant to be lived out in the professions in which these individuals work,’ said Trimble, [whose organization] launched an effort in 2020 alongside other groups to advance state medical conscience laws. If providers are ‘subject to ruinous lawsuits’ for not performing procedures that violate their beliefs, ‘this not only inflicts significant harm on that individual health-care provider but on the [health-care] system,’ he said.

Trimble’s comments return the emphasis to where it belongs. Religious freedom is meant to be exercised across American life, including in the healthcare profession. Far from undermining patients, securing medical conscience rights benefits them. It is an essential way of preserving a robust healthcare system capable of meeting the diverse needs of our highly pluralistic society. It is also a way of honoring the religious freedom and dignity of the faith communities that these religious doctors, nurses, clinics, and hospitals represent. 

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Nathan A. Berkeley is RFI’s Communications Director and Research Coordinator.