Biden Administration Bullying of Pro-Life Physicians Gets SCOTUS Smackdown

P reborn children and pro-life physicians won a much-needed victory on Monday.

The U.S. Supreme Court left in place the decision by the U.S. Fifth Circuit Court of Appeals against the Biden administration’s attempts to weaponize federal law to force pro-life emergency physicians to perform induced abortions.

As a pro-life obstetrician-gynecologist (as well as the vice chairwoman of the board of the American Association of Pro-Life Obstetricians and Gynecologists, one of the plaintiffs in this case), I see this decision as a ray of hope in an era of eroding conscience rights for physicians.

Throughout my 25-year career offering reproductive health care to women in my North Carolina community, I have been proud to practice with life-affirming values, operating in accordance with the principle that when I care for a pregnant woman, I have two patients: the mother and the baby. I strive to offer the highest-quality care to my pregnant and preborn patients alike.

In my view, induced abortion has no place in medicine. The CDC defines this practice as “an intervention performed by a licensed clinician . . . that is intended to terminate a suspected or known ongoing intrauterine pregnancy and that does not result in a live birth” (emphasis added.) This means that, unlike other pregnancy-ending medical interventions (such as caesarian sections), induced abortion intends to end the life of the fetus or embryo — my preborn patient. This flies in the face of my commitment to do no harm to my patients.

My approach to practicing medicine is not anomalous. The thousands of medical professionals belonging to the American Association of Pro-Life Obstetricians and Gynecologists testify to the prevalence of practitioners who share my values. Between 76 and 93 percent of OB-GYNs do not perform induced abortions. Yet they are perfectly capable of offering comprehensive, high-quality reproductive health care to their patients.

But the past several years have seen an erosion of protections for the conscience rights of pro-life physicians, both from government entities and medical professional organizations.

For centuries, the importance of physicians’ conscience rights was rightly acknowledged as fundamentally intertwined with the Hippocratic oath — the sacred vow that was understood to capture the foundation of medical ethics. The oath describes the physician’s conscientious duty to save the life and improve the health of his or her patients. Bound by the oath, a physician’s conscience commits him or her to act under certain restrictions — not to kill, have inappropriate relationships with patients, or breach their confidentiality — that best facilitate a doctor-patient relationship that promotes health and healing.

Under the model of the Hippocratic oath, doctors are treated as individual moral agents whose conscientious judgment must be respected because it allows them to best act out their duty as physicians in service of their patients.

It is no coincidence, then, that as the Hippocratic oath has declined in popularity within the medical community, so has respect for physicians’ conscience rights.

Today, physicians are viewed less as individual moral agents and more as mere “providers” (like vending machines) of the services that patients request or as extensions of the state, bound to implement state-defined health goals. In these roles, there is no room for conscientious objections to the demands of patients or the state.

Induced abortion is a salient example of an issue on which physicians are pressured against forming their own views. My own specialty’s largest professional organization, the American College of Obstetricians and Gynecologists (ACOG), published a Committee Opinion in 2007 titled “The Limits of Conscientious Refusal in Reproductive Medicine,” in which it argues that physicians who oppose practices such as induced abortion “have the duty to refer patients in a timely manner if they do not feel that they can in conscience provide” the requested services.

ACOG’s argument completely guts the concept of conscience rights. From a moral standpoint, referring a patient for an induced abortion is no different from performing the procedure oneself; the physician is merely delegating that task to someone else. ACOG is urging pro-life physicians like me to participate in a practice that we view as antithetical to ethical medicine.

Today, pro-life medical professionals face unprecedented pressures to participate in induced abortion, and while federal law supports their right to refuse, enforcement of this law is inconsistent. The U.S. Department of Health and Human Services (HHS) carries the responsibility of pursuing violations of conscience rights, but the department’s willingness to do so depends on its leadership at any given time. Under President Trump, HHS filed a lawsuit against one Vermont hospital that fired a nurse for refusing to participate in an abortion, but when President Biden stepped into office, HHS lost interest in this case.

This breakdown of conscience rights has immeasurable impacts on medical professionals as well as patients. In an era of record-high burnout in our profession, the last thing physicians need is to see our agency systematically undermined. Nor do we need competent colleagues forced out of the field for their views, worsening shortages of reproductive health care and increasing the workload of the already-overworked remaining physicians.

Most important, the loss of physician conscience protections harms patients. As physicians lose agency, the physician-patient relationship erodes, and patients lose confidence in their doctors’ willingness to truly, holistically act in their best interests based on their own medical training and judgment.

The Biden administration’s attempt to utilize the Emergency Medical Treatment and Labor Act (EMTALA) to compel pro-life emergency physicians to perform induced abortions does not only go beyond what is needed to provide women with excellent care during medical emergencies; it also infringes on physicians’ right to refuse to participate in a practice that they view as unethical. Luckily, with the Supreme Court’s decision, this attempt to override doctors’ conscience rights has failed.

For the sake of both doctors and patients, I hope to see further efforts to reclaim conscience rights. As Senator J. D. Vance said in the latest vice-presidential debate, “We can be a big and diverse country where we can respect people’s freedom of conscience.”