Until only a few years ago, medical ethics was preoccupied with what treatments were appropriate to preserve life. Today, the focus is on finding justifications to disfigure the body or even to destroy life altogether. While we need to reverse this harmful trend, we also need to ensure protection now for those who refuse to go along with it. We must recognize that safeguarding medical conscience rights is essential to defending America’s First Freedom in our present moment.
It used to be that arguments in medical ethics explored how far we should go to save or prolong human life. Today, the two most significant trends involve arguments about ending life prematurely and disfiguring healthy bodies. Both are based on an absolutist view of individual autonomy and are deceptively advanced under the banner of “compassion.” This is true in every domain from the beginning of life to its end — from abortion to assisted suicide and euthanasia to “transgender” surgeries.
It wasn't very long ago that accounts of medical ethics found in college philosophy courses, journalistic accounts, and elsewhere asked some form of the question, “How far should we go to save a life?” This was the underlying question in everything from the so-called “life boat survivor” thought experiment to justifications for using human subjects in experimental medical research. Perhaps the greatest public controversy raising this question in the past couple of decades surrounded embryonic and fetal stem cell research. The argument at the time, which has been shown to be scientifically and ethically bogus, was that it was not just morally licit but compulsory for scientists to use embryonic and fetal cells derived from abortion. The logic seemed straightforward: the destruction of embryos and fetuses was going to happen anyway, so why not use the cells derived from those sources for medical experimentation? Proponents told us at the time that our old-fashioned moral convictions were hurting people, and that only embryonic and fetal stem cells could result in the pioneering breakthroughs necessary to counter disease and save lives.
Of course, we now know that this was not true. And it was, nevertheless, true all along that the use of embryonic and fetal stem cells was and is a double immorality: the killing of a human life in the first place and then the use of that material for other ends, rather than the appropriate burial that every human being deserves. But the argument about the use of embryonic and fetal stem cells derived from abortions was still based on an admittedly twisted justification about saving life. Likewise, most arguments about human experiments, drug trials, and even patently harmful procedures have long been about preserving, prolonging, or improving human life. This is even true of the abortion debates of just a few years ago. Figures like President Bill Clinton told us that abortion was tragic and should be “safe, legal, and rare,” and the justification we were given was, supposedly, to protect the emotional and psychological health of victims of rape or incest. The arguments, though poorly reasoned, were framed as health-affirming, rather than life-denying.
Today, however, we are seeing a seismic shift in medical ethics. It can be seen in the changing language, destructive procedures, and rapidly evolving public health priorities that signify a movement from a culture of life to one of death. Consider the suite of procedures and flood of euphemisms around preemptive death, whether of the unborn Downs Syndrome baby or of the elderly patient who is now a “drain” on the system.
The area of abortion makes the point emphatically. Few on the Left argue any longer that abortion is a tragedy or recognize the psychological and physiological harm that abortion inflicts on so many women and their families. Indeed, we’ve entered a grotesque era with public campaigns encouraging women to “Shout Your Abortion!” and declaring it a human right, despite the grave reality that it takes an innocent life.
This culture of death also targets those with disabilities, those suffering from serious illness, and the elderly. We've seen the chilling results of Canada's ironically named “Medical Assistance in Dying” (MAID) law that pushes older citizens towards death as a public service in that it decreases their cost to the state-run health system. This so-called MAID law resulted in more than 13,000 deaths in Canada in 2022, or about 4.1% of all deaths that year. (Contrast that figure with the approximately 800 deaths per year in California enabled by that state’s “End of Life Option Act.” While the situation in California is still tragic, the devastating effects of Canada’s more expansive law are plain in light of the fact that California and Canada are similar in population).
While it is true that senior adults and people suffering from disease, at times, feel marginalized and a burden on those around them, our response should be to provide respectful, loving care. We must re-establish a social compact that values our forebears for their contributions and their wisdom but also, apart from anything they have accomplished, honors their inherent dignity and commits to caring for them to their natural end.
“Transgender” and “sex reassignment” treatments and procedures are another area that demands attention. We've so often heard extreme voices claim that unless you support these measures, you're complicit in making those struggling with gender dysphoria more susceptible to suicide, but the evidence suggests the opposite to be true. Our society should help hurting and confused people who struggle with the inherent maleness or femaleness of their body, especially young people, who in the vast majority of cases will mature out of their confusion and struggle.
During this period of seismic change in the field of medicine, when long-accepted first principles about its true nature and purposes are being upended, defending the medical conscience rights of those who reject this pernicious revolution is all the more vital. As the former consensus continues to unravel — about the nature of the human person, the inherent dignity of human life, and the natural goods and ends of the human body — safeguarding the right of religious doctors, nurses, clinics, and hospitals to be free to act in accord with their deepest convictions on these matters will be essential.
At a minimum, a truly pluralistic society should have Catholic, Jewish, Baptist, and other faith-based medical centers and medical professionals who can provide compassionate care for their neighbors and co-religionists that is consonant with their faith commitments. Moreover, America’s foundational freedoms of religion, speech, conscience, and association should protect dissenters who refuse to conform to the radical revolution in medical ethics gaining momentum all around us, even while urgent efforts are undertaken to turn back the revolutionary ideology itself.
Eric Patterson is President of the Religious Freedom Institute.
Nathan Berkeley is Communications Director of the Religious Freedom Institute.