Committed to doing no harm

Within the medical community, a debate is raging over conscience rights, and that debate is raising questions about the purpose of medicine itself. In January, the Department of Health and Human Services (HHS) declared that the right to practice medicine in accordance with one’s conscience is a civil right. In other words, you can’t make a doctor do something that violates his or her conscience. This announcement from Trump’s HHS is an abrupt change from a Biden Administration that was comfortable using the machinery of federal power to force medical professionals to participate in procedures they found morally objectionable.

The University of Vermont Medical Center, for example, attempted to compel health care providers to assist in abortions. The first Trump Administration had issued a Notice of Violation against them for conscience rights violations—but Biden’s HHS withdrew it, effectively blessing the coercion. The pattern held on gender procedures as well: The first Trump administration wrote guidance that protected providers from being forced to participate in gender-related interventions; Biden’s Office of Civil Rights rescinded that protection. When pharmacists objected on moral grounds to dispensing abortion-inducing drugs, the Biden administration moved to ensure they had no refuge there either.

The whiplash over conscience rights continues. In March, Trump’s HHS launched investigations into 13 states for allegedly violating federal conscience protections. The announcement accompanied a Notice of Violation against the state of Illinois, which insists medical providers who do not wish to perform abortions must still refer patients for them.

While efforts to protect conscience rights are coming from the right, it is not only conservatives who benefit. As with freedom of speech, conscience rights benefit everyone. We all win when the government is restrained from forcing us to violate our conscience.

But the issue feels conservative because it’s difficult to find examples of progressive medical professionals being asked to do things that violate their conscience. Challenges with abortions, assisted suicide, and gender transition cut in only one direction. But these medical issues, which are also relatively recent cultural issues, should make us think about something even more fundamental: What is the purpose of medicine?

Doctors who object to these controversial interventions do so, in part, because the entire purpose of medicine is to save, restore, and preserve life, and abortion does the opposite. In the same way, many medical professionals do not want to stop puberty or cut off healthy body parts because the purpose of medicine should be to help the body do what it was created to do. Healing should bring the body into alignment with its created purpose, not permanently prohibit it.

The language we use to describe these issues misleads the hearer about what is really happening. Euphemisms like “reproductive healthcare” and “gender-affirming care” describe interventions that interfere with the body’s natural, healthy function rather than assist it.

The proper end of medicine is health—the restoration and preservation of the body in its natural function. It is what medicine has meant in every civilization that has practiced it. Hippocrates was not making a partisan statement when he said the physician’s task is to heal, not to harm. It suddenly feels partisan not because medical professionals changed, but because the medical profession did.

So, while the debates over conscience rights are important, they remind us of something even more fundamental. We need the practice of medicine to remember its purpose again. Our bodies are not simply raw material that can be reshaped by ideology. They were created with purpose, and the goal of medicine should be to help our bodies fulfill that purpose. Remembering this will not only resolve all the conflicts over conscience rights in medicine, it will help a critical profession find its way again.