The right to be wrong

Last month, First Liberty released its 2026 Religious Liberty in the States index and moved Tennessee from tenth to second, praising the state’s Medical Ethics Defense Act as “exemplary.” That is worth celebrating. The law lets doctors, nurses, and pharmacists decline to participate in procedures that violate their conscience, with an exception for emergencies. Conscience protection in medicine is a genuine good, and Tennessee was right to secure it.

But the same law made national news last summer for a harder reason. A pregnant woman in East Tennessee said her doctor refused her prenatal care because she was unmarried, citing his Christian beliefs. She reportedly had to drive to Virginia to be seen.

Christians defending conscience protection need to be precise about what happened here, because two very different things are being confused.

Refusing to perform an abortion is a legitimate conscience protection. Refusing prenatal care to a woman who is already pregnant, because you disapprove of how she got that way, is something else entirely. The first is a refusal to participate in an act. The second is a refusal to care for a person.

The distinction is not subtle. Performing an abortion could reasonably persuade an onlooker that you believe abortion is good. Providing prenatal care to an unmarried woman would never be mistaken for an endorsement of anything except the health of a mother and her child. It is difficult to see how that would bind the Christian conscience because no one leaves that appointment thinking the doctor approves of promiscuity.

It is not even clear the law protects what this doctor did. The Medical Ethics Defense Act shields a provider from being forced to participate in a procedure, treatment, or service that violates his conscience. Turning away an entire category of patient is not obviously the same thing, and no court has said that it is.

In addition, this doctor’s decision raises legitimate questions about whether he understands the gospel at all. The gospel message is that we are sinners in need of a Savior and only by grace are we restored to a right relationship with our Creator. It is difficult to reconcile the claim that Jesus died for us while we were still sinners with the conviction that we should withhold medicine from someone who has sinned. A medical practice that serves only the sinless will not pay the bills. In my view, declining to treat an unmarried mother is not righteousness, it is self-righteousness. Christian ethics requires both the protection of conscience and the duty of care.

But my objection to this doctor’s conviction is a separate question from whether he should be free to act on his convictions. After all, freedom means nothing if it never includes the right to be wrong. People are not free unless they are free to do things some of us dislike. In the same way, free speech means nothing if it does not protect speech that offends.

It is genuinely difficult to balance the need for personal freedom with the need for order, but under no circumstances can we reasonably take the position that “People are only free to do things I like.” In our eagerness to appear reasonable, Christians must not take the position that only our convictions deserve constitutional protection. We can walk and chew gum.

Yes, the doctor was wrong. But compelling people to perform personal services in a professional context should set off alarms. To compel a physician to render a service he objects to on moral grounds is to claim a right to his labor. That, too, is a decision that should be respected in the law. Wrong and illegal are two distinct categories, even as both are essential to our moral reasoning.