December 9, 2023

Neonatal Resuscitation. male doctor performing emergency therapy to newborn infant baby in intensive care unit at clinic

By Chris Motz, executive director of the South Dakota Catholic Conference

“To refuse to take part in committing an injustice is not only a moral duty; it is also a basic human right.” Pope St. John Paul II wrote these words 26 years ago this month in his great pro-life encyclical, “Evangelium Vitae” (The Gospel of Life). He’s referring to what is called conscientious objection.

John Paul specifically explains this basic human right as being of fundamental importance for those working in health care when he goes on to teach,

“What is at stake therefore is an essential right which, precisely as such, should be acknowledged and protected by civil law. In this sense, the opportunity to refuse to take part in the phases of consultation, preparation and execution of these acts against life should be guaranteed to physicians, health-care personnel, and directors of hospitals, clinics and convalescent facilities. Those who have recourse to conscientious objection must be protected not only from legal penalties but also from any negative effects on the legal, disciplinary, financial and professional plane.” (No. 74)

Neonatal Resuscitation. male doctor performing emergency therapy to newborn infant baby in intensive care unit at clinic

It is in our consciences that we hear God’s voice as we reflect on moral truth. It is in our consciences that we come to acknowledge right and wrong, and it is there that we first exercise a choice for one or the other. The Church teaches we are bound to obey our consciences; this is one reason the Church teaches that we have a duty to form our consciences in accord with truth. What we come to know in our conscience, as either right or wrong, plays out in how we act.

Even so, why, in 1995, did St. John Paul the Great insist health care providers must be protected in rights of consciences, to refrain from participating in what they understand to be morally wrong?

He did so because he saw the great harms of a culture of death, and he was wise enough to foresee where such harms might lead in the medical profession. John Paul’s insights were prophetic. Consider this excerpt from a reading assigned to many medical students in our country: “[H]ealth care providers—and all those whose jobs affect patient care—should cast off the cloak of conscience when patients’ needs demand it.” The author tells us what is meant by patients’ needs. “Qualms about abortion, sterilization and birth control? Do not practice women’s health,” appears in the same essay. In contradiction to John Paul’s defense of rights of conscience and call to protect them robustly in civil law, this influential writer urges that conscience be “cast off”—in other words, to ignore morality. By this reckoning, faithful Catholics should not be working in medicine.

Which brings me to a bill currently (at the time of writing) under consideration by the South Dakota legislature, House Bill 1247. In addition to the SD Catholic Conference, the bill enjoys support from the Catholic Medical Association, Americans United for Life, the American Association of Pro-Life Obstetricians and Gynecologists, South Dakota Right to Life, and others. The bill aims to provide ironclad conscience protections for medical professionals, institutions and insurance payors. HB 1247 ensures Catholics and others of goodwill are free to live their faith in this noble and important profession.

Some have suggested HB 1247 is redundant with federal law. While federal law provides some protection in theory, reality is quite different. In practice, this relief is very difficult to pursue, much of it relies on politically appointed staff in federal agencies, and its future is tenuous.

For example, it took four years for the federal Health and Human Services Department (HHS) to resolve the complaint of one nurse who was forced to participate in a gruesome dismemberment abortion of an unborn child at 22 weeks’ gestation. In another case dating to 2016, HHS permitted a state to force all health insurance plans—no exceptions—to cover abortions, in plain violation of several federal legal provisions. And in comments collected during an HHS public input process in 2018, tens of thousands of health care workers reported facing an environment of discrimination and attempted coercion due to their moral or religious convictions.

Notably, existing statutory provisions have no “right of action” (a right to sue) for a person who has been wronged. With promises recently echoing from Washington to codify Roe v. Wade and strip current religious freedom protections, the need for state-based action is timely.

Medical providers must be free to decline involvement in procedures they believe are morally wrong. As St. John Paul II emphasized, what is at stake is a basic human right. Federal protections have shown themselves inadequate and recent executive actions portend rollbacks of even those. Safeguards are therefore needed in state law, where recourse for medical practitioners can be both timely and effective. For more information on how you can support HB 1247, visit