Abortion and the Catholic Church

Church doctrine

According to Respect For Unborn Human Life: The Church's Constant Teaching, a document released by United States Conference of Catholic Bishops Committee on Pro-Life Activities, the Catholic Church has condemned procured abortion as immoral since the 1st century. Early Christian writings rejecting abortion are the Didache, the Epistle of Barnabas, the Apocalypse of Peter, and the works of early writers such as Tertullian, Athenagoras of Athens, Clement of Alexandria and Basil of Caesarea. Earliest Church legislation did not make distinction between "formed" and "unformed" fetuses, as did in the Greek Septuagint version of Exodus 21:22-23; this position can be found in the writing of early Church Fathers such as Basil of Caesarea and early Church council canons (Elvira, Ancyra).

In the 4th and 5th centuries, some writers such as Gregory of Nyssa and Maximus the Confessor held that human life already began at conception, some writers such as Lactantius—following Aristotle's view—held that the soul was "infused" in forty days or more, and some writers such as Jerome and Augustine of Hippo left the mystery of the timing of the infusion to God.

Augustine of Hippo "vigorously condemned the practice of induced abortion" as a crime, in any stage of pregnancy, although he accepted the distinction between "formed" and "unformed" fetuses mentioned in the Septuagint translation of Exodus 21:22-23, and did not classify as murder the abortion of an "unformed" fetus since he thought that it could not be said with certainty whether the fetus had already received a soul. The distinction between "formed" and "unformed" fetuses introduced by mistranslation of the word "harm" from the original Hebrew text as "form" in the Greek Septuagint, the Old Testament version which was used by Augustine, and based in Aristotelian distinction "between the fetus before and after its supposed 'vivification'". Such a distinction is also seen as a result of the limitations of science in embryology at that time.

Later writers such as John Chrysostom and Caesarius of Arles, as well as later Church councils (e.g. Lerida and Braga II) also condemned abortion as "gravely wrong", without making distinction between "formed" and "unformed" fetuses nor defining precisely in what stage of pregnancy the human life began.

While the Church has always condemned abortion, changing beliefs about the moment the embryo gains a human soul—regardless of some views among early writers and Church Fathers—have led their stated reasons for such condemnation, and the classification in canon law of the sin of abortion, to change over time.

Belief in delayed animation

Following Aristotle's view, it was commonly held by some "leading Catholic thinkers" in early Church history that a human being did not come into existence as such immediately on conception, but only some weeks later. Abortion was viewed as a sin, but not as murder, until the embryo was animated by a human soul. In On Virginal Conception and Original Sin 7, Anselm of Canterbury (1033–1109) said that "no human intellect accepts the view that an infant has the rational soul from the moment of conception". A few decades after Anselm's death, Catholic canon law, in the Decretum Gratiani, stated that "he is not a murderer who brings about abortion before the soul is in the body."

However, even when Church law, in line with the then generally accepted theory of delayed ensoulment, assigned different penalties to earlier and later abortions, abortion at any stage was considered a grave evil. Thus Thomas Aquinas, who accepted the Aristotelian theory that a human soul was infused only after 40 days for a male fetus, 90 days for a female, saw abortion of an unsouled fetus as always unethical, a serious crime, a grave sin, a misdeed and contrary to nature. He wrote: "This sin, although grave and to be reckoned among misdeeds and against nature...is something less than homicide... nor is such to be judged irregular unless one procures the abortion of an already formed fetus."

This Aristotelian view of delayed ensoulment was abandoned by the 17th century, when the conviction prevailed that the soul was present from the moment of conception, and the scientific proof in 1827 of the existence of the female ovum and in 1875 of the involvement of the union of a gamete from each parent in conception reduced speculation about a delayed substantial change.

Juridical consequences

Most early penitentials imposed equal penances for abortion whether early-term or late-term, but others distinguished between the two. Later penitentials normally distinguished, imposing heavier penances for late-term abortions.

Although the Decretum Gratiani, which remained the basis of Catholic canon law until replaced by the 1917 Code of Canon Law, distinguished between early-term and late-term abortions, that canonical distinction was abolished for a period of three years by the bull of Pope Sixtus V Effraenatam of 28 October 1588. This decreed various penalties against perpetrators of all forms of abortion without distinction. Calling abortion murder, it decreed that those who procured the abortion of a fetus, whether animated or unanimated, formed or unformed (tam animati, quam etiam inanimati, formati, vel informis) should suffer the same punishments as "true murderers and assassins who have actually and really committed murder" (veros homicidas, qui homicidium voluntarium actu, & re ipsa patraverint). As well as decreeing those punishments for subjects of the Papal States, whose civil ruler he was, Pope Sixtus also inflicted on perpetrators the spiritual punishment of automatic excommunication (section 7). Sixtus's successor, Pope Gregory XIV, recognizing that the law was not producing the hoped-for effects, withdrew it three years later, limiting the punishments to abortion of a "formed" fetus.

With his 1869 bull Apostolicae Sedis moderationi, Pope Pius IX rescinded Gregory XIV's not-yet-animated fetus exception with regard to the spiritual penalty of excommunication, declaring that those who procured an effective abortion incurred excommunication reserved to bishops or ordinaries. From then on this penalty is incurred automatically through abortion at any stage of pregnancy, which even before was never seen as a merely venial sin.

In another respect Catholic canon law continued even after 1869 to maintain a distinction between abortion of a formed and of an unformed fetus. As indicated above in a quotation from Thomas Aquinas, one who procured the abortion of a quickened fetus was considered "irregular", meaning that he was disqualified from receiving or exercising Holy Orders. Pope Sixtus V extended this penalty even to early-term abortion (section 2 of his bull Effraenatam), but Gregory XIV restricted it again. Pius IX made no ruling in its regard, with the result that the penalty of irregularity was still limited to late-term abortion at the time of the article "Abortion" in the 1907 Catholic Encyclopedia. The 1917 Code of Canon Law finally did away with the distinction.

Discussions about possible justifying circumstances

In the Middle Ages, the Church condemned all abortions, and the 14th-century Dominican John of Naples is reported to have been the first to make an influential explicit statement that, if the purpose was to save the mother's life, abortion was actually permitted, provided that ensoulment had not been attained. This view met both support and rejection from other theologians. In the 16th century, while Thomas Sanchez accepted it, Antoninus de Corbuba made the distinction that from then on became generally accepted among Catholic theologians, namely that direct killing of the fetus was unacceptable, but that treatment to cure the mother should be given even if it would indirectly result in the death of the fetus.

When, in the 17th century, Francis Torreblanca approved abortions aimed merely at saving a woman's good name, the Holy Office (what is now called the Congregation for the Doctrine of the Faith), at that time headed by Pope Innocent XI, condemned the proposition that "it is lawful to procure abortion before ensoulment of the fetus lest a girl, detected as pregnant, be killed or defamed".

Although it is sometimes said that 18th-century Alphonsus Liguori argued that, because of uncertainty about when the soul entered the fetus, abortion, while in general morally wrong, was acceptable in circumstances such as when the mother's life was in danger, he clearly stated that it is never right to take a medicine that of itself is directed to killing a fetus, although it is lawful (at least according to general theological opinion) to give a mother in extreme illness a medicine whose direct result is to save her life, even when it indirectly results in expulsion of the fetus. While Liguori mentioned the distinction then made between animate and inanimate fetuses, he explained that there was no agreement about when the soul is infused, with many holding that it happens at the moment of conception, and said that the Church kindly followed the 40-day opinion when applying the penalties of irregularity and excommunication only on those who knowingly procured abortion of an animate fetus.

A disapproving letter published in the New York Medical Record in 1895 spoke of the Jesuit Augustine Lehmkuhl as considering craniotomy lawful when used to save the mother's life. The origin of the report was an article in a German medical journal denounced as false in the American Ecclesiastical Review of the same year, which said that, while Lehmkuhl had at an earlier stage of discussion admitted doubts and advanced tentative ideas, he had later adopted a view in full accord with the negative decision pronounced in 1884 and 1889 by the Sacred Penitentiary, which in 1869 had refrained from making a pronouncement. According to Mackler, Lehmkuhl had accepted as a defensible theory the licitness of removing even an animated fetus from the womb as not necessarily killing it, but had rejected direct attacks on the fetus such as craniotomy.

Craniotomy was thus prohibited in 1884 and again in 1889. In 1895 the Holy See excluded the inducing of non-viable premature birth and in 1889 established the principle that any direct killing of either fetus or mother is wrong; in 1902 it ruled out the direct removal of an ectopic embryo to save the mother's life, but did not forbid the removal of the infected fallopian tube, thus causing an indirect abortion.(see below).

In 1930 Pope Pius XI ruled out what he called "the direct murder of the innocent" as a means of saving the mother. And the Second Vatican Council declared: "Life must be protected with the utmost care from the moment of conception: abortion and infanticide are abominable crimes."

Unintentional abortion

The principle of double effect is frequently cited in relation to abortion. A doctor who believes abortion is always morally wrong may nevertheless remove the uterus or fallopian tubes of a pregnant woman, knowing the procedure will cause the death of the embryo or fetus, in cases in which the woman is certain to die without the procedure (examples cited include aggressive uterine cancer and ectopic pregnancy). In these cases, the intended effect is to save the woman's life, not to terminate the pregnancy, and the death of the embryo or fetus is foreseen as a side effect, not intended even as a means to another end. That is, the death of the fetus is not the means to an end, but an undesirable but unavoidable consequence. Thus chemotherapy or removal of a cancerous organ does not abort the fetus in order to cure the cancer, but instead it cures the cancer while also having the foreseen indirect result of aborting the embryo or fetus.

Ectopic pregnancy

An ectopic pregnancy is one of a few cases where the foreseeable death of an embryo is allowed, since it is categorized as an indirect abortion. This view was also advocated by Pius XII in a 1953 address to the Italian Association of Urology.

Using the Thomistic Principle of Totality (removal of a pathological part to preserve the life of the person) and the Doctrine of Double Effect, the only moral action in an ectopic pregnancy where a woman's life is directly threatened is the removal of the tube containing the human embryo (salpingectomy). The death of the human embryo is unintended although foreseen.

The use of methotrexate and salpingectomy remains controversial in the Catholic medical community, and the Church has not taken an official stance on these interventions. The Catholic Health Association of the United States, which issues guidelines for Catholic hospitals and health systems there, allows both procedures to be used. The argument that these methods amount to an indirect abortion revolves around the idea that the removal of the Fallopian tube or, in the case of methotrexate, the chemical destruction of the trophoblastic cells (those which go on to form the placenta), does not constitute a direct act upon the developing embryo. Individual hospitals and physicians, however, may choose to prohibit these procedures if they personally interpret these acts as a direct abortion. Despite the lack of an official pronouncement by the Church on these treatments, in a 2012 survey of 1,800 Ob/Gyns who work in religious hospitals, only 2.9% of respondents reported feeling constrained in their treatment options by their employers, suggesting that in practice, physicians and healthcare institutions generally choose to treat ectopic pregnancies.

Embryos

The Church considers the destruction of any embryo to be equivalent to abortion, and thus opposes embryonic stem cell research. The papal encyclical Humanae vitae states that "We are obliged once more to declare that the direct interruption of the generative process already begun and, above all, all direct abortion, even for therapeutic reasons, are to be absolutely excluded as lawful means of regulating the number of children."

Sanctions

Catholics who procure a completed abortion are subject to a latae sententiae excommunication. That means that the excommunication does not need to be imposed (as with a ferendae sententiae penalty); rather, being expressly established by canon law, it is incurred ipso facto when the delict is committed (a latae sententiae penalty). Canon law states that in certain circumstances "the accused is not bound by a latae sententiae penalty"; among the ten circumstances listed are commission of a delict by someone not yet sixteen years old, or by someone who without negligence does not know of the existence of the penalty, or by someone "who was coerced by grave fear, even if only relatively grave, or due to necessity or grave inconvenience".

According to a 2004 memorandum by Joseph Cardinal Ratzinger, Catholic politicians who consistently campaign and vote for permissive abortion laws should be informed by their priest of the Church's teaching and warned to refrain from receiving the Eucharist or risk being denied it until they end such activity. This position is based on Canon 915 of the 1983 Code of Canon Law and has also been supported, in a personal capacity, by Archbishop Raymond Leo Cardinal Burke, Prefect of the Apostolic Signatura, the highest judicial authority in the Catholic Church after the pope himself. Pope Francis reaffirmed this position on March 2013, when he stated that "[people] cannot receive Holy Communion and at the same time act with deeds or words against the commandments, particularly when abortion, euthanasia, and other grave crimes against life and family are encouraged. This responsibility weighs particularly over legislators, heads of governments, and health professionals."

Forgiveness of women who abort

Apart from indicating in its canon law that automatic excommunication does not apply to women who abort because of grave fear or due to grave inconvenience, the Catholic Church, without making any such distinctions, assures the possibility of forgiveness for women who have had an abortion. Pope John Paul II wrote:

I would now like to say a special word to women who have had an abortion. The Church is aware of the many factors which may have influenced your decision, and she does not doubt that in many cases it was a painful and even shattering decision. The wound in your heart may not yet have healed. Certainly what happened was and remains terribly wrong. But do not give in to discouragement and do not lose hope. Try rather to understand what happened and face it honestly. If you have not already done so, give yourselves over with humility and trust to repentance. The Father of mercies is ready to give you his forgiveness and his peace in the Sacrament of Reconciliation.

On the occasion of the Extraordinary Jubilee of Mercy in 2015, Pope Francis announced that all priests (during the Jubilee year – ending November 20, 2016) will be allowed in the Sacrament of Penance to remit the penalty of excommunication for abortion, which had been reserved to bishops and certain priests who were given such mandate by their bishop. This policy was made permanent by an apostolic letter titled Misericordia et misera (Mercy and Misery), which was issued on November 21, 2016.

Recent statements of the Church's position

The Church teaches that "human life must be respected and protected absolutely from the moment of conception. From the first moment of his existence, a human being must be recognized as having the rights of a person – among which is the inviolable right of every innocent being to life."

Since the 1st century, the Church has affirmed that every procured abortion is a moral evil, a teaching that the Catechism of the Catholic Church declares "has not changed and remains unchangeable".

The Church teaches that the inalienable right to life of every innocent human individual is a constitutive element of a civil society and its legislation. In other words, it is beholden upon society to legally protect the life of the unborn.

Catholic theologians trace Catholic thought on abortion to early Christian teachings such as the Didache, the Epistle of Barnabas and the Apocalypse of Peter. In contrast, Catholic philosophers Daniel Dombrowski and Robert Deltete analyzed Church theological history and the "development of science" in A Brief, Liberal, Catholic Defense of Abortion to argue that "a pro-choice position is defensibly Catholic".

Attitudes of Catholic laity

Although the church hierarchy campaigns against abortion and its legalization in all circumstances, including threats to a woman's life or health and pregnancy from rape, many Catholics disagree with this position, according to several surveys of Western Catholic views.

United States

A majority of U.S. Catholics hold views that differ from the official church doctrine on abortion. According to 1995 survey by Lake Research and Tarrance Group, 64% of U.S. Catholics say they disapprove of the statement that "abortion is morally wrong in every case". According to 2016 survey by Pew Research Center, 51% of U.S. Catholics say that "having an abortion is morally wrong". Surveys conducted by a number of polling organizations indicate that between 16% and 22% of American Catholic voters agree with Church policy that abortion should be illegal in all cases; the rest of the respondents held positions ranging from support for legal abortions in certain restricted circumstances to an unqualified acceptance of abortion in all cases. According to 2009 survey by Pew Research Center, 47% of American Catholics believe that abortion should be legal in "all or most cases", while 42% of American Catholics believe that abortion should be illegal in "all or most cases". When posed a binary question of whether abortion was acceptable or unacceptable, rather than a question of whether it should be allowed or not allowed in all or most cases, according to polls conducted in 2006-2008 by Gallup, 40% of American Catholics said it was acceptable, approximately the same percentage as non-Catholics. According to the National Catholic Reporter, some 58% of American Catholic women feel that they do not have to follow the abortion teaching of their bishop.

However, the results in the United States differ significantly when the polls distinguish between practicing and/or churchgoing Catholics and non-practicing Catholics. Those who attend church weekly are more likely to oppose abortion. According to Marist College Institute for Public Opinion's survey released in 2008, 36% of practising Catholics, defined as those who attend church at least twice a month, consider themselves "pro-choice"; while 65% of non-practicing Catholics considers themselves "pro-choice", 76% of them says that "abortion should be significantly restricted". According to polls conducted in 2006-2008 by Gallup, 24% of practicing Catholics, defined in this poll as those who attend church "weekly or almost every week", believe abortion is morally acceptable.

It is said that "Latino Catholics" in the United States are more likely to oppose abortion than "White Catholics".

Some reasons for dissenting from the church's position on the legality of abortion, other than finding abortion morally acceptable, include "I am personally opposed to abortion, but I think the Church is concentrating its energies too much on abortion rather than on social action" or "I do not wish to impose my views on others."

According to a poll conducted by Zogby International, 29% of Catholic voters choose their candidate based solely on the candidate's position on abortion; most of these vote for pro-life candidates. 44% believe a "good Catholic" cannot vote for a pro-choice politician, while 53% believe one can.

According to 2011 report from Public Religion Research Institute, 68% of American Catholics believe that one can still be a "good Catholic" while disagreeing with the church's position on abortion, approximately as many as members of other religious groups. On this long-standing phenomenon of a number of Catholics disagreeing with the Church's official position on abortion, Pope John Paul II commented: "It is sometimes claimed that dissent from the Magisterium is totally compatible with being a "good Catholic" and poses no obstacle to the reception of the sacraments. This is a grave error." In what the Los Angeles Times called a key admonition, he added: "It has never been easy to accept the Gospel teaching in its entirety, and it never will be."

United Kingdom

A 2010 poll indicated that one in fourteen British Catholics accept the Church's teaching that abortion should not be allowed in any circumstances.

Australia

According to one survey, 72% of Australian Catholics say that the decision to have an abortion "should be left to individual women and their doctors."

Italy

According to the Italian polling organization Eurispes, between 18.6% and 83.2% of Italian Catholics believe abortion is acceptable, depending on the circumstance. The highest number, 83.2%, is in favor of the voluntary termination of pregnancy in case the mother's life is in danger.

Belgium

Prior to 1990, Belgium remained one of the few countries where abortion was illegal. However, abortions were unofficially permitted (and even reimbursed out of 'sickness funds') as long as they were registered as "curettage". It was estimated that 20,000 abortions were performed each year (in comparison to 100,000 births).

In early 1990, despite the opposition of the Christian parties, a coalition of the Socialist and Liberal parties passed a law to partially liberalize abortion law in Belgium. The Belgian bishops appealed to the population at large with a public statement that expounded their doctrinal and pastoral opposition to the law. They warned Belgian Catholics that anyone who co-operated "effectively and directly" in the procurement of abortions was "excluding themselves from the ecclesiastical community." Motivated by the strong stance of the Belgian bishops, King Baudoin notified the Prime Minister on March 30 that he could not sign the law without violating his conscience as a Catholic. Since the legislation would not have the force of law without the king's signature, his refusal to sign threatened to precipitate a constitutional crisis. However, the problem was resolved by an agreement between the king and Prime Minister Martens by which the Belgian government declared the king unable to govern, assumed his authority and enacted the law, after which Parliament then voted to reinstate the king on the next day. The Vatican described the king's action as a "noble and courageous choice" dictated by a "very strong moral conscience." Others have suggested that Baudoin's action was "little more than a gesture", since he was reinstated as king just 44 hours after he was removed from power.

Brazil

In March 2009, Archbishop Jose Cardoso Sobrinho said that, by securing the abortion of a nine-year-old girl who had been raped by her stepfather, her mother and the doctors involved were excommunicated latae sententiae. This statement of the Archbishop drew criticism not only from women's rights groups and the Brazilian government, but also from Archbishop Rino Fisichella, president of the Pontifical Academy for Life, who said it was unjust, and other churchmen. In view of the interpretations that were placed upon Archbishop Fisichella's article, the Congregation for the Doctrine of the Faith issued a clarification reiterating that "the Church's teaching on procured abortion has not changed, nor can it change". The National Conference of Bishops of Brazil declared the Archbishop's statement mistaken, since in accordance with canon law, that she had acted under pressure and in order to save her daughter's life, the girl's mother certainly had not incurred automatic excommunication and there was insufficient evidence for declaring that any of the doctors involved had.

England

In September 2013, Archbishop Peter Smith, Vice-President of the Catholic Bishops' Conference of England and Wales, decried the decision of the Crown Prosecution Service not to proceed against two doctors who accepted a request to perform an abortion as a means of sex selection, a procedure that is illegal in Britain and that Archbishop Smith described as one expression of what he called the injustice that abortion is to the unwanted child.

India

Mother Teresa opposed abortion, and in the talk she gave in Norway on being awarded the 1979 Nobel Prize for Peace, she called abortion "the greatest destroyer of peace today". She further asserted that, "Any country that accepts abortion is not teaching its people to love but to use violence to get what they want".

Ireland

In October 2012, Savita Halappanavar died at University Hospital Galway in Ireland, after suffering a miscarriage which led to septicemia (blood poisoning), multiple organ failure and her death. She was denied abortion under Irish law because the fetus had a heartbeat and nothing could therefore be done. A midwife explained to her, in a remark for which she later apologized: "This is a Catholic country." Widespread protests were subsequently held in Ireland and India, and a call to re-examine the Irish abortion laws.

Italy

Speaking to a group of pro-life activists from the Congress of the Movement for Life of Italy, Pope Francis called them Good Samaritans and encouraged them "to protect the most vulnerable people, who have the right to be born into life". He called children a gift, and emphasized the dignity of women. He said they were doing "important work in favor of life from conception until its natural end".

Poland

It is widely believed that the Catholic Church in Poland is the main source of opposition to the liberalization of abortion laws and the reintroduction of sex education in Polish schools in accordance with European standards. However, research studies have shown that Polish Catholics have a wide range of views on sex and marriage. Many Poles, including devout Catholics, complain that the Catholic Church makes demands that very few Catholics want and are able to satisfy.

Before the transition to democracy, Poland's Soviet-orientated government presided over some of the highest abortion rates in Europe, with approximately 1.5 million procedures done per year. Polling in 1991, coming after the collapse of the past communist regime in Poland, found that about 60% of Poles supported nonrestrictive abortion laws.

United States

An advocacy organization called Catholics for Choice was founded in 1973 to support the availability of abortion, stating that this position is compatible with Catholic teachings, particularly with "primacy of conscience" and the importance of the laity in shaping church law. In October 1984, CFC (then Catholics for a Free Choice) placed an advertisement, signed by over one hundred prominent Catholics, including nuns, in the New York Times. The advertisement, called A Catholic Statement on Pluralism and Abortion contested claims by the Church hierarchy that all Catholics opposed abortion rights, and said that "direct abortion...can sometimes be a moral choice." The Vatican initiated disciplinary measures against some of the nuns who signed the statement, sparking controversy among American Catholics, and intra-Catholic conflict on the abortion issue remained news for at least two years in the United States. Bishop Fabian Bruskewitz excommunicated Catholics in his jurisdiction who were associated with this organization in 1996, and the United States Conference of Catholic Bishops stated in 2000 that "[CFC] is not a Catholic organization, does not speak for the Catholic Church, and in fact promotes positions contrary to the teaching of the Church as articulated by the Holy See and the USCCB."

Position of the Church

Since the Catholic Church views procured abortion as gravely wrong, it considers it a duty to reduce its acceptance by the public and in civil legislation. While it considers that Catholics should not favour direct abortion in any field, according to Frank K. Flinn, it recognizes that Catholics may accept compromises that, while permitting direct abortions, lessen their incidence by, for instance, restricting some forms or enacting remedies against the conditions that give rise to them. Flinn says that support may be given to a political platform that contains a clause in favour of abortion but also elements that will actually reduce the number of abortions, rather than to an anti-abortion platform that will lead to their increase.

In 2004, Joseph Cardinal Ratzinger, then Prefect of the Congregation for the Doctrine of the Faith, declared: "A Catholic would be guilty of formal cooperation in evil, and so unworthy to present himself for holy Communion, if he were to deliberately vote for a candidate precisely because of the candidate's permissive stand on abortion and/or euthanasia. When a Catholic does not share a candidate's stand in favor of abortion and/or euthanasia, but votes for that candidate for other reasons, it is considered remote material cooperation, which can be permitted in the presence of proportionate reasons."

Church treatment of pro-choice politicians

Many controversies have arisen over its treatment of Catholic politicians who support abortion rights. In most cases, Church officials have threatened to refuse communion to these politicians. In some cases, officials have stated that the politicians should refrain from receiving communion; in others, the possibility of excommunication has been suggested.

Medical personnel and hospitals

Some medical personnel, including many Catholics, have strong moral or religious objections to abortions and do not wish to perform or assist in abortions. The Catholic Church has argued that the "freedom of conscience" rights of such personnel should be legally protected. For example, the United States Conference of Catholic Bishops supports such "freedom of conscience" legislation arguing that all healthcare providers should be free to provide care to patients without violating their "most deeply held moral and religious convictions." The Virginia Catholic Conference expressed support for pharmacists who consider that they cannot in conscience be on duty during a sale of emergency contraception, which they believe is the same as abortion.

In response to such concerns, many states in the U.S. have enacted "freedom of conscience" laws that protect the right of medical personnel to refuse to participate in procedures such as abortion. In 2008, towards the end of the second Bush administration, the U.S. federal government issued a new rule that ensured that healthcare workers would have the right to "refuse to participate in abortions, sterilizations or any federally funded health service or research activity on religious or ethical grounds." The new rule was welcomed by pro-life organizations including the Catholic Church; however, pro-choice advocates criticized the new regulation arguing that it would "restrict access not only to abortion but also to contraception, infertility treatment, assisted suicide and stem-cell research." The incoming Obama administration proposed to rescind this rule.

Attempts have been made to oblige Catholic hospitals to accept an obligation to perform emergency abortions in cases where the pregnant woman's life is at risk; however, hospitals that agree to perform abortions in contradiction Church teaching may lose their official qualification as "Catholic". Church authorities have also admonished Catholic hospitals who, following medical standards, refer patients outside the hospital for abortion or contraception, or who perform tests for fetal deformity.

One Catholic hospital devotes care to helping women who wish to stop an abortion after the process has begun.

In November 2009, when Sister Margaret McBride, as a member of the ethics board of a Catholic hospital, allowed doctors to perform an abortion to save the life of a mother of four suffering from pulmonary hypertension, Bishop Thomas J. Olmsted excommunicated her on the grounds that, while efforts should be made to save a pregnant woman's life, abortion cannot be justified as a means to that end.