For you formed my inward parts; you knitted me together in my mother's womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. – Psalm 139:12-14
Each of us is, as the psalmist eloquently states, fearfully and wonderfully made. God’s work of creation continues as the Author of life, and the pinnacle of His creation are human beings. Psalm 8:4-6 asks:
“What is man that You are mindful of him, and the son of man that You visit him? For You have made him a little lower than the angels, and You have crowned him with glory and honor. You have made him to have dominion over the works of Your hands.”
At ADF, we take seriously what Scripture says about the value of life. And this drives us to seek to guarantee life at every stage, from conception to natural death.
Out of love God created us and then sent His Son to rescue and redeem us. This redemption story helps paint a vivid picture of the value and dignity of all human life.
This is why we’ve created the Generational Win of working to make sure that Life is Safeguarded.
A common thread we see emerging in arguments over abortion and physician-assisted suicide is an appeal to compassion. An expectant mother who can barely take care of herself shouldn’t be expected to carry and then care for a child. What about her quality of life? Her challenges are already formidable. Isn’t the compassionate, empowering response abortion?
A terminal illness can be grueling, with potentially painful pathways towards death. Physical, mental, and relational stress are sure to be prevalent at every turn. Isn’t giving a patient autonomy and control over how and when to enter their inevitable demise the dignified, compassionate thing to do?
In both instances, no.
Because life is created by God, it belongs to Him; so the killing of innocent humans created in His image is not only offensive but unjust. We see in Proverbs 6:17 that God hates “hands that shed innocent blood,” and the book of Deuteronomy implores us to “choose life that you and your offspring may live, loving the Lord your God, obeying His voice and holding fast to Him, for He is your life and length of days.”
God has even ordained governments to protect and uphold His gift of life. The State, as God’s servant, is tasked with carrying out justice to uphold and protect life, not destroy it:
Let every person be subject to the governing authorities. For there is no authority except from God, and those that exist have been instituted by God. Therefore whoever resists the authorities resists what God has appointed, and those who resist will incur judgment. For rulers are not a terror to good conduct, but to bad. Would you have no fear of the one who is in authority? Then do what is good, and you will receive his approval, for he is God's servant for your good. But if you do wrong, be afraid, for he does not bear the sword in vain. For he is the servant of God, an avenger who carries out God's wrath on the wrongdoer. (Romans 13:1-4 ESV)
Life is not ours to take, whether at the beginning, end, or somewhere in between.
Like most of our other work at ADF, one of the ways we tackle this Generational Win is through strategic litigation efforts. What follows are some cases you should know about that have shaped the legal landscape in both of these vital areas.
The Gestational Age Act is a Mississippi law that protects the health of pregnant mothers, the dignity of unborn children, and the integrity of the medical profession by limiting abortions after 15 weeks in gestational age, permitting them only in medical emergencies or for severe fetal abnormality.
Mississippi’s law highlighted a conflict between the Supreme Court’s ruling in Roe v. Wade and the Court’s repeated affirmation in subsequent cases that states have a legitimate interest in limiting abortion and protecting “vulnerable and innocent life” from the moment of conception.
On December 1, 2021, the Supreme Court heard oral arguments for this case, and six months later, the Court overturned its 1973 Roe v. Wade decision that invented a so-called constitutional right to abortion. Now that Roe is gone, the American people and their elected representatives are once again empowered to protect women and their children.
ADF was honored to serve on Mississippi’s team defending the law at the Supreme Court in this case. We worked behind the scenes with Mississippi’s governor and lawmakers to draft and enact the Gestational Age Act in 2018 and eagerly helped defend this important law.
Abortion remains a threat to children even after the overturning of Roe v. Wade. The paradigm has simply shifted. Instead of the Supreme Court dictating policy pertaining to abortion, now states, elected representatives, and the American people have the ability to protect and preserve life. Here are some other important cases to know about that speak to this seismic shift in a post-Roe United States.
In 2018, Iowa enacted a law protecting unborn lives by prohibiting elective abortions after a fetal heartbeat is detected. But, in 2019, an Iowa trial court stopped the law from taking effect, finding that it violated Iowa’s state constitutional right to abortion.
Now, ADF is working hard alongside Iowa’s pro-life Governor and Attorney General to persuade the Iowa courts to allow the law to take effect. Recently, ADF attorneys representing Governor Kim Reynolds filed an opening brief with Iowa’s Supreme Court, explaining that two recent, significant changes in the law removed all legal barriers to implementing Iowa’s fetal heartbeat law. First, the Iowa Supreme Court’s reversal of its 2018 decision finding a so-called state constitutional right to an abortion (ADF successfully briefed and argued the case before the court). And second, the U.S. Supreme Court’s overturning of Roe v. Wade and Planned Parenthood v. Casey. ADF Senior Counsel Chris Schandevel will be arguing the case in the Iowa Supreme Court on April 11.
Alliance Defending Freedom attorneys are representing doctors who are members of two pro-life organizations—the American Association of Pro-Life Obstetricians and Gynecologists, and the Christian Medical and Dental Associations. ADF is doing this to combat a deceptive attempt by the Biden Administration to undermine the Dobbs ruling by misinterpreting federal law to unilaterally create a new abortion mandate within hospital settings. Using the Emergency Medical Treatment and Labor Act that was passed in 1986 requiring all hospitals that participate in Medicare to provide medical screening and stabilizing treatment for emergency medical conditions, the Biden Administration made a back-door attempt to mandate abortions through this law.
Even though the law requires a doctor to care for both the mother and the unborn child, this new guidance says doctors must perform abortions, including to finish “an incomplete medical abortion,” and in undefined “health” conditions. ADF obtained a court order protecting our doctor clients from this illegal mandate, but the Biden administration recently appealed.
In 2022, after the U.S. Supreme Court overturned Roe v. Wade, West Virginia largely replaced its previous pro-life law with the Unborn Child Protection Act, protecting unborn life from abortion in most circumstances. In this case, an abortion facility and one of its abortionists challenged two of the state’s health-and-safety regulations: one that requires surgical abortions to be performed in a hospital, and another that requires an abortion to be performed by a licensed medical professional who has privileges at a West Virginia hospital.
In their response to the abortion facility’s attempt to halt enforcement of the law filed with the U.S. District Court for the Southern District of West Virginia, Attorney General Patrick Morrisey and ADF attorneys noted that, even under the now overturned decisions of Roe and Casey, an abortion provider had no constitutional right to perform an abortion using his or her preferred methods. Moreover, West Virginia’s legal statutes are specifically designed to protect women’s health.
The Supreme Court was very clear when it overturned Roe v. Wade: abortion policy is returned to the people of the states and their elected representatives, this law is clearly constitutional and ADF stands ready to defend it alongside allies in West Virginia.
Life in the womb isn’t the only gift from God being threatened in our society today – there’s an increased interest and push to accept and normalize physician-assisted suicide.
Physician-assisted suicide is the active introduction of a lethal agent into the patient’s body, intentionally causing death. It is often mistaken as synonymous with euthanasia, but the distinction between the two is important. Physician-assisted suicide occurs when a physician facilitates a patient’s death by providing him or her with a lethal dose of medication, knowing that the patient may commit suicide by taking that lethal dose.
Euthanasia is carried out when another person administers the dose or otherwise personally and directly assists in ending a person’s life.
In states that allow physician-assisted suicide, patients are required to have a “terminal illness” in order to qualify for lethal medications. However, these laws often have vague definitions of what qualifies as a “terminal illness” for these purposes. In a shocking recent example, a doctor assisted in carrying out the death of some of her patients struggling with eating disorders.
It’s important to remember that pain from terminal illness can be managed through palliative care and is not the sole reason the vast majority of patients pursue assisted suicide. Many fear being a burden on family and friends as they continue their struggle. Financial concerns are often also an issue. And thinking about quality of life amidst almost certain suffering clouds judgment and can lead to impulsive decisions.
Human suffering is a fact of life, a deeply engrained consequence of the sin and brokenness that entangles itself with God's good creation. We’re called by Christ to care for those who suffer, and point them to Christ’s love, hope, nearness, strength and redemption amidst any and all difficulties in this life.
Scripture teaches that even amidst suffering, no one is justified in taking or ending life; rather, there is abundant grace and a unique presence of Christ’s strength and peace amidst suffering.
While we are never to celebrate suffering for its own sake, and we should seek to alleviate human suffering wherever possible, physician-assisted suicide is not the compassionate solution to true human suffering. God has provided another truly life-giving pathway:
I lift up my eyes to the hills. From where does my help come? My help comes from the Lord, who made heaven and earth. He will not let your foot be moved; he who keeps you will not slumber. Behold, he who keeps Israel will neither slumber nor sleep. The Lord is your keeper; the Lord is your shade on your right hand. The sun shall not strike you by day, nor the moon by night. The Lord will keep you from all evil; he will keep your life. The Lord will keep your going out and your coming in from this time forth and forevermore (Psalm 121 ESV).
Christ also reminds us to bring our suffering to Him:
Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light (Matthew 11:28-30 ESV).
And the author of Hebrews reminds us that Christ knows our plight. He knows what it means to suffer and to lose hope. He is not aloof to human suffering. Instead, His passion, love, and presence are made even more evident through it.
Since then we have a great high priest who has passed through the heavens, Jesus, the Son of God, let us hold fast our confession. For we do not have a high priest who is unable to sympathize with our weaknesses, but one who in every respect has been tempted as we are, yet without sin. Let us then with confidence draw near to the throne of grace, that we may receive mercy and find grace to help in time of need (Hebrews 4:14-16 ESV).
Humans have inherent dignity and immeasurable intrinsic value because we’re made in the image of God. Young and old, and everyone in between is precious to God. and Christ came to rescue and redeem them and give them new life. To artificially cut life short defies God’s role as Creator and Sustainer, and flies in the face of the dignity He bestows on His cherished image-bearers.
Much of Christ’s earthly ministry was devoted to recognizing the dignity of the outcast and vulnerable. Near the outset of His mission, one of the ways Christ laid claim to His role as Messiah was by reading from the prophet Isaiah in a synagogue on a Sabbath day:
And he came to Nazareth, where he had been brought up. And as was his custom, he went to the synagogue on the Sabbath day, and he stood up to read. And the scroll of the prophet Isaiah was given to him. He unrolled the scroll and found the place where it was written, “The Spirit of the Lord is upon me, because he has anointed me to proclaim good news to the poor. He has sent me to proclaim liberty to the captives and recovering of sight to the blind, to set at liberty those who are oppressed, to proclaim the year of the Lord's favor.” (Luke 4:16-19 ESV)
Jesus didn’t spend His time pandering to the powerful; He lowered Himself to serve the powerless, weak, diseased, the sinner, and the broken. St. Paul put it this way in his letter to the Philippians:
Have this mind among yourselves, which is yours in Christ Jesus, who, though he was in the form of God, did not count equality with God a thing to be grasped, but emptied himself, by taking the form of a servant, being born in the likeness of men (Philippians 2:5-7 ESV).
Through the humility of God, human dignity is championed.
As followers of Christ and as a society as a whole, it’s vitally important that we champion the dignity of the elderly, vulnerable, and outcast. We don’t want to cast them off. We want to embrace and cherish them. And we don’t want to snuff out those whose life and strength is seemingly fleeting. Their lives still matter and the physical, mental, and emotional pain they experience must be taken seriously and ultimately met with compassion, care, and Christ’s love.
Laws that legalize physician-assisted suicide have effects beyond the initial tragic act of enabling physicians to help their patients commit suicide. They help normalize an unnatural, morally dubious pursuit of death. As the doors to this travesty open wider, it becomes harder to contain and stop.
Let’s consider briefly the role that insurance companies play in physician-assisted suicide. There have been instances where insurance companies have paid for physician-assisted suicide instead of treatments for terminal illnesses. And, sadly, it’s easy to see why they would do that: in some instances, it makes more economic sense to cover lethal drugs rather than more costly, life-sustaining treatments.
Think about it: Once a patient has a lethal dose to end his or her life, there is no accountability as to what happens next. No one is required to watch the patient take the prescription, and no one is ensuring that the patient takes it voluntarily.
Physician-assisted suicide laws compromise the medical profession, turning doctors’ Hippocratic Oath on its head. Participating in your patient’s suicide is anything but upholding the promise to not “give a lethal drug to anyone.” In fact, the American Medical Association’s Code of Ethics calls physician-assisted suicide “fundamentally incompatible with the physician’s role as healer” and says it “would pose serious societal risks.”
While most laws legalizing physician-assisted suicide affirm the right of health care providers to decline to write prescriptions for lethal medication, some laws require health care professionals to provide, upon request, information about assisted suicide to patients and to refer and transfer patients to another provider for lethal prescriptions. Similarly, while a health-care facility may maintain a policy against providing assisted suicide, it nevertheless must “coordinate” the transfer of a patient requesting physician-assisted suicide to a willing provider. Such actions would clearly violate the consciences of many health care providers.
Currently, 10 states (California, Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, Washington), and the District of Columbia allow physician-assisted suicide, and in recent years, there has been an increase in the number of states considering venturing down this deadly path. With God’s help, ADF will continue working hard to keep this from happening.
At ADF, we’re committed to remaining vigilant on this vital issue. In some cases, states that have already legalized physician-assisted suicide are going back and amending their current laws to make it even easier for patients to access lethal medications.
In October 2021, California Governor Gavin Newsom signed SB 380 into law, weakening an already-permissive 2015 law requiring a 15-day waiting period after a patient’s request for assisted suicide. The new law requires just 48 hours between requests.
Dr. Leslee Cochrane is a Christian Medical & Dental Associations (CMDA) member and full-time hospice physician in California who is board-certified in family medicine with a certificate of additional qualification in hospice and palliative medicine. CMDA and its members, like Dr. Cochrane, seek to live out their Christian beliefs in their practice of health care, including their belief in the sanctity of human life. It would violate their consciences to participate in assisted suicide in any way. But California law is now forcing these healthcare professionals to actively facilitate the physician-assisted suicide process.
CMDA members believe deeply that suffering patients need understanding and sound medical treatment, not encouragement to kill themselves. Their rights of conscience and religious freedom must be protected because the state has no authority to order them to act contrary to those sincere convictions.
Many doctors like Dr. Cochrane rightly see helping a patient fulfill legal requirements to commit suicide as facilitating the patient’s death and therefore cannot participate in the process. But if these health-care professionals continue to stand on their deeply held beliefs and focus on helping and healing instead of killing, they could be subject to civil or criminal penalties and could even lose their license. So, in February 2022, ADF filed a complaint, and then filed a motion for preliminary injunction in March.
Thankfully, in September 2022, a federal court granted our motion for preliminary injunction, saying that the California law likely violates the First Amendment rights of medical professionals by requiring them to participate in physician-assisted suicide against their religious convictions and professional ethics. ADF is still waiting on the final ruling.
Physician-assisted suicide is neither compassionate nor an appropriate solution for those who are suffering. Some of our society’s most vulnerable citizens—the elderly, the terminally ill, the disabled, and the depressed—are worthy of life and equal protection under the law. Life should be protected from conception to natural death, and those who object to participating in a culture of death should be defended from being forced to do so.
Taking a step back and looking at the big picture, there is a double standard at play in this issue. Our society generally promotes and teaches suicide prevention. Yet, many are also simultaneously advocating for prescribing suicide to the most vulnerable among us. This contradiction is dangerous. It muddles morality.
And that’s not all. By allowing the legalization of suicide and forcing physicians to be parties to it, we compromise the foundation upon which our society is built: the preservation of life. Doctors shouldn’t be forced to participate—in any way—in the death of a patient they’ve sworn to protect. Turning health-care professionals into killers serves neither patients nor doctors nor their families.
Ultimately, both abortion and physician-assisted suicide prematurely cut short God’s work of redemption in and through His beloved image-bearers. Both practices seek to wrench control away from God with the assumption that we know what’s best. For finite creatures, it’s the epitome of arrogance. And for the victims of these practices, it’s deadly.
With God’s help, ADF will continue to advocate for life at all stages to help ensure that one of God’s most precious gifts given to us is safeguarded in our laws and culture.
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