Our friends at the Becket Fund for Religious Liberty have advised us that a federal appeals court just blocked a harmful Health and Human Services (HHS) mandate that would have
forced doctors and hospitals to perform gender-transition procedures on their patients against their conscience and best medical judgment. In Franciscan Alliance v Becerra, the court ruled that a Catholic healthcare network and a group of nearly 19,000 healthcare professionals cannot be required to carry out these procedures in violation of their deeply held beliefs and professional medical judgment.
An association of over 19,000 healthcare professionals, eight states, and two religious hospitals challenged the mandate in the federal court for the Northern District of Texas. (A similar suit, involving other challengers, was filed in North Dakota). In December 2016, the Texas court issued a preliminary ruling that the policy was an unlawful overreach by a federal agency and a likely violation of religious liberty. And in October 2019, the court confirmed its earlier ruling, explaining that doctors must be free to practice in their field of medicine without being forced to perform these controversial procedures that violate their faith.
The court did not, however, issue an order permanently stopping the government from imposing this unlawful mandate on religious hospitals and doctors. Becket therefore appealed on behalf of the challengers. In April 2021, the U.S. Court of Appeals for the Fifth Circuit ruled that the district court should consider further whether to grant that lasting protection.
Back at the district court, in August 2021, the judge granted the permanent relief the doctors and hospitals sought. Under the district court’s final ruling, the government may not require the challengers to perform or insure gender-transition procedures contrary to their faith and medical judgment going forward—even if the agency tinkers around the edges with the language of its mandate.
Dissatisfied with not being able to force religious healthcare providers to violate their faith, in late 2021, the federal government, along with the ACLU, appealed the decision back to the Fifth Circuit. Oral argument took place on August 4, 2022.
In the unanimous ruling, the Fifth Circuit affirmed the lower court’s order “permanently enjoining [HHS] from requiring Franciscan Alliance to perform gender-reassignment surgeries or abortions in violation of its sincerely held religious beliefs.” The court explained that while the government argued it should get more chances to show why it needed religious healthcare providers to participate in gender-transition procedures, other cases showed that permanent protection was appropriate—including, ironically, cases brought by the ACLU, who had intervened in Franciscan to support the government.
Initially, the lower court's ruling blocked HHS "from requiring Franciscan Alliance to perform gender-transition surgeries or abortions in violation of its sincerely held religious beliefs."
“This ruling is a major victory for conscience rights and compassionate medical care in America,” said Joseph Davis, counsel at Becket.
Six years ago, the federal government issued the mandate as part of the Affordable Care Act and tried to apply it to virtually every doctor nationwide. The requirement would have forced doctors to perform these procedures on any patient, including on children, even if the procedures went against their conscience and professional medical judgment. A group of religious organizations and nine states quickly sued and received protection from federal courts in North Dakota and in Texas. Today’s ruling is another successful step in this fight to protect doctors’ conscience rights.
“For years, our clients have provided excellent medical care to all patients who need it,” said Davis. “Today’s ruling ensures that these doctors and hospitals may continue to do this critical work in accordance with their conscience and professional medical judgment.”
Joseph Davis, who works as counsel with Becket, a religious liberty group representing the physicians, said the ruling was appropriate for healthcare workers.
"This ruling," Davis says, "is a major victory for conscience rights and compassionate medical care in America. Doctors cannot do their jobs and comply with the Hippocratic Oath if the government requires them to perform harmful, irreversible procedures against their conscience and medical expertise."
Health and Human Services (HHS) mandate
Franciscan Alliance v Becerra
Court of Appeals