U.S. Assistant Secretary for Health Dr. Brian Christine encouraged medical residents to refuse to participate in procedures that would violate their consciences. The comments offer a refreshing contrast with the Biden administration, which often sided with the medical establishment in pressing abortion on medical providers. But HHS policy needs to catch up.
“If your deeply held religious convictions [are attacked] — say that you can’t engage in some activity, for instance, abortion, or a sex-rejecting procedure — stand strong in that,” Christine counseled medical residents in a recent interview with The Daily Signal. “Refuse to do that. And, again, reach out to the proper authorities and individuals at their institutions.”
The grisly backdrop to these comments is the medical establishment’s successful campaign to force medical schools to require abortion training.
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The effort dates back to 1994, two years after Planned Parenthood v. Casey, when the Accreditation Council for Graduate Medical Education (ACGME) adopted a mandate that “experience with induced abortion must be part of residency training” for all OB/GYN training programs. Before this, abortion training was available, but medical residents had to opt in to such training, instead of having to opt out. Additionally, while individuals with a moral or religious objection could opt out, medical training programs with a moral or religious objection (such as those run by Catholic or Protestant hospitals) could not.
As a recent congressional letter noted, “ACGME is the only accrediting body for GME [obstetrics and gynecology] programs in the US and thus there is no other option for training programs or residents.”
Before that, ACGME adopted that mandate, the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) set forth the reasons why the mandate served no medical purpose.
First, OB/GYN medical residents already learned “the surgical techniques utilized” in abortions, including how “to treat complications when they occur,” because the same procedures are used in cases when the unborn baby was already dead. “In other words, it is unnecessary to perform induced abortions to learn these techniques or how to care for the complications,” AAPLOG argued, in remarks shared by the AAPLOG Board of Directors in a May 11, 1994 memo.
Nothing has changed in three decades except that there are fewer surgical abortions, as unsafe, unregulated abortion pills take over the morbid market. In a December 5, 2025 letter to HHS leadership, 19 members of Congress led by Senator James Lankford (R-Okla.) and Rep. Greg Murphy (R-N.C.) made the same point, “Every obstetrician-gynecologist is trained in the medical and surgical methods used to evacuate the uterus, and it is the same procedure whether it is being performed on a dead unborn baby as a result of a miscarriage, or on a live unborn baby in the case of induced abortion.”
AAPLOG’s second argument observed the “exemption from performing induced abortions for individuals who have moral or religious objections.” For them, the very existence of such an exemption demonstrated that “the Residency Review Committee recognizes that an individual can become eligible for Board certification without having performed induced abortions. It follows then that a training program need not offer experience in performing induced abortions either on or off campus in order to properly prepare a candidate for certification.”
So, if the requirement that residency programs train medical residents to carry out induced abortions does not further a medical purpose, what is it about? Dr. Steven Foley concluded that “their unwavering ideological commitment to promoting abortion in all settings appears to be the driving force.”
The American College of Obstetricians and Gynecologists, the left-wing counterpart to AAPLOG, argued in favor of the training requirement after Dobbs, stating, “Abortion is an essential component of comprehensive, evidence-based medical care.”
It should come as no surprise, then, that a training requirement driven by an ideological commitment to abortion infringes on the conscience rights of health care professionals who maintain a moral objection to killing unborn babies.
Firstly, AAPLOG noted that the abortion training requirement “is in direct conflict with the moral and professional character of a number of hospitals.” Unfortunately, “Failure to comply meant withdrawal of the accreditation of that training program — a devastating blow to any program,” they explained. Unlike individuals, “Hospital programs could not opt out: If hospitals (e.g., religious institutions) did not have the abortion training program on site, they must have arrangements for abortion training off site.” The Lankford letter stated that “This requirement also forces faith-based hospitals … to provide this training as well as pay faculty to perform these procedures.”
Secondly, despite an “opt-out” right on paper, the abortion training requirement even pressures individual physicians to violate their conscience, because such opt-outs “can be accompanied by intimidation and retaliation,” AAPLOG alleged. “Now, if residents do not want to train in abortion for any reason, they must approach those higher in authority than themselves, and who are responsible for their evaluations and future career trajectories, to opt out of such training. … This is dissuading medical students from pursuing obstetrics in order to avoid this clash of conscience.”
Once again, the Lankford letter concurs, an “opt-out” training model “requires first year residents — the most vulnerable in the hierarchy of medical training — to publicly state to their fellow residents as well as their superiors, who will determine the course of their career, that they don’t want to do something they are being told is standard training.”
“This not only sets up an extremely coercive environment where many residents feel they need to ‘go along to get along,’” the letter added, “but we have also heard of several instances where residents who opt out are given increased workloads as a result (one example is attached).”
The ACGME’s 1994 mandate was scheduled to take effect in 1996. However, Congress intervened by passing “the Hoekstra-Coats Medical Training Nondiscrimination Act of 1995,” explained AAPLOG in 2009, “which declared that an entity that forced individuals or programs to participate in abortions would be discriminatory, and on that basis that entity would lose federal funding. Money talks. The ACGME Mandate was never enforced, although it is still on the books.”
However, in 2018, the ACGME finally did implement the requirement that all OB/GYN residencies provide abortion training. Yet AAPLOG notes that “the policy has failed to achieve its stated goal” of increasing the number of abortion suppliers, as the percentage of physicians carrying out abortions remains unchanged at 14% from 2009 to 2024.
During the Biden administration, the federal government summoned all its might to the cause of the unaccountable medical establishment as it tried to force the practice of abortion down providers’ throats. His administration implemented a rule, now revoked by the Trump administration, which required emergency room doctors to carry out abortions, without adequate conscience protections.
On November 25, 2025, the Trump administration’s HHS published a final rule defending the right of medical residents to opt out of abortion training. Notably, the rule declined to implement an “opt-in” model, choosing instead to kick the can down the road. “In response to comments recommending further expansion of the proposed policy,” it stated, “we may take these comments into consideration for future rulemaking.” This punch-pulling rule provoked Lankford, Murphy, and 17 other members of Congress to write their letter, urging the administration to do more.
“Because the current opt-out induced abortion training requirement is a clear violation of existing federal law, HHS and CMS should issue a rule to require any graduate medical education program to provide induced abortion as an opt-in only option in order to receive their federal GME funding and in order to receive CMS reimbursements,” the letter contended. “The change to opt-out did not provide any additional essential training to medical residents — the only thing it did was set up an environment which coerces residents to participate in procedures that intentionally end the lives of fetal human beings. By returning training in induced abortion to an opt-in system, OB/GYN residents will still receive all the training they need to fully care for women, and training in induced abortion will still be available for those who wish to receive it.”
Assistant Secretary Christine, recently appointed to the position, has spoken openly about how “my Catholic faith guides me” in “every decision that I make,” so that “I don’t set my faith aside at the door.” Even in the field of medicine, “We faithful don’t have to check our faith at the door to practice medicine or science,” because real medicine and science are consistent with biblical faith.
As a result, Christine said, HHS is “working hard to make sure that conscience protections for physicians, nurses, health care professionals, and health care institutions are protected.”
It’s great to hear such an endorsement of Christianity and religious liberty issuing from the mouth of a high-ranking government official. It would be even better if HHS policy lived up to the rhetoric.
“Religious liberty is incredibly important, and again, at the Department of Health and Human Services, we stand firm in our support for religious liberty,” Christine told The Daily Signal. “We’re not just simply saying that we believe in religious liberty. We’re not simply just saying that we’re going to protect conscience, we’re actually doing things. We are keeping promises that the president and [HHS] Secretary [Robert F.] Kennedy have made.”
If the Trump administration is serious about protecting the conscience rights of medical residents, then they should clarify that residents may not be pressured in any way to carry out abortions — and that entails implementing an “opt-in” model for abortion training.
“It’s difficult to overstate the importance of having health care professionals who recognize the value of all human life,” Family Research Council Policy Analyst Joy Stockbauer told The Washington Stand. “We must have systems in place that protect ethical medical professionals, rather than pressuring them to participate in practices that contradict their sincerely held moral values.”
LifeNews Note: Joshua Arnold is a staff writer at The Washington Stand, contributing both news and commentary from a biblical worldview. Originally published by The Washington Stand.
