Question from a reader:

I work in a doctor’s office and want to become a doctor one day, but I don’t know what I would do in this situation since some birth controls are abortifacient. If I’m a doctor who prescribes birth control or a pharmacist who fills the prescription for birth control, am I in sin? I know sin means missing the mark. I don’t know what that means exactly. It just seems like everything is a sin and it’s so stressful. Shouldn’t it be the patient’s responsibility if they choose to take the medication?

Answer from Stephanie Anderson, EPM staff:

I appreciate your thoughtfulness in this matter and that you are already contemplating what these issues may mean for your future practice. You mentioned specifically about the birth control pill, but in today’s culture, there are a myriad of medical procedures (transgender hormone blockers, abortion, physician assisted suicide) that may prove problematic for a Christian prolife physician and go against their conscience. So it seems wise for you to think through these issues carefully ahead of time and ask the Lord’s guidance and help.

Near the end of his book Does the Birth Control Pill Cause Abortions?, Randy writes, “I don’t want any of my countless physician friends, brothers and sisters to be made uncomfortable or put on the defensive. Unfortunately, this is one of those issues that will inevitably put them on the spot, especially OB/GYNs and family practitioners. Other than talking with them, sympathizing with them, and praying for them, I’m not sure what else to do. When discussing this issue, it is always relevant to remember that informed consent is a widely accepted ethical mandate of modern medicine. If nonbelievers recognize this, we as believers should take it even more seriously.”  (See “This Puts Medical Professionals in a Very Difficult Position”, page 148.)

If you are aware of the potential abortifacient effects of the pill, then it is important that you not suppress or deny those convictions, but honestly and graciously provide your patients with full and clear information about its various effects. To withhold that information out of fear might very well suppress or go against your conscience, which Scripture says could be sin: “So whoever knows the right thing to do and fails to do it, for him it is sin” (James 4:17). “But if you have doubts about whether or not you should eat something, you are sinning if you go ahead and do it. For you are not following your convictions. If you do anything you believe is not right, you are sinning” (Romans 14:23, NLT). “The aim of our charge is love that issues from a pure heart and a good conscience and a sincere faith” (1 Timothy 1:5).

What your patients do with that information is up to them, and yes, becomes their responsibility.

The Christian Medical & Dental Associations says this on their website:

Made in the image of God, we are endowed with a conscience that enables us to know and respond to moral truth. To live by conscience is to live with integrity, with pure hearts and transformed minds that seek God’s will and strive to love him and our neighbor. Christians should inform their consciences through Scripture, reason, and evidence, and when matters are uncertain, pray for the Holy Spirit’s guidance. Because moral judgments reflect our best understanding of what is good and right, we should always follow our conscience even as we recognize that our conscience is fallible and ultimately under God’s judgment and grace. Because reason is essential in conscience, Christians should be prepared to engage in moral deliberation and to explain and commend the reasons for their conscientious actions to others.

In clinical practice, Christian healthcare professionals should be in, but not of, the world, striving for what is good and avoiding complicity with evil. We should pray for wisdom to discern what is right when circumstances in our fallen world make it difficult to separate ourselves from associating with the evil actions or intentions of others. Christian healthcare professionals will sometimes need to disagree with patients, colleagues, or institutions over the ethical legitimacy of controversial medical practices. Under such circumstances, Christian healthcare professionals must be prepared to refuse to cooperate with such practices. They should do so with compassion and confidence, knowing that loving our neighbors sometimes means refusing to cooperate with their mistaken wishes. Conscience should be considered a right with profound ethical and religious importance. Therefore, Christian healthcare professionals should encourage colleagues, institutions, and governments to respect this right and to establish policies that accommodate clinicians who exercise it.

You can read more here.

This is focused specifically on abortion and not the birth control pill, but it may be a helpful resource from the American Association of Pro-Life Obstetricians and Gynecologists, talking about medical ethics, the Hippocratic Oath, and the doctor’s conscience.

Another group you might be interested in learning more about/contacting is Pharmacists for Life.

Though rare, there are physicians who have chosen not to prescribe birth control pills. Dr. Toffler (who authored an article we posted on our website) writes,

While I only recall one occasion where I prescribed EC [emergency contraception], I used to prescribe BCPs heavily and was enmeshed in the contraceptive paradigm. When I started to recognize my own inconsistency and considered changing, I became fearful. Even if I didn’t use them with my wife anymore, how could I reject contraception as an option for my patients? How could I continue to practice as a family physician? Could I do OB? Women’s Health? Could I continue to teach at a university? What would my colleagues say? What about residents? Students? Could I keep my job? Could I make even make a living in medicine? These weren’t trivial questions—at the time, I had seven children at home. In retrospect, needless to say, I shouldn’t have worried. God rewards abundantly even a small step in faith. He certainly has me. I am freed of my own inconsistency (hypocrisy?) and my life and practice has never been richer (both literally and figuratively).

(I actually see that Dr. Toffler is still in practice here in Oregon.)

Randy writes, “I realize there are some professional sacrifices that might be made by those who act on the belief that the Pill causes abortions. But I am convinced God can be trusted to guide and provide for those willing to make such sacrifices. Physicians, pharmacists and other medical providers should be more concerned with God’s approval than man’s. We should remember that Christians can expect suffering and trials (Romans 8:17-18, James 1: 2).”

I understand your dilemma, and sympathize with how overwhelming and stressful this can feel. These are tough ethical issues, and many wise and mature believers have wrestled with them before us, and are presently wrestling with them today. Please remember that God doesn’t want you to live in constant fear of sin, and to carry around unnecessary guilt. He wants you to experience life and freedom and joy and a clear conscience as you walk with Him and follow His leading. “Then the way you live will always honor and please the Lord, and your lives will produce every kind of good fruit. All the while, you will grow as you learn to know God better and better” (Colossians 1:10, NLT).

Finally, the promise of James 1:5 is one of my favorites: “If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him.” Perhaps you can also ask the Lord to provide wise, godly Christian mentors in the medical field who can give you advice and help as you walk this path.

Finally, this note that we received from a reader demonstrates how one nurse practitioner chose to change her practice in response to what she learned in Randy’s book:

I’ve just finished re-reading your book Does the Birth Control Pill Cause Abortions? At the end you invite readers to email you any comments.

In 2020 I found out that all hormonal contraceptives cause abortions. A doctor I work with asked me about an article he read about emergency contraceptives, which led me to look up how they worked, which then led me to look up the mechanism of action of other birth controls on UpToDate. I was shocked and horrified to see “inhibits implantation,” “inhibits nidation,” and “alters endometrium.” I immediately stopped prescribing it, and was overwhelmed with grief that I had prescribed it without knowing it caused abortions. God says, “You must not murder” in Deuteronomy 5:17. But I realized that is exactly what I had probably done by prescribing birth control. This was my thought process that day: Prescribing birth control kills babies. That’s murder since those babies did nothing to deserve death. God says, “You must not murder.” Therefore, I must not prescribe or use hormonal birth control.

…Since then not only do I NOT prescribe or recommend hormonal birth control any more, but also whenever I see any patient that is on birth control (no matter what the reason for their appointment) I explain to them the abortive mechanism of action so they can decide for themselves if they should continue to take it. Most people are shocked. But many people don’t seem to care, or it seems like they don’t want to care.

Since then one thing led to another and I am now being trained in the Marquette Method of natural family planning, I am quitting my nurse practitioner job, and I plan to start my own practice offering the Marquette Method to my community. God is good. Thank you for your hard work.

God bless you, as you follow Him.

Photo by Derek Finch on Unsplash