Leaving No One Behind: The Duty to Care, Not to Kill

Thank you, Father Spitzer, for that much-too-generous introduction. And so, to help with my humility, I will just point out that both of the Supreme Court citations were written dissenting opinions.

I also want to thank Mitch Boehma for giving me the coveted first speaking slot on the last day of the conference when everyone is thoroughly exhausted and hung over. So, if my talk bombs, no one will remember how bad it was.

Focus the Pro-Life on Beginning to End

What I’d like to do—originally, what I had written ahead of time—the title of the talk is Leaving No One Behind: The Duty to Care, Not to Kill. I had pitched Napa saying we really need to focus on assisted suicide, euthanasia, end-of-life battles, because that’s the next big challenge to the pro-life movement that is coming to the United States. And so that’s what I had prepared to speak on.

But after the past several weeks—at the beginning of life and the challenges that we have seen there—I actually have rewritten the talk, and I’m mainly going to focus on the beginning of life. Because I think that’s actually right now the more pressing issue, even if assisted suicide is the next issue.

I want to start with a Lenten homily that Cardinal Ratzinger delivered in 1981. It was published in a short little book titled In the Beginning: A Catholic Understanding of the Story of Creation and Fall. And this is what Cardinal Ratzinger writes:

Human life stands under God’s special protection because each human being, however wretched or exalted he or she may be, however sick or suffering, however good-for-nothing or important, whether born or unborn, whether incurably ill or radiant with health—each one bears God’s breath in himself or herself. Each one is God’s image.

This is the deepest reason for the inviolability of human life. It is the foundation of every civilization.

Image and Likeness of God: The True Basis of Worth

As Father Spitzer mentioned, I’m trained in natural law theory and political philosophy. I think there is a natural law philosophical defense of human dignity. But the deepest reason for our dignity—the deepest reason for our worth—is that each and every one of us, no matter how wretched or how exalted, how sick or how healthy, how rich or how poor, how smart or how uneducated, we’re made in the image and likeness of God. We possess God’s breath. That needs to be the foundation of any healthy society.

So I want to take stock, two years post-Dobbs, of how we’re doing with this. Because the other thing to add—it’s not just Cardinal Ratzinger’s point about our being made in the image and likeness of God that grounds our dignity—it’s also what Father Roger Landry shared with us yesterday about the social dimension of man.

We debase ourselves when we fail to respect the dignity of others. We debase our own dignity when we don’t fulfill our duties to care and not to kill. That part of the social dimension of man is that we’re made for solidarity. We’re made for communion with one another. We are our neighbor’s keeper, our brother’s keeper. And so we have a duty to leave no one behind—and we’re unfortunately failing in that duty.

Long-Term Vision for the Pro-Life Movement

So it was two years ago that we got the Dobbs decision that overturned Roe v. Wade. And I think the very first thing to say as we take stock of where we are is that in the past several weeks, there have been children that celebrated their second birthdays as a result of that decision. There are little kids that are walking and talking—some of them won’t shut up—because of what Dobbs did, and because of what the pro-life movement did for 49 and a half years in refusing to accept Roe v. Wade as the last word.

It took the pro-life movement 50 years to overturn Roe. And in God’s timing—we don’t know—but it may take us another 50 years until we have passed pro-life laws in all 50 states and at the federal level. And I think we need to prepare for the long haul.

Let me say a little bit more about this. In his last major address before Father Neuhaus passed away, he declared:

“Until every human being created in the image and likeness of God is protected in law and cared for in life, we shall not weary, we shall not rest.”

“Protected in law and cared for in life” remains the legal and cultural goal of the pro-life movement. But the past two years of less-than-stellar results in our political efforts to protect the unborn have shown us that we can’t simply jump to the goal.

Our entire constitutional, political, and social order was corrupted by 50 years of the Roe v. Wade decision. Conservatives are correct to point to the law as a teacher. There’s a pedagogical function to law. And the pedagogical result of a bad Supreme Court ruling that was allowed to stand for two generations was the darkening of our national conscience.

Multiple generations of Americans were catechized to believe that abortion is a right, that unborn babies have no rights, and that we have no duties to the unborn.

While Dobbs did important work to repair the damage to our constitutional order, it couldn’t erase half a century of political and social corruption. We’re all incrementalists now.

It does the pro-life cause no good to pass a protective law in the statehouse that will then be repealed at the ballot box in November—especially if it will then be replaced with something that’s even more outrageous: abortion on demand throughout all nine months of pregnancy, a repeal of parental notification laws, etc.

Our goal needs to be not simply the most protective law possible at the moment, but the most protective law that can withstand efforts to repeal it. Which means that some of our most protective immediate work is going to have to take place through executive actions, through federal agencies. Personnel is policy.

At both the federal and state level, we can do quite a bit to protect the unborn and serve their mothers simply by undoing all that the Biden Administration has done to promote abortion at the federal level and to obstruct pro-life laws at the state level. That would make a real difference.

Some of this work also needs to be educative—using law and politics to shape opinion. And this means we need to simultaneously take seriously the current political climate in which the pro-life movement finds itself, but also do something to change that climate—to use politics to change culture.

Cowardice vs. Courage

Unfortunately, Dobbs revealed what many of us who work in D.C. have long known: many political elites in the so-called pro-life party are frequently insincere in their pro-life commitments and are unwilling to provide real leadership to shift public opinion.

But there are committed pro-life politicians, and we’ve gotten our wins at the statehouse working through those committed pro-life officials.

Here’s an important contrast: we have lost every ballot initiative since Dobbs. They have all turned out a resounding defeat for the pro-life cause.

But pro-life politicians who stood firm have fared well in their elections. In fact, the most pro-life elected officials—the governors that signed heartbeat bills into law, the senators who championed federal legislation—they have all sailed to re-election, frequently winning by wider margins than their competitors who kept quiet on abortion.

Not a single pro-life elected official has paid a price at the ballot box. And there’s a lesson here.

With the ballot initiatives, pro-abortion activists who pose as media personalities—they control the messaging. Too few prominent pro-life politicians use the bully pulpit to rally voters to the pro-life side of the initiative. Some national political figures have even attacked state pro-life laws—we’ve seen that with the Florida initiative that’s underway.

And then the pro-life side is consistently outspent by wide margins. This is why the pro-abortion side will continue to bring the abortion question directly to ballot initiatives.

As we learned on the first day of the conference from Dr. Abela, every virtue has two opposing vices. And so, courage has two opposing vices: rashness on the one hand, but cowardice on the other hand.

Yes, there are some in the pro-life movement who have exhibited rashness in thinking that we could just abolish abortion overnight. But the more prevalent vice that we’re seeing right now is cowardice.

We’re currently seeing too few of our political leaders exemplifying the virtue of courage. Instead, they’re treating cowardice as if it was prudence. Many are simply retreating from the pro-life cause.

Political Responsibility and Moral Clarity

Yes, we need to win elections. But we need to win elections without throwing the pro-life cause under the bus.

Every human being is made in the image and likeness of God. Every human being deserves the law’s protections. This needs to be a bedrock principle.

It’s understandable why we’re seeing cowardice from some of our political leaders. They’re reading the public opinion polls, and they’re seeing that public opinion is not where it should be.

But politicians also play an essential role in shaping public opinion—not just being held captive to public opinion.

This is particularly important on the pro-life cause because, by and large, pro-lifers are locked out—or forced to be silent—of more or less every institution of elite society: the media, Hollywood, academia, business, athletics. With the exception of one kicker, we’re locked out of every institution of elite society.

The one venue you can be an outspoken pro-lifer without paying a professional cost is in politics. And unfortunately, we’re seeing too many of our leaders refuse to use that platform to speak about the abortion issue—intelligently, compassionately, and therefore boldly and persuasively.

The Illusion of a Pro-Life Majority

Right, as I said, it’s understandable, but it’s not defensible why the politicians are running for the hills. The sad reality here is that many of us have overestimated how pro-life our neighbors are. “We are the pro-life generation” is an excellent slogan to chant at the March for Life. Unfortunately, the data today does not back that up, and I think we need to come to grips with this reality.

A majority of Americans, although they’re ambivalent about abortion, they think that elective abortion should be legally permitted at least in the first trimester. And the majority of them will vote for a radically permissive abortion regime if they think the alternative is a complete prohibition on abortion.

We even lose a natural, um, part of our base. So Ohio was the most recent state to have a ballot initiative. One-third—um, um, let me get this stat correctly—one-third of voters who went to church at least once a week voted in favor of abortion. That is a scandal for the Church, that people who are in the pews at least weekly—we lost a third of them voting in favor of abortion.

Unfortunately, the public opinion has gotten worse in the past eight years. So I want to read you just a couple of stats from the most recent Gallup poll that looks at this.

We now have a record high 69% of Americans who say abortion should be generally legal in the first three months of pregnancy, and a record high 34% who say abortion should be legal under any circumstance. A record high 52% say abortion is morally acceptable, and this is 10 points higher than the historic average.

Things only get worse when you break down these numbers by party and by sex. In 2010, only 33% of Democrats thought abortion should be legal under any circumstance. Today, it’s 60%. And female support for abortion has jumped from 30% to 40% in the past decade. And so we’re just seeing a widening gulf on the abortion issue.

Cultural Shifts

There are many reasons why I think this is happening. Some of this has to do with the rise—we heard yesterday Dr. Francine speaking—of depression, the disconnection, the anxiety that the next generation in general is experiencing, but particularly young women. And young liberal women in particular are facing some of this.

The change in public opinion likely has to do with the person of Donald Trump, but I think a lot of it has to do with what Donald Trump first potentially embodied and then brought to actualization—and that was the overturning of Roe v. Wade.

Cultural Shifts

There are many reasons why I think this is happening. Some of this has to do with the rise—we heard yesterday Dr. Francine speaking—of depression, the disconnection, the anxiety that the next generation in general is experiencing, but particularly young women. And young liberal women in particular are facing some of this.

The change in public opinion likely has to do with the person of Donald Trump, but I think a lot of it has to do with what Donald Trump first potentially embodied and then brought to actualization—and that was the overturning of Roe v. Wade.

In 50 years of Roe v. Wade, people built their lives on the expectation that abortion is going to be available. Even when we know that abortion stops a beating heart, people just don’t care. Or at least they aren’t willing to make the personal sacrifices required to care.

The Brutal Honesty About Abortion

A few weeks ago—most of you probably don’t watch The Bill Maher Show, I would imagine at Napa that’s not a prevalent TV show—but Bill Maher said the quiet part out loud. And he actually kind of stunned his other guests and the audience. This is what Bill Maher said, speaking of pro-lifers:

“They think it’s murder. And it kind of is. I’m just okay with that.”

There’s so much motivated reasoning—what Catholics call rationalization—in the abortion debate. Because deep down, people know the law written on the heart. They just aren’t willing to make the necessary lifestyle changes to live in accordance with the law. And this will require us addressing the sexual revolution.

As Father Spitzer mentioned, right as the Dobbs decision was coming down, Alexandra DeSanctis and I co-authored a book: Tearing Us Apart: How Abortion Harms Everything and Solves Nothing. If you checked in for the conference and you got your tote bag, there should have been a free copy in the bag.

The reason why is that as writers, as intellectuals, Alexandra and I wanted to do our part to equip the pro-life movement for what would be a new stage in the pro-life battle. We had overturned Roe. Now we need to change hearts and minds. Necessary work of persuasion.

We’re in the persuasion business. Law shapes culture, but culture also shapes law. It’s a two-way street. And so part of our approach to that book was to go chapter by chapter by chapter of all of the ways in which abortion harms everything it touches and solves nothing.

The first chapter was about how it kills the unborn child, but there’s seven additional chapters. And we go through, part by part by part, point by point by point—how it harms women, how it harms people with disabilities, how it harms the medical professional, how it harms law, how it harms politics, how it harms culture, how it harms the economy—to broaden the scope of what’s going on.

Pro-Lifers Are Responding

I’m happy to say that pro-lifers have responded. My colleagues at EPPC did a report that came out about a month ago documenting every state that had passed a pro-life law protecting unborn babies from the lethal violence of abortion also passed multiple laws serving their mothers: increased funding for alternatives to abortion, increased funding for paid family leave, increased funding for maternal care both during the nine months of pregnancy but then for a year afterwards, etc. etc.

We saw pro-lifers putting their money where their mouth is—in supporting not only the child’s right to life, but then serving their mothers.

But the reality here is that no one’s getting an abortion because they can’t afford diapers. It’s important that we do the pro-family, pro-mom policy work. It’s important that we run the pregnancy centers.

But when you look at the statistics—and I want to share two statistics that will illustrate this—one statistic is who gets aborted, and the other statistic is who has an abortion.

4% of babies conceived inside of marriage will be aborted, compared to 40% of children who are conceived outside of marriage. 14% of women who have an abortion are married. 86% of women who have an abortion are unmarried.

Marriage is the best protector of unborn human life. The safest place to be conceived is inside of marriage. The safest place to conceive a child is with your partner—your husband—committed to you in marriage.

So long as non-marital sex is expected, abortion will be viewed as required emergency contraception.

The Real Battle: Why Women Have Abortions

And so it’s not so much a matter of persuading people about the humanity of the unborn—anyone who has ever seen an ultrasound knows. The challenge here is persuading how people lead their sexual lives. And that means we’ll need to think through what new institutions, or what refocusing of existing institutions we need for the post-Dobbs world.

Talk to anyone that’s had to wage one of these battles in the states and they’ll tell you the same thing: few in the donor class are willing to spend real money on the pro-life cause.

It’s frequently national pro-abortion talent and money going up against state and local pro-life talent and money. We’re consistently outspent—not just at these ballot initiatives but also for our organizations.

Most of our successful institutions in the pro-life movement have been focused on the law, and that was understandable so long as Roe was in place. The biggest challenge was to chip away legally with precedents—the Born Alive Infant Protection Act, getting that upheld, partial-birth abortion bans, getting the right people elected to then get the right justices not only nominated but then confirmed by the Senate.

It was a lot of work to change the law. But we can’t just play in the courts any longer. That’s where we’re strongest. That’s where we’ve built up institutions.

We now need to play a long game and figure out how to invest in culture-forming, opinion-shaping institutions. What Alliance Defending Freedom has done with their Blackstone program—to create now an entire new generation of legal expert talent that is socially conservative—we’re going to have to think through for other culture-shaping institutions.

And the focus needs to be on human nature. It’s why the theme of this conference is so important: sound anthropology, especially in light of the sexual revolution.

The question is: how do we reach ordinary people who don’t know what the word “anthropology” means, to help them to lead transformed lives and to resist the lies of the sexual revolution? How do we help people lead the virtue of chastity?

The Threat of Assisted Suicide

Okay, so I saved myself five minutes to talk about assisted suicide, because I did want to highlight this—that this is the next issue that’s coming and that we’re not prepared for it. I think too many people have bought into the logic of the sexual revolution and then applied it to the end of life.

The logic of the sexual revolution: consenting adults should do with their bodies whatever consenting adults want to do with their bodies. And now we’re saying, well, apply that at the end of life—if consenting adult A wants to die and consenting adult B wants to help kill, why not have a free market exchange, a contract in killing?

But remember that Ratzinger quote that I started with: every human being—however wretched or exalted, however sick or suffering, however good-for-nothing or important, whether born or unborn, whether incurably ill or radiant with health—each one bears God’s breath at himself. Each one is God’s image.

That is the deepest ground for why we must insist that doctors always care and never, never kill their patients. The moral principle at stake here of human dignity is the deepest reason.

But I want to give you three other ways of thinking about how assisted suicide would corrupt our entire culture—so in the same way that abortion has corrupted everything it’s touched—how this will transform our culture.

1. It Endangers the Weak and Vulnerable

First, what it will do for people who are already on the margins of society. How assisted suicide will endanger the weak and the vulnerable.

Who’s most likely to be at risk of being pressured into assisted suicide? It’s not people who attend the Napa Institute Summer Conference. It’s people with disabilities. It’s people who are aging and elderly without networks of care and affection, without family connections. It’s people who lack robust healthcare, lack access to healthcare.

Some of the most innovative work that’s being done right now is to use the Americans with Disabilities Act and the 14th Amendment to argue that laws allowing physician-assisted suicide discriminate on the basis of disability status. That if I’m suicidal and I go to a doctor, I get psychiatric care. But if I was disabled enough, or if I was sick enough, or if I was old enough, and I go to a doctor expressing a wish to die, they might prescribe me a lethal dosage of barbiturates.

So one question is, how is this going to change how people with disabilities view themselves, how we view people with disabilities, how we view people at the margins of society? “Better off dead” will be a much more common way of the way that we will think about others—and the way that they will think about themselves.

2. It Corrupts the Practice and Trust of Medicine

Second, this will corrupt the practice of medicine. Medicine is not a morally neutral action, just like a technical expertise. It’s a profession. And what professionals do—you can think about religious professions of vows—lawyers are professionals, academics are professors, because we hold certain standards, certain truths to be governing the profession.

And for doctors, it’s healing. It’s wholeness. And it’s fundamentally incompatible with the role of a doctor as a healer to also be a killer.

And we have testimony from doctor after doctor: “Precisely because I knew I couldn’t kill my patients, it allowed me to enter more deeply into their suffering. It allowed me to actually be a better doctor, knowing that their life was invaluable, and that therefore I had to do everything to heal but never do anything to kill.”

It won’t just corrupt the practice of medicine. It’ll also corrupt our ability to trust our physicians.

Think about it—you’re aging, you’re starting to have some mental decline, some physical decline. You’re rushed to the ER. Can you trust what the nurse is putting in the syringe that’s going into your IV tube?

Can you trust how much you can share with your physician about your mental struggles, about your emotional struggles, if you know that at this hospital and at this institution, physician-assisted suicide has not only become allowed, acceptable, but it’s now a regular part of medicine?

It’s going to have huge implications for the doctor–patient relationship. And because the doctor–patient relationship is not symmetrical—it’s an asymmetrical relationship. When you go to the doctor, the doctor has all of the knowledge. You frequently don’t have the knowledge, right? When you go to the doctor, you’re frequently the one that gets undressed. The doctor is not the one that gets undressed. When you go to the doctor, the doctor is the one who pokes and prods and touches. You’re not the one.

Which is why general ethics—you shouldn’t lie, you shouldn’t inappropriately touch people, you shouldn’t kill people—become at a heightened level when it’s the physician.

For a physician to lie to a patient, for a physician to abuse that vulnerability in the state of disrobing or inappropriate touching, for a physician to kill—it’ll fundamentally change how much trust we as patients can put into our physicians.

3. It Incentivizes the Cheap Solution Over Humane Care

Lastly, on this part: the funding. Assisted suicide is cheap and easy and quick. Hospice care, palliative care, a real death with dignity—what the Little Sisters of the Poor do when they’re not suing the federal government—that’s labor-intensive, because it’s humane, it’s loving.

We have scarce financial resources, and the health insurance companies are going to incentivize the quick, easy, and cheap solution. So how we finance end-of-life care will change.

Assisted Suicide Undermines the Role of the Family

And then lastly, it’s going to change the family. There’s a natural cycle to life. Every one of us enters life entirely dependent on other people. Any of you who are a parent, who have had a baby—that baby enters the world not as a fully autonomous, liberal, atomistic individual who is self-sufficient. There’s a process of nurture and care. And many of us will exit life where we’re dependent on other people.

And part of the family is to share one another’s burdens. It’s to share our dependencies on another. What it is to be human is actually to shoulder the burdens of one another.

There’s a great essay that Gil Mylander wrote in First Things about two decades ago titled I Want to Burden My Loved Ones. Because everyone else says, “I don’t want to be a burden to my loved ones.” And he’s like, “You’re getting the nature of what it means to be human wrong.”

The entire point of life is to burden each other and to shoulder one another’s burdens. And a death by suicide will teach: my parents are better off dead. I don’t want to burden my sons, their spouses, the grandkids.

How we respect—you think the commandment, “Honor thy mother and father”—it’s not just when you’re a little kid, “Behave yourself.” It’s actually more important when you’re middle-aged and you have your aging parents. And how do you honor them?

What It Means to Be Human for the Pro-Life Movement

All right, so let me wrap up because I’m now out of time.

For both the beginning-of-life struggles that we face and the end-of-life struggles that are going to be coming—and if you look at what’s happening in Canada right now, you look at what’s happening in the post-Christian European nations that have legalized this—it’s barbaric. And it’s coming here.

The solution to all of this is things that we should be doing anyway: getting married, staying married, loving our spouses, loving our children, loving our parents. And I think at the deepest level, that is what it means to be human. It’s to care for one another. It’s to leave no one behind. It’s to love one another.

And that’s going to be the challenge that we’re going to be facing. It took us 49 and a half years to get to Dobbs. In God’s providence, we don’t know if it’ll take another 49 and a half years. But we have to be committed for that long haul. Thank you.