The Trump administration is hijacking religious liberty to license discrimination against patients. It has reorganized the civil rights office of the United States Department of Health and Human Services so that conscience and religious freedom are “at the top.” The Department of Justice followed on Friday with a religious-liberty report that takes aim at vaccine mandates and quotes, at length, parents who do not want their children vaccinated. A new federal rule of religious conscience is on its way.

If you read these announcements the way they are written, you will conclude that a long-overlooked constituency — the religious provider — is being protected from a long-standing tyranny of secular medicine.

If you read them the way the texts on my kitchen table read them, you will conclude something else.

I was raised in the Southern Baptist church. I taught the women’s-ministry Bible study. I tithed to the denomination that paid for the institutions now doing this work. I am a Christian who can read the actual texts the captured operation has been hiding from, and I am telling you what those texts say.

The texts do not begin with the provider. They begin with the patient.

Matthew 25:36, in the King James my grandmother read: “I was sick, and ye visited me.” Not “I was sick, and ye enforced a conscience clause.” Not “I was sick, and ye formed a committee to determine whether treating me was compatible with your institutional theology.” “I was sick, and ye visited me.” The criterion of the last judgment, in Jesus’ own words, is what was done to the sick person — not what the doctor was allowed to refuse. Read the surrounding verses, Matthew 25:31 through 46, in any translation you trust, and the structure holds. The King is not asking the nations about their institutional policies. He is asking what they did to the hungry, the thirsty, the stranger, the naked, the sick, the prisoner.

The captured operation has spent forty years reading the Bible’s middle management — the verses on submission, on order, on authority — while skipping the verses that put the sick person at the center of the Kingdom. They are very skilled at finding the verse that supports the position they have already taken. The Bible they read on Sunday morning is not the Bible they cite on Wednesday in the HHS rule.

Let me show you what the Good Samaritan actually says, because the captured operation has been sentimentalizing this parable for a century. Luke 10:30–37. A man is beaten and left for dead on the road from Jerusalem to Jericho. Two religious professionals — a priest, then a Levite — pass him by. They are not villains in the text. They are doing what their institutional theology required them to do, or what their institutional theology permitted them to avoid. The hero of the parable is a Samaritan — a despised outsider, religiously disqualified from the audience Jesus is addressing. The man of religious conscience who actually acts is the religious outsider. The men of religious institution who fail are the religious insiders.

Read that again before you tell me the Gospel requires hospitals to refuse treatment to gay teenagers.

The prophets are clearer still. Isaiah 1:10–17 — “Stop bringing meaningless offerings… Learn to do right; seek justice. Defend the oppressed. Take up the cause of the fatherless; plead the case of the widow.” Amos 5:21–24 — “I hate, I despise your religious festivals… But let justice roll on like a river, righteousness like a never-failing stream.” The Hebrew prophets were not writing a religious-liberty framework. They were writing a religious-responsibility framework. Worship without the justice is what God hates, in the plain language of the text. The captured operation has had a long run of reading the worship half and skipping the justice half. The HHS reorganization is the institutional form of that selective reading.

The history of conscience-clause law in this country tells you how the capture happened. The original 1973 Church Amendments were designed to protect individual doctors and nurses — Catholic hospital staff, mostly — who did not want to be required to perform abortions after Roe. Individual conscience. A real and serious protection. Coats-Snowe in 1996 extended the protection to institutions. The 2005 Weldon Amendment, attached to appropriations every year since, lets the federal government defund any state or local entity that refuses to accommodate a provider’s refusal. Then Burwell v. Hobby Lobby in 2014 extended the doctrine to closely-held corporations. Then Little Sisters of the Poor v. Pennsylvania in 2020 made the exemption framework broad. Each step was an expansion from individual conscience to institutional conscience to corporate conscience to state-enforced institutional conscience. The expansion was not the original intent. The expansion is the captured operation.

The patient has been removed from the center of the picture, in law as in the parable.

This is not a question I am asking in the abstract. I have a patient — I will call her Mrs. Aldana, because that is not her name, and she has given me permission to write about her if I disguise her. She is a thirty-one-year-old high school mathematics teacher. She has been on a stable dose of a medication her OB-GYN prescribed two years ago, a medication her Baptist hospital’s ethics committee will, under the new HHS rule, be empowered to refuse to provide. She is a Christian herself — a churchgoing Christian, a Sunday-school-teaching Christian. Her religious liberty includes the right to keep taking the medication that allows her to keep teaching tenth-grade geometry. The new rule, as best I can read it, will protect the conscience of the hospital’s ethics committee. It will not protect the conscience of my patient.

That is what the captured operation means by religious liberty. Not the religious liberty of the woman at the center of the Gospel. The religious liberty of the institution that has been given, by the state, a license to refuse her.

Let me say what I mean plainly, and then let me say it again, because this is the part that needs to land. When the operation quotes Romans 13 to justify the state apparatus that protects institutional refusal, it is reading the Bible’s middle management. When it cites the priest and the Levite, it is reading the parable’s villains. When it cites the conscience clause, it is reading the captured form of a law that was originally designed to protect individual dissenters. The Bible it is reading is not the Bible the prophets wrote, not the Bible Jesus preached, not the Bible Paul wrote about the body being many members. The Bible it is reading is a forty-year project, well-funded, well-staffed, well-organized, and doctrinally thinner than the hymnbook in the foyer.

I love this church. I am still in it. And I am telling you, with the standing of a woman who was inside the apparatus that built this, that what the apparatus is doing with the words “religious liberty” is the inverse of what those words mean in the Gospel I was taught.

The sick person is the criterion. Not the doctor. Not the institution. Not the federal rule. The sick person.

Mrs. Aldana is the criterion. So is the gay teenager in the pediatric office. So is the pregnant woman in the emergency room. So is the patient on the gurney the EMTALA case tried to send home.

The captured operation has them removed. The Gospel has them at the center. The two are not the same, and the chasm between them is what I have been trying, in column after column, to name.

I will not let the Gospel be conscripted for what the Gospel itself rejects. I will read the actual text. And I will not keep quiet about what the text says.

— Joanna Rivera-Blackwell