Debate over whether ‘morning-after pill’ can cause abortion at heart of Catholic nurse’s lawsuit

Paige Casey Paige Casey had provided medical care for patients at CVS MinuteClinic Diagnostic of Virginia from 2018 until March 2022, when she was informed that she could no longer claim a religious exemption in order to opt out of a practice that violated her conscience. | Alliance Defending Freedom

A Catholic nurse practitioner is suing CVS and one of its medical clinics for firing her after she refused to prescribe abortion-inducing drugs to customers. 

Paige Casey, who primarily worked at CVS’s MinuteClinic in the Del Ray section of Alexandria, Virginia, alleges in her complaint that the company violated Virginia’s Conscience Clause, which allows medical professionals to opt out of participating in abortions.

The lawsuit — filed Aug. 30 in Circuit Court in Prince William County, Virginia — centers on an ongoing debate over whether or not some forms of birth control, such as Plan B and Ella, can act as abortifacients, meaning that they cause abortions to occur.

In Casey’s dispute, CVS maintains that Plan B and Ella are contraceptives, not abortifacients.

“MinuteClinic does not prescribe abortifacients or provide abortion care or services, Michael DeAngelis, a CVS spokesman, told CNA.

For Casey, however, the point is that those drugs act to destroy embryos, which the Catholic Church recognizes as human lives deserving of protection.

Religious exemption withdrawn

Casey is being represented in the case by the conservative legal nonprofit Alliance Defending Freedom (ADF). 

CVS granted Casey a religious exemption upon hiring her in 2018 when she alerted the clinic that her religion barred her from participating in and facilitating abortions, according to the complaint.

CVS kept Casey’s religious exemption active for three and a half years, allowing her to opt out of prescribing abortion-causing drugs or devices, the complaint states.

Then, last August, CVS reversed its position by announcing it would no longer allow employees with religious convictions to obtain exemptions, according to the complaint.

In January 2022, the lawsuit says, the clinic abruptly informed Casey in a letter that it was rescinding her religious exemption and she would be forced to provide abortion drugs and related services. 

She was later informed by CVS that her employment had been terminated. 

The clinic fired Casey despite Virginia’s Conscience Clause, which explicitly says medical professionals with religious and conscience convictions cannot be denied employment or face disciplinary action if they refuse to participate in abortions.

“Any person who shall state in writing an objection to any abortion or all abortions on personal, ethical, moral or religious grounds shall not be required to participate in procedures which will result in such abortion,” the law states.

Lawyers for ADF said that Casey’s religious freedom also was violated. 

“Corporations like CVS cannot defy the law by firing professionals who want to work consistently with their faith,” Denise Harle, ADF senior counsel and director of Center for Life, said in a statement. 

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Harle added that “Virginia law protects the freedom of everyone to work without fear of being fired for their religious beliefs prohibiting participation in abortion.”

Casey told CNA in an email statement that “CVS’s actions were unjust, and I hope that this case will prevent them from forcing health care professionals to act against their religious, moral, and ethical beliefs.” 

“For three and a half years, CVS easily accommodated my beliefs, and other medical professionals were willing and able to prescribe and administer the drugs if necessary,” she said.

DeAngelis told CNA that CVS has a “well-defined” process for employees to get a “reasonable accommodation” for religious beliefs which may prevent them from certain job duties. 

DeAngelis said that MinuteClinic “cannot grant exemptions” from “essential MinuteClinic functions,” adding that this included “sexual health matters” like “pregnancy prevention.”

Conflicting definitions of human life

Casey’s lawsuit underscores the disagreement over the way drugs such as Plan B and Ella work — and even over the question of when human life begins.

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Those drugs can induce an abortion when used post-conception to prevent a fertilized egg from implanting in a woman’s uterus, explains Dr. Chris Stroud, an Indiana OB-GYN who is a member of the Catholic Medical Association. 

In a phone interview with CNA, Stroud explained how Plan B works to prevent pregnancy when taken before ovulation, but if taken after, works as an abortive drug.

“It is an abortifacient some percentage of the time,” Stroud said. “The only way it works post-ovulation is to be an abortifacient.”

“The question I always pose to pro-life people is, what percentage of the time are you comfortable with greater than zero? What percentage of greater than zero can you live with?” he asked. 

The U.S. Food and Drug Administration (FDA) also says Plan B can be used after the egg has already been fertilized by stopping it “from attaching to the womb (implantation).”

This, says Stroud, amounts to abortion. 

“Disruption of a fertilized egg is the disruption of an embryo, and disrupting an embryo is an abortion,” he emphasized.

Some in the medical community, however, subscribe to the view that life begins at implantation, not fertilization — in their view, preventing implantation is not the same as an abortion, Stroud said. 

The Catholic Church teaches that “human life must be respected and protected absolutely from the moment of conception” (No. 2270). 

This teaching is consistent with the overall scientific consensus that an embryo’s life begins at fertilization when a distinct human being comes into existence after the sperm and egg join. 

“That's not Catholic, that's just mammalian biology,” Stroud said. 

The Catechism also states that “formal cooperation in an abortion constitutes a grave offense” (No. 2272).

Kevin Theriot, senior counsel for ADF, told CNA over email that “CVS tried to force Paige to agree to prescribe or dispense abortion-causing drugs, like Ella and some forms of contraception, after accommodating her beliefs for years.”

“These drugs can act as an abortifacient, preventing implantation of a fertilized egg — after conception — which is an abortion under Virginia law,” Theriot said. He added, “This means that a new life, with its own unique DNA, has already formed before the drug takes that life and ends the pregnancy.”