Catholics, like all other citizens of the United States of America, have a duty to participate in our representative form of government by informing themselves about the issues and stances of candidates and then voting. The United States Conference of Catholic Bishops (USCCB) hit the nail on the head when they titled their document to guide Catholic voters “Forming Consciences for Faithful Citizenship.” Voting is an important conscientious decision for Catholics and all persons of good will, but is complicated by the fact that in this fallen world no perfect candidates exist.

The National Catholic Bioethics Center (NCBC) has at the core of our mission promoting and safeguarding the dignity of the human person, especially in the realms of medicine and the life sciences. Tragically, there is no consensus as there should be on some basic human dignity and rights issues, like the right to life. As president of the NCBC I see it as my responsibility to help voters with information about the most important bioethical issues in the rapidly approaching 2020 national election.

I join with our bishops in affirming that there can be no doubt that “the threat of abortion remains our preeminent priority because it directly attacks life itself, because it takes place within the sanctuary of the family, and because of the number of lives destroyed.” The sheer enormity of the problem is hard to overstate as so many millions have died. No disease or war or other calamity kills as many human beings as abortion does every year. All killing is horrible, but abortion involves parents and medical professionals deliberately taking the lives of totally innocent preborn babies. It is one of the few crimes under canon law that is sanctioned with a latae sententiae or automatic excommunication.

On such a preeminent issue, one that surpasses all others, there should be broad agreement, but this is not the case. Former Vice President Joe Biden and many Democratic candidates take positions that wholeheartedly support legalized abortion for almost any reason and would even force taxpayers to fund abortions. This is in the Democratic Party Platform. President Donald Trump and many, but not all, Republicans have broadly opposed legalized abortion and taxpayer funding of abortion. This is included in the 2020 Republican Party Platform, which was a readoption of that of 2016. This is and has been the “elephant in the room” when it comes to making a conscientious decision to support one candidate or the other in US elections. It is a very broad issue, as the bishops point out in “Faithful Citizenship,” because the stance on abortion greatly affects other important areas like health care reform, care for the poor, immigration, and foreign policy.

Health care reform is another topic where many bioethical issues are at stake. What procedures/drugs will be mandated? The Little Sisters of the Poor have had to fight all the way up to the US Supreme Court multiple times to resist an unethical mandate from the Obama administration that they cover contraception in their health plans. How will the poorest members of our society be able to access quality health care? What kind of end of life care will be promoted in policies and legislation? The Holy See recently reminded the faithful about the intrinsically evil nature of euthanasia and assisted suicide that was legalized or threatens to be in some countries and US states. It is clearly important to research where candidates stand on the different aspects of health care reform.

Modern scientific research is also an area of concern. The NCBC was privileged to have one of our ethicists, Father Tad Pacholczyk, appointed to the National Institutes of Health Human Fetal Tissue Research Ethics Advisory Board in 2020. This body decided against federal funding for research proposals involving organs or tissues taken from aborted babies. The scientific research ethics issue is very broad and includes human embryonic stem cell research obtained by killing human embryos and cell lines derived from abortions. There is also a major threat of genetic research on human embryos that is ethically unacceptable. There should be widespread agreement here, but this is frequently not the case. Voters should know that the Trump administration has supported many restrictions on ethically tainted research involving the killing of human embryos and fetuses. Joe Biden was vice president when the Obama administration lifted bans on human embryonic stem cell research funding and he supports such research.

I personally believe that the protection of conscience rights for individuals and institutions is becoming one of the most worrying bioethical issues of our time. This is so because a question that achieved bipartisan support in the past is now a major bone of contention. The George W. Bush administration put into place a federal Conscience Rule aimed at protecting health care workers. The Obama administration rescinded and replaced it with a rule that struck down most of the protections, except for not being forced to participate in abortion. The Trump administration returned to a more far-reaching conscience protection rule and created a new division of the U.S. Department of Health and Human Services (HHS) Office of Civil Rights: The Conscience and Religious Freedom division. All indications are that a Biden administration would go back to minimal support for conscience and religious freedom protections as was the case under Obama’s presidency.

The NCBC is nonpartisan and does not endorse candidates for public office. Our civic and religious duty is to encourage US citizens to be informed voters who take their consciences with them to their polling places. In our field of bioethics there is a stark contrast between the positions taken by the leading candidates in these upcoming elections. I wholeheartedly reiterate the guidance given by the US bishops conference about the most important issue in this election, the threat of abortion.