National Institute of Family and Life Advocates v. Treto
Illinois bullies pro-life healthcare professionals into supporting abortion
For nearly 40 years, Illinois protected healthcare providers who declined to participate in abortion by giving them immunity from lawsuits and disciplinary action. But in 2016, the state gutted that long-standing protection. The Illinoislegislature amended its Health Care Right of Conscience Act to require any healthcare professional who refuses to participate in abortion for reasons of conscience to do two things if they want to receive any conscience-based protections: tell women about the supposed “benefits” of abortion, and refer them to a list abortion of providers. For pro-life pregnancy centers and many religious healthcare professionals, this mandate attacks the core of their work. These ministries exist to offer life-affirming care rooted in the belief that every person is made in the image of God. The law instead demands that they speak a message that contradicts their faith and the very purpose of their ministry.
An impossible choice
Under the law, anyone who refuses to promote abortion loses the legal immunity that normally protects healthcare providers from malpractice suits, discrimination claims, and enforcement actions by the state licensing board. That loss of protection puts pro-life healthcare professionals to an impossible choice—either speak and promote the state’s message about abortion, or face legal and professional consequences for refusing to say what violates their beliefs. A group of pro-life pregnancy centers and doctors challenged the law in federal court. In spring 2025, the district court blocked the “benefits-discussion” requirement but left the referral mandate in place, and both sides appealed.
Becket defends America’s long tradition protecting religious speech
On December 16, 2025, Becket filed a friend-of-the-court brief on behalf of the Catholic bishops of Illinois, the Illinois Catholic Health Association, and two Orthodox Church bodies. The brief argues that, while the pro-life pregnancy centers and doctors should prevail under the First Amendment rule against government compelling speech, there is an even simpler way to decide the case. It urges the court to reaffirm that, in the Anglo-American legal tradition, protections for speech first developed to safeguard religious speech; and for that reason, governments have never been permitted to force religious groups to voice a message they do not believe. The court should ensure thatIllinois is not allowed to do so here.
For the Catholic Conference of Illinois, being required to speak positively about abortion risks confusing the faithful and weakening the Church’s public witness. For the Illinois Catholic Health Association, which includes Catholic hospitals and healthcare ministries, the mandate threatens the integrity of the healing work they carry out every day, forcing them to contradict the very mission that animates their service. And for the Orthodox Church in America and Serbian Orthodox Church, minority religious groups whose teachings are not always widely understood, government-forced speech creates the danger of pressure and misunderstanding that can chill its ministry.
Importance to religious liberty:
- Religious communities: The First Amendment upholds special regard for the authority of religious institutions to govern themselves and ensure their distinctive religious ways of life, whether they be in fashion or not with state regulators.
- Free speech: Free speech includes the right to a free and peaceful exchange of ideas with others—including religious ideas. Freedom of speech and religious liberty go hand-in-hand; protecting one protects the other.


In the spring of 2001, however, a neighbor complained to the Town Planning Board, and the Mortensens were asked to apply for a special use permit that would allow them to use the home as a “church or other place of worship,” although neither of those terms is defined anywhere in the Town zoning ordinance. The Zoning Board of Appeals held a hearing on the application on September 5, 2001, and a group of neighbors appeared in opposition. None claimed that they had been harmed or even inconvenienced by Pine Hill Zendo during the previous two years. One resident even testified that other neighbors told her they had never seen or heard anything, and didn’t even realize the Zendo existed. Opponents simply speculated that traffic and parking problems might develop.