For nearly 50 years, U.S. federal law has per-mitted medical professionals and religious institutions to refuse, for religious and moral reasons, to provide abortions and sterilizations. In more recent decades, similar safe-guards have been developed for medical professionals who do not wish to comply with patients’ ad-vance directives or deliver physi-cian aid in dying. Under existing statutes, recipients of federal fund-ing — from hospitals and clinics to states and cities — may not discriminate against individuals or organizations that refuse to provide such care.