Healthcare Stocks: Big Pharma's Mixed Record on Pro-Life Issues

Healthcare is supposed to be the easy sector for Biblically Responsible Investing. These are companies that develop medicines, save lives, and do work that Christians broadly affirm. The Good Samaritan parable in Luke 10:25-37 treats caring for the sick and injured as a mark of genuine neighborly love. How could any Christian screening framework reject a pharmaceutical company?

It turns out the answer is more complicated than you would expect. Big Pharma has a mixed record on pro-life issues, on pricing practices, and on some research questions. Here is how BRI funds actually evaluate the sector.

The basic case for healthcare in BRI portfolios

Most BRI funds are meaningfully overweight healthcare compared to a broad market index. Eventide ETGLX typically has a significant healthcare allocation. Inspire BIBL has had healthcare as a top sector. Timothy Plan funds usually hold several healthcare names.

The reason is partly positive (healthcare is a mission aligned industry) and partly structural (excluding alcohol, tobacco, gambling, and entertainment leaves you overweight the sectors that pass the screens, and healthcare is one of them).

From a biblical standpoint, Luke 10, Matthew 25:36 ("I was sick and you visited me"), and the general biblical affirmation of care for the suffering all support treating healthcare as directionally positive. The question is which specific healthcare companies you want to own.

The pro-life complications

Here is where it gets layered. Most of the large pharmaceutical companies have some connection to reproductive health or abortion-related research, even if the core business is other things. Let me walk through the main names.

Pfizer (PFE). Pfizer makes some of the largest-selling drugs in the world. They do not make mifepristone directly, but they have produced various hormonal contraceptives, and some BRI screens flag this as part of the pro-life evaluation. Pfizer has also made political contributions to organizations BRI funds track. The company's COVID-19 vaccine work brought attention to fetal cell line usage in research and testing, which some stricter Christian ethicists have flagged, though most mainstream Christian ethicists have concluded that the historical distance is sufficient to permit use.

Merck (MRK). Merck makes hormonal contraceptives (Implanon, Nexplanon). These are not abortion drugs but they are on the contraceptive side of the reproductive health spectrum, and some BRI funds flag hormonal contraceptives based on possible post-fertilization mechanisms. This is the same debate we covered in the Plan B section of the CVS post. Protestant BRI funds are split on how to handle it.

Johnson and Johnson (JNJ). JNJ is a complicated case. The company has a massive product portfolio spanning consumer health, pharmaceuticals, and medical devices. It has made some hormonal products. It has also been the defendant in major product liability lawsuits (talc, opioid, others) that some BRI funds weigh separately. And JNJ has had corporate giving patterns that some funds flag. On balance, JNJ is owned by some BRI funds and excluded by others.

AbbVie (ABBV). AbbVie is a large pharma company with a portfolio heavy in immunology and oncology. They have some reproductive health products but not as much as their peers. Most BRI funds own AbbVie without major concerns.

Eli Lilly (LLY). Lilly has been a strong performer, especially with the diabetes and obesity drug lines (Mounjaro, Zepbound). The company has a mixed corporate giving history but not as heavy on the reproductive health side as some peers. Most BRI funds have held Lilly.

Bristol Myers Squibb (BMY). BMY is primarily focused on oncology and immunology. Limited reproductive health exposure. Most BRI funds hold BMY without major concerns.

The fetal cell line question

This came up during COVID-19 vaccine development and has remained a live issue for some Christian ethicists. Several decades ago, cell lines were derived from tissue from elective abortions. These lines have been propagated in labs ever since and used in various research contexts, including vaccine testing.

The question is whether using these historical cell lines implicates current researchers or manufacturers in the original abortions. The mainstream Catholic position (and most mainstream Protestant positions) is that the historical distance is sufficient to permit current use, especially for serious medical needs. Stricter positions argue that any use perpetuates a moral wrong.

BRI funds are mostly in the mainstream position. They do not usually exclude companies solely for using historical fetal cell lines, though they note the usage in their analysis. The stricter Protestant funds (Timothy Plan) sometimes weight this more heavily.

Pfizer, Merck, Moderna, and several others all have COVID-19 vaccine products that used cell lines derived from historical fetal tissue in testing. The debate about ownership is thus pretty broad-based.

The drug pricing concern

Separate from pro-life issues, BRI funds increasingly pay attention to drug pricing practices. When a pharma company charges 300 dollars for a drug in the US that it sells for 20 dollars elsewhere, that pricing disparity raises stewardship questions.

Eventide's Business 360 framework specifically weighs customer treatment, and pricing is a big part of customer treatment in healthcare. Companies with the worst pricing practices have sometimes been excluded or underweighted in Eventide funds even when the core business and corporate giving were acceptable.

Mylan (now Viatris VTRS) was flagged years ago for the EpiPen pricing controversy. Gilead (GILD) has been scrutinized for hepatitis C drug pricing. Various specialty drug makers have been flagged for price increases unrelated to cost.

The pricing concern is not a hard exclusion in most BRI funds, but it is a factor that can tip a borderline company into exclusion.

The medical device companies

Medical device makers are generally safer territory for BRI funds. Companies like Medtronic (MDT), Boston Scientific (BSX), Stryker (SYK), Abbott Laboratories (ABT), and Edwards Lifesciences (EW) make products that are clearly life-affirming: heart valves, joint replacements, insulin pumps, diagnostic equipment.

Most BRI funds hold multiple medical device names. The screens are cleaner because the product categories are less ambiguous.

Abbott is particularly interesting because it has a nutrition business (Ensure, PediaSure) and a pediatric diagnostics business that BRI funds view as mission-aligned.

The biotech question

Small and mid-cap biotech is a mixed bag. Some companies are working on cancer therapies that BRI funds would view very positively. Some are working on gene therapies and cell-based research that raise ethical questions depending on the research methods. Some are developing reproductive health products that some BRI funds would flag.

Eventide runs a dedicated healthcare fund (Eventide Healthcare and Life Sciences, ETAHX) that does the work of evaluating biotech on a company-by-company basis. This is one of the best options for investors who want biotech exposure with BRI screens applied.

Inspire's Impact Score covers biotech names and is searchable on their website. Timothy Plan is stricter on biotech and tends to exclude companies with any reproductive health or controversial research exposure.

The health insurance angle

UnitedHealth Group (UNH), Elevance Health (ELV), Humana (HUM), and Cigna (CI) are the major US health insurers. We covered them briefly in the abortion stocks post.

BRI treatment varies. The concerns are:

Coverage decisions that include abortion services in some plans.
Corporate giving patterns.
Claims denial practices that raise stewardship questions about customer treatment.
The overall business model complexity (PBMs, pharmacy networks, provider networks).

UnitedHealth specifically is the largest US health insurer, has owned a pharmacy benefits manager (Optum Rx), and has had recent controversies over claims denials and executive security. BRI funds have had varying positions on UNH over time.

None of the large insurers are uniformly excluded by BRI funds, but none are uniformly held either. They are judgment calls.

The hospital and services companies

HCA Healthcare (HCA), Tenet Healthcare (THC), and Community Health Systems (CYH) are hospital operators. These are a small category in public markets because most hospitals are nonprofit.

BRI treatment of hospital operators tends to focus on whether the hospitals perform abortions. Some HCA and Tenet facilities have included abortion services in the past. The analysis is complicated by the fact that most of these hospitals do many things, and abortion services are usually a tiny fraction of what any individual facility does. BRI funds generally do not exclude the entire hospital operator based on a small fraction of services at some facilities, but they do weigh the exposure.

The biblical framework

Luke 10:25-37, the Good Samaritan, establishes care for the sick and injured as a core expression of love of neighbor.

Matthew 9:12, "Those who are well have no need of a physician, but those who are sick." Jesus affirms the role of doctors and healthcare.

Exodus 15:26, "I am the Lord, your healer." God himself is described as a healer, and human healers participate in this role.

3 John 1:2, "Beloved, I pray that all may go well with you and that you may be in good health." Physical health is treated as a good to be prayed for.

These verses support a strong presumption in favor of healthcare as a legitimate and blessed field of work. BRI funds approach the sector with this presumption. The exclusions are specific: companies involved in abortion, companies with extreme pricing abuses, companies with corporate behavior that crosses other BRI lines. The baseline is positive.

The practical approach

If you want healthcare exposure in a BRI portfolio, here are practical options:

Hold a BRI fund that already manages healthcare exposure (ETGLX, BIBL, Timothy Plan funds) and let the managers handle the specific company selection.

Use Eventide's Healthcare and Life Sciences fund for targeted sector exposure with BRI screens.

Avoid the specific names that are most likely to be excluded (pharmacies dispensing mifepristone, pharma companies with aggressive pricing and controversial products).

Pay attention to medical device companies as generally cleaner BRI plays than large pharma.

Consider hospital operators and health insurers as case-by-case rather than sector-level decisions.

The takeaway

Healthcare is not the sector of automatic exclusions that BRI critics sometimes assume. Most BRI funds are actively overweight healthcare because the sector aligns with the broader stewardship mission and because excluding the sin stock sectors leaves room to emphasize mission-aligned industries.

The complications are in the specifics. Big Pharma has mixed records. Health insurers have coverage questions. Pharmacy chains have the mifepristone decision. Hospital operators have variable service mixes. BRI funds handle these complications by building stock-by-stock evaluations rather than applying blanket sector exclusions.

Proverbs 17:22 says "a joyful heart is good medicine, but a crushed spirit dries up the bones." The Bible is not anti-medicine. It treats healing and health as goods to be pursued. For Christian investors, healthcare is usually a good place to put capital. Just do the specific work of evaluating which companies within healthcare match your values. BRI funds can do that work for you if you want, or you can do it yourself if you prefer to pick stocks.

Either way, do not default to exclusion because you read a headline. The sector is more mission-aligned than it gets credit for, and most BRI funds recognize it.