According to the Office for Civil Rights at HHS, UVMMC broke the law, and needs to change its staffing policy on abortion procedures. In a statement, a spokesperson for UVMMC wrote that the medical center “has robust, formal protections that strike the appropriate and legal balance between supporting our employees’ religious, ethical, and cultural beliefs, and making sure our patients are not denied access to safe and legal abortion.”

This case is the latest signal that the Trump administration is pointedly championing the rights of religious Americans. As Roger Severino, the head of the Office of Civil Rights, told me in an interview, “Religious-freedom laws are the ones mentioned in the very first amendment to the Constitution—they have pride of place. And they have been neglected for too long.”

Read: The man behind Trump’s religious-freedom agenda for health care

Since taking over the Office for Civil Rights in 2017, Severino has consistently taken action to protect people’s religious rights in health-care settings. According to Severino, UVMMC’s alleged actions are part of a broader pattern at that medical center, and around the country, of health-care workers being forced to participate in procedures they find morally or religiously objectionable. When it comes to abortion and end-of-life procedures, these objections are often protected by law, including the Weldon Amendment and the Church Amendments. Severino claims that enforcement of these statues has been systematically neglected by previous administrations. In 2018, he established a new office dedicated to investigating claims made along these lines, and this spring, HHS finalized a rule designed to protect people with these kinds of objections.

While Barack Obama–era officials have maintained that they took conscience complaints seriously but received relatively few of them, Severino said his office has seen “a surge of complaints” in the two and a half years since Trump’s election. In fiscal year 2018, according to numbers provided by HHS, the Office of Civil Rights received and dealt with more than 1,300 complaints alleging conscience violations or religious discrimination. Trump “has set the tone … that this is going to be taken seriously by the federal government,” Severino said. “If you don’t tell the world that you’re there to help, then people … get frustrated and have nowhere to turn.”

In this case, the nurse at UVMMC approached a conservative legal firm that has been closely allied with the Trump administration, the American Center for Law and Justice, and the firm helped her get in touch with HHS. The nurse’s lawyer, Francis Manion, told me that her case is the most extreme example of this kind of discrimination he has encountered. “This is the first time we’ve ever represented somebody who was put in a position where she couldn’t escape from it, even though her employer knew she was a conscientious objector,” he said.