Democratic societies have a hard time dealing with extremists in their midst. The desire to show respect for other people's beliefs all too easily turns into denial: nobody wants to talk about the threat posed by those whose beliefs include contempt for democracy itself.

We can see this failing clearly in other countries. In the Netherlands, for example, a culture of tolerance led the nation to ignore the growing influence of Islamic extremists until they turned murderous.

But it's also true of the United States, where dangerous extremists belong to the majority religion and the majority ethnic group, and wield great political influence.

Before he saw the polls, Tom DeLay declared that "one thing that God has brought to us is Terri Schiavo, to help elevate the visibility of what is going on in America." Now he and his party, shocked by the public's negative reaction to their meddling, want to move on. But we shouldn't let them. The Schiavo case is, indeed, a chance to highlight what's going on in America.

One thing that's going on is a climate of fear for those who try to enforce laws that religious extremists oppose. Randall Terry, a spokesman for Terri Schiavo's parents, hasn't killed anyone, but one of his former close associates in the anti-abortion movement is serving time for murdering a doctor. George Greer, the judge in the Schiavo case, needs armed bodyguards.

Another thing that's going on is the rise of politicians willing to violate the spirit of the law, if not yet the letter, to cater to the religious right.

Everyone knows about the attempt to circumvent the courts through "Terri's law." But there has been little national exposure for a Miami Herald report that Jeb Bush sent state law enforcement agents to seize Terri Schiavo from the hospice - a plan called off when local police said they would enforce the judge's order that she remain there.

And the future seems all too likely to bring more intimidation in the name of God and more political intervention that undermines the rule of law.

The religious right is already having a big impact on education: 31 percent of teachers surveyed by the National Science Teachers Association feel pressured to present creationism-related material in the classroom.

But medical care is the cutting edge of extremism.

Yesterday The Washington Post reported on the growing number of pharmacists who, on religious grounds, refuse to fill prescriptions for birth control or morning-after pills. These pharmacists talk of personal belief; but the effect is to undermine laws that make these drugs available. And let me make a prediction: soon, wherever the religious right is strong, many pharmacists will be pressured into denying women legal drugs.

And it won't stop there. There is a nationwide trend toward "conscience" or "refusal" legislation. Laws in Illinois and Mississippi already allow doctors and other health providers to deny virtually any procedure to any patient. Again, think of how such laws expose doctors to pressure and intimidation.

But the big step by extremists will be an attempt to eliminate the filibuster, so that the courts can be packed with judges less committed to upholding the law than Mr. Greer.

We can't count on restraint from people like Mr. DeLay, who believes that he's on a mission to bring a "biblical worldview" to American politics, and that God brought him a brain-damaged patient to help him with that mission.

What we need - and we aren't seeing - is a firm stand by moderates against religious extremism. Some people ask, with justification, Where are the Democrats? But an even better question is, Where are the doctors fiercely defending their professional integrity? I think the American Medical Association disapproves of politicians who second-guess medical diagnoses based on video images - but the association's statement on the Schiavo case is so timid that it's hard to be sure.

The closest parallel I can think of to current American politics is Israel. There was a time, not that long ago, when moderate Israelis downplayed the rise of religious extremists. But no more: extremists have already killed one prime minister, and everyone realizes that Ariel Sharon is at risk.

America isn't yet a place where liberal politicians, and even conservatives who aren't sufficiently hard-line, fear assassination. But unless moderates take a stand against the growing power of domestic extremists, it can happen here.

E-mail: krugman@nytimes.com