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The Implications of Title X Restrictions

The Court found that the regulations were limited to a prohibition on abortion as a means of birth control. It specifically found that the personnel in Title X-funded facilities were free to discuss abortion and refer patients when the abortion was medically necessary:

On their face, the regulations cannot be read, as petitioners contend, to bar abortion referral or counseling where a woman's life is placed in imminent peril by her pregnancy, since it does not seem that such counseling could be considered a "method of family planning" under sec. 1008, and since provisions of the regulations themselves contemplate that a Title X project could engage in otherwise prohibited abortion-related activities in such circumstances.[177]

The Court was careful to distinguish Title X regulations from a more general prohibition on abortion counseling:

Nor is the doctor-patient relationship established by the Title X program sufficiently all-encompassing so as to justify an expectation on the part of the patient of comprehensive medical advice. The program does not provide postconception medical care, and therefore a doctor's silence with regard to abortion cannot reasonably be thought to mislead a client into thinking that the doctor does not consider abortion an appropriate option for her. The doctor is always free to make clear that advice regarding abortion is simply beyond the scope of the program.

Assuming that these restrictions are not modified by Congress, clinics providing Title X services should track this language to explain the limitations on their services. Every woman should be told specifically that abortions cannot be discussed as a birth control option and that she will have to seek that information elsewhere. While the clinic personnel cannot refer women to abortion counselors, they can make sure the women know that the Title X clinic is not a full-service facility and that advice should be sought elsewhere. Information about abortion counseling can be provided outside the clinic as long as it is not provided by clinic personnel. If the clinic is in a multipurpose building, a separate office with separate funding could be setup next to the family planning clinic to provide abortion counseling.

[177]Rust v. Sullivan. 111 S. Ct. 1759 (1991).

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