Title X gag rule: What's on the line in upcoming oral arguments
The AMA will have its say in upcoming oral arguments in the 9th U.S. Circuit Court of Appeals in an effort to block a Trump administration rule that would gag physicians and decimate the Title X program. The new rule limits the medical advice physicians can give their Title X patients and compels physicians to act as government mouthpieces, violating the AMA Code of Medical Ethics.
The Title X family planning program ensures that every person has access to basic, preventive reproductive health care such as birth control, cancer screenings, and sexually transmitted-infection testing and treatment regardless of economic or insurance status. Roughly 4,000 clinics have served 4 million family-planning patients annually in the Title X program.
The oral arguments will be heard Sept. 23 in the lawsuit (PDF) that was filed by the AMA, the Oregon Medical Association and others in March. The case was later consolidated on appeal with other lawsuits that include 20 states, the District of Columbia and individual health professionals.
The AMA and its co-plaintiffs are seeking to enjoin implementation of the new federal rule while the courts determine whether it passes legal muster. U.S. District Judge Michael McShane in April issued a nationwide injunction blocking the rule's implementation.
"The gag rule prevents doctors from behaving like informed professionals," McShane wrote. "At the heart of this rule is the arrogant assumption that government is better suited to direct the health care of women than their medical providers."
A three-judge panel of the 9th U.S. Circuit Court of Appeals stayed that district court ruling in June, allowing the rule to take effect. Now attorneys for the AMA and the other co-plaintiffs will argue before an 11-judge panel of the appeals court to reverse course.
Court blocks law that would force physicians to mislead patients
A federal district court in North Dakota has sided with the AMA and others and issued a preliminary injunction to block enforcement of a state law that would force physicians to violate the AMA Code of Medical Ethics and act as mouthpieces for a politically motivated message that is misleading and could harm patients.
The provision would have forced North Dakota physicians to tell women "that it may be possible to reverse the effect of an abortion-inducing drug if she changes her mind, but time is of the essence, and information and assistance with reversing the effects of an abortion-inducing drug are available" in government-printed materials to be given to the patients.
"State legislatures should not be mandating unproven medical treatments, or requiring physicians to provide patients with misleading and inaccurate information," says Chief Judge Daniel Hovland's decision (PDF). "The provisions of [this law] violate a physician's right not to speak and go far beyond any informed consent laws addressed by the United States Supreme Court, the 8th Circuit Court of Appeals, or other courts to date."
The lawsuit was filed by the AMA in in the U.S. District Court for the District of North Dakota, in Bismarck, on behalf of the Red River Women's Clinic, and the clinic's medical director, AMA member Kathryn Eggleston, MD, as co-plaintiffs.
"Open, honest conversations between patients and physicians are the cornerstone of medicine, so we are pleased that the federal district court of North Dakota has blocked enforcement of the newest compelled speech law while this case advances in the courts," said AMA President Dr. Patrice Harris. "With this ruling, physicians in North Dakota will not be forced by law to provide patients with false, misleading, nonmedical information about reproductive health that contradicts reality and science."
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