AMA decries appeals court ruling on Title X ‘gag rule’

February 26, 2020

AMA argues the court failed to consider the ruling’s impact on the physician-patient relationship.

The American Medical Association (AMA) is speaking out after a panel of appellate judges upheld the Title X “gag rule” which bars physicians receiving Title X funds from referring pregnant patients to abortion specialists.

In a statement, Patrice A. Harris, MD, president of AMA, says the organization is disappointed and “strongly disagrees with” the judges’ reasoning allowing the rule to stand.

“The judges failed to properly take into consideration the AMA’s legal arguments or the decision’s impact on either health care or the patient-physician relationship,” she says in the statement. “This government overreach and interference demands that physicians violate their ethical obligations-prohibiting open, frank conversations with patients about all their health care options-if they want to continue treating patients under the Title X program. It is unconscionable that the government is telling physicians that they can treat this underserved population only if they promise not to discuss or make referrals for all treatment options.”

The AMA argued that the rule would reinforce a belief that “physicians and others in the medical profession are to place the interests of the government above the interests of their patients” and that the rule violates the AMA’s Code of Medical Ethics.

The decision came Feb. 24 from a panel of judges on the Ninth Circuit Appeals Court, after a number of district court judges had blocked the rule’s implementation. One of these lower judges sitting on a court in Oregon described the rule as preventing “doctors from behaving like informed professionals.”

In the Ninth Circuit’s opinion removing the lower courts’ injunctions, Judge Sandra S. Ikuta wrote that such fearmongering about the rule is unwarranted and that a physician could discuss abortion through nondirective counseling, but could not give a referral for one through Title X.

Writing for the dissenting judges on the panel, Judge Richard A. Paez says that HHS does not have the authority to implement the rule and that the majority’s opinion on the case sanctions “the agency’s gross overreach and puts its own policy preferences before the law.”

The case can now be appealed to the U.S. Supreme Court.

In the AMA statement, Harris said the association will continue their fight “for open conversations between patients and physicians-the cornerstone of quality health care.”

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