Trump’s Title X Gag Rule: An Ethical Conundrum for Planned Parenthood

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By Beatrice Brown

On August 19, Planned Parenthood announced that they would be leaving the Title X family planning program due to the Trump Administration’s new prohibition that restricts those who receive Title X funds from providing or referring patients for abortion. This restriction on Title X funding has unsurprisingly been met with a lot of criticism, namely, that it interferes with a woman’s constitutional right to abortion. This can be seen as a partial victory for those who have been attempting to defund Planned Parenthood for years, an organization that, despite others’ characterizations, is fundamentally committed to providing all women access to quality health care and is not solely an abortion provider.

As a result of this gag rule, Planned Parenthood has faced a huge ethical dilemma: Do they continue to accept Title X funding to assist low-income women with everyday health care, such as yearly routine wellness visits, or do they reject this funding and both 1) take a stand on a woman’s constitutional right to abortion and 2) continue to provide a service (or retain the right to refer patients to a service) that is crucial to women’s health? Planned Parenthood has chosen the latter, and I think that Planned Parenthood’s difficult choice is justified.

To be unable to provide abortion or refer patients to other clinics that perform abortions is to undermine the goals of Planned Parenthood. Planned Parenthood is “dedicated to offering all people high-quality, affordable medical care.” Part of this mission, then, is the ability to either provide a patient with an abortion or to refer them to a clinic that will provide this patient with the procedure. Often, abortion is a medically-indicated procedure – there are many cases where a fetus is not viable, or where carrying the pregnancy to term would result in extreme danger, including possibly death, for the mother. And not all women can afford this procedure, so they turn to a place like Planned Parenthood, where the procedure is less expensive. For Planned Parenthood, to continue to accept Title X funding would thus mean to, in part, give up a vital part of its mission.

Some may object to this argument that the ability to provide low-income women with more routine services, such as yearly Pap smears or STI testing, is more crucial to Planned Parenthood’s mission than the provision of abortions. While I agree that this is indeed a grave problem, there are several reasons why I still think Planned Parenthood made the correct decision.

First, I believe the gag rule itself is unethical: It places an undue burden on a woman’s right to abortion by reducing funds for clinics who perform abortions or refer patients to clinics who perform abortions, leading to less access. Moreover, I also think that giving in to the pressure of an unethical gag rule cannot be ethically justified. Second, low-income women are unfortunately harmed if Planned Parenthood rejects Title X funding: Abortion tends to be concentrated among low-income women, meaning that the women who frequently access these services through Planned Parenthood would be unable to do so. There is of course the question of which option presents low-income women with a greater harm, and this is difficult to adjudicate. Planned Parenthood was essentially left in the position to “pick their poison,” and I think they picked the correct one.

The effects of Trump’s gag rule on low-income women are already clear, as two clinics have already shut down as a result of the loss of funding. The gag rule continues to be challenged in court, and in two weeks, oral arguments will be heard in California. I am hopeful that proponents of women’s rights will win this battle and that all women will be provided with the health care services that they need and are rightfully theirs.

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