Don't Even Talk About It!

Ellen Goodman

October 30, 1990|By Ellen Goodman

NEW YORK — New York.

THIS IS the South Bronx, where reporters come to write about drugs and dropouts, about AIDs and abuse. Photographers come here to take pictures of blocks that make Lebanon look like a decorator's showplace.

One flight above the street, past the lounge where teen-age girls sit at Formica tables reading, talking, collaborating on a questionnaire in an old magazine, there is a haven from the street's statistics of hopelessness. It's called The Hub.

To some, The Hub is a model of what its organizer, Planned Parenthood, calls ''a center for change.'' It was built on the belief that family planning is less a matter of pill-pushing than of life-building. The programs that combine health services with education, job training with family counseling, are meant to give teen-agers a reason to plan, a sense of life's possibilities.

But to others, The Hub is a target, because it also provides abortions for this community. And though few protesters dare carry their pickets to this tough territory, the center is not immune from the struggles over rights.

Today Irving Rust, the courtly, Harlem-raised doctor who works on the third floor, will travel to Washington and take his seat at a Supreme Court hearing. The man who once thought of teaching history will instead be making history.

Rust vs. Sullivan will test just how many freedoms can be lost to those who claim the fetus as their cause. This time an abortion case is not about the right to decide or the right to privacy. It's about the right to free speech.

In 1987, the Reagan administration wrote a set of regulations for Title X's federally funded family-planning clinics. Money for performing abortions had been banned much earlier, but these regulations went further. They banned talking about abortion.

The government told doctors what they could not say. ''Title X projects may not provide counseling concerning the use of abortion . . . or provide referral for abortion.''

And the government told doctors what they had to say. If a woman asked about abortion, they were to answer: ''The project does not consider abortion an appropriate method of family planning.'' The only referrals they could make were for prenatal care by those ''who do not perform abortions.''

To pro-lifers, these regulations were just another way to shut off any one or group that supported abortion rights. But for the doctors and counselors who challenged this law and have kept it at legal bay, it is nothing less than a ''gag rule.''

Dr. Rust tries to explain what it would mean to a doctor to withhold legal information from his patient. Imagine, he says, that a woman comes in who has hypertension, diabetes, sickle-cell anemia, someone whose health is at risk from pregnancy. ''How,'' he asks, ''can you just close your mouth and stay quiet and say nothing to a patient?''

He struggles with another medical analogy. ''If a woman came in with cancer of the ovary and there were three methods of treatment, could I tell her the government says that chemotherapy is the treatment no matter what I think? '' Marking his words carefully, he concludes, ''I will not not tell a woman.''

What is at stake for this blighted neighborhood is $450,000 in Title X money -- one-fourth of The Hub's budget -- for pap smears and counseling as well as contraceptives for the community's only health center. What is at stake across the country is the health care for 5 million poor women. But what is also at stake is what most of us take for granted: the free and honest flow of information and help, the relationship of trust between doctor and patient.

''The words of a doctor to her patient, of the lawyer to her client and of the professor to her public-university students are most assuredly the speech of private citizens,'' argues the brief for Dr. Rust and Planned Parenthood.

But if taking funds from the government means that you must take the party line from the government, doctors will be little more than bureaucrats. If the government becomes a medical ventriloquist, then a doctor is only ''the voice of America.''

Funny isn't it -- did you ever notice how rights are connected to each other? The right to privacy, the right to speech. Attack one and pretty soon, another is gone. The same people who want to let government take over the decisions about our private lives would also let government put a firm hand over the doctor's mouth.

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