WASHINGTON -- The Bush administration renewed yesterday its flat ban on any mention of abortion to pregnant poor women by nurses or counselors at federally funded clinics but relaxed slightly its ban on what doctors there could say.
The new rules, designed to replace a controversial 1988 "gag rule" that had never gone into effect, kept intact a ban on sending any pregnant patient from a federally funded clinic to an abortion clinic.
The only kind of medical referral that could be done with a patient having a problem pregnancy would be to a hospital -- that is, to "a full-service health care provider," as the new rules put it.
Doctors at clinics getting federal money were released from a nearly total ban on any discussion of abortion with their patients. Carrying out a pledge that President Bush made last November, the new rules say that they are not intended to keep a pregnant patient from receiving "complete medical information about her condition from a physician."
The rules go on to stress that that only applies to information from doctors, not other staff members at a clinic.
The doctor must provide medical information -- presumably, including any comment that abortion might be a good idea medically -- "directly to" the patient, during a clinic visit or in a follow-up telephone call. Thus, a suggestion of a possible abortion could not be relayed through a nurse or counselor.
But the doctor may not tell the patient that she is being referred elsewhere expressly for an abortion, and the referral cannot be to a clinic "whose principal activity is providing abortion services."
The government's four-year effort to close down abortion discussions at federally aided clinics has been deeply controversial. The new rules were issued yesterday afternoon with little fanfare.
Groups supporting abortion rights complained that the "gag" remained intact, and anti-abortion groups said that the rules will satisfy most Americans' wishes.
Federally funded clinics must begin to obey the new rules within 60 days if they want to continue receiving federal money.
More than 4,000 "family planning clinics" across the country have been receiving federal aid since 1970. Those clinics mostly serve the medical needs of poor women; their patients number more than 5 million.
Planned Parenthood Federation of America, which operates many of those clinics, has said it would refuse federal money rather than obey a "gag rule."
Douglas Johnson, legislative director of the nation's largest anti-abortion group, the National Right to Life Committee, said: "Most Americans will agree with President Bush that abortion is not an acceptable method of birth control and should not be promoted with tax dollars."
The 1970 federal law that provides "family planning" funds of nearly $200 million a year to clinics bars the clinics from performing abortions themselves. After the clinics had counseled abortions as a medical option and referred women to abortion clinics for years, the Reagan administration issued its sweeping ban on such counseling and referral in 1988.
Because of constitutional challenges, that ban has never been implemented. The Supreme Court, however, upheld the so-called "gag rule" by a 5-4 vote last May.
Since then, the administration has been engaged in prolonged negotiations over whether and how to revise the rules.