Document: 500 U.S. 173 111 S.Ct. 1759 114 L.Ed.2d 233 Irving RUST, etc., et al., Petitioners,v.Louis W. SULLIVAN, Secretary of Health and Human Services. NEW YORK, Petitioners, v. Louis Nos. 89-1391, 89-1392. Argued Oct. 30, 1990. Decided May 23, 1991. Syllabus Section 1008 the Public Service Act specifies that none federal funds appropriated under Act's Title X for family-planning services "shall be used in programs where abortion is a method family planning." In 1988, respondent Services issued new regulations that, inter alia, prohibit projects from engaging counseling concerning, referrals for, activities advocating as planning, require such to maintain an objective integrity independence prohibited by use separate facilities, personnel, accounting records. Before could applied, petitioners—Title grantees doctors who supervise funds—filed suits, which were consolidated, challenging regulations' facial validity seeking declaratory injunctive relief prevent their implementation. affirming District Court's grant summary judgment Secretary, Court Appeals held permissible construction statute consistent with First Fifth Amendments. Held: 1. The are X. Pp. 183-191. (a) Because § ambiguous it does not speak directly issues counseling, referral, advocacy, or "program integrity," Secretary's must accorded substantial deference interpretation agency charged administering statute, may disturbed abuse discretion if reflects plausible statute's plain language otherwise conflict Congress' expressed intent. Chevron U.S.A. Inc. Natural Resources Defense Council, Inc., 467 837, 842-844, 104 2778, 2781-2782, 81 694. P. 184. (b) X's broad plainly allows advocacy regulations. Since neither defines 1008's "method planning" phrase nor enumerates what types medical entitled funding, cannot said prohibition ban on within impermissible. Moreover, since legislative history intent these issues, this will defer expertise. Petitioners' contention, little no because they reverse longstanding policy permitting nondirective referral abortion, rejected. given ample latitude adapt its rules changing circumstances, revised deserve deference. change amply supported "reasoned analysis" indicating more keeping original intent, justified client experience prior policy, accord shift attitude against "elimination unborn children abortion." 184-187. (c) integrity" requirements inconsistent language. view, necessary ensure apply only authorized purposes avoid creating appearance governmental support abortion-related activities, unreasonable light express prohibitory contention unpersuasive frustrate clearly history, integral part broader, comprehensive, health-care system envisions efficient non-Title funds. statements relied highly generalized do address scope and, therefore, form basis enjoining Indeed, demonstrates Congress intended kept distinct activities. there need invalidate order save unconstitutionality, petitioners' constitutional arguments carry day. 187-191. 2. violate Amendment free speech rights private fund recipients, staffs, patients impermissibly imposing viewpoint-discriminatory conditions Government subsidies. There question but constitutional, make value favoring childbirth over implement allocation public Maher Roe, 432 464, 474, 97 2376, 2382, 53 484. so doing, has discriminated viewpoint; merely chosen one activity exclusion another. Similarly, implementing statutory forbidding provision information regarding simply including speech, outside program's scope. Arkansas Writers' Project, Ragland, 481 221, 107 1722, 95 209, distinguished. view chooses subsidize protected right, analogous counterpart rights, been soundly See, e.g., Regan Taxation With Representation Wash., 461 540, 103 1997, 76 129. On face, read, petitioners contend, bar woman's life placed imminent peril her pregnancy, seem considered 1008, provisions themselves contemplate project engage circumstances. Nor can restrictions subsidization unconstitutionally condition receipt benefit, relinquishment right counseling. force grantee, employees, give up speech; project. FCC League Women Voters Cal., 468 364, 400, 3106, 3127, 82 278; Regan, supra, U.S., at 546, S.Ct., 2001, Although argued traditional doctor-patient relationship should enjoy protection regulation, even when subsidized Government, cf., United States Kokinda, 497 ----, 110 3115, 571, resolved here, program significantly impinge relationship. 192-200. 3. choose whether terminate pregnancy. duty constitutionally validly allocate relating abortion. Webster Reproductive Services, 492 490, 109 3040, 106 410. That places obstacle path woman wishing pregnancy leaves same choices had all. Harris McRae, 448 297, 315, 317, 100 2671, 2687, 2688, 65 784; Webster, ----. place patient/doctor dialogue informed voluntary choice Akron Center Health, 462 416, 2481, 687, Thornburg American College Obstetricians Gynecologists, 476 747, 2169, 90 779. Unlike laws invalidated those cases, required all provide pregnant contemplating specific antiabortion information, doctor's ability provide, receive, remains unfettered context fact most clients effectively precluded indigency seeing provider affect outcome financial constraints full range freedom product restrictions, indigency. 316, 2687. 201-203. 889 F.2d 401 (C.A.2 1989), affirmed. REHNQUIST, C.J., delivered opinion Court, WHITE, KENNEDY, SCALIA, SOUTER, JJ., joined. BLACKMUN, J., filed dissenting opinion, MARSHALL, joined; Part I O'CONNOR, Parts II III STEVENS, opinions. Laurence H. Tribe, Cambridge, Mass., petitioners. Solicitor Gen. Kenneth Starr, Washington, D.C., respondent. Chief Justice REHNQUIST Court. 1 These cases concern challenge Department (HHS) limit recipients Second Circuit upheld regulations, finding them well Amendments Constitution. We granted certiorari resolve split among Courts Appeals.1 affirm. 2 * A. 3 1970, enacted (Act), 84 stat. 1506, amended, 42 U.S.C. §§ 300-300a-6, provides funding services. authorizes "make grants enter into contracts nonprofit entities assist establishment operation planning shall offer acceptable effective methods services." 300(a). Grants "be made accordance promulgate." 300a-4. Act, however, "[n]one subchapter 300a-6. restriction was would preventive services, population research, infertility other related medical, informational, educational activities." H.R.Conf.Rep. No. 91-1667, p. 8 (1970), U.S.Code Cong. & Admin.News pp. 5068, 5081-82. 4 promulgated designed " 'clear operational guidance' about how preserve distinction between Fed.Reg. 2923-2924 (1988). clarify, through definition term "family planning," "to 8, 5081 (emphasis added). Accordingly, limited "preconceptual education, general reproductive health care," expressly exclude "pregnancy care (including obstetric prenatal care)." CFR 59.2 (1989).2 "focus emphasis mission: specifically enable individuals determine number spacing children, while clarifying women referred appropriate 2925 5 attach three principal projects. First, specify "Title concerning 59.8(a)(1) (1989). preconceptional furnish childbirth. Only out transitional information. 59.8(a)(2). refer every "for and/or social furnishing list available providers promote welfare mother child." Ibid. indirectly encourage "such weighing favor perform abortions, whose business excluding 'steering' 59.8(a)(3). referring provider, upon request. One response inquiry "the consider therefore counsel 59.8(b)(5). 6 Second, broadly "encourage, advocate 59.10(a). Forbidden include lobbying legislation increase availability developing disseminating materials providing speakers using legal action any way paying dues group advocates 7 Third, organized "physically financially separate" 59.9. To deemed physically separate, "a have Mere bookkeeping separation monies sufficient." nonexclusive factors conducting case-by-case determination independence, existence records degree physical facilities B Petitioners suing behalf patients. Respondent After promulgated, before two actions, later implementation challenged grounds providers. initially granting preliminary injunction, rejected challenges Secretary. New York Bowen, 690 F.Supp. 1261 (SDNY 1988). 9 A panel Applying decision 842-843, 694 (1984), determined legitimately effectuated Congressional court "highly strained," forbids performing abortions. reasoned "it wholly anomalous read mean counsels abortions 'method planning.' F.2d, 407. "[T]he natural . planning' includes found observed "[a]ppellants' contrary based entirely expansive services" "do mention service projects" "surely trump section excludes it." Id., 407-408. 10 Turning challenge. It burden "government Finding performance 410 (1989), "substantially greater impact than instant matter," 411, concluded "create[d] affirmative barriers access Ibid., citing 11 likewise "Secretary's Congress's also not, applicable Supreme precedent, constitute violation women." 412. explained 129 (1983), government obligation exercise fundamental "speech rights." "condition[ing] benefit rights" employees "remain say whatever wish project." Finally, "facially discriminate viewpoint involved." 414. 12 begin pointing posture us. Thus, we concerned whether, both construed manner applied set without infringing rights. face heavy facially unconstitutional. "A is, course, difficult mount successfully, challenger establish circumstances exists valid. [the regulations] might operate some conceivable insufficient render [them] invalid." Salerno, 739, 745, 2095, 2100, 697 (1987). 13 turn first exceed authority arbitrary capricious. examination then requirement," respect courts below adopted conflicting positions. petitioner's claim struck down raise question. 14 dwell agree addressed issue ambiguous. 1008—that planning"—does integrity. If "silent issue, agency's answer statute." Chevron, 2782. 15 determining permissible, "[t]he conclude permissibly reading reached arisen judicial proceeding." 843, n. 11, 2782, 11. Rather, authorizing it. 844, 16 statute. By own terms, prohibits "in define enumerate funding. Based directives provided particular, unable project, 17 examined found, least regard provisions, enacting 1008. Massachusetts Sullivan, 899 53, 62 (CA1 1990) ("Congress prohibition. either litigants' positions"); Planned Parenthood Federation America 913 1492, 1497 (CA10 ("[T]he contemporaneous clinics receiving option referrals"); 401, 407 (CA2 1989) (case below) ("Nothing detracts" 1008). join holding fails shed relevant congressional At time did advocacy. parties' attempts characterize generalized, accurate revelations unavailing.3 18 When find, unenlightening matters deal, customarily expertise agency. argue, "reverse permitted abortion," Brief 89-1392, 20, thus represent sharp beak argue permit coordination local state weight. 19 This argument "is represents break interpretations" 862, 2791. deserves "[a]n initial instantly carved stone" agency, rulemaking, varying interpretations wisdom continuing basis." 863-864, 2792. An 'establish conduct last forever,' Motor Vehicle Mfrs. Assn. State Farm Mutual Automobile Ins. Co., 463 29, 42, 2856, 2866, 77 443 quoting Trucking Assns., Atchinson, T. S.F.R. 387 397, 87 1608, 1618, 847 (1967); NLRB Curtin Matheson Scientific, 494 1542, 108 801 (1990), rather "must 'adapt [its] policies demands circumstances.' Mfrs., Permian Basin Area Rate Cases, 390 784, 88 1344, 1369, 20 312 (1968). find his analysis." 2866. result determination, wake critical reports General Accounting Office (GAO) Inspector (OIG), failed properly "clear guidance He believe justifications sufficient approach. Having X, 21 next embodied 59.9 mandating impermissible system. They integration burdened adversely affected 22 defends assure federally supporting direct observations GAO OIG "[b]ecause recipient's title easily recognized, get impression Federal being improperly App. 85. that: 23 "[M]eeting requirement mandates inclusion program. predicate included program." 2940 24 further argues deviation past consistently taken position requires 25 As noted, clear very little, exception. infer 26 For example, cornerstone conclusion integrated statement requiring authorities applying submit plan coordinated comprehensive 1002. Placed context, "coordinated eligible evinces funds; overall responsibility Likewise, House Report "not interfere conducted laws" equally unclear. 8-9 5082. follows "intent Houses conferees contained clear." fall short evidencing 27 While one, means certainly established demonstrate certain See "squarely funded 52 33212 thing undisputed primarily prepregnancy Certainly necessary, especially judged unreasonable. 28 contend serious questions law. rely Edward J. Debartolo Corp. Florida Gulf Coast Building Construction Trades 485 568, 1392, 99 645 (1988), Catholic Bishop Chicago, 440 1313, 59 533 (1979), hold "an ought Constitution possible available. 5. Under canon construction, elementary rule reasonable resorted unconstitutionality." Corp., 575, 1397 added) Hooper California, 155 648, 657, 207, 211, 39 L.Ed. 297 (1895). 29 principle enunciated subsequent categorical one: "as unconstitutional valid, our adopt Act." Blodgett Holden, 275 142, 148, 48 105, 107, 72 206 (1927) (opinion Holmes, J.). declare act gravest delicate called perform." Id. Following Hooper, Delaware Hudson 213 366, 408, 527, 535, 836, Jin Fuey Moy, 241 394, 36 658, 659, 60 1061, developed corollary doctrine "[a] construed, fairly possible, grave doubts score." 659. followed Congress, assume legislates limitations. FTC Tobacco 264 298, 305-307, 44 336, 337, 68 696 (1924). qualified proposition "avoidance difficulty pressed point disingenuous evasion." Moore Ice Cream Co. Rose, 289 373, 379, 620, 622, 1265 (1933). 30 Here forbade planning. promulgate provision. extensive litigation Roe Wade, 113, 93 705, 35 147 (1973), suggests likely Secretary—other ones 1988 him relatively toothless ineffectual—would grounds. think case force, III, infra, discussion best can, sort "grave doubtful questions," 536, lead us intend authorize issuance. Therefore, unconstitutionality. 31 discriminating "all lawful option—including neutral ending pregnancy—while compelling clinic counselor promotes term." assert "free organizations receive funds, staff, patients" "viewpoint-discriminatory subsidies" penaliz[e] monies." 13, 14, 24. continues ancillary testing evenhanded views invidiously discriminates viewpoint." 18. Relying Writers 234, 1730, 209 (1987), subsidies, "discriminate subsidies 'ai[m] suppression dangerous ideas.' 548, 2002 (quoting Cammarano States, 358 498, 513, 79 524, 533, (1959)). 32 constitutional. regulation Medicaid received payments childbirth, nontherapeutic unequal worked funds." 2382. exercising possesses McRae conception declining "promote violating Constitution, selectively believes interest, alternate seeks deal problem another way. other. "[A] legislature's infringe right." 549, 2003. also, Buckley Valeo, 424 1, 96 612, 46 659 (1976); supra. refusal activity, more, equated imposition 'penalty' activity." 19, 19. "There basic difference interference encouragement alternative consonant policy." Maher, 475, 2383. 33 prohibiting limits observed. care, doctor wished patient became doing ilk; "no employed course duties "suppressing idea," grantee 34 dedicated advance goals, advancing goals necessarily discourages numerous suspect. National Endowment Democracy countries democratic principles, 4411(b), competing lines political philosophy Communism Fascism. assertions ultimately boil But proposition. supra; Within far broader willing concede, appropriates reliance misplaced. involved sales tax magazines content. fact, "targets small press," Minneapolis Star Tribune Minnesota Comm'r Revenue, 460 1365, 75 295 invalid. here law singling disfavored content, refusing excluded funded. heavily circumstance emergency, case, involves application situation. Abortion prohibited, medically necessitated equivalent Neither apply. 59.8(a)(2) exemption emergency immediately 59.5(b)(1) "necessary indicated."4 37 Perry Sindermann, 408 593, 597, 92 2694, 2697, 570 (1972), 278 "even though deny [a] reasons, reasons rely. person infringes interests—especially, interest speech." Perry, 2697. 38 unavailing, denying anyone, instead insisting spent authorized. keep distinguishes normally organization, variety sources purposes. 3, 5, 13. receives purpose establishing operating govern project's leave continue advocacy; independent contrast, "unconstitutional conditions" involve situations recipient subsidy particular service, noncommercial television radio stations "engage editorializing." law, "barred absolutely editorializing" able segregate according source funding" "has limiting noneditorializing effect station 1% income [federal] barred finance editorial 3128. "establish 'affiliate' station's editorialize nonfederal mechanism valid." Such scheme known importance nonfederally funded, editorializing affiliate losing broadcast 40 could, spending power, reasonably refuse tax-exempt charitable tax-deductible contributions efforts. holding, remained deductible nonlobbying activit[ies]." 545, 2001. organization create, 501(c)(3) Internal Revenue Code 1954, 501(c)(3), contributions, establish, 501(c)(4), pursue efforts contributions. 544, 2000. Given alternative, "Congress infringed regulated activity[; it] pay [appellee's] lobbying." noted appellee "would, 501(c)(4) organization; otherwise, chose subsidize." combating teenage drug abuse, money lobby legislatures." id., 2002. 41 separately has, teachings denied refused fisc, principles abridge grantee's staff. Individuals voluntarily regulation's referral. remain free, acting auspices solely restrict persons individuals. employees' expression during actually work project; limitation consequence accept employment restricted authority.5 43 suggest coupled Government-funded invariably justify control content expression. recognized "subsidy," Government-owned property, areas "been traditionally open expressive activity," --- 3119, 571 (1990); Hague CIO, 307 496, 515, 954, 963, 83 1423 (1939) Roberts, J.), "expressly 3119; Education Local Educators' Assn., 37, 45, 948, 74 794 (1983). university sphere functioning society Government's attached expenditure vagueness overbreadth doctrines Amendment, Keyishian Board Regents, 385 589, 603, 605-606, 675, 683, 684-685, 629 (1967). analogy relationships Government. Nothing he hold. sufficiently all-encompassing expectation advice. post-conception silence thought mislead thinking her. always advice beyond applies force. IV now recently reaffirmed long-recognized 'the Due Process Clauses generally confer aid, aid secure life, liberty, property interests itself deprive individual.' 3042, DeShaney Winnebago County Dept. Social 489 189, 196, 998, 1003, 249 'implement funds' (citation omitted). "commit resources facilitating abortions," 3052, "places rather, encourages interest." 45 evident line beginning culminating recent Webster. Just left indigent deciding obtain she costs all," "Missouri's allow hospitals hospitals," encounters different stated "[h]aving State's [in ] strains logic reach employees." 3052. similarly strain logic, extreme mere pre-conceptual program, 47 doctor/patient depriving self-determination decisions government-imposed harm. 687 779 (1986), placing dialogue. Akron, city ordinance physicians specified consent "truly informed." 423, 2488. Thornburg, agencies offering alternatives description fetal development considering terminating Critical intrusion respective jurisdictions litany regardless sought patient's decision. unfettered. undoubtedly easier distort mandated 49 poverty once again, worse never "The indigency." 2688. 50 51 Affirmed. whom MARSHALL joins, STEVENS joins O'CONNOR I, dissenting. Casting aside administrative jurisprudence, majority today unnecessarily passes important time, upholds viewpoint-based imposed dependent economic support. essentially rationale, physician manipulating continuance exceeds authority, Regulations dissent divided-vote Appeals. 54 dispute "[f]ederal statutes doubt constitutionality." Machinists Street, 367 740, 749, 1784, 1790, 1141 (1961). (1895); Crowell Benson, 285 22, 62, 285, 296, 598 (1932); Security Industrial Bank, 459 70, 78, 407, 412, 235 (1982). fully suspect regulation. DeBartolo 1397, (1988); (1979); Kent Dulles, 357 116, 129-130, 78 1113, 1119, 1204 (1958). zeal sidesteps feeble excuse 'grave questions,' issuance." Ante, 191, 836 (1909). 55 facile intractable addresses best. Whether avoids reality rise questions. Regulations] grounds," ante, squarely presented Regulations—the extent benefit—implicates troubled area jurisprudence entangle unnecessarily. Epstein, Unconstitutional Conditions, Power, Limits Consent, 102 Harv.L.Rev. 4, (1988) (describing structural hundred years bedeviled commentators alike. ."); 1413, 1415-1416 (1989) (observing "seem minefield traversed gingerly"). 56 discussed impose aimed respects, implicate core values. verity evidenced entertained 1990); 1492 1990). 57 divided Tenth "fal[l] Thornburgh City requests doctor." 1501. Circuit, en banc judge dissenting, privacy grantees. 415 (Kearse, part). bare reaches raised doubtful. 58 Stat. 1508, 300a-6, simply: "None concedes "does 184, ambiguous" respect. 186. Consequently, sustains trouble-free interpretation.1 situation intention revealed too distinctly ignore misgivings power." appear passing strongest where, decidedly logical eminently prudent intends press constitutionality enactments, explicit unambiguous terms. Sunstein, Law Administration Colum.L.Rev. 2071, 2113 (1990) ("It implausible after prevail produce invalidity doubts"). 'fairly possible' reasonable," Machinists, 750, ground Regulations. 61 strongly disagree majority's disposition claims, feel thereto indicated, move issue. Until today, acceptance Whatever power largess surely extend suppresses cherished speech. Speiser Randall, 518-519, 1332, 1338, 1460 (1958) ("To claimants forms penalize denial 'frankly ideas,' Communications Douds, 339 382, 402, 70 674, 685, 94 925 (1950)). (1959). Voters, 3131 (REHNQUIST, dissenting). Cf. 237, 1731, (1987) (SCALIA, sound often noted: 'A motivated nothing desire curtail controversial purest example "law abridging press." ' 383-384, Consolidated Edison Comm'n York, 447 530, 2326, 2338, 319 (1980) (STEVENS, concurring judgment). "[A]bove else, message, ideas, subject matter, content." Police Chicago Mosley, 92, 95, 2286, 2290, 212 (1972). 63 long-settled understanding. content-neutral Code, disallowed status "attempt[ed] influence legislation," affording veterans' irrespective controlled Cammarano, explained: indication suppress ideas demonstration effect." 2002, Speiser, 519, 1338. concurrence joined precisely 501's discrimination 551, 2004. 64 seriously disputed present content-based wide topics, 537, 2333 ("The Amendment's hostility extends viewpoints, entire topic"); Boos Barry, 312, 319, 1157, 1163, 333 J.) (same). viewpoint-based. suppressing favorable hand, compels anti-abortion Services' makes facilitate adoption needed well-being child, making abundantly process." 2927 66 command each diagnosed pregnant, (1990). asks say, essence, 59.8(b)(4). Both antithetical Amendment. Wooley Maynard, 430 714, 1428, 1435, 752 (1977). 67 pertaining "advocacy" explicitly provide: encourage, 59.10 explain: "This actions accessibility purposes." 59.10(a) proscribe regulate "dangerous ideas." Remarkably, concludes another." 193. ibid., rings hollow non-preventive provide.2 targeted viewpoint. Ward Rock Against Racism, 491 781, 2746, 105 661 pertain begs Clearly, bases rest fund. Members base considerations race. Yick Wo Hopkins, 118 356, 1064, 220 (1886). demonstrated above, ideological repugnant decisions. 69 connection stands party's petition legislature views. confined non-ideological limitations exist having encouraging, promoting, addition focus intrude communicative conduct, words spoken physician. dialogue, instrument fostering adherence [he she] finds unacceptable." 715, 1435. type intrusive, ideologically goes narrow approved benefit.3 staff members 198-199. employee escape relinquishing job. "that individual relinquish guaranteed employment." Abood Detroit Education, 431 1782, 1799, 261 (1977), Elrod Burns, 427 347, 357-360, 2673, 2681-2683, 547 (1976), cited therein; (1972); Nearly decades ago, said: 71 "For quarter-century, 'right' valuable associations, freedoms penalized inhibited. 'produce [it] directly.' 526, 1342, circumvent emphasizing counselors 198. regulations," explains, individuals." reasoning, tolerate employee's long workplace. proposition, rightly past. 73 Abood, compelled workplace unregulated State. Rankin McPherson, 483 378, 2891, 315 derogated communication employer punish occurred hours. least, balance speaker's message preventing dissemination. 384, 2896; Pickering 391 563, 1734, 811 bar, vital. addressing needs clients, seek options freedom. legitimate expectations ethical responsibilities profession demand less. self-decision exercised enough intelligent choice. help therapeutic good practice." Current Opinions, Council Ethical Judicial Affairs Medical Association ¶ 8.08 President's Commission Study Problems Medicine Biomedical Behavioral Research, Making Care Decisions (1982); Standards Obstetric-Gynecologic (7th ed. 1989). becomes option, counselors' compelling. articulated distorting dialogue—ensuring program—falls truthful professional conduct.4 offending Regulation narrowly tailored serve interest. stake served rigorous standards adopting balanced dissemination 1990), cert. pending, 89-1929. failing claimed asserted falters message. C significance vital listener. imagine Concededly, debate divisive contentious Nation faced years. "But differ things matter much. shadow test substance touch heart existing order." West Virginia Barnette, 624, 642, 1178, 1187, 1628 (1943). disturbing aspect today's ruling who, supposedly, beneficiaries programs. rejects claims summarily. relies 784 (1980), dissents wrongly unfortunately decided. Be may, accepts valid theorizing reasoning flawed. allowed stand intact decide coercion term. 484 effect. Today's abandons principle, disastrous results. Contrary characterization, progeny much procedure self-determination. Those vindicate idea "liberty," anything, entail domination intimate personal 444, 2500, (1983) (governmental ensuring "will childbirth"); 473, 2382 (noting "recognize 'in kinds decisions' compulsion," Whalen 429 599, 869, 876, (1977)); see 2685; Thornburgh, 759, ,S.Ct., 2178; 169-170, 735 (Stewart, concurring). pertinent injecting restrictive unrelated maternal health, formidable obstacles clients' thereby violates 80 crystal-clear aim noticing—is "reduce incidence (in planning"). recounted situation, inquiry, respond "appropriate method" undeniable conveyed forced draw it, nearly improper option. physician's words, strictly construe forgo rational patients, many follow perceived term, despite safety vast them. Others, delayed Regulations' mandatory prevented acquiring period process protected. inevitable Regulations, X," 202, insensitive common human experience. procreative destiny. women, obliterated banned outright. ill-intentioned distortion provide.5 bodily doubly offensive effected society, embodies unique trust. specialized nature science emotional distress attendant health-related complete confidence, lives, hands professionals. medication diagnosis, guidance, judgment, attaches profound reason guarded jealously intrusion. "[I]n 'stressed repeatedly central role physician, consulting carried out.' 447, 2501, Colautti Franklin, 439 387, 681, 596 (1979). 763, 2180. approval flies repeated warnings tending "confine attending undesired uncomfortable straitjacket practice profession," endure. Central Mo. Danforth, 428 52, 67, 2831, 2840, 788 (1976). 85 distinguish holdings post-hoc intrusions jurisdiction class healthcare professionals 202. Loving Virginia, 388 12, 1817, 1823, 1010 Shelley Kraemer, 334 846, 1161 (1948). And woman, deprivation liberty less affects few many. infringement touches Nation's 86 manipulation achieved effort deter hers make." 2178. such, Amendment.6 haste integrity, disregards contorts decided arrive preordained result. professes undisturbed protections come rely, wonder retains countenance deliberate technically leaving "through relentlessly formalistic catechism," 341, 2707-2708 (MARSHALL, dissenting), again rendered right's nugatory. 3067 560, 3079 (opinions noxious overruling directly, unenforceable, flagrant ceases This, fear, 89 my paid attention controlling responsible cabinet officers four Presidencies text "Family Planning Population Research 1970" unchanged enactment. 1504. preamble states passed: 91 "To expanding, improving, better coordinating research declaration emphasizes educating states, part, is: "(1) readily desiring services; "(5) develop materials) growth information." 300 (Congressional Declaration Purpose). contrast public, contains suggestion censorship recipient. empowers utilized made." 300a-4(b). Not word recipients. 98 "prohibition" Act. 6, adds covering programs, following provision: "PROHIBITION OF ABORTION "SEC. None 101 Read directed advice, potential 1971 Welfare interpreted 'contemporaneous [the] men setting machinery motion' Power Reactor Development Electrical Workers, 396, 1529, 1535, 924 (1961) omitted); Udall Tallman, 380 16, 792, 801, 616 (1965); Aluminum Lincoln Peoples' Utility District, 380, 390, 2472, 2479, 301 (1984). described kind purport clients. Conforming governing 59.5(a)(9) (1972) Like itself, true 1986 censor mandate 59.1-59.13 (1986). approach reflect make. Counsel, 865, 2792, represented assumption policymaking delegated 2781-2782 ("If clear, end matter; court, unambiguously Congress"). abhors policymakers highest communicate, unrealistic implicitly Executive am convinced 1970 invalid Even ambiguous, O'CONNOR's opinion. result, comment parties debated. questions, persuaded BLACKMUN correct concluding merit response. correctly analyzed issues. "[W]here problems, problems unless Congress." why long-standing dissent. "raise problems": years." 215. conclude, II, reason. dissent, grounded large time-honored reaching DeBartolo, 1397. "It restraint necessity them." Three Affiliated Tribes Fort Berthold Reservation Wold Engineering, P.C., 138, 157, 2267, 2279, 113 Alexander Louisiana, 405 625, 633, 1221, 1226, 536 Burton 196 283, 295, 243, 245, 482 (1905); Liverpool, Philadelphia S.S. Commissioners Emigration, 33, 39, 352, 355, (1885) (In pronounce rigidly adhered" "never anticipate it"). acts invalidates recognition scheme, "great gravity delicacy" telling coordinate branch absent amendment. Adkins Children's Hospital Columbia, 525, 785 (1923). 147-148, 106-107, (Holmes, tell statute; pass legislation. grounds, legislating explicitly. nothing. Congress; interpretation, raises concerns. alone, "Most X-sponsored examinations, education contraceptive methods, birth control." Report, 95. instance, passage evidence intent: been, preceding stressing supplying Senate states: committee euphemism control. consist dispensation devices. [A] successful contain [m]edical consultation examination, prescription, supervision, supplies, instruction, needed." S.Rep. 91-1004, (1970). inadequacies "traditional tools construction," Immigration Naturalization Cardoza-Fonseca, 480 [421] 446-447, 1207, 434, resolving fit advocate" compliance prescribed use. South Dakota Dole, 203, 207-209, 2793, 2796-2797, 171 (upholding drinking age highway funds); 99, 673, penalizing monies. contribute financing matching grant-related income, privately flawed several reasons. just decline subsidy. Grove Bell, 465 555, 1211, 1222, 516 (1984) (petitioner's violated "may participation program]"). accepting consents income. Potential funds—subject project—or unsubsidized "limi[t] [Title X] 3128, finance" pro-abortion private, constitutional." 192. Were actual funds—as, indeed, until February 2, 2923 (1988)—the category interpreting patient, screening breast cancer, treatment gynecological sexually transmitted diseases. latter preventive, obscure breadth curious relationship." 200. substantially dispute. undiminished "all-encompassing" one. expect, all, withhold visit. uninformed fantasy. Further, somehow incomplete lacks single Americans. context: perfectly proper judges requires. disgraceful premised unfounded assumptions people live." Kras, 409 460, 631, 646, 626 (1973) (dissenting opinion). common-law tort liability, recognized: "If go assistance peril, worse. true, charity patient. defendant liable failure plaintiff's interests." Keeton Prosser Torts 378 (5th 1984) (footnotes observation seems bar. Significantly, interprets endangered continued provider. 195. substantive due process. Youngberg Romeo, 457 307, 2452, Revere Hospital, 239, 2979, 605 oral argument, afforded interpretation. Tr. Oral Arg. 44-47.

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