The Doctors Take On Bush

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But it was the gag rule that really got doctors steamed. The Supreme Court case centered on the Public Health Service's Title X program, created during the Nixon Administration to provide family-planning services to low-income women. The original act stated explicitly that federal funds were not to be used to finance abortions, but in 1981 the guidelines were changed to make it clear that pregnant women should be advised of their full menu of medical options, including prenatal care, foster care, adoption and abortion.

Then in 1988 the Reagan Administration revised the rules: doctors and nurses were prohibited not only from counseling on abortion but even from pointing patients to Yellow Pages listings of clinics that would offer such advice. If a woman asked about terminating her pregnancy, doctors were instructed to recite these words: "The project does not consider abortion an appropriate method of family planning and therefore does not counsel or refer for abortion." The directive did not take effect immediately because it was challenged in several state courts, but the Supreme Court cleared away those obstacles when it declared the gag rule constitutional on May 23.

The next day, the American College of Obstetricians and Gynecologists issued a bulletin to 600 key members, headlined ALERT -- IMMEDIATE ACTION NEEDED and calling for a lobbying campaign in Congress. By mid-June the group had pulled together a coalition of 21 national organizations representing 425,000 health- care professionals. Coalition activists hand delivered letters to every member of Congress, cornered the leadership of both Houses and pressed for a meeting with the President. Even the conservative American Medical Association * -- one of the most powerful lobbies in Washington -- raised its voice in protest. "We are convinced," said A.M.A. executive vice president James Todd, "that political medicine is harmful to the health of all Americans."

For doctors, already beset by nit-picking insurance companies, shrinking Medicaid payments and malpractice lawyers, the gag rule seemed the final intrusion -- one that was doubly galling because it came from an Administration many had supported. Says Alan Altman, a gynecologist in Brookline, Mass.: "((The government)) bothers me in the pocketbook, it bothers me in the delivery room, but it has never before bothered me in the consultation room." Dr. Laura Sirott, a Pasadena, Calif., obstetrician- gynecologist who describes herself as a past supporter of Bush, complains that the gag rule violates a patient's right to be fully informed. "This is absurd. I don't think abortion should be a political issue."