The Legal and Ethical Implications of Gag Clauses in Physician Contracts

Abstract

Throughout history, those in power have feared the consequences of unfettered discourse within their society. The empowered have restricted and directly manipulated discourse in the context of doctor-patient discussions with surprising frequency, resulting in disturbing curtailments of individual autonomy. During the Cultural Revolution, the Chinese government dispatched physicians to peasants’ homes to convince them to use contraception. In the 1930s, the Soviet government expedited the completion of the Siberian railroad by ordering physicians to deny workers’ requests for medical leave and to conceal this order from those workers. Recently, Nicolae Ceausescu sought to increase the Romanian birth rate by prohibiting physicians from advising patients about birth control and barring the dissemination of information about condom use to prevent HIV transmission.Restraints on doctor-patient discussions have not been limited to socialist regimes. In 1988, the Bush Administration implemented a federal regulation prohibiting physicians from discussing abortion with patients in federally funded clinics.