Compelling Honesty

It’s interesting how many people indignantly wrap themselves in the Free Speech provisions of the First Amendment in order to justify behaviors that–properly understood–aren’t really speech at all.

In all fairness, it can be difficult to distinguish between actions that are intended to communicate a message (protected) from actions that are committed through speech (not protected).

If you describe that cubic zirconium you are selling as an expensive diamond, the fact that your fraud involved the spoken word won’t turn your deception into a free speech issue. On the other hand, if you burn an American flag (assuming it’s yours to burn), you are clearly doing so in order to convey a message. (The content of that message is precisely why people get so angry.)

This little exercise in First Amendment philosophy is an introduction to an interesting case involving Crisis Pregnancy Centers.

Crisis pregnancy centers (CPCs) are pro-life organizations that often offer women incorrect, incomplete or misleading information about their reproductive options.

In response, some localities have passed legislation requiring CPCs to make disclosures to their clients. California, for example, passed the Reproductive FACT Act in 2015. Under this law, CPCs must notify clients of public resources available to prevent or terminate pregnancies. It also mandates that CPCs inform their patients if they are not licensed as a medical facility.

Anti-choice advocates have taken issue with these requirements. The National Institute of Family and Life Advocates has sued California’s attorney general on behalf of CPCs. In November 2017, the U.S. Supreme Court decided it would hear the case.

The question the Court will have to decide is deceptively simple: does requiring Crisis Pregnancy Centers to disclose accurate information that counters or undermines their beliefs violate their First Amendment right to free speech?

At first blush, the idea of requiring speech to be truthful seems like a great idea. (Fox “news” anyone?) In practice, it’s difficult if not impossible to separate opinion from flat-out lying. After all, most lies aren’t as obvious as those constantly being told by Donald Trump and Sarah Huckabee Sanders. In the case of Crisis Pregnancy Centers, however, the intent to mislead is pretty transparent.

A 2016 paper published in the Journal of Pediatric and Adolescent Gynecology found that nearly half of the 85 websites surveyed promoted abstinence-only sexual education. Over 60 percent of these websites provided negative facts about condoms, including minimizing their efficacy and suggesting they break often, and less than 10 percent encouraged the use of condoms to prevent sexually transmitted infections.

A larger examination of 254 CPC websites, published in Contraception in 2014, found that 80 percent provided at least one item of false or misleading information — most commonly, claiming links between abortion and mental health concerns.

A study published in 2017 in Women’s Health Issues focused on the websites of crisis pregnancy centers in Georgia. It reviewed all of the accessible websites of the CPCs in the state and found that more than half had “false or misleading statements regarding the need to make a decision about abortion or links between abortion and mental health problems or breast cancer.” Eighty-nine percent of sites did not indicate that their centers do not offer contraceptives or direct patients to resources where they might find them.

There is considerably more abortion research at the link.

The question that the Justices will have to weigh, however, is unrelated to the issue of reproductive choice–although attitudes about abortion will undoubtedly play an outsized role.

The legal issue to be resolved will apply in areas far removed from reproductive rights. What level of harm to the public justifies government interference with an advocacy organization’s communications? Do the lies being peddled rise to the level of fraud, as in our cubic zirconium example? Or should the risks to the “consumers” of these services be governed by the doctrine of caveat emptor–let the buyer (or in this case, the pregnant woman) beware? Should the imposition of government sanctions require intent–that is, should a finding of culpability require evidence that the people making the false claims know better?

I personally think that organizations willing to lie to women who are already distraught are despicable. But legal analysis must consider the consequences of a decision based upon that sort of emotional reaction.

Can the Supreme Court craft a decision that limits the ability of dishonest folks to prey on vulnerable women, without handing government a cudgel with which to beat the merely opinionated? And if so, what should be the burden of proof?


  1. Isn’t – or wasn’t – there an actual law requiring “truth in advertising”? If I remember correctly, it went so far as to labeling food contents in order of largest amount to smallest; such as “mac and cheese” meaning more macaroni than cheese in the package.

    Health care, in any form, is the ultimate area of need for telling “the truth, the whole truth and nothing but the truth”. Of course, that is simply my opinion on this matter.

  2. Honesty and integrity are such passe concepts in the pursuit of control over our population.

  3. “Compelling Honesty”!!! Where is the honesty in the countless times I have read that Trump received “severe backlash” due to his ridiculous and frequently dangerous Tweets? What backlash? When will it happen? Who will deliver the backlash? And, yes, my questions do fit into today’s blog subject; who has been more dishonest and worked harder at destroying all women’s health care support and sources than Trump? This is the utmost dishonesty as we wait for some semblance of salvation from somewhere, buried deep within our own government.

    What can be more dangerous than threatening any country about the size and power of his “button”? The calendar page has flipped to a new year but we are reading, seeing and hearing the same old s*+t which has overflowed from the 2018 toilet-year. Here’s another old saying, “Either poo-poo or get off the pot!”

  4. The point that struck me was the sentence: “The question the Court will have to decide is deceptively simple: does requiring Crisis Pregnancy Centers to disclose accurate information that counters or undermines their beliefs violate their First Amendment right to free speech.”

    Isn’t this equivalent to the “wedding cake” case the Court is considering now?

  5. This will be an intersting case, considering the mis-information many states require heath care providers to give to patients. Add to that prohibitions of questions from physicians about gun-ownership.

  6. Today’s blog reminds me of the multi-million grant pence gave to a PA religious based organization to fund their centers in IN. There are at least three of them in Fort Wayne.

    When he did this there was great anger among citizens that he had the power to use taxpayer money to force his fanatic religious beliefs on women under the guise of “helping” them while they are in a pregnancy crisis. However, the media outlets quickly moved on and dropped the news about him using public funds to trick women.

    Women are led to believe that these centers will provide medical care and attention, while their only motive is to scare those women out of getting an abortion. Of course, we all know that once those precious babies are born to these women the evangelicals wipe their hands from providing any help or care to those children and their mothers. Pro-life my a**.

  7. It’s harder to get an abortion in this country than it is to own a gun. Both are legal by the way.

    If Pence becomes POTUS, we are in serious trouble concerning this subject.

    I’m so glad we don’t have women that tweet that their abortion is bigger and better than someone else’s abortion.

    This is our truth and reality now.

    I hope all of the GOP that are silent, burn in hell.

  8. This would seem to me to be Medical Malpractice by the Crisis pregnancy centers (CPCs). It is like going to a medical facility for severe chest pains and having the staff advise you they can cure you with a salt tablet and a glass of water.

    These Crisis pregnancy centers (CPCs) fit into the Republican and bible thumping duplicity. Say or publish anything no matter how false to achieve your ends.

    Side bar: Donald Trump’s former chief strategist Steve Bannon has described the Trump Tower meeting between the president’s son and a group of Russians during the 2016 election campaign as “treasonous” and “unpatriotic”, according to an explosive new book seen by the Guardian.

    Bannon, speaking to author Michael Wolff, warned that the investigation into alleged collusion with the Kremlin will focus on money laundering and predicted: “They’re going to crack Don Junior like an egg on national TV.”

  9. As I have not been in or near a CPC, Query: do these centers clearly promote who they are, their affiliation, and where their funding is sourced? I would postulate that if they state clearly who and what they are (anti-choice, non-medically licensed, non-government funded/privately funded, counseling center), they can exist.

  10. I’m a Registered Nurse with over 45 years of experience (in multiple states) and still working 32 hours in A surgery center. I know of no incorrect information that I am or have been required to give.

  11. one would have to question the stigma given,not asked for by those,involved in those sites,programs. so called religious matrons who beleive that they are saving the world, may be more effective in being someone who helps,the hungry,homeless,and vet with needs,over some self imposed ideology,to serve ones so called religious needs. They have obviously failed to reconize the decision to terminate,a very private one,and not to be decided by those who feel their opinion counts.

  12. Jennie; when I had aortic repair surgery (you would know what that entails) in 2005, the surgeon stressed the fact that it was necessary and how serious it was. What he didn’t tell me or my daughter till I was being wheeled into surgery and he told her I only had a 50/50 chance of survival. I should have had the right to be informed of this prior to signing the surgical release; at age 34 with 5 children and serious “female problems” I could not have surgery till my husband signed the legal document giving me permission to have the surgery. We seem to be heading back in that direction regarding women’s health issues – is anything relating to men’s health care limited or denied by the government?

  13. All this “pro-life” stuff is the extension of the primitive, religious-based control of women and women’s activities that pre-dates Biblical times. Women are STILL subjected to the level of being chattel or property in many parts of the world where “civilization” was allegedly born. Irony.

    Right-wing Christian reactionaries still want to “own” women and keep trying to do so through “legal” controls based on false morality. Mike Pence is so backward-thinking in this area as to be laughable if he weren’t so dangerous to the rights of women.

    Sadly, this debate will never be solved and women’s rights will constantly be attacked for as long as their is the wrong-headed and primitive ideology from extremists. Voting them out of office wherever possible pushes this issue to the curb – at least temporarily – so responsible legislation can be passed to protect women from the horrors of religious prosecution.

  14. Agree with Nancy’s statement: “Of course, we all know that once those precious babies are born to these women the evangelicals wipe their hands from providing any help or care to those children and their mothers. Pro-life my a**.” If you support and encourage (or scare) women to have these babies, then you have an obligation to provide adequate support and home for both the woman and the child afterwards.

  15. “Compelling Honesty”

    Isn’t Trump committing slander and libel numerous times every day of the week?

  16. Liberals advocate for freedom, the other end of the political spectrum, authoritarians, for power. Authoritarians can be classified as generalist (as long as order and structure and authority exists that’s all that counts) and specialists (male or white or undereducated or theologic or those with firepower).

    Free speech to liberals has to consider the nuances Sheila mentions to keep everyone free (freedom at all is freedom for all). For authoritarians it must include speech that imposes what they want on others. No better example than the silo speech of Fox News and Rush Limbaugh et al.

    Which will define America?

  17. Respect life, including the ones that are already here! Lying to someone when it’s decision time for them is egregious! I believe human life begins at conception, and women should have extensive education & resources in birth control. Lumping pre-conception birth control with abortion looks to be blocking progress. That being said, here the law allows for women to choose abortion and if they view it as birth control and haven’t qualms about ending the beginning of human life, what right do others have to make that decision for them? Also using abortion as a wedge issue in politics is the most egregious !

  18. A great piece as usual Sheila!
    This once or to strikes close to home for me and it is appalling to read. For nearly 14 years straight I worked as both a family resource center manager and family resource librarian at Riley Hospital for Children at Indiana University Health, sort of a strange place for someone with an academic background international relations and political science research to end up at but I did and loved every minute of it. My primary function was to ensure that every family that we worked with, and there were hundreds of them perhaps even more than that, that I worked with everyday pulling down the most accurate information possible for them.

    This information included both consumer medical and scholarly medical journal articles and instructional materials regarding the medical conditions they were dealing with, the treatment plans in dealing with those medical conditions, and the support that was available to them both while they were in the hospital and when they were returned home from support organizations throughout the state of Indiana and beyond. Riley was building the fifth family resource center in any children’s hospital in the country when I first got there in 2000 and we built the content based on the recommendations of our medical staff, the staff of other children’s hospitals and what they had developed themselves, and ultimately, our families. When you are doing this type of work for people one of the most important things you can do is ask those that are going to be the recipients of it as to what their needs really are and make sure their included in the mix of things that you’re trying too present to them.

    To do otherwise and deliberately feed erroneous medical and support information is truly malpractice and it is stunning to read that Crisis Pregnancy Centers across the country are doing this based on their organizational staff’s personal ethics and not thinking past that every day. I’m proud of the crew that I worked with in my previous position with the hospital and their dedication to giving the most accurate information and support possible to the patients and families that they worked with. Knowing so many of them as I do I never saw anybody do anything remotely like what these centers are doing and those that operate those centers should be thoroughly ashamed of themselves. Of course they’re not since they have put judging people based on their own perceptions and beliefs ahead of providing that care that their patients expect and deserve to have.

  19. Those who think pro-lifers hold the position they do because they want to “control women” simply do not understand the abortion issue. (It also ignores the huge percent of women who are pro-life.) Some of us believe a fetus is a human life and science certainly seems to support that position. Deciding at what point a woman’s autonomy has to give way to the right of that developing human being to live is the essence of the abortion issue. It’s not a black and white issue as the extremes on both sides of the issue would seem to think it is.

  20. Mr. Ogden; my daughter is alive because she could get an abortion 38 years ago. Due to careless doctors, they didn’t run tests till she was 5 1/2 months pregnant to learn why they had not detected a heartbeat. The fetus had died at 2 months and was a mass of severely infected tissue which had infected her uterus and was in her bloodstream. It also caused difficult pregnancies and births later in her life.

    My 24 year old granddaughter died having seizures at 5 months pregnant because she decided to try to carry her baby to term knowing it further increased the possibility of fatal seizures. This was shortly before Pence’s arbitrary anti-abortion law went into effect; but the young women whose lives are or were in danger due to pregnancy will be or are just as dead as my granddaughter and her baby girl. YOU do not understand that most women do understand the control issue is a major part of the law. YOU also do not understand why the denial of birth control due to someone else’s religious belief is bringing babies into this world that cannot be cared for and the state and the do-gooders do not step up to take responsibility for babies they are responsible for being born.

    A developing human being is just that, a developing human being which is not a viable life form, it is being given life and being carried – and protected – by the living human being carrying it under her heart.

  21. Some pro-lifers just want to protect the developing fetus. But as Sheila’s blog illuminates, pro-life organizations also wish to deny contraceptive information, medications, and contraception itself to women. Many pro-life politicians are the first to repeal Children’s Health Insurance Programs; underfund for education and particularly for special ed.; cut Medicaid for children and adults who haven’t the funds for expensive medical procedures and services; deny protections for pre-existing conditions; cut food stamps and other nutritional assistance for expectant mothers who are poor and their babies; the list goes on and on. And yes the pro-lifers deny funds for women’s reproductive care and contraception. I’ve NEVER understood the pro-life opposition to contraception. The best way to prevent abortions is to prevent unwanted pregnancies.

  22. A fetus is not the limiter for life. Being of sufficient development to live outside the uterus would define that viability. I think 22-28 weeks is the viability window.

    Beliefs don’t matter. What matters is the woman’s right to choose and our duty to keep ourselves informed about contraception to prevent unwanted pregnancies. Any religion dogma or social “norm” that blocks that education is doing far more harm than good.

    And I also agree strongly with those who say that taking care of the newborn to the poor is equally as important as ensuring the women’s rights.

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