rust sullivan argued october decided may section public health service act specifies none federal funds appropriated act title services shall used programs abortion method family planning respondent secretary health human services issued new regulations inter alia prohibit title projects engaging counseling concerning referrals activities advocating abortion method family planning require projects maintain objective integrity independence prohibited abortion activities use separate facilities personnel accounting records regulations applied petitioners title grantees doctors supervise title funds filed suits consolidated challenging regulations facial validity seeking declaratory injunctive relief prevent implementation affirming district grant summary judgment secretary appeals held regulations permissible construction statute consistent first fifth amendments held regulations permissible construction title pp ambiguous speak directly issues abortion counseling referral advocacy program integrity secretary construction must accorded substantial deference interpretation agency charged administering statute may disturbed abuse discretion reflects plausible construction statute plain language otherwise conflict congress expressed intent chevron natural resource defense council title broad language plainly allows abortion counseling referral advocacy regulations since title neither defines method family planning phrase enumerates types medical counseling services entitled funding said secretary construction prohibition require ban activities within title projects impermissible moreover since legislative history ambiguous congress intent issues defer secretary expertise petitioners contention regulations entitled little deference reverse secretary longstanding policy permitting nondirective counseling referral abortion rejected agency must given ample latitude adapt rules changing circumstances revised interpretation may deserve deference secretary change interpretation amply supported reasoned analysis indicating new regulations keeping statute original intent justified client experience prior policy accord shift attitude elimination unborn children abortion pp regulations program integrity requirements inconsistent title plain language secretary view requirements necessary ensure title grantees apply federal funds authorized purposes avoid creating appearance governmental support activities unreasonable light express prohibitory language entitled deference petitioners contention unpersuasive requirements frustrate congress intent clearly expressed act legislative history title programs integral part broader comprehensive health care system envisions efficient use funds statements relied highly generalized directly address scope therefore form basis enjoining regulations indeed legislative history demonstrates congress intended title funds kept separate distinct activities moreover need invalidate regulations order save statute unconstitutionality since petitioners constitutional arguments carry day pp regulations violate first amendment free speech rights private title fund recipients staffs patients impermissibly imposing conditions government subsidies question prohibition constitutional since government may make value judgment favoring childbirth abortion implement judgment allocation public funds maher roe government discriminated basis viewpoint merely chosen fund one activity exclusion another similarly implementing statutory prohibition forbidding counseling referral provision information regarding abortion method family planning regulations simply ensure appropriated funds used activities including speech outside federal program scope arkansas writers project ragland distinguished petitioners view government chooses subsidize one protected right must subsidize analogous counterpart rights soundly rejected see regan taxation representation face regulations read petitioners contend bar abortion referral counseling woman life placed imminent peril pregnancy since seem counseling considered method family planning since provisions regulations contemplate title project engage otherwise prohibited activities circumstances regulations restrictions subsidization speech held unconstitutionally condition receipt benefit title funding relinquishment constitutional right right engage abortion advocacy counseling regulations force title grantee employees give speech merely require activities kept separate distinct activities title project fcc league women voters regan supra distinguished although argued traditional relationship enjoy first amendment protection government regulation even subsidized government kokinda question need resolved since title program regulations significantly impinge relationship pp regulations violate woman fifth amendment right choose whether terminate pregnancy government constitutional duty subsidize activity merely constitutionally protected may validly choose allocate public funds medical services relating childbirth abortion webster reproductive health services allocation places governmental obstacle path woman wishing terminate pregnancy leaves choices government chosen fund family planning services see harris mcrae webster supra regulations place restrictions dialogue violate woman right make informed voluntary choice akron akron center reproductive health thornburgh american college obstetricians gynecologists unlike laws invalidated cases required doctors provide pregnant patients contemplating abortion specific antiabortion information doctor ability provide woman right receive information remains unfettered outside context title project fact title clients may effectively precluded indigency seeing health care provider services affect outcome since financial constraints woman ability enjoy full range constitutionally protected freedom choice product governmental restrictions indigency mcrae supra pp rehnquist delivered opinion white kennedy scalia souter joined blackmun filed dissenting opinion marshall joined part joined parts ii iii stevens joined post stevens post filed dissenting opinions post laurence tribe argued cause petitioners cases briefs petitioners kathleen sullivan rachael pine janet benshoof lynn paltrow kathryn kolbert steven shapiro norman siegel arthur eisenberg roger evans laurie rockett peter rubin robert abrams attorney general new york peter sherwood solicitor general suzanne lynn sanford cohen assistant attorneys general victor kovner leonard koerner lorna bade goodman gail rubin hillary weisman filed briefs petitioners solicitor general starr argued cause filed brief respondent cases brief assistant attorney general gerson deputy solicitor general roberts jeffrey minear anthony steinmeyer lowell sturgill joel fn briefs amici curiae urging reversal filed commonwealth massachusetts et al david cole james shannon attorney general massachusetts ruth bourquin assistant attorney general anthony celebrezze attorney general ohio et al celebrezze pro se suzanne mohr jack decker assistant attorneys general rita eppler douglas baily attorney general alaska john van de kamp attorney general california clarine nardi riddle attorney general connecticut charles oberly iii attorney general delaware herbert reid corporation counsel district columbia james tierney attorney general maine hubert humphrey iii attorney general minnesota robert spire attorney general nebraska robert del tufo attorney general new jersey dave frohnmayer attorney general oregon jim mattox attorney general texas jeffrey amestoy attorney general vermont mary sue terry attorney general virginia american college obstetricians gynecologists et al carter phillips ann allen kirk johnson laurie rockett joel klein jack bierig american library association et al bruce ennis david ogden american public health association et al larry lavinsky charles sims michele ovesey nadine taub association bar city new york conrad harper janice goodman diane wilner naacp legal defense educational fund et al julius levonne chambers charles stephen ralston national association women lawyers et al james fitzpatrick hope walter dellinger planned parenthood federation america et al dara klassel eve paul barbara otten biomedical ethicists michael fine douglas smith representative patricia schroeder et al david becker briefs amici curiae urging affirmance filed american academy medical ethics carolyn kuhl association american physicians surgeons clarke forsythe kent masterson brown feminists life america et al edward grant knights columbus carl anderson rutherford institute et al wm charles bundren john whitehead eric johnston david morris stephen hurst joseph secola thomas neuberger brian heller thomas strahan william bonner larry crain james knicely catholic conference mark chopko phillip harris senator gordon humphrey et al james bopp richard coleson briefs amici curiae filed american life league et al robert sassone catholics life et al thomas patrick monaghan jay alan sekulow walter weber thomas glessner charles rice michael laird legal defense education fund et al john hall sarah burns alison wetherfield national right life committee et al james bopp richard coleson chief justice rehnquist delivered opinion cases concern facial challenge department health human services hhs regulations limit ability title fund recipients engage activities appeals second circuit upheld regulations finding permissible construction statute well consistent first fifth amendments constitution granted certiorari resolve split among courts appeals affirm congress enacted title public health service act act stat amended provides federal funding family planning services act authorizes secretary make grants enter contracts public nonprofit private entities assist establishment operation voluntary family planning projects shall offer broad range acceptable effective family planning methods services grants contracts title must made accordance regulations secretary may promulgate section act however provides one funds appropriated subchapter shall used programs abortion method family planning restriction intended ensure title funds used support preventive family planning services population research infertility services related medical informational educational activities conf secretary promulgated new regulations designed provide clear operational guidance grantees preserve distinction title programs abortion method family planning fed reg regulations clarify definition term family planning congress intended title funds used support preventive family planning services conf emphasis added accordingly title services limited preconceptual counseling education general reproductive health care expressly exclude pregnancy care including obstetric prenatal care cfr regulations focus emphasis title program traditional mission provision preventive family planning services specifically designed enable individuals determine number spacing children clarifying pregnant women must referred appropriate prenatal care services fed reg regulations attach three principal conditions grant federal funds title projects first regulations specify title project may provide counseling concerning use abortion method family planning provide referral abortion method family planning cfr title limited preconceptional services program furnish services related childbirth context referral title program pregnant woman given transitional information title projects must refer every pregnant client appropriate prenatal social services furnishing list available providers promote welfare mother unborn child ibid list may used indirectly encourage promote abortion weighing list referrals favor health care providers perform abortions including list referral providers health care providers whose principal business provision abortions excluding available providers provide abortions steering clients providers offer abortion method family planning title project expressly prohibited referring pregnant woman abortion provider even upon specific request one permissible response inquiry project consider abortion appropriate method family planning therefore counsel refer abortion second regulations broadly prohibit title project engaging activities encourage promote advocate abortion method family planning forbidden activities include lobbying legislation increase availability abortion method family planning developing disseminating materials advocating abortion method family planning providing speakers promote abortion method family planning using legal action make abortion available way method family planning paying dues group advocates abortion method family planning substantial part activities ibid third regulations require title projects organized physically financially separate prohibited abortion activities deemed physically financially separate title project must objective integrity independence prohibited activities mere bookkeeping separation title funds monies sufficient ibid regulations provide list nonexclusive factors secretary consider conducting determination objective integrity independence existence separate accounting records separate personnel degree physical separation project facilities prohibited activities ibid petitioners title grantees doctors supervise title funds suing behalf patients respondent secretary department health human services regulations promulgated applied petitioners filed two separate actions later consolidated challenging facial validity regulations seeking declaratory injunctive relief prevent implementation regulations petitioners challenged regulations grounds authorized title violate first fifth amendment rights title clients first amendment rights title health providers initially granting petitioners preliminary injunction district rejected petitioners statutory constitutional challenges regulations granted summary judgment favor secretary new york bowen sdny panel appeals second circuit affirmed applying decision chevron natural resources defense council appeals determined regulations permissible construction statute legitimately effectuated congressional intent rejected highly strained petitioners contention plain language forbids title projects performing abortions reasoned wholly anomalous read section mean program merely counsels perform abortions include abortion method family planning natural construction term method family planning includes counseling concerning abortion ibid found construction consistent legislative history observed ppellants contrary view legislative history based entirely highly generalized statements expansive scope family planning services specifically mention counseling concerning abortion intended service title projects surely read trump section statute specifically excludes turning petitioners constitutional challenges regulations appeals rejected petitioners fifth amendment challenge held regulations impermissibly burden woman right abortion government may validly choose favor childbirth abortion implement choice funding medical services relating childbirth relating abortion finding prohibition performance abortions upheld webster reproductive health services substantially greater impact regulations challenged instant matter concluded regulations create affirmative legal barriers access abortion citing webster reproductive health services likewise found secretary implementation congress decision fund abortion counseling referral advocacy also applicable precedent constitute facial violation first amendment rights health care providers women explained regan taxation representation government obligation subsidize even exercise fundamental rights including speech rights also held regulations violate first amendment condition ing receipt benefit relinquishment constitutional rights title grantees employees remain free say whatever wish abortion outside title project finally rejected petitioners contention regulations facially discriminate basis viewpoint speech involved ii begin pointing posture cases us petitioners challenging facial validity regulations thus concerned question whether face regulations authorized act construed manner applied set individuals without infringing upon constitutionally protected rights petitioners face heavy burden seeking regulations invalidated facially facial challenge legislative act course difficult challenge mount successfully since challenger must establish set circumstances exists act valid fact regulations might operate unconstitutionally conceivable set circumstances insufficient render wholly invalid salerno turn first petitioners contention regulations exceed secretary authority title arbitrary capricious begin examination regulations concerning abortion counseling referral advocacy every appeals found authorized statute turn program integrity requirement respect courts adopted conflicting positions address petitioner claim regulations must struck raise substantial constitutional question need dwell plain language statute agree every addressed issue language ambiguous language one funds appropriated subchapter shall used programs abortion method family planning speak directly issues counseling referral advocacy program integrity statute silent ambiguous respect specific issue question whether agency answer based permissible construction statute chevron secretary construction title may disturbed abuse discretion reflects plausible construction plain language statute otherwise conflict congress expressed intent ibid determining whether construction permissible need conclude agency construction one permissibly adopted even reading reached question initially arisen judicial proceeding rather substantial deference accorded interpretation authorizing statute agency authorized administering broad language title plainly allows secretary construction statute terms prohibits use title funds programs abortion method family planning title define term method family planning enumerate types medical counseling services entitled title funding based broad directives provided congress title general particular unable say secretary construction prohibition require ban counseling referral advocacy within title project impermissible district courts courts appeals examined legislative history found least regard act counseling referral advocacy provisions legislative history ambiguous respect congress intent enacting title prohibition massachusetts sullivan congress addressed specifically question scope abortion prohibition language statute legislative history support either litigants positions planned parenthood federation america sullivan contemporaneous legislative history address whether clinics receiving title funds engage nondirective counseling including abortion option referrals case nothing legislative history title detracts secretary construction join courts holding legislative history ambiguous fails shed light relevant congressional intent time congress directly address issues abortion counseling referral advocacy parties attempts characterize highly generalized conflicting statements legislative history accurate revelations congressional intent unavailing find legislative history ambiguous unenlightening matters respect regulations deal customarily defer expertise agency petitioners argue however regulations entitled little deference reverse longstanding agency policy permitted nondirective counseling referral abortion brief petitioners thus represent sharp beak secretary prior construction statute petitioners argue agency prior consistent interpretation section permit nondirective counseling encourage coordination local state family planning services entitled substantial weight rejected argument agency interpretation entitled deference represents sharp break prior interpretations statute question chevron chevron held revised interpretation deserves deference initial agency interpretation instantly carved stone agency engage informed rulemaking must consider varying interpretations wisdom policy continuing basis agency required establish rules conduct last forever motor vehicle mfrs assn state farm mut automobile ins quoting american trucking atchison nlrb curtin matheson scientific rather must given ample latitude adapt rules policies demands changing circumstances motor vehicle supra quoting permian basin area rate cases find secretary amply justified change interpretation reasoned analysis motor vehicle supra secretary explained regulations result determination wake critical reports general accounting office gao office inspector general oig prior policy failed implement properly statute necessary provide clear operational guidance grantees preserve distinction title programs abortion method family planning fed reg also determined new regulations keeping original intent statute justified client experience prior policy supported shift attitude elimination unborn children abortion believe justifications sufficient support secretary revised approach concluded plain language legislative history ambiguous congress intent enacting title must defer secretary permissible construction statute turn next program integrity requirements embodied regulations mandating separate facilities personnel records requirements inconsistent plain language title petitioners contend however based impermissible construction statute frustrate clearly expressed intent congress title programs integral part broader comprehensive health care system argue integration impermissibly burdened efficient use funds title grantees adversely affected regulations secretary defends separation requirements grounds necessary assure title grantees apply federal funds federally authorized purposes grantees avoid creating appearance government supporting activities program integrity regulations promulgated direct response observations gao oig reports ecause distinction recipient title activities may easily recognized public get impression federal funds improperly used abortion activities app secretary concluded eeting requirement section mandates title programs organized physically financially separate activities prohibited inclusion title program program separate activities necessary predicate determination abortion included method family planning title program agree program integrity requirements based permissible construction statute inconsistent congressional intent noted legislative history clear little program integrity exception statements relied upon petitioners infer intent highly generalized directly address scope example cornerstone conclusion title congress intended comprehensive integrated system family planning services statement statute requiring state health authorities applying title funds submit state plan coordinated comprehensive program family planning services statement face ambiguous congress intent enacting title prohibition placed context statement merely requires state health authority submit plan coordinated comprehensive program family planning services order eligible title funds terms language evinces congress intent place duty state entities seeking federal funds speak either overall view family planning services secretary responsibility implementing statute likewise statement original house report title act intended interfere limit programs conducted accordance state local laws supported funds equally unclear conf pp language directly follows statement intent houses funds authorized legislation used support preventive family planning services conferees adopted language contained section prohibits use funds abortion order make intent clear placed context read light express prohibition statements fall short evidencing congressional intent render secretary interpretation statute impermissible petitioners interpretation legislative history may permissible one means one certainly one found secretary well established legislative history demonstrate clear certain congressional intent form basis enjoining regulations see motor vehicle secretary based need separation requirements squarely congressional intent abortion part title funded program fed reg indeed one thing clear legislative history congress intended title funds kept separate distinct activities undisputed title intended provide primarily prepregnancy preventive services certainly secretary interpretation statute separate facilities necessary especially light express prohibition judged unreasonable accordingly defer secretary reasoned determination program integrity requirements necessary implement prohibition petitioners also contend regulations must invalidated raise serious questions constitutional law rely edward debartolo florida gulf coast building construction trades council nlrb catholic bishop chicago hold act congress construed violate constitution possible construction remains available canon statutory construction elementary rule every reasonable construction must resorted order save statute unconstitutionality debartolo supra emphasis added quoting hooper california principle enunciated hooper california supra subsequent cases categorical one two possible interpretations statute one unconstitutional valid plain duty adopt save act blodgett holden opinion holmes principle based least part fact decision declare act congress unconstitutional gravest delicate duty called perform following hooper supra cases delaware hudson jin fuey moy developed corollary doctrine statute must construed fairly possible avoid conclusion unconstitutional also grave doubts upon score canon followed respect congress assume legislates light constitutional limitations ftc american tobacco qualified proposition avoidance difficulty pressed point disingenuous evasion moore ice cream rose congress forbade use appropriated funds programs abortion method family planning authorized secretary promulgate regulations implementing provision extensive litigation regarding governmental restrictions abortion since decision roe wade suggests likely set regulations promulgated secretary ones force prior found relatively toothless ineffectual challenged constitutional grounds think constitutional arguments made petitioners case without force part iii infra hold carry day applying canon construction discussion best hold regulations promulgated secretary raise sort grave doubtful constitutional questions delaware hudson supra lead us assume congress intend authorize issuance therefore need invalidate regulations order save statute unconstitutionality iii petitioners contend regulations violate first amendment impermissibly discriminating based viewpoint prohibit discussion abortion lawful option including counseling referral provision neutral accurate information ending pregnancy compelling clinic counselor provide information promotes continuing pregnancy term brief petitioners assert regulations violate free speech rights private health care organizations receive title funds staff patients impermissibly imposing conditions government subsidies thus penaliz speech funded monies title continues fund speech ancillary pregnancy testing manner evenhanded respect views information abortion invidiously discriminates basis viewpoint relying regan taxation representation arkansas writers project ragland petitioners also assert government may place certain conditions receipt federal subsidies may discriminate invidiously subsidies way ai suppression dangerous ideas regan supra quoting cammarano question statutory prohibition contained constitutional maher roe upheld state welfare regulation medicaid recipients received payments services related childbirth nontherapeutic abortions rejected claim unequal subsidization worked violation constitution held government may make value judgment favoring childbirth abortion implement judgment allocation public funds government exercising authority possesses maher harris mcrae subsidize family planning services lead conception childbirth declining promote encourage abortion government without violating constitution selectively fund program encourage certain activities believes public interest without time funding alternate program seeks deal problem another way government discriminated basis viewpoint merely chosen fund one activity exclusion legislature decision subsidize exercise fundamental right infringe right regan supra see also buckley valeo cammarano supra refusal fund protected activity without equated imposition penalty activity mcrae basic difference direct state interference protected activity state encouragement alternative activity consonant legislative policy maher supra challenged regulations implement statutory prohibition prohibiting counseling referral provision information regarding abortion method family planning designed ensure limits federal program observed title program designed prenatal care encourage family planning doctor wished offer prenatal care project patient became pregnant properly prohibited service outside scope federally funded program regulations prohibiting abortion counseling referral ilk funds appropriated project may used programs abortion method family planning doctor employed project may prohibited course project duties counseling abortion referring abortion case government suppressing dangerous idea prohibition project grantee employees engaging activities outside scope hold government unconstitutionally discriminates basis viewpoint chooses fund program dedicated advance certain permissible goals program advancing goals necessarily discourages alternate goals render numerous government programs constitutionally suspect congress established national endowment democracy encourage countries adopt democratic principles constitutionally required fund program encourage competing lines political philosophy communism fascism petitioners assertions ultimately boil position government chooses subsidize one protected right must subsidize analogous counterpart rights soundly rejected proposition regan taxation representation supra maher roe supra harris mcrae supra within far broader limits petitioners willing concede government appropriates public funds establish program entitled define limits program believe petitioners reliance upon decision arkansas writers project supra misplaced case involved state sales tax discriminated magazines basis content relying fact fact tax targets small group within press contrary decision minneapolis star tribune minnesota revenue held tax invalid case general law singling disfavored group basis speech content case government refusing fund activities including speech specifically excluded scope project funded petitioners rely heavily claim regulations circumstance medical emergency permit title project refer woman whose pregnancy places life imminent peril provider abortions services case course involves facial challenge regulations us application secretary specific fact situation face read regulations bar abortion referral counseling circumstances abortion counseling method family planning prohibited seem medically necessitated abortion circumstances equivalent use method family planning neither specific restrictions regulations apply moreover regulations contemplate title project permitted engage otherwise prohibited activity circumstances section provides specific exemption emergency care requires title recipients refer client immediately appropriate provider emergency medical services cfr section also requires title projects provide necessary referral medical facilities medically indicated petitioners also contend restrictions subsidization speech contained regulations impermissible condition receipt benefit case title funding relinquishment constitutional right right engage abortion advocacy counseling relying perry sindermann fcc league women voters petitioners argue even though government may deny benefit number reasons reasons upon government may rely may deny benefit person basis infringes constitutionally protected interests especially interest freedom speech perry supra petitioners reliance cases unavailing however government denying benefit anyone instead simply insisting public funds spent purposes authorized secretary regulations force title grantee give speech merely require grantee keep activities separate distinct title activities title expressly distinguishes title grantee title project grantee normally organization may receive funds variety sources variety purposes brief petitioners pp grantee receives title funds however specific limited purpose establishing operating title project regulations govern scope title project activities leave grantee unfettered activities title grantee continue perform abortions provide services engage abortion advocacy simply required conduct activities programs separate independent project receives title funds cfr contrast unconstitutional conditions cases involve situations government placed condition recipient subsidy rather particular program service thus effectively prohibiting recipient engaging protected conduct outside scope federally funded program fcc league women voters invalidated federal law providing noncommercial television radio stations receive federal grants may engage editorializing law recipient federal funds barred absolutely editorializing able segregate activities according source funding thus way limiting use federal funds noneditorializing activities effect law noncommercial educational station receives overall income federal grants barred absolutely editorializing barred using even wholly private funds finance editorial activity expressly recognized however congress permit recipient stations establish affiliate organizations use station facilities editorialize nonfederal funds statutory mechanism plainly valid ibid scheme permit station make known views matters public importance nonfederally funded editorializing affiliate without losing federal grants noneditorializing broadcast activities ibid similarly regan held congress exercise spending power reasonably refuse subsidize lobbying activities charitable organizations prohibiting organizations using contributions support lobbying efforts holding explained organizations remained free receive deductible contributions support nonlobbying activit ies thus charitable organization create internal revenue code affiliate conduct nonlobbying activities using contributions time establish separate affiliate pursue lobbying efforts without contributions given alternative concluded congress infringed first amendment rights regulated first amendment activity simply chosen pay appellee lobbying also noted appellee course ensure th organization subsidize organization otherwise public funds might spent activity congress chose subsidize condition federal funds used purposes grant violate constitutional rights congress example grant funds organization dedicated combating teenage drug abuse condition grant providing none money received congress used lobby state legislatures see requiring title grantee engage activity separately activity receiving federal funding congress consistent teachings league women voters regan denied right engage activities congress merely refused fund activities public fisc secretary simply required certain degree separation title project order ensure integrity federally funded program principles apply petitioners claim regulations abridge free speech rights grantee staff individuals voluntarily employed title project must perform duties accordance regulation restrictions abortion counseling referral employees remain free however pursue activities acting auspices title project regulations govern solely scope title project activities way restrict activities persons acting private individuals employees freedom expression limited time actually work project limitation consequence decision accept employment project scope permissibly restricted funding authority suggest funding government even coupled freedom fund recipients speak outside scope project invariably sufficient justify government control content expression example recognized existence government subsidy form property justify restriction speech areas traditionally open public expressive activity kokinda hague cio opinion roberts expressly dedicated speech activity kokinda supra perry education assn perry local educators similarly recognized university traditional sphere free expression fundamental functioning society government ability control speech within sphere means conditions attached expenditure government funds restricted vagueness overbreadth doctrines first amendment keyishian board regents argued analogy traditional relationships doctor patient enjoy protection first amendment government regulation even subsidized government need resolve question however title program regulations significantly impinge upon doctorpatient relationship nothing requires doctor represent opinion fact hold relationship established title program sufficiently justify expectation part patient comprehensive medical advice program provide medical care therefore doctor silence regard abortion reasonably thought mislead client thinking doctor consider abortion appropriate option doctor always free make clear advice regarding abortion simply beyond scope program circumstances general rule government may choose subsidize speech applies full force iv turn petitioners argument regulations violate woman fifth amendment right choose whether terminate pregnancy recently reaffirmed principle due process clauses generally confer affirmative right governmental aid even aid may necessary secure life liberty property interests government may deprive individual webster quoting deshaney winnebago county dept social services government constitutional duty subsidize activity merely activity constitutionally protected may validly choose fund childbirth abortion implement judgment allocation public funds medical services relating childbirth relating abortion webster supra citation omitted government affirmative duty commit resources facilitating abortions webster decision fund childbirth abortion places governmental obstacle path woman chooses terminate pregnancy rather means unequal subsidization abortion medical services encourages alternative activity deemed public interest mcrae regulations impermissibly burden woman fifth amendment rights evident line cases beginning maher mcrae culminating recent decision webster congress refusal fund abortions mcrae left indigent woman least range choice deciding whether obtain medically necessary abortion congress chosen subsidize health care costs missouri refusal allow public employees perform abortions public hospitals leaves pregnant woman choices state chosen operate public hospitals webster supra congress refusal fund abortion counseling advocacy leaves pregnant woman choices government chosen fund family planning services difficulty woman encounters title project provide abortion counseling referral leaves different position government enacted title webster stated aving held state refusal maher fund abortions violate roe wade strains logic reach contrary result use public facilities employees similarly strain logic light extreme restrictions cases find mere decision exclude services federally funded family planning program unconstitutional petitioners also argue impermissibly infringing relationship depriving title client information concerning abortion method family planning regulations violate woman fifth amendment right medical make informed medical decisions free harm argue decisions akron akron center reproductive health thornburg american college obstetricians gynecologists government interfere woman right make informed voluntary choice placing restrictions dialogue akron invalidated city ordinance requiring physicians make specified statements patient prior performing abortion order ensure woman consent truly informed similarly thornburg struck state statute mandating list agencies offering alternatives abortion description fetal development provided every woman considering terminating pregnancy abortion critical decisions akron thornburg invalidate governmental intrusion dialogue fact laws cases required doctors within respective jurisdictions provide pregnant patients contemplating abortion litany information regardless whether patient sought information whether doctor thought information necessary patient decision secretary regulations however doctor ability provide woman right receive information concerning abortion services outside context title project remains unfettered undoubtedly easier woman seeking abortion receive information abortion title project constitution require government distort scope mandated program order provide information petitioners contend however title clients effectively precluded indigency poverty seeing provider provide services even title clients worse position congress never enacted title financial constraints restrict indigent woman ability enjoy full range constitutionally protected freedom choice product governmental restrictions access abortion rather indigency mcrae supra secretary regulations permissible construction title violate either first fifth amendments constitution accordingly judgment appeals affirmed footnotes clients title clinics pregnant generally receive physical examinations education contraceptive methods services related birth control general accounting office report app instance secretary relies following passage house report evidence regulations consistent legislative intent intent houses funds authorized legislation used support preventive family planning services population research infertility services related medical informational educational activities conferees adopted language contained section prohibits use funds abortion order make intent clear conf committee view family planning merely euphemism birth control properly part comprehensive health care consist much dispensation contraceptive devices successful family planning program must contain edical services including consultation examination prescription continuing supervision supplies instruction referral medical services needed also find face regulations narrowly tailored fit congress intent title federal funds used promote advocate abortion method family planning regulations designed ensure compliance prohibition none funds appropriated title used program abortion method family planning recognized congress power allocate funds public purposes includes ancillary power ensure funds properly applied prescribed use see south dakota dole upholding tenth amendment challenge requirement raise drinking age condition receipt federal highway funds buckley valeo petitioners also contend regulations violate first amendment penalizing speech funded moneys argue since title requires grant recipients contribute financing title projects use matching funds income regulation restrictions abortion counseling advocacy penalize privately funded speech find argument flawed several reasons first title subsidies subsidies recipient way compelled operate title project avoid force regulations simply decline subsidy see grove city college bell petitioner first amendment rights violated may terminate participation federal program thus avoid requirements federal program accepting title funds recipient voluntarily consents restrictions placed matching funds income potential grant recipients choose accepting title funds subject government conditions provide matching funds forgo abortion counseling referral title project declining subsidy financing unsubsidized program never held government violates first amendment simply offering choice second secretary regulations apply title programs recipient therefore able limi use federal funds title activities fcc league women voters way barred using even wholly private funds finance activities outside title program ibid regulations limited title funds recipient remains free use private funds finance activities justice blackmun justice marshall joins justice stevens joins parts ii iii justice joins part dissenting casting aside established principles statutory construction administrative jurisprudence majority cases today unnecessarily passes upon important questions constitutional law first time upholds suppression speech solely imposed dependent upon government economic support essentially rationale majority upholds direct regulation dialogue pregnant woman physician regulation purpose effect manipulating decision continuance pregnancy conclude secretary regulation referral advocacy counseling activities exceeds statutory authority also regulations violate first fifth amendments constitution accordingly dissent reverse judgment appeals majority dispute ederal statutes construed avoid serious doubt constitutionality machinists street see also hooper california crowell benson security industrial bank majority deny principle fully applicable cases instant one plausible constitutionally suspect statutory interpretation embodied administrative regulation see edward debartolo florida gulf coast building construction trades council nlrb catholic bishop chicago kent dulles rather zeal address constitutional issues majority sidesteps established canon construction feeble excuse challenged regulations raise sort grave doubtful constitutional questions lead us assume congress intend authorize issuance ante quoting ex rel attorney general delaware hudson facile response intractable problem addresses today disingenuous best whether one believes regulations valid avoids reality contend give rise serious constitutional questions canon applicable case likely regulations challenged constitutional grounds ante question squarely presented regulations extent government may attach otherwise unconstitutional condition receipt public benefit implicates troubled area jurisprudence entangle unnecessarily see epstein unconstitutional conditions state power limits consent harv rev describing problem basic structural issue hundred years bedeviled courts commentators alike sullivan unconstitutional conditions harv rev observing unconstitutional conditions cases seem minefield traversed gingerly discussed parts ii iii infra regulations impose restrictions upon protected speech aimed woman decision whether continue terminate pregnancy respects implicate core constitutional values verity evidenced fact two three courts appeals entertained challenges regulations invalidated constitutional grounds see massachusetts secretary health human services planned parenthood federation america sullivan divided panel tenth circuit found regulations fal squarely within prohibition thornburgh american college obstetricians gynecologists city akron akron center reproductive health intrusion advice woman requests given doctor first circuit en banc one judge dissenting found regulations violate privacy rights title patients first amendment rights title grantees see also kearse dissenting part bare majority today reaches different result change fact constitutional questions raised regulations grave doubtful case statutory language requires us address constitutional question section public health service act stat provides simply none funds appropriated title shall used programs abortion method family planning majority concedes language speak directly issues counseling referral advocacy program integrity ante legislative history ambiguous respect ante consequently language easily sustains constitutionally interpretation thus situation intention congress revealed distinctly permit us ignore mere misgivings power george moore ice cream rose indeed appear duty avoid passing unnecessarily upon important constitutional questions strongest language statute decidedly ambiguous logical eminently prudent assume congress intends press limits constitutionality enactments express intent explicit unambiguous terms see sunstein law administration chevron colum rev thus implausible chevron agency interpretations ambiguous statutes prevail even consequence interpretations produce invalidity raise serious constitutional doubts conclude plainly constitutional construction fairly possible entirely reasonable machinists reverse judgment appeals ground without deciding constitutionality secretary regulations ii also strongly disagree majority disposition petitioners constitutional claims feel response thereto indicated move issue today never upheld suppression speech simply suppression condition upon acceptance public funds whatever may government power condition receipt largess upon relinquishment constitutional rights surely extend condition suppresses recipient cherished freedom speech based solely upon content viewpoint speech speiser randall deny exemption claimants engage certain forms speech effect penalize speech denial frankly aimed suppression dangerous ideas quoting american communications assn douds see cammarano see also league women voters rehnquist dissenting cf arkansas writers project ragland scalia dissenting rule sound one often noted regulation speech motivated nothing desire curtail expression particular point view controversial issues general interest purest example law abridging freedom speech press league women voters quoting consolidated edison public service stevens concurring judgment bove else first amendment means government power restrict expression message ideas subject matter content police department chicago mosley nothing opinion regan taxation representation washington said challenge understanding regan upheld provision internal revenue code disallowed particular status organizations attempt ed influence legislation affording status veterans organizations irrespective lobbying activities finding case controlled cammarano supra explained case different congress discriminate invidiously subsidies way ai suppression dangerous ideas find indication statute intended suppress ideas demonstration effect quoting cammarano turn quoting speiser separate concurrence regan joined opinion precisely ecause discrimination veterans organizations charitable organizations based content speech seriously disputed counseling referral provisions issue present cases constitute regulation speech title grantees may provide counseling referral regarding wide range family planning topics save abortion cf consolidated edison first amendment hostility regulation extends restrictions particular viewpoints also prohibition public discussion entire topic boos barry opinion regulations also clearly suppressing speech favorable abortion one hand secretary compels speech example department health human services description regulations makes plain title projects required facilitate access prenatal care social services including adoption services might needed pregnant client promote wellbeing child making abundantly clear project permitted promote abortion facilitating access abortion referral process fed reg emphasis added moreover regulations command project refer prenatal care woman diagnosed pregnant irrespective woman expressed desire continue terminate pregnancy cfr client asks directly abortion title physician counselor required say essence project consider abortion appropriate method family planning requirements antithetical first amendment see wooley maynard regulations pertaining advocacy even explicitly provide title project may encourage promote advocate abortion method family planning emphasis added explain requirement prohibits actions assist women obtain abortions increase availability accessibility abortion family planning purposes emphasis added regulations however proscribe even regulate antiabortion advocacy clearly restrictions aimed suppression dangerous ideas remarkably majority concludes government discriminated basis viewpoint merely chosen fund one activity exclusion another ante majority claim regulations merely limit title project speech preventive preconceptional services rings hollow light broad range services regulations authorize title projects provide refusing fund family planning projects advocate abortion advocate abortion government plainly targeted particular viewpoint cf ward rock racism majority reliance fact regulations pertain solely funding decisions simply begs question clearly bases upon government may rest decision fund fund example members majority surely agree government may base decision support activity upon considerations race see yick wo hopkins demonstrated cases make clear ideological viewpoint similarly repugnant ground upon base funding decisions majority reliance upon regan connection also misplaced case stands proposition government obligation subsidize private party efforts petition legislature regarding views thus challenged regulations confined nonideological limitations upon use title funds lobbying activities exist violation first amendment advocacy regulations issue however limited lobbying extend speech effect encouraging promoting advocating abortion method family planning cfr thus addition impermissible focus upon viewpoint regulated speech provisions intrude upon wide range communicative conduct including words spoken woman physician manipulating content dialogue regulations upheld today force petitioners instrument fostering public adherence ideological point view finds unacceptable wooley maynard type intrusive ideologically based regulation speech goes far beyond narrow lobbying limitations approved regan justified simply condition upon receipt governmental benefit concludes challenged regulations violate first amendment rights title staff members limitation employees freedom expression simply consequence decision accept employment federally funded project ante never sufficient justify otherwise unconstitutional condition upon public employment employee may escape condition relinquishing job beyond question government may require individual relinquish rights guaranteed first amendment condition public employment abood detroit bd citing elrod burns cases cited therein perry sindermann keyishian board regents state univ nearly two decades ago said least made clear even though person right valuable governmental benefit even though government may deny benefit number reasons reasons upon government may rely may deny benefit person basis infringes constitutionally protected interests especially interest freedom speech government deny benefit person constitutionally protected speech associations exercise freedoms effect penalized inhibited allow government produce result command directly perry sindermann quoting speiser randall abood answer petitioners claim compelled speech condition upon public employment speech outside workplace remained unregulated state public employee first amendment claim rankin mcpherson derogated communication employer sought punish occurred business hours least conditions require courts balance speaker interest message government preventing dissemination pickering board education cases bar speaker interest communication clear vital addressing family planning needs clients physicians counselors staff title projects seek provide full range information options regarding health reproductive freedom indeed legitimate expectations patient ethical responsibilities medical profession demand less patient right effectively exercised patient possesses enough information enable intelligent choice physician ethical obligation help patient make choices among therapeutic alternatives consistent good medical practice current opinions council ethical judicial affairs american medical association see also president commission study ethical problems medicine biomedical behavioral research making health care decisions american college obstetricians gynecologists standards services ed client becomes pregnant full range therapeutic alternatives includes abortion option title counselors interest providing information compelling government articulated interest distorting dialogue ensuring federal funds spent purpose outside scope program falls far short necessary justify suppression truthful information professional medical opinion regarding constitutionally protected conduct moreover offending regulation narrowly tailored serve interest example governmental interest stake served imposing rigorous bookkeeping standards ensure financial separation adopting rules balanced dissemination family planning health information see massachusetts secretary health human services cert pending failing balance even consider free speech interests claimed title physicians government asserted interest suppressing speech falters duty implement protection first amendment clearly provides important message finally small significance speech secretary suppress truthful information regarding constitutionally protected conduct vital importance listener one imagine legitimate governmental interest might served suppressing information concededly abortion debate among divisive contentious issues nation faced recent years freedom differ limited things matter much mere shadow freedom test substance right differ things touch heart existing order west virginia bd ed barnette iii far disturbing aspect today ruling effect fifth amendment rights women supposedly beneficiaries title programs majority rejects petitioners fifth amendment claims summarily relies primarily upon decisions harris mcrae webster reproductive health services dissents cases continue believe wrongly unfortunately decided may even one accepts valid theorizing cases majority reasoning present cases flawed today allowed stand restrictions upon reproductive freedom limiting availability abortion left intact woman ability decide without coercion whether continue pregnancy term maher roe mcrae webster effect today decision abandons principle disastrous results contrary majority characterization case individuals seek government aid exercising fundamental rights fifth amendment right asserted petitioners right pregnant woman free affirmative governmental interference decision roe wade progeny much medical procedure woman fundamental right cases serve vindicate idea liberty means anything must entail freedom governmental domination making intimate personal decisions see akron akron center reproductive health governmental interest ensuring pregnant women receive medically relevant information justify abortion regulations designed influence woman informed choice abortion childbirth maher roe noting abortion cases recognize constitutionally protected interest making certain kinds important decisions free governmental compulsion quoting whalen roe see also harris mcrae thornburgh roe wade stewart concurring suppressing medically pertinent information injecting restrictive ideological message unrelated considerations maternal health government places formidable obstacles path title clients freedom choice thereby violates fifth amendment rights crystal clear aim challenged provisions aim majority escape noticing simply ensure federal funds used perform abortions reduce incidence abortion cfr definition family planning recounted regulations require title physicians counselors provide information pertaining childbirth refer pregnant woman prenatal care irrespective medical situation upon direct inquiry respond abortion appropriate method family planning undeniable message conveyed forced speech one title client draw abortion nearly always improper medical option although physician words fact strictly controlled government wholly unrelated particular medical situation title client reasonably construe professional advice forgo right obtain abortion rational patients many women follow perceived advice carry pregnancy term despite needs contrary despite safety abortion procedure vast majority others delayed regulations mandatory prenatal referral prevented acquiring abortions period process medically sound constitutionally protected view inevitable effect regulations majority conclusion difficulty woman encounters title project provide abortion counseling referral leaves different position government enacted title ante insensitive contrary common human experience purpose result challenged regulations deny women ability voluntarily decide procreative destiny women government obliterated freedom choose surely banned abortions outright denial freedom consequence poverty government distortion information chosen provide substantial obstacles bodily regulations impose doubly offensive effected manipulating words spoken physicians counselors patients society dialogue embodies unique relationship trust specialized nature medical science emotional distress often attendant decisions requires patients place complete confidence often lives hands medical professionals one seeks physician aid medication diagnosis also guidance professional judgment vital emotional support accordingly us attaches profound importance authority words advice spoken physician reason guarded jealously dialogue governmental intrusion roe subsequent cases stressed repeatedly central role physician consulting woman whether abortion determining abortion carried akron quoting colautti franklin see also thornburgh majority approval secretary regulations flies face repeated warnings regulations tending confine attending physician undesired uncomfortable straitjacket practice profession endure planned parenthood central mo danforth majority attempts distinguish holdings akron thornburgh post hoc basis governmental intrusions dialogue invalidated cases applied physicians within jurisdiction regulations pertain narrow class healthcare professionals employed title projects ante rights protected constitution personal rights loving virginia shelley kraemer individual woman deprivation liberty government less substantial affects rather many otherwise unconstitutional infringement choice made lawful touches nation pregnant women manipulation dialogue achieved secretary regulations clearly effort deter woman making decision physician make thornburgh violates fifth amendment iv haste restrict right every woman control reproductive freedom bodily integrity majority disregards established principles law contorts decided cases arrive preordained result majority professes leave undisturbed free speech protections upon society come rely one must wonder force first amendment retains read countenance deliberate manipulation government dialogue woman physician technically leaving intact fundamental right protected roe wade relentlessly formalistic catechism mcrae marshall dissenting rendered right substance nugatory see webster reproductive health services opinions concurring part dissenting part course nearly noxious overruling roe directly right found unenforceable even flagrant attempts government circumvent ceases right fear may effect today decision majority question statutory prohibition contained constitutional ante statement simply begs question read prohibit actual performance abortions title fund indeed secretary february see provision fall within category restrictions upheld harris mcrae maher roe interpreting statute authorize regulation speech physician patient however secretary rejected constitutionally sound construction favor one means clearly constitutional addition requiring referral prenatal care adoption services regulations permit general health services physical examinations screening breast cancer treatment gynecological problems treatment sexually transmitted diseases fed reg none latter strictly preventive preconceptional services majority attempts obscure breadth decision curious contention title program regulations significantly impinge upon relationship ante relationship substantially burdened rule prohibiting dissemination physician pertinent medical information beyond serious dispute burden undiminished fact relationship issue one woman seeking services title clinic every reason expect physician withhold relevant information regarding purpose visit suggest otherwise engage uninformed fantasy hold relationship somehow incomplete patient lacks resources seek comprehensive health care single provider ignore situation vast number americans justice marshall noted different context perfectly proper judges disagree constitution requires disgraceful interpretation constitution premised upon unfounded assumptions people live kras dissenting opinion noted secretary made claim regulations issue reflect concern health welfare title clients context common law tort liability commentators recognized duty go assistance person difficulty peril least duty avoid affirmative acts make situation worse true course physician accepts charity patient defendant liable failure use reasonable care protection plaintiffs interests keeton dobbs keeton owen prosser keeton law torts ed footnotes omitted observation seems equally appropriate cases bar significantly interprets challenged regulations allow title project refer woman whose health seriously endangered continued pregnancy abortion provider ante hold otherwise adopt interpretation certainly violate patient right substantive due process see youngberg romeo revere massachusetts general hospital solicitor general oral argument however afforded regulations far less charitable interpretation see tr oral arg justice stevens dissenting relevant text family planning services population research act remained unchanged since enactment stat preamble act passed promote public health welfare expanding improving better coordinating family planning services population research activities federal government purposes ibid assist making comprehensive voluntary family planning services readily available persons desiring services develop make readily available information including educational materials family planning population growth persons desiring information congressional declaration purpose section act authorizes provision federal funds support establishment operation voluntary family planning projects section also empowers secretary promulgate regulations imposing conditions grant recipients ensure grants effectively utilized purposes made word statute however authorizes secretary impose restrictions dissemination truthful information professional advice grant recipients word prohibition used act section adds public health service act new title covering subject population research voluntary planning programs includes following provision prohibition abortion sec none funds appropriated title shall used programs abortion method family planning stat original regulations promulgated secretary health education welfare interpreted statute contemporaneous construction statute men charged responsibility setting machinery motion entitled particular respect see power reactor development electrical workers citation omitted udall tallman aluminum america central lincoln peoples utility regulations described kind services grant recipients provide order eligible federal funding purport regulate restrict kinds advice information recipients might make available clients conforming language governing statute regulations provided project provide abortions method family planning cfr emphasis added like statute regulations prohibited conduct speech true regulations promulgated secretary health human services also prohibited grant recipients performing abortions purport censor mandate kind speech see cfr entirely new approach adopted secretary view authorized statute new regulations merely reflect change policy determination secretary authorized congress make cf chevron natural resources defense counsel rather represented assumption policymaking responsibility congress delegated secretary see id intent congress clear end matter well agency must give effect unambiguously expressed intent congress society abhors censorship policymakers traditionally placed highest value freedom communicate unrealistic conclude statutory authority regulate conduct implicitly authorized executive regulate speech convinced act authorize secretary censor speech grant recipients employees hold challenged regulations invalid reverse judgment appeals even thought statute ambiguous however reach result reasons stated justice dissenting opinion also explains majority reached result improper comment constitutional issues parties debated majority reached decide constitutional questions however persuaded justice blackmun correct concluding majority arguments merit response also persuaded justice blackmun correctly analyzed issues therefore joined parts ii iii opinion justice dissenting otherwise acceptable construction statute raise serious constitutional problems construe statute avoid problems unless construction plainly contrary intent congress edward debartolo florida gulf coast building construction trades council justice blackmun explained well longstanding canon statutory construction applies case join part dissent part ii demonstrates challenged regulations constitute secretary interpretation public health service act stat raise serious constitutional problems regulations place restrictions speech title fund recipients restrictions directed precisely speech concerning one divisive contentious issues nation faced recent years ante acts limits power invalidates law constitutional grounds recognition place constitutional scheme must act great gravity delicacy telling coordinate branch actions absolutely prohibited absent constitutional amendment adkins children hospital district columbia see also blodgett holden holmes concurring case need tell secretary regulations reasonable interpretation statute need tell congress pass legislation rule solely statutory grounds congress retains power force constitutional question legislating explicitly may instead choose nothing decision left congress tell congress chosen enough case conclude neither language history compels secretary interpretation interpretation raises serious first amendment concerns basis alone reverse judgment appeals invalidate challenged regulations