The message of the PowerPoint was unmistakable.
Eliminate references to “diverse students” and the word “marginalized” from websites and policy statements. Scrutinize and reconsider phrases such as “systemic racism” or “vulnerable.” Add more references to concepts like “opportunity” and “equal access.”
Lawyers for NYU Langone Health, a leading hospital system in Manhattan, proposed these changes to the hospital’s website late last month, according to an internal PowerPoint presentation that contained a list of “trigger words.” By changing the tone and deleting certain words, lawyers for NYU Langone hoped to comply with a flurry of executive orders and other policy dictates from the Trump administration — and avoid losing funding or being investigated.
The PowerPoint presentation, obtained by The New York Times, offers a case study of the far-reaching impact of the Trump administration’s broadsides against D.E.I. programs and the way private institutions — such as a major hospital on Manhattan’s East Side — respond.
The presentation makes clear that NYU Langone’s lawyers viewed the administration’s new policies as creating a legal minefield for the health care system and its affiliated medical school.
Some of the administration’s executive orders are aimed at ending “diversity, equity and inclusion” programs at universities, hospitals, federal contractors and large corporations. Others were directed at transgender individuals and the doctors and hospitals who provide puberty blockers, hormones and other medical treatments to children and teenagers who want to transition.
“Many organizations feel like they’re walking a tightrope in an untenable situation,” said Laura Alfredo, the general counsel of the Greater New York Hospital Association, a trade group representing hospitals.
Dated Feb. 27, the PowerPoint presentation was sent to some doctors and administrators at the hospital. One physician shared it with The New York Times because of concerns about what the physician regarded as censorship. The doctor, who shared it on the condition of anonymity because the physician was not authorized to speak publicly, expressed astonishment that using words such as “marginalized” and “vulnerable” was viewed as potentially risky.
A spokesman for NYU Langone, Steve Ritea, declined to answer questions about changes the hospital had implemented in response to the executive orders.
“We are reviewing our policies and programs and how they are represented on websites to ensure compliance with federal nondiscrimination laws,” Mr. Ritea said in a statement. “We remain committed to ensuring that our institution welcomes and cares for people from all communities and backgrounds.”
Doctors at other hospitals said they were troubled that the executive orders appeared to be pressuring medical schools and hospitals to self-censor out of fear of losing federal funding.
“It is deeply concerning that the Trump administration is using the power of federal dollars to control the language that people working in hospitals and universities can use,” Dr. Robert Klitzman, a psychiatrist and bioethicist at Columbia University’s medical school, said this month after reviewing the PowerPoint slides. “These actions send chills through hospitals and universities.”
He said universities and hospitals were terrified at the prospect of being investigated or sanctioned on the basis of Trump’s executive orders.
The Trump administration has proved willing to dramatically cut federal research funding in the name of government efficiency and as an enforcement mechanism for various policies. Last month, it announced a $4 billion cut to federal funding that had been dedicated to covering administrative and overhead costs at institutions conducting biomedical research.
On March 7, the Trump administration announced it had canceled $400 million in research funding and contracts at Columbia University over what the administration said was the school’s failure to protect Jewish students from harassment. That cut threatens to decimate medical research conducted at Columbia’s medical school and its affiliated hospital, NewYork-Presbyterian/Columbia University Medical Center, a major competitor to NYU Langone Health.
“There’s a lot of money on the table, so hospitals and universities are being very risk-averse,” Dr. Klitzman said in an interview before the Columbia cuts.
This is not the first time that federal policy changes have prompted concerns about censorship or self-censorship among medical researchers. More than 20 years ago, scientists who studied AIDS and other sexually transmitted diseases were advised to avoid phrases such as “sex workers” or “men who sleep with men” in their research proposals. Those scientists were applying for federal funding — and hoping to avoid having their grants subjected to extra scrutiny.
The PowerPoint presentation from the NYU Langone Health attorneys outlined penalties that institutions could face if they violated the Trump executive orders, including loss of research funding and investigations by federal agencies.
The PowerPoint describes in detail the provisions of the executive orders that have implications for NYU Langone Health — and that clearly have its lawyers concerned.
One executive order instructed federal agencies to find ways to “combat illegal private-sector DEI” programs and advised agencies to draw up lists of large institutions that have DEI programs or values “that constitute illegal discrimination or preferences.” That executive order, and others like it, are mentioned in the PowerPoint as “important to NYU Langone Health re DEI.”
NYU Langone Health includes a leading medical school, NYU Grossman School of Medicine. The health system’s lawyers were reviewing faculty recruitment and medical school admissions, according to the PowerPoint, to ensure compliance with the Trump administration’s interpretation of anti-discrimination law.
The Trump administration declared that a 2023 Supreme Court ruling that found it was unconstitutional for colleges to use race as a factor in admissions also prohibits universities from taking race into account for hiring or promotions.
NYU Langone’s lawyers described a range of measures that might be deemed illegal, including company diversity goals and efforts to seek a diverse slate of candidates when hiring for a position, or prioritizing spending on minority-owned businesses.
The PowerPoint also notes that any attempt to engage in “work-force balancing” on the basis of race or sex could be found to be illegal.