U.S. Supreme Court
THORNBURGH v. AMERICAN COLL. OF OBST. & GYN., 476 U.S. 747
(1986)
476 U.S. 747
THORNBURGH, GOVERNOR OF PENNSYLVANIA, ET AL. v. AMERICAN
COLLEGE OF
OBSTETRICIANS AND GYNECOLOGISTS ET AL.
APPEAL FROM THE UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT
No. 84-495.
Argued November 5, 1985
Decided June 11, 1986
Appellees brought an action in Federal District Court alleging that the
Pennsylvania Abortion Control Act of 1982 violated the Federal Constitution and
seeking declaratory and injunctive relief. The court denied appellees' motion
for a preliminary injunction, except as to one provision of the Act which it
held was invalid. The Court of Appeals, after granting appellees' motion to
enjoin enforcement of the entire Act, held unconstitutional, on the basis of the
intervening decisions in Akron v. Akron Center for Reproductive Health, Inc.,
462 U.S. 416, Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft,
462 U.S. 476, and Simopoulos v. Virginia, 462 U.S. 506, the following provisions
of the Act: (1) the portions of 3205 that, with respect to the requirement that
the woman give her "informed consent" to an abortion, require her to be informed
of the name of the physician who will perform the abortion, the "particular
medical risks" of the abortion procedure to be used and of carrying her child to
term, and the facts that there may be "detrimental physical and psychological
effects," medical assistance benefits may be available for prenatal care,
childbirth, and neonatal care, the father is liable to assist in the child's
support, and printed materials are available from the State that describe the
fetus and list agencies offering alternatives to abortion; (2) 3208 that
requires such printed materials to include a statement that there are agencies
willing to help the mother carry her child to term and to assist her after the
child is born and a description of the probable anatomical and physiological
characteristics of an unborn child at "two-week gestational increments"; (3)
3214(a) and (h) that require the physician to report, among other things,
identification of the performing and referring physicians, information as to the
woman's residence, age, race, marital status, and number of prior pregnancies,
and the basis for any judgment that a medical emergency existed or for any
determination of nonviability, and the method of payment for the abortion, and
further provide that such reports shall not be deemed public records but shall
be available for public inspection and copying in a form that will not lead to
disclosure of the identity of any person filing a report; (4) 3211(a) that
requires the physician, after the first trimester, to report
[476 U.S. 747, 748] the basis for his determination that a child is not
viable; (5) 3210(b) that requires a physician performing a post-viability
abortion to exercise the degree of care required to preserve the life and health
of any unborn child intended to be born and to use the abortion technique that
would provide the best opportunity for the unborn child to be aborted alive
unless it would present a significantly greater medical risk to the pregnant
woman's life or health; and (6) 3210(c) that requires that a second physician be
present during an abortion performed when viability is possible, which physician
is to take all reasonable steps necessary to preserve the child's life and
health. The court held that the validity of other provisions of the Act might
depend on evidence adduced at the trial and accordingly remanded these features
of the case to the District Court.
Held:
1. In a situation such as is presented by this case, where the judgment
below is not final and the case is remanded for further development of the
facts, this Court has no appellate jurisdiction under 28 U.S.C. 1254(2). But
the jurisdictional statement here is treated as a petition for certiorari,
and the writ is granted. Pp. 754-755.
2. With a full record before it on the issues as to the validity of the Act
and with the intervening decisions in Akron, Ashcroft, and Simopoulos at
hand, the Court of Appeals was justified in proceeding to plenary review of
those issues. It was not limited to determining whether the District Court
abused its discretion in denying a preliminary injunction. Pp. 755-757.
3. The States are not free, under the guise of protecting maternal health
or potential life, to intimidate women into continuing pregnancies. The
provisions of the Pennsylvania Act that the Court of Appeals invalidated
wholly subordinate constitutional privacy interests and concerns with
maternal health to the effort to deter a woman from making a decision that,
with her physician, is hers to make. Pp. 758-771.
(a) The printed materials required by 3205 and 3208 are nothing less than
an attempt to wedge the State's message discouraging abortion into the
privacy of the informed-consent dialogue between the woman and her
physician. Similarly, 3205's requirement that the woman be advised that
medical assistance may be available and that the father is responsible for
financial assistance in support of the child are poorly disguised elements
of discouragement for the abortion decision. And 3205's requirements that
the physician inform the woman of "detrimental physical and psychological
effects" and of all "particular medical risks" are the antithesis of
informed consent. Pp. 759-765.
(b) The scope of the information required by 3214(a) and (h) and 3211(a)
and its availability to the public belie any assertions by the
[476 U.S. 747, 749] State that it is advancing any legitimate
interest. The reporting requirements of those sections raise the specter of
public exposure and harassment of women who choose to exercise their
personal, intensely private, right, with their physician, to end a
pregnancy. Thus, they pose an unacceptable danger of deterring the exercise
of that right and must be invalidated. Pp. 765-768.
(c) Section 3210(b) is facially invalid as being unsusceptible to a
construction that does not require the mother to bear an increased medical
risk in order save her viable fetus. Section 3210(c), by failing to provide
a medical-emergency exception for the situation where the mother's health is
endangered by delay in the second physician's arrival, chills the
performance of a late abortion, which, more than one performed at an earlier
date, tends to be under emergency conditions. Pp. 768-771.
737 F.2d 283, affirmed.
BLACKMUN, J., delivered the opinion of the Court, in which BRENNAN, MARSHALL,
POWELL, and STEVENS, JJ., joined. STEVENS, J., filed a concurring opinion, post,
p. 772. BURGER, C. J., filed a dissenting opinion, post, p. 782. WHITE, J.,
filed a dissenting opinion, in which REHNQUIST, J., joined, post, p. 785.
O'CONNOR, J., filed a dissenting opinion, in which REHNQUIST, J., joined, post,
p. 814.
Andrew S. Gordon, Senior Deputy Attorney General of Pennsylvania, argued the
cause for appellants. With him on the briefs were LeRoy S. Zimmerman, Attorney
General, and Allen C. Warshaw, Chief Deputy Attorney General.
Kathryn Kolbert argued the cause for appellees. With her on the brief was
Thomas E. Zemaitis.*
[Footnote *] Briefs of amici curiae urging reversal filed
for the United States by Acting Solicitor General Fried, Acting Assistant
Attorney General Willard, Deputy Assistant Attorney General Kuhl, John F.
Cordes, and John M. Rogers; for the National Right to Life Committee, Inc., by
James Bopp, Jr.; for the United States Catholic Conference by Wilfred R. Caron
and Mark E. Chopko; for Senator Gordon J. Humphrey et al. by Robert A. Destro
and Basile J. Uddo; for Watson D. Bowes, Jr., et al. by Steven Frederick
McDowell; and for John D. Lane et al. by John E. McKeever.
Briefs of amici curiae urging affirmance were filed for the Attorney General
of New York by Robert Abrams, Attorney General, pro se, Robert Hermann,
Solicitor General, Rosemarie Rhodes, Assistant Attorney General, and Lawrence S.
Kahn, Sanford M. Cohen, and Martha J. Olson, Assistant Attorneys General; for
the American Civil Liberties Union et al. by Nan D. Hunter, Janet Benshoof, and
Suzanne M. Lynn; for the American [476 U.S. 747, 750] Medical Association et al. by
Benjamin W. Heineman, Jr., Carter G. Phillips, Newton N. Minow, Jack R. Bierig,
Stephan E. Lawton, Joel I. Klein, Joseph A. Keyes, Jr., and Ann E. Allen; for
the Center for Constitutional Rights et al. by Anne E. Simon, Nadine Taub,
Rhonda Copelon, and Judith Levin; for the National Abortion Federation by David
I. Shapiro, Sidney Dickstein, Kenneth M. Simon, and Amy G. Applegate; for the
National Abortion Rights Action League et al. by Lynn I. Miller; for the
National Family Planning and Reproductive Health Association, Inc., by Robert T.
Crothers; for the National Organization for Women et al. by Diane E. Thompson;
and for the Planned Parenthood Federation of America, Inc., et al. by Dara
Klassel and Eve W. Paul.
Briefs of amici curiae were filed for the American Psychological Association
by Donald N. Bersoff and Bruce J. Ennis; for the Women's Lawyers' Association of
Los Angeles, California, et al. by Susan R. Schwartz, Carol Boyk, Judith Gordon,
and Lorraine Loder; for the Unitarian Universalist Association et al. by
Madeline Kochen; for Senator Bob Packwood et al. by Laurence H. Tribe and
Kathleen M. Sullivan; for Susan Bandes et al. by Arthur Kinoy; and for Olivia
Gans et al. by James Bopp, Jr. [476 U.S. 747,
750]
JUSTICE BLACKMUN delivered the opinion of the Court.
This is an appeal from a judgment of the United States Court of Appeals for
the Third Circuit reviewing the District Court's rulings upon a motion for a
preliminary injunction. The Court of Appeals held unconstitutional several
provisions of Pennsylvania's current Abortion Control Act, 1982 Pa. Laws, Act
No. 138, now codified as 18 Pa. Cons. Stat. 3201 et seq. (1982).1
Among the provisions ruled invalid by the Court of Appeals were portions of
3205, relating to "informed consent"; 3208, concerning "printed information";
3210(b) and (c), having to do with postviability abortions; and 3211(a) and
3214(a) and (h), regarding reporting requirements.2 [476 U.S. 747, 751]
I
The Abortion Control Act was approved by the Governor of the
Commonwealth on June 11, 1982. By its own terms, however, see 7 of the Act, it
was to become effective only 180 days thereafter, that is, on the following
December 8. It had been offered as an amendment to a pending bill to regulate
paramilitary training.
The 1982 Act was not the Commonwealth's first attempt, after this Court's
1973 decisions in Roe v. Wade, 410 U.S. 113, and Doe v. Bolton, 410 U.S. 179, to
impose abortion restraints. The State's first post-1973 Abortion Control Act,
1974 Pa. Laws, Act No. 209, was passed in 1974 over the Governor's veto. After
extensive litigation, various provisions of the 1974 statute were ruled
unconstitutional, including those relating to spousal or parental consent, to
the choice of procedure for a postviability abortion, and to the proscription of
abortion advertisements. See Planned Parenthood Assn. v. Fitzpatrick, 401 F.
Supp. 554 (ED Pa. 1975), summarily aff'd in part sub nom. Franklin v.
Fitzgerald, 428 U.S. 901 (1976), and summarily vacated in part and remanded sub
nom. Beal v. Franklin, 428 U.S. 901 (1976), modified on remand (No. 74-2440) (ED
Pa. 1977), aff'd sub nom. Colautti v. Franklin, 439 U.S. 379 (1979). See also
Doe v. Zimmerman, 405 F. Supp. 534 (MD Pa. 1975).
In 1978, the Pennsylvania Legislature attempted to restrict access to
abortion by limiting medical-assistance funding for the procedure. 2 1978 Pa.
Laws, Act No. 16A (pp. 1506-1507) and 1 1978 Pa. Laws, Act No. 148. This effort,
too, was successfully challenged in federal court, Roe v. Casey, 464 F. Supp.
487 (ED Pa. 1978), and that judgment was affirmed by the Third Circuit. 623 F.2d
829 (1980).
In 1981, abortion legislation was proposed in the Pennsylvania House as an
amendment to a pending Senate bill to outlaw [476
U.S. 747, 752]
"tough-guy competitions."3 The suggested amendment, aimed at limiting abortions, was
patterned after a model statute developed by a Chicago-based, nonprofit
anti-abortion organization. See Note, Toward Constitutional Abortion Control
Legislation: The Pennsylvania Approach, 87 Dick. L. Rev. 373, 382, n. 84 (1983).
The bill underwent further change in the legislative process but, when passed,
was vetoed by the Governor. See 737 F.2d 283, 288-289 (CA3 1984). Finally, the
1982 Act was formulated, enacted, and approved.
After the passage of the Act, but before its effective date, the present
litigation was instituted in the United States District Court for the Eastern
District of Pennsylvania. The plaintiffs, who are the appellees here, were the
American College of Obstetricians and Gynecologists, Pennsylvania Section;
certain physicians licensed in Pennsylvania; clergymen; an individual who
purchases from a Pennsylvania insurer health-care and disability insurance
extending to abortions; and Pennsylvania abortion counselors and providers.
Alleging that the Act violated the United States Constitution, the plaintiffs,
pursuant to 42 U.S.C. 1983, sought declaratory and injunctive relief. The
defendants named in the complaint were the Governor of the Commonwealth, other
Commonwealth officials, and the District Attorney for Montgomery County, Pa.
The plaintiffs promptly filed a motion for a preliminary injunction.
Forty-one affidavits accompanied the motion. The defendants, on their part,
submitted what the Court of Appeals described as "an equally comprehensive
opposing memorandum." 737 F.2d, at 289. The District Court then ordered the
parties to submit a "stipulation of uncontested facts," as authorized by local
rule. The parties produced a stipulation "solely for purposes of a determination
on plaintiffs' [476 U.S. 747, 753] motion
for preliminary injunction," and "without prejudice to any party's right to
controvert any facts or to prove any additional facts at any later proceeding in
this action." App. 9a-10a.
Relying substantially on the opinions of the respective Courts of Appeals in
Akron Center for Reproductive Health, Inc. v. City of Akron, 651 F.2d 1198 (CA6
1981), later aff'd in part and rev'd in part, 462 U.S. 416 (1983), and in
Planned Parenthood Assn. of Kansas City v. Ashcroft, 655 F.2d 848 (CA8 1981),
later aff'd in part and rev'd in part, 462 U.S. 476 (1983), the District Court
concluded that, with one exception, see n. 1, supra, the plaintiffs had failed
to establish a likelihood of success on the merits and thus were not entitled to
preliminary injunctive relief. 552 F. Supp. 791 (1982).
Appellees appealed from the denial of the preliminary injunction, and
appellants cross-appealed with respect to the single statutory provision as to
which the District Court had allowed relief. The Third Circuit then granted
appellees' motion to enjoin enforcement of the entire Act pending appeal. After
expedited briefing and argument, the court withheld judgment pending the
anticipated decisions by this Court in Akron, supra, Ashcroft, supra, and
Simopoulos v. Commonwealth, 221 Va. 1059, 277 S. E. 2d 194 (1981), all of which
had been accepted for review here, had been argued, and were under submission.
Those three cases were decided by this Court on June 15, 1983. See Akron v.
Akron Center for Reproductive Health, Inc., 462 U.S. 416; Planned Parenthood
Assn. of Kansas City, Missouri, Inc. v. Ashcroft, 462 U.S. 476; Simopoulos v.
Virginia, 462 U.S. 506. After reargument in light of those decisions, the Court
of Appeals, with one judge concurring in part and dissenting in part, ruled that
various provisions of the Act were unconstitutional. 737 F.2d 283 (1984).
Appellants' petition for rehearing en banc was denied, with four judges voting
to grant the petition. Id., at 316, 317. When a jurisdictional statement
[476 U.S. 747, 754] was filed here, we postponed further consideration of
the question of our jurisdiction to the hearing on the merits. 471 U.S. 1014
(1985).
II
We are confronted initially with the question whether we have
appellate jurisdiction in this case. Appellants purport to have taken their
appeal to this Court pursuant to 28 U.S.C. 1254(2).4 It seems clear, and the parties appear to agree, see Brief for
Appellants 21, that the judgment of the Court of Appeals was not a final
judgment in the ordinary meaning of that term. The court did not hold the entire
Act unconstitutional, but ruled, instead, that some provisions were invalid
under Akron, Ashcroft, and Simopoulos, and that the validity of other provisions
might depend on evidence adduced at the trial, see 737 F.2d, at 299-300, or on
procedural rules to be promulgated by the Supreme Court of Pennsylvania, see
id., at 296-297. It remanded these features of the case to the District Court.
Id., at 304.
Slaker v. O'Connor, 278 U.S. 188, 189-190 (1929), and McLish v. Roff, 141
U.S. 661, 665-666 (1891), surely suggest that, under these circumstances, we do
not have appellate jurisdiction.5
See also South Carolina Electric & Gas Co. v. Flemming, 351 U.S. 901 (1956).
Although the authority of Slaker and South Carolina Electric has been
questioned, the Court to date has found it unnecessary to put the issue to rest.
See Doran v. Salem Inn, Inc., 422 U.S. 922, 927 (1975); Renton v. Playtime
Theatres, Inc., 475 U.S. 41, 43-44, n. 1 (1986). In some cases raising this
issue of the [476 U.S. 747, 755] scope of appellate jurisdiction, the
Court has found any finality requirement to have been satisfied in light of the
facts. See, e. g., New Orleans v. Dukes, 427 U.S. 297, 302 (1976); Chicago v.
Atchison, T. & S. F. R. Co., 357 U.S. 77, 82-83 (1958). In other cases, the
Court has avoided the issue by utilizing 28 U.S.C. 2103 and granting certiorari.
See, e. g., Doran, 422 U.S., at 927; El Paso v. Simmons, 379 U.S. 497, 503
(1965); see also Escambia County v. McMillan, 466 U.S. 48, 50, n. 4 (1984).
We have concluded that it is time that this undecided issue be resolved. We
therefore hold, on the reasoning of McLish v. Roff, 141 U.S., at 665-668, that
in a situation such as this one, where the judgment is not final, and where the
case is remanded for further development of the facts, we have no appellate
jurisdiction under 1254(2).
We nevertheless treat appellants' jurisdictional statement as a petition for
certiorari, grant the writ, and move on to the merits.6
III
Appellants assert that the Court of Appeals erred in holding
portions of the Act unconstitutional since the scope of its review of the
District Court's denial of a preliminary injunction as to those sections should
have been limited to determining whether the trial court abused its discretion
in finding the presence or absence of irreparable harm and a probability that
the plaintiffs would succeed on the merits. Such limited review normally is
appropriate, see Doran v. Salem Inn, Inc., 422 U.S., at 931-932; Brown v. Chote,
411 U.S. 452, 456-457 (1973), inasmuch as the primary purpose of a preliminary
injunction is to preserve the relative positions of the parties. See University
of Texas v. Camenisch, 451 U.S. 390, 395 (1981). Further, the necessity for an
expeditious resolution often means that the injunction is issued on a procedure
[476 U.S. 747, 756]
less stringent than that which prevails at the subsequent trial on the merits of
the application for injunctive relief. See United States Steel Corp. v.
Fraternal Assn. of Steelhaulers, 431 F.2d 1046, 1048 (CA3 1970); see also Mayo
v. Lakeland Highlands Canning Co., 309 U.S. 310, 316 (1940).
This approach, however, is not inflexible. The Court on more than one
occasion in this area has approved proceedings deviating from the stated norm.
In Youngstown Sheet & Tube Co. v. Sawyer, 343 U.S. 579 (1952), the District
Court had issued a preliminary injunction restraining the Secretary of Commerce
from seizing the Nation's steel mills. The Court of Appeals stayed the
injunction. This Court found that the case was ripe for review, despite the
early stage of the litigation, and went on to address the merits. Id., at 585.
And in Smith v. Vulcan Iron Works, 165 U.S. 518 (1897), the District Court
issued injunctions in two patent cases and referred them to a Master for
accounting. The Court of Appeals reversed. This Court ruled that the Court of
Appeals had acted properly in deciding the merits since review of interlocutory
appeals was designed not only to permit the defendant to obtain immediate relief
but also in certain cases to save the parties the expense of further litigation.
Id., at 525.
The Third Circuit's decision to address the constitutionality of the
Pennsylvania Act finds further support in this Court's decisions that when the
unconstitutionality of the particular state action under challenge is clear, a
federal court need not abstain from addressing the constitutional issue pending
state-court review. See, e. g., Bailey v. Patterson, 369 U.S. 31, 33 (1962);
Turner v. City of Memphis, 369 U.S. 350, 353 (1962); Zwickler v. Koota, 389 U.S.
241, 251, n. 14 (1967). See also Singleton v. Wulff, 428 U.S. 106, 121 (1976).
See generally Spann, Simple Justice, 73 Geo. L. J. 1041, 1055, n. 77 (1985).7 [476 U.S. 747, 757]
Thus, as these cases indicate, if a district court's ruling rests solely on a
premise as to the applicable rule of law, and the facts are established or of no
controlling relevance, that ruling may be reviewed even though the appeal is
from the entry of a preliminary injunction.8 The Court of Appeals in this case properly recognized and
applied these principles when it observed:
"Thus, although this appeal arises from a ruling on a request for a
preliminary injunction, we have before us an unusually complete factual and
legal presentation from which to address the important constitutional issues
at stake. The customary discretion accorded to a District Court's ruling on
a preliminary injunction yields to our plenary scope of review as to the
applicable law." 737 F.2d, at 290.
That a court of appeals ordinarily will limit its review in a case of this
kind to abuse of discretion is a rule of orderly judicial administration, not a
limit on judicial power. With a full record before it on the issues now before
us, and with the intervening decisions in Akron, Ashcroft, and Simopoulos at
hand, the Court of Appeals was justified in proceeding to plenary review of
those issues. [476 U.S. 747, 758]
IV
This case, as it comes to us, concerns the constitutionality
of six provisions of the Pennsylvania Act that the Court of Appeals struck down
as facially invalid: 3205 ("informed consent"); 3208 ("printed information");
3214(a) and (h) (reporting requirements); 3211(a) (determination of viability);
3210(b) (degree of care required in postviability abortions); and 3210(c)
(second-physician requirement). We have no reason to address the validity of the
other sections of the Act challenged in the District Court.9 [476 U.S. 747, 759]
A
Less than three years ago, this Court, in Akron, Ashcroft, and
Simopoulos, reviewed challenges to state and municipal legislation regulating
the performance of abortions. In Akron, the Court specifically reaffirmed Roe v.
Wade, 410 U.S. 113 (1973). See 462 U.S., at 420, 426-431. Again today, we
reaffirm the general principles laid down in Roe and in Akron.
In the years since this Court's decision in Roe, States and municipalities
have adopted a number of measures seemingly designed to prevent a woman, with
the advice of her physician, from exercising her freedom of choice. Akron is but
one example. But the constitutional principles that led this Court to its
decisions in 1973 still provide the compelling reason for recognizing the
constitutional dimensions of a woman's right to decide whether to end her
pregnancy. "[I]t should go without saying that the vitality of these
constitutional principles cannot be allowed to yield simply because of
disagreement with them." Brown v. Board of Education, 349 U.S. 294, 300 (1955).
The States are not free, under the guise of protecting maternal health or
potential life, to intimidate women into continuing pregnancies. Appellants
claim that the statutory provisions before us today further legitimate
compelling interests of the Commonwealth. Close analysis of those provisions,
however, shows that they wholly subordinate constitutional privacy interests and
concerns with maternal health in an effort to deter a woman from making a
decision that, with her physician, is hers to make.
B
We turn to the challenged statutes:
1. Section 3205 ("informed consent") and 3208 ("printed information").
Section 3205(a) requires that the woman give her "voluntary and informed
consent" to an abortion. Failure to observe the provisions of 3205 subjects the
physician to suspension or revocation of his license, and subjects any [476 U.S. 747, 760] other person obligated to provide
information relating to informed consent to criminal penalties. 3205(c). A
requirement that the woman give what is truly a voluntary and informed consent,
as a general proposition, is, of course, proper and is surely not
unconstitutional. See Planned Parenthood of Central Missouri v. Danforth, 428
U.S. 52, 67 (1976). But the State may not require the delivery of information
designed "to influence the woman's informed choice between abortion or
childbirth." Akron, 462 U.S., at 443-444.
Appellants refer to the Akron ordinance, Brief for Appellants 67, as did this
Court in Akron itself, 462 U.S., at 445, as "a litany of information" and as "`a
parade of horribles'" of dubious validity plainly designed to influence the
woman's choice. They would distinguish the Akron situation, however, from the
Pennsylvania one. Appellants assert that statutes "describing the general
subject matter relevant to informed consent," ibid., and stating "in general
terms the information to be disclosed," id., at 447, are permissible, and they
further assert that the Pennsylvania statutes do no more than that.
We do not agree. We conclude that, like Akron's ordinance, 3205 and 3208 fail
the Akron measurement. The two sections prescribe in detail the method for
securing "informed consent." Seven explicit kinds of information must be
delivered to the woman at least 24 hours before her consent is given, and five
of these must be presented by the woman's physician. The five are: (a) the name
of the physician who will perform the abortion, (b) the "fact that there may be
detrimental physical and psychological effects which are not accurately
foreseeable," (c) the "particular medical risks associated with the particular
abortion procedure to be employed," (d) the probable gestational age, and (e)
the "medical risks associated with carrying her child to term." The remaining
two categories are (f) the "fact that medical assistance benefits may be
available for prenatal care, childbirth [476 U.S.
747, 761]
and neonatal care," and (g) the "fact that the father is liable to assist" in
the child's support, "even in instances where the father has offered to pay for
the abortion." 3205(a)(1) and (2). The woman also must be informed that
materials printed and supplied by the Commonwealth that describe the fetus and
that list agencies offering alternatives to abortion are available for her
review. If she chooses to review the materials but is unable to read, the
materials "shall be read to her," and any answer she seeks must be "provided her
in her own language." 3205(a)(2)(iii). She must certify in writing, prior to the
abortion, that all this has been done. 3205(a)(3). The printed materials "shall
include the following statement":
"`There are many public and private agencies willing and able to help you
to carry your child to term, and to assist you and your child after your
child is born, whether you choose to keep your child or place her or him for
adoption. The Commonwealth of Pennsylvania strongly urges you to contact
them before making a final decision about abortion. The law requires that
your physician or his agent give you the opportunity to call agencies like
these before you undergo an abortion.'" 3208(a)(1).
The materials must describe the "probable anatomical and physiological
characteristics of the unborn child at two-week gestational increments from
fertilization to full term, including any relevant information on the
possibility of the unborn child's survival." 3208(a)(2).
In Akron, this Court noted: "The validity of an informed consent requirement
thus rests on the State's interest in protecting the health of the pregnant
woman." 462 U.S., at 443. The Court went on to state:
"This does not mean, however, that a State has unreviewable authority to
decide what information a woman must be given before she chooses to have an [476 U.S. 747, 762] abortion. It remains primarily the
responsibility of the physician to ensure that appropriate information is
conveyed to his patient, depending on her particular circumstances.
Danforth's recognition of the State's interest in ensuring that this
information be given will not justify abortion regulations designed to
influence the woman's informed choice between abortion or childbirth." Id.,
at 443-444.
The informational requirements in the Akron ordinance were invalid for two
"equally decisive" reasons. Id., at 445. The first was that "much of the
information required is designed not to inform the woman's consent but rather to
persuade her to withhold it altogether." Id., at 444. The second was that a
rigid requirement that a specific body of information be given in all cases,
irrespective of the particular needs of the patient, intrudes upon the
discretion of the pregnant woman's physician and thereby imposes the "undesired
and uncomfortable straitjacket" with which the Court in Danforth, 428 U.S., at
67, n. 8, was concerned.
These two reasons apply with equal and controlling force to the specific and
intrusive informational prescriptions of the Pennsylvania statutes. The printed
materials required by 3205 and 3208 seem to us to be nothing less than an
outright attempt to wedge the Commonwealth's message discouraging abortion into
the privacy of the informed-consent dialogue between the woman and her
physician. The mandated description of fetal characteristics at 2-week
intervals, no matter how objective, is plainly overinclusive. This is not
medical information that is always relevant to the woman's decision, and it may
serve only to confuse and punish her and to heighten her anxiety, contrary to
accepted medical practice.10
Even the listing of agencies in the printed Pennsylvania
[476 U.S. 747, 763] form presents serious problems; it contains names of
agencies that well may be out of step with the needs of the particular woman and
thus places the physician in an awkward position and infringes upon his or her
professional responsibilities. Forcing the physician or counselor to present the
materials and the list to the woman makes him or her in effect an agent of the
State in treating the woman and places his or her imprimatur upon both the
materials and the list. See Women's Medical Center of Providence, Inc. v.
Roberts, 530 F. Supp. 1136, 1154 (RI 1982). All this is, or comes close to
being, state medicine imposed upon the woman, not the professional medical
guidance she seeks, and it officially structures - as it obviously was intended
to do - the dialogue between the woman and her physician.
The requirements of 3205(a)(2)(i) and (ii) that the woman be advised that
medical assistance benefits may be available, and that the father is responsible
for financial assistance in the support of the child similarly are poorly
disguised elements of discouragement for the abortion decision. Much of this
would be nonmedical information beyond the physician's area of expertise and,
for many patients, would be irrelevant and inappropriate. For a patient with a
life-threatening pregnancy, the "information" in its very rendition may be cruel
as well as destructive of the physician-patient relationship. As any experienced
social worker or other counselor knows, theoretical financial responsibility
often does not equate with fulfillment. And a victim of rape should not have to
hear gratuitous advice that an unidentified perpetrator is liable for support if
she continues the pregnancy to term. Under the guise of informed consent, the
Act requires the dissemination of information that is not relevant to such
consent, and, thus, it advances no legitimate state interest. [476 U.S. 747, 764]
The requirements of 3205(a)(1)(ii) and (iii) that the woman be informed by
the physician of "detrimental physical and psychological effects" and of all
"particular medical risks" compound the problem of medical attendance, increase
the patient's anxiety, and intrude upon the physician's exercise of proper
professional judgment. This type of compelled information is the antithesis of
informed consent. That the Commonwealth does not, and surely would not, compel
similar disclosure of every possible peril of necessary surgery or of simple
vaccination, reveals the anti-abortion character of the statute and its real
purpose. Pennsylvania, like Akron, "has gone far beyond merely describing the
general subject matter relevant to informed consent." Akron, 462 U.S., at 445.
In addition, the Commonwealth would require the physician to recite its litany
"regardless of whether in his judgment the information is relevant to [the
patient's] personal decision." Ibid. These statutory defects cannot be saved by
any facts that might be forthcoming at a subsequent hearing. Section 3205's
informational requirements therefore are facially unconstitutional.11
Appellants assert, however, that even if this be so, the remedy is to allow
the remainder of 3205 to be severed and become effective. We rule otherwise. The
radical dissection necessary for this would leave 3205 with little resemblance
to that intended by the Pennsylvania Legislature. We rejected a similar
suggestion as to the ordinance in [476 U.S. 747, 765] Akron, 462 U.S. at 445, n.
37, despite the presence there of a broad severability clause. We reach the same
conclusion here, where no such clause is present, and reject the plea for
severance. See Carter v. Carter Coal Co., 298 U.S. 238, 312-313 (1936).
2. Sections 3214(a) and (h) (reporting) and 3211(a) (determination of
viability). Section 3214(a)(8), part of the general reporting section,
incorporates 3211(a). Section 3211(a) requires the physician to report the basis
for his determination "that a child is not viable." It applies only after the
first trimester. The report required by 3214(a) and (h) is detailed and must
include, among other things, identification of the performing and referring
physicians and of the facility or agency; information as to the woman's
political subdivision and State of residence, age, race, marital status, and
number of prior pregnancies; the date of her last menstrual period and the
probable gestational age; the basis for any judgment that a medical emergency
existed; the basis for any determination of nonviability; and the method of
payment for the abortion. The report is to be signed by the attending physician.
3214(b).
Despite the fact that 3214(e)(2) provides that such reports "shall not be
deemed public records," within the meaning of the Commonwealth's "Right-to-Know
Law," Pa. Stat. Ann., Tit. 65, 66.1 et seq. (Purdon 1959 and Supp. 1985), each
report "shall be made available for public inspection and copying within 15 days
of receipt in a form which will not lead to the disclosure of the identity of
any person filing a report." Similarly, the report of complications, required by
3214(h), "shall be open to public inspection and copying." A willful failure to
file a report required under 3214 is "unprofessional conduct" and the
noncomplying physician's license "shall be subject to suspension or revocation."
3214(i)(1).
The scope of the information required and its availability to the public
belie any assertions by the Commonwealth that it is advancing any legitimate
interest. In Planned Parenthood [476 U.S. 747,
766] of Central Missouri v. Danforth, 428 U.S., at 80, we recognized that
recordkeeping and reporting provisions "that are reasonably directed to the
preservation of maternal health and that properly respect a patient's
confidentiality and privacy are permissible." But the reports required under the
Act before us today go well beyond the health-related interests that served to
justify the Missouri reports under consideration in Danforth. Pennsylvania would
require, as Missouri did not, information as to method of payment, as to the
woman's personal history, and as to the bases for medical judgments. The
Missouri reports were to be used "only for statistical purposes." See id., at
87. They were to be maintained in confidence, with the sole exception of public
health officers. In Akron, the Court explained its holding in Danforth when it
said: "The decisive factor was that the State met its burden of demonstrating
that these regulations furthered important health-related state concerns." 462
U.S., at 430.
The required Pennsylvania reports, on the other hand, while claimed not to be
"public," are available nonetheless to the public for copying. Moreover, there
is no limitation on the use to which the Commonwealth or the public copiers may
put them. The elements that proved persuasive for the ruling in Danforth are
absent here. The decision to terminate a pregnancy is an intensely private one
that must be protected in a way that assures anonymity. JUSTICE STEVENS, in his
opinion concurring in the judgment in Bellotti v. Baird, 443 U.S. 622 (1979),
aptly observed:
"It is inherent in the right to make the abortion decision that the right
may be exercised without public scrutiny and in defiance of the contrary
opinion of the sovereign or other third parties." Id., at 655.
A woman and her physician will necessarily be more reluctant to choose an
abortion if there exists a possibility that her decision and her identity will
become known publicly. Although the statute does not specifically require the
reporting [476 U.S. 747, 767] of the woman's name, the amount of
information about her and the circumstances under which she had an abortion are
so detailed that identification is likely. Identification is the obvious purpose
of these extreme reporting requirements.12
The "impermissible limits" that Danforth mentioned and that Missouri approached,
see 428 U.S., at 81, have been exceeded here.
We note, as we reach this conclusion, that the Court consistently has refused
to allow government to chill the exercise of constitutional rights by requiring
disclosure of protected, but sometimes unpopular, activities. See, e. g., Lamont
v. Postmaster General, 381 U.S. 301 (1965) (invalidating Post Office requirement
that addressee affirmatively request delivery of "communist" materials in order
to receive them); Talley v. California, 362 U.S. 60, 64-65 (1960) (striking down
municipal ban on unsigned handbills); NAACP v. Alabama ex rel. Patterson, 357
U.S. 449, 462-465 (1958) (invalidating compelled disclosure of NAACP membership
list). Pennsylvania's reporting requirements raise the specter of public
exposure and harassment of women who choose to exercise their personal,
intensely private, right, with their physician, to end a pregnancy. Thus, they
pose an unacceptable [476 U.S. 747, 768] danger of deterring the exercise of
that right, and must be invalidated.
3. Section 3210(b) (degree of care for postviability abortions) and 3210(c)
(second-physician requirement when the fetus is possibly viable). Section
3210(b)13 sets forth two independent requirements for
a postviability abortion. First, it demands the exercise of that degree of care
"which such person would be required to exercise in order to preserve the life
and health of any unborn child intended to be born and not aborted." Second,
"the abortion technique employed shall be that which would provide the best
opportunity for the unborn child to be aborted alive unless," in the physician's
good-faith judgment, that technique "would present a significantly greater
medical risk to the life or health of the pregnant woman." An intentional,
knowing, or reckless violation of this standard is a felony of the third degree,
and subjects the violator to the possibility of imprisonment for not more than
seven years and to a fine of not more than $15,000. See 18 Pa. Cons. Stat.
1101(2) and 1103(3) (1982).
The Court of Appeals ruled that 3210(b) was unconstitutional because it
required a "trade-off" between the woman's health and fetal survival, and failed
to require that maternal [476 U.S. 747, 769]
health be the physician's paramount consideration. 737 F.2d, at 300, citing
Colautti v. Franklin, 439 U.S. 379, 397-401 (1979) (where Pennsylvania's 1974
Abortion Control Act was reviewed). In Colautti, this Court recognized the
undesirability of any "`trade-off' between the woman's health and additional
percentage points of fetal survival." Id., at 400.
Appellants do not take any real issue with this proposition. See Brief for
Appellants 84-86. They argue instead, as did the District Court, see 552 F.
Supp., at 806-807, that the statute's words "significantly greater medical risk"
for the life or health of the woman do not mean some additional risk (in which
case unconstitutionality apparently is conceded) but only a "meaningfully
increased" risk. That interpretation, said the District Court, renders the
statute constitutional. Id., at 807. The Court of Appeals disagreed, pointing
out that such a reading is inconsistent with the statutory language and with the
legislative intent reflected in that language; that the adverb "significantly"
modifies the risk imposed on the woman; that the adverb is "patently not
surplusage"; and that the language of the statute "is not susceptible to a
construction that does not require the mother to bear an increased medical risk
in order to save her viable fetus." 737 F.2d, at 300. We agree with the Court of
Appeals and therefore find the statute to be facially invalid.14
Section 3210(c)15 requires that a second physician be present during an
abortion performed when viability is possible. [476 U.S. 747, 770] The second physician is to
"take control of the child and . . . provide immediate medical care for the
child, taking all reasonable steps necessary, in his judgment, to preserve the
child's life and health." Violation of this requirement is a felony of the third
degree.
In Planned Parenthood Assn. of Kansas City, Missouri, Inc. v. Ashcroft, 462
U.S. 476 (1983), the Court, by a 5-4 vote, but not by a controlling single
opinion, ruled that a Missouri statute requiring the presence of a second
physician during an abortion performed after viability was constitutional.
JUSTICE POWELL, joined by THE CHIEF JUSTICE, concluded that the State had a
compelling interest in protecting the life of a viable fetus and that the second
physician's presence provided assurance that the State's interest was protected
more fully than with only one physician in attendance. Id., at 482-486.16 JUSTICE POWELL recognized that, to pass constitutional
muster, the statute must contain an exception for the situation where the health
of the mother was endangered by delay in the arrival of the second physician.
Recognizing that there was "no clearly expressed exception" on the face of the
Missouri statute for the emergency situation, JUSTICE POWELL found the exception
implicit in the statutory requirement that action be taken to preserve the fetus
"provided it does not pose an increased risk to the life or health of the
woman." Id., at 485, n. 8.
Like the Missouri statute, 3210(c) of the Pennsylvania statute contains no
express exception for an emergency situation. While the Missouri statute, in the
view of JUSTICE POWELL, was worded sufficiently to imply an emergency exception,
Pennsylvania's statute contains no such comforting or
[476 U.S. 747, 771]
helpful language and evinces no intent to protect a woman whose life may be at
risk. Section 3210(a)17
provides only a defense to criminal liability for a physician who concluded, in
good faith, that a fetus was nonviable "or that the abortion was necessary to
preserve maternal life or health." It does not relate to the second-physician
requirement and its words are not words of emergency.
It is clear that the Pennsylvania Legislature knows how to provide a
medical-emergency exception when it chooses to do so. It defined "[m]edical
emergency" in general terms in 3203, and it specifically provided a
medical-emergency exception with respect to informational requirements, 3205(b);
for parental consent, 3206; for post-first-trimester hospitalization, 3209; and
for a public official's issuance of an order for an abortion without the express
voluntary consent of the woman, 3215(f). We necessarily conclude that the
legislature's failure to provide a medical-emergency exception in 3210(c) was
intentional. All the factors are here for chilling the performance of a late
abortion, which, more than one performed at an earlier date, perhaps tends to be
under emergency conditions.
V
Constitutional rights do not always have easily ascertainable
boundaries, and controversy over the meaning of our Nation's most majestic
guarantees frequently has been turbulent. As judges, however, we are sworn to
uphold the law even when its content gives rise to bitter dispute. See Cooper v.
Aaron, 358 U.S. 1 (1958). We recognized at the very
[476 U.S. 747, 772]
beginning of our opinion in Roe, 410 U.S., at 116, that abortion raises moral
and spiritual questions over which honorable persons can disagree sincerely and
profoundly. But those disagreements did not then and do not now relieve us of
our duty to apply the Constitution faithfully.
Our cases long have recognized that the Constitution embodies a promise that
a certain private sphere of individual liberty will be kept largely beyond the
reach of government. See, e. g., Carey v. Population Services International, 431
U.S. 678 (1977); Moore v. East Cleveland, 431 U.S. 494 (1977); Eisenstadt v.
Baird, 405 U.S. 438 (1972); Griswold v. Connecticut, 381 U.S. 479 (1965); Pierce
v. Society of Sisters, 268 U.S. 510 (1925); Meyer v. Nebraska, 262 U.S. 390
(1923). See also Whalen v. Roe, 429 U.S. 589, 598-600 (1977). That promise
extends to women as well as to men. Few decisions are more personal and
intimate, more properly private, or more basic to individual dignity and
autonomy, than a woman's decision - with the guidance of her physician and
within the limits specified in Roe - whether to end her pregnancy. A woman's
right to make that choice freely is fundamental. Any other result, in our view,
would protect inadequately a central part of the sphere of liberty that our law
guarantees equally to all.
The Court of Appeals correctly invalidated the specified provisions of
Pennsylvania's 1982 Abortion Control Act. Its judgment is affirmed.
It is so ordered.
Footnotes
[Footnote 1] The District Court had held
invalid and had enjoined preliminarily only the requirement of 3205(a)(2) that
at least 24 hours must elapse between a woman's receipt of specified information
and the performance of her abortion. 552 F. Supp. 791, 797-798, 811 (ED Pa.
1982).
[Footnote 2] The Court of Appeals also
held 3215(e) invalid. That section requires health-care insurers to make
available, at a lesser premium, policies expressly excluding coverage "for
abortion services not necessary to avert [476
U.S. 747, 751] the death of the woman or to terminate pregnancies caused
by rape or incest." This ruling on 3215(e) is not before us.
[Footnote 3] A "tough-guy competition" is
a physical contact bout between persons who lack professional experience and who
attempt to render each other unconscious. See Note, 87 Dick. L. Rev. 373, 382,
n. 84 (1983).
[Footnote 4] Section 1254 reads in
pertinent part:
"Cases in the courts of appeals may be reviewed by the Supreme Court by the
following methods:
. . . . .
"(2) By appeal by a party relying on a State statute held by a court of
appeals to be invalid as repugnant to the Constitution, treaties or laws of
the United States . . . ."
[Footnote 5] Appellants ask that Slaker be
overruled. See Brief for Appellants 10, 22-25.
[Footnote 6] We continue, however, to
refer to the parties as appellants and appellees, respectively.
[Footnote 7] This principle finds an
analogy in an established doctrine of administrative law. In SEC v. Chenery
Corp., 318 U.S. 80 (1943), the Court [476 U.S.
747, 757] ruled that a reviewing court could not affirm an agency on a
principle the agency might not embrace. But the ruling in Chenery has not
required courts to remand in futility. See Illinois v. ICC, 722 F.2d 1341,
1348-1349 (CA7 1983); see also Friendly, Chenery Revisited: Reflections on
Reversal and Remand of Administrative Orders, 1969 Duke L. J. 199.
[Footnote 8] A different situation is
presented, of course, when there is no disagreement as to the law, but the
probability of success on the merits depends on facts that are likely to emerge
at trial. See Delaware & Hudson R. Co. v. United Transportation Union, 146 U.S.
App. D.C. 142, 159, 450 F.2d 603, 620, cert. denied, 403 U.S. 911 (1971). See
also Airco, Inc. v. Energy Research & Development Admin., 528 F.2d 1294, 1296
(CA7 1975); California ex rel. Younger v. Tahoe Regional Planning Agency, 516
F.2d 215, 217 (CA9), cert. denied, 423 U.S. 868 (1975); Natural Resources
Defense Council, Inc. v. Morton, 148 U.S. App. D.C. 5, 10, 458 F.2d 827, 832
(1972); Benda v. Grand Lodge, 584 F.2d 308, 314 (CA9 1978), cert. dism'd, 441
U.S. 937 (1979); FTC v. Southwest Sunsites, Inc., 665 F.2d 711, 717 (CA5), cert.
denied, 456 U.S. 973 (1982).
[Footnote 9] Not before us are: 3203
(definition of "abortion"); 3205 (24-hour waiting period and physician-only
counselling); 3207(b) and 3214(f) (public disclosure of reports); 3209
(requirement of hospitalization for an abortion subsequent to the first
trimester); 3210(a) (penalties for abortion after viability, and the "complete
defense" thereto); 3215(c) (proscription of use of public funds for abortion
services); and 3215(e) (compulsory availability of insurance excluding certain
abortion services).
Remanded for record development or otherwise not invalidated, and therefore
not before us, are: 3206 (parental consent - operation of statute enjoined until
promulgation of rules by the Supreme Court of Pennsylvania assuring
confidentiality and promptness of disposition); 3207(b) (abortion facilities and
reports from them for public disclosure); and 3214(c), (d), (f), and (g) (other
reporting requirements - challenges either not made or withdrawn).
On June 17, 1985, the District Court, after hearing, preliminarily enjoined
the enforcement of 3207(b) and 3214(f). 613 F. Supp. 656 (ED Pa.). See n. 12,
infra.
The Supreme Court of Pennsylvania issued the suggested rules, mentioned
above, on November 26, 1984, after the appeal in this case was docketed here.
See Pennsylvania Orphans' Court Rules 16.1 to 16.8, reprinted in Pa. Stat. Ann.,
Tit. 20, pp. 65, 66 (Purdon Supp. to 101-2507, 1986-1987). Appellants thereupon
filed a motion with the District Court that the injunction against enforcement
of 3206 be vacated. App. 53a. That court, however, denied the motion, concluding
that it had no jurisdiction "to issue the order [appellants] seek" while the
case was on appeal here. Id., at 57a, 61a. We decline appellants' suggestion
that we now examine this feature of the case in the light of the new rules, for
we conclude that this development should be considered by the District Court in
the first instance.
[Footnote 10] Following this Court's
lead in Akron, federal courts consistently have stricken fetal-description
requirements because of their inflammatory impact. See, e. g., Planned
Parenthood League of Massachusetts v. Bellotti, 641 F.2d 1006, 1021-1022 (CA1
1981); Charles v. Carey, 627 F.2d 772, [476 U.S.
747, 763]
784 (CA7 1980); Planned Parenthood Assn. of Kansas City v. Ashcroft, 655 F.2d
848, 868 (CA8 1981); Women's Medical Center of Providence, Inc. v. Roberts, 530
F. Supp. 1136, 1152-1154 (RI 1982).
[Footnote 11] In their argument against
this conclusion, appellants claim that the informational requirements must be
held constitutional in the light of this Court's summary affirmance in Franklin
v. Fitzpatrick, 428 U.S. 901 (1976), of the judgment in Planned Parenthood Assn.
v. Fitzpatrick, 401 F. Supp. 554 (ED Pa. 1975). That litigation concerned the
Commonwealth's 1974 Abortion Control Act. Its informed-consent provision,
however, did not contain such plainly unconstitutional informational requests as
those in the current Act, or any physician-only counselling or 24-hour
waiting-period requirements. The summary affirmance also preceded the decision
in Akron and, to the extent, if any at all, it might be considered to be
inconsistent with Akron, the latter, of course, controls.
[Footnote 12] Appellees advise us, see
Brief for Appellees 38-39, that they sought in the District Court a preliminary
injunction against the requirement that the facility identification report and
the quarterly statistical report be made available for public inspection and
copying, and that on June 17, 1985, after full hearing, the District Court
entered a preliminary injunction against the enforcement of these
public-disclosure requirements. Appellees assert that the record of that hearing
shows a continuous pattern of violence and harassment directed against the
patients and staff of abortion clinics; that the District Court concluded that
this would be increased by the public disclosure of facility names and quarterly
statistical reports; and that public disclosure would impose a burden on the
woman's right to an abortion by heightening her fear and anxiety, and by
discouraging her physician from offering an abortion because, by so doing, he
would avoid pressure from anti-abortion forces. That record, of course, is not
now before us. We need place no reliance upon it and we draw no conclusion from
it.
[Footnote 13] Section 3210(b) reads:
"Every person who performs or induces an abortion after an unborn child has
been determined to be viable shall exercise that degree of professional
skill, care and diligence which such person would be required to exercise in
order to preserve the life and health of any unborn child intended to be
born and not aborted and the abortion technique employed shall be that which
would provide the best opportunity for the unborn child to be aborted alive
unless, in the good faith judgment of the physician, that method or
technique would present a significantly greater medical risk to the life or
health of the pregnant woman than would another available method or
technique and the physician reports the basis for his judgment. The
potential psychological or emotional impact on the mother of the unborn
child's survival shall not be deemed a medical risk to the mother. Any
person who intentionally, knowingly or recklessly violates the provisions of
this subsection commits a felony of the third degree."
[Footnote 14] This makes it unnecessary
for us to consider appellees' further argument that 3210(b) is void for
vagueness.
[Footnote 15] Section 3210(c) reads:
"Any person who intends to perform an abortion the method chosen for which,
in his good faith judgment, does not preclude the possibility of the child
surviving the abortion, shall arrange for the attendance, in the same room
in which the abortion is to be completed, of a second physician. Immediately
after the complete expulsion or extraction of the child, the second
physician shall take control of the child and shall provide immediate
medical care for the child, taking all reasonable steps necessary, in his
[476 U.S. 747, 770] judgment, to preserve the child's life and
health. Any person who intentionally, knowingly or recklessly violates the
provisions of this subsection commits a felony of the third degree."
[Footnote 16] JUSTICE O'CONNOR, joined
by JUSTICE WHITE and REHNQUIST, stated somewhat categorically that the
second-physician requirement was constitutional. 462 U.S., at 505.
[Footnote 17] Section 3210(a) reads:
"Any person who intentionally, knowingly or recklessly performs or induces
an abortion when the fetus is viable commits a felony of the third degree.
It shall be a complete defense to any charge brought against a physician for
violating the requirements of this section that he had concluded in good
faith, in his best medical judgment, that the unborn child was not viable at
the time the abortion was performed or induced or that the abortion was
necessary to preserve maternal life or health."
JUSTICE STEVENS, concurring.
The scope of the individual interest in liberty that is given protection by
the Due Process Clause of the Fourteenth Amendment is a matter about which
conscientious judges have long disagreed. Although I believe that that interest
is significantly broader than JUSTICE WHITE does,1 I have always [476 U.S. 747, 773] had the highest respect for his views
on this subject.2
In this case, although our ultimate conclusions differ, it may be useful to
emphasize some of our areas of agreement in order to ensure that the clarity of
certain fundamental propositions not be obscured by his forceful rhetoric.
Let me begin with a reference to Griswold v. Connecticut, 381 U.S. 479
(1965), the case holding that a State may not totally forbid the use of birth
control devices. Although the Court's opinion relied on a "right of marital
privacy" within the "penumbra" of the Bill of Rights, id., at 481-486, JUSTICE
WHITE's concurring opinion went right to the heart of the issue. He wrote:
"It would be unduly repetitious, and belaboring the obvious, to expound on
the impact of this statute on the liberty guaranteed by the Fourteenth
Amendment against arbitrary or capricious denials or on the nature of this
liberty. Suffice it to say that this is not the first time this Court has
had occasion to articulate that the liberty entitled to protection under the
Fourteenth Amendment includes the right `to marry, establish a home and
bring up children,' Meyer v. Nebraska, 262 U.S. 390, 399, and `the liberty .
. . to direct the upbringing and education of children,' Pierce v. Society
of Sisters, 268 U.S. 510, 534-535, and that these are among `the basic civil
rights of man.' Skinner v. Oklahoma, 316 U.S. 535, 541. These decisions
affirm that there is a `realm of family life which the state cannot enter'
without substantial justification. Prince v. Massachusetts, 321 U.S. 158,
166. Surely the right invoked in this case, to be free of regulation of the
intimacies of the marriage relationship, `come[s] to this Court with a
momentum for respect lacking when appeal is made to liberties which derive
merely from shifting economic arrangements.'
[476 U.S. 747, 774] Kovacs v. Cooper, 336 U.S. 77, 95 (opinion of
Frankfurter, J.)." Id., at 502-503 (WHITE, J., concurring in the judgment).
He concluded that the statute could not be constitutionally applied to
married persons, explaining:
"I find nothing in this record justifying the sweeping scope of this
statute, with its telling effect on the freedoms of married persons, and
therefore conclude that it deprives such persons of liberty without due
process of law." Id., at 507.
That conclusion relied in part on the fact that the statute involved
"sensitive areas of liberty"3 and in part on the absence of any colorable justification for
applying the statute to married couples.
In Eisenstadt v. Baird, 405 U.S. 438 (1972), JUSTICE WHITE concluded that a
similar Massachusetts statute was invalid as applied to a person whom the record
did not identify as either married or unmarried, id., at 464-465, and in Carey
v. Population Services International, 431 U.S. 678 (1977), he subscribed to this
explanation of the holdings in Griswold and Eisenstadt:
"The fatal fallacy in [the appellants'] argument is that it overlooks the
underlying premise of those decisions that the Constitution protects `the
right of the individual [476 U.S. 747, 775]
. . . to be free from unwarranted governmental intrusion into . . . the
decision whether to bear or beget a child.' [Eisenstadt v. Baird, 405 U.S.]
at 453. Griswold did state that by `forbidding the use of contraceptives
rather than regulating their manufacture or sale,' the Connecticut statute
there had `a maximum destructive impact' on privacy rights. 381 U.S., at
485. This intrusion into `the sacred precincts of marital bedrooms' made
that statute particularly `repulsive.' Id., at 485-486. But subsequent
decisions have made clear that the constitutional protection of individual
autonomy in matters of childbearing is not dependent on that element.
Eisenstadt v. Baird, holding that the protection is not limited to married
couples, characterized the protected right as the `decision whether to bear
or beget a child.' 405 U.S., at 453 (emphasis added). Similarly, Roe v.
Wade, held that the Constitution protects `a woman's decision whether or not
to terminate her pregnancy.' 410 U.S., at 153 (emphasis added). See also
Whalen v. Roe, [429 U.S. 589,] 599-600, and n. 26. These decisions put
Griswold in proper perspective. Griswold may no longer be read as holding
only that a State may not prohibit a married couple's use of contraceptives.
Read in light of its progeny, the teaching of Griswold is that the
Constitution protects individual decisions in matters of childbearing from
unjustified intrusion by the State." 431 U.S., at 687; id., at 702 (WHITE,
J., concurring in pertinent part and concurring in result).
Thus, the aspect of liberty at stake in this case is the freedom from
unwarranted governmental intrusion into individual decisions in matters of
childbearing. As JUSTICE WHITE explained in Griswold, that aspect of liberty
comes to this Court with a momentum for respect that is lacking when appeal is
made to liberties which derive merely from shifting economic arrangements.
[476 U.S. 747, 776]
Like the birth control statutes involved in Griswold and Baird, the abortion
statutes involved in Roe v. Wade, 410 U.S. 113 (1973), and in the case before us
today apply equally to decisions made by married persons and by unmarried
persons. Consistently with his views in those cases, JUSTICE WHITE agrees that
"a woman's ability to choose an abortion is a species of `liberty' that is
subject to the general protections of the Due Process Clause." Post, at 790. His
agreement with that "indisputable" proposition, ibid., is not qualified or
limited to decisions made by pregnant women who are married and, indeed, it
would be a strange form of liberty if it were so limited.
Up to this point in JUSTICE WHITE's analysis, his opinion is fully consistent
with the accepted teachings of the Court and with the major premises of Roe v.
Wade. For reasons that are not entirely clear, however, JUSTICE WHITE abruptly
announces that the interest in "liberty" that is implicated by a decision not to
bear a child that is made a few days after conception is less fundamental than a
comparable decision made before conception. Post, at 791-792. There may, of
course, be a significant difference in the strength of the countervailing state
interest, but I fail to see how a decision on childbearing becomes less
important the day after conception than the day before. Indeed, if one decision
is more "fundamental" to the individual's freedom than the other, surely it is
the postconception decision that is the more serious. Thus, it is difficult for
me to understand how JUSTICE WHITE reaches the conclusion that restraints upon
this aspect of a woman's liberty do not "call into play anything more than the
most minimal judicial scrutiny." Post, at 790.4 [476 U.S. 747, 777]
If JUSTICE WHITE were correct in regarding the post-conception decision of
the question whether to bear a child as a relatively unimportant, second-class
sort of interest, I might agree with his view that the individual should be
required to conform her decision to the will of the majority. But if that
decision commands the respect that is traditionally associated with the
"sensitive areas of liberty" protected by the Constitution, as JUSTICE WHITE
characterized reproductive decisions in Griswold, 381 U.S., at 503, no
individual should be compelled to surrender the freedom to make that decision
for herself simply because her "value preferences" are not shared by the
majority.5
In a sense, the basic question is whether the "abortion decision" should be made
by the individual or by the majority "in the unrestrained imposition [476 U.S. 747, 778] of its own, extraconstitutional value
preferences." Post, at 794. But surely JUSTICE WHITE is quite wrong in
suggesting that the Court is imposing value preferences on anyone else. Ibid.6
JUSTICE WHITE is also surely wrong in suggesting that the governmental
interest in protecting fetal life is equally compelling during the entire period
from the moment of conception until the moment of birth. Post, at 795. Again, I
recognize that a powerful theological argument can be made for that position,
but I believe our jurisdiction is limited to the evaluation of secular state
interests.7 I should think it obvious that the State's interest in the
protection of an embryo - even if that interest is defined as "protecting those
who will be citizens," ibid. - increases progressively and dramatically as the
organism's capacity to feel pain, to experience pleasure, to survive, and to
react to its surroundings increases day by day. The development of a fetus - and
pregnancy itself - are not static conditions, and the assertion that the
government's interest is static simply ignores this reality.
[476 U.S. 747, 779]
Nor is it an answer to argue that life itself is not a static condition, and
that "there is no nonarbitrary line separating a fetus from a child, or indeed,
an adult human being," post, at 792. For, unless the religious view that a fetus
is a "person" is adopted - a view JUSTICE WHITE refuses to embrace, ibid. -
there is a fundamental and well-recognized difference between a fetus and a
human being; indeed, if there is not such a difference, the permissibility of
terminating the life of a fetus could scarcely be left to the will of the state
legislatures.8 And if distinctions may be drawn between a fetus and a human
being in terms of the state interest in their protection - even though the fetus
represents one of "those who will be citizens" - it seems to me quite odd to
argue that distinctions may not also be drawn between the state interest in
protecting the freshly fertilized egg and the state interest in protecting the
9-month-gestated, fully sentient fetus on the eve of birth. Recognition of this
distinction is supported not only by logic, but also by history9 and by our shared experiences.
Turning to JUSTICE WHITE's comments on stare decisis, he is of course correct
in pointing out that the Court "has not hesitated to overrule decisions, or even
whole lines of cases, where experience, scholarship, and reflection demonstrated
that their fundamental premises were not to be found in the Constitution." Post,
at 787. But JUSTICE WHITE has not disavowed the "fundamental premises" on which
the decision in Roe v. Wade rests. He has not disavowed the Court's prior
approach to the interpretation of the word "liberty" or, more narrowly, the line
of cases that culminated in the unequivocal holding, applied to unmarried
persons and married persons alike, "that the Constitution protects individual
decisions in matters of childbearing from unjustified intrusion by
[476 U.S. 747, 780] the State." Carey, 431 U.S., at 687; id., at 702
(WHITE, J., concurring in pertinent part).10
Nor does the fact that the doctrine of stare decisis is not an absolute bar
to the reexamination of past interpretations of the Constitution mean that the
values underlying that doctrine may be summarily put to one side. There is a
strong public interest in stability, and in the orderly conduct of our
[476 U.S. 747, 781] affairs, that is served by a consistent course of
constitutional adjudication. Acceptance of the fundamental premises that
underlie the decision in Roe v. Wade, as well as the application of those
premises in that case, places the primary responsibility for decision in matters
of childbearing squarely in the private sector of our society.11 The majority remains free to preach the
evils of birth control and abortion and to persuade others to make correct
decisions while the individual faced with the reality of a difficult choice
having serious and personal consequences of major importance to her own future -
perhaps to the salvation of her own immortal soul - remains free to seek and to
obtain sympathetic guidance from those who share her own value preferences.
In the final analysis, the holding in Roe v. Wade presumes that it is far
better to permit some individuals to make incorrect decisions than to deny all
individuals the right to make decisions that have a profound effect upon their
destiny. Arguably a very primitive society would have been protected from evil
by a rule against eating apples; a majority familiar with Adam's experience
might favor such a rule. But the lawmakers who placed a special premium on the
protection of [476 U.S. 747, 782]
individual liberty have recognized that certain values are more important than
the will of a transient majority.12
[Footnote 1] Compare, e. g., his
opinion for the Court in Meachum v. Fano, 427 U.S. 215 (1976), with my dissent
in that case, id., at 229.
[Footnote 2] See, e. g., Stevens,
Judicial Restraint, 22 San Diego L. Rev. 437, 449-450 (1985).
[Footnote 3] "The nature of the right
invaded is pertinent, to be sure, for statutes regulating sensitive areas of
liberty do, under the cases of this Court, require `strict scrutiny,' Skinner v.
Oklahoma, 316 U.S. 535, 541, and `must be viewed in the light of less drastic
means for achieving the same basic purpose.' Shelton v. Tucker, 364 U.S. 479,
488. `Where there is a significant encroachment upon personal liberty, the State
may prevail only upon showing a subordinating interest which is compelling.'
Bates v. Little Rock, 361 U.S. 516, 524. See also McLaughlin v. Florida, 379
U.S. 184. But such statutes, if reasonably necessary for the effectuation of a
legitimate and substantial state interest, and not arbitrary or capricious in
application, are not invalid under the Due Process Clause. Zemel v. Rusk, 381
U.S. 1." 381 U.S., at 503-504.
[Footnote 4] At times JUSTICE WHITE's
rhetoric conflicts with his own analysis. For instance, his emphasis on the lack
of a decision by "the people . . . in 1787, 1791, 1868, or any time since,"
post, at 797, stands in sharp contrast to his earlier, forthright rejection of
"the simplistic view that constitutional interpretation can possibly be limited
to `the plain meaning' of the Constitution's text or to the subjective intention
of the Framers." Post, at 789. Similarly, his statement that an abortion
decision should be [476 U.S. 747, 777]
subject to "the will of the people," post, at 796, does not take us very far in
determining which people - the majorities in state legislatures or the
individuals confronted with unwanted pregnancies. In view of his agreement that
the decision about abortion is "a species of liberty" protected by the
Constitution, moreover, post, at 790, and in view of the fact that "liberty"
plays a rather prominent role in our Constitution, his suggestion that the
Court's evaluation of that interest represents the imposition of
"extraconstitutional value preferences," post, at 794, seems to me inexplicable.
This characterization of the Court's analysis as "extraconstitutional" also does
not reflect JUSTICE WHITE's simultaneous recognition that "[t]he Constitution .
. . is a document announcing fundamental principles in value-laden terms that
leave ample scope for the exercise of normative judgment by those charged with
interpreting and applying it." Post, at 789. Finally, I fail to see how the fact
that "men and women of good will and high commitment to constitutional
government," post, at 793, are on both sides of the abortion issue helps to
resolve the difficult constitutional question before us; I take it that the
disputants in most constitutional controversies in our free society can be
similarly characterized.
[Footnote 5] "What a person is, what
he wants, the determination of his life plan, of his concept of the good, are
the most intimate expressions of self-determination, and by asserting a person's
responsibility for the results of this self-determination we give substance to
the concept of liberty." C. Fried, Right and Wrong, 146-147 (1978).
See also Fried, Correspondence, 6 Phil. & Pub. Aff. 288-289 (1977) (the
concept of privacy embodies the "moral fact that a person belongs to himself and
not others nor to society as a whole").
[Footnote 6] JUSTICE WHITE's
characterization of the governmental interest as "protecting those who will be
citizens if their lives are not ended in the womb," post, at 795, reveals that
his opinion may be influenced as much by his own value preferences as by his
view about the proper allocation of decisionmaking responsibilities between the
individual and the State. For if federal judges must allow the State to make the
abortion decision, presumably the State is free to decide that a woman may never
abort, may sometimes abort, or, as in the People's Republic of China, must
always abort if her family is already too large. In contrast, our cases
represent a consistent view that the individual is primarily responsible for
reproductive decisions, whether the State seeks to prohibit reproduction,
Skinner v. Oklahoma, 316 U.S. 535 (1942), or to require it, Roe v. Wade, 410
U.S. 113 (1973).
[Footnote 7] The responsibility for
nurturing the soul of the newly born, as well as the unborn, rests with
individual parents, not with the State. No matter how important a sacrament such
as baptism may be, a State surely could not punish a mother for refusing to
baptize her child.
[Footnote 8] No Member of this Court
has ever suggested that a fetus is a "person" within the meaning of the
Fourteenth Amendment.
[Footnote 9] See Roe v. Wade, supra, at
129-147.
[Footnote 10] He has, however,
suggested that the concept of "liberty" is limited by two basic "definitions" of
the values at stake. Post, at 790-791. Like JUSTICE WHITE, I share Justice
Harlan's concern about "judges . . . roaming at large in the constitutional
field." Ibid.; see also Stevens, 22 San Diego L. Rev., at 449-450. But I am
convinced that JUSTICE WHITE's use of "definitions" is an inadequate substitute
for the difficult process of analysis and judgment that the guarantee of liberty
requires, a process nowhere better expressed than by Justice Harlan:
"Due process has not been reduced to any formula; its content cannot be
determined by reference to any code. The best that can be said is that
through the course of this Court's decisions it has represented the balance
which our Nation, built upon postulates of respect for the liberty of the
individual, has struck between that liberty and the demands of organized
society. If the supplying of content to this Constitutional concept has of
necessity been a rational process, it certainly has not been one where
judges have felt free to roam where unguided speculation might take them.
The balance of which I speak is the balance struck by this country, having
regard to what history teaches are the traditions from which it developed as
well as the traditions from which it broke. That tradition is a living
thing. A decision of this Court which radically departs from it could not
long survive, while a decision which builds on what has survived is likely
to be sound. No formula could serve as a substitute, in this area, for
judgment and restraint.
. . . . .
"Each new claim to Constitutional protection must be considered against a
background of Constitutional purposes, as they have been rationally
perceived and historically developed. Though we exercise limited and sharply
restrained judgment, yet there is no `mechanical yardstick,' no `mechanical
answer.' The decision of an apparently novel claim must depend on grounds
which follow closely on well-accepted principles and criteria. The new
decision must take `its place in relation to what went before and further
[cut] a channel for what is to come.' Irvine v. California, 347 U.S. 128,
147 (dissenting opinion)." Poe v. Ullman, 367 U.S. 497, 542-544 (1961)
(Harlan, J., dissenting).
[Footnote 11] "These cases do not deal
with the individual's interest in protection from unwarranted public attention,
comment, or exploitation. They deal, rather, with the individual's right to make
certain unusually important decisions that will affect his own, or his family's,
destiny. The Court has referred to such decisions as implicating `basic values,'
as being `fundamental,' and as being dignified by history and tradition. The
character of the Court's language in these cases brings to mind the origins of
the American heritage of freedom - the abiding interest in individual liberty
that makes certain state intrusions on the citizen's right to decide how he will
live his own life intolerable. Guided by history, our tradition of respect for
the dignity of individual choice in matters of conscience and the restraints
implicit in the federal system, federal judges have accepted the responsibility
for recognition and protection of these rights in appropriate cases." Fitzgerald
v. Porter Memorial Hospital, 523 F.2d 716, 719-720 (CA7 1975) (footnotes
omitted), cert. denied, 425 U.S. 916 (1976).
[Footnote 12] "The very purpose of a
Bill of Rights was to withdraw certain subjects from the vicissitudes of
political controversy, to place them beyond the reach of majorities and
officials and to establish them as legal principles to be applied by the courts.
One's right to life, liberty, and property, to free speech, a free press,
freedom of worship and assembly, and other fundamental rights may not be
submitted to vote; they depend on the outcome of no elections." West Virginia
Board of Education v. Barnette, 319 U.S. 624, 638 (1943).
CHIEF JUSTICE BURGER, dissenting.
I agree with much of JUSTICE WHITE's and JUSTICE O'CONNOR's dissents. In my
concurrence in the companion case to Roe v. Wade, 410 U.S. 113, in 1973, I
noted:
"I do not read the Court's holdings today as having the sweeping
consequences attributed to them by the dissenting Justices; the dissenting
views discount the reality that the vast majority of physicians observe the
standards of their profession, and act only on the basis of carefully
deliberated medical judgments relating to life and health. Plainly, the
Court today rejects any claim that the Constitution requires abortions on
demand." Doe v. Bolton, 410 U.S. 179, 208 (1973).
Later, in Maher v. Roe, 432 U.S. 464, 481 (1977), I stated my view that
"[t]he Court's holdings in Roe . . . and Doe v. Bolton . . . simply require
that a State not create an absolute barrier to a woman's decision to have an
abortion."
I based my concurring statements in Roe and Maher on the principle expressed
in the Court's opinion in Roe that the right to an abortion "is not unqualified
and must be considered against important state interests in regulation." 410
U.S., at 154-155. In short, every Member of the Roe Court rejected the idea of
abortion on demand. The Court's opinion today, however, plainly undermines that
important [476 U.S. 747, 783] principle, and I regretfully
conclude that some of the concerns of the dissenting Justices in Roe, as well as
the concerns I expressed in my separate opinion, have now been realized.
The extent to which the Court has departed from the limitations expressed in
Roe is readily apparent. In Roe, the Court emphasized
"that the State does have an important and legitimate interest in
preserving and protecting the health of the pregnant woman . . . ." Id., at
162.
Yet today the Court astonishingly goes so far as to say that the State may
not even require that a woman contemplating an abortion be provided with
accurate medical information concerning the risks inherent in the medical
procedure which she is about to undergo and the availability of state-funded
alternatives if she elects not to run those risks. Can anyone doubt that the
State could impose a similar requirement with respect to other medical
procedures? Can anyone doubt that doctors routinely give similar information
concerning risks in countless procedures having far less impact on life and
health, both physical and emotional than an abortion, and risk a malpractice
lawsuit if they fail to do so?
Yet the Court concludes that the State cannot impose this simple
information-dispensing requirement in the abortion context where the decision is
fraught with serious physical, psychological, and moral concerns of the highest
order. Can it possibly be that the Court is saying that the Constitution forbids
the communication of such critical information to a woman?* We
have apparently already passed the point at [476
U.S. 747, 784]
which abortion is available merely on demand. If the statute at issue here is to
be invalidated, the "demand" will not even have to be the result of an informed
choice.
The Court in Roe further recognized that the State "has still another
important and legitimate interest" which is "separate and distinct" from the
interest in protecting maternal health, i. e., an interest in "protecting the
potentiality of human life." Ibid. The point at which these interests become
"compelling" under Roe is at viability of the fetus. Id., at 163. Today,
however, the Court abandons that standard and renders the solemnly stated
concerns of the 1973 Roe opinion for the interests of the states mere shallow
rhetoric. The statute at issue in this case requires that a second physician be
present during an abortion performed after viability, so that the second
physician can "take control of the child and . . . provide immediate medical
care . . . taking all reasonable steps necessary, in his judgment, to preserve
the child's life and health." 18 Pa. Cons. Stat. 3210(c) (1982).
Essentially this provision simply states that a viable fetus is to be cared
for, not destroyed. No governmental power exists to say that a viable fetus
should not have every protection required to preserve its life. Undoubtedly the
Pennsylvania Legislature added the second-physician requirement on the mistaken
assumption that this Court meant what it said in Roe concerning the "compelling
interest" of the states in potential life after viability.
The Court's opinion today is but the most recent indication of the distance
traveled since Roe. Perhaps the first important road marker was the Court's
holding in Planned Parenthood of Central Missouri v. Danforth, 428 U.S. 52
(1976), in which the Court held (over the dissent of JUSTICE WHITE [476 U.S. 747, 785] joined by JUSTICE REHNQUIST and
myself) that the State may not require that minors seeking an abortion first
obtain parental consent. Parents, not judges or social workers, have the
inherent right and responsibility to advise their children in matters of this
sensitivity and consequence. Can one imagine a surgeon performing an amputation
or even an appendectomy on a 14-year-old girl without the consent of a parent or
guardian except in an emergency situation?
Yet today the Court goes beyond Danforth by remanding for further
consideration of the provisions of Pennsylvania's statute requiring that a minor
seeking an abortion without parental consent petition the appropriate court for
authorization. Even if I were to agree that the Constitution requires that the
states may not provide that a minor receive parental consent before undergoing
an abortion, I would certainly hold that judicial approval may be required. This
is in keeping with the longstanding common-law principle that courts may
function in loco parentis when parents are unavailable or neglectful, even
though courts are not very satisfactory substitutes when the issue is whether a
12-, 14-, or 16-year-old unmarried girl should have an abortion. In my view, no
remand is necessary on this point because the statutory provision in question is
constitutional.
In discovering constitutional infirmities in state regulations of abortion
that are in accord with our history and tradition, we may have lured judges into
"roaming at large in the constitutional field." Griswold v. Connecticut, 381
U.S. 479, 502 (1965) (Harlan, J., concurring). The soundness of our holdings
must be tested by the decisions that purport to follow them. If Danforth and
today's holding really mean what they seem to say, I agree we should reexamine
Roe.
[Footnote *] The Court's astounding rationale for this
holding is that such information might have the effect of "discouraging
abortion," ante, at 762, as though abortion is something to be advocated and
encouraged. This is at odds not only with Roe but with our subsequent abortion
decisions as well. As I stated in my opinion for the Court in H. L. v. Matheson,
450 U.S. 398 (1981), upholding a Utah statute requiring that a doctor notify the
parents of a minor seeking an abortion: "The Constitution does not compel a
state [476 U.S. 747, 784] to fine-tune its statutes so as to
encourage or facilitate abortions. To the contrary, state action `encouraging
childbirth except in the most urgent circumstances' is `rationally related to
the legitimate governmental objective of protecting potential life.'" Id., at
413 (quoting Harris v. McRae, 448 U.S. 297, 325 (1980)).
JUSTICE WHITE, with whom JUSTICE REHNQUIST joins, dissenting.
Today the Court carries forward the "difficult and continuing venture in
substantive due process," Planned Parenthood of Central Missouri v. Danforth,
428 U.S. 52 (1976) [476 U.S. 747, 786]
(WHITE, J., dissenting), that began with the decision in Roe v. Wade, 410 U.S.
113 (1973), and has led the Court further and further afield in the 13 years
since that decision was handed down. I was in dissent in Roe v. Wade and am in
dissent today. In Part I below, I state why I continue to believe that this
venture has been fundamentally misguided since its inception. In Part II, I
submit that even accepting Roe v. Wade, the concerns underlying that decision by
no means command or justify the results reached today. Indeed, in my view, our
precedents in this area, applied in a manner consistent with sound principles of
constitutional adjudication, require reversal of the Court of Appeals on the
ground that the provisions before us are facially constitutional.1
I
The rule of stare decisis is essential if case-by-case
judicial decisionmaking is to be reconciled with the principle of the [476 U.S. 747, 787] rule of law, for when governing legal
standards are open to revision in every case, deciding cases becomes a mere
exercise of judicial will, with arbitrary and unpredictable results. But stare
decisis is not the only constraint upon judicial decisionmaking. Cases - like
this one - that involve our assumed power to set aside on grounds of
unconstitutionality a state or federal statute representing the democratically
expressed will of the people call other considerations into play. Because the
Constitution itself is ordained and established by the people of the United
States, constitutional adjudication by this Court does not, in theory at any
rate, frustrate the authority of the people to govern themselves through
institutions of their own devising and in accordance with principles of their
own choosing. But decisions that find in the Constitution principles or values
that cannot fairly be read into that document usurp the people's authority, for
such decisions represent choices that the people have never made and that they
cannot disavow through corrective legislation. For this reason, it is essential
that this Court maintain the power to restore authority to its proper possessors
by correcting constitutional decisions that, on reconsideration, are found to be
mistaken.
The Court has therefore adhered to the rule that stare decisis is not rigidly
applied in cases involving constitutional issues, see Glidden Co. v. Zdanok, 370
U.S. 530, 543 (1962) (opinion of Harlan, J.), and has not hesitated to overrule
decisions, or even whole lines of cases, where experience, scholarship, and
reflection demonstrated that their fundamental premises were not to be found in
the Constitution. Stare decisis did not stand in the way of the Justices who, in
the late 1930's, swept away constitutional doctrines that had placed unwarranted
restrictions on the power of the State and Federal Governments to enact social
and economic legislation, see United States v. Darby, 312 U.S. 100 (1941); West
Coast Hotel Co. v. Parrish, 300 U.S. 379 (1937). Nor did stare decisis deter a
different set of Justices, some 15 years [476 U.S. 747, 788] later, from rejecting the
theretofore prevailing view that the Fourteenth Amendment permitted the States
to maintain the system of racial segregation. Brown v. Board of Education, 347
U.S. 483 (1954). In both instances, history has been far kinder to those who
departed from precedent than to those who would have blindly followed the rule
of stare decisis. And only last Term, the author of today's majority opinion
reminded us once again that "when it has become apparent that a prior decision
has departed from a proper understanding" of the Constitution, that decision
must be overruled. Garcia v. San Antonio Metropolitan Transit Authority, 469
U.S. 528, 557 (1985).
In my view, the time has come to recognize that Roe v. Wade, no less than the
cases overruled by the Court in the decisions I have just cited, "departs from a
proper understanding" of the Constitution and to overrule it. I do not claim
that the arguments in support of this proposition are new ones or that they were
not considered by the Court in Roe or in the cases that succeeded it. Cf. Akron
v. Akron Center for Reproductive Health, Inc., 462 U.S. 416, 419-420 (1983). But
if an argument that a constitutional decision is erroneous must be novel in
order to justify overruling that precedent, the Court's decisions in Lochner v.
New York, 198 U.S. 45 (1905), and Plessy v. Ferguson, 163 U.S. 537 (1896), would
remain the law, for the doctrines announced in those decisions were nowhere more
eloquently or incisively criticized than in the dissenting opinions of Justices
Holmes (in Lochner) and Harlan (in both cases). That the flaws in an opinion
were evident at the time it was handed down is hardly a reason for adhering to
it.
A
Roe v. Wade posits that a woman has a fundamental right to
terminate her pregnancy, and that this right may be restricted only in the
service of two compelling state interests: the interest in maternal health
(which becomes compelling [476 U.S. 747, 789] only at the stage in pregnancy at
which an abortion becomes more hazardous than carrying the pregnancy to term)
and the interest in protecting the life of the fetus (which becomes compelling
only at the point of viability). A reader of the Constitution might be surprised
to find that it encompassed these detailed rules, for the text obviously
contains no references to abortion, nor, indeed, to pregnancy or reproduction
generally; and, of course, it is highly doubtful that the authors of any of the
provisions of the Constitution believed that they were giving protection to
abortion. As its prior cases clearly show, however, this Court does not
subscribe to the simplistic view that constitutional interpretation can possibly
be limited to the "plain meaning" of the Constitution's text or to the
subjective intention of the Framers. The Constitution is not a deed setting
forth the precise metes and bounds of its subject matter; rather, it is a
document announcing fundamental principles in value-laden terms that leave ample
scope for the exercise of normative judgment by those charged with interpreting
and applying it. In particular, the Due Process Clause of the Fourteenth
Amendment, which forbids the deprivation of "life, liberty, or property without
due process of law," has been read by the majority of the Court to be broad
enough to provide substantive protection against state infringement of a broad
range of individual interests. See Moore v. East Cleveland, 431 U.S. 494,
541-552 (1977) (WHITE, J., dissenting).
In most instances, the substantive protection afforded the liberty or
property of an individual by the Fourteenth Amendment is extremely limited:
State action impinging on individual interests need only be rational to survive
scrutiny under the Due Process Clause, and the determination of rationality is
to be made with a heavy dose of deference to the policy choices of the
legislature. Only "fundamental" rights are entitled to the added protection
provided by strict judicial scrutiny of legislation that impinges upon them. See
id., at 499 (opinion of POWELL, J.); id., at 537 (Stewart, J., joined by [476 U.S. 747, 790] REHNQUIST, J., dissenting);
id., at 547-549 (WHITE, J., dissenting). I can certainly agree with the
proposition - which I deem indisputable - that a woman's ability to choose an
abortion is a species of "liberty" that is subject to the general protections of
the Due Process Clause. I cannot agree, however, that this liberty is so
"fundamental" that restrictions upon it call into play anything more than the
most minimal judicial scrutiny.
Fundamental liberties and interests are most clearly present when the
Constitution provides specific textual recognition of their existence and
importance. Thus, the Court is on relatively firm ground when it deems certain
of the liberties set forth in the Bill of Rights to be fundamental and therefore
finds them incorporated in the Fourteenth Amendment's guarantee that no State
may deprive any person of liberty without due process of law. When the Court
ventures further and defines as "fundamental" liberties that are nowhere
mentioned in the Constitution (or that are present only in the so-called
"penumbras" of specifically enumerated rights), it must, of necessity, act with
more caution, lest it open itself to the accusation that, in the name of
identifying constitutional principles to which the people have consented in
framing their Constitution, the Court has done nothing more than impose its own
controversial choices of value upon the people.
Attempts to articulate the constraints that must operate upon the Court when
it employs the Due Process Clause to protect liberties not specifically
enumerated in the text of the Constitution have produced varying definitions of
"fundamental liberties." One approach has been to limit the class of fundamental
liberties to those interests that are "implicit in the concept of ordered
liberty" such that "neither liberty nor justice would exist if [they] were
sacrificed." Palko v. Connecticut, 302 U.S. 319, 325, 326 (1937); see Moore v.
East Cleveland, 431 U.S., at 537 (Stewart, J., joined by REHNQUIST, J.,
dissenting). Another, broader approach is [476
U.S. 747, 791] to define fundamental liberties as those that are "deeply
rooted in this Nation's history and tradition." Id., at 503 (opinion of POWELL,
J.); see also Griswold v. Connecticut, 381 U.S. 479, 501 (1965) (Harlan, J.,
concurring). These distillations of the possible approaches to the
identification of unenumerated fundamental rights are not and do not purport to
be precise legal tests or "mechanical yardstick[s]," Poe v. Ullman, 367 U.S.
497, 544 (1961) (Harlan, J., dissenting). Their utility lies in their effort to
identify some source of constitutional value that reflects not the philosophical
predilections of individual judges, but basic choices made by the people
themselves in constituting their system of government - "the balance struck by
this country," id., at 542 (emphasis added) - and they seek to achieve this end
through locating fundamental rights either in the traditions and consensus of
our society as a whole or in the logical implications of a system that
recognizes both individual liberty and democratic order. Whether either of these
approaches can, as Justice Harlan hoped, prevent "judges from roaming at large
in the constitutional field," Griswold, supra, at 502, is debatable. What for me
is not subject to debate, however, is that either of the basic definitions of
fundamental liberties, taken seriously, indicates the illegitimacy of the
Court's decision in Roe v. Wade.
The Court has justified the recognition of a woman's fundamental right to
terminate her pregnancy by invoking decisions upholding claims of personal
autonomy in connection with the conduct of family life, the rearing of children,
marital privacy, the use of contraceptives, and the preservation of the
individual's capacity to procreate. See Carey v. Population Services
International, 431 U.S. 678 (1977); Moore v. East Cleveland, supra; Eisenstadt
v. Baird, 405 U.S. 438 (1972); Griswold v. Connecticut, supra; Skinner v.
Oklahoma, 316 U.S. 535 (1942); Pierce v. Society of Sisters, 268 U.S. 510
(1925); Meyer v. Nebraska, 262 U.S. 390 (1923). Even if each of these cases was
correctly decided [476 U.S. 747, 792] and could be properly grounded in
rights that are "implicit in the concept of ordered liberty" or "deeply rooted
in this Nation's history and tradition," the issues in the cases cited differ
from those at stake where abortion is concerned. As the Court appropriately
recognized in Roe v. Wade, "[t]he pregnant woman cannot be isolated in her
privacy," 410 U.S., at 159; the termination of a pregnancy typically involves
the destruction of another entity: the fetus. However one answers the
metaphysical or theological question whether the fetus is a "human being" or the
legal question whether it is a "person" as that term is used in the
Constitution, one must at least recognize, first, that the fetus is an entity
that bears in its cells all the genetic information that characterizes a member
of the species homo sapiens and distinguishes an individual member of that
species from all others, and second, that there is no nonarbitrary line
separating a fetus from a child or, indeed, an adult human being. Given that the
continued existence and development - that is to say, the life - of such an
entity are so directly at stake in the woman's decision whether or not to
terminate her pregnancy, that decision must be recognized as sui generis,
different in kind from the others that the Court has protected under the rubric
of personal or family privacy and autonomy.2 Accordingly, the [476 U.S. 747, 793] decisions cited by the Court both in
Roe and in its opinion today as precedent for the fundamental nature of the
liberty to choose abortion do not, even if all are accepted as valid, dictate
the Court's classification.
If the woman's liberty to choose an abortion is fundamental, then, it is not
because any of our precedents (aside from Roe itself) command or justify that
result; it can only be because protection for this unique choice is itself
"implicit in the concept of ordered liberty" or, perhaps, "deeply rooted in this
Nation's history and tradition." It seems clear to me that it is neither. The
Court's opinion in Roe itself convincingly refutes the notion that the abortion
liberty is deeply rooted in the history or tradition of our people, as does the
continuing and deep division of the people themselves over the question of
abortion. As for the notion that choice in the matter of abortion is implicit in
the concept of ordered liberty, it seems apparent to me that a free,
egalitarian, and democratic society does not presuppose any particular rule or
set of rules with respect to abortion. And again, the fact that many men and
women of good will and high commitment to constitutional government place
themselves on both sides of the abortion controversy strengthens my own
conviction that the values animating the Constitution do not compel recognition
[476 U.S. 747, 794]
of the abortion liberty as fundamental. In so denominating that liberty, the
Court engages not in constitutional interpretation, but in the unrestrained
imposition of its own, extraconstitutional value preferences.3
B
A second, equally basic error infects the Court's decision in
Roe v. Wade. The detailed set of rules governing state restrictions on abortion
that the Court first articulated in Roe and has since refined and elaborated
presupposes not only that the woman's liberty to choose an abortion is
fundamental, but also that the State's countervailing interest in protecting
fetal life (or, as the Court would have it, "potential human life," 410 U.S., at
159) becomes "compelling" only at the point at which the fetus is viable. As
JUSTICE O'CONNOR pointed out three years ago in her dissent in Akron v. Akron
Center for Reproductive Health, Inc., 462 U.S., at 461, the Court's choice of
viability as the point at which the State's interest becomes compelling is
entirely arbitrary. The Court's "explanation" for the line it has drawn is that
the State's interest becomes compelling at viability "because the fetus then
presumably has the capacity of meaningful life outside the mother's womb." 410
U.S., at 163. As one critic [476 U.S. 747, 795]
of Roe has observed, this argument "mistakes a definition for a syllogism." Ely,
The Wages of Crying Wolf: A Comment on Roe v. Wade, 82 Yale L. J. 920, 924
(1973).
The governmental interest at issue is in protecting those who will be
citizens if their lives are not ended in the womb. The substantiality of this
interest is in no way dependent on the probability that the fetus may be capable
of surviving outside the womb at any given point in its development, as the
possibility of fetal survival is contingent on the state of medical practice and
technology, factors that are in essence morally and constitutionally irrelevant.
The State's interest is in the fetus as an entity in itself, and the character
of this entity does not change at the point of viability under conventional
medical wisdom. Accordingly, the State's interest, if compelling after
viability, is equally compelling before viability.4 [476 U.S. 747, 796]
C
Both the characterization of the abortion liberty as
fundamental and the denigration of the State's interest in preserving the lives
of nonviable fetuses are essential to the detailed set of constitutional rules
devised by the Court to limit the States' power to regulate abortion. If either
or both of these facets of Roe v. Wade were rejected, a broad range of
limitations on abortion (including outright prohibition) that are now
unavailable to the States would again become constitutional possibilities.
In my view, such a state of affairs would be highly desirable from the
standpoint of the Constitution. Abortion is a hotly contested moral and
political issue. Such issues, in our society, are to be resolved by the will of
the people, either as expressed through legislation or through the general
principles they have already incorporated into the Constitution they have
adopted.5 Roe v. Wade implies that the people
[476 U.S. 747, 797] have already resolved the debate by weaving into the
Constitution the values and principles that answer the issue. As I have argued,
I believe it is clear that the people have never - not in 1787, 1791, 1868, or
at any time since - done any such thing. I would return the issue to the people
by overruling Roe v. Wade.
II
As it has evolved in the decisions of this Court, the freedom
recognized by the Court in Roe v. Wade and its progeny is essentially a negative
one, based not on the notion that abortion is a good in itself, but only on the
view that the legitimate goals that may be served by state coercion of private
choices regarding abortion are, at least under some circumstances, outweighed by
the damage to individual autonomy and privacy that such coercion entails. In
other words, the evil of abortion does not justify the evil of forbidding it.
Cf. Stanley v. Georgia, 394 U.S. 557 (1969). But precisely because Roe v. Wade
is not premised on the notion that abortion is itself desirable (either as a
matter of constitutional entitlement or of social policy), the decision does not
command the States to fund or encourage abortion, or even to approve
[476 U.S. 747, 798] of it. Rather, we have
recognized that the States may legitimately adopt a policy of encouraging normal
childbirth rather than abortion so long as the measures through which that
policy is implemented do not amount to direct compulsion of the woman's choice
regarding abortion. Harris v. McRae, 448 U.S. 297 (1980); Maher v. Roe, 432 U.S.
464 (1977); Beal v. Doe, 432 U.S. 438 (1977). The provisions before the Court
today quite obviously represent the State's effort to implement such a policy.
The majority's opinion evinces no deference toward the State's legitimate
policy. Rather, the majority makes it clear from the outset that it simply
disapproves of any attempt by Pennsylvania to legislate in this area. The
history of the state legislature's decade-long effort to pass a constitutional
abortion statute is recounted as if it were evidence of some sinister
conspiracy. See ante, at 751-752. In fact, of course, the legislature's past
failure to predict the evolution of the right first recognized in Roe v. Wade is
understandable and is in itself no ground for condemnation. Moreover, the
legislature's willingness to pursue permissible policies through means that go
to the limits allowed by existing precedents is no sign of mens rea. The
majority, however, seems to find it necessary to respond by changing the rules
to invalidate what before would have seemed permissible. The result is a
decision that finds no justification in the Court's previous holdings, departs
from sound principles of constitutional and statutory interpretation, and unduly
limits the State's power to implement the legitimate (and in some circumstances
compelling) policy of encouraging normal childbirth in preference to abortion.
A
The Court begins by striking down statutory provisions
designed to ensure that the woman's choice of an abortion is fully informed -
that is, that she is aware not only of the reasons for having an abortion, but
also of the risks associated with an abortion and the availability of assistance
that might [476 U.S. 747, 799] make the alternative of normal
childbirth more attractive than it might otherwise appear. At first blush, the
Court's action seems extraordinary: after all, Roe v. Wade purports to be about
freedom of choice, and statutory provisions requiring that a woman seeking an
abortion be afforded information regarding her decision not only do not limit
her ability to choose abortion, but also would appear to enhance her freedom of
choice by helping to ensure that her decision whether or not to terminate her
pregnancy is an informed one. Indeed, maximization of the patient's freedom of
choice - not restriction of his or her liberty - is generally perceived to be
the principal value justifying the imposition of disclosure requirements upon
physicians:
"The root premise is the concept, fundamental in American jurisprudence,
that `[e]very human being of adult years and sound mind has a right to
determine what shall be done with his own body. . . .' True consent to what
happens to one's self is the informed exercise of a choice, and that entails
an opportunity to evaluate knowledgeably the options available and the risks
attendant upon each. The average patient has little or no understanding of
the medical arts, and ordinarily has only his physician to whom he can look
for enlightenment with which to reach an intelligent decision. From these
almost axiomatic considerations springs the need, and in turn the
requirement, of a reasonable divulgence by physician to patient to make such
a decision possible." Canterbury v. Spence, 150 U.S. App. D.C. 263, 271, 464
F.2d 772, 780 (1972).
One searches the majority's opinion in vain for a convincing reason why the
apparently laudable policy of promoting informed consent becomes
unconstitutional when the subject is abortion. The majority purports to find
support in Akron v. Akron Center for Reproductive Health, Inc., 462 U.S. 416
(1983). But Akron is not controlling. The informed-consent
[476 U.S. 747, 800] provisions struck down in that case, as characterized
by the majority, required the physician to advance tendentious statements
concerning the unanswerable question of when human life begins, to offer merely
speculative descriptions of the anatomical features of the fetus carried by the
woman seeking the abortion, and to recite a "parade of horribles" suggesting
that abortion is "a particularly dangerous procedure." Id., at 444-445. I have
no quarrel with the general proposition, for which I read Akron to stand, that a
campaign of state-promulgated disinformation cannot be justified in the name of
"informed consent" or "freedom of choice." But the Pennsylvania statute before
us cannot be accused of sharing the flaws of the ordinance at issue in Akron. As
the majority concedes, the statute does not, on its face, require that the
patient be given any information that is false or unverifiable. Moreover, it is
unquestionable that all of the information required would be relevant in many
cases to a woman's decision whether or not to obtain an abortion.
Why, then, is the statute unconstitutional? The majority's argument, while
primarily rhetorical, appears to offer three answers. First, the information
that must be provided will in some cases be irrelevant to the woman's decision.
This is true. Its pertinence to the question of the statute's constitutionality,
however, is beyond me. Legislators are ordinarily entitled to proceed on the
basis of rational generalizations about the subject matter of legislation, and
the existence of particular cases in which a feature of a statute performs no
function (or is even counterproductive) ordinarily does not render the statute
unconstitutional or even constitutionally suspect. Only where the statute is
subject to heightened scrutiny by virtue of its impingement on some fundamental
right or its employment of a suspect classification does the imprecision of the
"fit" between the statute's ends and means become potentially damning. Here,
there is nothing to trigger such scrutiny, for the statute does not directly
[476 U.S. 747, 801] infringe the allegedly fundamental right at issue -
the woman's right to choose an abortion. Indeed, I fail to see how providing a
woman with accurate information - whether relevant or irrelevant - could ever be
deemed to impair any constitutionally protected interest (even if, as the
majority hypothesizes, the information may upset her). Thus, the majority's
observation that the statute may require the provision of irrelevant information
in some cases is itself an irrelevancy.
Second, the majority appears to reason that the informed-consent provisions
are invalid because the information they require may increase the woman's
"anxiety" about the procedure and even "influence" her in her choice. Again,
both observations are undoubtedly true; but they by no means cast the
constitutionality of the provisions into question. It is in the very nature of
informed-consent provisions that they may produce some anxiety in the patient
and influence her in her choice. This is in fact their reason for existence, and
- provided that the information required is accurate and nonmisleading - it is
an entirely salutary reason. If information may reasonably affect the patient's
choice, the patient should have that information; and, as one authority has
observed, "the greater the likelihood that particular information will influence
[the patient's] decision, the more essential the information arguably becomes
for securing her informed consent." Appleton, Doctors, Patients and the
Constitution, 63 Wash. U. L. Q. 183, 211 (1985). That the result of the
provision of information may be that some women will forgo abortions by no means
suggests that providing the information is unconstitutional, for the ostensible
objective of Roe v. Wade is not maximizing the number of abortions, but
maximizing choice. Moreover, our decisions in Maher, Beal, and Harris v. McRae
all indicate that the State may encourage women to make their choice in favor of
childbirth rather than abortion, and the provision of accurate information
regarding abortion [476 U.S. 747, 802] and
its alternatives is a reasonable and fair means of achieving that objective.
Third, the majority concludes that the informed-consent provisions are
invalid because they "intrud[e] upon the discretion of the pregnant woman's
physician," ante, at 762, violate "the privacy of the informed-consent dialogue
between the woman and her physician," ibid., and "officially structur[e]" that
dialogue, ante, at 763. The provisions thus constitute "state medicine" that
"infringes upon [the physician's] professional responsibilities." Ibid. This is
nonsensical. I can concede that the Constitution extends its protection to
certain zones of personal autonomy and privacy, see Griswold v. Connecticut, 381
U.S., at 502 (WHITE, J., concurring in judgment), and I can understand, if not
share, the notion that that protection may extend to a woman's decision
regarding abortion. But I cannot concede the possibility that the Constitution
provides more than minimal protection for the manner in which a physician
practices his or her profession or for the "dialogues" in which he or she
chooses to participate in the course of treating patients. I had thought it
clear that regulation of the practice of medicine, like regulation of other
professions and of economic affairs generally, was a matter peculiarly within
the competence of legislatures, and that such regulation was subject to review
only for rationality. See, e. g., Williamson v. Lee Optical of Oklahoma, Inc.,
348 U.S. 483 (1955).
Were the Court serious about the need for strict scrutiny of regulations that
infringe on the "judgment" of medical professionals, "structure" their relations
with their patients, and amount to "state medicine," there is no telling how
many state and federal statutes (not to mention principles of state tort law)
governing the practice of medicine might be condemned. And of course, there
would be no reason why a concern for professional freedom could be confined to
the medical profession: nothing in the Constitution indicates a preference for
the liberty of doctors over that of lawyers, [476
U.S. 747, 803] accountants, bakers, or brickmakers. Accordingly, if the
State may not "structure" the dialogue between doctor and patient, it should
also follow that the State may not, for example, require attorneys to disclose
to their clients information concerning the risks of representing the client in
a particular proceeding. Of course, we upheld such disclosure requirements only
last Term. See Zauderer v. Office of Disciplinary Counsel, 471 U.S. 626 (1985).
The rationale for state efforts to regulate the practice of a profession or
vocation is simple: the government is entitled not to trust members of a
profession to police themselves, and accordingly the legislature may for the
most part impose such restrictions on the practice of a profession or business
as it may find necessary to the protection of the public. This is precisely the
rationale for infringing the professional freedom of doctors by imposing
disclosure requirements upon them: "Respect for the patient's right of
self-determination on particular therapy demands a standard set by law for
physicians rather than one which physicians may or may not impose upon
themselves." Canterbury v. Spence, 150 U.S. App. D.C., at 275, 464 F.2d, at 784.
Unless one is willing to recast entirely the law with respect to the legitimacy
of state regulation of professional conduct, the obvious rationality of the
policy of promoting informed patient choice on the subject of abortion must
defeat any claim that the disclosure requirements imposed by Pennsylvania are
invalid because they infringe on "professional freedom" or on the
"physician-patient relationship."
I do not really believe that the Court's invocation of professional freedom
signals a retreat from the principle that the Constitution is largely
unconcerned with the substantive aspects of governmental regulation of
professional and business relations. Clearly, the majority is uninterested in
undermining the edifice of post-New Deal constitutional law by extending its
holding to cases that do not concern the issue of abortion. But if one assumes,
as I do, that the majority [476 U.S. 747, 804]
is unwilling to commit itself to the implications of that part of its rhetoric
which smacks of economic due process rights for physicians, it becomes obvious
that the talk of "infringement of professional responsibility" is mere window
dressing for a holding that must stand or fall on other grounds. And because the
informed-consent provisions do not infringe the essential right at issue - the
right of the woman to choose to have an abortion - the majority's conclusion
that the provisions are unconstitutional is without foundation.
B
The majority's decision to strike down the reporting
requirements of the statute is equally extraordinary. The requirements obviously
serve legitimate purposes. The information contained in the reports is highly
relevant to the State's efforts to enforce 3210(a) of the statute, which forbids
abortion of viable fetuses except when necessary to the mother's health. The
information concerning complications plainly serves the legitimate goal of
advancing the state of medical knowledge concerning maternal and fetal health.
See Planned Parenthood of Central Missouri v. Danforth, 428 U.S., at 80. Given
that the subject of abortion is a matter of considerable public interest and
debate (constrained to some extent, of course, by the pre-emptive effect of this
Court's ill-conceived constitutional decisions), the collection and
dissemination of demographic information concerning abortions is clearly a
legitimate goal of public policy. Moreover, there is little reason to believe
that the required reports, though fairly detailed, would impose an undue burden
on physicians and impede the ability of their patients to obtain abortions, as
all of the information required would necessarily be readily available to a
physician who had performed an abortion. Accordingly, under this Court's prior
decisions in this area, the reporting requirements are constitutional. Planned
Parenthood Assn. of Kansas City, Missouri, Inc. v. Ashcroft, 462 U.S. 476,
486-490 (1983) (opinion of POWELL, [476 U.S. 747,
805] J.); id., at 505 (opinion of O'CONNOR, J.); Planned Parenthood of
Central Missouri v. Danforth, supra, at 79-81.
Nonetheless, the majority strikes down the reporting requirements because it
finds that notwithstanding the explicit statutory command that the reports be
made public only in a manner ensuring anonymity, "the amount of information
about [the patient] and the circumstances under which she had an abortion are so
detailed that identification is likely," ante, at 767, and that
"[i]dentification is the obvious purpose of these extreme reporting
requirements," ibid. Where these "findings" come from is mysterious, to say the
least. The Court of Appeals did not make any such findings on the record before
it, and the District Court expressly found that "the requirements of
confidentiality in 3214(e) regarding the identity of both patient and physician
prevent any invasion of privacy which could present a legally significant burden
on the abortion decision." 552 F. Supp. 791, 804 (ED Pa. 1982). Rather than
pointing to anything in the record that demonstrates that the District Court's
conclusion is erroneous, the majority resorts to the handy, but mistaken,
solution of substituting its own view of the facts and strikes down the statute.
I can accept the proposition that a statute whose purpose and effect are to
allow harassment and intimidation of citizens for their constitutionally
protected conduct is unconstitutional, but the majority's action in striking
down the Pennsylvania statute on this basis is procedurally and substantively
indefensible. First, it reflects a complete disregard for the principle,
embodied in Federal Rule of Civil Procedure 52(a), that an appellate court must
defer to a trial court's findings of facts unless those findings are clearly
erroneous. The Rule is expressly applicable to findings of fact that constitute
the grounds for a district court's action granting or refusing a preliminary
injunction, and, of course, the Rule limits this Court to the same degree as it
does any other [476 U.S. 747, 806] federal appellate court, see
United States v. General Dynamics Corp., 415 U.S. 486 (1974).
Second, the majority has seriously erred in purporting to make a final
determination of fact, conclusive of the constitutionality of the statute, on a
motion for preliminary injunction. In so doing, the Court overlooks the
principle that although a district court's findings of fact on a motion for a
preliminary injunction are entitled to deference on appeal from the grant or
denial of preliminary relief, "the findings of fact . . . made by a court
granting a preliminary injunction are not binding at trial on the merits"
because "a preliminary injunction is customarily granted on the basis of
procedures that are less formal and evidence that is less complete than in a
trial on the merits." University of Texas v. Camenisch, 451 U.S. 390, 395 (1981)
(emphasis added). What Camenisch stated to be true customarily is also true in
this case: the record on which the motion for preliminary injunction was decided
in the trial court consisted solely of affidavits and a stipulation of
undisputed facts, none of which provides a sufficient basis for a conclusive
finding on the complex question of the motive and effect of the reporting
requirements and the adequacy of the statute's protection of the anonymity of
doctors and patients. Issuing what amounts to a final declaratory judgment on
the constitutionality of the statute under these circumstances is highly
inappropriate.
Finally, in addition to being procedurally flawed, the majority's holding is
substantively suspect. The information contained in the reports identifies the
patient on the basis of age, race, marital status, and "political subdivision"
of residence; the remainder of the information included in the reports concerns
the medical aspects of the abortion. It is implausible that a particular patient
could be identified on the basis of the combination of the general identifying
information and the specific medical information in these reports by anyone who
did not already know (at a minimum) that the woman had been pregnant and
obtained an abortion. [476 U.S. 747, 807]
Accordingly, the provisions pose little or no threat to the woman's privacy.
In sum, there is no basis here even for a preliminary injunction against the
reporting provisions of the statute, much less for a final determination that
the provisions are unconstitutional.
C
The majority resorts to linguistic nit-picking in striking
down the provision requiring physicians aborting viable fetuses to use the
method of abortion most likely to result in fetal survival unless that method
would pose a "significantly greater medical risk to the life or health of the
pregnant woman" than would other available methods. The majority concludes that
the statute's use of the word "significantly" indicates that the statute
represents an unlawful "trade-off" between the woman's health and the chance of
fetal survival. Not only is this conclusion based on a wholly unreasonable
interpretation of the statute, but the statute would also be constitutional even
if it meant what the majority says it means.
The majority adopts the Court of Appeals' view that the statute's use of the
term "significantly" renders it "`not susceptible to a construction that does
not require the mother to bear an increased medical risk in order to save her
viable fetus.'" Ante, at 769 (quoting 737 F.2d 283, 300 (CA3 1984)). The term
"significant" in this context, however, is most naturally read as synonymous
with the terms "meaningful," "cognizable," "appreciable," or "nonnegligible."
That is, the statute requires only that the risk be a real and identifiable one.
Surely, if the State's interest in preserving the life of a viable fetus is, as
Roe purported to recognize, a compelling one, the State is at the very least
entitled to demand that that interest not be subordinated to a purported
maternal health risk that is in fact wholly insubstantial. The statute, on its
face, demands no more than this of a doctor performing an abortion of a viable
fetus. [476 U.S. 747, 808]
Even if the Pennsylvania statute is properly interpreted as requiring a
pregnant woman seeking abortion of a viable fetus to endure a method of abortion
chosen to protect the health of the fetus despite the existence of an
alternative that in some substantial degree is more protective of her own
health, I am not convinced that the statute is unconstitutional. The Court seems
to read its earlier opinion in Colautti v. Franklin, 439 U.S. 379 (1979), as
incorporating a holding that tradeoffs between the health of the pregnant woman
and the survival of her viable fetus are constitutionally impermissible under
Roe v. Wade. Of course, Colautti held no such thing: the Court there stated only
that it did not address the "serious ethical and constitutional difficulties"
that such a tradeoff would present. 439 U.S., at 400.6
Nothing in Colautti or any of the Court's previous abortion decisions compels
the per se "tradeoff" rule the Court adopts today.
The Court's ruling in this respect is not even consistent with its decision
in Roe v. Wade. In Roe, the Court conceded that the State's interest in
preserving the life of a viable fetus is a compelling one, and the Court has
never disavowed that concession. The Court now holds that this compelling
interest cannot justify any regulation that imposes a quantifiable medical risk
upon the pregnant woman who seeks to abort a viable fetus: if attempting to save
the fetus imposes any additional risk of injury to the woman, she must be
permitted to kill it. This holding hardly accords with the usual understanding
of the term "compelling interest," which we have used to describe those
governmental interests that are so weighty as to justify substantial and
ordinarily impermissible impositions on the individual - impositions that, I had
thought, could include the infliction of [476
U.S. 747, 809] some degree of risk of physical harm. The most obvious
illustration of this principle may be found in the opinion of the elder Justice
Harlan in Jacobson v. Massachusetts, 197 U.S. 11, 29 (1905): "The liberty
secured by the Fourteenth Amendment . . . consists, in part, in the right of a
person `to live and work where he will,' Allgeyer v. Louisiana, 165 U.S. 578;
and yet he may be compelled, by force if need be, against his will and without
regard to his personal wishes or his pecuniary interests, . . . to take his
place in the ranks of the army of his country and risk the chance of being shot
down in its defense." The actual holding of Jacobson provides another
illustration, more pertinent to this particular case: the Court there sustained
a regulation requiring all adult citizens of Cambridge, Massachusetts, to be
vaccinated against smallpox, notwithstanding that exposure to vaccination
carried with it a statistical possibility of serious illness and even death. If,
as I believe these examples demonstrate, a compelling state interest may justify
the imposition of some physical danger upon an individual, and if, as the Court
has held, the State has a compelling interest in the preservation of the life of
a viable fetus, I find the majority's unwillingness to tolerate the imposition
of any nonnegligible risk of injury to a pregnant woman in order to protect the
life of her viable fetus in the course of an abortion baffling.
The Court's ruling today that any tradeoff between the woman's health and
fetal survival is impermissible is not only inconsistent with Roe's recognition
of a compelling state interest in viable fetal life; it directly contradicts one
of the essential holdings of Roe - that is, that the State may forbid all
postviability abortions except when necessary to protect the life or health of
the pregnant woman. As is evident, this holding itself involves a tradeoff
between maternal health and protection of the fetus, for it plainly permits the
State to forbid a postviability abortion even when such an abortion may be
statistically safer than carrying the pregnancy to
[476 U.S. 747, 810] term, provided that the abortion is not medically
necessary.7 The tradeoff contained in the Pennsylvania
statute, even as interpreted by the majority, is no different in kind: the State
has simply required that when an abortion of some kind is medically necessary,
it shall be conducted so as to spare the fetus (to the greatest degree possible)
unless a method less protective of the fetus is itself to some degree medically
necessary for the woman. That this choice may involve the imposition of some
risk on the woman undergoing the abortion should be no more troublesome than
that a prohibition on nonnecessary postviability abortions may involve the
imposition of some risk on women who are thereby forced to continue their
pregnancies to term; yet for some reason, the Court concludes that whereas the
tradeoffs it devises are compelled by the Constitution, the essentially
indistinguishable tradeoff the State has attempted is foreclosed. This cannot be
the law.
The framework of rights and interests devised by the Court in Roe v. Wade
indicates that just as a State may prohibit a postviability abortion unless it
is necessary to protect the life or health of the woman, the State may require
that postviability abortions be conducted using the method most protective of
the fetus unless a less protective method is necessary to protect the life or
health of the woman. Under this standard, the Pennsylvania statute - which does
not require the woman to accept any significant health risks to protect the
fetus - is plainly constitutional.
D
The Court strikes down the statute's second-physician
requirement because, in its view, the existence of a medical emergency requiring
an immediate abortion to save the life of the pregnant woman would not be a
defense to a prosecution [476 U.S. 747, 811] under the statute. The Court
does not question the proposition, established in the Ashcroft case, that a
second-physician requirement accompanied by an exception for emergencies is a
permissible means of vindicating the compelling state interest in protecting the
lives of viable fetuses. Accordingly, the majority's ruling on this issue does
not on its face involve a substantial departure from the Court's previous
decisions.
What is disturbing about the Court's opinion on this point is not the general
principle on which it rests, but the manner in which that principle is applied.
The Court brushes aside the fact that the section of the statute in which the
second-physician requirement is imposed states that "[i]t shall be a complete
defense to any charge brought against a physician for violating the requirements
of this section that he had concluded, in good faith, in his best medical
judgment, . . . that the abortion was necessary to preserve maternal life or
health" (emphasis added). 18 Pa. Cons. Stat. 3210(a) (1982). This language is
obviously susceptible of the construction the State advances: namely, that it is
a defense to a charge of violating the second-physician requirement that the
physician performing the abortion believed that performing an abortion in the
absence of a second physician was necessary to the life or health of the mother.
The Court's rejection of this construction is based on its conclusion that
the statutory language "does not relate to the second-physician requirement" and
that "its words are not words of emergency." Ante, at 771. This reasoning eludes
me. The defense of medical necessity "relates" to any charge that a doctor has
violated one of the requirements of the section in which it appears, and the
second-physician requirement is imposed by that section. The defense thus quite
evidently "relates" to the second-physician requirement. True, the "words" of
the defense are not "words of emergency," but words of necessity. Why this
should make a difference is unclear: a defense of medical necessity is fully as
protective of the interests of the pregnant woman as a defense of
[476 U.S. 747, 812] "emergency." The Court falls back, ibid., on the
notion that the legislature "knows how to provide a medical-emergency exception
when it chooses to do so." No doubt. But the legislature obviously also "knows
how" to provide a medical-necessity exception, and it has done so. Why this
exception is insufficient is unexplained and inexplicable.
The Court's rejection of a perfectly plausible reading of the statute flies
in the face of the principle - which until today I had thought applicable to
abortion statutes as well as to other legislative enactments - that "[w]here
fairly possible, courts should construe a statute to avoid a danger of
unconstitutionality." Planned Parenthood Assn. of Kansas City, Missouri, Inc. v.
Ashcroft, 462 U.S., at 493. The Court's reading is obviously based on an
entirely different principle: that in cases involving abortion, a permissible
reading of a statute is to be avoided at all costs. Not sharing this viewpoint,
I cannot accept the majority's conclusion that the statute does not provide for
the equivalent of a defense of emergency.8
E
Finally, the majority refuses to vacate the preliminary
injunction entered against the enforcement of the parental notice and consent
provisions of the statute. See ante, at 758, n. 9. The reason offered is that
the propriety of the injunction depends upon the adequacy of the rules, recently
promulgated by the Pennsylvania Supreme Court, setting forth
[476 U.S. 747, 813] procedures by which a minor desiring an abortion may
speedily and confidentially obtain either judicial approval of her decision to
obtain an abortion or a judicial determination that she herself is capable of an
informed consent to the procedure. The Court concludes that review of the rules
is best carried out in the first instance in the District Court.
The Court's decision in Ashcroft, however, compels the conclusion that the
Third Circuit erred in directing that the operation of the parental notice and
consent provisions be enjoined pending promulgation of the required rules;
accordingly, the injunction should be vacated irrespective of the adequacy of
those rules. As the Court of Appeals apparently recognized, the Pennsylvania
statute, on its face, is substantively identical to that upheld by the Court in
Ashcroft; thus, the sole basis for the injunction ordered by the Court of
Appeals was the absence of procedural rules implementing the statute. What the
Court of Appeals failed to recognize was that this Court denied relief to the
plaintiffs challenging the statute in Ashcroft despite the same purported
defect: in that case, as in this, the State Supreme Court had not yet
promulgated rules establishing the expedited procedures called for by the
statute. Nonetheless, as JUSTICE POWELL's opinion explained, the plaintiffs were
not entitled to any relief against enforcement of the statutory scheme, as
"[t]here is no reason to believe that [the State] will not expedite any appeal
consistent with the mandate in our prior opinions." 462 U.S., at 491, n. 16.
Similarly, there was no reason here for the Court of Appeals to believe that
Pennsylvania would not provide for the adequate, expedited procedures
contemplated by the statute; thus, its entry of an injunction against
enforcement of the statute was erroneous.
III
The decision today appears symptomatic of the Court's own
insecurity over its handiwork in Roe v. Wade and the cases following that
decision. Aware that in Roe it essentially [476
U.S. 747, 814] created something out of nothing and that there are many
in this country who hold that decision to be basically illegitimate, the Court
responds defensively. Perceiving, in a statute implementing the State's
legitimate policy of preferring childbirth to abortion, a threat to or criticism
of the decision in Roe v. Wade, the majority indiscriminately strikes down
statutory provisions that in no way contravene the right recognized in Roe. I do
not share the warped point of view of the majority, nor can I follow the
tortuous path the majority treads in proceeding to strike down the statute
before us. I dissent.
[Footnote 1] I shall, for the most part,
leave to one side the Court's somewhat extraordinary procedural rulings. I do
not strongly disagree with the Court's decision to read a finality requirement
into 28 U.S.C. 1254(2), although I would have thought it incumbent on the Court
to explain why the Court of Appeals' judgment as to the statutory provisions
before us today, which represents a definitive ruling on their
constitutionality, is not sufficiently "final" to satisfy the jurisdictional
statute as interpreted by the Court.
As for the Court's ruling that it is permissible for an appellate court to
resolve an appeal from the grant or the denial of a preliminary injunction by
issuing a final judgment as to the constitutionality of a statute, I do not
disagree that this may, in rare cases, be an appropriate course of action where
the constitutional issues are clear. I would stress that this is by no means the
preferred course of action in the run of cases, and I assume that the majority's
opinion is not to the contrary. I do disagree quite strongly with the majority's
application of this principle here, as I believe, contrary to the majority, that
it is quite evident that the statute before us is constitutional on its face. I
also believe, as will become evident, that at least one of the Court's rulings
is exceedingly inappropriate in view of the preliminary posture of this case
even if the majority's legal premises are accepted.
[Footnote 2] That the abortion decision,
like the decisions protected in Griswold, Eisenstadt, and Carey, concerns
childbearing (or, more generally, family life) in no sense necessitates a
holding that the liberty to choose abortion is "fundamental." That the decision
involves the destruction of the fetus renders it different in kind from the
decision not to conceive in the first place. This difference does not go merely
to the weight of the state interest in regulating abortion; it affects as well
the characterization of the liberty interest itself. For if the liberty to make
certain decisions with respect to contraception without governmental constraint
is "fundamental," it is not only because those decisions are "serious" and
"important" to the individual, see ante, at 776 (STEVENS, J., concurring), but
also because some value of privacy or individual autonomy that is somehow
implicit in the scheme of ordered liberties established by the Constitution
supports a judgment that such decisions are none of government's business. The
[476 U.S. 747, 793] same cannot be said where, as here, the individual is
not "isolated in her privacy."
My point can be illustrated by drawing on a related area in which fundamental
liberty interests have been found: childrearing. The Court's decisions in Moore
v. East Cleveland, Pierce v. Society of Sisters, and Meyer v. Nebraska can be
read for the proposition that parents have a fundamental liberty to make
decisions with respect to the upbringing of their children. But no one would
suggest that this fundamental liberty extends to assaults committed upon
children by their parents. It is not the case that parents have a fundamental
liberty to engage in such activities and that the State may intrude to prevent
them only because it has a compelling interest in the well-being of children;
rather, such activities, by their very nature, should be viewed as outside the
scope of the fundamental liberty interest.
[Footnote 3] JUSTICE STEVENS asserts,
ante, at 778, that I am "quite wrong in suggesting that the Court is imposing
value preferences on anyone else" when it denominates the liberty to choose
abortion as "fundamental" (in contradistinction to such other, nonfundamental
liberties as the liberty to use dangerous drugs or to operate a business without
governmental interference) and thereby disempowers state electoral majorities
from legislating in this area. I can only respond that I cannot conceive of a
definition of the phrase "imposing value preferences" that does not encompass
the Court's action.
JUSTICE STEVENS also suggests that it is the legislative majority that has
engaged in "the unrestrained imposition of its own, extraconstitutional value
preferences" when a state legislature restricts the availability of abortion.
Ibid. But a legislature, unlike a court, has the inherent power to do so unless
its choices are constitutionally forbidden, which, in my view, is not the case
here.
[Footnote 4] Contrary to JUSTICE
STEVENS' suggestion, ibid., this is no more a "theological" position than is the
Court's own judgment that viability is the point at which the state interest
becomes compelling. (Interestingly, JUSTICE STEVENS omits any real effort to
defend this judgment.) The point is that the specific interest the Court has
recognized as compelling after the point of viability - that is, the interest in
protecting "potential human life" - is present as well before viability, and the
point of viability seems to bear no discernible relationship to the strength of
that interest. Thus, there is no basis for concluding that the essential
character of the state interest becomes transformed at the point of viability.
Further, it is self-evident that neither the legislative decision to assert a
state interest in fetal life before viability nor the judicial decision to
recognize that interest as compelling constitutes an impermissible "religious"
decision merely because it coincides with the belief of one or more religions.
Certainly the fact that the prohibition of murder coincides with one of the Ten
Commandments does not render a State's interest in its murder statutes less than
compelling, nor are legislative and judicial decisions concerning the use of the
death penalty tainted by their correspondence to varying religious views on that
subject. The simple, and perhaps unfortunate, fact of the matter is that in
determining whether to assert an interest in fetal life, a State cannot avoid
taking a position that will correspond to some religious beliefs and contradict
others. The same is true to some extent with respect to the choice this Court
faces in characterizing an asserted state [476
U.S. 747, 796]
interest in fetal life, for denying that such an interest is a "compelling" one
necessarily entails a negative resolution of the "religious" issue of the
humanity of the fetus, whereas accepting the State's interest as compelling
reflects at least tolerance for a state decision that is congruent with the
equally "religious" position that human life begins at conception. Faced with
such a decision, the most appropriate course of action for the Court is to defer
to a legislative resolution of the issue: in other words, if a state legislature
asserts an interest in protecting fetal life, I can see no satisfactory basis
for denying that it is compelling.
[Footnote 5] JUSTICE STEVENS, see ante,
at 776-777, n. 4, finds a contradiction between my recognition that
constitutional analysis requires more than mere textual analysis or a search for
the specific intent of the Framers, supra, at 789, and my assertion that it is
ultimately the will of the people that is the source of whatever values are
incorporated in the Constitution. The fallacy of JUSTICE STEVENS' argument is
glaring. The rejection of what has been characterized as "clause-bound"
interpretivism, J. Ely, Democracy and Distrust 12 (1980), does not necessarily
carry with it a rejection of the notion that constitutional adjudication is a
search for values and principles that are implicit (and explicit) in the
structure of rights and institutions that the people have themselves created.
The implications of those values for the resolution of particular issues will in
many if not most cases not have been explicitly considered when the values
themselves were
[476 U.S. 747, 797] chosen - indeed, there
will be some cases in which those who framed the provisions incorporating
certain principles into the Constitution will be found to have been incorrect in
their assessment of the consequences of their decision. See, e. g., Brown v.
Board of Education, 347 U.S. 483 (1954). Nonetheless, the hallmark of a correct
decision of constitutional law is that it rests on principles selected by the
people through their Constitution, and not merely on the personal philosophies,
be they libertarian or authoritarian, of the judges of the majority. While
constitutional adjudication involves judgments of value, it remains the case
that some values are indeed "extraconstitutional," in that they have no roots in
the Constitution that the people have chosen. The Court's decision in Lochner v.
New York, 198 U.S. 45 (1905), was wrong because it rested on the Court's belief
that the liberty to engage in a trade or occupation without governmental
regulation was somehow fundamental - an assessment of value that was unsupported
by the Constitution. I believe that Roe v. Wade - and today's decision as well -
rests on similarly extraconstitutional assessments of the value of the liberty
to choose an abortion.
[Footnote 6] Interestingly, the Court's
statement seems to have assumed that the Court would have had the same authority
over "ethical questions" as "constitutional issues" had it chosen to reach them
- an illuminating revelation of the state of the Court's jurisprudence in this
area.
[Footnote 7] Surely it cannot be argued
that any abortion that is safer than delivery is medically necessary, since
under such a definition an abortion would be medically necessary in all
pregnancies.
[Footnote 8] Even if I were to accept
the majority's conclusion that the medical-necessity defense of 3210(a) is not
specifically applicable to charges brought under 3210(c), I would not strike
down the statute. Under Pennsylvania criminal law, justification is a defense,
see 18 Pa. Cons. Stat. 502 (1982), and, under the general rule of justification,
conduct is deemed justified if "the actor believes [it] to be necessary to avoid
a harm or evil to . . . another," and "the harm or evil sought to be avoided by
such conduct is greater than that sought to be prevented by the law defining the
offense charged." 503(a)(1). I have little doubt that a Pennsylvania court
applying this statute would find noncompliance with the second-physician rule
justified where necessary to save the life of the pregnant woman.
JUSTICE O'CONNOR, with whom JUSTICE REHNQUIST joins, dissenting.
This Court's abortion decisions have already worked a major distortion in the
Court's constitutional jurisprudence. See Akron v. Akron Center for Reproductive
Health, Inc., 462 U.S. 416, 452 (1983) (O'CONNOR, J., dissenting). Today's
decision goes further, and makes it painfully clear that no legal rule or
doctrine is safe from ad hoc nullification by this Court when an occasion for
its application arises in a case involving state regulation of abortion. The
permissible scope of abortion regulation is not the only constitutional issue on
which this Court is divided, but - except when it comes to abortion - the Court
has generally refused to let such disagreements, however longstanding or deeply
felt, prevent it from evenhandedly applying uncontroversial legal doctrines to
cases that come before it. See Heckler v. Chaney, 470 U.S. 821, 838 (1985); id.,
at 839-840, n. 2 (BRENNAN, J., concurring) (differences over the validity of the
death penalty under the Eighth Amendment should not influence the Court's
consideration of a question of statutory administrative law). That the Court's
unworkable scheme for constitutionalizing the regulation of abortion has had
this institutionally debilitating effect should not be surprising, however,
since the Court is not suited to the expansive role it
[476 U.S. 747, 815] has claimed for itself in the series of cases that
began with Roe v. Wade, 410 U.S. 113 (1973).
The Court today holds that "[t]he Court of Appeals correctly invalidated the
specified provisions of Pennsylvania's 1982 Abortion Control Act." Ante, at 772.
In so doing, the Court prematurely decides serious constitutional questions on
an inadequate record, in contravention of settled principles of constitutional
adjudication and procedural fairness. The constitutionality of the challenged
provisions was not properly before the Court of Appeals, and is not properly
before this Court. There has been no trial on the merits, and appellants have
had no opportunity to develop facts that might have a bearing on the
constitutionality of the statute. The only question properly before the Court is
whether or not a preliminary injunction should have been issued to restrain
enforcement of the challenged provisions pending trial on the merits. This
Court's decisions in Akron v. Akron Center for Reproductive Health, supra,
Planned Parenthood Assn. of Kansas City, Missouri, Inc. v. Ashcroft, 462 U.S.
476 (1983), and Simopoulos v. Virginia, 462 U.S. 506 (1983), do not establish a
likelihood that appellees would succeed on the merits of their constitutional
claims sufficient to warrant overturning the District Court's denial of a
preliminary injunction. Under the approach to abortion regulation outlined in my
dissenting opinion in Akron, to which I adhere, it is even clearer that no
preliminary injunction should have issued. I therefore dissent.
I
The only issue before the District Court in this case was
whether to grant appellees' motion for a preliminary injunction against
enforcement of Pennsylvania's Abortion Control Act. The limited record before
the District Court consisted of affidavits submitted by appellees, the parties'
memoranda of law, the Act itself, including the findings of the Pennsylvania
Legislature, and a stipulation of uncontested facts. As [476 U.S. 747, 816] the District Judge noted,
this stipulation "was entered into solely for the purpose of the motion for
preliminary injunction." 552 F. Supp. 791, 794, n. 1 (ED Pa. 1982). Indeed, the
parties expressly provided that the stipulation should be "without prejudice to
any party's right to controvert any facts or to prove any additional facts at
any later proceeding in this action." App. 9a-10a. In light of the stipulation
of uncontested facts, no testimony or evidence was submitted at the hearing on
the motion for a preliminary injunction.
In these circumstances, the District Judge's consideration of the motion
before him was governed by the black letter law recapitulated in University of
Texas v. Camenisch, 451 U.S. 390, 395 (1981):
"The purpose of a preliminary injunction is merely to preserve the relative
positions of the parties until a trial on the merits can be held. Given this
limited purpose, and given the haste that is often necessary if those
positions are to be preserved, a preliminary injunction is customarily
granted on the basis of procedures that are less formal and evidence that is
less complete than in a trial on the merits. A party thus is not required to
prove his case in full at a preliminary injunction hearing, and the findings
of fact and conclusions of law made by a court granting a preliminary
injunction are not binding at trial on the merits. In light of these
considerations, it is generally inappropriate for a federal court at the
preliminary-injunction stage to give a final judgment on the merits.
"Should an expedited decision on the merits be appropriate, Rule 65(a)(2)
of the Federal Rules of Civil Procedure provides a means of securing one.
That Rule permits a court to `order the trial of the action on the merits to
be advanced and consolidated with the hearing of the application.' Before
such an order may issue, however, the courts have commonly required that
`the parties should normally receive clear and unambiguous notice [of
[476 U.S. 747, 817] the court's intent to consolidate the trial and
the hearing] either before the hearing commences or at a time which will
still afford the parties a full opportunity to present their respective
cases'" (citations omitted).
The District Judge scrupulously adhered to these settled principles. He
granted the preliminary injunction as to one provision of the Act, and denied
preliminary relief as to all the other challenged provisions. Having seen no
occasion to issue a Rule 65 order, he properly refrained from rendering final
judgment on the merits by declaratory judgment or otherwise. That the District
Judge understood the preliminary nature of the proceedings, and ruled
accordingly, is incontrovertible:
"I have applied the traditional criteria applicable to a motion for
preliminary injunction: likelihood of success on the merits, irreparable
harm if the relief is not granted, possibility of harm to the non-moving
party, and where relevant, harm to the public. Given the importance of the
right involved in this litigation, I have assumed that if the plaintiffs
were able to show likelihood of success on the merits, then the irreparable
harm requirement would be met. I conclude that in only one instance, the
24-hour waiting period, did the plaintiffs carry their burden of
demonstrating likelihood of success on the merits.
. . . . .
"My adjudication is limited to the plaintiffs' request for a preliminary
injunction. It is circumscribed by the record produced by the parties and
the arguments advanced in the briefs on this motion. After applying the
criteria for a preliminary injunction, I conclude that the only portion of
the Act which the plaintiffs have demonstrated should be preliminarily
enjoined is the 24-hour waiting period. In all other respects, the
plaintiffs have failed to show a right to a preliminary injunction pending [476 U.S. 747, 818] the outcome of the trial
on the merits." 552 F. Supp., at 811 (emphasis in original).
The District Judge correctly discerned that "[t]he traditional standard for
granting a preliminary injunction requires a plaintiff to show that in the
absence of its issuance he will suffer irreparable injury and also that he is
likely to prevail on the merits." Doran v. Salem Inn, Inc., 422 U.S. 922, 931
(1975). Unsurprisingly, the likelihood of success on the merits emerged, in the
District Judge's view, as the most important factor in determining whether an
injunction should issue in this case. In sum, when the District Judge denied
appellees' motion for a preliminary injunction, he faithfully applied
uncontroversial criteria for ruling on such motions and rendered a decision that
"was not in any sense intended as a final decision as to the constitutionality
of the challenged statute." Brown v. Chote, 411 U.S. 452, 456 (1973).
When the appeal was taken to the Court of Appeals for the Third Circuit, that
court's review should have been limited to determining whether the District
Court had abused its discretion in denying preliminary relief. Doran, supra, at
931-932; Brown, supra, at 457. If the Court of Appeals concluded that the
District Court had committed legal errors that infected its assessment of the
likelihood that appellees would succeed on the merits, the Court of Appeals
should then have addressed the remaining factors that make up the preliminary
injunction inquiry. If it concluded that denial of the preliminary injunction
was an abuse of discretion, it should have entered judgment providing for entry
of a preliminary injunction. What it should not have done, and what it did do,
was to issue a final, binding declaration on the merits of appellees'
constitutional claims.
The Court concedes that a court of appeals should ordinarily review the
denial of a preliminary injunction under an abuse of discretion standard, and it
concedes that a court of appeals should ordinarily confine itself to assessing
the "probability that the plaintiffs would succeed on the merits."
[476 U.S. 747, 819] Ante, at 755. But the Court purports to find an
exception to this rule in the decisions in Youngstown Sheet & Tube Co. v.
Sawyer, 343 U.S. 579 (1952), and Smith v. Vulcan Iron Works, 165 U.S. 518
(1897). It asserts that these cases indicate that "if a district court's ruling
rests solely on a premise as to the applicable rule of law, and the facts are
established or of no controlling relevance, that ruling may be reviewed even
though the appeal is from the entry of a preliminary injunction." Ante, at 757.
The Court then announces that the requirement that appellate review proceed
under the deferential abuse of discretion standard is "a rule of orderly
judicial administration, not a limit on judicial power." Ibid. Postulating that
the Court of Appeals had a "full record before it on the issues now before us,"
ibid., the Court concludes that this "full record," and the fact that this
Court's decisions in Akron, Ashcroft, and Simopoulos were handed down during the
pendency of the appeal, justified the Court of Appeals "in proceeding to plenary
review of those issues." Ante, at 757.
This analysis mischaracterizes the proceedings in the District Court and is
unsupported by precedent or logic. No one doubts that the legal premises on
which the District Judge proceeded were reviewable. But the fact is that the
District Judge did not make the final, definitive "ruling" on the merits the
Court imputes to him. The only "ruling" the Court of Appeals had before it with
respect to the merits was a determination of "likelihood of success" based on
facts which were stipulated only for purposes of the preliminary injunction
motion, and on arguments framed with a view toward only those facts. Nor was
there a "full record" upon which the Court of Appeals could decide the merits.
The Court falls into precisely the error pointed out in Camenisch, 451 U.S., at
394, where this Court unanimously rejected the proposition that determinations
on the propriety of preliminary relief are "tantamount to decisions on the
underlying merits," because that view "improperly equates `likelihood of [476 U.S. 747, 820] success' with `success,' and
what is more important, . . . ignores the significant procedural differences
between preliminary and permanent injunctions."
The Court of Appeals was convinced that the District Judge, in reliance on
the decisions of the Courts of Appeals that were later reviewed in Akron and
Ashcroft, had taken a view of the applicable law which this Court's decisions in
those cases demonstrated to be erroneous. Citing Apple Computer, Inc. v.
Franklin Computer Corp., 714 F.2d 1240, 1242 (CA3 1983), cert. dism'd under this
Court's Rule 53, 464 U.S. 1033 (1984), the Court of Appeals stated that "[t]he
customary discretion accorded to a district court's ruling on a preliminary
injunction yields to our plenary scope of review as to the applicable law." 737
F.2d 283, 290 (1984). Apple Computer, in turn, relied on Judge Friendly's
opinion for the Second Circuit in Donovan v. Bierwirth, 680 F.2d 263, 269, cert.
denied, 459 U.S. 1069 (1982): "Despite oft repeated statements that the issuance
of a preliminary injunction rests in the discretion of the trial judge whose
decisions will be reversed only for `abuse', a court of appeals must reverse if
the district court has proceeded on the basis of an erroneous view of the
applicable law, or of the standards governing the granting or denial of
interlocutory relief" (citations omitted).
Donovan's reasoning, however, goes only to the standard of appellate review,
not to the extent of the issues to be reviewed. Whether or not Donovan's
approach is sound, it is clear that a district court does not have discretion to
rule on the basis of a misapprehension of controlling law. But even assuming,
arguendo, that, where a court of appeals detects such an error, it may then
engage in de novo review of the determination whether a preliminary injunction
should issue, see 680 F.2d, at 270, such discretion does not ordinarily extend
to deciding the merits of the controversy with finality. Judge Friendly did no
such thing in Donovan, id., [476 U.S. 747, 821]
at 276, nor did the Third Circuit in Apple Computer, see 714 F.2d, at 1242.
What is at issue here is a matter of legal principle. As JUSTICE BLACKMUN has
observed on a previous occasion: "The distinction between the preliminary and
final injunction stages of a proceeding is more than mere formalism. The time
pressures involved in a request for a preliminary injunction require courts to
make determinations without the aid of full briefing or factual development, and
make all such determinations necessarily provisional." Firefighters v. Stotts,
467 U.S. 561, 603-604, n. 7 (1984) (dissenting opinion). The holding of the
Court today thus comes at the expense of the basic principle underlying the
framework set out in Camenisch for ruling on a motion for a preliminary
injunction: that fairness to the parties and reliable adjudication of disputes
require final, binding rulings on the merits of a controversy to be made only
after each side has had an opportunity to establish its version of the disputed
facts or to establish that the facts are not in dispute.
Equally neglected by the Court is a second principle, closely related to the
first:
"Ordinarily an appellate court does not give consideration to issues not
raised below. For our procedural scheme contemplates that parties shall come
to issue in the trial forum vested with authority to determine questions of
fact. This is essential in order that parties may have the opportunity to
offer all the evidence they believe relevant to the issues which the trial
tribunal is alone competent to decide; it is equally essential in order that
litigants may not be surprised on appeal by final decision there of issues
upon which they have had no opportunity to introduce evidence." Hormel v.
Helvering, 312 U.S. 552, 556 (1941).
See also Singleton v. Wulff, 428 U.S. 106, 120-121 (1976); cf. Fountain v.
Filson, 336 U.S. 681, 683 (1949) (per curiam) (reversing a summary judgment
order "made on appeal on a [476 U.S. 747, 822]
new issue as to which the opposite party had no opportunity to present a defense
before the trial court"). The cases on which the Court relies simply do not
support the short shrift the Court gives these basic principles.
In Youngstown Sheet & Tube Co., President Truman, invoking an immediate
threat to the national defense precipitated by a threatened nationwide strike in
the steel industry, ordered the Secretary of Commerce to seize the steel mills
and keep them running. 343 U.S., at 583. The steel companies sought a
declaratory judgment, a preliminary injunction, and a permanent injunction
against the seizure, on the grounds that the President had no authority to order
it. Ibid. Although the District Court had before it only "motions for temporary
injunctions" when it ruled, 103 F. Supp. 569, 572 (DC 1952), "in the light of
the facts presented, the District Court saw no reason for delaying decision of
the constitutional validity of the orders." Youngstown Sheet & Tube Co., supra,
at 585. Indeed, the District Court had "com[e] to a fixed conclusion . . . that
defendant's acts are illegal. . . . Nothing that could be submitted at such
trial on the facts would alter the legal conclusion I have reached." 103 F.
Supp., at 576.
Thus, the District Court's preliminary injunction in Youngstown Sheet & Tube
Co. rested on what amounted to a declaratory judgment that the orders were
constitutionally invalid. That in itself was a pronounced departure from normal
practice, although one that this Court found proper in the highly unusual
circumstances presented in Youngstown Sheet & Tube Co., where time was
manifestly of the essence,* and there was no contention that the Government had been
deprived of an opportunity to present facts that could have [476 U.S. 747, 823] altered the resolution of
the constitutional question. To the contrary, when "[p]laintiffs moved for a
preliminary injunction before answer or hearing, [d]efendant opposed the motion,
filing uncontroverted affidavits of Government officials describing the facts
underlying the President's order." 343 U.S., at 678 (Vinson, C. J., dissenting).
Neither of the foregoing justifications for the District Court's unusual
decision to reach the merits in Youngstown Sheet & Tube is present here. No
emergency remotely comparable to the one in Youngstown Sheet & Tube confronted
the Court of Appeals, which granted appellees' motion to enjoin enforcement of
the entire Act pending appeal, and withheld judgment until after this Court had
ruled in Akron and its companion cases. 737 F.2d, at 290. Appellants conceded in
the Court of Appeals that several provisions of the Abortion Act were
unconstitutional in the wake of those decisions, but appellants did not concede
that the provisions on which the Court of Appeals dispositively ruled were
unconstitutional. Nor is there any suggestion that appellants conceded in the
Court of Appeals that there were no factual issues that could have a bearing on
the constitutionality of these provisions. Consequently, even if a preliminary
injunction should have issued, the proper course would have been to remand for
final determination of the merits.
Indeed, since Youngstown Sheet & Tube Co. was decided this Court has
expressly reaffirmed that "a state statute should not be declared
unconstitutional by a district court if a preliminary injunction is granted a
plaintiff to protect his interests during the ensuing litigation." Withrow v.
Larkin, 421 U.S. 35, 43 (1975). See Mayo v. Lakeland Highlands Canning Co., 309
U.S. 310 (1940). If it is improper for a district court to enter such a
declaratory judgment when it grants a preliminary injunction, then a fortiori it
is improper for a court of appeals to do so when the district court has only
appraised the likelihood of success on the merits. What happened here is even
more extreme: the Court of Appeals, reviewing [476 U.S. 747, 824] the denial of a preliminary
injunction, held in the first instance that nothing that could be submitted at a
trial on the merits would alter its conclusion that "most of the provisions
attacked by appellants are unconstitutional as a matter of law." 737 F.2d, at
287. Nothing in Youngstown Sheet & Tube Co. remotely suggests that it was proper
for the Court of Appeals to take this extraordinary step. "Camenisch makes clear
that a determination of a party's entitlement to a preliminary injunction is a
separate issue from the determination of the merits of the party's underlying
legal claim, and that a reviewing court should not confuse the two." Stotts, 467
U.S., at 603 (BLACKMUN, J., dissenting).
The Court strays even further afield when it invokes Smith v. Vulcan Iron
Works in defense of the Court of Appeals' decision to reach and resolve the
merits despite the fact that the District Court had not done so and without
giving the parties "the benefit . . . of a full opportunity to present their
cases." Camenisch, 451 U.S., at 396. The trial court in Smith, "upon a bill in
equity for the infringement of a patent for an invention . . . entered an
interlocutory decree, adjudging that the patent was valid and had been
infringed, granting an injunction, and referring the case to a master to take an
account of profits and damages." 165 U.S., at 518 (emphasis added). The
defendant challenged the trial court's alleged "error in holding that the patent
was valid, and that it had been infringed." Ibid. The Circuit Court of Appeals
reversed the decree, rejecting the plaintiff's contention that it could rule
only on "whether an injunction should be awarded." Ibid. This Court held that
under the plain language of the statute conferring jurisdiction on the Circuit
Court of Appeals, an appeal was authorized "from the whole of such interlocutory
order or decree, and not from that part of it only which grants or continues an
injunction," and consequently the statute conferred "authority to consider and
decide the case upon its merits." Id., at 525. The trial court, of course, had
already done precisely that, deciding the issue
[476 U.S. 747, 825] of liability after the parties had joined issue on
the merits, while referring the matter of damages to a master. Reliance on Smith
in this case is therefore misplaced, for, to repeat, the District Court did not
decide - and could not properly have decided - the merits of appellees'
constitutional claims when it refused to grant a preliminary injunction.
The Court also seeks comfort in an analogy to the rule that a federal court
need not abstain, pending state-court review, from reviewing a constitutional
challenge to the validity of a state statute that is not fairly subject to an
interpretation that will avoid the constitutional question. Zwickler v. Koota,
389 U.S. 241, 251, and n. 14 (1967). When a federal district court declines to
abstain, however, it does not in so doing decide the merits of the
constitutional question even if the parties have not had a full opportunity to
air them. The court simply proceeds to decide the case in accordance with the
normal procedural requirements that safeguard the parties' rights to be heard. A
refusal to abstain therefore infringes neither the principle that final judgment
should follow a full opportunity to be heard on the factual and legal merits of
the case, nor the principle that "parties shall come to issue in the trial forum
vested with authority to determine questions of fact." Hormel, 312 U.S., at 556.
The same cannot be said of what the Court of Appeals did here.
Whatever the exceptions which would justify a district court in finally
resolving an issue on the merits at the preliminary injunction stage, no such
exception was applicable here. Nor is this a case in which the court of appeals
was justified in resolving an issue not passed on in the district court because
proper resolution was beyond any doubt or grave injustice might result from
failure to do so. See Singleton v. Wulff, 428 U.S., at 121. The Court of Appeals
not only decided to stand in the shoes of the District Court by ruling on an
issue not passed upon below - it ruled on an issue on which, absent
extraordinary circumstances, the District Court could not have ruled without
"`clear and unambiguous [476 U.S. 747, 826]
notice'" that would "`afford the parties a full opportunity to present their
respective cases.'" Camenisch, supra, at 395. The Court attempts to veil the
impropriety of its decision to affirm on the merits despite the procedural
posture of this case by implying that the challenged provisions are patently
unconstitutional. But this claim too is unsupported in this Court's decisions
concerning state regulation of abortion.
The discretionary exception the Court fashions today will also prove
vexatious to administer. Parties now face the risk that a final ruling on the
merits will be entered against them by a court of appeals when an appeal is
taken from the grant or denial of a motion for a preliminary injunction,
although the district court made only an initial assessment of the likelihood
that the moving party would succeed on the merits. It is predictable that
parties will respond by attempting to turn preliminary injunction proceedings
into contests over summary judgment or full-scale trials on the merits. That
tendency will make the preliminary injunction less useful in serving its
intended function of preserving the status quo pending final judgment on the
merits, while making litigation more expensive, less reliable, and less fair. If
this case did not involve state regulation of abortion, it may be doubted that
the Court would entertain, let alone adopt, such a departure from its
precedents.
II
In this Court, appellants argue that the judgment of the Court
of Appeals should be vacated and the District Court's denial of a preliminary
injunction sustained. Appellants have stated that they "intend to present to the
District Court a complete factual record which . . . could affect the
disposition of this case," and have indicated some of the specific factual
propositions they would seek to establish. Brief for Appellants 44-48. At oral
argument, counsel for appellants reiterated that, with the exception of the
second-physician requirement, "there are additional justifications by way of
[476 U.S. 747, 827] facts that we can offer" as to each of the challenged
provisions. Tr. of Oral Arg. 13. These assertions alone would justify vacating
the judgment of the Court of Appeals insofar as that court did more than direct
the entry of a preliminary injunction. In Singleton v. Wulff, supra, at 120, for
example, this Court reversed the Court of Appeals' decision to reach the merits
of that case, even though this Court had "no idea what evidence, if any,
petitioner would, or could, offer in defense of this statute," because it was
clear that "petitioner has had no opportunity to proffer such evidence." I would
apply that reasoning here even if I were not persuaded that as to several of the
challenged provisions additional factual development - for example, facts
concerning the costs associated with the reporting and informed consent
provisions, and the extent of the problems Pennsylvania was seeking to correct -
could affect the decision on the merits. Appellants should not have to prove
that they are entitled to an opportunity to be heard.
Since it rendered "what amounts to a final declaratory judgment on the
constitutionality of the statute," ante, at 806 (WHITE, J., dissenting), the
Court of Appeals necessarily believed that in light of Akron and its companion
cases appellees had established a sufficient likelihood of success on the merits
to warrant issuance of a preliminary injunction. Pennsylvania contends that this
ruling is erroneous even under the supervening decisions of this Court. In the
alternative, Pennsylvania suggests that the facial constitutionality of the
challenged provisions of its Abortion Act may be sustained on this record.
I agree with much of what JUSTICE WHITE has written in Part II of his
dissenting opinion, and the arguments he has framed might well suffice to show
that the provisions at issue are facially constitutional. Nonetheless, I believe
the proper course is to decide this case as the Court of Appeals should have
decided it, lest appellees suffer the very prejudice the Court sees fit to
inflict on appellants. For me, then, the [476 U.S. 747, 828] question is not one of "success" but
of the "likelihood of success." In addition, because Pennsylvania has not asked
the Court to reconsider or overrule Roe v. Wade, 410 U.S. 113 (1973), I do not
address that question.
I do, however, remain of the views expressed in my dissent in Akron, 462
U.S., at 459-466. The State has compelling interests in ensuring maternal health
and in protecting potential human life, and these interests exist "throughout
pregnancy." Id., at 461 (O'CONNOR, J., dissenting). Under this Court's
fundamental-rights jurisprudence, judicial scrutiny of state regulation of
abortion should be limited to whether the state law bears a rational
relationship to legitimate purposes such as the advancement of these compelling
interests, with heightened scrutiny reserved for instances in which the State
has imposed an "undue burden" on the abortion decision. Id., at 461-463
(O'CONNOR, J., dissenting). An undue burden will generally be found "in
situations involving absolute obstacles or severe limitations on the abortion
decision," not wherever a state regulation "may `inhibit' abortions to some
degree." Id., at 464 (O'CONNOR, J., dissenting). And if a state law does
interfere with the abortion decision to an extent that is unduly burdensome, so
that it becomes "necessary to apply an exacting standard of review," id., at 467
(O'CONNOR, J., dissenting), the possibility remains that the statute will
withstand the stricter scrutiny. See id., at 473-474 (O'CONNOR, J., dissenting);
Ashcroft, 462 U.S., at 505 (O'CONNOR, J., concurring in judgment in part and
dissenting in part).
These principles for evaluating state regulation of abortion were not newly
minted in my dissenting opinion in Akron. Apart from Roe's outmoded trimester
framework, the "unduly burdensome" standard had been articulated and applied
with fair consistency by this Court in cases such as Harris v. McRae, 448 U.S.
297, 314 (1980), Maher v. Roe, 432 U.S. 464, 473 (1977), Beal v. Doe, 432 U.S.
438, 446 (1977), and Bellotti v. Baird, 428 U.S. 132, 147 (1976). In Akron and
[476 U.S. 747, 829]
Ashcroft the Court, in my view, distorted and misapplied this standard, see
Akron, 462 U.S., at 452-453 (O'CONNOR, J., dissenting), but made no clean break
with precedent and indeed "follow[ed] this approach" in assessing some of the
regulations before it in those cases. Id., at 463 (O'CONNOR, J., dissenting).
The Court today goes well beyond mere distortion of the "unduly burdensome"
standard. By holding that each of the challenged provisions is facially
unconstitutional as a matter of law, and that no conceivable facts appellants
might offer could alter this result, the Court appears to adopt as its new test
a per se rule under which any regulation touching on abortion must be
invalidated if it poses "an unacceptable danger of deterring the exercise of
that right." Ante, at 767. Under this prophylactic test, it seems that the mere
possibility that some women will be less likely to choose to have an abortion by
virtue of the presence of a particular state regulation suffices to invalidate
it. Simultaneously, the Court strains to discover "the anti-abortion character
of the statute," ante, at 764, and, as JUSTICE WHITE points out, invents an
unprecedented canon of construction under which "in cases involving abortion, a
permissible reading of a statute is to be avoided at all costs." Ante, at 812
(dissenting). I shall not belabor the dangerous extravagance of this dual
approach, because I hope it represents merely a temporary aberration rather than
a portent of lasting change in settled principles of constitutional law. Suffice
it to say that I dispute not only the wisdom but also the legitimacy of the
Court's attempt to discredit and pre-empt state abortion regulation regardless
of the interests it serves and the impact it has.
Under the "unduly burdensome" test, the District Judge's conclusion that
appellees were not entitled to a preliminary injunction was clearly correct.
Indeed, the District Judge applied essentially that test, after suggesting that
no "meaningful distinction can be made between the plaintiffs' `legally
[476 U.S. 747, 830] significant burden' and defendants' `undue burden.'"
552 F. Supp., at 796. I begin, as does the Court, with the Act's informed
consent provisions.
The Court condemns some specific features of the informed consent provisions
of 3205, and issues a blanket condemnation of the provisions in their entirety
as irrelevant or distressing in some cases and as intruding on the relationship
between the woman and her physician. JUSTICE WHITE convincingly argues that none
of the Court's general criticisms is appropriate, since the information is
clearly relevant in many cases and is calculated to inform rather than
intimidate, and since all informed consent requirements must, from the very
rationale for their existence, intrude to some extent on the physician's
discretion to be the sole judge of what his or her patient needs to know. The
"parade of horribles" the Court invalidated in Akron, supra, at 445, is missing
here. For example, 3205(a)(iii) requires that the woman be informed, "when
medically accurate," of the risks associated with a particular abortion
procedure, and 3205(a)(v) requires the physician to inform the woman of "[t]he
medical risks associated with carrying her child to term." This is the kind of
balanced information I would have thought all could agree is relevant to a
woman's informed consent.
I do not dismiss the possibility that requiring the physician or counselor to
read aloud the State's printed materials if the woman wishes access to them but
cannot read raises First Amendment concerns. Even the requirement that women who
can read be informed of the availability of those materials, and furnished with
them on request, may create some possibility that the physician or counselor is
being required to "communicate [the State's] ideology." Akron, supra, at 472, n.
16 (O'CONNOR, J., dissenting); see Wooley v. Maynard, 430 U.S. 705 (1977). Since
the Court of Appeals did not reach appellees' First Amendment claim, and since
appellees do not raise it here, I need not decide whether this potential problem
would be sufficiently serious to warrant issuance of a
[476 U.S. 747, 831] preliminary injunction as to those portions of 3205
that incorporate the printed information provisions of 3208. I note, however,
that this is one of many points on which fuller factual development, including
the actual contents of the printed materials, could affect resolution of the
merits.
The Court singles out for specific criticism the required description, in the
printed materials, of fetal characteristics at 2-week intervals. These
materials, of course, will be shown to the woman only if she chooses to inspect
them. If the materials were sufficiently inflammatory and inaccurate the fact
that the woman must ask to see them would not necessarily preclude finding an
undue burden, but there is no indication that this is true of the description of
fetal characteristics the statute contemplates. Accordingly, I think it unlikely
that appellees could succeed in making the threshold showing of an undue burden
on this point, and the information is certainly rationally related to the
State's interests in ensuring informed consent and in protecting potential human
life. Similarly, I see little chance that appellees can establish that the
abortion decision is unduly burdened by 3205's requirements that the woman be
informed of the availability of medical assistance benefits and of the father's
legal responsibility. Here again, the information is indisputably relevant in
many cases and would not appear to place a severe limitation on the abortion
decision.
The Court's rationale for striking down the reporting requirements of 3214,
as JUSTICE WHITE shows, rests on an unsupported finding of fact by this Court to
the effect that "[i]dentification is the obvious purpose of these extreme
reporting requirements." Ante, at 767 (opinion of the Court). The Court's
"finding," which is contrary to the preliminary finding of the District Judge
that the statute's confidentiality requirements protected against any invasion
of privacy that could burden the abortion decision, see 552 F. Supp., at 804, is
simply another consequence of the Court's determination to prevent the parties
from developing the facts. I do not [476 U.S. 747, 832] know whether JUSTICE WHITE
is correct in stating that "the provisions pose little or no threat to the
woman's privacy," ante, at 807 (dissenting), and I would leave that
determination for the District Court, which can hear evidence on this point
before making its findings. I do not, however, see a substantial threat of
identification on the face of the statute, which does not require disclosure of
the woman's identity to anyone, and which provides that reports shall be
disclosed to the public only in "a form which will not lead to the disclosure of
the identity of any person filing a report." 3214(e)(2). I therefore conclude
that the District Judge correctly ruled that appellees are unlikely to succeed
in establishing an undue burden on the abortion decision stemming from the
possibility of identification.
I fully agree with JUSTICE WHITE that the Court has misconstrued the intended
meaning of 3210(b)'s requirement that physicians employ the abortion method that
is most likely to save the fetus unless, in the physician's good-faith judgment,
that method "would present a significantly greater risk to the life or health of
the pregnant woman." Since 3210(b) can fairly be read to require "only that the
risk be a real and identifiable one," ante, at 807 (WHITE, J., dissenting),
there is little possibility that a woman's abortion decision will be unduly
burdened by risks falling below that threshold. Accordingly, 3210(b) should not
be preliminarily enjoined, and I express no opinion as to the point at which a
"trade-off" between the health of the woman and the survival of the fetus would
rise to the level of an undue burden.
Since appellants and appellees agree that no further factfinding is needed
concerning appellees' challenge to 3210(c)'s second-physician requirement, I am
willing to assume that the merits of that challenge are properly before us. I
have nothing to add to JUSTICE WHITE'S demonstration that this provision is
constitutional under Ashcroft because the Act effectively provides for an
exception making this requirement inapplicable in emergency situations. I
likewise agree [476 U.S. 747, 833]
with JUSTICE WHITE that the preliminary injunction entered against enforcement
of the Act's parental notice and consent provisions should be vacated, since, as
in Ashcroft, there is no reason here to believe that the State will not provide
for the expedited procedures called for by its statute. See Ashcroft, 462 U.S.,
at 491, n. 16 (opinion of POWELL, J.). I add only that the Court's explanation
for its refusal to follow Ashcroft - that the new rules "should be considered by
the District Court in the first instance," ante, at 758, n. 9 - does not square
with its insistence on resolving the rest of this case without giving the
District Court an opportunity to do so.
In my view, today's decision makes bad constitutional law and bad procedural
law. The "`undesired and uncomfortable straitjacket'" in this case, ante, at
762, is not the one the Court purports to discover in Pennsylvania's statute; it
is the one the Court has tailored for the 50 States. I respectfully dissent.
[Footnote *] The extraordinary importance
of prompt resolution of the steel companies' claims is shown by the fact that
this Court granted certiorari before judgment in the Court of Appeals three days
after the District Court ruled, and set the case for argument nine days later,
"[d]eeming it best that the issues raised be promptly decided by this Court."
343 U.S., at 584. [476 U.S. 747, 834]
Copyright © 1994-1999 FindLaw Inc.

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