Constitutional Law Cases: Rehnquist Court
1990 - 1999
U.S. Supreme Court
PLANNED PARENTHOOD OF SOUTHEASTERN PA. v. CASEY, 505 U.S. 833 (1992)
505 U.S. 833
PLANNED PARENTHOOD OF SOUTHEASTERN
PENNSYLVANIA, ET AL. v.
CASEY, GOVERNOR OF PENNSYLVANIA, ET AL., CERTIORARI TO THE UNITED STATES COURT OF
APPEALS FOR THE THIRD CIRCUIT Nos. 91-744
Argued April 22, 1992
Decided June 29, 1992 *
[ Footnote * ] Together with No. 91-902, Casey, Governor of Pennsylvania, et al, v. Planned Parenthood of Southeastern Pennsylvania et al., also on certiorari to the same court.
At issue are five provisions of the Pennsylvania Abortion Control Act of 1982: 3205,
which requires that a woman seeking an abortion give her informed consent prior to
the procedure, and specifies that she be provided with certain information at least
24 hours before the abortion is performed; 3206, which mandates the informed consent
of one parent for a minor to obtain an abortion, but provides a judicial bypass procedure;
3209, which commands that, unless certain exceptions apply, a married woman seeking
an abortion must sign a statement indicating that she has notified her husband; 3203,
which defines a "medical emergency" that will excuse compliance with the foregoing
requirements; and 3207(b), 3214(a), and 3214(f), which impose certain reporting requirements
on facilities providing abortion services. Before any of the provisions took effect,
the petitioners, five abortion clinics and a physician representing himself and a
class of doctors who provide abortion services, brought this suit seeking a declaratory
judgment that each of the provisions was unconstitutional on its face, as well as
injunctive relief. The District Court held all the provisions unconstitutional, and
permanently enjoined their enforcement. The Court of Appeals affirmed in part and
reversed in part, striking down the husband notification provision but upholding the
others.
Held:
The judgment in No. 91-902 is affirmed; the judgment in No. 91-744 is affirmed in
part and reversed in part, and the case is remanded.
947 F.2d 682: No. 91-902, affirmed; No. 91-744, affirmed in part, reversed in part,
and remanded.
JUSTICE O'CONNOR, JUSTICE KENNEDY, and JUSTICE SOUTER delivered the opinion of the
Court with respect to Parts I, II, and III, concluding that consideration of the fundamental
constitutional question resolved by Roe v. Wade, 410 U.S. 113 , principles of institutional
integrity, and the rule of stare decisis require that Roe's essential holding be retained
[505 U.S. 833, 834] and reaffirmed as to each of its three parts: (1) a recognition
of a woman's right to choose to have an abortion before fetal viability and to obtain
it without undue interference from the State, whose pre-viability interests are not
strong enough to support an abortion prohibition or the imposition of substantial
obstacles to the woman's effective right to elect the procedure; (2) a confirmation
of the State's power to restrict abortions after viability, if the law contains exceptions
for pregnancies endangering a woman's life or health; and (3) the principle that the
State has legitimate interests from the outset of the pregnancy in protecting the
health of the woman and the life of the fetus that may become a child. Pp. 844-869.
(a) A reexamination of the principles that define the woman's rights and the State's
authority regarding abortions is required by the doubt this Court's subsequent decisions
have cast upon the meaning and reach of Roe's central holding, by the fact that THE
CHIEF JUSTICE would overrule Roe, and by the necessity that state and federal courts
and legislatures have adequate guidance on the subject. Pp. 844-845.
(b) Roe determined that a woman's decision to terminate her pregnancy is a "liberty"
protected against state interference by the substantive component of the Due Process
Clause of the Fourteenth Amendment. Neither the Bill of Rights nor the specific practices
of States at the time of the Fourteenth Amendment's adoption marks the outer limits
of the substantive sphere of such "liberty." Rather, the adjudication of substantive
due process claims may require this Court to exercise its reasoned judgment in determining
the boundaries between the individual's liberty and the demands of organized society.
The Court's decisions have afforded constitutional protection to personal decisions
relating to marriage, see, e.g., Loving v. Virginia, 388 U.S. 1 , procreation, Skinner
v. Oklahoma ex rel Williamson, 316 U.S. 535 , family relationships, Prince v. Massachusetts,
321 U.S. 158 , child rearing and education, Pierce v. Society of Sisters, 268 U.S.
510 , and contraception, Griswold v. Connecticut, 381 U.S. 479 , and have recognized
the right of the individual to be free from unwarranted governmental intrusion into
matters so fundamentally affecting a person as the decision whether to bear or beget
a child, Eisenstadt v. Baird, 405 U.S. 438, 453 . Roe's central holding properly invoked
the reasoning and tradition of these precedents. Pp. 846-853.
(c) Application of the doctrine of stare decisis confirms that Roe's essential holding
should be reaffirmed. In reexamining that holding, the Court's judgment is informed
by a series of prudential and pragmatic considerations designed to test the consistency
of overruling the holding with the ideal of the rule of law, and to gauge the respective
costs of reaffirming and overruling. Pp. 854-855. [505 U.S. 833, 835]
(d) Although Roe has engendered opposition, it has in no sense proven unworkable,
representing as it does a simple limitation beyond which a state law is unenforceable.
P. 835.
(e) The Roe rule's limitation on state power could not be repudiated without serious
inequity to people who, for two decades of economic and social developments, have
organized intimate relationships and made choices that define their views of themselves
and their places in society, in reliance on the availability of abortion in the event
that contraception should fail. The ability of women to participate equally in the
economic and social life of the Nation has been facilitated by their ability to control
their reproductive lives. The Constitution serves human values, and while the effect
of reliance on Roe cannot be exactly measured, neither can the certain costs of overruling
Roe for people who have ordered their thinking and living around that case be dismissed.
Pp. 855-856.
(f) No evolution of legal principle has left Roe's central rule a doctrinal anachronism
discounted by society. If Roe is placed among the cases exemplified by Griswold, supra,
it is clearly in no jeopardy, since subsequent constitutional developments have neither
disturbed, nor do they threaten to diminish, the liberty recognized in such cases.
Similarly, if Roe is seen as stating a rule of personal autonomy and bodily integrity,
akin to cases recognizing limits on governmental power to mandate medical treatment
or to bar its rejection, this Court's post-Roe decisions accord with Roe's view that
a State's interest in the protection of life falls short of justifying any plenary
override of individual liberty claims. See, e.g., Cruzan v. Director, M. Dept. of
Health, 497 U.S. 261, 278 . Finally, if Roe is classified as sui generis, there clearly
has been no erosion of its central determination. It was expressly reaffirmed in Akron
v. Akron Center for Reproductive Health, Inc., 462 U.S. 416 (Akron I), and Thornburgh
v. American College of Obstetricians and Gynecologists, 476 U.S. 747 ; and, in Webster
v. Reproductive Health Services, 492 U.S. 490 , a majority either voted to reaffirm
or declined to address the constitutional validity of Roe's central holding. Pp. 857-859.
(g) No change in Roe's factual underpinning has left its central holding obsolete,
and none supports an argument for its overruling. Although subsequent maternal health
care advances allow for later abortions safe to the pregnant woman, and post-Roe neonatal
care developments have advanced viability to a point somewhat earlier, these facts
go only to the scheme of time limits on the realization of competing interests. Thus,
any later divergences from the factual premises of Roe have no bearing on the validity
of its central holding, that viability marks the earliest point at which the State's
interest in fetal [505 U.S. 833, 836] life is constitutionally adequate to justify
a legislative ban on nontherapeutic abortions. The soundness or unsoundness of that
constitutional judgment in no sense turns on when viability occurs. Whenever it may
occur, its attainment will continue to serve as the critical fact. Pp. 860.
(h) A comparison between Roe and two decisional lines of comparable significance
- the line identified with Lochner v. New York, 198 U.S. 45 , and the line that began
with Plessy v. Ferguson, 163 U.S. 537 - confirms the result reached here. Those lines
were overruled - by, respectively, West Coast Hotel Co. v. Parrish, 300 U.S. 379 ,
and Brown v. Board of Education, 347 U.S. 483 - on the basis of facts, or an understanding
of facts, changed from those which furnished the claimed justifications for the earlier
constitutional resolutions. The overruling decisions were comprehensible to the Nation,
and defensible, as the Court's responses to changed circumstances. In contrast, because
neither the factual underpinnings of Roe's central holding nor this Court's understanding
of it has changed (and because no other indication of weakened precedent has been
shown), the Court could not pretend to be reexamining Roe with any justification beyond
a present doctrinal disposition to come out differently from the Roe Court. That is
an inadequate basis for overruling a prior case. Pp. 861-864.
(i) Overruling Roe's central holding would not only reach an unjustifiable result
under stare decisis principles, but would seriously weaken the Court's capacity to
exercise the judicial power and to function as the Supreme Court of a Nation dedicated
to the rule of law. Where the Court acts to resolve the sort of unique, intensely
divisive controversy reflected in Roe, its decision has a dimension not present in
normal cases, and is entitled to rare precedential force to counter the inevitable
efforts to overturn it and to thwart its implementation. Only the most convincing
justification under accepted standards of precedent could suffice to demonstrate that
a later decision overruling the first was anything but a surrender to political pressure
and an unjustified repudiation of the principle on which the Court staked its authority
in the first instance. Moreover, the country's loss of confidence in the Judiciary
would be underscored by condemnation for the Court's failure to keep faith with those
who support the decision at a cost to themselves. A decision to overrule Roe's essential
holding under the existing circumstances would address error, if error there was,
at the cost of both profound and unnecessary damage to the Court's legitimacy and
to the Nation's commitment to the rule of law. Pp. 864-869.
JUSTICE O'CONNOR, JUSTICE KENNEDY, and JUSTICE SOUTER concluded in Part IV that an
examination of Roe v. Wade, 410 U.S. 113 , and [505 U.S. 833, 837] subsequent cases,
reveals a number of guiding principles that should control the assessment of the Pennsylvania
statute:
(a) To protect the central right recognized by Roe while at the same time accommodating
the State's profound interest in potential life, see id., at 162, the undue burden
standard should be employed. An undue burden exists, and therefore a provision of
law is invalid, if its purpose or effect is to place substantial obstacles in the
path of a woman seeking an abortion before the fetus attains viability.
(b) Roe's rigid trimester framework is rejected. To promote the State's interest
in potential life throughout pregnancy, the State may take measures to ensure that
the woman's choice is informed. Measures designed to advance this interest should
not be invalidated if their purpose is to persuade the woman to choose childbirth
over abortion. These measures must not be an undue burden on the right.
(c) As with any medical procedure, the State may enact regulations to further the
health or safety of a woman seeking an abortion, but may not impose unnecessary health
regulations that present a substantial obstacle to a woman seeking an abortion.
(d) Adoption of the undue burden standard does not disturb Roe's holding that, regardless
of whether exceptions are made for particular circumstances, a State may not prohibit
any woman from making the ultimate decision to terminate her pregnancy before viability.
(e) Roe's holding that "subsequent to viability, the State, in promoting its interest
in the potentiality of human life, may, if it chooses, regulate, and even proscribe,
abortion except where it is necessary, in appropriate medical judgment, for the preservation
of the life or health of the mother" is also reaffirmed. Id., at 164-165. Pp. 869-879.
JUSTICE O'CONNOR, JUSTICE KENNEDY, and JUSTICE SOUTER delivered the opinion of the
Court with respect to Parts V-A and V-C, concluding that:
1. As construed by the Court of Appeals, 3203's medical emergency definition is intended
to assure that compliance with the State's abortion regulations would not in any way
pose a significant threat to a woman's life or health, and thus does not violate the
essential holding of Roe, supra, at 164. Although the definition could be interpreted
in an unconstitutional manner, this Court defers to lower federal court interpretations
of state law unless they amount to "plain" error. Pp. 879-880.
2. Section 3209's husband notification provision constitutes an undue burden, and
is therefore invalid. A significant number of women will likely be prevented from
obtaining an abortion just as surely as if Pennsylvania had outlawed the procedure
entirely. The fact that 3209 may affect fewer than one percent of women seeking abortions
does not save it from facial invalidity, since the proper focus of constitutional
inquiry [505 U.S. 833, 838] is the group for whom the law is a restriction, not the
group for whom it is irrelevant. Furthermore, it cannot be claimed that the father's
interest in the fetus' welfare is equal to the mother's protected liberty, since it
is an inescapable biological fact that state regulation with respect to the fetus
will have a far greater impact on the pregnant woman's bodily integrity than it will
on the husband. Section 3209 embodies a view of marriage consonant with the common
law status of married women, but repugnant to this Court's present understanding of
marriage and of the nature of the rights secured by the Constitution. See Planned
Parenthood of Central Mo. v. Danforth, 428 U.S. 52, 69 . Pp. 887-898.
JUSTICE O'CONNOR, JUSTICE KENNEDY, and JUSTICE SOUTER, joined by JUSTICE STEVENS,
concluded in Part V-E that all of the statute's recordkeeping and reporting requirements,
except that relating to spousal notice, are constitutional. The reporting provision
relating to the reasons a married woman has not notified her husband that she intends
to have an abortion must be invalidated, because it places an undue burden on a woman's
choice. Pp. 900-901.
JUSTICE O'CONNOR, JUSTICE KENNEDY, and JUSTICE SOUTER concluded in Parts V-B and
V-D that:
1. Section 3205's informed consent provision is not an undue burden on a woman's
constitutional right to decide to terminate a pregnancy. To the extent Akron I, 462
U.S., at 444 , and Thornburgh, 476 U.S., at 762 , find a constitutional violation
when the government requires, as it does here, the giving of truthful, nonmisleading
information about the nature of the abortion procedure, the attendant health risks
and those of childbirth, and the "probable gestational age" of the fetus, those cases
are inconsistent with Roe's acknowledgment of an important interest in potential life,
and are overruled. Requiring that the woman be informed of the availability of information
relating to the consequences to the fetus does not interfere with a constitutional
right of privacy between a pregnant woman and her physician, since the doctor-patient
relation is derivative of the woman's position, and does not underlie or override
the abortion right. Moreover, the physician's First Amendment rights not to speak
are implicated only as part of the practice of medicine, which is licensed and regulated
by the State. There is no evidence here that requiring a doctor to give the required
information would amount to a substantial obstacle to a woman seeking an abortion.
The premise behind Akron I's invalidation of a waiting period between the provision
of the information deemed necessary to informed consent and the performance of an
abortion, 462 U.S., at 450 , is also wrong. Although 3205's 24-hour waiting period
may make some abortions more expensive and less convenient, it cannot be said that
it is invalid [505 U.S. 833, 839] on the present record and in the context of this
facial challenge. Pp. 881-887.
2. Section 3206's one-parent consent requirement and judicial bypass procedure are
constitutional. See, e.g., Ohio v. Akron Center for Reproductive Health, 497 U.S.
502, 510 -519. Pp. 899-900.
JUSTICE BLACKMUN concluded that application of the strict scrutiny standard of review
required by this Court's abortion precedents results in the invalidation of all the
challenged provisions in the Pennsylvania statute, including the reporting requirements,
and therefore concurred in the judgment that the requirement that a pregnant woman
report her reasons for failing to provide spousal notice is unconstitutional. Pp.
830, 934-936.
THE CHIEF JUSTICE, joined by JUSTICE WHITE, JUSTICE SCALIA, and JUSTICE THOMAS, concluded
that:
1. Although Roe v. Wade, 410 U.S. 113 , is not directly implicated by the Pennsylvania
statute, which simply regulates, and does not prohibit, abortion, a reexamination
of the "fundamental right" Roe accorded to a woman's decision to abort a fetus, with
the concomitant requirement that any state regulation of abortion survive "strict
scrutiny," id., at 154-156, is warranted by the confusing and uncertain state of this
Court's post-Roe decisional law. A review of post-Roe cases demonstrates both that
they have expanded upon Roe in imposing increasingly greater restrictions on the States,
see Thornburgh v. American College of Obstetricians and Gynecologists, 476 U.S. 747,
783 (Burger, C.J., dissenting), and that the Court has become increasingly more divided,
none of the last three such decisions having commanded a majority opinion, see Ohio
v. Akron Center for Reproductive Health, 497 U.S. 502 ; Hodgson v. Minnesota, 497
U.S. 417 ; Webster v. Reproductive Health Services, 492 U.S. 490 . This confusion
and uncertainty complicated the task of the Court of Appeals, which concluded that
the "undue burden" standard adopted by JUSTICE O'CONNOR in Webster and Hodgson governs
the present cases. Pp. 944-951.
2. The Roe Court reached too far when it analogized the right to abort a fetus to
the rights involved in Pierce v. Society of Sisters, 268 U.S. 510 ; Meyer v. Nebraska,
262 U.S. 390 ; Loving v. Virginia, 388 U.S. 1 ; and Griswold v. Connecticut, 381 U.S.
479 , and thereby deemed the right to abortion to be "fundamental." None of these
decisions endorsed an all-encompassing "right of privacy," as Roe, supra, at 152-153,
claimed. Because abortion involves the purposeful termination of potential life, the
abortion decision must be recognized as sui generis, different in kind from the rights
protected in the earlier cases under the rubric of personal or family privacy and
autonomy. And the historical traditions of the American people - as evidenced by the
English common [505 U.S. 833, 840] law and by the American abortion statutes in existence
both at the time of the Fourteenth Amendment's adoption and Roe's issuance - do not
support the view that the right to terminate one's pregnancy is "fundamental." Thus,
enactments abridging that right need not be subjected to strict scrutiny. Pp. 951-953.
3. The undue burden standard adopted by the joint opinion of JUSTICES O'CONNOR, KENNEDY,
and SOUTER has no basis in constitutional law, and will not result in the sort of
simple limitation, easily applied, which the opinion anticipates. To evaluate abortion
regulations under that standard, judges will have to make the subjective, unguided
determination whether the regulations place "substantial obstacles" in the path of
a woman seeking an abortion, undoubtedly engendering a variety of conflicting views.
The standard presents nothing more workable than the trimester framework the joint
opinion discards, and will allow the Court, under the guise of the Constitution, to
continue to impart its own preferences on the States in the form of a complex abortion
code. Pp. 964-966.
4. The correct analysis is that set forth by the plurality opinion in Webster, supra:
a woman's interest in having an abortion is a form of liberty protected by the Due
Process Clause, but States may regulate abortion procedures in ways rationally related
to a legitimate state interest. P. 966.
5. Section 3205's requirements are rationally related to the State's legitimate interest
in assuring that a woman's consent to an abortion be fully informed. The requirement
that a physician disclose certain information about the abortion procedure and its
risks and alternatives is not a large burden, and is clearly related to maternal health
and the State's interest in informed consent. In addition, a State may rationally
decide that physicians are better qualified than counselors to impart this information
and answer questions about the abortion alternatives' medical aspects. The requirement
that information be provided about the availability of paternal child support and
state-funded alternatives is also related to the State's informed consent interest,
and furthers the State's interest in preserving unborn life. That such information
might create some uncertainty and persuade some women to forgo abortions only demonstrates
that it might make a difference, and is therefore relevant to a woman's informed choice.
In light of this plurality's rejection of Roe's "fundamental right" approach to this
subject, the Court's contrary holding in Thornburgh is not controlling here. For the
same reason, this Court's previous holding invalidating a State's 24-hour mandatory
waiting period should not be followed. The waiting period helps ensure that a woman's
decision to abort is a well-considered one, and rationally furthers the State's legitimate
interest in maternal health and [505 U.S. 833, 841] in unborn life. It may delay,
but does not prohibit, abortions; and both it and the informed consent provisions
do not apply in medical emergencies. Pp. 966-970.
6. The statute's parental consent provision is entirely consistent with this Court's
previous decisions involving such requirements. See, e.g., Planned Parenthood Ass.
of Kansas City, M., Inc. v. Ashcroft, 462 U.S. 476 . It is reasonably designed to
further the State's important and legitimate interest "in the welfare of its young
citizens, whose immaturity, inexperience, and lack of judgment may sometimes impair
their ability to exercise their rights wisely." Hodgson, supra, at 444. Pp. 970-971.
7. Section 3214(a)'s requirement that abortion facilities file a report on each abortion
is constitutional, because it rationally furthers the State's legitimate interests
in advancing the state of medical knowledge concerning maternal health and prenatal
life, in gathering statistical information with respect to patients, and in ensuring
compliance with other provisions of the Act, while keeping the reports completely
confidential. Public disclosure of other reports made by facilities receiving public
funds - those identifying the facilities and any parent, subsidiary, or affiliated
organizations, 3207(b), and those revealing the total number of abortions performed,
broken down by trimester, 3214(f) - are rationally related to the State's legitimate
interest in informing taxpayers as to who is benefiting from public funds and what
services the funds are supporting; and records relating to the expenditure of public
funds are generally available to the public under Pennsylvania law. Pp. 976-977.
JUSTICE SCALIA, joined by THE CHIEF JUSTICE, JUSTICE WHITE, and JUSTICE THOMAS, concluded
that a woman's decision to abort her unborn child is not a constitutionally protected
"liberty," because (1) the Constitution says absolutely nothing about it, and (2)
the longstanding traditions of American society have permitted it to be legally proscribed.
See, e.g., Ohio v. Akron Center for Reproductive Health, 497 U.S. 502, 520 (SCALIA,
J., concurring). The Pennsylvania statute should be upheld in its entirety under the
rational basis test. Pp. 979-981.
O'CONNOR, KENNEDY, and SOUTER, JJ., announced the judgment of the Court and delivered
the opinion of the Court with respect to Parts I, II, III, V-A, V-C, and VI, in which
BLACKMUN and STEVENS, JJ., joined, an opinion with respect to Part V-E, in which STEVENS,
J., joined, and an opinion with respect to Parts IV, V-B, and V-D. STEVENS, J., filed
an opinion concurring in part and dissenting in part. BLACKMUN, J., filed an opinion
concurring in part, concurring in the judgment in part, and dissenting in part, post,
p. 911. REHNQUIST, C.J., filed an opinion concurring in the judgment in part and dissenting
in part, in which [505 U.S. 833, 842] WHITE, SCALIA, and THOMAS, JJ., joined, post,
p. 922. SCALIA, J., filed an opinion concurring in the judgment in part and dissenting
in part, in which REHNQUIST, C.J., and WHITE and THOMAS, JJ., joined, post, p. 979.
Kathryn Kolbert argued the cause for petitioners in No. 91-744 and respondents in
No. 91-902. With her on the briefs were Janet Benshoof, Lynn M. Paltrow, Rachael N.
Pine, Steven R. Shapiro, John A. Powell, Linda J. Wharton, and Carol E. Tracy.
Ernest D. Preate, Jr., Attorney General of Pennsylvania, argued the cause for respondents
in No. 91-744 and petitioners in No. 91-902. With him on the brief were John G. Knorr
III, Chief Deputy Attorney General, and Kate L. Mershimer, Senior Deputy Attorney
General.
Solicitor General Starr argued the cause for the United States as amicus curiae in
support of respondents in No. 91-744 and petitioners in No. 91-902. With him on the
brief were Assistant Attorney General Gerson, Paul J. Larkin, Jr., Thomas G. Hungar,
and Alfred R. Mollin.Fn
Fn [505 U.S. 833, 842] Briefs of amici curiae were filed for the State of New York
et al. by Robert Abrams, Attorney General of New York, Jerry Boone, Solicitor General,
Mary Ellen Burns, Chief Assistant Attorney General, and Sanford M. Cohen, Donna I.
Dennis, Marjorie Fujiki, and Shelley B. Mayer, Assistant Attorneys General, and John
McKernan, Governor of Maine, and Michael E. Carpenter, Attorney General, Richard Blumenthal,
Attorney General of Connecticut, Charles M. Oberly III, Attorney General of Delaware,
Warren Price III, Attorney General of Hawaii, Roland W. Burris, Attorney General of
Illinois, Bonnie J. Campbell, Attorney General of Iowa, J. Joseph Curran, Jr., Attorney
General of Maryland, Scott Harshbarger, Attorney General of Massachusetts, Frankie
Sue Del Papa, Attorney General of Nevada, Robert J. Del Tufo, Attorney General of
New Jersey, Tom Udall, Attorney General of New Mexico, Lacy H. Thornburg, Attorney
General of North Carolina, James E. O'Neil, Attorney General of Rhode Island, Dan
Morales, Attorney General of Texas, Jeffrey L. Amestoy, Attorney General of Vermont,
and John Payton, Corporation Counsel of District of Columbia; for the State of Utah
by R. Paul Van Dam, Attorney General, and Mary Anne Q. Wood, Special Assistant Attorney
General; for the city of New York et al. by O. Peter Sherwood, Conrad Harper, Janice
Goodman, Leonard J. Koerner, Lorna Bade Goodman, Gail Rubin, and Julie Mertus; for
178 Organizations by Pamela S. [505 U.S. 833, 843] Karlan and Sarah Weddington; for
Agudath Israel of America by David Zwiebel; for the Alan Guttmacher Institute et al.
by Colleen K. Connell and Dorothy B. Zimbrakos; for the American Academy of Medical
Ethics by Joseph W. Dellapenna; for the American Association of Prolife Obstetricians
and Gynecologists et al. by William Bentley Ball, Philip J. Murren, and Maura K. Quinlan;
for the American College of Obstetricians and Gynecologists et al. by Carter G. Phillips,
Ann E. Allen, Laurie R. Rockett, Joel I. Klein, Nadine Taub, and Sarah C. Carey; for
the American Psychological Association by David W. Ogden; for Texas Black Americans
for Life by Lawrence J. Joyce and Craig H. Greenwood; for Catholics United for Life
et al. by Thomas Patrick Monaghan, Jay Alan Sekulow, Walter M. Weber, Thomas A. Glessner,
Charles E. Rice, and Michael J. Laird; for the Elliot Institute for Social Sciences
Research by Stephen R. Kaufmann; for Feminists for Life of America et al. by Keith
A. Fournier, John G. Stepanovich, Christine Smith Torre, Theodore H. Amshoff, Jr.,
and Mary Dice Grenen; for Focus on the Family et al. by Stephen H. Galebach, Gregory
J. Granitto, Stephen W. Reed, David L. Llewellyn, Jr., Benjamin W. Bull, and Leonard
J. Pranschke; for the Knights of Columbus by Carl A. Anderson; for Life Issues Institute
by James Bopp, Jr., and Richard E. Coleson; for the NAACP Legal Defense and Educational
Fund, Inc., et al. by Julius L. Chambers, Ronald L. Ellis, and Alice L. Brown; for
the National Legal Foundation by Robert K. Skolrood; for National Right to Life, Inc.,
by Messrs. Bopp and Coleson, Robert A. Destro, and A. Eric Johnston; for the Pennsylvania
Coalition Against Domestic Violence et al. by Phyllis Gelman; for the Rutherford Institute
et al. by Thomas W. Strahan, John W. Whitehead, Mr. Johnston, Stephen E. Hurst, Joseph
Secola, Thomas S. Neuberger, J. Brian Heller, Amy Dougherty, Stanley R. Jones, David
Melton, Robert R. Melnick, William Bonner, W. Charles Bundren, and James Knicely;
for the Southern Center for Law & Ethics by Tony G. Miller; for the United States
Catholic Conference et al. by Mark E. Chopko, Phillip H. Harris, Michael K. Whitehead,
and Forest D. Montgomery; for University Faculty for Life by Clarke D. Forsythe and
Victor G. Rosenblum; for Certain American State Legislators by Paul Benjamin Linton;
for 19 Arizona Legislators by Ronald D. Maines; for Representative Henry J. Hyde et
al. by Albert P. Blaustein and Kevin J. Todd; for Representative Don Edwards et al.
by Walter Dellinger and Lloyd N. Cutler; and for 250 American Historians by Sylvia
A. Law. [505 U.S. 833, 843]
JUSTICE O'CONNOR, JUSTICE KENNEDY, and JUSTICE SOUTER announced the judgment of the
Court and delivered the opinion of the Court with respect to Parts I, II, III, V-A,
[505 U.S. 833, 844] V-C, and VI, an opinion with respect to Part V-E, in which JUSTICE
STEVENS joins, and an opinion with respect to Parts IV, V-B, and V-D.
I
Liberty finds no refuge in a jurisprudence of doubt. Yet, 19 years after our holding
that the Constitution protects a woman's right to terminate her pregnancy in its early
stages, Roe v. Wade, 410 U.S. 113 (1973), that definition of liberty is still questioned.
Joining the respondents as amicus curiae, the United States, as it has done in five
other cases in the last decade, again asks us to overrule Roe. See Brief for Respondents
104-117; Brief for United States as Amicus Curiae 8.
At issue in these cases are five provisions of the Pennsylvania Abortion Control
Act of 1982, as amended in 1988 and 1989. 18 Pa. Cons. Stat. 3203-3220 (1990). Relevant
portions of the Act are set forth in the Appendix. Infra at 60. The Act requires that
a woman seeking an abortion give her informed consent prior to the abortion procedure,
and specifies that she be provided with certain information at least 24 hours before
the abortion is performed. 3205. For a minor to obtain an abortion, the Act requires
the informed consent of one of her parents, but provides for a judicial bypass option
if the minor does not wish to or cannot obtain a parent's consent. 3206. Another provision
of the Act requires that, unless certain exceptions apply, a married woman seeking
an abortion must sign a statement indicating that she has notified her husband of
her intended abortion. 3209. The Act exempts compliance with these three requirements
in the event of a "medical emergency," which is defined in 3203 of the Act. See 3203,
3205(a), 3206(a), 3209(c). In addition to the above provisions regulating the performance
of abortions, the Act imposes certain reporting requirements on facilities that provide
abortion services. 3207(b), 3214(a), 3214(f). [505 U.S. 833, 845]
Before any of these provisions took effect, the petitioners, who are five abortion
clinics and one physician representing himself as well as a class of physicians who
provide abortion services, brought this suit seeking declaratory and injunctive relief.
Each provision was challenged as unconstitutional on its face. The District Court
entered a preliminary injunction against the enforcement of the regulations, and,
after a 3-day bench trial, held all the provisions at issue here unconstitutional,
entering a permanent injunction against Pennsylvania's enforcement of them. 744 F.
Supp. 1323 (ED Pa. 1990). The Court of Appeals for the Third Circuit affirmed in part
and reversed in part, upholding all of the regulations except for the husband notification
requirement. 947 F.2d 682 (1991). We granted certiorari. 502 U.S. 1056 (1992).
The Court of Appeals found it necessary to follow an elaborate course of reasoning
even to identify the first premise to use to determine whether the statute enacted
by Pennsylvania meets constitutional standards. See 947 F.2d, at 687-698. And at oral
argument in this Court, the attorney for the parties challenging the statute took
the position that none of the enactments can be upheld without overruling Roe v. Wade.
Tr. of Oral Arg. 5-6. We disagree with that analysis; but we acknowledge that our
decisions after Roe cast doubt upon the meaning and reach of its holding. Further,
The CHIEF JUSTICE admits that he would overrule the central holding of Roe and adopt
the rational relationship test as the sole criterion of constitutionality. See post,
at 944,966. State and federal courts, as well as legislatures throughout the Union,
must have guidance as they seek to address this subject in conformance with the Constitution.
Given these premises, we find it imperative to review once more the principles that
define the rights of the woman and the legitimate authority of the State respecting
the termination of pregnancies by abortion procedures.
After considering the fundamental constitutional questions resolved by Roe, principles
of institutional integrity, [505 U.S. 833, 846] and the rule of stare decisis, we
are led to conclude this: the essential holding of Roe v. Wade should be retained
and once again reaffirmed.
It must be stated at the outset and with clarity that Roe's essential holding, the
holding we reaffirm, has three parts. First is a recognition of the right of the woman
to choose to have an abortion before viability and to obtain it without undue interference
from the State. Before viability, the State's interests are not strong enough to support
a prohibition of abortion or the imposition of a substantial obstacle to the woman's
effective right to elect the procedure. Second is a confirmation of the State's power
to restrict abortions after fetal viability if the law contains exceptions for pregnancies
which endanger the woman's life or health. And third is the principle that the State
has legitimate interests from the outset of the pregnancy in protecting the health
of the woman and the life of the fetus that may become a child. These principles do
not contradict one another; and we adhere to each.
II
Constitutional protection of the woman's decision to terminate her pregnancy derives
from the Due Process Clause of the Fourteenth Amendment. It declares that no State
shall "deprive any person of life, liberty, or property, without due process of law."
The controlling word in the cases before us is "liberty." Although a literal reading
of the Clause might suggest that it governs only the procedures by which a State may
deprive persons of liberty, for at least 105 years, since Mugler v. Kansas, 123 U.S.
623, 660 -661 (1887), the Clause has been understood to contain a substantive component
as well, one "barring certain government actions regardless of the fairness of the
procedures used to implement them." Daniels v. Williams, 474 U.S. 327, 331 (1986).
As Justice Brandeis (joined by Justice Holmes) observed, [d]espite arguments to the
contrary which had seemed to me persuasive, it is settled that the due process clause
of the Fourteenth [505 U.S. 833, 847] Amendment applies to matters of substantive
law as well as to matters of procedure. Thus all fundamental rights comprised within
the term liberty are protected by the Federal Constitution from invasion by the States.
Whitney v. California, 274 U.S. 357, 373 (1927) (concurring opinion). [T]he guaranties
of due process, though having their roots in Magna Carta's "per legem terrae" and
considered as procedural safeguards "against executive usurpation and tyranny," have
in this country "become bulwarks also against arbitrary legislation." Poe v. Ullman,
367 U.S. 497, 541 (1961) (Harlan, J., dissenting from dismissal on jurisdictional
grounds) (quoting Hurtado v. California, 110 U.S. 516, 532 (1884)).
The most familiar of the substantive liberties protected by the Fourteenth Amendment
are those recognized by the Bill of Rights. We have held that the Due Process Clause
of the Fourteenth Amendment incorporates most of the Bill of Rights against the States.
See, e.g., Duncan v. Louisiana, 391 U.S. 145, 147 -148 (1968). It is tempting, as
a means of curbing the discretion of federal judges, to suppose that liberty encompasses
no more than those rights already guaranteed to the individual against federal interference
by the express provisions of the first eight amendments to the Constitution. See Adamson
v. California, 332 U.S. 46, 68 -92 (1947) (Black, J., dissenting). But of course this
Court has never accepted that view.
It is also tempting, for the same reason, to suppose that the Due Process Clause
protects only those practices, defined at the most specific level, that were protected
against government interference by other rules of law when the Fourteenth Amendment
was ratified. See Michael H. v. Gerald D., 491 U.S. 110, 127 -128, n. 6 (1989) (opinion
of SCALIA, J.). But such a view would be inconsistent with our law. It is a promise
of the Constitution that there is a realm of personal liberty which the government
may not enter. We have vindicated this principle before. Marriage is mentioned nowhere
in the Bill of Rights, and interracial marriage was illegal [505 U.S. 833, 848] in
most States in the 19th century, but the Court was no doubt correct in finding it
to be an aspect of liberty protected against state interference by the substantive
component of the Due Process Clause in Loving v. Virginia, 388 U.S. 1, 12 (1967) (relying,
in an opinion for eight Justices, on the Due Process Clause). Similar examples may
be found in Turner v. Safley, 482 U.S. 78, 94 -99 (1987); in Carey v. Population Services
International, 431 U.S. 678, 684 -686 (1977); in Griswold v. Connecticut, 381 U.S.
479, 481 -482 (1965), as well as in the separate opinions of a majority of the Members
of the Court in that case, id. at 486-488 (Goldberg, J., joined by Warren, C.J., and
Brennan, J., concurring) (expressly relying on due process), id. at 500-502 (Harlan,
J., concurring in judgment) (same), id. at 502-507, (WHITE, J., concurring in judgment)
(same); in Pierce v. Society of Sisters, 268 U.S. 510, 534 -535 (1925); and in Meyer
v. Nebraska, 262 U.S. 390, 399 -403 (1923).
Neither the Bill of Rights nor the specific practices of States at the time of the
adoption of the Fourteenth Amendment marks the outer limits of the substantive sphere
of liberty which the Fourteenth Amendment protects. See U.S. Const., Amdt. 9. As the
second Justice Harlan recognized:
[T]he full scope of the liberty guaranteed by the Due Process Clause cannot be found
in or limited by the precise terms of the specific guarantees elsewhere provided in
the Constitution. This "liberty" is not a series of isolated points pricked out in
terms of the taking of property; the freedom of speech, press, and religion; the right
to keep and bear arms; the freedom from unreasonable searches and seizures; and so
on. It is a rational continuum which, broadly speaking, includes a freedom from all
substantial arbitrary impositions and purposeless restraints, . . . and which also
recognizes, what a reasonable and sensitive judgment must, that certain interests
require particularly careful scrutiny of the state needs asserted to justify their
abridgment. Poe v. [505 U.S. 833, 849] Ullman, supra, 367 U.S., at 543 (dissenting
from dismissal on jurisdictional grounds).
Justice Harlan wrote these words in addressing an issue the full Court did not reach
in Poe v. Ullman, but the Court adopted his position four Terms later in Griswold
v. Connecticut, supra. In Griswold, we held that the Constitution does not permit
a State to forbid a married couple to use contraceptives. That same freedom was later
guaranteed, under the Equal Protection Clause, for unmarried couples. See Eisenstadt
v. Baird, 405 U.S. 438 (1972). Constitutional protection was extended to the sale
and distribution of contraceptives in Carey v. Population Services International,
supra. It is settled now, as it was when the Court heard arguments in Roe v. Wade,
that the Constitution places limits on a State's right to interfere with a person's
most basic decisions about family and parenthood, see Carey v. Population Services
International, supra; Moore v. East Cleveland, 431 U.S. 494 (1977); Eisenstadt v.
Baird, supra; Loving v. Virginia, supra; Griswold v. Connecticut, supra; Skinner v.
Oklahoma ex rel. Williamson, 316 U.S. 535 (1942); Pierce v. Society of Sisters, supra;
Meyer v. Nebraska, supra, as well as bodily integrity, see, e.g., Washington v. Harper,
494 U.S. 210, 221 -222 (1990); Winston v. Lee, 470 U.S. 753 (1985); Rochin v. California,
342 U.S. 165 (1952).
The inescapable fact is that adjudication of substantive due process claims may call
upon the Court in interpreting the Constitution to exercise that same capacity which,
by tradition, courts always have exercised: reasoned judgment. Its boundaries are
not susceptible of expression as a simple rule. That does not mean we are free to
invalidate state policy choices with which we disagree; yet neither does it permit
us to shrink from the duties of our office. As Justice Harlan observed:
"Due process has not been reduced to any formula; its content cannot be determined
by reference to any code. [505 U.S. 833, 850] 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." Poe v. Ullman, 367 U.S.,
at 542 (dissenting from dismissal on jurisdictional grounds).
See also Rochin v. California, supra, at 171-172 (Frankfurter, J., writing for the
Court) ("To believe that this judicial exercise of judgment could be avoided by freezing
`due process of law' at some fixed stage of time or thought is to suggest that the
most important aspect of constitutional adjudication is a function for inanimate machines,
and not for judges").
Men and women of good conscience can disagree, and we suppose some always shall disagree,
about the profound moral and spiritual implications of terminating a pregnancy, even
in its earliest stage. Some of us as individuals find abortion offensive to our most
basic principles of morality, but that cannot control our decision. Our obligation
is to define the liberty of all, not to mandate our own moral code. The underlying
constitutional issue is whether the State can resolve these philosophic questions
in such a definitive way that a woman lacks all choice in the matter, except perhaps
[505 U.S. 833, 851] in those rare circumstances in which the pregnancy is itself a
danger to her own life or health, or is the result of rape or incest.
It is conventional constitutional doctrine that, where reasonable people disagree,
the government can adopt one position or the other. See, e.g., Ferguson v. Skrupa,
372 U.S. 726 (1963); Williamson v. Lee Optical of Okla., Inc., 348 U.S. 483 (1955).
That theorem, however, assumes a state of affairs in which the choice does not intrude
upon a protected liberty. Thus, while some people might disagree about whether or
not the flag should be saluted, or disagree about the proposition that it may not
be defiled, we have ruled that a State may not compel or enforce one view or the other.
See West Virginia Bd. of Ed. v. Barnette, 319 U.S. 624 (1943); Texas v. Johnson, 491
U.S. 397 (1989).
Our law affords constitutional protection to personal decisions relating to marriage,
procreation, contraception, family relationships, child rearing, and education. Carey
v. Population Services International, 431 U.S., at 685 . Our cases recognize the right
of the individual, married or single, to be free from unwarranted governmental intrusion
into matters so fundamentally affecting a person as the decision whether to bear or
beget a child. Eisenstadt v. Baird, supra, 405 U.S., at 453 (emphasis in original).
Our precedents "have respected the private realm of family life which the state cannot
enter." Prince v. Massachusetts, 321 U.S. 158, 166 (1944). These matters, involving
the most intimate and personal choices a person may make in a lifetime, choices central
to personal dignity and autonomy, are central to the liberty protected by the Fourteenth
Amendment. At the heart of liberty is the right to define one's own concept of existence,
of meaning, of the universe, and of the mystery of human life. Beliefs about these
matters could not define the attributes of personhood were they formed under compulsion
of the State. [505 U.S. 833, 852]
These considerations begin our analysis of the woman's interest in terminating her
pregnancy, but cannot end it, for this reason: though the abortion decision may originate
within the zone of conscience and belief, it is more than a philosophic exercise.
Abortion is a unique act. It is an act fraught with consequences for others: for the
woman who must live with the implications of her decision; for the persons who perform
and assist in the procedure; for the spouse, family, and society which must confront
the knowledge that these procedures exist, procedures some deem nothing short of an
act of violence against innocent human life; and, depending on one's beliefs, for
the life or potential life that is aborted. Though abortion is conduct, it does not
follow that the State is entitled to proscribe it in all instances. That is because
the liberty of the woman is at stake in a sense unique to the human condition, and
so, unique to the law. The mother who carries a child to full term is subject to anxieties,
to physical constraints, to pain that only she must bear. That these sacrifices have
from the beginning of the human race been endured by woman with a pride that ennobles
her in the eyes of others and gives to the infant a bond of love cannot alone be grounds
for the State to insist she make the sacrifice. Her suffering is too intimate and
personal for the State to insist, without more, upon its own vision of the woman's
role, however dominant that vision has been in the course of our history and our culture.
The destiny of the woman must be shaped to a large extent on her own conception of
her spiritual imperatives and her place in society.
It should be recognized, moreover, that in some critical respects, the abortion decision
is of the same character as the decision to use contraception, to which Griswold v.
Connecticut, Eisenstadt v. Baird, and Carey v. Population Services International afford
constitutional protection. We have no doubt as to the correctness of those decisions.
They support [505 U.S. 833, 853] the reasoning in Roe relating to the woman's liberty,
because they involve personal decisions concerning not only the meaning of procreation
but also human responsibility and respect for it. As with abortion, reasonable people
will have differences of opinion about these matters. One view is based on such reverence
for the wonder of creation that any pregnancy ought to be welcomed and carried to
full term, no matter how difficult it will be to provide for the child and ensure
its wellbeing. Another is that the inability to provide for the nurture and care of
the infant is a cruelty to the child and an anguish to the parent. These are intimate
views with infinite variations, and their deep, personal character underlay our decisions
in Griswold, Eisenstadt, and Carey. The same concerns are present when the woman confronts
the reality that, perhaps despite her attempts to avoid it, she has become pregnant.
It was this dimension of personal liberty that Roe sought to protect, and its holding
invoked the reasoning and the tradition of the precedents we have discussed, granting
protection to substantive liberties of the person. Roe was, of course, an extension
of those cases and, as the decision itself indicated, the separate States could act
in some degree to further their own legitimate interests in protecting prenatal life.
The extent to which the legislatures of the States might act to outweigh the interests
of the woman in choosing to terminate her pregnancy was a subject of debate both in
Roe itself and in decisions following it.
While we appreciate the weight of the arguments made on behalf of the State in the
cases before us, arguments which in their ultimate formulation conclude that Roe should
be overruled, the reservations any of us may have in reaffirming the central holding
of Roe are outweighed by the explication of individual liberty we have given, combined
with the force of stare decisis. We turn now to that doctrine. [505 U.S. 833, 854]
III
A
The obligation to follow precedent begins with necessity, and a contrary necessity
marks its outer limit. With Cardozo, we recognize that no judicial system could do
society's work if it eyed each issue afresh in every case that raised it. See B. Cardozo,
The Nature of the Judicial Process 149 (1921). Indeed, the very concept of the rule
of law underlying our own Constitution requires such continuity over time that a respect
for precedent is, by definition, indispensable. See Powell, Stare Decisis and Judicial
Restraint, 1991 Journal of Supreme Court History 13, 16. At the other extreme, a different
necessity would make itself felt if a prior judicial ruling should come to be seen
so clearly as error that its enforcement was, for that very reason, doomed.
Even when the decision to overrule a prior case is not, as in the rare, latter instance,
virtually foreordained, it is common wisdom that the rule of stare decisis is not
an "inexorable command," and certainly it is not such in every constitutional case,
see Burnet v. Coronado Oil & Gas Co., 285 U.S. 393, 405 -411 (1932) (Brandeis, J.,
dissenting). See also Payne v. Tennessee, 501 U.S. 808, 842 (1991) (SOUTER, J., joined
by KENNEDY, J., concurring); Arizona v. Rumsey, 467 U.S. 203, 212 (1984). Rather,
when this Court reexamines a prior holding, its judgment is customarily informed by
a series of prudential and pragmatic considerations designed to test the consistency
of overruling a prior decision with the ideal of the rule of law, and to gauge the
respective costs of reaffirming and overruling a prior case. Thus, for example, we
may ask whether the rule has proven to be intolerable simply in defying practical
workability, Swift & Co. v. Wickham, 382 U.S. 111, 116 (1965); whether the rule is
subject to a kind of reliance that would lend a special hardship to the consequences
of overruling and add inequity to the cost of repudiation, e.g., United States v.
Title Ins. & Trust [505 U.S. 833, 855] Co., 265 U.S. 472, 486 (1924); whether related
principles of law have so far developed as to have left the old rule no more than
a remnant of abandoned doctrine, see Patterson v. McLean Credit Union, 491 U.S. 164,
173 -174 (1989); or whether facts have so changed, or come to be seen so differently,
as to have robbed the old rule of significant application or justification, e.g.,
Burnet, supra, 285 U.S. at 412 (Brandeis, J., dissenting).
So in this case, we may enquire whether Roe's central rule has been found unworkable;
whether the rule's limitation on state power could be removed without serious inequity
to those who have relied upon it or significant damage to the stability of the society
governed by it; whether the law's growth in the intervening years has left Roe's central
rule a doctrinal anachronism discounted by society; and whether Roe's premises of
fact have so far changed in the ensuing two decades as to render its central holding
somehow irrelevant or unjustifiable in dealing with the issue it addressed.
1
Although Roe has engendered opposition, it has in no sense proven "unworkable," see
Garcia v. San Antonio Metropolitan Transit Authority, 469 U.S. 528, 546 (1985), representing
as it does a simple limitation beyond which a state law is unenforceable. While Roe
has, of course, required judicial assessment of state laws affecting the exercise
of the choice guaranteed against government infringement, and although the need for
such review will remain as a consequence of today's decision, the required determinations
fall within judicial competence.
2
The inquiry into reliance counts the cost of a rule's repudiation as it would fall
on those who have relied reasonably on the rule's continued application. Since the
classic case for weighing reliance heavily in favor of following the earlier rule
occurs in the commercial context, see Payne v. Tennessee, [505 U.S. 833, 856] supra,
at 828, where advance planning of great precision is most obviously a necessity, it
is no cause for surprise that some would find no reliance worthy of consideration
in support of Roe.
While neither respondents nor their amici in so many words deny that the abortion
right invites some reliance prior to its actual exercise, one can readily imagine
an argument stressing the dissimilarity of this case to one involving property or
contract. Abortion is customarily chosen as an unplanned response to the consequence
of unplanned activity or to the failure of conventional birth control, and except
on the assumption that no intercourse would have occurred but for Roe's holding, such
behavior may appear to justify no reliance claim. Even if reliance could be claimed
on that unrealistic assumption, the argument might run, any reliance interest would
be de minimis. This argument would be premised on the hypothesis that reproductive
planning could take virtually immediate account of any sudden restoration of state
authority to ban abortions.
To eliminate the issue of reliance that easily, however, one would need to limit
cognizable reliance to specific instances of sexual activity. But to do this would
be simply to refuse to face the fact that, for two decades of economic and social
developments, people have organized intimate relationships and made choices that define
their views of themselves and their places in society, in reliance on the availability
of abortion in the event that contraception should fail. The ability of women to participate
equally in the economic and social life of the Nation has been facilitated by their
ability to control their reproductive lives. See, e.g., R. Petchesky, Abortion and
Woman's Choice 109, 133, n. 7 (rev. ed. 1990). The Constitution serves human values,
and while the effect of reliance on Roe cannot be exactly measured, neither can the
certain cost of overruling Roe for people who have ordered their thinking and living
around that case be dismissed. [505 U.S. 833, 857]
3
No evolution of legal principle has left Roe's doctrinal footings weaker than they
were in 1973. No development of constitutional law since the case was decided has
implicitly or explicitly left Roe behind as a mere survivor of obsolete constitutional
thinking.
It will be recognized, of course, that Roe stands at an intersection of two lines
of decisions, but in whichever doctrinal category one reads the case, the result for
present purposes will be the same. The Roe Court itself placed its holding in the
succession of cases most prominently exemplified by Griswold v. Connecticut, 381 U.S.
479 (1965). See Roe, 410 U.S., at 152 -153. When it is so seen, Roe is clearly in
no jeopardy, since subsequent constitutional developments have neither disturbed,
nor do they threaten to diminish, the scope of recognized protection accorded to the
liberty relating to intimate relationships, the family, and decisions about whether
or not to beget or bear a child. See, e.g., Carey v. Population Services International,
431 U.S. 678 (1977); Moore v. East Cleveland, 431 U.S. 494 (1977).
Roe, however, may be seen not only as an exemplar of Griswold liberty but as a rule
(whether or not mistaken) of personal autonomy and bodily integrity, with doctrinal
affinity to cases recognizing limits on governmental power to mandate medical treatment
or to bar its rejection. If so, our cases since Roe accord with Roe's view that a
State's interest in the protection of life falls short of justifying any plenary override
of individual liberty claims. Cruzan v. Director, Mo. Dept. of Health, 497 U.S. 261,
278 (1990); cf., e.g., Riggins v. Nevada, 504 U.S. 127, 135 (1992); Washington v.
Harper, 494 U.S. 210 (1990); see also, e.g., Rochin v. California, 342 U.S. 165 (1952);
Jacobson v. Massachusetts, 197 U.S. 11, 24 -30 (1905).
Finally, one could classify Roe as sui generis. If the case is so viewed, then there
clearly has been no erosion of its central determination. The original holding resting
on the [505 U.S. 833, 858] concurrence of seven Members of the Court in 1973 was expressly
affirmed by a majority of six in 1983, see Akron v. Akron Center for Reproductive
Health, Inc., 462 U.S. 416 (1983) (Akron I), and by a majority of five in 1986, see
Thornburgh v. American College of Obstetricians and Gynecologists, 476 U.S. 747 (1986),
expressing adherence to the constitutional ruling despite legislative efforts in some
States to test its limits. More recently, in Webster v. Reproductive Health Services,
492 U.S. 490 (1989), although two of the present authors questioned the trimester
framework in a way consistent with our judgment today, see id., at 518 (REHNQUIST,
C.J., joined by WHITE and KENNEDY, JJ.); id., at 529 (O'CONNOR, J., concurring in
part and concurring in judgment), a majority of the Court either decided to reaffirm
or declined to address the constitutional validity of the central holding of Roe.
See Webster, 492 U.S., at 521 (REHNQUIST, C.J., joined by WHITE and KENNEDY, JJ.);
id., at 525-526 (O'CONNOR, J., concurring in part and concurring in judgment); id.,
at 537, 553 (BLACKMUN, J., joined by Brennan and Marshall, JJ., concurring in part
and dissenting in part); id., at 561-563 (STEVENS, J., concurring in part and dissenting
in part).
Nor will courts building upon Roe be likely to hand down erroneous decisions as a
consequence. Even on the assumption that the central holding of Roe was in error,
that error would go only to the strength of the state interest in fetal protection,
not to the recognition afforded by the Constitution to the woman's liberty. The latter
aspect of the decision fits comfortably within the framework of the Court's prior
decisions, including Skinner v. Oklahoma ex rel. Williamson, 316 U.S. 535 (1942);
Griswold, supra; Loving v. Virginia, 388 U.S. 1 (1967); and Eisenstadt v. Baird, 405
U.S. 438 (1972), the holdings of which are "not a series of isolated points," but
mark a "rational continuum." Poe v. Ullman, 367 U.S., at 543 (Harlan, J., dissenting).
As we described in [505 U.S. 833, 859] Carey v. Population Services International,
supra, the liberty which encompasses those decisions
"includes "the interest in independence in making certain kinds of important decisions."
While the outer limits of this aspect of [protected liberty] have not been marked
by the Court, it is clear that among the decisions that an individual may make without
unjustified government interference are personal decisions "`relating to marriage,
procreation, contraception, family relationships, and childrearing and education.'"
431 U.S., at 684 -685 (citations omitted).
The soundness of this prong of the Roe analysis is apparent from a consideration
of the alternative. If indeed the woman's interest in deciding whether to bear and
beget a child had not been recognized as in Roe, the State might as readily restrict
a woman's right to choose to carry a pregnancy to term as to terminate it, to further
asserted state interests in population control, or eugenics, for example. Yet Roe
has been sensibly relied upon to counter any such suggestions. E.g., Arnold v. Board
of Education of Escambia County, Ala., 880 F.2d 305, 311 (CA11 1989) (relying upon
Roe and concluding that government officials violate the Constitution by coercing
a minor to have an abortion); Avery v. County of Burke, 660 F.2d 111, 115 (CA4 1981)
(county agency inducing teenage girl to undergo unwanted sterilization on the basis
of misrepresentation that she had sickle cell trait); see also In re Quinlan, 70 N.
J. 10, 355 A.2d 647, cert. denied sub nom. Garger v. New Jersey, 429 U.S. 922 (1976)
(relying on Roe in finding a right to terminate medical treatment). In any event,
because Roe's scope is confined by the fact of its concern with postconception potential
life, a concern otherwise likely to be implicated only by some forms of contraception
protected independently under Griswold and later cases, any error in Roe is unlikely
to have serious ramifications in future cases. [505 U.S. 833, 859]
4
We have seen how time has overtaken some of Roe's factual assumptions: advances in
maternal health care allow for abortions safe to the mother later in pregnancy than
was true in 1973, see Akron I, supra, 462 U.S. at 429, n. 11, and advances in neonatal
care have advanced viability to a point somewhat earlier. Compare Roe, 410 U.S., at
160 , with Webster, supra, 492 U.S., at 515 -516 (opinion of REHNQUIST, C.J.); see
Akron I, 462 U.S., at 457 , and n. 5 (O'CONNOR, J., dissenting). But these facts go
only to the scheme of time limits on the realization of competing interests, and the
divergences from the factual premises of 1973 have no bearing on the validity of Roe's
central holding, that viability marks the earliest point at which the State's interest
in fetal life is constitutionally adequate to justify a legislative ban on nontherapeutic
abortions. The soundness or unsoundness of that constitutional judgment in no sense
turns on whether viability occurs at approximately 28 weeks, as was usual at the time
of Roe, at 23 to 24 weeks, as it sometimes does today, or at some moment even slightly
earlier in pregnancy, as it may if fetal respiratory capacity can somehow be enhanced
in the future. Whenever it may occur, the attainment of viability may continue to
serve as the critical fact, just as it has done since Roe was decided; which is to
say that no change in Roe's factual underpinning has left its central holding obsolete,
and none supports an argument for overruling it.
5
The sum of the precedential enquiry to this point shows Roe's underpinnings unweakened
in any way affecting its central holding. While it has engendered disapproval, it
has not been unworkable. An entire generation has come of age free to assume Roe's
concept of liberty in defining the capacity of women to act in society, and to make
reproductive decisions; no erosion of principle going to liberty or personal autonomy
has left Roe's central holding a doctrinal remnant; [505 U.S. 833, 861] Roe portends
no developments at odds with other precedent for the analysis of personal liberty;
and no changes of fact have rendered viability more or less appropriate as the point
at which the balance of interests tips. Within the bounds of normal stare decisis
analysis, then, and subject to the considerations on which it customarily turns, the
stronger argument is for affirming Roe's central holding, with whatever degree of
personal reluctance any of us may have, not for overruling it.
B
In a less significant case, stare decisis analysis could, and would, stop at the
point we have reached. But the sustained and widespread debate Roe has provoked calls
for some comparison between that case and others of comparable dimension that have
responded to national controversies and taken on the impress of the controversies
addressed. Only two such decisional lines from the past century present themselves
for examination, and in each instance the result reached by the Court accorded with
the principles we apply today.
The first example is that line of cases identified with Lochner v. New York, 198
U.S. 45 (1905), which imposed substantive limitations on legislation limiting economic
autonomy in favor of health and welfare regulation, adopting, in Justice Holmes's
view, the theory of laissez-faire. Id., at 75 (dissenting opinion). The Lochner decisions
were exemplified by Adkins v. Children's Hospital of District of Columbia, 261 U.S.
525 (1923), in which this Court held it to be an infringement of constitutionally
protected liberty of contract to require the employers of adult women to satisfy minimum
wage standards. Fourteen years later, West Coast Hotel Co. v. Parrish, 300 U.S. 379
(1937), signaled the demise of Lochner by overruling Adkins. In the meantime, the
Depression had come and, with it, the lesson that seemed unmistakable to most people
by 1937, that the interpretation of contractual freedom protected in Adkins rested
on fundamentally [505 U.S. 833, 862] false factual assumptions about the capacity
of a relatively unregulated market to satisfy minimal levels of human welfare. See
West Coast Hotel Co., supra, at 399. As Justice Jackson wrote of the constitutional
crisis of 1937 shortly before he came on the bench: "The older world of laissez-faire
was recognized everywhere outside the Court to be dead." The Struggle for Judicial
Supremacy 85 (1941). The facts upon which the earlier case had premised a constitutional
resolution of social controversy had proven to be untrue, and history's demonstration
of their untruth not only justified but required the new choice of constitutional
principle that West Coast Hotel announced. Of course, it was true that the Court lost
something by its misperception, or its lack of prescience, and the Court-packing crisis
only magnified the loss; but the clear demonstration that the facts of economic life
were different from those previously assumed warranted the repudiation of the old
law.
The second comparison that 20th century history invites is with the cases employing
the separate-but-equal rule for applying the Fourteenth Amendment's equal protection
guarantee. They began with Plessy v. Ferguson, 163 U.S. 537 (1896), holding that legislatively
mandated racial segregation in public transportation works no denial of equal protection,
rejecting the argument that racial separation enforced by the legal machinery of American
society treats the black race as inferior. The Plessy Court considered the underlying
fallacy of the plaintiff's argument to consist in the assumption that the enforced
separation of the two races stamps the colored race with a badge of inferiority. If
this be so, it is not by reason of anything found in the act, but solely because the
colored race chooses to put that construction upon it. Id., at 551. Whether, as a
matter of historical fact, the Justices in the Plessy majority believed this or not,
see id., 557, 562 (Harlan, J., dissenting), this understanding of the implication
of segregation was the stated justification for the Court's opinion. But this understanding
of [505 U.S. 833, 863] the facts and the rule it was stated to justify were repudiated
in Brown v. Board of Education, 347 U.S. 483 (1954) (Brown I). As one commentator
observed, the question before the Court in Brown was whether discrimination inheres
in that segregation which is imposed by law in the twentieth century in certain specific
states in the American Union. And that question has meaning, and can find an answer
only on the ground of history and of common knowledge about the facts of life in the
times and places aforesaid. Black, The Lawfulness of the Segregation Decisions, 69
Yale L.J. 421, 427 (1960).
The Court in Brown addressed these facts of life by observing that whatever may have
been the understanding in Plessy's time of the power of segregation to stigmatize
those who were segregated with a "badge of inferiority," it was clear by 1954 that
legally sanctioned segregation had just such an effect, to the point that racially
separate public educational facilities were deemed inherently unequal. 347 U.S., at,
494-495. Society's understanding of the facts upon which a constitutional ruling was
sought in 1954 was thus fundamentally different from the basis claimed for the decision
in 1896. While we think Plessy was wrong the day it was decided, see Plessy, supra,
163 U.S., at 552 -564 (Harlan, J., dissenting), we must also recognize that the Plessy
Court's explanation for its decision was so clearly at odds with the facts apparent
to the Court in 1954 that the decision to reexamine Plessy was, on this ground alone,
not only justified but required.
West Coast Hotel and Brown each rested on facts, or an understanding of facts, changed
from those which furnished the claimed justifications for the earlier constitutional
resolutions. Each case was comprehensible as the Court's response to facts that the
country could understand, or had come to understand already, but which the Court of
an earlier day, as its own declarations disclosed, had not been able to perceive.
As the decisions were thus comprehensible, [505 U.S. 833, 864] they were also defensible,
not merely as the victories of one doctrinal school over another by dint of numbers
(victories though they were), but as applications of constitutional principle to facts
as they had not been seen by the Court before. In constitutional adjudication, as
elsewhere in life, changed circumstances may impose new obligations, and the thoughtful
part of the Nation could accept each decision to overrule a prior case as a response
to the Court's constitutional duty.
Because the cases before us present no such occasion, it could be seen as no such
response. Because neither the factual underpinnings of Roe's central holding nor our
understanding of it has changed (and because no other indication of weakened precedent
has been shown), the Court could not pretend to be reexamining the prior law with
any justification beyond a present doctrinal disposition to come out differently from
the Court of 1973. To overrule prior law for no other reason than that would run counter
to the view, repeated in our cases, that a decision to overrule should rest on some
special reason over and above the belief that a prior case was wrongly decided. See,
e.g., Mitchell v. W.T. Grant Co., 416 U.S. 600, 636 (1974) (Stewart, J., dissenting)
("A basic change in the law upon a ground no firmer than a change in our membership
invites the popular misconception that this institution is little different from the
two political branches of the Government. No misconception could do more lasting injury
to this Court, and to the system of law which it is our abiding mission to serve");
Mapp v. Ohio, 367 U.S. 643, 677 (1961) (Harlan, J., dissenting).
C
The examination of the conditions justifying the repudiation of Adkins by West Coast
Hotel and Plessy by Brown is enough to suggest the terrible price that would have
been paid if the Court had not overruled as it did. In the present cases, however,
as our analysis to this point makes clear, the terrible price would be paid for overruling.
Our analysis [505 U.S. 833, 865] would not be complete, however, without explaining
why overruling Roe's central holding would not only reach an unjustifiable result
under principles of stare decisis, but would seriously weaken the Court's capacity
to exercise the judicial power and to function as the Supreme Court of a Nation dedicated
to the rule of law. To understand why this would be so, it is necessary to understand
the source of this Court's authority, the conditions necessary for its preservation,
and its relationship to the country's understanding of itself as a constitutional
Republic.
The root of American governmental power is revealed most clearly in the instance
of the power conferred by the Constitution upon the Judiciary of the United States,
and specifically upon this Court. As Americans of each succeeding generation are rightly
told, the Court cannot buy support for its decisions by spending money, and, except
to a minor degree, it cannot independently coerce obedience to its decrees. The Court's
power lies, rather, in its legitimacy, a product of substance and perception that
shows itself in the people's acceptance of the Judiciary as fit to determine what
the Nation's law means, and to declare what it demands.
The underlying substance of this legitimacy is of course the warrant for the Court's
decisions in the Constitution and the lesser sources of legal principle on which the
Court draws. That substance is expressed in the Court's opinions, and our contemporary
understanding is such that a decision without principled justification would be no
judicial act at all. But even when justification is furnished by apposite legal principle,
something more is required. Because not every conscientious claim of principled justification
will be accepted as such, the justification claimed must be beyond dispute. The Court
must take care to speak and act in ways that allow people to accept its decisions
on the terms the Court claims for them, as grounded truly in principle, not as compromises
with social and political pressures having, as such, no bearing on the principled
choices that the Court is [505 U.S. 833, 866] obliged to make. Thus, the Court's legitimacy
depends on making legally principled decisions under circumstances in which their
principled character is sufficiently plausible to be accepted by the Nation.
The need for principled action to be perceived as such is implicated to some degree
whenever this, or any other appellate court, overrules a prior case. This is not to
say, of course, that this Court cannot give a perfectly satisfactory explanation in
most cases. People understand that some of the Constitution's language is hard to
fathom, and that the Court's Justices are sometimes able to perceive significant facts
or to understand principles of law that eluded their predecessors and that justify
departures from existing decisions. However upsetting it may be to those most directly
affected when one judicially derived rule replaces another, the country can accept
some correction of error without necessarily questioning the legitimacy of the Court.
In two circumstances, however, the Court would almost certainly fail to receive the
benefit of the doubt in overruling prior cases. There is, first, a point beyond which
frequent overruling would overtax the country's belief in the Court's good faith.
Despite the variety of reasons that may inform and justify a decision to overrule,
we cannot forget that such a decision is usually perceived (and perceived correctly)
as, at the least, a statement that a prior decision was wrong. There is a limit to
the amount of error that can plausibly be imputed to prior Courts. If that limit should
be exceeded, disturbance of prior rulings would be taken as evidence that justifiable
reexamination of principle had given way to drives for particular results in the short
term. The legitimacy of the Court would fade with the frequency of its vacillation.
That first circumstance can be described as hypothetical; the second is to the point
here and now. Where, in the performance of its judicial duties, the Court decides
a case in such a way as to resolve the sort of intensely divisive controversy reflected
in Roe and those rare, comparable cases, its [505 U.S. 833, 867] decision has a dimension
that the resolution of the normal case does not carry. It is the dimension present
whenever the Court's interpretation of the Constitution calls the contending sides
of a national controversy to end their national division by accepting a common mandate
rooted in the Constitution.
The Court is not asked to do this very often, having thus addressed the Nation only
twice in our lifetime, in the decisions of Brown and Roe. But when the Court does
act in this way, its decision requires an equally rare precedential force to counter
the inevitable efforts to overturn it and to thwart its implementation. Some of those
efforts may be mere unprincipled emotional reactions; others may proceed from principles
worthy of profound respect. But whatever the premises of opposition may be, only the
most convincing justification under accepted standards of precedent could suffice
to demonstrate that a later decision overruling the first was anything but a surrender
to political pressure and an unjustified repudiation of the principle on which the
Court staked its authority in the first instance. So to overrule under fire in the
absence of the most compelling reason to reexamine a watershed decision would subvert
the Court's legitimacy beyond any serious question. Cf. Brown v. Board okf Education,
349 U.S. 294, 300 (1955) (Brown II) ("[I]t should go without saying that the vitality
of th[e] constitutional principles [announced in Brown I,] cannot be allowed to yield
simply because of disagreement with them").
The country's loss of confidence in the Judiciary would be underscored by an equally
certain and equally reasonable condemnation for another failing in overruling unnecessarily
and under pressure. Some cost will be paid by anyone who approves or implements a
constitutional decision where it is unpopular, or who refuses to work to undermine
the decision or to force its reversal. The price may be criticism or ostracism, or
it may be violence. An extra price will be paid by those who themselves disapprove
of the decision's results [505 U.S. 833, 868] when viewed outside of constitutional
terms, but who nevertheless struggle to accept it, because they respect the rule of
law. To all those who will be so tested by following, the Court implicitly undertakes
to remain steadfast, lest in the end a price be paid for nothing. The promise of constancy,
once given, binds its maker for as long as the power to stand by the decision survives
and the understanding of the issue has not changed so fundamentally as to render the
commitment obsolete. From the obligation of this promise, this Court cannot and should
not assume any exemption when duty requires it to decide a case in conformance with
the Constitution. A willing breach of it would be nothing less than a breach of faith,
and no Court that broke its faith with the people could sensibly expect credit for
principle in the decision by which it did that.
It is true that diminished legitimacy may be restored, but only slowly. Unlike the
political branches, a Court thus weakened could not seek to regain its position with
a new mandate from the voters, and even if the Court could somehow go to the polls,
the loss of its principled character could not be retrieved by the casting of so many
votes. Like the character of an individual, the legitimacy of the Court must be earned
over time. So, indeed, must be the character of a Nation of people who aspire to live
according to the rule of law. Their belief in themselves as such a people is not readily
separable from their understanding of the Court invested with the authority to decide
their constitutional cases and speak before all others for their constitutional ideals.
If the Court's legitimacy should be undermined, then, so would the country be in its
very ability to see itself through its constitutional ideals. The Court's concern
with legitimacy is not for the sake of the Court, but for the sake of the Nation to
which it is responsible.
The Court's duty in the present case is clear. In 1973, it confronted the already-divisive
issue of governmental power [505 U.S. 833, 869] to limit personal choice to undergo
abortion, for which it provided a new resolution based on the due process guaranteed
by the Fourteenth Amendment. Whether or not a new social consensus is developing on
that issue, its divisiveness is no less today than in 1973, and pressure to overrule
the decision, like pressure to retain it, has grown only more intense. A decision
to overrule Roe's essential holding under the existing circumstances would address
error, if error there was, at the cost of both profound and unnecessary damage to
the Court's legitimacy, and to the Nation's commitment to the rule of law. It is therefore
imperative to adhere to the essence of Roe's original decision, and we do so today.
IV
From what we have said so far, it follows that it is a constitutional liberty of
the woman to have some freedom to terminate her pregnancy. We conclude that the basic
decision in Roe was based on a constitutional analysis which we cannot now repudiate.
The woman's liberty is not so unlimited, however, that, from the outset, the State
cannot show its concern for the life of the unborn and, at a later point in fetal
development, the State's interest in life has sufficient force so that the right of
the woman to terminate the pregnancy can be restricted.
That brings us, of course, to the point where much criticism has been directed at
Roe, a criticism that always inheres when the Court draws a specific rule from what
in the Constitution is but a general standard. We conclude, however, that the urgent
claims of the woman to retain the ultimate control over her destiny and her body,
claims implicit in the meaning of liberty, require us to perform that function. Liberty
must not be extinguished for want of a line that is clear. And it falls to us to give
some real substance to the woman's liberty to determine whether to carry her pregnancy
to full term. [505 U.S. 833, 870]
We conclude the line should be drawn at viability, so that, before that time, the
woman has a right to choose to terminate her pregnancy. We adhere to this principle
for two reasons. First, as we have said, is the doctrine of stare decisis. Any judicial
act of line-drawing may seem somewhat arbitrary, but Roe was a reasoned statement,
elaborated with great care. We have twice reaffirmed it in the face of great opposition.
See Thornburgh v. American College of Obstetricians and Gynecologists, 476 U.S., at
759 ; Akron I, 462 U.S., at 419 -420. Although we must overrule those parts of Thornburgh
and Akron I which, in our view, are inconsistent with Roe's statement that the State
has a legitimate interest in promoting the life or potential life of the unborn, see
infra, at 40-41, the central premise of those cases represents an unbroken commitment
by this Court to the essential holding of Roe. It is that premise which we reaffirm
today.
The second reason is that the concept of viability, as we noted in Roe, is the time
at which there is a realistic possibility of maintaining and nourishing a life outside
the womb, so that the independent existence of the second life can, in reason and
all fairness, be the object of state protection that now overrides the rights of the
woman. See Roe v. Wade, 410 U.S., at 163 . Consistent with other constitutional norms,
legislatures may draw lines which appear arbitrary without the necessity of offering
a justification. But courts may not. We must justify the lines we draw. And there
is no line other than viability which is more workable. To be sure, as we have said,
there may be some medical developments that affect the precise point of viability,
see supra, at 17-18, but this is an imprecision within tolerable limits, given that
the medical community and all those who must apply its discoveries will continue to
explore the matter. The viability line also has, as a practical matter, an element
of fairness. In some broad sense, it might be said that a woman who fails to act before
viability has consented to the State's intervention on behalf of the developing child.
[505 U.S. 833, 871]
The woman's right to terminate her pregnancy before viability is the most central
principle of Roe v. Wade. It is a rule of law and a component of liberty we cannot
renounce.
On the other side of the equation is the interest of the State in the protection
of potential life. The Roe Court recognized the State's "important and legitimate
interest in protecting the potentiality of human life." Roe, supra, at 162. The weight
to be given this state interest, not the strength of the woman's interest, was the
difficult question faced in Roe. We do not need to say whether each of us, had we
been Members of the Court when the valuation of the state interest came before it
as an original matter, would have concluded, as the Roe Court did, that its weight
is insufficient to justify a ban on abortions prior to viability even when it is subject
to certain exceptions. The matter is not before us in the first instance, and, coming
as it does after nearly 20 years of litigation in Roe's wake we are satisfied that
the immediate question is not the soundness of Roe's resolution of the issue, but
the precedential force that must be accorded to its holding. And we have concluded
that the essential holding of Roe should be reaffirmed.
Yet it must be remembered that Roe v. Wade speaks with clarity in establishing not
only the woman's liberty but also the State's "important and legitimate interest in
potential life." Roe, supra, at 163. That portion of the decision in Roe has been
given too little acknowledgment and implementation by the Court in its subsequent
cases. Those cases decided that any regulation touching upon the abortion decision
must survive strict scrutiny, to be sustained only if drawn in narrow terms to further
a compelling state interest. See, e.g., Akron I, supra, at 427. Not all of the cases
decided under that formulation can be reconciled with the holding in Roe itself that
the State has legitimate interests in the health of the woman and in protecting the
potential life within her. In resolving this tension, we choose to rely upon Roe,
as against the later cases. [505 U.S. 833, 872]
Roe established a trimester framework to govern abortion regulations. Under this
elaborate but rigid construct, almost no regulation at all is permitted during the
first trimester of pregnancy; regulations designed to protect the woman's health,
but not to further the State's interest in potential life, are permitted during the
second trimester; and, during the third trimester, when the fetus is viable, prohibitions
are permitted provided the life or health of the mother is not at stake. Roe, supra,
at 163-166. Most of our cases since Roe have involved the application of rules derived
from the trimester framework. See, e.g., Thornburgh v. American College of Obstetricians
and Gynecologists, supra; Akron I, supra.
The trimester framework no doubt was erected to ensure that the woman's right to
choose not become so subordinate to the State's interest in promoting fetal life that
her choice exists in theory, but not in fact. We do not agree, however, that the trimester
approach is necessary to accomplish this objective. A framework of this rigidity was
unnecessary, and, in its later interpretation, sometimes contradicted the State's
permissible exercise of its powers.
Though the woman has a right to choose to terminate or continue her pregnancy before
viability, it does not at all follow that the State is prohibited from taking steps
to ensure that this choice is thoughtful and informed. Even in the earliest stages
of pregnancy, the State may enact rules and regulations designed to encourage her
to know that there are philosophic and social arguments of great weight that can be
brought to bear in favor of continuing the pregnancy to full term, and that there
are procedures and institutions to allow adoption of unwanted children as well as
a certain degree of state assistance if the mother chooses to raise the child herself.
"[T]he Constitution does not forbid a State or city, pursuant to democratic processes,
from expressing a preference for normal childbirth." Webster v. Reproductive Health
Services, 492 U.S., at 511 (opinion of [505 U.S. 833, 873] the Court) (quoting Poelker
v. Doe, 432 U.S. 519, 521 (1977)). It follows that States are free to enact laws to
provide a reasonable framework for a woman to make a decision that has such profound
and lasting meaning. This, too, we find consistent with Roe's central premises, and
indeed the inevitable consequence of our holding that the State has an interest in
protecting the life of the unborn.
We reject the trimester framework, which we do not consider to be part of the essential
holding of Roe. See Webster v. Reproductive Health Services, supra, at 518 (opinion
of REHNQUIST, C.J.); id., at 529 (O'CONNOR, J., concurring in part and concurring
in judgment) (describing the trimester framework as "problematic"). Measures aimed
at ensuring that a woman's choice contemplates the consequences for the fetus do not
necessarily interfere with the right recognized in Roe, although those measures have
been found to be inconsistent with the rigid trimester framework announced in that
case. A logical reading of the central holding in Roe itself, and a necessary reconciliation
of the liberty of the woman and the interest of the State in promoting prenatal life,
require, in our view, that we abandon the trimester framework as a rigid prohibition
on all pre-viability regulation aimed at the protection of fetal life. The trimester
framework suffers from these basic flaws: in its formulation, it misconceives the
nature of the pregnant woman's interest; and in practice, it undervalues the State's
interest in potential life, as recognized in Roe.
As our jurisprudence relating to all liberties save perhaps abortion has recognized,
not every law which makes a right more difficult to exercise is, ipso facto, an infringement
of that right. An example clarifies the point. We have held that not every ballot
access limitation amounts to an infringement of the right to vote. Rather, the States
are granted substantial flexibility in establishing the framework within which voters
choose the candidates for whom they [505 U.S. 833, 874] wish to vote. Anderson v.
Celebrezze, 460 U.S. 780, 788 (1983); Norman v. Reed, 502 U.S. 279 (1992).
The abortion right is similar. Numerous forms of state regulation might have the
incidental effect of increasing the cost or decreasing the availability of medical
care, whether for abortion or any other medical procedure. The fact that a law which
serves a valid purpose, one not designed to strike at the right itself, has the incidental
effect of making it more difficult or more expensive to procure an abortion cannot
be enough to invalidate it. Only where state regulation imposes an undue burden on
a woman's ability to make this decision does the power of the State reach into the
heart of the liberty protected by the Due Process Clause. See Hodgson v. Minnesota,
497 U.S. 417, 458 -459 (1990) (O'CONNOR, J., concurring in part and concurring in
judgment in part); Ohio v. Akron Center for Reproductive Health, 497 U.S. 502, 519
-520; (1990) (Akron II) (opinion of KENNEDY, J.); Webster v. Reproductive Health Services,
supra, at 530 (O'CONNOR, J., concurring in part and concurring in judgment); Thornburgh
v. American College of Obstetricians and Gynecologists, 476 U.S., at 828 (O'CONNOR,
J., dissenting); Simopoulos v. Virginia, 462 U.S. 506, 520 (1983) (O'CONNOR, J., concurring
in part and concurring in judgment); Planned Parenthood Assn. of Kansas City Mo.,
Inc. v. Ashcroft, 462 U.S. 476, 505 (1983) (O'CONNOR, J., concurring in judgment in
part and dissenting in part); Akron I, 462 U.S., at 464 (O'CONNOR, J., joined by WHITE
and REHNQUIST, JJ., dissenting); Bellotti v. Baird, 428 U.S. 132, 147 (1976) (Bellotti
I).
For the most part, the Court's early abortion cases adhered to this view. In Maher
v. Roe, 432 U.S. 464, 473 -474 (1977), the Court explained: Roe did not declare an
unqualified "constitutional right to an abortion," as the District Court seemed to
think. Rather, the right protects the woman from unduly burdensome interference with
her freedom to decide whether to terminate her pregnancy. See [505 U.S. 833, 875]
also Doe v. Bolton, 410 U.S. 179, 198 (1973) ("[T]he interposition of the hospital
abortion committee is unduly restrictive of the patient's rights"); Bellotti I, supra,
428 U.S., at 147 (State may not "impose undue burdens upon a minor capable of giving
an informed consent"); Harris v. McRae, 448 U.S. 297, 314 (1980) (citing Maher, supra,).
Cf. Carey v. Population Services International, 431 U.S., at 688 ("[T]he same test
must be applied to state regulations that burden an individual's right to decide to
prevent conception or terminate pregnancy by substantially limiting access to the
means of effectuating that decision as is applied to state statutes that prohibit
the decision entirely").
These considerations of the nature of the abortion right illustrate that it is an
overstatement to describe it as a right to decide whether to have an abortion "without
interference from the State." Planned Parenthood of Central Mo. v. Danforth, 428 U.S.
52, 61 (1976). All abortion regulations interfere to some degree with a woman's ability
to decide whether to terminate her pregnancy. It is, as a consequence, not surprising
that, despite the protestations contained in the original Roe opinion to the effect
that the Court was not recognizing an absolute right, 410 U.S., at 154 -155, the Court's
experience applying the trimester framework has led to the striking down of some abortion
regulations which in no real sense deprived women of the ultimate decision. Those
decisions went too far, because the right recognized by Roe is a right to be free
from unwarranted governmental intrusion into matters so fundamentally affecting a
person as the decision whether to bear or beget a child. Eisenstadt v. Baird, 405
U.S., at 453 . Not all governmental intrusion is, of necessity, unwarranted, and that
brings us to the other basic flaw in the trimester framework: even in Roe's terms,
in practice, it undervalues the State's interest in the potential life within the
woman.
Roe v. Wade was express in its recognition of the State's important and legitimate
interest[s] in preserving and protecting [505 U.S. 833, 876] the health of the pregnant
woman [and] in protecting the potentiality of human life. 410 U.S., at 162 . The trimester
framework, however, does not fulfill Roe's own promise that the State has an interest
in protecting fetal life or potential life. Roe began the contradiction by using the
trimester framework to forbid any regulation of abortion designed to advance that
interest before viability. Id., at 163. Before viability, Roe and subsequent cases
treat all governmental attempts to influence a woman's decision on behalf of the potential
life within her as unwarranted. This treatment is, in our judgment, incompatible with
the recognition that there is a substantial state interest in potential life throughout
pregnancy. Cf. Webster, 492 U.S., at 519 (opinion of REHNQUIST, C.J.); Akron I, supra,
462 U.S., at 461 (O'CONNOR, J., dissenting).
The very notion that the State has a substantial interest in potential life leads
to the conclusion that not all regulations must be deemed unwarranted. Not all burdens
on the right to decide whether to terminate a pregnancy will be undue. In our view,
the undue burden standard is the appropriate means of reconciling the State's interest
with the woman's constitutionally protected liberty.
The concept of an undue burden has been utilized by the Court as well as individual
Members of the Court, including two of us, in ways that could be considered inconsistent.
See, e.g., Hodgson v. Minnesota, supra, 459-461 (O'CONNOR, J., concurring in part
and concurring in judgment); Akron II, supra at 519-520 (opinion of KENNEDY, J.);
Thornburgh v. American College of Obstetricians and Gynecologists, supra at 828-829
(O'CONNOR, J., dissenting); Akron I, supra, 462 U.S., at 461 -466 (O'CONNOR, J., dissenting);
Harris v. McRae, supra, 448 U.S., at 314 ; Maher v. Roe, supra, 432 U.S., at 473 ;
Beal v. Doe, 432 U.S. 438, 446 (1977); Bellotti I, supra, 428 U.S., at 147 . Because
we set forth a standard of general application to which we intend to adhere, it is
important to clarify what is meant by an undue burden. [505 U.S. 833, 877]
A finding of an undue burden is a shorthand for the conclusion that a state regulation
has the purpose or effect of placing a substantial obstacle in the path of a woman
seeking an abortion of a nonviable fetus. A statute with this purpose is invalid because
the means chosen by the State to further the interest in potential life must be calculated
to inform the woman's free choice, not hinder it. And a statute which, while furthering
the interest in potential life or some other valid state interest, has the effect
of placing a substantial obstacle in the path of a woman's choice cannot be considered
a permissible means of serving its legitimate ends. To the extent that the opinions
of the Court or of individual Justices use the undue burden standard in a manner that
is inconsistent with this analysis, we set out what, in our view, should be the controlling
standard. Cf. McCleskey v. Zant, 499 U.S. 467, 489 (1991) (attempting "to define the
doctrine of abuse of the writ with more precision" after acknowledging tension among
earlier cases). In our considered judgment, an undue burden is an unconstitutional
burden. See Akron II, 497 U.S., at 519 -520 (opinion of KENNEDY, J.). Understood another
way, we answer the question, left open in previous opinions discussing the undue burden
formulation, whether a law designed to further the State's interest in fetal life
which imposes an undue burden on the woman's decision before fetal viability could
be constitutional. See, e.g., Akron I, 462 U.S. at 462-463 (O'CONNOR, J., dissenting).
The answer is no.
Some guiding principles should emerge. What is at stake is the woman's right to make
the ultimate decision, not a right to be insulated from all others in doing so. Regulations
which do no more than create a structural mechanism by which the State, or the parent
or guardian of a minor, may express profound respect for the life of the unborn are
permitted, if they are not a substantial obstacle to the woman's exercise of the right
to choose. See infra, at 899-900 (addressing Pennsylvania's parental consent requirement).
[505 U.S. 833, 878] Unless it has that effect on her right of choice, a state measure
designed to persuade her to choose childbirth over abortion will be upheld if reasonably
related to that goal. Regulations designed to foster the health of a woman seeking
an abortion are valid if they do not constitute an undue burden.
Even when jurists reason from shared premises, some disagreement is inevitable. Compare
Hodgson, 497 U.S., at 482 -497 (KENNEDY, J., concurring in judgment in part and dissenting
in part) with id., at 458-460 (O'CONNOR, J., concurring in part and concurring in
judgment in part). That is to be expected in the application of any legal standard
which must accommodate life's complexity. We do not expect it to be otherwise with
respect to the undue burden standard. We give this summary:
(a) To protect the central right recognized by Roe v. Wade while at the same time
accommodating the State's profound interest in potential life, we will employ the
undue burden analysis as explained in this opinion. An undue burden exists, and therefore
a provision of law is invalid, if its purpose or effect is to place a substantial
obstacle in the path of a woman seeking an abortion before the fetus attains viability.
(b) We reject the rigid trimester framework of Roe v. Wade. To promote the State's
profound interest in potential life, throughout pregnancy, the State may take measures
to ensure that the woman's choice is informed, and measures designed to advance this
interest will not be invalidated as long as their purpose is to persuade the woman
to choose childbirth over abortion. These measures must not be an undue burden on
the right.
(c) As with any medical procedure, the State may enact regulations to further the
health or safety of a woman seeking an abortion. Unnecessary health regulations that
have the purpose or effect of presenting a substantial obstacle to a woman seeking
an abortion impose an undue burden on the right. [505 U.S. 833, 879]
(d) Our adoption of the undue burden analysis does not disturb the central holding
of Roe v. Wade, and we reaffirm that holding. Regardless of whether exceptions are
made for particular circumstances, a State may not prohibit any woman from making
the ultimate decision to terminate her pregnancy before viability.
(e) We also reaffirm Roe's holding that, subsequent to viability, the State, in promoting
its interest in the potentiality of human life, may, if it chooses, regulate, and
even proscribe, abortion except where it is necessary, in appropriate medical judgment,
for the preservation of the life or health of the mother. Roe v. Wade, 410 U.S., at
164 -165.
These principles control our assessment of the Pennsylvania statute, and we now turn
to the issue of the validity of its challenged provisions.
V
The Court of Appeals applied what it believed to be the undue burden standard, and
upheld each of the provisions except for the husband notification requirement. We
agree generally with this conclusion, but refine the undue burden analysis in accordance
with the principles articulated above. We now consider the separate statutory sections
at issue.
A
Because it is central to the operation of various other requirements, we begin with
the statute's definition of medical emergency. Under the statute, a medical emergency
is
[t]hat condition which, on the basis of the physician's good faith clinical judgment,
so complicates the medical condition of a pregnant woman as to necessitate the immediate
abortion of her pregnancy to avert her death or for which a delay will create serious
risk of substantial and irreversible impairment of a major bodily function. 18 Pa.Cons.Stat.
3203 (1990). [505 U.S. 833, 880]
Petitioners argue that the definition is too narrow, contending that it forecloses
the possibility of an immediate abortion despite some significant health risks. If
the contention were correct, we would be required to invalidate the restrictive operation
of the provision, for the essential holding of Roe forbids a State from interfering
with a woman's choice to undergo an abortion procedure if continuing her pregnancy
would constitute a threat to her health. 410 U.S., at 164 . See also Harris v. McRae,
448 U.S., at 316 .
The District Court found that there were three serious conditions which would not
be covered by the statute: preeclampsia, inevitable abortion, and premature ruptured
membrane. 744 F.Supp., at 1378. Yet, as the Court of Appeals observed, 947 F.2d, at
700-701, it is undisputed that, under some circumstances, each of these conditions
could lead to an illness with substantial and irreversible consequences. While the
definition could be interpreted in an unconstitutional manner, the Court of Appeals
construed the phrase "serious risk" to include those circumstances. Id., at 701. It
stated: "[W]e read the medical emergency exception as intended by the Pennsylvania
legislature to assure that compliance with its abortion regulations would not in any
way pose a significant threat to the life or health of a woman." Ibid. As we said
in Brockett v. Spokane Arcades, Inc., 472 U.S. 491, 499 -500 (1985): "Normally, .
. . we defer to the construction of a state statute given it by the lower federal
courts." Indeed, we have said that we will defer to lower court interpretations of
state law unless they amount to "plain" error. Palmer v. Hoffman, 318 U.S. 109, 118
(1943). This "reflect[s] our belief that district courts and courts of appeals are
better schooled in, and more able to interpret, the laws of their respective States."
Frisby v. Schultz, 487 U.S. 474, 482 (1988) (citation omitted). We adhere to that
course today, and conclude that, as construed by the Court of Appeals, the medical
emergency definition imposes no undue burden on a woman's abortion right.
B
We next consider the informed consent requirement. 18 Pa. Cons.Stat. 3205 (1990).
Except in a medical emergency, the statute requires that at least 24 hours before
performing an abortion a physician inform the woman of the nature of the procedure,
the health risks of the abortion and of childbirth, and the "probable gestational
age of the unborn child." The physician or a qualified nonphysician must inform the
woman of the availability of printed materials published by the State describing the
fetus and providing information about medical assistance for childbirth, information
about child support from the father, and a list of agencies which provide adoption
and other services as alternatives to abortion. An abortion may not be performed unless
the woman certifies in writing that she has been informed of the availability of these
printed materials and has been provided them if she chooses to view them.
Our prior decisions establish that, as with any medical procedure, the State may
require a woman to give her written informed consent to an abortion. See Planned Parenthood
of Central Mo. v. Danforth, 428 U.S., at 67 . In this respect, the statute is unexceptional.
Petitioners challenge the statute's definition of informed consent because it includes
the provision of specific information by the doctor and the mandatory 24-hour waiting
period. The conclusions reached by a majority of the Justices in the separate opinions
filed today and the undue burden standard adopted in this opinion require us to overrule
in part some of the Court's past decisions, decisions driven by the trimester framework's
prohibition of all pre-viability regulations designed to further the State's interest
in fetal life.
In Akron I, 462 U.S. 416 , we invalidated an ordinance which required that a woman
seeking an abortion be provided by her physician with specific information "designed
to influence the woman's informed choice between abortion or childbirth." Id., at
444. As we later described [505 U.S. 833, 882] the Akron I holding in Thornburgh v.
American College of Obstetricians and Gynecologists, 476 U.S., at 762 , there were
two purported flaws in the Akron ordinance: the information was designed to dissuade
the woman from having an abortion, and the ordinance imposed "a rigid requirement
that a specific body of information be given in all cases, irrespective of the particular
needs of the patient. . . ." Ibid.
To the extent Akron I and Thornburgh find a constitutional violation when the government
requires, as it does here, the giving of truthful, nonmisleading information about
the nature of the procedure, the attendant health risks and those of childbirth, and
the "probable gestational age" of the fetus, those cases go too far, are inconsistent
with Roe's acknowledgment of an important interest in potential life, and are overruled.
This is clear even on the very terms of Akron I and Thornburgh. Those decisions, along
with Danforth, recognize a substantial government interest justifying a requirement
that a woman be apprised of the health risks of abortion and childbirth. E.g., Danforth,
supra, at 66-67. It cannot be questioned that psychological wellbeing is a facet of
health. Nor can it be doubted that most women considering an abortion would deem the
impact on the fetus relevant, if not dispositive, to the decision. In attempting to
ensure that a woman apprehend the full consequences of her decision, the State furthers
the legitimate purpose of reducing the risk that a woman may elect an abortion, only
to discover later, with devastating psychological consequences, that her decision
was not fully informed. If the information the State requires to be made available
to the woman is truthful and not misleading, the requirement may be permissible.
We also see no reason why the State may not require doctors to inform a woman seeking
an abortion of the availability of materials relating to the consequences to the fetus,
even when those consequences have no direct relation to her health. An example illustrates
the point. We would think [505 U.S. 833, 883] it constitutional for the State to require
that, in order for there to be informed consent to a kidney transplant operation,
the recipient must be supplied with information about risks to the donor as well as
risks to himself or herself. A requirement that the physician make available information
similar to that mandated by the statute here was described in Thornburgh as 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. 476 U.S., at
762 . We conclude, however, that informed choice need not be defined in such narrow
terms that all considerations of the effect on the fetus are made irrelevant. As we
have made clear, we depart from the holdings of Akron I and Thornburgh to the extent
that we permit a State to further its legitimate goal of protecting the life of the
unborn by enacting legislation aimed at ensuring a decision that is mature and informed,
even when, in so doing, the State expresses a preference for childbirth over abortion.
In short, requiring that the woman be informed of the availability of information
relating to fetal development and the assistance available should she decide to carry
the pregnancy to full term is a reasonable measure to ensure an informed choice, one
which might cause the woman to choose childbirth over abortion. This requirement cannot
be considered a substantial obstacle to obtaining an abortion, and, it follows, there
is no undue burden.
Our prior cases also suggest that the "straitjacket," Thornburgh, supra, at 762 (quoting
Danforth, supra, at 67, n. 8), of particular information which must be given in each
case interferes with a constitutional right of privacy between a pregnant woman and
her physician. As a preliminary matter, it is worth noting that the statute now before
us does not require a physician to comply with the informed consent provisions if
he or she can demonstrate by a preponderance of the evidence that he or she reasonably
believed that furnishing the information would have resulted in a severely [505 U.S.
833, 884] adverse effect on the physical or mental health of the patient. 18 Pa. Cons.Stat.
3205 (1990). In this respect, the statute does not prevent the physician from exercising
his or her medical judgment.
Whatever constitutional status the doctor-patient relation may have as a general
matter, in the present context, it is derivative of the woman's position. The doctor-patient
relation does not underlie or override the two more general rights under which the
abortion right is justified: the right to make family decisions and the right to physical
autonomy. On its own, the doctor-patient relation here is entitled to the same solicitude
it receives in other contexts. Thus, a requirement that a doctor give a woman certain
information as part of obtaining her consent to an abortion is, for constitutional
purposes, no different from a requirement that a doctor give certain specific information
about any medical procedure.
All that is left of petitioners' argument is an asserted First Amendment right of
a physician not to provide information about the risks of abortion, and childbirth,
in a manner mandated by the State. To be sure, the physician's First Amendment rights
not to speak are implicated, see Wooley v. Maynard, 430 U.S. 705 (1977), but only
as part of the practice of medicine, subject to reasonable licensing and regulation
by the State cf. Whalen v. Roe, 429 U.S. 589, 603 (1977). We see no constitutional
infirmity in the requirement that the physician provide the information mandated by
the State here.
The Pennsylvania statute also requires us to reconsider the holding in Akron I that
the State may not require that a physician, as opposed to a qualified assistant, provide
information relevant to a woman's informed consent. 462 U.S., at 448 . Since there
is no evidence on this record that requiring a doctor to give the information as provided
by the statute would amount, in practical terms, to a substantial obstacle to a woman
seeking an abortion, we conclude that it is not [505 U.S. 833, 885] an undue burden.
Our cases reflect the fact that the Constitution gives the States broad latitude to
decide that particular functions may be performed only by licensed professionals,
even if an objective assessment might suggest that those same tasks could be performed
by others. See Williamson v. Lee Optical of Okla., Inc., 348 U.S. 483 (1955). Thus,
we uphold the provision as a reasonable means to ensure that the woman's consent is
informed.
Our analysis of Pennsylvania's 24-hour waiting period between the provision of the
information deemed necessary to informed consent and the performance of an abortion
under the undue burden standard requires us to reconsider the premise behind the decision
in Akron I invalidating a parallel requirement. In Akron I we said: Nor are we convinced
that the State's legitimate concern that the woman's decision be informed is reasonably
served by requiring a 24-hour delay as a matter of course. 462 U.S., at 450 . We consider
that conclusion to be wrong. The idea that important decisions will be more informed
and deliberate if they follow some period of reflection does not strike us as unreasonable,
particularly where the statute directs that important information become part of the
background of the decision. The statute, as construed by the Court of Appeals, permits
avoidance of the waiting period in the event of a medical emergency, and the record
evidence shows that, in the vast majority of cases, a 24-hour delay does not create
any appreciable health risk. In theory, at least, the waiting period is a reasonable
measure to implement the State's interest in protecting the life of the unborn, a
measure that does not amount to an undue burden.
Whether the mandatory 24-hour waiting period is nonetheless invalid because, in practice,
it is a substantial obstacle to a woman's choice to terminate her pregnancy is a closer
question. The findings of fact by the District Court indicate that, because of the
distances many women must travel to reach an abortion provider, the practical effect
will often be [505 U.S. 833, 886] a delay of much more than a day because the waiting
period requires that a woman seeking an abortion make at least two visits to the doctor.
The District Court also found that, in many instances, this will increase the exposure
of women seeking abortions to "the harassment and hostility of anti-abortion protestors
demonstrating outside a clinic." 744 F.Supp., at 1351. As a result, the District Court
found that, for those women who have the fewest financial resources, those who must
travel long distances, and those who have difficulty explaining their whereabouts
to husbands, employers, or others, the 24-hour waiting period will be "particularly
burdensome." Id., at 1352.
These findings are troubling in some respects, but they do not demonstrate that the
waiting period constitutes an undue burden. We do not doubt that, as the District
Court held, the waiting period has the effect of "increasing the cost and risk of
delay of abortions," id., at 1378, but the District Court did not conclude that the
increased costs and potential delays amount to substantial obstacles. Rather, applying
the trimester framework's strict prohibition of all regulation designed to promote
the State's interest in potential life before viability, see id., at 1374, the District
Court concluded that the waiting period does not further the state "interest in maternal
health" and "infringes the physician's discretion to exercise sound medical judgment,"
id., at 1378. Yet, as we have stated, under the undue burden standard, a State is
permitted to enact persuasive measures which favor childbirth over abortion, even
if those measures do not further a health interest. And while the waiting period does
limit a physician's discretion, that is not, standing alone, a reason to invalidate
it. In light of the construction given the statute's definition of medical emergency
by the Court of Appeals, and the District Court's findings, we cannot say that the
waiting period imposes a real health risk.
We also disagree with the District Court's conclusion that the "particularly burdensome"
effects of the waiting period [505 U.S. 833, 887] on some women require its invalidation.
A particular burden is not, of necessity, a substantial obstacle. Whether a burden
falls on a particular group is a distinct inquiry from whether it is a substantial
obstacle even as to the women in that group. And the District Court did not conclude
that the waiting period is such an obstacle even for the women who are most burdened
by it. Hence, on the record before us, and in the context of this facial challenge,
we are not convinced that the 24-hour waiting period constitutes an undue burden.
We are left with the argument that the various aspects of the informed consent requirement
are unconstitutional because they place barriers in the way of abortion on demand.
Even the broadest reading of Roe, however, has not suggested that there is a constitutional
right to abortion on demand. See, e.g., Doe v. Bolton, 410 U.S., at 189 . Rather,
the right protected by Roe is a right to decide to terminate a pregnancy free of undue
interference by the State. Because the informed consent requirement facilitates the
wise exercise of that right, it cannot be classified as an interference with the right
Roe protects. The informed consent requirement is not an undue burden on that right.
C
Section 3209 of Pennsylvania's abortion law provides, except in cases of medical
emergency, that no physician shall perform an abortion on a married woman without
receiving a signed statement from the woman that she has notified her spouse that
she is about to undergo an abortion. The woman has the option of providing an alternative
signed statement certifying that her husband is not the man who impregnated her; that
her husband could not be located; that the pregnancy is the result of spousal sexual
assault which she has reported; or that the woman believes that notifying her husband
will cause him or someone else to inflict bodily injury upon her. A physician who
performs an abortion on [505 U.S. 833, 888] a married woman without receiving the
appropriate signed statement will have his or her license revoked, and is liable to
the husband for damages.
The District Court heard the testimony of numerous expert witnesses, and made detailed
findings of fact regarding the effect of this statute. These included:
"273. The vast majority of women consult their husbands prior to deciding to terminate
their pregnancy. . . .
. . . . .
"279. The "bodily injury" exception could not be invoked by a married woman whose
husband, if notified, would, in her reasonable belief, threaten to (a) publicize her
intent to have an abortion to family, friends or acquaintances; (b) retaliate against
her in future child custody or divorce proceedings; (c) inflict psychological intimidation
or emotional harm upon her, her children or other persons; (d) inflict bodily harm
on other persons such as children, family members or other loved ones; or (e) use
his control over finances to deprive of necessary monies for herself or her children.
. . .
. . . . .
"281. Studies reveal that family violence occurs in two million families in the United
States. This figure, however, is a conservative one that substantially understates
(because battering is usually not reported until it reaches life-threatening proportions)
the actual number of families affected by domestic violence. In fact, researchers
estimate that one of every two women will be battered at some time in their life.
. . .
"282. A wife may not elect to notify her husband of her intention to have an abortion
for a variety of reasons, including the husband's illness, concern about her own health,
the imminent failure of the marriage, or the husband's absolute opposition to the
abortion. . . .
"283. The required filing of the spousal consent form would require plaintiff-clinics
to change their counseling [505 U.S. 833, 889] procedures and force women to reveal
their most intimate decisionmaking on pain of criminal sanctions. The confidentiality
of these revelations could not be guaranteed, since the woman's records are not immune
from subpoena. . . .
"284. Women of all class levels, educational backgrounds, and racial, ethnic and
religious groups are battered. . . .
"285. Wife-battering or abuse can take on many physical and psychological forms.
The nature and scope of the battering can cover a broad range of actions, and be gruesome
and torturous. . . .
"286. Married women, victims of battering, have been killed in Pennsylvania and throughout
the United States. . . .
"287. Battering can often involve a substantial amount of sexual abuse, including
marital rape and sexual mutilation. . . .
"288. In a domestic abuse situation, it is common for the battering husband to also
abuse the children in an attempt to coerce the wife. . . .
"289. Mere notification of pregnancy is frequently a flashpoint for battering and
violence within the family. The number of battering incidents is high during the pregnancy,
and often the worst abuse can be associated with pregnancy. . . . The battering husband
may deny parentage and use the pregnancy as an excuse for abuse. . . .
"290. Secrecy typically shrouds abusive families. Family members are instructed not
to tell anyone, especially police or doctors, about the abuse and violence. Battering
husbands often threaten their wives or her children with further abuse if she tells
an outsider of the violence, and tells her that nobody will believe her. A battered
woman, therefore, is highly unlikely to disclose [505 U.S. 833, 890] the violence
against her for fear of retaliation by the abuser. . . .
"291. Even when confronted directly by medical personnel or other helping professionals,
battered women often will not admit to the battering, because they have not admitted
to themselves that they are battered. . . .
. . . . .
"294. A woman in a shelter or a safe house unknown to her husband is not "reasonably
likely" to have bodily harm inflicted upon her by her batterer; however, her attempt
to notify her husband pursuant to section 3209 could accidentally disclose her whereabouts
to her husband. Her fear of future ramifications would be realistic under the circumstances.
"295. Marital rape is rarely discussed with others or reported to law enforcement
authorities, and of those reported, only few are prosecuted. . . .
"296. It is common for battered women to have sexual intercourse with their husbands
to avoid being battered. While this type of coercive sexual activity would be spousal
sexual assault as defined by the Act, many women may not consider it to be so, and
others would fear disbelief. . . .
"297. The marital rape exception to section 3209 cannot be claimed by women who are
victims of coercive sexual behavior other than penetration. The 90-day reporting requirement
of the spousal sexual assault statute, 18 Pa.Con.Stat.Ann. 3218(c), further narrows
the class of sexually abused wives who can claim the exception, since many of these
women may be psychologically unable to discuss or report the rape for several years
after the incident. . . .
"298. Because of the nature of the battering relationship, battered women are unlikely
to avail themselves of the exceptions to section 3209 of the Act, regardless of [505
U.S. 833, 891] whether the section applies to them. 744 F.Supp., at 1360-1362 (footnote
omitted).
These findings are supported by studies of domestic violence. The American Medical
Association (AMA) has published a summary of the recent research in this field, which
indicates that, in an average 12-month period in this country, approximately two million
women are the victims of severe assaults by their male partners. In a 1985 survey,
women reported that nearly one of every eight husbands had assaulted their wives during
the past year. The AMA views these figures as "marked underestimates," because the
nature of these incidents discourages women from reporting them, and because surveys
typically exclude the very poor, those who do not speak English well, and women who
are homeless or in institutions or hospitals when the survey is conducted. According
to the AMA, [r]esearchers on family violence agree that the true incidence of partner
violence is probably double the above estimates; or four million severely assaulted
women per year. Studies suggest that from one-fifth to one-third of all women will
be physically assaulted by a partner or ex-partner during their lifetime. AMA Council
on Scientific Affairs, Violence Against Women 7 (1991) (emphasis in original). Thus,
on an average day in the United States, nearly 11,000 women are severely assaulted
by their male partners. Many of these incidents involve sexual assault. Id., at 3-4;
Shields & Hanneke, Battered Wives' Reactions to Marital Rape, in The Dark Side of
Families: Current Family Violence Research 131, 144 (D. Finkelhor, R. Gelles, G. Hataling,
& M. Straus eds. 1983). In families where wifebeating takes place, moreover, child
abuse is often present as well. Violence Against Women, supra, at 12.
Other studies fill in the rest of this troubling picture. Physical violence is only
the most visible form of abuse. Psychological abuse, particularly forced social and
economic isolation of women, is also common. L. Walker, The Battered [505 U.S. 833,
892] Woman Syndrome 27-28 (1984). Many victims of domestic violence remain with their
abusers, perhaps because they perceive no superior alternative. Herbert, Silver, &
Ellard, Coping with an Abusive Relationship: I. How and Why do Women Stay?, 53 J.
Marriage & the Family 311 (1991). Many abused women who find temporary refuge in shelters
return to their husbands, in large part because they have no other source of income.
Aguirre, Why Do They Return? Abused Wives in Shelters, 30 J.Nat.Assn. of Social Workers
350, 352 (1985). Returning to one's abuser can be dangerous. Recent Federal Bureau
of Investigation statistics disclose that 8.8 percent of all homicide victims in the
United States are killed by their spouses. Mercy & Saltzman, Fatal Violence Among
Spouses in the United States, 1976-85, 79 Am.J. Public Health 595 (1989). Thirty percent
of female homicide victims are killed by their male partners. Domestic Violence: Terrorism
in the Home, Hearing before the Subcommittee on Children, Family, Drugs and Alcoholism
of the Senate Committee on Labor and Human Resources, 101st Cong., 2d Sess., 3 (1990).
The limited research that has been conducted with respect to notifying one's husband
about an abortion, although involving samples too small to be representative, also
supports the District Court's findings of fact. The vast majority of women notify
their male partners of their decision to obtain an abortion. In many cases in which
married women do not notify their husbands, the pregnancy is the result of an extramarital
affair. Where the husband is the father, the primary reason women do not notify their
husbands is that the husband and wife are experiencing marital difficulties, often
accompanied by incidents of violence. Ryan & Plutzer, When Married Women Have Abortions:
Spousal Notification and Marital Interaction, 51 J. Marriage & the Family 41, 44 (1989).
This information and the District Court's findings reinforce what common sense would
suggest. In well-functioning [505 U.S. 833, 893] marriages, spouses discuss important
intimate decisions such as whether to bear a child. But there are millions of women
in this country who are the victims of regular physical and psychological abuse at
the hands of their husbands. Should these women become pregnant, they may have very
good reasons for not wishing to inform their husbands of their decision to obtain
an abortion. Many may have justifiable fears of physical abuse, but may be no less
fearful of the consequences of reporting prior abuse to the Commonwealth of Pennsylvania.
Many may have a reasonable fear that notifying their husbands will provoke further
instances of child abuse; these women are not exempt from 3209's notification requirement.
Many may fear devastating forms of psychological abuse from their husbands, including
verbal harassment, threats of future violence, the destruction of possessions, physical
confinement to the home, the withdrawal of financial support, or the disclosure of
the abortion to family and friends. These methods of psychological abuse may act as
even more of a deterrent to notification than the possibility of physical violence,
but women who are the victims of the abuse are not exempt from 3209's notification
requirement. And many women who are pregnant as a result of sexual assaults by their
husbands will be unable to avail themselves of the exception for spousal sexual assault,
3209(b)(3), because the exception requires that the woman have notified law enforcement
authorities within 90 days of the assault, and her husband will be notified of her
report once an investigation begins, 3128(c). If anything in this field is certain,
it is that victims of spousal sexual assault are extremely reluctant to report the
abuse to the government; hence, a great many spousal rape victims will not be exempt
from the notification requirement imposed by 3209.
The spousal notification requirement is thus likely to prevent a significant number
of women from obtaining an abortion. It does not merely make abortions a little more
difficult or expensive to obtain; for many women, it will impose [505 U.S. 833, 894]
a substantial obstacle. We must not blind ourselves to the fact that the significant
number of women who fear for their safety and the safety of their children are likely
to be deterred from procuring an abortion as surely as if the Commonwealth had outlawed
abortion in all cases.
Respondents attempt to avoid the conclusion that 3209 is invalid by pointing out
that it imposes almost no burden at all for the vast majority of women seeking abortions.
They begin by noting that only about 20 percent of the women who obtain abortions
are married. They then note that, of these women, about 95 percent notify their husbands
of their own volition. Thus, respondents argue, the effects of 3209 are felt by only
one percent of the women who obtain abortions. Respondents argue that, since some
of these women will be able to notify their husbands without adverse consequences
or will qualify for one of the exceptions, the statute affects fewer than one percent
of women seeking abortions. For this reason, it is asserted, the statute cannot be
invalid on its face. See Brief for Respondents 83-86. We disagree with respondents'
basic method of analysis.
The analysis does not end with the one percent of women upon whom the statute operates;
it begins there. Legislation is measured for consistency with the Constitution by
its impact on those whose conduct it affects. For example, we would not say that a
law which requires a newspaper to print a candidate's reply to an unfavorable editorial
is valid on its face because most newspapers would adopt the policy even absent the
law. See Miami Herald Publishing Co. v. Tornillo, 418 U.S. 241 (1974). The proper
focus of constitutional inquiry is the group for whom the law is a restriction, not
the group for whom the law is irrelevant.
Respondents' argument itself gives implicit recognition to this principle at one
of its critical points. Respondents speak of the one percent of women seeking abortions
who are married and would choose not to notify their husbands of their plans. By selecting
as the controlling class women [505 U.S. 833, 895] who wish to obtain abortions, rather
than all women or all pregnant women, respondents, in effect, concede that 3209 must
be judged by reference to those for whom it is an actual, rather than an irrelevant,
restriction. Of course, as we have said, 3209's real target is narrower even than
the class of women seeking abortions identified by the State: it is married women
seeking abortions who do not wish to notify their husbands of their intentions and
who do not qualify for one of the statutory exceptions to the notice requirement.
The unfortunate yet persisting conditions we document above will mean that, in a large
fraction of the cases in which 3209 is relevant, it will operate as a substantial
obstacle to a woman's choice to undergo an abortion. It is an undue burden, and therefore
invalid.
This conclusion is in no way inconsistent with our decisions upholding parental notification
or consent requirements. See, e.g., Akron II, 497 U.S., at 510 -519; Bellotti v. Baird,
443 U.S. 622 (1979) (Bellotti II); Planned Parenthood of Central Mo. v. Danforth,
428 U.S., at 74 . Those enactments, and our judgment that they are constitutional,
are based on the quite reasonable assumption that minors will benefit from consultation
with their parents and that children will often not realize that their parents have
their best interests at heart. We cannot adopt a parallel assumption about adult women.
We recognize that a husband has a deep and proper concern and interest . . . in his
wife's pregnancy and in the growth and development of the fetus she is carrying. Danforth,
supra, at 69. With regard to the children he has fathered and raised, the Court has
recognized his "cognizable and substantial" interest in their custody. Stanley v.
Illinois, 405 U.S. 645, 651 -652 (1972); see also Quilloin v. Walcott, 434 U.S. 246
(1978); Caban v. Mohammed, 441 U.S. 380 (1979); Lehr v. Robertson, 463 U.S. 248 (1983).
If this case concerned a State's ability to require the mother to notify the father
before taking some action with respect to a living [505 U.S. 833, 896] child raised
by both, therefore, it would be reasonable to conclude, as a general matter, that
the father's interest in the welfare of the child and the mother's interest are equal.
Before birth, however, the issue takes on a very different cast. It is an inescapable
biological fact that state regulation with respect to the child a woman is carrying
will have a far greater impact on the mother's liberty than on the father's. The effect
of state regulation on a woman's protected liberty is doubly deserving of scrutiny
in such a case, as the State has touched not only upon the private sphere of the family,
but upon the very bodily integrity of the pregnant woman. Cf. Cruzan v. Director,
Mo. Dept. of Health, 497 U.S., at 281 . The Court has held that, when the wife and
the husband disagree on this decision, the view of only one of the two marriage partners
can prevail. Inasmuch as it is the woman who physically bears the child and who is
the more directly and immediately affected by the pregnancy, as between the two, the
balance weighs in her favor. Danforth, supra, at 71. This conclusion rests upon the
basic nature of marriage and the nature of our Constitution: [T]he marital couple
is not an independent entity with a mind and heart of its own, but an association
of two individuals, each with a separate intellectual and emotional makeup. If the
right of privacy means anything, it is the right of the individual, married or single,
to be free from unwarranted governmental intrusion into matters so fundamentally affecting
a person as the decision whether to bear or beget a child. Eisenstadt v. Baird, 405
U.S., at 453 (emphasis in original). The Constitution protects individuals, men and
women alike, from unjustified state interference, even when that interference is enacted
into law for the benefit of their spouses.
There was a time, not so long ago, when a different understanding of the family and
of the Constitution prevailed. In Bradwell v. State, 16 Wall. 130 (1873), three Members
of this [505 U.S. 833, 897] Court reaffirmed the common law principle that a woman
had no legal existence separate from her husband, who was regarded as her head and
representative in the social state; and, notwithstanding some recent modifications
of this civil status, many of the special rules of law flowing from and dependent
upon this cardinal principle still exist in full force in most States. Id., at 141
(Bradley, J., joined by Swayne and Field, JJ., concurring in judgment). Only one generation
has passed since this Court observed that "woman is still regarded as the center of
home and family life," with attendant "special responsibilities" that precluded full
and independent legal status under the Constitution. Hoyt v. Florida, 368 U.S. 57,
62 (1961). These views, of course, are no longer consistent with our understanding
of the family, the individual, or the Constitution.
In keeping with our rejection of the common law understanding of a woman's role within
the family, the Court held in Danforth that the Constitution does not permit a State
to require a married woman to obtain her husband's consent before undergoing an abortion.
428 U.S., at 69 . The principles that guided the Court in Danforth should be our guides
today. For the great many women who are victims of abuse inflicted by their husbands,
or whose children are the victims of such abuse, a spousal notice requirement enables
the husband to wield an effective veto over his wife's decision. Whether the prospect
of notification itself deters such women from seeking abortions, or whether the husband,
through physical force or psychological pressure or economic coercion, prevents his
wife from obtaining an abortion until it is too late, the notice requirement will
often be tantamount to the veto found unconstitutional in Danforth. The women most
affected by this law - those who most reasonably fear the consequences of notifying
their husbands that they are pregnant - are in the gravest danger. [505 U.S. 833,
898]
The husband's interest in the life of the child his wife is carrying does not permit
the State to empower him with this troubling degree of authority over his wife. The
contrary view leads to consequences reminiscent of the common law. A husband has no
enforceable right to require a wife to advise him before she exercises her personal
choices. If a husband's interest in the potential life of the child outweighs a wife's
liberty, the State could require a married woman to notify her husband before she
uses a post-fertilization contraceptive. Perhaps next in line would be a statute requiring
pregnant married women to notify their husbands before engaging in conduct causing
risks to the fetus. After all, if the husband's interest in the fetus' safety is a
sufficient predicate for state regulation, the State could reasonably conclude that
pregnant wives should notify their husbands before drinking alcohol or smoking. Perhaps
married women should notify their husbands before using contraceptives or before undergoing
any type of surgery that may have complications affecting the husband's interest in
his wife's reproductive organs. And if a husband's interest justifies notice in any
of these cases, one might reasonably argue that it justifies exactly what the Danforth
Court held it did not justify - a requirement of the husband's consent as well. A
State may not give to a man the kind of dominion over his wife that parents exercise
over their children.
Section 3209 embodies a view of marriage consonant with the common law status of
married women, but repugnant to our present understanding of marriage and of the nature
of the rights secured by the Constitution. Women do not lose their constitutionally
protected liberty when they marry. The Constitution protects all individuals, male
or female, married or unmarried, from the abuse of governmental power, even where
that power is employed for the supposed benefit of a member of the individual's family.
These considerations confirm our conclusion that 3209 is invalid. [505 U.S. 833, 899]
D
We next consider the parental consent provision. Except in a medical emergency, an
unemancipated young woman under 18 may not obtain an abortion unless she and one of
her parents (or guardian) provides informed consent as defined above. If neither a
parent nor a guardian provides consent, a court may authorize the performance of an
abortion upon a determination that the young woman is mature and capable of giving
informed consent and has, in fact, given her informed consent, or that an abortion
would be in her best interests.
We have been over most of this ground before. Our cases establish, and we reaffirm
today, that a State may require a minor seeking an abortion to obtain the consent
of a parent or guardian, provided that there is an adequate judicial bypass procedure.
See, e.g., Akron II, 497 U.S., at 510 -519; Hodgson, 497 U.S., at 461 (O'Connor, J.,
concurring in part and concurring in judgment in part); id., at 497-501 (Kennedy,
J., concurring in judgment in part and dissenting in part); Akron I, 462 U.S., at
440 ; Bellotti II, 443 U.S., at 643 -644 (plurality opinion). Under these precedents,
in our view, the one-parent consent requirement and judicial bypass procedure are
constitutional.
The only argument made by petitioners respecting this provision and to which our
prior decisions do not speak is the contention that the parental consent requirement
is invalid because it requires informed parental consent. For the most part, petitioners'
argument is a reprise of their argument with respect to the informed consent requirement
in general, and we reject it for the reasons given above. Indeed, some of the provisions
regarding informed consent have particular force with respect to minors: the waiting
period, for example, may provide the parent or parents of a pregnant young woman the
opportunity to consult with her in private, and to discuss the consequences of her
decision in [505 U.S. 833, 900] the context of the values and moral or religious principles
of their family. See Hodgson, supra, at 448-449 (opinion of Stevens, J.)
E
Under the recordkeeping and reporting requirements of the statute, every facility
which performs abortions is required to file a report stating its name and address
as well as the name and address of any related entity, such as a controlling or subsidiary
organization. In the case of state-funded institutions, the information becomes public.
For each abortion performed, a report must be filed identifying: the physician (and
the second physician where required); the facility; the referring physician or agency;
the woman's age; the number of prior pregnancies and prior abortions she has had;
gestational age; the type of abortion procedure; the date of the abortion; whether
there were any preexisting medical conditions which would complicate pregnancy; medical
complications with the abortion; where applicable, the basis for the determination
that the abortion was medically necessary; the weight of the aborted fetus; and whether
the woman was married, and if so, whether notice was provided or the basis for the
failure to give notice. Every abortion facility must also file quarterly reports showing
the number of abortions performed broken down by trimester. See 18 Pa.Cons.Stat. 3207,
3214 (1990). In all events, the identity of each woman who has had an abortion remains
confidential.
In Danforth, 428 U.S., at 80 , we held 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. We think that, under
this standard, all the provisions at issue here except that relating to spousal notice
are constitutional. Although they do not relate to the State's interest in informing
the woman's choice, they do relate to health. The collection of information with respect
to actual patients [505 U.S. 833, 901] is a vital element of medical research, and
so it cannot be said that the requirements serve no purpose other than to make abortions
more difficult. Nor do we find that the requirements impose a substantial obstacle
to a woman's choice. At most, they might increase the cost of some abortions by a
slight amount. While at some point increased cost could become a substantial obstacle,
there is no such showing on the record before us.
Subsection (12) of the reporting provision requires the reporting of, among other
things, a married woman's "reason for failure to provide notice" to her husband. 3214(a)(12).
This provision in effect requires women, as a condition of obtaining an abortion,
to provide the Commonwealth with the precise information we have already recognized
that many women have pressing reasons not to reveal. Like the spousal notice requirement
itself, this provision places an undue burden on a woman's choice, and must be invalidated
for that reason.
VI
Our Constitution is a covenant running from the first generation of Americans to
us, and then to future generations. It is a coherent succession. Each generation must
learn anew that the Constitution's written terms embody ideas and aspirations that
must survive more ages than one. We accept our responsibility not to retreat from
interpreting the full meaning of the covenant in light of all of our precedents. We
invoke it once again to define the freedom guaranteed by the Constitution's own promise,
the promise of liberty.
* * *
The judgment in No. 91-902 is affirmed. The judgment in No. 91-744 is affirmed in
part and reversed in part, and the case is remanded for proceedings consistent with
this opinion, including consideration of the question of severability.
It is so ordered.
APPENDIX TO OPINION OF O'CONNOR, KENNEDY, AND SOUTER, JJ.
Selected Provisions of the 1988 and 1989 Amendments to the Pennsylvania Abortion
Control Act of 1982
18 PA.CONS.STAT. (1990)
" 3203. Definitions.
. . . . .
"`Medical emergency.' That condition which, on the basis of the physician's good
faith clinical judgment, so complicates the medical condition of a pregnant woman
as to necessitate the immediate abortion of her pregnancy to avert her death or for
which a delay will create serious risk of substantial and irreversible impairment
of major bodily function."
" 3205. Informed consent.
(a) General rule. - No abortion shall be performed or induced except with the voluntary
and informed consent of the woman upon whom the abortion is to be performed or induced.
Except in the case of a medical emergency, consent to an abortion is voluntary and
informed if and only if:
"(1) At least 24 hours prior to the abortion, the physician who is to perform the
abortion or the referring physician has orally informed the woman of:
"(i) The nature of the proposed procedure or treatment and of those risks and alternatives
to the procedure or treatment that a reasonable patient would consider material to
the decision of whether or not to undergo the abortion.
"(ii) The probable gestational age of the unborn child at the time the abortion is
to be performed.
"(iii) The medical risks associated with carrying her child to term.
"(2) At least 24 hours prior to the abortion, the physician who is to perform the
abortion or the referring physician, or a qualified physician assistant, health care
practitioner, technician or social worker to whom the [505 U.S. 833, 903] responsibility
has been delegated by either physician, has informed the pregnant woman that:
"(i) The department publishes printed materials which describe the unborn child and
list agencies which offer alternatives to abortion and that she has a right to review
the printed materials and that a copy will be provided to her free of charge if she
chooses to review it.
"(ii) Medical assistance benefits may be available for prenatal care, childbirth
and neonatal care, and that more detailed information on the availability of such
assistance is contained in the printed materials published by the department.
"(iii) The father of the unborn child is liable to assist in the support of her child,
even in instances where he has offered to pay for the abortion. In the case of rape,
this information may be omitted.
"(3) A copy of the printed materials has been provided to the woman if she chooses
to view these materials.
"(4) The pregnant woman certifies in writing, prior to the abortion, that the information
required to be provided under paragraphs (1), (2) and (3) has been provided. [505
U.S. 833, 63]
"(b) Emergency. - Where a medical emergency compels the performance of an abortion,
the physician shall inform the woman, prior to the abortion if possible, of the medical
indications supporting his judgment that an abortion is necessary to avert her death
or to avert substantial and irreversible impairment of major bodily function.
"(c) Penalty. - Any physician who violates the provisions of this section is guilty
of "unprofessional conduct" and his license for the practice of medicine and surgery
shall be subject to suspension or revocation in accordance with procedures provided
under the act of October 5, 1978 (P.L. 1109, No. 261), known as the Osteopathic Medical
Practice Act, the [505 U.S. 833, 904] act of December 20, 1985 (P.L. 457, No. 112),
known as the Medical Practice Act of 1985, or their successor acts. Any physician
who performs or induces an abortion without first obtaining the certification required
by subsection (a)(4) or with knowledge or reason to know that the informed consent
of the woman has not been obtained shall for the first offense be guilty of a summary
offense and for each subsequent offense be guilty of a misdemeanor of the third degree.
No physician shall be guilty of violating this section for failure to furnish the
information required by subsection (a) if he or she can demonstrate, by a preponderance
of the evidence, that he or she reasonably believed that furnishing the information
would have resulted in a severely adverse effect on the physical or mental health
of the patient.
"(d) Limitation on civil liability. - Any physician who complies with the provisions
of this section may not be held civilly liable to his patient for failure to obtain
informed consent to the abortion within the meaning of that term as defined by the
act of October 15, 1975 (P.L. 390, No. 111), known as the Health Care Services Malpractice
Act.
" 3206. Parental consent.
"(a) General rule. - Except in the case of a medical emergency or except as provided
in this section, if a pregnant woman is less than 18 years of age and not emancipated,
or if she has been adjudged an incompetent under 20 Pa.C.S. 5511 (relating to petition
and hearing; examination by court-appointed physician), a physician shall not perform
an abortion upon her unless, in the case of a woman who is less than 18 years of age,
he first obtains the informed consent both of the pregnant woman and of one of her
parents; or, in the case of a woman who is incompetent, he first obtains the informed
consent of her guardian. In deciding whether to grant such consent, a pregnant woman's
parent or guardian shall consider only their child's or ward's best interests. In
the case of a pregnancy that is the result of incest, where [505 U.S. 833, 905] the
father is a party to the incestuous act, the pregnant woman need only obtain the consent
of her mother.
"(b) Unavailability of parent or guardian. - If both parents have died or are otherwise
unavailable to the physician within a reasonable time and in a reasonable manner,
consent of the pregnant woman's guardian or guardians shall be sufficient. If the
pregnant woman's parents are divorced, consent of the parent having custody shall
be sufficient. If neither any parent nor a legal guardian is available to the physician
within a reasonable time and in a reasonable manner, consent of any adult person standing
in loco parentis shall be sufficient.
"(c) Petition to the court for consent. - If both of the parents or guardians of
the pregnant woman refuse to consent to the performance of an abortion or if she elects
not to seek the consent of either of her parents or of her guardian, the court of
common pleas of the judicial district in which the applicant resides or in which the
abortion is sought shall, upon petition or motion, after an appropriate hearing, authorize
a physician to perform the abortion if the court determines that the pregnant woman
is mature and capable of giving informed consent to the proposed abortion, and has,
in fact, given such consent.
"(d) Court order. - If the court determines that the pregnant woman is not mature
and capable of giving informed consent or if the pregnant woman does not claim to
be mature and capable of giving informed consent, the court shall determine whether
the performance of an abortion upon her would be in her best interests. If the court
determines that the performance of an abortion would be in the best interests of the
woman, it shall authorize a physician to perform the abortion.
"(e) Representation in proceedings. - The pregnant woman may participate in proceedings
in the court on her own behalf and the court may appoint a guardian ad litem to assist
her. The court shall, however, advise her that she has [505 U.S. 833, 906] a right
to court-appointed counsel, and shall provide her with such counsel unless she wishes
to appear with private counsel or has knowingly and intelligently waived representation
by counsel.
" 3207. Abortion facilities.
"(b) Reports. - Within 30 days after the effective date of this chapter, every facility
at which abortions are performed shall file, and update immediately upon any change,
a report with the department, containing the following information:
"(1) Name and address of the facility.
"(2) Name and address of any parent, subsidiary or affiliated organizations, corporations
or associations.
"(3) Name and address of any parent, subsidiary or affiliated organizations, corporations
or associations having contemporaneous commonality of ownership, beneficial interest,
directorship or officership with any other facility.
The information contained in those reports which are filed pursuant to this subsection
by facilities which receive State-appropriated funds during the 12 calendar-month
period immediately preceding a request to inspect or copy such reports shall be deemed
public information. Reports filed by facilities which do not receive State-appropriated
funds shall only be available to law enforcement officials, the State Board of Medicine
and the State Board of Osteopathic Medicine for use in the performance of their official
duties. Any facility failing to comply with the provisions of this subsection shall
be assessed by the department a fine of $500 for each day it is in violation hereof.
" 3208. Printed information.
"(a) General rule. - The department shall cause to be published in English, Spanish
and Vietnamese, within 60 days after this chapter becomes law, and shall update on
an annual basis, the following easily comprehensible printed materials: [505 U.S.
833, 907]
"(1) Geographically indexed materials designed to inform the woman of public and
private agencies and services available to assist a woman through pregnancy, upon
childbirth and while the child is dependent, including adoption agencies, which shall
include a comprehensive list of the agencies available, a description of the services
they offer and a description of the manner, including telephone numbers, in which
they might be contacted, or, at the option of the department, printed materials including
a toll-free 24 hour-a-day telephone number which may be called to obtain, orally,
such a list and description of agencies in the locality of the caller and of the services
they offer. The materials shall provide information on the availability of medical
assistance benefits for prenatal care, childbirth and neonatal care, and state that
it is unlawful for any individual to coerce a woman to undergo abortion, that any
physician who performs an abortion upon a woman without obtaining her informed consent
or without according her a private medical consultation may be liable to her for damages
in a civil action at law, that the father of a child is liable to assist in the support
of that child, even in instances where the father has offered to pay for an abortion
and that the law permits adoptive parents to pay costs of prenatal care, childbirth
and neonatal care.
(2) Materials designed to inform the woman of the probable anatomical and physiological
characteristics of the unborn child at two-week gestational increments from fertilization
to full term, including pictures representing the development of unborn children at
two-week gestational increments, and any relevant information on the possibility of
the unborn child's survival; provided that any such pictures or drawings must contain
the dimensions of the fetus and must be realistic and appropriate for the woman's
stage of pregnancy. The materials shall be objective, non-judgmental and designed
[505 U.S. 833, 908] to convey only accurate scientific information about the unborn
child at the various gestational ages. The material shall also contain objective information
describing the methods of abortion procedures commonly employed, the medical risks
commonly associated with each such procedure, the possible detrimental psyschological
effects of abortion and the medical risks commonly associated with each such procedure
and the medical risks commonly associated with carrying a child to term. [505 U.S.
833, 68]
"(b) Format. - The materials shall be printed in a typeface large enough to be clearly
legible.
"(c) Free distribution. - The materials required under this section shall be available
at no cost from the department upon request and in appropriate number to any person,
facility or hospital.
" 3209. Spousal notice.
"(a) Spousal notice required. - In order to further the Commonwealth's interest in
promoting the integrity of the marital relationship and to protect a spouse's interests
in having children within marriage and in protecting the prenatal life of that spouse's
child, no physician shall perform an abortion on a married woman, except as provided
in subsections (b) and (c), unless he or she has received a signed statement, which
need not be notarized, from the woman upon whom the abortion is to be performed, that
she has notified her spouse that she is about to undergo an abortion. The statement
shall bear a notice that any false statement made therein is punishable by law.
"(b) Exceptions. - The statement certifying that the notice required by subsection
(a) has been given need not be furnished where the woman provides the physician a
signed statement certifying at least one of the following:
"(1) Her spouse is not the father of the child.
"(2) Her spouse, after diligent effort, could not be located. [505 U.S. 833, 909]
"(3) The pregnancy is a result of spousal sexual assault as described in section
3128 (relating to spousal sexual assault), which has been reported to a law enforcement
agency having the requisite jurisdiction.
"(4) The woman has reason to believe that the furnishing of notice to her spouse
is likely to result in the infliction of bodily injury upon her by her spouse or by
another individual.
Such statement need not be notarized, but shall bear a notice that any false statements
made therein are punishable by law.
"(c) Medical emergency. - The requirements of subsection (a) shall not apply in case
of a medical emergency.
"(d) Forms. - The department shall cause to be published, forms which may be utilized
for purposes of providing the signed statements required by subsections (a) and (b).
The department shall distribute an adequate supply of such forms to all abortion facilities
in this Commonwealth.
"(e) Penalty; civil action. - Any physician who violates the provisions of this section
is guilty of "unprofessional conduct," and his or her license for the practice of
medicine and surgery shall be subject to suspension or revocation in accordance with
procedures provided under the act of October 5, 1978 (P.L. 1109, No. 261), known as
the Osteopathic Medical Practice Act, the act of December 20, 1985 (P. L. 457, No.
112), known as the Medical Practice Act of 1985, or their successor acts. In addition,
any physician who knowingly violates the provisions of this section shall be civilly
liable to the spouse who is the father of the aborted child for any damages caused
thereby and for punitive damages in the amount of $5,000, and the court shall award
a prevailing plaintiff a reasonable attorney fee as part of costs.
" 3214. Reporting.
"(a) General rule. - For the purpose of promotion of maternal health and life by
adding to the sum of medical and [505 U.S. 833, 910] public health knowledge through
the compilation of relevant data, and to promote the Commonwealth's interest in protection
of the unborn child, a report of each abortion performed shall be made to the department
on forms prescribed by it. The report forms shall not identify the individual patient
by name and shall include the following information:
"(1) Identification of the physician who performed the abortion, the concurring physician
as required by section 3211(c)(2) (relating to abortion on unborn child of 24 or more
weeks gestational age), the second physician as required by section 3211(c)(5) and
the facility where the abortion was performed and of the referring physician, agency
or service, if any.
"(2) The county and state in which the woman resides.
"(3) The woman's age.
"(4) The number of prior pregnancies and prior abortions of the woman.
"(5) The gestational age of the unborn child at the time of the abortion.
"(6) The type of procedure performed or prescribed and the date of the abortion.
"(7) Preexisting medical conditions of the woman which would complicate pregnancy,
if any, and if known, any medical complication which resulted from the abortion itself.
"(8) The basis for the medical judgment of the physician who performed the abortion
that the abortion was necessary to prevent either the death of the pregnant woman
or he substantial and irreversible impairment of a major bodily function of the woman,
where an abortion has been performed pursuant to section 3211(b)(1).
"(9) The weight of the aborted child for any abortion performed pursuant to section
3211(b)(1).
"(10) Basis for any medical judgment that a medical emergency existed which excused
the physician from compliance with any provision of this chapter. [505 U.S. 833, 911]
"(11) The information required to be reported under section 3210(a) (relating to
determination of gestational age).
"(12) Whether the abortion was performed upon a married woman and, if so, whether
notice to her spouse was given. If no notice to her spouse was given, the report shall
also indicate the reason for failure to provide notice.
. . . . .
"(f) Report by facility. - Every facility in which an abortion is performed within
this Commonwealth during any quarter year shall file with the department a report
showing the total number of abortions performed within the hospital or other facility
during that quarter year. This report shall also show the total abortions performed
in each trimester of pregnancy. Any report shall be available for public inspection
and copying only if the facility receives State-appropriated funds within the 12 calendar-month
period immediately preceding the filing of the report. These reports shall be submitted
on a form prescribed by the department which will enable a facility to indicate whether
or not it is receiving State-appropriated funds: If the facility indicates on the
form that it is not receiving State-appropriated funds, the department shall regard
its report as confidential unless it receives other evidence which causes it to conclude
that the facility receives State-appropriated funds.
JUSTICE STEVENS, concurring in part and dissenting in part.
The portions of the Court's opinion that I have joined are more important than those
with which I disagree. I shall therefore first comment on significant areas of agreement,
and then explain the limited character of my disagreement. [505 U.S. 833, 912]
I
The Court is unquestionably correct in concluding that the doctrine of stare decisis
has controlling significance in a case of this kind, notwithstanding an individual
Justice's concerns about the merits. 1 The central holding of Roe v. Wade, 410 U.S.
113 (1973), has been a "part of our law" for almost two decades. Planned Parenthood
of Central Mo. v. Danforth, 428 U.S. 52, 101 (1976) (STEVENS, J., concurring in part
and dissenting in part). It was a natural sequel to the protection of individual liberty
established in Griswold v. Connecticut, 381 U.S. 479 (1965). See also Carey v. Population
Services International, 431 U.S. 678, 687 , 702 (1977) (WHITE, J., concurring in part
and concurring in result). The societal costs of overruling Roe at this late date
would be enormous. Roe is an integral part of a correct understanding of both the
concept of liberty and the basic equality of men and women.
Stare decisis also provides a sufficient basis for my agreement with the joint opinion's
reaffirmation of Roe's postviability analysis. Specifically, I accept the proposition
that, [i]f the State is interested in protecting fetal life after viability, it may
go so far as to proscribe abortion during that period, except when it is necessary
to preserve the life or health of the mother. 410 U.S., at 163 -164; see ante, at
879.
I also accept what is implicit in the Court's analysis, namely, a reaffirmation of
Roe's explanation of why the State's obligation to protect the life or health of the
mother [505 U.S. 833, 913] must take precedence over any duty to the unborn. The Court
in Roe carefully considered, and rejected, the State's argument "that the fetus is
a `person' within the language and meaning of the Fourteenth Amendment." 410 U.S.,
at 156 . After analyzing the usage of "person" in the Constitution, the Court concluded
that that word "has application only postnatally." Id., at 157. Commenting on the
contingent property interests of the unborn that are generally represented by guardians
ad litem, the Court noted: Perfection of the interests involved, again, has generally
been contingent upon live birth. In short, the unborn have never been recognized in
the law as persons in the whole sense. Id., at 162. Accordingly, an abortion is not
"the termination of life entitled to Fourteenth Amendment protection." Id., at 159.
From this holding, there was no dissent, see id., at 173; indeed, no Member of the
Court has ever questioned this fundamental proposition. Thus, as a matter of federal
constitutional law, a developing organism that is not yet a "person" does not have
what is sometimes described as a "right to life." 2 This has been and, by the Court's
holding today, [505 U.S. 833, 914] remains, a fundamental premise of our constitutional
law governing reproductive autonomy.
II
My disagreement with the joint opinion begins with its understanding of the trimester
framework established in Roe. Contrary to the suggestion of the joint opinion, ante,
at 876, it is not a "contradiction" to recognize that the State may have a legitimate
interest in potential human life and, at the same time, to conclude that that interest
does not justify the regulation of abortion before viability (although other interests,
such as maternal health, may). The fact that the State's interest is legitimate does
not tell us when, if ever, that interest outweighs the pregnant woman's interest in
personal liberty. It is appropriate, therefore, to consider more carefully the nature
of the interests at stake.
First, it is clear that, in order to be legitimate, the State's interest must be
secular; consistent with the First Amendment, the State may not promote a theological
or sectarian interest. See Thornburgh v. American College of Obstetricians and Gynecologists,
476 U.S. 747, 778 (1986) (STEVENS, J., concurring); see generally Webster v. Reproductive
Health Services, 492 U.S. 490, 563 -572 (1989) (STEVENS, J., concurring in part and
dissenting in part). Moreover, as discussed above, the state interest in potential
human life is not an interest in loco parentis, for the fetus is not a person.
Identifying the State's interests - which the States rarely articulate with any precision
- makes clear that the interest in protecting potential life is not grounded in the
Constitution. It is, instead, an indirect interest supported by both humanitarian
and pragmatic concerns. Many of our citizens believe that any abortion reflects an
unacceptable disrespect for potential human life, and that the performance of more
[505 U.S. 833, 915] than a million abortions each year is intolerable; many find third-trimester
abortions performed when the fetus is approaching personhood particularly offensive.
The State has a legitimate interest in minimizing such offense. The State may also
have a broader interest in expanding the population, 3 believing society would benefit
from the services of additional productive citizens - or that the potential human
lives might include the occasional Mozart or Curie. These are the kinds of concerns
that comprise the State's interest in potential human life.
In counterpoise is the woman's constitutional interest in liberty. One aspect of
this liberty is a right to bodily integrity, a right to control one's person. See,
e.g., Rochin v. California, 342 U.S. 165 (1952); Skinner v. Oklahoma ex rel Williamson,
316 U.S. 535 (1942). This right is neutral on the question of abortion: the Constitution
would be equally offended by an absolute requirement that all women undergo abortions
as by an absolute prohibition on abortions. "Our whole constitutional heritage rebels
at the thought of giving government the power to control men's minds." Stanley v.
Georgia, 394 U.S. 557, 565 (1969). The same holds true for the power to control women's
bodies.
The woman's constitutional liberty interest also involves her freedom to decide matters
of the highest privacy and the most personal nature. Cf. Whalen v. Roe, 429 U.S. 589
, [505 U.S. 833, 916] 598-600 (1977). A woman considering abortion faces a difficult
choice having serious and personal consequences of major importance to her own future
- perhaps to the salvation of her own immortal soul. Thornburgh, 476 U.S., at 781
. The authority to make such traumatic and yet empowering decisions is an element
of basic human dignity. As the joint opinion so eloquently demonstrates, a woman's
decision to terminate her pregnancy is nothing less than a matter of conscience.
Weighing the State's interest in potential life and the woman's liberty interest,
I agree with the joint opinion that the State may "`"expres[s] a preference for normal
childbirth,"'" that the State may take steps to ensure that a woman's choice "is thoughtful
and informed," and that States are free to enact laws to provide a reasonable framework
for a woman to make a decision that has such profound and lasting meaning. Ante, at
872-873. Serious questions arise, however, when a State attempts to "persuade the
woman to choose childbirth over abortion." Ante, at 878. Decisional autonomy must
limit the State's power to inject into a woman's most personal deliberations its own
views of what is best. The State may promote its preferences by funding childbirth,
by creating and maintaining alternatives to abortion, and by espousing the virtues
of family; but it must respect the individual's freedom to make such judgments.
This theme runs throughout our decisions concerning reproductive freedom. In general,
Roe's requirement that restrictions on abortions before viability be justified by
the State's interest in maternal health has prevented States from interjecting regulations
designed to influence a woman's decision. Thus, we have upheld regulations of abortion
that are not efforts to sway or direct a woman's choice, but rather are efforts to
enhance the deliberative quality of that decision or are neutral regulations on the
health aspects of her decision. We have, for example, upheld regulations requiring
[505 U.S. 833, 917] written informed consent, see Planned Parenthood of Central Mo.
v. Danforth, 428 U.S. 52 (1976); limited recordkeeping and reporting, see ibid.; and
pathology reports, see Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft,
462 U.S. 476 (1983); as well as various licensing and qualification provisions, see,
e.g., Roe, 410 U.S., at 150 ; Simopoulos v. Virginia, 462 U.S. 506 (1983). Conversely,
we have consistently rejected state efforts to prejudice a woman's choice, either
by limiting the information available to her, see Bigelow v. Virginia, 421 U.S. 809
(1975), or by "requir[ing] the delivery of information designed `to influence the
woman's informed choice between abortion or childbirth.'" Thornburgh, 476 U.S., at
760 ; see also Akron v. Akron Center for Reproductive Health, Inc., 462 U.S. 416,
442 -449 (1983).
In my opinion, the principles established in this long line of cases and the wisdom
reflected in Justice Powell's opinion for the Court in Akron (and followed by the
Court just six years ago in Thornburgh) should govern our decision today. Under these
principles, Pa. Cons. Stat. 3205(a)(2)(i)-(iii) (1990) of the Pennsylvania statute
are unconstitutional. Those sections require a physician or counselor to provide the
woman with a range of materials clearly designed to persuade her to choose not to
undergo the abortion. While the Commonwealth is free, pursuant to 3208 of the Pennsylvania
law, to produce and disseminate such material, the Commonwealth may not inject such
information into the woman's deliberations just as she is weighing such an important
choice.
Under this same analysis, 3205(a)(1)(i) and (iii) of the Pennsylvania statute are
constitutional. Those sections, which require the physician to inform a woman of the
nature and risks of the abortion procedure and the medical risks of carrying to term,
are neutral requirements comparable to those imposed in other medical procedures.
Those sections indicate no effort by the Commonwealth to influence the [505 U.S. 833,
918] woman's choice in any way. If anything, such requirements enhance, rather than
skew, the woman's decisionmaking.
III
The 24-hour waiting period required by 3205(a)(1)-(2) of the Pennsylvania statute
raises even more serious concerns. Such a requirement arguably furthers the Commonwealth's
interests in two ways, neither of which is constitutionally permissible.
First, it may be argued that the 24 hour delay is justified by the mere fact that
it is likely to reduce the number of abortions, thus furthering the Commonwealth's
interest in potential life. But such an argument would justify any form of coercion
that placed an obstacle in the woman's path. The Commonwealth cannot further its interests
by simply wearing down the ability of the pregnant woman to exercise her constitutional
right.
Second, it can more reasonably be argued that the 24-hour delay furthers the Commonwealth's
interest in ensuring that the woman's decision is informed and thoughtful. But there
is no evidence that the mandated delay benefits women, or that it is necessary to
enable the physician to convey any relevant information to the patient. The mandatory
delay thus appears to rest on outmoded and unacceptable assumptions about the decisionmaking
capacity of women. While there are well-established and consistently maintained reasons
for the Commonwealth to view with skepticism the ability of minors to make decisions,
see Hodgson v. Minnesota, 497 U.S. 417, 449 (1990), 4 none of those reasons applies
to an [505 U.S. 833, 919] adult woman's decisionmaking ability. Just as we have left
behind the belief that a woman must consult her husband before undertaking serious
matters, see ante, at 895-898, so we must reject the notion that a woman is less capable
of deciding matters of gravity. Cf. Reed v. Reed, 404 U.S. 71 (1971).
In the alternative, the delay requirement may be premised on the belief that the
decision to terminate a pregnancy is presumptively wrong. This premise is illegitimate.
Those who disagree vehemently about the legality and morality of abortion agree about
one thing: the decision to terminate a pregnancy is profound and difficult. No person
undertakes such a decision lightly - and States may not presume that a woman has failed
to reflect adequately merely because her conclusion differs from the State's preference.
A woman who has, in the privacy of her thoughts and conscience, weighed the options
and made her decision cannot be forced to reconsider all, simply because the State
believes she has come to the wrong conclusion. 5 [505 U.S. 833, 920]
Part of the constitutional liberty to choose is the equal dignity to which each of
us is entitled. A woman who decides to terminate her pregnancy is entitled to the
same respect as a woman who decides to carry the fetus to term. The mandatory waiting
period denies women that equal respect.
IV
In my opinion, a correct application of the "undue burden" standard leads to the
same conclusion concerning the constitutionality of these requirements. A state-imposed
burden on the exercise of a constitutional right is measured both by its effects and
by its character: a burden may be "undue" either because the burden is too severe
or because it lacks a legitimate, rational justification. 6
The 24-hour delay requirement fails both parts of this test. The findings of the
District Court establish the severity of [505 U.S. 833, 921] the burden that the 24-hour
delay imposes on many pregnant women. Yet even in those cases in which the delay is
not especially onerous, it is, in my opinion, "undue," because there is no evidence
that such a delay serves a useful and legitimate purpose. As indicated above, there
is no legitimate reason to require a woman who has agonized over her decision to leave
the clinic or hospital and return again another day. While a general requirement that
a physician notify her patients about the risks of a proposed medical procedure is
appropriate, a rigid requirement that all patients wait 24 hours or (what is true
in [505 U.S. 833, 11] practice) much longer to evaluate the significance of information
that is either common knowledge or irrelevant is an irrational, and therefore "undue,"
burden.
The counseling provisions are similarly infirm. Whenever government commands private
citizens to speak or to listen, careful review of the justification for that command
is particularly appropriate. In this case, the Pennsylvania statute directs that counselors
provide women seeking abortions with information concerning alternatives to abortion,
the availability of medical assistance benefits, and the possibility of child support
payments. 3205(a)(2)(i)-(iii). The statute requires that this information be given
to all women seeking abortions, including those for whom such information is clearly
useless, such as those who are married, those who have undergone the procedure in
the past and are fully aware of the options, and those who are fully convinced that
abortion is their only reasonable option. Moreover, the statute requires physicians
to inform all of their patients of "[t]he probable gestational age of the unborn child."
3205(a)(1)(ii). This information is of little decisional value in most cases, because
90% of all abortions are performed during the first trimester, 7 when fetal age has
less relevance than when the fetus nears viability. Nor can the information [505 U.S.
833, 922] required by the statute be justified as relevant to any "philosophic" or
"social" argument, ante at 872, either favoring or disfavoring the abortion decision
in a particular case. In light of all of these facts, I conclude that the information
requirements in 3205(a)(1)(ii) and 3205(a)(2)(i) (iii) do not serve a useful purpose,
and thus constitute an unnecessary - and therefore undue - burden on the woman's constitutional
liberty to decide to terminate her pregnancy.
Accordingly, while I disagree with Parts IV, V-B, and V-D of the joint opinion, 8
I join the remainder of the Court's opinion.
Footnotes
[ Footnote 1 ] It is sometimes useful to view the issue of stare decisis from a historical
perspective. In the last 19 years, 15 Justices have confronted the basic issue presented
in Roe v. Wade, 410 U.S. 113 (1973). Of those, 11 have voted as the majority does
today: Chief Justice Burger, Justices Douglas, Brennan, Stewart, Marshall, and Powell,
and Justices BLACKMUN, O'CONNOR, KENNEDY, SOUTER, and myself. Only four - all of whom
happen to be on the Court today - have reached the opposite conclusion.
[ Footnote 2 ] Professor Dworkin has made this comment on the issue:
"The suggestion that states are free to declare a fetus a person. . . . assumes that
a state can curtail some persons' constitutional rights by adding new persons to the
constitutional population. The constitutional rights of one citizen are, of course,
very much affected by who or what else also has constitutional rights, because the
rights of others may compete or conflict with his. So any power to increase the constitutional
population by unilateral decision would be, in effect, a power to decrease rights
the national Constitution grants to others.
". . . If a state could declare trees to be persons with a constitutional right to
life, it could prohibit publishing newspapers or books in spite of the First Amendment's
guarantee of free speech, which could not be understood as a license to kill. . .
. Once we understand that the suggestion we are considering has that implication,
we must reject it. If a fetus is not part of the constitutional population under the
national constitutional arrangement, then states have no power to overrule that national
arrangement by themselves declaring that fetuses have rights competitive with [505
U.S. 833, 914] the constitutional rights of pregnant women." Unenumerated Rights:
Whether and How Doe Should be Overruled, 59 U.Chi.L.Rev. 381, 400 401 (1992).
[ Footnote 3 ] The state interest in protecting potential life may be compared to
the state interest in protecting those who seek to immigrate to this country. A contemporary
example is provided by the Haitians who have risked the perils of the sea in a desperate
attempt to become "persons" protected by our laws. Humanitarian and practical concerns
would support a state policy allowing those persons unrestricted entry; countervailing
interests in population control support a policy of limiting the entry of these potential
citizens. While the state interest in population control might be sufficient to justify
strict enforcement of the immigration laws, that interest would not be sufficient
to overcome a woman's liberty interest. Thus, a state interest in population control
could not justify a state-imposed limit on family size or, for that matter, state-mandated
abortions.
[ Footnote 4 ] As we noted in that opinion, the State's "legitimate interest in protecting
minor women from their own immaturity" distinguished that case from Akron v. Akron
Center for Reproductive Health, Inc., 462 U.S. 416 (1983), which involved a provision
that required that mature women, capable of consenting to an abortion, wait 24 hours
after giving consent before undergoing an abortion. Hodgson, 497 U.S., at 449 , n.
35.
[ Footnote 5 ] The joint opinion's reliance on the indirect effects of the regulation
of constitutionally protected activity, see ante, at 873-874, is misplaced; what matters
is not only the effect of a regulation, but also the reason for the regulation. As
I explained in Hodgson:
"In cases involving abortion, as in cases involving the right to travel or the right
to marry, the identification of the constitutionally protected interest is merely
the beginning of the analysis. State regulation of travel and of marriage is obviously
permissible even though a State may not categorically exclude nonresidents from its
borders, Shapiro v. Thompson, 394 U.S. 618, 631 (1969), or deny prisoners the right
to marry, Turner v. Safley, 482 U.S. 78, 94 -99 (1987). But the regulation of constitutionally
protected decisions, such as where a person shall reside or whom he or she shall marry,
must be predicated on legitimate state concerns other than disagreement with the choice
the individual has made. Cf. Turner v. Safley, supra; Loving v. Virginia, 388 U.S.
1, 12 (1967). In the abortion area, a State may have no obligation to spend its own
money, or use its own facilities, to subsidize nontherapeutic abortions for minors
or adults. See, e.g., Maher v. Roe, 432 U.S. 464 (1977); cf. Webster v. Reproductive
[505 U.S. 833, 920] Health Services, 492 U.S. 490, 508 -511 (1989); id., at 523-524
(O'CONNOR, J., concurring in part and concurring in judgment). A State's value judgment
favoring childbirth over abortion may provide adequate support for decisions involving
such allocation of public funds, but not for simply substituting a state decision
for an individual decision that a woman has a right to make for herself. Otherwise,
the interest in liberty protected by the Due Process Clause would be a nullity. A
state policy favoring childbirth over abortion is not in itself a sufficient justification
for overriding the woman's decision or for placing `obstacles - absolute or otherwise
- in the pregnant woman's path to an abortion.'" 497 U.S., at 435 .
[ Footnote 6 ] The meaning of any legal standard can only be understood by reviewing
the actual cases in which it is applied. For that reason, I discount both JUSTICE
SCALIA's comments on past descriptions of the standard, see post, at 988-990 (opinion
concurring in judgment in part and dissenting in part), and the attempt to give it
crystal clarity in the joint opinion. The several opinions supporting the judgment
in Griswold v. Connecticut, 381 U.S. 479 (1965), are less illuminating than the central
holding of the case, which appears to have passed the test of time. The future may
also demonstrate that a standard that analyzes both the severity of a regulatory burden
and the legitimacy of its justification will provide a fully adequate framework for
the review of abortion legislation even if the contours of the standard are not authoritatively
articulated in any single opinion.
[ Footnote 7 ] U.S. Dept. of Commerce, Bureau of the Census, Statistical Abstract
of the United States 71 (111th ed. 1991).
[ Footnote 8 ] Although I agree that a parental consent requirement (with the appropriate
bypass) is constitutional, I do not join Part V-D of the joint opinion because its
approval of Pennsylvania's informed parental consent requirement is based on the reasons
given in Part V-B, with which I disagree.
JUSTICE BLACKMUN, concurring in part, concurring in the judgment in part, and dissenting
in part.
I join Parts I, II, III, V-A, V-C, and VI of the joint opinion of JUSTICES O'CONNOR,
KENNEDY, and SOUTER, ante.
Three years ago, in Webster v. Reproductive Health Services 492 U.S. 490 (1989),
four Members of this Court appeared poised to "cas[t] into darkness the hopes and
visions of every woman in this country" who had come to believe that the Constitution
guaranteed her the right to reproductive choice. Id., at 557 (BLACKMUN, J., dissenting).
See id., at 499 (plurality opinion of REHNQUIST, C. J., joined by White and Kennedy,
JJ.); id., at 532 (SCALIA, J., concurring in part and concurring in judgment). All
that remained between the promise of Roe and the darkness of the plurality was a single,
flickering flame. Decisions since Webster gave little reason to hope that this flame
would cast much light. See, e.g., Ohio v. Akron Center for Reproductive Health, 497
U.S. 502, 524 (1990) (BLACKMUN, J., dissenting). But now, just when so many expected
the darkness to fall, the flame has grown bright. [505 U.S. 833, 923]
I do not underestimate the significance of today's joint opinion. Yet I remain steadfast
in my belief that the right to reproductive choice is entitled to the full protection
afforded by this Court before Webster. And I fear for the darkness as four Justices
anxiously await the single vote necessary to extinguish the light.
I
Make no mistake, the joint opinion of Justices O'CONNOR, KENNEDY, and SOUTER is an
act of personal courage and constitutional principle. In contrast to previous decisions
in which Justices O'CONNOR and KENNEDY postponed reconsideration of Roe v. Wade, 410
U.S. 113 (1973), the authors of the joint opinion today join JUSTICE STEVENS and me
in concluding that "the essential holding of Roe v. Wade should be retained and once
again reaffirmed." Ante at 846. In brief, five Members of this Court today recognize
that "the Constitution protects a woman's right to terminate her pregnancy in its
early stages." Ante,, at 844.
A fervent view of individual liberty and the force of stare decisis have led the
Court to this conclusion. Ante, at 853. Today a majority reaffirms that the Due Process
Clause of the Fourteenth Amendment establishes "a realm of personal liberty which
the government may not enter," ante, at 847 - a realm whose outer limits cannot be
determined by interpretations of the Constitution that focus only on the specific
practices of States at the time the Fourteenth Amendment was adopted. See ante, at
848-849. Included within this realm of liberty is "the right of the individual, married
or single, to be free from unwarranted governmental intrusion into matters so fundamentally
affecting a person as the decision whether to bear or beget a child." Ante, at 851,
quoting Eisenstadt v. Baird, 405 U.S. 438, 453 (1972) (emphasis in original). These
matters, involving the most intimate and personal choices a person may make in a lifetime,
choices central to personal dignity and autonomy, are central to the [505 U.S. 833,
924] liberty protected by the Fourteenth Amendment. Ante, at 851 (emphasis added).
Finally, the Court today recognizes that, in the case of abortion, the liberty of
the woman is at stake in a sense unique to the human condition and so unique to the
law. The mother who carries a child to full term is subject to anxieties, to physical
constraints, to pain that only she must bear. Ante, at 852.
The Court's reaffirmation of Roe's central holding is also based on the force of
stare decisis. [N]o erosion of principle going to liberty or personal autonomy has
left Roe's central holding a doctrinal remnant; Roe portends no developments at odds
with other precedent for the analysis of personal liberty; and no changes of fact
have rendered viability more or less appropriate as the point at which the balance
of interests tips. Ante, at 860-861. Indeed, the Court acknowledges that Roe's limitation
on state power could not be removed without serious inequity to those who have relied
upon it or significant damage to the stability of the society governed by the rule
in question. Ante, at 855. In the 19 years since Roe was decided, that case has shaped
more than reproductive planning - [a]n entire generation has come of age free to assume
Roe's concept of liberty in defining the capacity of women to act in society, and
to make reproductive decisions. Ante, at 860. The Court understands that, having "call[ed]
the contending sides . . . to end their national division by accepting a common mandate
rooted in the Constitution," ante, at 867, a decision to overrule Roe would seriously
weaken the Court's capacity to exercise the judicial power and to function as the
Supreme Court of a Nation dedicated to the rule of law. Ante, at 865. What has happened
today should serve as a model for future Justices and a warning to all who have tried
to turn this Court into yet another political branch.
In striking down the Pennsylvania statute's spousal notification requirement, the
Court has established a framework [505 U.S. 833, 925] for evaluating abortion regulations
that responds to the social context of women facing issues of reproductive choice.
1 In determining the burden imposed by the challenged regulation, the Court inquires
whether the regulation's "purpose or effect is to place a substantial obstacle in
the path of a woman seeking an abortion before the fetus attains viability." Ante,
at 878 (emphasis added). The Court reaffirms: The proper focus of constitutional inquiry
is the group for whom the law is a restriction, not the group for whom the law is
irrelevant. Ante, at 894. Looking at this group, the Court inquires, based on expert
testimony, empirical studies, and common sense, whether, in a large fraction of the
cases in which [the restriction] is relevant, it will operate as a substantial obstacle
to a woman's choice to undergo an abortion. Ante,, at 895. A statute with this purpose
is invalid because the means chosen by the State to further the interest in potential
life must be calculated to inform the woman's free choice, not hinder it. Ante, at
877. And in applying its test, the Court remains sensitive to the unique role of women
in the decisionmaking process. Whatever may have been the practice when the Fourteenth
Amendment was adopted, the Court observes, [w]omen do not lose their constitutionally
protected liberty when they marry. The Constitution protects all individuals, male
or female, married or unmarried, from the abuse of governmental power, even where
that power is employed for the supposed benefit of a member of the individual's family.
Ante, at 898. 2 [505 U.S. 833, 926]
Lastly, while I believe that the joint opinion errs in failing to invalidate the
other regulations, I am pleased that the joint opinion has not ruled out the possibility
that these regulations may be shown to impose an unconstitutional burden. The joint
opinion makes clear that its specific holdings are based on the insufficiency of the
record before it. See, e.g., ante,, at 885-886. I am confident that, in the future,
evidence will be produced to show that, in a large fraction of the cases in which
[these regulations are] relevant, [they] will operate as a substantial obstacle to
a woman's choice to undergo an abortion. Ante, at 895.
II
Today, no less than yesterday, the Constitution and decisions of this Court require
that a State's abortion restrictions be subjected to the strictest of judicial scrutiny.
Our precedents and the joint opinion's principles require us to subject all non-de-minimis
abortion regulations to strict scrutiny. Under this standard, the Pennsylvania statute's
provisions requiring content-based counseling, a 24-hour delay, informed parental
consent, and reporting of abortion-related information must be invalidated.
A
The Court today reaffirms the long recognized rights of privacy and bodily integrity.
As early as 1891, the Court held, [n]o right is held more sacred, or is more carefully
guarded by the common law, than the right of every individual to the possession and
control of his own person, free from all restraint or interference of others. . .
. Union Pacific R. Co. v. Botsford, 141 U.S. 250, 251 (1891). Throughout this century,
this Court also has held that the fundamental right of privacy protects citizens against
governmental intrusion [505 U.S. 833, 927] in such intimate family matters as procreation,
childrearing, marriage, and contraceptive choice. See ante, at 847-849. These cases
embody the principle that personal decisions that profoundly affect bodily integrity,
identity, and destiny should be largely beyond the reach of government. Eisenstadt,
405 U.S., at 453 . In Roe v. Wade, this Court correctly applied these principles to
a woman's right to choose abortion.
State restrictions on abortion violate a woman's right of privacy in two ways. First,
compelled continuation of a pregnancy infringes upon a woman's right to bodily integrity
by imposing substantial physical intrusions and significant risks of physical harm.
During pregnancy, women experience dramatic physical changes and a wide range of health
consequences. Labor and delivery pose additional health risks and physical demands.
In short, restrictive abortion laws force women to endure physical invasions far more
substantial than those this Court has held to violate the constitutional principle
of bodily integrity in other contexts. See, e.g., Winston v. Lee, 470 U.S. 753 (1985)
(invalidating surgical removal of bullet from murder suspect); Rochin v. California,
342 U.S. 165 (1952) (invalidating stomach-pumping). 3
Further, when the State restricts a woman's right to terminate her pregnancy, it
deprives a woman of the right to make her own decision about reproduction and family
planning - critical life choices that this Court long has deemed central to the right
to privacy. The decision to terminate or continue a pregnancy has no less an impact
on a woman's life than decisions about contraception or marriage. 410 U.S., [505 U.S.
833, 928] at 153. Because motherhood has a dramatic impact on a woman's educational
prospects, employment opportunities, and self-determination, restrictive abortion
laws deprive her of basic control over her life. For these reasons, "the decision
whether or not to beget or bear a child" lies at "the very heart of this cluster of
constitutionally protected choices." Carey v. Population Services International, 431
U.S. 678, 685 (1977).
A State's restrictions on a woman's right to terminate her pregnancy also implicate
constitutional guarantees of gender equality. State restrictions on abortion compel
women to continue pregnancies they otherwise might terminate. By restricting the right
to terminate pregnancies, the State conscripts women's bodies into its service, forcing
women to continue their pregnancies, suffer the pains of childbirth, and in most instances,
provide years of maternal care. The State does not compensate women for their services;
instead, it assumes that they owe this duty as a matter of course. This assumption
- that women can simply be forced to accept the "natural" status and incidents of
motherhood - appears to rest upon a conception of women's role that has triggered
the protection of the Equal Protection Clause. See, e.g., Mississippi Univ. for Women
v. Hogan, 458 U.S. 718, 724 -726 (1982); Craig v. Boren, 429 U.S. 190, 198 -199 (1976).
4 The joint opinion recognizes that these assumptions about women's place in society
"are no longer consistent with our [505 U.S. 833, 929] understanding of the family,
the individual, or the Constitution." Ante, at 897.
B
The Court has held that limitations on the right of privacy are permissible only
if they survive "strict" constitutional scrutiny - that is, only if the governmental
entity imposing the restriction can demonstrate that the limitation is both necessary
and narrowly tailored to serve a compelling governmental interest. Griswold v. Connecticut,
381 U.S. 479, 485 (1965). We have applied this principle specifically in the context
of abortion regulations. Roe v. Wade, 410 U.S., at 155 . 5
Roe implemented these principles through a framework that was designed to ensure
that the woman's right to choose not become so subordinate to the State's interest
in promoting fetal life that her choice exists in theory, but not in fact, ante, at
872. Roe identified two relevant state interests: "an interest in preserving and protecting
the health of the pregnant woman" and an interest in "protecting the potentiality
of human life." 410 U.S., at 162 . With respect to the State's interest in the health
of the mother, "the `compelling' point . . . is at approximately the end of the first
trimester," because it is at that point that the mortality rate in abortion approaches
that in childbirth. Id., at 163. With respect to the State's interest in potential
life, "the `compelling' point is at viability," because it is at that point that the
[505 U.S. 833, 930] fetus "presumably has the capability of meaningful life outside
the mother's womb." Ibid. In order to fulfill the requirement of narrow tailoring,
"the State is obligated to make a reasonable effort to limit the effect of its regulations
to the period in the trimester during which its health interest will be furthered.
Akron v. Akron Center for Reproductive Health, Inc., 462 U.S. 416, 434 (1983).
In my view, application of this analytical framework is no less warranted than when
it was approved by seven Members of this Court in Roe. Strict scrutiny of state limitations
on reproductive choice still offers the most secure protection of the woman's right
to make her own reproductive decisions, free from state coercion. No majority of this
Court has ever agreed upon an alternative approach. The factual premises of the trimester
framework have not been undermined, see Webster, 492 U.S., at 553 (BLACKMUN, J., dissenting),
and the Roe framework is far more administrable, and far less manipulable, than the
"undue burden" standard adopted by the joint opinion.
Nonetheless, three criticisms of the trimester framework continue to be uttered.
First, the trimester framework is attacked because its key elements do not appear
in the text of the Constitution. My response to this attack remains the same as it
was in Webster:
"Were this a true concern, we would have to abandon most of our constitutional jurisprudence.
[T]he "critical elements" of countless constitutional doctrines nowhere appear in
the Constitution's text. . . . The Constitution makes no mention, for example, of
the First Amendment's "actual malice" standard for proving certain libels, see New
York Times Co. v. Sullivan, 376 U.S. 254 (1964). . . . Similarly, the Constitution
makes no mention of the rational basis test, or the specific verbal formulations of
intermediate and strict scrutiny by which this Court evaluates claims under the Equal
Protection Clause. The reason is simple. Like the Roe framework, these [505 U.S. 833,
931] tests or standards are not, and do not purport to be, rights protected by the
Constitution. Rather, they are judge-made methods for evaluating and measuring the
strength and scope of constitutional rights or for balancing the constitutional rights
of individuals against the competing interests of government. Id., at 548.
The second criticism is that the framework more closely resembles a regulatory code
than a body of constitutional doctrine. Again, my answer remains the same as in Webster:
"[I]f this were a true and genuine concern, we would have to abandon vast areas of
our constitutional jurisprudence. . . . Are [the distinctions entailed in the trimester
framework] any finer, or more "regulatory," than the distinctions we have often drawn
in our First Amendment jurisprudence, where, for example, we have held that a "release
time" program permitting public school students to leave school grounds during school
hours to receive religious instruction does not violate the Establishment Clause,
even though a release time program permitting religious instruction on school grounds
does violate the Clause? Compare Zorach v. Clauson, 343 U.S. 306 (1952), with Illinois
ex rel. McCollum v. Board of Education of School Dist. No. 71, Champaign County, 333
U.S. 203 (1948). . . . Similarly, in a Sixth Amendment case, the Court held that,
although an overnight ban on attorney-client communication violated the constitutionally
guaranteed right to counsel, Geders v. United States, 425 U.S. 80 (1976), that right
was not violated when a trial judge separated a defendant from his lawyer during a
15-minute recess after the defendant's direct testimony. Perry v. Leeke, 488 U.S.
272 (1989).
"That numerous constitutional doctrines result in narrow differentiations between
similar circumstances does [505 U.S. 833, 932] not mean that this Court has abandoned
adjudication in favor of regulation. Id., at 549-550.
The final, and more genuine, criticism of the trimester framework is that it fails
to find the State's interest in potential human life compelling throughout pregnancy.
No Member of this Court - nor for that matter, the Solicitor General, Tr. of Oral
Arg. 42 - has ever questioned our holding in Roe that an abortion is not "the termination
of life entitled to Fourteenth Amendment protection." 410 U.S., at 159 . Accordingly,
a State's interest in protecting fetal life is not grounded in the Constitution. Nor,
consistent with our Establishment Clause, can it be a theological or sectarian interest.
See Thornburgh v. American College of Obtetricians and Gynecologists, 476 U.S. 778,
747 , (1986) (STEVENS, J., concurring). It is, instead, a legitimate interest grounded
in humanitarian or pragmatic concerns. See ante, at 914-915 (STEVENS, J., concurring
in part and dissenting in part).
But while a State has "legitimate interests from the outset of the pregnancy in protecting
the health of the woman and the life of the fetus that may become a child," ante,
at 846, legitimate interests are not enough. To overcome the burden of strict scrutiny,
the interests must be compelling. The question then is how best to accommodate the
State's interest in potential human life with the constitutional liberties of pregnant
women. Again, I stand by the views I expressed in Webster:
"I remain convinced, as six other Members of this Court 16 years ago were convinced,
that the Roe framework, and the viability standard in particular, fairly, sensibly,
and effectively functions to safeguard the constitutional liberties of pregnant women
while recognizing and accommodating the State's interest in potential human life.
The viability line reflects the biological facts and truths of fetal development;
it marks that threshold moment prior to which a fetus cannot survive separate from
the [505 U.S. 833, 933] woman and cannot reasonably and objectively be regarded as
a subject of rights or interests distinct from, or paramount to, those of the pregnant
woman. At the same time, the viability standard takes account of the undeniable fact
that, as the fetus evolves into its postnatal form, and as it loses its dependence
on the uterine environment, the State's interest in the fetus' potential human life,
and in fostering a regard for human life in general, becomes compelling. As a practical
matter, because viability follows "quickening" - the point at which a woman feels
movement in her womb - and because viability occurs no earlier than 23 weeks gestational
age, it establishes an easily applicable standard for regulating abortion, while providing
a pregnant woman ample time to exercise her fundamental right with her responsible
physician to terminate her pregnancy. 492 U.S., at 553 -554. 6
Roe's trimester framework does not ignore the State's interest in prenatal life.
Like JUSTICE STEVENS, ante, at 916, I agree that the State may take steps to ensure
that a woman's choice "is thoughtful and informed," ante, at 872, and that States
are free to enact laws to provide a reasonable framework for a woman to make a decision
that has such profound and lasting meaning. Ante, at 873. But
"[s]erious questions arise . . . when a State attempts to "persuade the woman to
choose childbirth over abortion." Ante, at 878. Decisional autonomy must limit the
State's power to inject into a woman's most personal deliberations its own views of
what is best. The State may promote its preferences by funding childbirth, by creating
and maintaining alternatives to abortion, and by espousing the virtues of family;
but it must respect [505 U.S. 833, 934] the individual's freedom to make such judgments.
Ante, at 916 (STEVENS, J., concurring in part and dissenting in part) (internal quotation
marks omitted).
As the joint opinion recognizes, the means chosen by the State to further the interest
in potential life must be calculated to inform the woman's free choice, not hinder
it. Ante, at 877.
In sum, Roe's requirement of strict scrutiny as implemented through a trimester framework
should not be disturbed. No other approach has gained a majority, and no other is
more protective of the woman's fundamental right. Lastly, no other approach properly
accommodates the woman's constitutional right with the State's legitimate interests.
C
Application of the strict scrutiny standard results in the invalidation of all the
challenged provisions. Indeed, as this Court has invalidated virtually identical provisions
in prior cases, stare decisis requires that we again strike them down.
This Court has upheld informed and written consent requirements only where the State
has demonstrated that they genuinely further important health-related state concerns.
See Planned Parenthood of Central Mo. v. Danforth, 428 U.S. 65 -67, 52, (1976). A
State may not, under the guise of securing informed consent, "require the delivery
of information `designed to influence the woman's informed choice between abortion
or childbirth.'" Thornburgh, 476 U.S., at 760 quoting Akron, 462 U.S., at 443 -444.
Rigid requirements that a specific body of information be imparted to a woman in all
cases, regardless of the needs of the patient, improperly intrude upon the discretion
of the pregnant woman's physician. and thereby impose an "`undesired and uncomfortable
straitjacket.'" Thornburgh, 476 U.S., at 762 , quoting Danforth, 428 U.S., at 67 ,
n. 8.
Measured against these principles, some aspects of the Pennsylvania informed consent
scheme are unconstitutional. [505 U.S. 833, 935] While it is unobjectionable for the
Commonwealth to require that the patient be informed of the nature of the procedure,
the health risks of the abortion and of childbirth, and the probable gestational age
of the unborn child, compare Pa. Cons. Stat. 3205(a)(1)(i)-(iii) (1990) with Akron,
462 U.S., at 446 , n. 37, I remain unconvinced that there is a vital state need for
insisting that the information be provided by a physician, rather than a counselor.
Id., at 448. The District Court found that the physician-only requirement necessarily
would increase costs to the plaintiff clinics, costs that undoubtedly would be passed
on to patients. And because trained women counselors are often more understanding
than physicians, and generally have more time to spend with patients, see App. 366-387,
the physician-only disclosure requirement is not narrowly tailored to serve the Commonwealth's
interest in protecting maternal health.
Sections 3205(a)(2)(i) (iii) of the Act further requires that the physician or a
qualified nonphysician inform the woman that printed materials are available from
the Commonwealth that describe the fetus and provide information about medical assistance
for childbirth, information about child support from the father, and a list of agencies
offering adoption and other services as alternatives to abortion. Thornburgh invalidated
biased patient counseling requirements virtually identical to the one at issue here.
What we said of those requirements fully applies in this case:
"[T]he listing of agencies in the printed Pennsylvania 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. All this is, or [505 U.S. 833, 936] 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 . . . 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 . . ., 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. . . . 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., at 762 .
"This type of compelled information is the antithesis of informed consent," id.,
at 764, and goes far beyond merely describing the general subject matter relevant
to the woman's decision. 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 antiabortion character of the statute and its real purpose." Ibid. 7 [505
U.S. 833, 937]
The 24-hour waiting period following the provision of the foregoing information is
also clearly unconstitutional. The District Court found that the mandatory 24-hour
delay could lead to delays in excess of 24 hours, thus increasing health risks, and
that it would require two visits to the abortion provider, thereby increasing travel
time, exposure to further harassment, and financial cost. Finally, the District Court
found that the requirement would pose especially significant burdens on women living
in rural areas and those women that have difficulty explaining their whereabouts.
744 F. Supp. 1323, 1378-1379 (ED pa. 1990). In Akron, this Court invalidated a similarly
arbitrary or inflexible waiting period because, as here, it furthered no legitimate
state interest. 8
As JUSTICE STEVENS insightfully concludes, the mandatory delay rests either on outmoded
or unacceptable assumptions about the decisionmaking capacity of women or the belief
that the decision to terminate the pregnancy is [505 U.S. 833, 938] presumptively
wrong. Ante, at 918-919. The requirement that women consider this obvious and slanted
information for an additional 24 hours contained in these provisions will only influence
the woman's decision in improper ways. The vast majority of women will know this information
- of the few that do not, it is less likely that their minds will be changed by this
information than it will be either by the realization that the State opposes their
choice or the need once again to endure abuse and harassment on return to the clinic.
9
Except in the case of a medical emergency, 3206 requires a physician to obtain the
informed consent of a parent or guardian before performing an abortion on an unemancipated
minor or an incompetent woman. Based on evidence in the record, the District Court
concluded that, in order to fulfill the informed consent requirement, generally accepted
medical principles would require an in-person visit by the parent to the facility.
744 F. Supp., at 1382.Although the Court "has recognized that the State has somewhat
broader authority to regulate the activities of children than of adults," the State
nevertheless must demonstrate that there is a "significant State interest in conditioning
an abortion . . . that is not present in the case of an adult." Danforth, 428 U.S.,
at 74 -75 (emphasis added). The requirement of an in-person visit would carry with
it the risk of a delay of several days or possibly weeks, even where the parent is
willing to consent. While the State has an interest in encouraging parental involvement
in the minor's abortion decision, 3206 is not narrowly drawn to serve that interest.
10 [505 U.S. 833, 939]
Finally, the Pennsylvania statute requires every facility performing abortions to
report its activities to the Commonwealth. Pennsylvania contends that this requirement
is valid under Danforth, in which this Court held that recordkeeping and reporting
requirements that are reasonably directed to the preservation of maternal health,
and that properly respect a patient's confidentiality, are permissible. Id., at 79-81.
The Commonwealth attempts to justify its required reports on the ground that the public
has a right to know how its tax dollars are spent. A regulation designed to inform
the public about public expenditures does not further the Commonwealth's interest
in protecting maternal health. Accordingly, such a regulation cannot justify a legally
significant burden on a woman's right to obtain an abortion.
The confidential reports concerning the identities and medical judgment of physicians
involved in abortions at first glance may seem valid, given the Commonwealth's interest
in maternal health and enforcement of the Act. The District Court found, however,
that, notwithstanding the confidentiality protections, many physicians, particularly
those who have previously discontinued performing abortions because of harassment,
would refuse to refer patients to abortion clinics if their names were to appear on
these reports. 744 F. Supp., at 1392. The Commonwealth has failed to show that the
name of the referring physician either adds to the pool of scientific knowledge concerning
abortion or is reasonably related to the Commonwealth's interest in maternal health.
I therefore agree with the District Court's conclusion that the confidential reporting
requirements are unconstitutional [505 U.S. 833, 940] insofar as they require the
name of the referring physician and the basis for his or her medical judgment.
In sum, I would affirm the judgment in No. 91-902 and reverse the judgment in No.
91-744 and remand the cases for further proceedings.
III
At long last, THE CHIEF JUSTICE and those who have joined him admit it. Gone are
the contentions that the issue need not be (or has not been) considered. There, on
the first page, for all to see, is what was expected: We believe that Roe was wrongly
decided, and that it can and should be overruled consistently with our traditional
approach to stare decisis in constitutional cases. Post, at 944. If there is much
reason to applaud the advances made by the joint opinion today, there is far more
to fear from THE CHIEF JUSTICE's opinion.
THE CHIEF JUSTICE's criticism of Roe follows from his stunted conception of individual
liberty. While recognizing that the Due Process Clause protects more than simple physical
liberty, he then goes on to construe this Court's personal liberty cases as establishing
only a laundry list of particular rights, rather than a principled account of how
these particular rights are grounded in a more general right of privacy. Post, at
951. This constricted view is reinforced by THE CHIEF JUSTICE's exclusive reliance
on tradition as a source of fundamental rights. He argues that the record in favor
of a right to abortion is no stronger than the record in Michael H. v. Gerald D.,
491 U.S. 110 (1989), where the plurality found no fundamental right to visitation
privileges by an adulterous father, or in Bowers v. Hardwick, 478 U.S. 186 (1986),
where the Court found no fundamental right to engage in homosexual sodomy, or in a
case involving the "`firing [of] a gun . . . into another person's body.'" Post, at
951-952. In THE CHIEF JUSTICE's world, a woman considering whether to terminate a
pregnancy is entitled to no more protection than adulterers, murderers, and so-called
sexual [505 U.S. 833, 941] deviates. 11 Given THE CHIEF JUSTICE's exclusive reliance
on tradition, people using contraceptives seem the next likely candidate for his list
of outcasts.
Even more shocking than THE CHIEF JUSTICE's cramped notion of individual liberty
is his complete omission of any discussion of the effects that compelled childbirth
and motherhood have on women's lives. The only expression of concern with women's
health is purely instrumental - for THE CHIEF JUSTICE, only women's psychological
health is a concern, and only to the extent that he assumes that every woman who decides
to have an abortion does so without serious consideration of the moral implications
of their decision. Post, at 967-968. In short, THE CHIEF JUSTICE's view of the State's
compelling interest in maternal health has less to do with health than it does with
compelling women to be maternal.
Nor does THE CHIEF JUSTICE give any serious consideration to the doctrine of stare
decisis. For THE CHIEF JUSTICE, the facts that gave rise to Roe are surprisingly simple:
women become pregnant, there is a point somewhere, depending on medical technology,
where a fetus becomes viable, and women give birth to children. Post, at 955. This
characterization of the issue thus allows THE CHIEF JUSTICE quickly to discard the
joint opinion's reliance argument by asserting that "reproductive planning could take
virtually immediate account of" a decision overruling Roe. Post, at 956. (internal
quotation marks omitted).
THE CHIEF JUSTICE's narrow conception of individual liberty and stare decisis leads
him to propose the same standard of review proposed by the plurality in Webster. States
may regulate abortion procedures in ways rationally related to a legitimate state
interest. Williamson v. Lee Optical of Oklahoma, Inc., 348 U.S. 483, 491 (1955); cf.
Stanley v. Illinois, 405 U.S. 645, 651 -653 (1972). Post, at 966. THE [505 U.S. 833,
942] CHIEF JUSTICE then further weakens the test by providing an insurmountable requirement
for facial challenges: Petitioners must "`show that no set of circumstances exists
under which the [provision] would be valid.'" Post, at 973, quoting Ohio v. Akron
Center for Reproductive Health, 497 U.S., at 514 . In short, in his view, petitioners
must prove that the statute cannot constitutionally be applied to anyone. Finally,
in applying his standard to the spousal-notification provision, THE CHIEF JUSTICE
contends that the record lacks any "hard evidence" to support the joint opinion's
contention that a "large fraction" of women who prefer not to notify their husbands
involve situations of battered women and unreported spousal assault. Post, at 974,
n. 2. Yet throughout the explication of his standard, THE CHIEF JUSTICE never explains
what hard evidence is, how large a fraction is required, or how a battered women is
supposed to pursue an as-applied challenge.
Under his standard, States can ban abortion if that ban is rationally related to
a legitimate state interest - a standard which the United States calls "deferential,
but not toothless." Yet when pressed at oral argument to describe the teeth, the best
protection that the Solicitor General could offer to women was that a prohibition,
enforced by criminal penalties, with no exception for the life of the mother, "could
raise very serious questions." Tr. of Oral Arg. 48. Perhaps, the Solicitor General
offered, the failure to include an exemption for the life of the mother would be "arbitrary
and capricious." Id., at 49. If, as THE CHIEF JUSTICE contends, the undue burden test
is made out of whole cloth, the so-called "arbitrary and capricious" limit is the
Solicitor General's "new clothes."
Even if it is somehow "irrational" for a State to require a woman to risk her life
for her child, what protection is offered for women who become pregnant through rape
or incest? Is there anything arbitrary or capricious about a [505 U.S. 833, 943] State's
prohibiting the sins of the father from being visited upon his offspring? 12
But, we are reassured, there is always the protection of the democratic process.
While there is much to be praised about our democracy, our country, since its founding,
has recognized that there are certain fundamental liberties that are not to be left
to the whims of an election. A woman's right to reproductive choice is one of those
fundamental liberties. Accordingly, that liberty need not seek refuge at the ballot
box.
IV
In one sense, the Court's approach is worlds apart from that of THE CHIEF JUSTICE
and JUSTICE SCALIA. And yet, in another sense, the distance between the two approaches
is short - the distance is but a single vote.
I am 83 years old. I cannot remain on this Court forever, and when I do step down,
the confirmation process for my successor well may focus on the issue before us today.
That, I regret, may be exactly where the choice between the two worlds will be made.
[ Footnote 1 ] As I shall explain, the joint opinion and I disagree on the appropriate
standard of review for abortion regulations. I do agree, however that the reasons
advanced by the joint opinion suffice to invalidate the spousal notification requirement
under a strict scrutiny standard.
[ Footnote 2 ] I also join the Court's decision to uphold the medical emergency provision.
As the Court notes, its interpretation is consistent with the essential holding of
Roe that forbids a State from interfering with a woman's choice to undergo an abortion
procedure if continuing her pregnancy [505 U.S. 833, 926] would constitute a threat
to her health. Ante, at 880. As is apparent in my analysis below, however, this exception
does not render constitutional the provisions which I conclude do not survive strict
scrutiny.
[ Footnote 3 ] As the joint opinion acknowledges, ante, at 857, this Court has recognized
the vital liberty interest of persons in refusing unwanted medical treatment. Cruzan
v. Director, Mo. Dept. of Health, 497 U.S. 261 (1990). Just as the Due Process Clause
protects the deeply personal decision of the individual to refuse medical treatment,
it also must protect the deeply personal decision to obtain medical treatment, including
a woman's decision to terminate a pregnancy.
[ Footnote 4 ] A growing number of commentators are recognizing this point. See,
e.g., L. Tribe, American Constitutional Law 15-10, pp. 1353-1359 (2d ed. 1988); Siegel,
Reasoning from the Body: A Historical Perspective on Abortion Regulation and Questions
of Equal Protection, 44 Stan.L.Rev. 261, 350-380 (1992); Sunstein, Neutrality in Constitutional
Law (With Special Reference to Pornography, Abortion, and Surrogacy), 92 Colum.L.Rev.
1, 31-44 (1992); MacKinnon, Reflections on Sex Equality Under Law, 100 Yale L.J. 1281,
1308-1324 (1991); cf. Rubenfeld, The Right of Privacy, 102 Harv.L.Rev. 737, 788-791
(1989) (similar analysis under the rubric of privacy); MacKinnon, Reflections on Sex
Equality Under Law, 100 Yale L. J. 1281, 1308-1324 (1991).
[ Footnote 5 ] To say that restrictions on a right are subject to strict scrutiny
is not to say that the right is absolute. Regulations can be upheld if they have no
significant impact on the woman's exercise of her right and are justified by important
state health objectives. See, e.g., Planned Parenthood of Central Mo. v. Danforth,
428 U.S. 52, 65 -67, 79-81 (1976) (upholding requirements of a woman's written consent
and record-keeping). But the Court today reaffirms the essential principle of Roe
that a woman has the right "to choose to have an abortion before viability and to
obtain it without undue interference from the State." Ante, at 846. Under Roe, any
more than de minimis interference is undue.
[ Footnote 6 ] The joint opinion agrees with Roe's conclusion that viability occurs
at 23 or 24 weeks at the earliest. Compare ante, at 860 with Roe v. Wade, 410 U.S.
113, 160 (1973).
[ Footnote 7 ] While I do not agree with the joint opinion's conclusion that these
provisions should be upheld, the joint opinion has remained faithful to principles
this Court previously has announced in examining counseling provisions. For example,
the joint opinion concludes that the "information the State requires to be made available
to the woman" must be "truthful and not misleading." Ante, at 882. Because the State's
information must be "calculated to inform the woman's free choice, not hinder [505
U.S. 833, 937] it," ante, at 877, the measures must be designed to ensure that a woman's
choice is "mature and informed," ante,, at 883, not intimidated, imposed, or impelled.
To this end, when the State requires the provision of certain information, the State
may not alter the manner of presentation in order to inflict "psychological abuse,"
ante,, at 893, designed to shock or unnerve a woman seeking to exercise her liberty
right. This, for example, would appear to preclude a State from requiring a woman
to view graphic literature or films detailing the performance of an abortion operation.
Just as a visual preview of an operation to remove an appendix plays no part in a
physician's securing informed consent to an appendectomy, a preview of scenes appurtenant
to any major medical intrusion into the human body does not constructively inform
the decision of a woman of the State's interest in the preservation of the woman's
health or demonstrate the State's "profound respect for the life of the unborn." Ante,,
at 877.
[ Footnote 8 ] The Court's decision in Hodgson v. Minnesota, 497 U.S. 417 (1990),
validating a 48-hour waiting period for minors seeking an abortion to permit parental
involvement does not alter this conclusion. Here the 24-hour delay is imposed on an
adult woman. See id., at 449-450, n. 35; Ohio v. Akron Center for Reproductive Health,
Inc., 497 U.S. 502 , (1990). Moreover, the statute in Hodgson did not require any
delay once the minor obtained the affirmative consent of either a parent or the court.
[ Footnote 9 ] Because this information is so widely known, I am confident that a
developed record can be made to show that the 24-hour delay, in a large fraction of
the cases in which [the restriction] is relevant, . . . will operate as a substantial
obstacle to a woman's choice to undergo an abortion. Ante, at 895.
[ Footnote 10 ] The judicial-bypass provision does not cure this violation. Hodgson
is distinguishable, since this case involves more than parental involvement or approval
- rather, the Pennsylvania law requires that the parent receive information designed
to discourage abortion in a face-to-face meeting with [505 U.S. 833, 939] the physician.
The bypass procedure cannot ensure that the parent would obtain the information, since,
in many instances, the parent would not even attend the hearing. A State may not place
any restriction on a young woman's right to an abortion, however irrational, simply
because it has provided a judicial bypass.
[ Footnote 11 ] Obviously, I do not share The CHIEF JUSTICE's views of homosexuality
as sexual deviance. See Bowers, 478 U.S., at 202 -203, n. 2
[ Footnote 12 ] JUSTICE SCALIA urges the Court to "get out of this area," post, at
1002, and leave questions regarding abortion entirely to the States, post, at 999-1002.
Putting aside the fact that what he advocates is nothing short of an abdication by
the Court of its constitutional responsibilities, JUSTICE SCALIA is uncharacteristically
naive if he thinks that overruling Roe and holding that restrictions on a woman's
right to an abortion are subject only to rational basis review will enable the Court
henceforth to avoid reviewing abortion-related issues. State efforts to regulate and
prohibit abortion in a post-Roe world undoubtedly would raise a host of distinct and
important constitutional questions meriting review by this Court. For example, does
the Eighth Amendment impose any limits on the degree or kind of punishment a State
can inflict upon physicians who perform, or women who undergo, abortions? What effect
would differences among States in their approaches to abortion have on a woman's right
to engage in interstate travel? Does the First Amendment permit States that choose
not to criminalize abortion to ban all advertising providing information about where
and how to obtain abortions?
CHIEF JUSTICE REHNQUIST, with whom JUSTICE WHITE, JUSTICE SCALIA, and JUSTICE THOMAS
join, concurring in the judgment in part and dissenting in part.
The joint opinion, following its newly minted variation on stare decisis, retains
the outer shell of Roe v. Wade, 410 U.S. 113 (1973), but beats a wholesale retreat
from the substance of that case. We believe that Roe was wrongly decided, and that
it can and should be overruled consistently with our traditional approach to stare
decisis in constitutional cases. We would adopt the approach of the plurality in Webster
v. Reproductive Health Services, 492 U.S. 490 (1989), and uphold the challenged provisions
of the Pennsylvania statute in their entirety.
I
In ruling on this litigation below, the Court of Appeals for the Third Circuit first
observed that "this appeal does not directly implicate Roe; this case involves the
regulation of abortions, rather than their outright prohibition." 947 F.2d 682, 687
(1991). Accordingly, the court directed its attention to the question of the standard
of review for abortion regulations. In attempting to settle on the correct standard,
however, the court confronted the confused state of this Court's abortion jurisprudence.
After considering the several opinions in Webster v. Reproductive Health Services,
supra, and Hodgson v. Minnesota, 497 U.S. 417 (1990), the Court of Appeals concluded
that JUSTICE O'CONNOR's "undue burden" test was controlling, as that was the narrowest
ground on which we had upheld recent abortion regulations. 947 F.2d, at 693-697 ("`When
a fragmented court decides a case and no single rationale explaining the result enjoys
the assent of five Justices, the holding of the Court may be viewed as that position
taken by those Members who concurred in the judgments on the narrowest grounds'" (quoting
Marks v. United States, 430 U.S. 188, 193 (1977) (internal quotation marks omitted)).
Applying this standard, the Court of Appeals upheld all of the challenged regulations
except the one [505 U.S. 833, 945] requiring a woman to notify her spouse of an intended
abortion.
In arguing that this Court should invalidate each of the provisions at issue, petitioners
insist that we reaffirm our decision in Roe v. Wade, supra, in which we held unconstitutional
a Texas statute making it a crime to procure an abortion except to save the life of
the mother. 1 We agree with the Court of Appeals that our decision in Roe is not directly
implicated by the Pennsylvania statute, which does not prohibit, but simply regulates,
abortion. But, as the Court of Appeals found, the state of our post-Roe decisional
law dealing with the regulation of abortion is confusing and uncertain, indicating
that a reexamination of that line of cases is in order. Unfortunately for those who
must apply this Court's decisions, the reexamination undertaken today leaves the Court
no less divided than beforehand. Although they reject the trimester framework that
formed the underpinning of Roe, Justices O'CONNOR, KENNEDY, and SOUTER adopt a revised
undue burden standard to analyze the challenged regulations. We conclude, however,
that such an outcome is an unjustified constitutional compromise, one which leaves
the Court in a position to closely scrutinize all types of abortion regulations despite
the fact that it lacks the power to do so under the Constitution.
In Roe, the Court opined that the State does have an important and legitimate interest
in preserving and protecting the health of the pregnant woman, . . . and that it has
still another important and legitimate interest in protecting [505 U.S. 833, 946]
the potentiality of human life. 410 U.S., at 162 (emphasis omitted). In the companion
case of Doe v. Bolton, 410 U.S. 179 (1973), the Court referred to its conclusion in
Roe "that a pregnant woman does not have an absolute constitutional right to an abortion
on her demand." 410 U.S., at 189 . But while the language and holdings of these cases
appeared to leave States free to regulate abortion procedures in a variety of ways,
later decisions based on them have found considerably less latitude for such regulations
than might have been expected.
For example, after Roe, many States have sought to protect their young citizens by
requiring that a minor seeking an abortion involve her parents in the decision. Some
States have simply required notification of the parents, while others have required
a minor to obtain the consent of her parents. In a number of decisions, however, the
Court has substantially limited the States in their ability to impose such requirements.
With regard to parental notice requirements, we initially held that a State could
require a minor to notify her parents before proceeding with an abortion. H. L. v.
Matheson, 450 U.S. 398, 407 -410 (1981). Recently, however, we indicated that a State's
ability to impose a notice requirement actually depends on whether it requires notice
of one or both parents. We concluded that, although the Constitution might allow a
State to demand that notice be given to one parent prior to an abortion, it may not
require that similar notice be given to two parents, unless the State incorporates
a judicial bypass procedure in that two-parent requirement. Hodgson v. Minnesota,
supra.
We have treated parental consent provisions even more harshly. Three years after
Roe, we invalidated a Missouri regulation requiring that an unmarried woman under
the age of 18 obtain the consent of one of her parents before proceeding with an abortion.
We held that our abortion jurisprudence prohibited the State from imposing such a
"blanket provision . . . requiring the consent of a parent." Planned Parenthood [505
U.S. 833, 947] of Central Mo. v. Danforth, 428 U.S. 52, 74 (1976). In Bellotti v.
Baird, 443 U.S. 622 (1979), the Court struck down a similar Massachusetts parental
consent statute. A majority of the Court indicated, however, that a State could constitutionally
require parental consent if it alternatively allowed a pregnant minor to obtain an
abortion without parental consent by showing either that she was mature enough to
make her own decision or that the abortion would be in her best interests. See id.,
at 643-644 (plurality opinion); id., at 656-657 (WHITE, J., dissenting). In light
of Bellotti, we have upheld one parental consent regulation which incorporated a judicial
bypass option we viewed as sufficient, see Planned Parenthood Assn. of Kansas City,
Mo., Inc. v. Ashcroft, 462 U.S. 476 (1983), but have invalidated another because of
our belief that the judicial procedure did not satisfy the dictates of Bellotti, see
Akron v. Akron Center for Reproductive Health, Inc., 462 U.S. 416, 439 -442 (1983).
We have never had occasion, as we have in the parental notice context, to further
parse our parental consent Jurisprudence into one-parent and two-parent components.
In Roe, the Court observed that certain States recognized the right of the father
to participate in the abortion decision in certain circumstances. Because neither
Roe nor Doe involved the assertion of any paternal right, the Court expressly stated
that the case did not disturb the validity of regulations that protected such a right.
Roe v. Wade, supra, at 165, n. 67. But three years later, in Danforth, the Court extended
its abortion jurisprudence and held that a State could not require that a woman obtain
the consent of her spouse before proceeding with an abortion. Planned Parenthood of
Central Mo. v. Danforth, 428 U.S., at 69 -71.
States have also regularly tried to ensure that a woman's decision to have an abortion
is an informed and well-considered one. In Danforth, we upheld a requirement that
a woman sign a consent form prior to her abortion, and observed that "it is desirable
and imperative that [the decision] [505 U.S. 833, 948] be made with full knowledge
of its nature and consequences." Id., at 67. Since that case, however, we have twice
invalidated state statutes designed to impart such knowledge to a woman seeking an
abortion. In Akron, we held unconstitutional a regulation requiring a physician to
inform a woman seeking an abortion of the status of her pregnancy, the development
of her fetus, the date of possible viability, the complications that could result
from an abortion, and the availability of agencies providing assistance and information
with respect to adoption and childbirth. Akron v. Akron Center for Reproductive Health,
supra, 462 U.S., at 442 -445. More recently, in Thornburgh v. American College of
Obstetricians and Gynecologists, 476 U.S. 747 (1986), we struck down a more limited
Pennsylvania regulation requiring that a woman be informed of the risks associated
with the abortion procedure and the assistance available to her if she decided to
proceed with her pregnancy, because we saw the compelled information as "the antithesis
of informed consent." Id., at 764. Even when a State has sought only to provide information
that, in our view, was consistent with the Roe framework, we concluded that the State
could not require that a physician furnish the information, but instead had to alternatively
allow nonphysician counselors to provide it. Akron v. Akron Center for Reproductive
Health, 462 U.S., at 448 -449. In Akron as well, we went further and held that a State
may not require a physician to wait 24 hours to perform an abortion after receiving
the consent of a woman. Although the State sought to ensure that the woman's decision
was carefully considered, the Court concluded that the Constitution forbade the State
from imposing any sort of delay. Id., at 449-451.
We have not allowed States much leeway to regulate even the actual abortion procedure.
Although a State can require that second-trimester abortions be performed in outpatient
clinics, see Simopoulos v. Virginia, 462 U.S. 506 (1983), we concluded in Akron and
Ashcroft that a State could not [505 U.S. 833, 949] require that such abortions be
performed only in hospitals. See Akron v. Akron Center for Reproductive Health, supra,
462 U.S., at 437 -439; Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft,
supra, 462 U.S., at 481 -482. Despite the fact that Roe expressly allowed regulation
after the first trimester in furtherance of maternal health, "`present medical knowledge,'"
in our view, could not justify such a hospitalization requirement under the trimester
framework. Akron v. Akron Center for Reproductive Health, supra, at 437 (quoting Roe
v. Wade, supra, at 163). And in Danforth, the Court held that Missouri could not outlaw
the saline amniocentesis method of abortion, concluding that the Missouri Legislature
had "failed to appreciate and to consider several significant facts" in making its
decision. 428 U.S., at 77 .
Although Roe allowed state regulation after the point of viability to protect the
potential life of the fetus, the Court subsequently rejected attempts to regulate
in this manner. In Colautti v. Franklin, 439 U.S. 379 (1979), the Court struck down
a statute that governed the determination of viability. Id., at 390-397. In the process,
we made clear that the trimester framework incorporated only one definition of viability
- ours - as we forbade States from deciding that a certain objective indicator - "be
it weeks of gestation or fetal weight or any other single factor" - should govern
the definition of viability. Id., at 389. In that same case, we also invalidated a
regulation requiring a physician to use the abortion technique offering the best chance
for fetal survival when performing postviability abortions. See id., at 397-401; see
also Thornburgh v. American College of Obstetricians and Gynecologists, supra, at
768-769 (invalidating a similar regulation). In Thornburgh, the Court struck down
Pennsylvania's requirement that a second physician be present at postviability abortions
to help preserve the health of the unborn child, on the ground that it did not incorporate
a sufficient medical emergency exception. Id., at 769-771. Regulations governing the
treatment of aborted fetuses have [505 U.S. 833, 950] met a similar fate. In Akron,
we invalidated a provision requiring physicians performing abortions to "insure that
the remains of the unborn child are disposed of in a humane and sanitary manner."
462 U.S., at 451 (internal quotation marks omitted).
Dissents in these cases expressed the view that the Court was expanding upon Roe
in imposing ever greater restrictions on the States. See Thornburgh v. American College
of Obstetricians and Gynecologists, 476 U.S., at 783 (Burger, C.J., dissenting) ("The
extent to which the Court has departed from the limitations expressed in Roe is readily
apparent"); id., at 814 (WHITE, J., dissenting) ("[T]he majority indiscriminately
strikes down statutory provisions that in no way contravene the right recognized in
Roe"). And, when confronted with State regulations of this type in past years, the
Court has become increasingly more divided: The three most recent abortion cases have
not commanded a Court opinion. See Ohio v. Akron Center for Reproductive Health, 497
U.S. 502 (1990); Hodgson v. Minnesota, 497 U.S. 417 (1990); Webster v. Reproductive
Health Services, 492 U.S. 490 (1989).
The task of the Court of Appeals in the present case was obviously complicated by
this confusion and uncertainty. Following Marks v. United States, 430 U.S. 188 (1977),
it concluded that, in light of Webster and Hodgson, the strict scrutiny standard enunciated
in Roe was no longer applicable, and that the "undue burden" standard adopted by JUSTICE
O'CONNOR was the governing principle. This state of confusion and disagreement warrants
reexamination of the "fundamental right" accorded to a woman's decision to abort a
fetus in Roe, with its concomitant requirement that any state regulation of abortion
survive "strict scrutiny." See Payne v. Tennessee, 501 U.S. 808, 827 -828 (1991) (observing
that reexamination of constitutional decisions is appropriate when those decisions
have generated uncertainty and failed to provide clear guidance, because "correction
through legislative [505 U.S. 833, 951] action is practically impossible" (internal
quotation marks omitted)); Garcia v. San Antonio Metropolitan Transit Authority, 469
U.S. 528, 546 -547, 557 (1985).
We have held that a liberty interest protected under the Due Process Clause of the
Fourteenth Amendment will be deemed fundamental if it is "implicit in the concept
of ordered liberty." Palko v. Connecticut, 302 U.S. 319, 325 (1937). Three years earlier,
in Snyder v. Massachusetts, 291 U.S. 97 (1934), we referred to a "principle of justice
so rooted in the traditions and conscience of our people as to be ranked as fundamental."
Id., at 105; see also Michael H. v. Gerald D., 491 U.S. 110, 122 (1989) (plurality
opinion) (citing the language from Snyder). These expressions are admittedly not precise,
but our decisions implementing this notion of "fundamental" rights do not afford any
more elaborate basis on which to base such a classification.
In construing the phrase "liberty" incorporated in the Due Process Clause of the
Fourteenth Amendment, we have recognized that its meaning extends beyond freedom from
physical restraint. In Pierce v. Society of Sisters, 268 U.S. 510 (1925), we held
that it included a parent's right to send a child to private school; in Meyer v. Nebraska,
262 U.S. 390 (1923), we held that it included a right to teach a foreign language
in a parochial school. Building on these cases, we have held that the term "liberty"
includes a right to marry, Loving v. Virginia, 388 U.S. 1 (1967); a right to procreate,
Skinner v. Oklahoma ex rel. Williamson, 316 U.S. 535 (1942); and a right to use contraceptives,
Griswold v. Connecticut, 381 U.S. 479 (1965); Eisenstadt v. Baird, 405 U.S. 438 (1972).
But a reading of these opinions makes clear that they do not endorse any all-encompassing
"right of privacy."
In Roe v. Wade, the Court recognized a "guarantee of personal privacy" which "is
broad enough to encompass a woman's decision whether or not to terminate her pregnancy."
410 U.S., at 152 -153. We are now of the view that, in terming this right fundamental,
the Court in Roe read the earlier [505 U.S. 833, 952] opinions upon which it based
its decision much too broadly. Unlike marriage, procreation, and contraception, abortion
"involves the purposeful termination of a potential life." Harris v. McRae, 448 U.S.
297, 325 (1980). The abortion decision must therefore 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. Thornburgh v. American College of Obstetricians
and Gynecologists, supra, 476 U.S., at 792 (WHITE, J., dissenting). One cannot ignore
the fact that a woman is not isolated in her pregnancy, and that the decision to abort
necessarily involves the destruction of a fetus. See Michael H. v. Gerald D., supra,
491 U.S., at 124 , n. 4 (To look "at the act which is assertedly the subject of a
liberty interest in isolation from its effect upon other people [is] like inquiring
whether there is a liberty interest in firing a gun where the case at hand happens
to involve its discharge into another person's body").
Nor do the historical traditions of the American people support the view that the
right to terminate one's pregnancy is "fundamental." The common law which we inherited
from England made abortion after "quickening" an offense. At the time of the adoption
of the Fourteenth Amendment, statutory prohibitions or restrictions on abortion were
commonplace; in 1868, at least 28 of the then-37 States and 8 Territories had statutes
banning or limiting abortion. J. Mohr, Abortion in America 200 (1978). By the turn
of the century, virtually every State had a law prohibiting or restricting abortion
on its books. By the middle of the present century, a liberalization trend had set
in. But 21 of the restrictive abortion laws in effect in 1868 were still in effect
in 1973 when Roe was decided, and an overwhelming majority of the States prohibited
abortion unless necessary to preserve the life or health of the mother. Roe v. Wade,
410 U.S., at 139 -140; id. at 176-177, n. 2 (REHNQUIST, J., dissenting). On this record,
it can scarcely be said that any deeply rooted tradition of relatively unrestricted
abortion in our history [505 U.S. 833, 953] supported the classification of the right
to abortion as "fundamental" under the Due Process Clause of the Fourteenth Amendment.
We think, therefore, both in view of this history and of our decided cases dealing
with substantive liberty under the Due Process Clause, that the Court was mistaken
in Roe when it classified a woman's decision to terminate her pregnancy as a "fundamental
right" that could be abridged only in a manner which withstood "strict scrutiny."
In so concluding, we repeat the observation made in Bowers v. Hardwick, 478 U.S. 186
(1986):
"Nor are we inclined to take a more expansive view of our authority to discover new
fundamental rights imbedded in the Due Process Clause. The Court is most vulnerable
and comes nearest to illegitimacy when it deals with judge-made constitutional law
having little or no cognizable roots in the language or design of the Constitution."
Id., at 194.
We believe that the sort of constitutionally imposed abortion code of the type illustrated
by our decisions following Roe is inconsistent "with the notion of a Constitution
cast in general terms, as ours is, and usually speaking in general principles, as
ours does." Webster v. Reproductive Health Services, 492 U.S., at 518 (plurality opinion).
The Court in Roe reached too far when it analogized the right to abort a fetus to
the rights involved in Pierce, Meyer, Loving, and Griswold, and thereby deemed the
right to abortion fundamental.
II
The joint opinion of Justices O'CONNOR, KENNEDY, and SOUTER cannot bring itself to
say that Roe was correct as an original matter, but the authors are of the view that
the immediate question is not the soundness of Roe's resolution of the issue, but
the precedential force that must be accorded to its holding. Ante, at 871. Instead
of claiming that Roe [505 U.S. 833, 954] was correct as a matter of original constitutional
interpretation, the opinion therefore contains an elaborate discussion of stare decisis.
This discussion of the principle of stare decisis appears to be almost entirely dicta,
because the joint opinion does not apply that principle in dealing with Roe. Roe decided
that a woman had a fundamental right to an abortion. The joint opinion rejects that
view. Roe decided that abortion regulations were to be subjected to "strict scrutiny,"
and could be justified only in the light of "compelling state interests." The joint
opinion rejects that view. Ante, at 872-873; see Roe v. Wade, supra, 410 U.S., at
162 -164. Roe analyzed abortion regulation under a rigid trimester framework, a framework
which has guided this Court's decisionmaking for 19 years. The joint opinion rejects
that framework. Ante, at 873.
Stare decisis is defined in Black's Law Dictionary as meaning "to abide by, or adhere
to, decided cases." Black's Law Dictionary 1406 (6th ed. 1990). Whatever the "central
holding" of Roe that is left after the joint opinion finishes dissecting it is surely
not the result of that principle. While purporting to adhere to precedent, the joint
opinion instead revises it. Roe continues to exist, but only in the way a storefront
on a western movie set exists: a mere facade to give the illusion of reality. Decisions
following Roe, such as Akron v. Akron Center for Reproductive Health, Inc., 462 U.S.
416 (1983), and Thornburgh v. American College of Obstetricians and Gynecologists,
476 U.S. 747 (1986), are frankly overruled in part under the "undue burden" standard
expounded in the joint opinion. Ante at 881-884.
In our view, authentic principles of stare decisis do not require that any portion
of the reasoning in Roe be kept intact. "Stare decisis is not . . . a universal, inexorable
command," especially in cases involving the interpretation of the Federal Constitution.
Burnet v. Coronado Oil & Gas Co., 285 U.S. 393, 405 (1932) (Brandeis, J., dissenting).
Erroneous decisions in such constitutional cases are uniquely durable, because correction
through legislative action, save for [505 U.S. 833, 955] constitutional amendment,
is impossible. It is therefore our duty to reconsider constitutional interpretations
that "depar[t] from a proper understanding" of the Constitution. Garcia v. San Antonio
Metropolitan Transit Authority, 469 U.S., at 557 ; see United States v. Scott, 437
U.S. 82, 101 (1978) ("`[I]n cases involving the Federal Constitution, . . . [t]he
Court bows to the lessons of experience and the force of better reasoning, recognizing
that the process of trial and error, so fruitful in the physical sciences, is appropriate
also in the judicial function'" (quoting Burnet v. Coronado Oil & Gas Co., supra,
at 406-408 (Brandeis, J., dissenting))); Smith v. Allwright, 321 U.S. 649, 665 (1944).
Our constitutional watch does not cease merely because we have spoken before on an
issue; when it becomes clear that a prior constitutional interpretation is unsound,
we are obliged to reexamine the question. See, e.g., West Virginia Bd. of Ed. v. Barnette,
319 U.S. 624, 642 (1943); Erie R. Co. v. Tompkins, 304 U.S. 64, 74 -78 (1938).
The joint opinion discusses several stare decisis factors which, it asserts, point
toward retaining a portion of Roe. Two of these factors are that the main "factual
underpinning" of Roe has remained the same, and that its doctrinal foundation is no
weaker now than it was in 1973. Ante, at 857-860. Of course, what might be called
the basic facts which gave rise to Roe have remained the same - women become pregnant,
there is a point somewhere, depending on medical technology, where a fetus becomes
viable, and women give birth to children. But this is only to say that the same facts
which gave rise to Roe will continue to give rise to similar cases. It is not a reason,
in and of itself, why those cases must be decided in the same incorrect manner as
was the first case to deal with the question. And surely there is no requirement,
in considering whether to depart from stare decisis in a constitutional case, that
a decision be more wrong now than it was at the time it was rendered. If that were
true, the most outlandish constitutional decision could survive [505 U.S. 833, 955]
forever, based simply on the fact that it was no more outlandish later than it was
when originally rendered.
Nor does the joint opinion faithfully follow this alleged requirement. The opinion
frankly concludes that Roe and its progeny were wrong in failing to recognize that
the State's interests in maternal health and in the protection of unborn human life
exist throughout pregnancy. Ante, at 871-873. But there is no indication that these
components of Roe are any more incorrect at this juncture than they were at its inception.
The joint opinion also points to the reliance interests involved in this context
in its effort to explain why precedent must be followed for precedent's sake. Certainly
it is true that, where reliance is truly at issue, as in the case of judicial decisions
that have formed the basis for private decisions, "[c]onsiderations in favor of stare
decisis are at their acme." Payne v. Tennessee, 501 U.S., at 828 . But, as the joint
opinion apparently agrees, ante, at 855-856, any traditional notion of reliance is
not applicable here. The Court today cuts back on the protection afforded by Roe,
and no one claims that this action defeats any reliance interest in the disavowed
trimester framework. Similarly, reliance interests would not be diminished were the
Court to go further and acknowledge the full error of Roe, as "reproductive planning
could take virtually immediate account of" this action. Ante, at 856.
The joint opinion thus turns to what can only be described as an unconventional -
and unconvincing - notion of reliance, a view based on the surmise that the availability
of abortion since Roe has led to "two decades of economic and social developments"
that would be undercut if the error of Roe were recognized. Ante, at 856. The joint
opinion's assertion of this fact is undeveloped, and totally conclusory. In fact,
one cannot be sure to what economic and social developments the opinion is referring.
Surely it is dubious to suggest that women have reached their "places in society"
in [505 U.S. 833, 957] reliance upon Roe, rather than as a result of their determination
to obtain higher education and compete with men in the job market, and of society's
increasing recognition of their ability to fill positions that were previously thought
to be reserved only for men. Ante, at 856.
In the end, having failed to put forth any evidence to prove any true reliance, the
joint opinion's argument is based solely on generalized assertions about the national
psyche, on a belief that the people of this country have grown accustomed to the Roe
decision over the last 19 years and have "ordered their thinking and living around"
it. Ante, at 856. As an initial matter, one might inquire how the joint opinion can
view the "central holding" of Roe as so deeply rooted in our constitutional culture
when it so casually uproots and disposes of that same decision's trimester framework.
Furthermore, at various points in the past, the same could have been said about this
Court's erroneous decisions that the Constitution allowed "separate but equal" treatment
of minorities, see Plessy v. Ferguson, 163 U.S. 537 (1896), or that "liberty" under
the Due Process Clause protected "freedom of contract," see Adkins v. Children's Hospital
of District of Columbia, 261 U.S. 525 (1923); Lochner v. New York, 198 U.S. 45 (1905).
The "separate but equal" doctrine lasted 58 years after Plessy, and Lochner's protection
of contractual freedom lasted 32 years. However, the simple fact that a generation
or more had grown used to these major decisions did not prevent the Court from correcting
its errors in those cases, nor should it prevent us from correctly interpreting the
Constitution here. See Brown v. Board of Education, 347 U.S. 483 (1954) (rejecting
the "separate but equal" doctrine); West Coast Hotel Co. v. Parrish, 300 U.S. 379
(1937) (overruling Adkins v. Children's Hospital, supra, in upholding Washington's
minimum wage law).
Apparently realizing that conventional stare decisis principles do not support its
position, the joint opinion advances a belief that retaining a portion of Roe is necessary
to protect [505 U.S. 833, 958] the "legitimacy" of this Court. Ante, at 861-869. Because
the Court must take care to render decisions "grounded truly in principle," and not
simply as political and social compromises, ante, at 865, the joint opinion properly
declares it to be this Court's duty to ignore the public criticism and protest that
may arise as a result of a decision. Few would quarrel with this statement, although
it may be doubted that Members of this Court, holding their tenure as they do during
constitutional "good behavior," are at all likely to be intimidated by such public
protests.
But the joint opinion goes on to state that, when the Court "resolve[s] the sort
of intensely divisive controversy reflected in Roe and those rare, comparable cases,"
its decision is exempt from reconsideration under established principles of stare
decisis in constitutional cases. Ante, at 866. This is so, the joint opinion contends,
because, in those "intensely divisive" cases, the Court has call[ed] the contending
sides of a national controversy to end their national division by accepting a common
mandate rooted in the Constitution, and must therefore take special care not to be
perceived as "surrender[ing] to political pressure" and continued opposition. Ante,
at 866,867. This is a truly novel principle, one which is contrary to both the Court's
historical practice and to the Court's traditional willingness to tolerate criticism
of its opinions. Under this principle, when the Court has ruled on a divisive issue,
it is apparently prevented from overruling that decision for the sole reason that
it was incorrect, unless opposition to the original decision has died away.
The first difficulty with this principle lies in its assumption that cases that are
"intensely divisive" can be readily distinguished from those that are not. The question
of whether a particular issue is "intensely divisive" enough to qualify for special
protection is entirely subjective and dependent on the individual assumptions of the
Members of this Court. In addition, because the Court's duty is to ignore public opinion
and criticism on issues that come before it, its Members are [505 U.S. 833, 959] in
perhaps the worst position to judge whether a decision divides the Nation deeply enough
to justify such uncommon protection. Although many of the Court's decisions divide
the populace to a large degree, we have not previously on that account shied away
from applying normal rules of stare decisis when urged to reconsider earlier decisions.
Over the past 21 years, for example, the Court has overruled in whole or in part 34
of its previous constitutional decisions. See Payne v. Tennessee, supra, at 828-830,
and n. 1 (listing cases).
The joint opinion picks out and discusses two prior Court rulings that it believes
are of the "intensely divisive" variety, and concludes that they are of comparable
dimension to Roe. Ante, at 861-864 (discussing Lochner v. New York, supra, and Plessy
v. Ferguson, supra). It appears to us very odd indeed that the joint opinion chooses
as benchmarks two cases in which the Court chose not to adhere to erroneous constitutional
precedent, but instead enhanced its stature by acknowledging and correcting its error,
apparently in violation of the joint opinion's "legitimacy" principle. See West Coast
Hotel Co. v. Parrish, supra; Brown v. Board of Education, supra. One might also wonder
how it is that the joint opinion puts these, and not others, in the "intensely divisive"
category, and how it assumes that these are the only two lines of cases of comparable
dimension to Roe. There is no reason to think that either Plessy or Lochner produced
the sort of public protest when they were decided that Roe did. There were undoubtedly
large segments of the bench and bar who agreed with the dissenting views in those
cases, but surely that cannot be what the Court means when it uses the term "intensely
divisive," or many other cases would have to be added to the list. In terms of public
protest, however, Roe, so far as we know, was unique. But just as the Court should
not respond to that sort of protest by retreating from the decision simply to allay
the concerns of the protesters, it should likewise not respond by determining to adhere
to the [505 U.S. 833, 960] decision at all costs, lest it seem to be retreating under
fire. Public protests should not alter the normal application of stare decisis, lest
perfectly lawful protest activity be penalized by the Court itself.
Taking the joint opinion on its own terms, we doubt that its distinction between
Roe, on the one hand, and Plessy and Lochner, on the other, withstands analysis. The
joint opinion acknowledges that the Court improved its stature by overruling Plessy
in Brown on a deeply divisive issue. And our decision in West Coast Hotel, which overruled
Adkins v. Children's Hospital, supra, and Lochner, was rendered at a time when Congress
was considering President Franklin Roosevelt's proposal to "reorganize" this Court
and enable him to name six additional Justices in the event that any Member of the
Court over the age of 70 did not elect to retire. It is difficult to imagine a situation
in which the Court would face more intense opposition to a prior ruling than it did
at that time, and, under the general principle proclaimed in the joint opinion, the
Court seemingly should have responded to this opposition by stubbornly refusing to
reexamine the Lochner rationale, lest it lose legitimacy by appearing to "overrule
under fire." Ante, at 867.
The joint opinion agrees that the Court's stature would have been seriously damaged
if, in Brown and West Coast Hotel, it had dug in its heels and refused to apply normal
principles of stare decisis to the earlier decisions. But the opinion contends that
the Court was entitled to overrule Plessy and Lochner in those cases, despite the
existence of opposition to the original decisions, only because both the Nation and
the Court had learned new lessons in the interim. This is at best a feebly supported
post hoc rationalization for those decisions.
For example, the opinion asserts that the Court could justifiably overrule its decision
in Lochner only because the Depression had convinced "most people" that constitutional
protection of contractual freedom contributed to an economy [505 U.S. 833, 961] that
failed to protect the welfare of all. Ante, at 861. Surely the joint opinion does
not mean to suggest that people saw this Court's failure to uphold minimum wage statutes
as the cause of the Great Depression! In any event, the Lochner Court did not base
its rule upon the policy judgment that an unregulated market was fundamental to a
stable economy; it simply believed, erroneously, that "liberty" under the Due Process
Clause protected the "right to make a contract." Lochner v. New York, 198 U.S., at
53 . Nor is it the case that the people of this Nation only discovered the dangers
of extreme laissez-faire economics because of the Depression. State laws regulating
maximum hours and minimum wages were in existence well before that time. A Utah statute
of that sort enacted in 1896 was involved in our decision in Holden v. Hardy, 169
U.S. 366 (1898), and other states followed suit shortly afterwards, see, e.g., Muller
v. Oregon, 208 U.S. 412 (1908); Bunting v. Oregon, 243 U.S. 426 (1917). These statutes
were indeed enacted because of a belief on the part of their sponsors that "freedom
of contract" did not protect the welfare of workers, demonstrating that that belief
manifested itself more than a generation before the Great Depression. Whether "most
people" had come to share it in the hard times of the 1930's is, insofar as anything
the joint opinion advances, entirely speculative. The crucial failing at that time
was not that workers were not paid a fair wage, but that there was no work available
at any wage.
When the Court finally recognized its error in West Coast Hotel, it did not engage
in the post hoc rationalization that the joint opinion attributes to it today; it
did not state that Lochner had been based on an economic view that had fallen into
disfavor, and that it therefore should be overruled. Chief Justice Hughes, in his
opinion for the Court, simply recognized what Justice Holmes had previously recognized
in his Lochner dissent, that "[t]he Constitution does not speak of freedom of contract."
West Coast Hotel Co. v. Parrish, 300 U.S., at 391 ; Lochner v. New York, supra, at
75 (Holmes, [505 U.S. 833, 962] J., dissenting) ("[A] constitution is not intended
to embody a particular economic theory, whether of paternalism and the organic relation
of the citizen to the State or of laissez faire"). Although the Court did acknowledge
in the last paragraph of its opinion the state of affairs during the then-current
Depression, the theme of the opinion is that the Court had been mistaken as a matter
of constitutional law when it embraced "freedom of contract" 32 years previously.
The joint opinion also agrees that the Court acted properly in rejecting the doctrine
of "separate but equal" in Brown. In fact, the opinion lauds Brown in comparing it
to Roe. Ante, at 867. This is strange, in that, under the opinion's "legitimacy" principle,
the Court would seemingly have been forced to adhere to its erroneous decision in
Plessy because of its "intensely divisive" character. To us, adherence to Roe today
under the guise of "legitimacy" would seem to resemble more closely adherence to Plessy
on the same ground. Fortunately, the Court did not choose that option in Brown, and
instead frankly repudiated Plessy. The joint opinion concludes that such repudiation
was justified only because of newly discovered evidence that segregation had the effect
of treating one race as inferior to another. But it can hardly be argued that this
was not urged upon those who decided Plessy, as JUSTICE Harlan observed in his dissent
that the law at issue "puts the brand of servitude and degradation upon a large class
of our fellow-citizens, our equals before the law." Plessy v. Ferguson, 163 U.S.,
at 562 . It is clear that the same arguments made before the Court in Brown were made
in Plessy as well. The Court in Brown simply recognized, as Justice Harlan had recognized
beforehand, that the Fourteenth Amendment does not permit racial segregation. The
rule of Brown is not tied to popular opinion about the evils of segregation; it is
a judgment that the Equal Protection Clause does not permit racial segregation, no
matter whether the public might come to believe that it is beneficial. On that ground
it stands, and on that ground [505 U.S. 833, 963] alone the Court was justified in
properly concluding that the Plessy Court had erred.
There is also a suggestion in the joint opinion that the propriety of overruling
a "divisive" decision depends in part on whether "most people" would now agree that
it should be overruled. Either the demise of opposition or its progression to substantial
popular agreement apparently is required to allow the Court to reconsider a divisive
decision. How such agreement would be ascertained, short of a public opinion poll,
the joint opinion does not say. But surely even the suggestion is totally at war with
the idea of "legitimacy" in whose name it is invoked. The Judicial Branch derives
its legitimacy not from following public opinion, but from deciding by its best lights
whether legislative enactments of the popular branches of Government comport with
the Constitution. The doctrine of stare decisis is an adjunct of this duty, and should
be no more subject to the vagaries of public opinion than is the basic judicial task.
There are other reasons why the joint opinion's discussion of legitimacy is unconvincing,
as well. In assuming that the Court is perceived as "surrender[ing] to political pressure"
when it overrules a controversial decision, ante, at 867, the joint opinion forgets
that there are two sides to any controversy. The joint opinion asserts that, in order
to protect its legitimacy, the Court must refrain from overruling a controversial
decision lest it be viewed as favoring those who oppose the decision. But a decision
to adhere to prior precedent is subject to the same criticism, for, in such a case,
one can easily argue that the Court is responding to those who have demonstrated in
favor of the original decision. The decision in Roe has engendered large demonstrations,
including repeated marches on this Court and on Congress, both in opposition to and
in support of that opinion. A decision either way on Roe can therefore be perceived
as favoring one group or the other. But this perceived dilemma arises only if one
assumes, as the joint opinion does, that the Court [505 U.S. 833, 964] should make
its decisions with a view toward speculative public perceptions. If one assumes instead,
as the Court surely did in both Brown and West Coast Hotel, that the Court's legitimacy
is enhanced by faithful interpretation of the Constitution irrespective of public
opposition, such self-engendered difficulties may be put to one side.
Roe is not this Court's only decision to generate conflict. Our decisions in some
recent capital cases, and in Bowers v. Hardwick, 478 U.S. 186 (186), have also engendered
demonstrations in opposition. The joint opinion's message to such protesters appears
to be that they must cease their activities in order to serve their cause, because
their protests will only cement in place a decision which, by normal standards of
stare decisis, should be reconsidered. Nearly a century ago, Justice David J. Brewer
of this Court, in an article discussing criticism of its decisions, observed that
"many criticisms may be, like their authors, devoid of good taste, but better all
sorts of criticism than no criticism at all." Justice Brewer on "The Nation's Anchor,"
57 Albany L.J. 166, 169 (1898). This was good advice to the Court then, as it is today.
Strong and often misguided criticism of a decision should not render the decision
immune from reconsideration, lest a fetish for legitimacy penalize freedom of expression.
The end result of the joint opinion's paeans of praise for legitimacy is the enunciation
of a brand new standard for evaluating state regulation of a woman's right to abortion
- the "undue burden" standard. As indicated above, Roe v. Wade adopted a "fundamental
right" standard under which state regulations could survive only if they met the requirement
of "strict scrutiny." While we disagree with that standard, it at least had a recognized
basis in constitutional law at the time Roe was decided. The same cannot be said for
the "undue burden" standard, which is created largely out of whole cloth by the authors
of the joint opinion. It is a standard which even today does not command the support
of a majority of this Court. And it will not, we believe, result [505 U.S. 833, 965]
in the sort of "simple limitation," easily applied, which the joint opinion anticipates.
Ante, at 855. In sum, it is a standard which is not built to last.
In evaluating abortion regulations under that standard, judges will have to decide
whether they place a "substantial obstacle" in the path of a woman seeking an abortion.
Ante at 877. In that this standard is based even more on a judge's subjective determinations
than was the trimester framework, the standard will do nothing to prevent "judges
from roaming at large in the constitutional field," guided only by their personal
views. Griswold v. Connecticut, 381 U.S., at 502 (Harlan, J., concurring in judgment).
Because the undue burden standard is plucked from nowhere, the question of what is
a "substantial obstacle" to abortion will undoubtedly engender a variety of conflicting
views. For example, in the very matter before us now, the authors of the joint opinion
would uphold Pennsylvania's 24-hour waiting period, concluding that a "particular
burden" on some women is not a substantial obstacle. Ante, at 887. But the authors
would at the same time strike down Pennsylvania's spousal notice provision, after
finding that, in a "large fraction" of cases, the provision will be a substantial
obstacle. Ante, at 895. And, while the authors conclude that the informed consent
provisions do not constitute an "undue burden," JUSTICE STEVENS would hold that they
do. Ante, at 920-922.
Furthermore, while striking down the spousal notice regulation, the joint opinion
would uphold a parental consent restriction that certainly places very substantial
obstacles in the path of a minor's abortion choice. The joint opinion is forthright
in admitting that it draws this distinction based on a policy judgment that parents
will have the best interests of their children at heart, while the same is not necessarily
true of husbands as to their wives. Ante, at 895. This may or may not be a correct
judgment, but it is quintessentially a legislative one. The "undue burden" inquiry
does not in any way supply the distinction between parental consent and [505 U.S.
833, 966] spousal consent which the joint opinion adopts. Despite the efforts of the
joint opinion, the undue burden standard presents nothing more workable than the trimester
framework which it discards today. Under the guise of the Constitution, this Court
will still impart its own preferences on the States in the form of a complex abortion
code.
The sum of the joint opinion's labors in the name of stare decisis and "legitimacy"
is this: Roe v. Wade stands as a sort of judicial Potemkin Village, which may be pointed
out to passers-by as a monument to the importance of adhering to precedent. But behind
the facade, an entirely new method of analysis, without any roots in constitutional
law, is imported to decide the constitutionality of state laws regulating abortion.
Neither stare decisis nor "legitimacy" are truly served by such an effort.
We have stated above our belief that the Constitution does not subject state abortion
regulations to heightened scrutiny. Accordingly, we think that the correct analysis
is that set forth by the plurality opinion in Webster. A woman's interest in having
an abortion is a form of liberty protected by the Due Process Clause, but States may
regulate abortion procedures in ways rationally related to a legitimate state interest.
Williamson v. Lee Optical of Oklahoma, Inc., 348 U.S. 483, 491 (1955); cf. Stanley
v. Illinois, 405 U.S. 645, 651 -65 (1972). With this rule in mind, we examine each
of the challenged provisions.
III
A
Section 3205 of the Act imposes certain requirements related to the informed consent
of a woman seeking an abortion. 18 Pa.Cons.Stat. 3205 (1990). Section 3205(a)(1) requires
that the referring or performing physician must inform a woman contemplating an abortion
of (i) the nature of the procedure and the risks and alternatives that a reasonable
patient would find material; (ii) the fetus' probable gestational [505 U.S. 833, 967]
age; and (iii) the medical risks involved in carrying her pregnancy to term. Section
3205(a)(2) requires a physician or a nonphysician counselor to inform the woman that
(i) the state health department publishes free materials describing the fetus at different
stages and listing abortion alternatives; (ii) medical assistance benefits may be
available for prenatal, childbirth, and neonatal care; and (iii) the child's father
is liable for child support. The Act also imposes a 24-hour waiting period between
the time that the woman receives the required information and the time that the physician
is allowed to perform the abortion. See Appendix to opinion of O'CONNOR, KENNEDY,
and SOUTER, JJ., ante, at 902-904.
This Court has held that it is certainly within the province of the States to require
a woman's voluntary and informed consent to an abortion. See Thornburgh v. American
College of Obstetricians and Gynecologists, 476 U.S., at 760 . Here, Pennsylvania
seeks to further its legitimate interest in obtaining informed consent by ensuring
that each woman 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
make the alternative of normal childbirth more attractive than it might otherwise
appear. Id., at 798-799 (WHITE, J., dissenting).
We conclude that this provision of the statute is rationally related to the State's
interest in assuring that a woman's consent to an abortion be a fully informed decision.
Section 3205(a)(1) requires a physician to disclose certain information about the
abortion procedure and its risks and alternatives. This requirement is certainly no
large burden, as the Court of Appeals found that the record shows that the clinics,
without exception, insist on providing this information to women before an abortion
is performed. 947 F.2d, at 703. We are of the view that this information "clearly
is related to maternal health and to the State's legitimate purpose in requiring informed
consent." Akron v. [505 U.S. 833, 968] Akron Center for Reproductive Health, Inc.,
462 U.S., at 446 . An accurate description of the gestational age of the fetus and
of the risks involved in carrying a child to term helps to further both those interests
and the State's legitimate interest in unborn human life. See id., at 445-446, n.
37 (required disclosure of gestational age of the fetus "certainly is not objectionable").
Although petitioners contend that it is unreasonable for the State to require that
a physician, as opposed to a nonphysician counselor, disclose this information, we
agree with the Court of Appeals that a State may rationally decide that physicians
are better qualified than counselors to impart this information and answer questions
about the medical aspects of the available alternatives. 947 F.2d, at 704.
Section 3205(a)(2) compels the disclosure, by a physician or a counselor, of information
concerning the availability of paternal child support and state-funded alternatives
if the woman decides to proceed with her pregnancy. Here again, the Court of Appeals
observed that the record indicates that most clinics already require that a counselor
consult in person with the woman about alternatives to abortion before the abortion
is performed. Id., at 704-705. And petitioners do not claim that the information required
to be disclosed by statute is in any way false or inaccurate; indeed, the Court of
Appeals found it to be "relevant, accurate, and noninflammatory." Id., at 705. We
conclude that this required presentation of "balanced information" is rationally related
to the State's legitimate interest in ensuring that the woman's consent is truly informed,
Thornburgh v. American College of Obstetricians and Gynecologists, 476 U.S., at 830
(O'CONNOR, J., dissenting), and in addition furthers the State's interest in preserving
unborn life. That the information might create some uncertainty and persuade some
women to forgo abortions does not lead to the conclusion that the Constitution forbids
the provision of such information. Indeed, it only demonstrates that this information
might [505 U.S. 833, 969] very well make a difference, and that it is therefore relevant
to a woman's informed choice. Cf. id., at 801 (WHITE, J., dissenting) ("[T]he ostensible
objective of Roe v. Wade is not maximizing the number of abortions, but maximizing
choice"). We acknowledge that, in Thornburgh, this Court struck down informed consent
requirements similar to the ones at issue here. See id., at 760-764. It is clear,
however, that while the detailed framework of Roe led to the Court's invalidation
of those informational requirements, they "would have been sustained under any traditional
standard of judicial review, . . . or for any other surgical procedure except abortion."
Webster v. Reproductive Health Services, 492 U.S., at 517 (plurality opinion) (citing
Thornburgh v. American College of Obstetricians and Gynecologists, 476 U.S., at 802
(WHITE, J., dissenting); id., at 783 (Burger, C.J., dissenting)). In light of our
rejection of Roe's "fundamental right" approach to this subject, we do not regard
Thornburgh as controlling.
For the same reason, we do not feel bound to follow this Court's previous holding
that a State's 24-hour mandatory waiting period is unconstitutional. See Akron v.
Akron Center for Reproductive Health, Inc., 462 U.S., at 449 -451. Petitioners are
correct that such a provision will result in delays for some women that might not
otherwise exist, therefore placing a burden on their liberty. But the provision in
no way prohibits abortions, and the informed consent and waiting period requirements
do not apply in the case of a medical emergency. See 18 Pa. Cons.Stat. 3205(a), (b)
(1990). We are of the view that, in providing time for reflection and reconsideration,
the waiting period helps ensure that a woman's decision to abort is a well-considered
one, and reasonably furthers the State's legitimate interest in maternal health and
in the unborn life of the fetus. It "is surely a small cost to impose to ensure that
the woman's decision is wellconsidered in light of its certain and irreparable consequences
[505 U.S. 833, 970] on fetal life, and the possible effects on her own. 462 U.S.,
at 474 (O'CONNOR, J., dissenting).
B
In addition to providing her own informed consent, before an unemancipated woman
under the age of 18 may obtain an abortion, she must either furnish the consent of
one of her parents or must opt for the judicial procedure that allows her to bypass
the consent requirement. Under the judicial bypass option, a minor can obtain an abortion
if a state court finds that she is capable of giving her informed consent, and has
indeed given such consent, or determines that an abortion is in her best interests.
Records of these court proceedings are kept confidential. The Act directs the state
trial court to render a decision within three days of the woman's application, and
the entire procedure, including appeal to Pennsylvania Superior Court, is to last
no longer than eight business days. The parental consent requirement does not apply
in the case of a medical emergency. 18 Pa.Cons.Stat. 3206 (1990). See Appendix to
opinion of O'CONNOR, KENNEDY, and SOUTER, JJ., ante, at 904-906.
This provision is entirely consistent with this Court's previous decisions involving
parental consent requirements. See Planned Parenthood Ass. of Kansas City, Mo., Inc.
v. Ashcroft, 462 U.S. 476 (1983) (upholding parental consent requirement with a similar
judicial bypass option); Akron v. Akron Center for Reproductive Health, Inc., supra,
at 439-440 (approving of parental consent statutes that include a judicial bypass
option allowing a pregnant minor to "demonstrate that she is sufficiently mature to
make the abortion decision herself or that, despite her immaturity, an abortion would
be in her best interests"); Bellotti v. Baird, 443 U.S. 622 (1979).
We think it beyond dispute that a State has a strong and legitimate interest in the
welfare of its young citizens, whose immaturity, inexperience, and lack of judgment
may sometimes [505 U.S. 833, 971] impair their ability to exercise their rights wisely.
Hodgson v. Minnesota, 497 U.S., at 444 (opinion of STEVENS, J.). A requirement of
parental consent to abortion, like myriad other restrictions placed upon minors in
other contexts, is reasonably designed to further this important and legitimate state
interest. In our view, it is entirely rational and fair for the State to conclude
that, in most instances, the family will strive to give a lonely or even terrified
minor advice that is both compassionate and mature. Ohio v. Akron Center for Reproductive
Health, 497 U.S., at 520 (opinion of KENNEDY, J.); see also Planned Parenthood of
Central Mo. v. Danforth, 428 U.S., at 91 (Stewart, J., concurring) ("There can be
little doubt that the State furthers a constitutionally permissible end by encouraging
an unmarried pregnant minor to seek the help and advice of her parents in making the
very important decision whether or not to bear a child"). We thus conclude that Pennsylvania's
parental consent requirement should be upheld.
C
Section 3209 of the Act contains the spousal notification provision. It requires
that, before a physician may perform an abortion on a married woman, the woman must
sign a statement indicating that she has notified her husband of her planned abortion.
A woman is not required to notify her husband if (1) her husband is not the father,
(2) her husband, after diligent effort, cannot be located, (3) the pregnancy is the
result of a spousal sexual assault that has been reported to the authorities, or (4)
the woman has reason to believe that notifying her husband is likely to result in
the infliction of bodily injury upon her by him or by another individual. In addition,
a woman is exempted from the notification requirement in the case of a medical emergency.
18 Pa.Cons.Stat. 3209 (1990). See Appendix to opinion of O'Connor, Kennedy, and Souter,
JJ., ante, at 908-909.
We first emphasize that Pennsylvania has not imposed a spousal consent requirement
of the type the Court struck down in Planned Parenthood of Central Mo. v. Danforth,
428 U.S., at 67 -72. Missouri's spousal consent provision was invalidated in that
case because of the Court's view that it unconstitutionally granted to the husband
"a veto power exercisable for any reason whatsoever or for no reason at all." Id.,
at 71. But the provision here involves a much less intrusive requirement of spousal
notification, not consent. Such a law requiring only notice to the husband does not
give any third party the legal right to make the [woman's] decision for her, or to
prevent her from obtaining an abortion should she choose to have one performed. Hodgson
v. Minnesota, supra, at 496 (KENNEDY, J., concurring in judgment in part and dissenting
in part); see H.L. v. Matheson, 450 U.S., at 411 , n. 17. Danforth thus does not control
our analysis. Petitioners contend that it should, however; they argue that the real
effect of such a notice requirement is to give the power to husbands to veto a woman's
abortion choice. The District Court indeed found that the notification provision created
a risk that some woman who would otherwise have an abortion will be prevented from
having one. 947 F.2d, at 712. For example, petitioners argue, many notified husbands
will prevent abortions through physical force, psychological coercion, and other types
of threats. But Pennsylvania has incorporated exceptions in the notice provision in
an attempt to deal with these problems. For instance, a woman need not notify her
husband if the pregnancy is the result of a reported sexual assault, or if she has
reason to believe that she would suffer bodily injury as a result of the notification.
18 Pa.Cons.Stat. 3209(b) (1990). Furthermore, because this is a facial challenge to
the Act, it is insufficient for petitioners to show that the notification provision
"might operate unconstitutionally under some conceivable set of circumstances." United
States v. Salerno, 481 U.S. 739, 745 (1987). Thus, it is not enough for petitioners
[505 U.S. 833, 973] to show that, in some "worst case" circumstances, the notice provision
will operate as a grant of veto power to husbands. Ohio v. Akron Center for Reproductive
Health, 497 U.S., at 514 . Because they are making a facial challenge to the provision,
they must "show that no set of circumstances exists under which the [provision] would
be valid." Ibid. (internal quotation marks omitted). This they have failed to do.
2 [505 U.S. 833, 973]
The question before us is therefore whether the spousal notification requirement
rationally furthers any legitimate state interests. We conclude that it does. First,
a husband's interests in procreation within marriage and in the potential life of
his unborn child are certainly substantial ones. See Planned Parenthood of Central
Mo. v. Danforth, 428 U.S., at 69 ("We are not unaware of the deep and proper concern
and interest that a devoted and protective husband has in his wife's pregnancy and
in the growth and development of the fetus she is carrying"); id., at 93 (WHITE, J.,
concurring in part and dissenting in part); Skinner v. Oklahoma ex rel. Williamson,
316 U.S., at 541 . The State itself has legitimate interests both in protecting these
interests of the father and in protecting the potential life of the fetus, and the
spousal notification requirement is reasonably related to advancing those state interests.
By providing that a husband will usually know of his spouse's intent to have an abortion,
the provision makes it more likely that the husband will participate in deciding the
fate of his unborn child, a possibility that might otherwise have been denied him.
This participation might in some cases result in a decision to proceed with the pregnancy.
As Judge Alito observed in his dissent below, [t]he Pennsylvania legislature could
have rationally believed that some married women are initially inclined to obtain
an abortion without their husbands' knowledge because of perceived problems - such
as economic constraints, future plans, or the husbands' previously expressed [505
U.S. 833, 975] opposition - that may be obviated by discussion prior to the abortion.
947 F.2d, at 726 (opinion concurring in part and dissenting in part).
The State also has a legitimate interest in promoting "the integrity of the marital
relationship." 18 Pa.Cons.Stat. 3209(a) (1990). This Court has previously recognized
"the importance of the marital relationship in our society." Planned Parenthood of
Central Mo. v. Danforth, supra, at 69. In our view, the spousal notice requirement
is a rational attempt by the State to improve truthful communication between spouses
and encourage collaborative decisionmaking, and thereby fosters marital integrity.
See Labine v. Vincent, 401 U.S. 532, 538 (1971) ("[T]he power to make rules to establish,
protect, and strengthen family life" is committed to the state legislatures). Petitioners
argue that the notification requirement does not further any such interest; they assert
that the majority of wives already notify their husbands of their abortion decisions,
and the remainder have excellent reasons for keeping their decisions a secret. In
the first case, they argue, the law is unnecessary, and in the second case it will
only serve to foster marital discord and threats of harm. Thus, petitioners see the
law as a totally irrational means of furthering whatever legitimate interest the State
might have. But, in our view, it is unrealistic to assume that every husband-wife
relationship is either (1) so perfect that this type of truthful and important communication
will take place as a matter of course, or (2) so imperfect that, upon notice, the
husband will react selfishly, violently, or contrary to the best interests of his
wife. See Planned Parenthood of Central Mo. v. Danforth, supra, at 103-104 (STEVENS,
J., concurring in part and dissenting in part) (making a similar point in the context
of a parental consent statute). The spousal notice provision will admittedly be unnecessary
in some circumstances, and possibly harmful in others, but the existence of particular
cases in which a feature of a statute performs no function (or is even counterproductive)
[505 U.S. 833, 976] ordinarily does not render the statute unconstitutional or even
constitutionally suspect. Thornburgh v. American College of Obstetricians and Gynecologists,
476 U.S., at 800 (WHITE, J., dissenting). The Pennsylvania Legislature was in a position
to weigh the likely benefits of the provision against its likely adverse effects,
and presumably concluded, on balance, that the provision would be beneficial. Whether
this was a wise decision or not, we cannot say that it was irrational. We therefore
conclude that the spousal notice provision comports with the Constitution. See Harris
v. McRae, 448 U.S., at 325 -326 ("It is not the mission of this Court or any other
to decide whether the balance of competing interests . . . is wise social policy").
D
The Act also imposes various reporting requirements. Section 3214(a) requires that
abortion facilities file a report on each abortion performed. The reports do not include
the identity of the women on whom abortions are performed, but they do contain a variety
of information about the abortions. For example, each report must include the identities
of the performing and referring physicians, the gestational age of the fetus at the
time of abortion, and the basis for any medical judgment that a medical emergency
existed. See 18 Pa. Cons.Stat. 3214(a)(1), (5), (10) (1990). See Appendix to opinion
of O'Connor, Kennedy, and Souter, JJ., ante, at 909-911. The District Court found
that these reports are kept completely confidential. 947 F.2d, at 716. We further
conclude that these reporting requirements rationally further the State's legitimate
interests in advancing the state of medical knowledge concerning maternal health and
prenatal life, in gathering statistical information with respect to patients, and
in ensuring compliance with other provisions of the Act.
Section 3207 of the Act requires each abortion facility to file a report with its
name and address, as well as the names [505 U.S. 833, 977] and addresses of any parent,
subsidiary, or affiliated organizations. 18 Pa.Cons.Stat. 3207(b) (1990). Section
3214(f) further requires each facility to file quarterly reports stating the total
number of abortions performed, broken down by trimester. Both of these reports are
available to the public only if the facility received state funds within the preceding
12 months. See Appendix to opinion of O'Connor, Kennedy, and Souter, JJ., ante, at
906,911. Petitioners do not challenge the requirement that facilities provide this
information. They contend, however, that the forced public disclosure of the information
given by facilities receiving public funds serves no legitimate state interest. We
disagree. Records relating to the expenditure of public funds are generally available
to the public under Pennsylvania law. See Pa.Stat.Ann., Tit. 65, 66.1, 66.2 (Purdon
1959 and Supp. 1991-1992). As the Court of Appeals observed, "[w]hen a state provides
money to a private commercial enterprise, there is a legitimate public interest in
informing taxpayers who the funds are benefiting and what services the funds are supporting."
947 F.2d, at 718. These reporting requirements rationally further this legitimate
state interest.
E
Finally, petitioners challenge the medical emergency exception provided for by the
Act. The existence of a medical emergency exempts compliance with the Act's informed
consent, parental consent, and spousal notice requirements. See 18 Pa. Cons.Stat.
3205(a), 3206(a), 3209(c) (1990). The Act defines a "medical emergency" as
"[t]hat condition which, on the basis of the physician's good faith clinical judgment,
so complicates the medical condition of a pregnant woman as to necessitate the immediate
abortion of her pregnancy to avert her death or for which a delay will create serious
risk of substantial [505 U.S. 833, 978] and irreversible impairment of major bodily
function." 3203.
Petitioners argued before the District Court that the statutory definition was inadequate
because it did not cover three serious conditions that pregnant women can suffer -
preeclampsia, inevitable abortion, and prematurely ruptured membrane. The District
Court agreed with petitioners that the medical emergency exception was inadequate,
but the Court of Appeals reversed this holding. In construing the medical emergency
provision, the Court of Appeals first observed that all three conditions do indeed
present the risk of serious injury or death when an abortion is not performed, and
noted that the medical profession's uniformly prescribed treatment for each of the
three conditions is an immediate abortion. See 947 F.2d, at 700-701. Finding that
"[t]he Pennsylvania legislature did not choose the wording of its medical emergency
exception in a vacuum," the court read the exception as intended to assure that compliance
with its abortion regulations would not in any way pose a significant threat to the
life or health of a woman. Id., at 701. It thus concluded that the exception encompassed
each of the three dangerous conditions pointed to by petitioners.
We observe that Pennsylvania's present definition of medical emergency is almost
an exact copy of that State's definition at the time of this Court's ruling in Thornburgh,
one which the Court made reference to with apparent approval. 476 U.S., at 771 ("It
is clear that the Pennsylvania Legislature knows how to provide a medical emergency
exception when it chooses to do so"). 3 We find that the interpretation [505 U.S.
833, 979] of the Court of Appeals in this case is eminently reasonable, and that the
provision thus should be upheld. When a woman is faced with any condition that poses
a "significant threat to [her] life or health," she is exempted from the Act's consent
and notice requirements, and may proceed immediately with her abortion.
IV
For the reasons stated, we therefore would hold that each of the challenged provisions
of the Pennsylvania statute is consistent with the Constitution. It bears emphasis
that our conclusion in this regard does not carry with it any necessary approval of
these regulations. Our task is, as always, to decide only whether the challenged provisions
of a law comport with the United States Constitution. If, as we believe, these do,
their wisdom as a matter of public policy is for the people of Pennsylvania to decide.
[ Footnote 1 ] Two years after Roe, the West German constitutional court, by contrast,
struck down a law liberalizing access to abortion on the grounds that life developing
within the womb is constitutionally protected. Judgment of February 25, 1975, 39 BVerfGE
I (translated in Jonas & Gorby, West German Abortion Decision: A Contrast to Roe v.
Wade, 9 John Marshall J.Prac. & Proc. 605 (1976)). In 1988, the Canadian Supreme Court
followed reasoning similar to that of Roe in striking down a law that restricted abortion.
Morgentaler v. Queen, I S.C.R. 30, 44 D.L.R. 4th 385 (1988).
[ Footnote 2 ] The joint opinion of JUSTICES O'CONNOR, KENNEDY, and SOUTER appears
to ignore this point in concluding that the spousal notice provision imposes an undue
burden on the abortion decision. Ante, at 887-898. In most instances, the notification
requirement operates without difficulty. As the District Court found, the vast majority
of wives seeking abortions notify and consult with their husbands, and thus suffer
no burden as a result of the provisions. For example, notification is not required
if the husband is not the father, if the pregnancy is the result of a reported spousal
sexual assault, or if the woman fears bodily injury as a result of notifying her husband.
Thus, in these instances as well, the notification provision imposes no obstacle to
the abortion decision.
The joint opinion puts to one side these situations where the regulation imposes
no obstacle at all, and instead focuses on the group of married women who would not
otherwise notify their husbands and who do not qualify for one of the exceptions.
Having narrowed the focus, the joint opinion concludes that, in a "large fraction"
of those cases, the notification provision operates as a substantial obstacle, ante,
at 895, and that the provision is therefore invalid. There are certainly instances
where a woman would prefer not to notify her husband, and yet does not qualify for
an exception. For example, there are the situations of the battered women who fear
psychological abuse or injury to their children as a result of notification; because
in these situations the women do not fear bodily injury, they do not qualify for an
exception. And there are situations where a woman has become pregnant as a result
of an unreported spousal sexual assault; when such an assault is unreported, no exception
is available. But, as the District Court found, there are also instances where the
woman prefers not to notify her husband for a variety of other reasons. See 744 F.Supp.,
at 1360. For example, a woman might desire to obtain an abortion without her husband's
knowledge because of perceived economic constraints or her husband's previously expressed
opposition to abortion. The joint [505 U.S. 833, 974] opinion concentrates on the
situations involving battered women and unreported spousal assault, and assumes, without
any support in the record, that these instances constitute a "large fraction" of those
cases in which women prefer not to notify their husbands (and do not qualify for an
exception). Ante, at 895. This assumption is not based on any hard evidence, however.
And were it helpful to an attempt to reach a desired result, one could just as easily
assume that the battered women situations form 100 percent of the cases where women
desire not to notify, or that they constitute only 20 percent of those cases. But
reliance on such speculation is the necessary result of adopting the undue burden
standard.
[ Footnote 3 ] The definition in use at that time provided as follows:
"`Medical emergency.' That condition which, on the basis of the physician's best
clinical judgment, so complicates a pregnancy as to necessitate the immediate abortion
of same to avert the death of the mother or for which a 2-hour delay will create grave
peril of immediate and irreversible loss of major bodily function. Pa. Stat.Ann.,
Tit. 18, 3203 (Purdon 1983).
JUSTICE SCALIA, with whom THE CHIEF JUSTICE, JUSTICE WHITE, and JUSTICE THOMAS join,
concurring in the judgment in part and dissenting in part.
My views on this matter are unchanged from those I set forth in my separate opinions
in Webster v. Reproductive Health Services, 492 U.S. 490, 532 (1989) (opinion concurring
in part and concurring in judgment), and Ohio v. Akron Center for Reproductive Health,
497 U.S. 502, 520 (1990) (Akron II) (concurring opinion). The States may, if they
wish, permit abortion on demand, but the Constitution does not require them to do
so. The permissibility of abortion, and the limitations upon it, are to be resolved
like most important questions in our democracy: by citizens trying to persuade one
another and then voting. As the Court acknowledges, "where reasonable people disagree,
the government can adopt one position or the other." Ante, at 851. The Court is correct
in adding the qualification that this "assumes a state of affairs in which the choice
does not intrude upon a protected liberty," ibid., - but the crucial part of that
qualification [505 U.S. 833, 980] is the penultimate word. A State's choice between
two positions on which reasonable people can disagree is constitutional even when
(as is often the case) it intrudes upon a "liberty" in the absolute sense. Laws against
bigamy, for example - with which entire societies of reasonable people disagree -
intrude upon men and women's liberty to marry and live with one another. But bigamy
happens not to be a liberty specially "protected" by the Constitution.
That is, quite simply, the issue in this case: not whether the power of a woman to
abort her unborn child is a "liberty" in the absolute sense; or even whether it is
a liberty of great importance to many women. Of course it is both. The issue is whether
it is a liberty protected by the Constitution of the United States. I am sure it is
not. I reach that conclusion not because of anything so exalted as my views concerning
the "concept of existence, of meaning, of the universe, and of the mystery of human
life." Ibid. Rather, I reach it for the same reason I reach the conclusion that bigamy
is not constitutionally protected - because of two simple facts: (1) the Constitution
says absolutely nothing about it, and (2) the longstanding traditions of American
society have permitted it to be legally proscribed. 1 Akron II, supra, at 520 (SCALIA,
J., concurring). [505 U.S. 833, 981]
The Court destroys the proposition, evidently meant to represent my position, that
"liberty" includes only those practices, defined at the most specific level, that
were protected against government interference by other rules of law when the Fourteenth
Amendment was ratified, ante, at 847 (citing Michael H. v. Gerald D., 491 U.S. 110,
127 , n. 6 (1989) (opinion of SCALIA, J.). That is not, however, what Michael H. says;
it merely observes that, in defining "liberty," we may not disregard a specific, "relevant
tradition protecting, or denying protection to, the asserted right," Ibid. But the
Court does not wish to be fettered by any such limitations on its preferences. The
Court's statement that it is "tempting" to acknowledge the authoritativeness of tradition
in order to "cur[b] the discretion of federal judges," ante, at 847, is, of course,
rhetoric rather than reality; no government official is "tempted" to place restraints
upon his own freedom of action, which is why Lord Acton did not say "Power tends to
purify." The Court's temptation is in the quite opposite and more natural direction
- towards systematically eliminating checks upon its own power; and it succumbs.
Beyond that brief summary of the essence of my position, I will not swell the United
States Reports with repetition of what I have said before; and applying the rational
basis test, I would uphold the Pennsylvania statute in its entirety. I must, however,
respond to a few of the more outrageous arguments in today's opinion, which it is
beyond human nature to leave unanswered. I shall discuss each of them under a quotation
from the Court's opinion to which they pertain.
"The inescapable fact is that adjudication of substantive due process claims may
call upon the Court, [505 U.S. 833, 982] in interpreting the Constitution, to exercise
that same capacity which, by tradition, courts always have exercised: reasoned judgment".
Ante, at 849.
Assuming that the question before us is to be resolved at such a level of philosophical
abstraction, in such isolation from the traditions of American society, as by simply
applying "reasoned judgment," I do not see how that could possibly have produced the
answer the Court arrived at in Roe v. Wade, 410 U.S. 113 (1973). Today's opinion describes
the methodology of Roe, quite accurately, as weighing against the woman's interest
the State's "`important and legitimate interest in protecting the potentiality of
human life.'" Ante, at 871 (quoting Roe, supra, at 162). But "reasoned judgment" does
not begin by begging the question, as Roe and subsequent cases unquestionably did
by assuming that what the State is protecting is the mere "potentiality of human life."
See, e.g., Roe, supra, at 162; Planned Parenthood of Central Mo. v. Danforth, 428
U.S. 52, 61 (1976); Colautti v. Franklin, 439 U.S. 379, 386 (1979); Akron v. Akron
Center for Reproductive Health, Inc., 462 U.S. 416, 428 (1983) (Akron I); Planned
Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, 462 U.S. 476, 482 (1983).
The whole argument of abortion opponents is that what the Court calls the fetus and
what others call the unborn child is a human life. Thus, whatever answer Roe came
up with after conducting its "balancing" is bound to be wrong, unless it is correct
that the human fetus is in some critical sense merely potentially human. There is,
of course, no way to determine that as a legal matter; it is, in fact, a value judgment.
Some societies have considered newborn children not yet human, or the incompetent
elderly no longer so.
The authors of the joint opinion, of course, do not squarely contend that Roe v.
Wade was a correct application of "reasoned judgment"; merely that it must be followed,
because of stare decisis. Ante, at 853, 861, 871. But in their exhaustive discussion
of all the factors that go into the determination [505 U.S. 833, 983] of when stare
decisis should be observed and when disregarded, they never mention "how wrong was
the decision on its face?" Surely, if "[t]he Court's power lies . . . in its legitimacy,
a product of substance and perception," ante, at 865, the "substance" part of the
equation demands that plain error be acknowledged and eliminated. Roe was plainly
wrong - even on the Court's methodology of "reasoned judgment," and even more so (of
course) if the proper criteria of text and tradition are applied.
The emptiness of the "reasoned judgment" that produced Roe is displayed in plain
view by the fact that, after more than 19 years of effort by some of the brightest
(and most determined) legal minds in the country, after more than 10 cases upholding
abortion rights in this Court, and after dozens upon dozens of amicus briefs submitted
in this and other cases, the best the Court can do to explain how it is that the word
"liberty" must be thought to include the right to destroy human fetuses is to rattle
off a collection of adjectives that simply decorate a value judgment and conceal a
political choice. The right to abort, we are told, inheres in "liberty" because it
is among "a person's most basic decisions," ante, at 849; it involves a "most intimate
and personal choic[e]," ante, at 851; it is "central to personal dignity and autonomy,"
ibid.; it "originate[s] within the zone of conscience and belief," ante, at 852 it
is "too intimate and personal" for state interference, ibid.;, it reflects "intimate
views" of a "deep, personal character," ante, at 853; it involves "intimate relationships"
and notions of "personal autonomy and bodily integrity," ante, at 857; and it concerns
a particularly "`important decisio[n],'" ante, at 859 (citation omitted). 2 But it
is [505 U.S. 833, 984] obvious to anyone applying "reasoned judgment" that the same
adjectives can be applied to many forms of conduct that this Court (including one
of the Justices in today's majority, see Bowers v. Hardwick, 478 U.S. 186 (1986))
has held are not entitled to constitutional protection - because, like abortion, they
are forms of conduct that have long been criminalized in American society. Those adjectives
might be applied, for example, to homosexual sodomy, polygamy, adult incest, and suicide,
all of which are equally "intimate" and "deep[ly] personal" decisions involving "personal
autonomy and bodily integrity," and all of which can constitutionally be proscribed
because it is our unquestionable constitutional tradition that they are proscribable.
It is not reasoned judgment that supports the Court's decision; only personal predilection.
Justice Curtis' warning is as timely today as it was 135 years ago:
"[W]hen a strict interpretation of the Constitution, according to the fixed rules
which govern the interpretation of laws, is abandoned, and the theoretical opinions
of individuals are allowed to control its meaning, we have no longer a Constitution;
we are under the government of individual men, who for the time being have power to
declare what the Constitution is, according to their own views of what it ought to
mean." Dred Scott v. Sandford, 19 How. 393, 621 (1857) (dissenting opinion).
Liberty finds no refuge in a jurisprudence of doubt. Ante, at 844.
One might have feared to encounter this august and sonorous phrase in an opinion
defending the real Roe v. Wade, rather than the revised version fabricated today by
the authors [505 U.S. 833, 985] of the joint opinion. The shortcomings of Roe did
not include lack of clarity: virtually all regulation of abortion before the third
trimester was invalid. But to come across this phrase in the joint opinion - which
calls upon federal district judges to apply an "undue burden" standard as doubtful
in application as it is unprincipled in origin - is really more than one should have
to bear.
The joint opinion frankly concedes that the amorphous concept of "undue burden" has
been inconsistently applied by the Members of this Court in the few brief years since
that "test" was first explicitly propounded by JUSTICE O'CONNOR in her dissent in
Akron I, See 462 U.S. 416 (1983). See ante at 876. 3 Because the three Justices now
wish to "set forth a standard of general application," the joint opinion announces
that "it is important to clarify what is meant by an undue burden." Ibid. I certainly
agree with that, but I do not agree that the joint opinion succeeds in the announced
endeavor. To the contrary, its efforts at clarification [505 U.S. 833, 986] make clear
only that the standard is inherently manipulable, and will prove hopelessly unworkable
in practice.
The joint opinion explains that a state regulation imposes an "undue burden" if it
"has the purpose or effect of placing a substantial obstacle in the path of a woman
seeking an abortion of a nonviable fetus." Ante, at 877; see also ante, at 877-879.
An obstacle is "substantial," we are told, if it is "calculated[,] [not] to inform
the woman's free choice, [but to] hinder it." Ante, at 877. 4 This latter statement
cannot [505 U.S. 833, 987] possibly mean what it says. Any regulation of abortion
that is intended to advance what the joint opinion concedes is the State's "substantial"
interest in protecting unborn life will be "calculated [to] hinder" a decision to
have an abortion. It thus seems more accurate to say that the joint opinion would
uphold abortion regulations only if they do not unduly hinder the woman's decision.
That, of course, brings us right back to square one: defining an "undue burden" as
an "undue hindrance" (or a "substantial obstacle") hardly "clarifies" the test. Consciously
or not, the joint opinion's verbal shell game will conceal raw judicial policy choices
concerning what is "appropriate" abortion legislation.
The ultimately standardless nature of the "undue burden" inquiry is a reflection
of the underlying fact that the concept has no principled or coherent legal basis.
As THE CHIEF JUSTICE points out, Roe's strict scrutiny standard "at least had a recognized
basis in constitutional law at the time Roe was decided," ante, at 964, while [t]he
same cannot be said for the "undue burden" standard, which is created largely out
of whole cloth by the authors of the joint opinion. ibid. The joint opinion is flatly
wrong in asserting that "our jurisprudence relating to all liberties save perhaps
abortion has recognized" the permissibility of laws that do not impose an "undue burden."
Ante, at 873. It argues that the abortion right is similar to other rights in that
a law not designed to strike at the right itself, [but which] has the incidental effect
of making it more difficult or more expensive to [exercise the right,] is not invalid.
Ante, at 874. I agree, indeed I have [505 U.S. 833, 988] forcefully urged, that a
law of general applicability which places only an incidental burden on a fundamental
right does not infringe that right, see R.A.V. v. St. Paul, 505 U.S. 377 , (1992);
Employment Div., Dept. of Human Resources of Ore. v. Smith, 494 U.S. 872, 878 -882
(1990), but that principle does not establish the quite different (and quite dangerous)
proposition that a law which directly regulates a fundamental right will not be found
to violate the Constitution unless it imposes an "undue burden." It is that, of course,
which is at issue here: Pennsylvania has consciously and directly regulated conduct
that our cases have held is constitutionally protected. The appropriate analogy, therefore,
is that of a state law requiring purchasers of religious books to endure a 24-hour
waiting period, or to pay a nominal additional tax of 1 › . The joint opinion cannot
possibly be correct in suggesting that we would uphold such legislation on the ground
that it does not impose a "substantial obstacle" to the exercise of First Amendment
rights. The "undue burden" standard is not at all the generally applicable principle
the joint opinion pretends it to be; rather, it is a unique concept created specially
for this case, to preserve some judicial foothold in this ill-gotten territory. In
claiming otherwise, the three Justices show their willingness to place all constitutional
rights at risk in an effort to preserve what they deem the "central holding in Roe."
Ante, at 873.
The rootless nature of the "undue burden" standard, a phrase plucked out of context
from our earlier abortion decisions, see n. 3, supra, is further reflected in the
fact that the joint opinion finds it necessary expressly to repudiate the more narrow
formulations used in JUSTICE O'CONNOR's earlier opinions. Ante, at 876-877. Those
opinions stated that a statute imposes an "undue burden" if it imposes "absolute obstacles
or severe limitations on the abortion decision," Akron I, 462 U.S., at 464 (dissenting
opinion) (emphasis added); see also Thornburgh v. American College of Obstetricians
and Gynecologists, 476 U.S. 747, 828 (1986) (dissenting [505 U.S. 833, 989] opinion).
Those strong adjectives are conspicuously missing from the joint opinion, whose authors
have, for some unexplained reason, now determined that a burden is "undue" if it merely
imposes a "substantial" obstacle to abortion decisions. See, e.g., ante, at 895, 901.
JUSTICE O'CONNOR has also abandoned (again without explanation) the view she expressed
in Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, 462 U.S. 476 (1983)
(dissenting opinion), that a medical regulation which imposes an "undue burden" could
nevertheless be upheld if it "reasonably relate[s] to the preservation and protection
of maternal health," id., at 505 (citation and internal quotation marks omitted).
In today's version, even health measures will be upheld only "if they do not constitute
an undue burden," ante, at 878 (emphasis added). Gone too is JUSTICE O'CONNOR's statement
that "the State possesses compelling interests in the protection of potential human
life . . . throughout pregnancy," Akron I, supra, at 461 (dissenting opinion) (emphasis
added); see also Ashcroft, supra, at 505 (O'CONNOR, J., concurring in judgment in
part and dissenting in part); Thornburgh, supra, at 828 (O'CONNOR, J., dissenting);
instead, the State's interest in unborn human life is stealthily downgraded to a merely
"substantial" or "profound" interest, ante, at 876, 878. (That had to be done, of
course, since designating the interest as "compelling" throughout pregnancy would
have been, shall we say, a "substantial obstacle" to the joint opinion's determined
effort to reaffirm what it views as the "central holding" of Roe. See Akron I, 462
U.S., at 420 , n. 1). And "viability" is no longer the "arbitrary" dividing line previously
decried by JUSTICE O'CONNOR in Akron I, id., at 461; the Court now announces that
"the attainment of viability may continue to serve as the critical fact," ante, at
860. 5 It is difficult to [505 U.S. 833, 990] maintain the illusion that we are interpreting
a Constitution, rather than inventing one, when we amend its provisions so breezily.
Because the portion of the joint opinion adopting and describing the undue burden
test provides no more useful guidance than the empty phrases discussed above, one
must turn to 23 pages applying that standard to the present facts, for further guidance.
In evaluating Pennsylvania's abortion law, the joint opinion relies extensively on
the factual findings of the District Court, and repeatedly qualifies its conclusions
by noting that they are contingent upon the record developed in this case. Thus, the
joint opinion would uphold the 24-hour waiting period contained in the Pennsylvania
statute's informed consent provision, 18 Pa.Cons.Stat. 3205 (1990), because "the record
evidence shows that, in the vast majority of cases, a 24-hour delay does not create
any appreciable health risk," ante, at 885. The three Justices therefore conclude
that, "on the record before us, . . . we are not convinced that the 24-hour waiting
period constitutes an undue burden." Ante, at 887. The requirement that a doctor provide
the information pertinent to informed consent would also be upheld because there is
no evidence on this record that [this requirement] would amount, in practical terms,
to a substantial obstacle to a woman seeking an abortion. Ante, at 884. Similarly,
the joint opinion would uphold the reporting requirements of the Act, 3207, 3214,
because "there is no . . . showing on the record before us" that these requirements
constitute a "substantial obstacle" [505 U.S. 833, 991] to abortion decisions. Ante,
at 901. But, at the same time, the opinion pointedly observes that these reporting
requirements may increase the costs of abortions, and that "at some point, [that fact]
could become a substantial obstacle." Ibid. Most significantly, the joint opinion's
conclusion that the spousal notice requirement of the Act, see 3209, imposes an "undue
burden" is based in large measure on the District Court's "detailed findings of fact,"
which the joint opinion sets out at great length, ante, at 888-891.
I do not, of course, have any objection to the notion that, in applying legal principles,
one should rely only upon the facts that are contained in the record or that are properly
subject to judicial notice. 6 But what is remarkable about the joint opinion's fact-intensive
analysis is that it does not result in any measurable clarification of the "undue
burden" standard. Rather, the approach of the joint opinion is, for the most part,
simply to highlight certain facts in the record that apparently strike the three Justices
as particularly significant in establishing (or refuting) the existence of an undue
burden; after describing these facts, the opinion then simply announces that the provision
either does or does not impose a "substantial obstacle" or an "undue burden." See,
e.g., ante, at 880, 884-885, 887, 893-894, 895, 901. We do not know whether the same
conclusions could have been reached on a different record, or in what respects the
record would have had to differ before an opposite conclusion would have been [505
U.S. 833, 992] appropriate. The inherently standardless nature of this inquiry invites
the district judge to give effect to his personal preferences about abortion. By finding
and relying upon the right facts, he can invalidate, it would seem, almost any abortion
restriction that strikes him as "undue" - subject, of course, to the possibility of
being reversed by a Court of Appeals or Supreme Court that is as unconstrained in
reviewing his decision as he was in making it.
To the extent I can discern any meaningful content in the "undue burden" standard
as applied in the joint opinion, it appears to be that a State may not regulate abortion
in such a way as to reduce significantly its incidence. The joint opinion repeatedly
emphasizes that an important factor in the "undue burden" analysis is whether the
regulation "prevent[s] a significant number of women from obtaining an abortion,"
ante, at 893; whether a "significant number of women . . . are likely to be deterred
from procuring an abortion," ibid.; and whether the regulation often "deters" women
from seeking abortions, ante, at 894. We are not told, however, what forms of "deterrence"
are impermissible or what degree of success in deterrence is too much to be tolerated.
If, for example, a State required a woman to read a pamphlet describing, with illustrations,
the facts of fetal development before she could obtain an abortion, the effect of
such legislation might be to "deter" a "significant number of women" from procuring
abortions, thereby seemingly allowing a district judge to invalidate it as an undue
burden. Thus, despite flowery rhetoric about the State's "substantial" and "profound"
interest in "potential human life," and criticism of Roe for undervaluing that interest,
the joint opinion permits the State to pursue that interest only so long as it is
not too successful. As JUSTICE BLACKMUN recognizes (with evident hope), ante, at 926,
the "undue burden" standard may ultimately require the invalidation of each provision
upheld today if it can be shown, on a better record, that the State is too effectively
"express[ing] a preference [505 U.S. 833, 993] for childbirth over abortion," ante,
at 883. Reason finds no refuge in this jurisprudence of confusion.
"While we appreciate the weight of the arguments . . . that Roe should be overruled,
the reservations any of us may have in reaffirming the central holding of Roe are
outweighed by the explication of individual liberty we have given combined with the
force of stare decisis. Ante, at 853.
The Court's reliance upon stare decisis can best be described as contrived. It insists
upon the necessity of adhering not to all of Roe, but only to what it calls the "central
holding." It seems to me that stare decisis ought to be applied even to the doctrine
of stare decisis, and I confess never to have heard of this new, keep-what-you-want-and-throw-away-the-rest
version. I wonder whether, as applied to Marbury v. Madison, 1 Cranch 137 (1803),
for example, the new version of stare decisis would be satisfied if we allowed courts
to review the constitutionality of only those statutes that (like the one in Marbury)
pertain to the jurisdiction of the courts.
I am certainly not in a good position to dispute that the Court has saved the "central
holding" of Roe, since, to do that effectively, I would have to know what the Court
has saved, which in turn would require me to understand (as I do not) what the "undue
burden" test means. I must confess, however, that I have always thought, and I think
a lot of other people have always thought, that the arbitrary trimester framework,
which the Court today discards, was quite as central to Roe as the arbitrary viability
test, which the Court today retains. It seems particularly ungrateful to carve the
trimester framework out of the core of Roe, since its very rigidity (in sharp contrast
to the utter indeterminability of the "undue burden" test) is probably the only reason
the Court is able to say, in urging stare decisis, that Roe "has in no sense proven
`unworkable,'" ante, at 855. I suppose the [505 U.S. 833, 994] Court is entitled to
call a "central holding" whatever it wants to call a "central holding" - which is,
come to think of it, perhaps one of the difficulties with this modified version of
stare decisis. I thought I might note, however, that the following portions of Roe
have not been saved:
* Under Roe, requiring that a woman seeking an abortion be provided truthful information
about abortion before giving informed written consent is unconstitutional if the information
is designed to influence her choice. Thornburgh, 476 U.S., at 759 -765; Akron I, 462
U.S., at 442 -445. Under the joint opinion's "undue burden" regime (as applied today,
at least) such a requirement is constitutional. Ante, at 881-885.
* Under Roe, requiring that information be provided by a doctor, rather than by nonphysician
counselors, is unconstitutional. Akron I, supra, at 446-449. Under the "undue burden"
regime (as applied today, at least) it is not. Ante, at 884-885.
* Under Roe, requiring a 24-hour waiting period between the time the woman gives
her informed consent and the time of the abortion is unconstitutional. Akron I, supra,
at 449-451. Under the "undue burden" regime (as applied today, at least) it is not.
Ante, at 885-887.
* Under Roe, requiring detailed reports that include demographic data about each
woman who seeks an abortion and various information about each abortion is unconstitutional.
Thornburgh, supra, 476 U.S., at 765 -768. Under the "undue burden" regime (as applied
today, at least) it generally is not. Ante at 900-901.
"Where, in the performance of its judicial duties, the Court decides a case in such
a way as to resolve the sort of intensely divisive controversy reflected in Roe .
. ., its decision has a dimension that the resolution of the normal case does not
carry. It is the dimension present whenever the Court's interpretation of the Constitution
calls the contending sides of a [505 U.S. 833, 995] national controversy to end their
national division by accepting a common mandate rooted in the Constitution. Ante,
at 866-867.
The Court's description of the place of Roe in the social history of the United States
is unrecognizable. Not only did Roe not, as the Court suggests, resolve the deeply
divisive issue of abortion; it did more than anything else to nourish it, by elevating
it to the national level, where it is infinitely more difficult to resolve. National
politics were not plagued by abortion protests, national abortion lobbying, or abortion
marches on Congress before Roe v. Wade was decided. Profound disagreement existed
among our citizens over the issue - as it does over other issues, such as the death
penalty - but that disagreement was being worked out at the state level. As with many
other issues, the division of sentiment within each State was not as closely balanced
as it was among the population of the Nation as a whole, meaning not only that more
people would be satisfied with the results of state-by-state resolution, but also
that those results would be more stable. Pre-Roe, moreover, political compromise was
possible.
Roe's mandate for abortion on demand destroyed the compromises of the past, rendered
compromise impossible for the future, and required the entire issue to be resolved
uniformly, at the national level. At the same time, Roe created a vast new class of
abortion consumers and abortion proponents by eliminating the moral opprobrium that
had attached to the act. ("If the Constitution guarantees abortion, how can it be
bad?" - not an accurate line of thought, but a natural one.) Many favor all of those
developments, and it is not for me to say that they are wrong. But to portray Roe
as the statesmanlike "settlement" of a divisive issue, a jurisprudential Peace of
Westphalia that is worth preserving, is nothing less than Orwellian. Roe fanned into
life an issue that has inflamed our national politics in general, and has obscured
with its smoke the selection of Justices to this Court, [505 U.S. 833, 996] in particular,
ever since. And by keeping us in the abortion-umpiring business, it is the perpetuation
of that disruption, rather than of any Pax Roeana that the Court's new majority decrees.
"[T]o overrule under fire . . . would subvert the Court's legitimacy. . . .
". . . To all those who will be . . . tested by following, the Court implicitly undertakes
to remain steadfast. . . . The promise of constancy, once given, binds its maker for
as long as the power to stand by the decision survives and . . . the commitment [is
not] obsolete. . . .
"[The American people's] belief in themselves as . . . a people [who aspire to live
according to the rule of law] is not readily separable from their understanding of
the Court invested with the authority to decide their constitutional cases and speak
before all others for their constitutional ideals. If the Court's legitimacy should
be undermined, then so would the country be in its very ability to see itself through
its constitutional ideals." Ante, at 867-868.
The Imperial Judiciary lives. It is instructive to compare this Nietzschean vision
of us unelected, life-tenured judges - leading a Volk who will be "tested by following,"
and whose very "belief in themselves" is mystically bound up in their "understanding"
of a Court that "speak[s] before all others for their constitutional ideals" - with
the somewhat more modest role envisioned for these lawyers by the Founders.
"The judiciary . . . has . . . no direction either of the strength or of the wealth
of the society, and can take no active resolution whatever. It may truly be said to
have neither Force nor Will, but merely judgment. . . ." The Federalist No. 78, pp.
393-394 (G. Wills ed. 1982).
Or, again, to compare this ecstasy of a Supreme Court in which there is, especially
on controversial matters, no [505 U.S. 833, 997] shadow of change or hint of alteration
("There is a limit to the amount of error that can plausibly be imputed to prior Courts,"
ante, at 866), with the more democratic views of a more humble man:
"[T]he candid citizen must confess that, if the policy of the Government upon vital
questions affecting the whole people is to be irrevocably fixed by decisions of the
Supreme Court, . . . the people will have ceased to be their own rulers, having to
that extent practically resigned their Government into the hands of that eminent tribunal."
A. Lincoln, First Inaugural Address (Mar. 4, 1861), reprinted in Inaugural Addresses
of the Presidents of the United States, S. Doc. No. 101-10, p. 139 (1989).
It is particularly difficult, in the circumstances of the present decision, to sit
still for the Court's lengthy lecture upon the virtues of "constancy," ante, at 868,
of "remain[ing] steadfast," ibid.;,, and adhering to "principle," ante, passim. Among
the five Justices who purportedly adhere to Roe, at most three agree upon the principle
that constitutes adherence (the joint opinion's "undue burden" standard) - and that
principle is inconsistent with Roe. See 410 U.S., at 154 -156. 7 To make matters worse,
two of the three, in order thus to remain steadfast, had to abandon previously stated
positions. See n. 4, supra; see supra at 11-12. It is beyond me how the Court expects
these accommodations to be accepted as grounded truly in principle, not as compromises
with social and political pressures having, as such, no bearing on the principled
choices that the Court is obliged to make. Ante, at 865-866. The only principle the
Court "adheres" [505 U.S. 833, 998] to, it seems to me, is the principle that the
Court must be seen as standing by Roe. That is not a principle of law (which is what
I thought the Court was talking about), but a principle of Realpolitik - and a wrong
one, at that.
I cannot agree with, indeed I am appalled by, the Court's suggestion that the decision
whether to stand by an erroneous constitutional decision must be strongly influenced
- against overruling, no less - by the substantial and continuing public opposition
the decision has generated. The Court's judgment that any other course would "subvert
the Court's legitimacy" must be another consequence of reading the error-filled history
book that described the deeply divided country brought together by Roe. In my history
book, the Court was covered with dishonor and deprived of legitimacy by Dred Scott
v. Sandford, 19 How. 393 (1857), an erroneous (and widely opposed) opinion that it
did not abandon, rather than by West Coast Hotel Co. v. Parrish, 300 U.S. 379 (1937),
which produced the famous "switch in time" from the Court's erroneous (and widely
opposed) constitutional opposition to the social measures of the New Deal. Both Dred
Scott and one line of the cases resisting the New Deal rested upon the concept of
"substantive due process" that the Court praises and employs today. Indeed, Dred Scott
was very possibly the first application of substantive due process in the Supreme
Court, the original precedent for Lochner v. New York and Roe v. Wade. D. Currie,
The Constitution in the Supreme Court 271 (1985) (footnotes omitted).
But whether it would "subvert the Court's legitimacy" or not, the notion that we
would decide a case differently from the way we otherwise would have in order to show
that we can stand firm against public disapproval is frightening. It is a bad enough
idea, even in the head of someone like me, who believes that the text of the Constitution,
and our traditions, say what they say and there is no fiddling with them. But when
it is in the mind of a Court that believes the Constitution [505 U.S. 833, 999] has
an evolving meaning, see ante, at 848; that the Ninth Amendment's reference to "othe[r]"
rights is not a disclaimer, but a charter for action, ibid.; and that the function
of this Court is to "speak before all others for [the people's] constitutional ideals"
unrestrained by meaningful text or tradition - then the notion that the Court must
adhere to a decision for as long as the decision faces "great opposition" and the
Court is "under fire" acquires a character of almost czarist arrogance. We are offended
by these marchers who descend upon us, every year on the anniversary of Roe, to protest
our saying that the Constitution requires what our society has never thought the Constitution
requires. These people who refuse to be "tested by following" must be taught a lesson.
We have no Cossacks, but at least we can stubbornly refuse to abandon an erroneous
opinion that we might otherwise change - to show how little they intimidate us.
Of course, as THE CHIEF JUSTICE points out, we have been subjected to what the Court
calls "`political pressure'" by both sides of this issue. Ante, at 963. Maybe today's
decision not to overrule Roe will be seen as buckling to pressure from that direction.
Instead of engaging in the hopeless task of predicting public perception - a job not
for lawyers but for political campaign managers - the Justices should do what is legally
right by asking two questions: (1) Was Roe correctly decided? (2) Has Roe succeeded
in producing a settled body of law? If the answer to both questions is no, Roe should
undoubtedly be overruled.
In truth, I am as distressed as the Court is - and expressed my distress several
years ago, see Webster, 492 U.S., at 535 - about the "political pressure" directed
to the Court: the marches, the mail, the protests aimed at inducing us to change our
opinions. How upsetting it is, that so many of our citizens (good people, not lawless
ones, on both sides of this abortion issue, and on various sides of other issues as
well) think that we Justices should properly take into account [505 U.S. 833, 1000]
their views, as though we were engaged not in ascertaining an objective law, but in
determining some kind of social consensus. The Court would profit, I think, from giving
less attention to the fact of this distressing phenomenon, and more attention to the
cause of it. That cause permeates today's opinion: a new mode of constitutional adjudication
that relies not upon text and traditional practice to determine the law, but upon
what the Court calls "reasoned judgment," ante, at 849, which turns out to be nothing
but philosophical predilection and moral intuition. All manner of "liberties," the
Court tells us, inhere in the Constitution, and are enforceable by this Court - not
just those mentioned in the text or established in the traditions of our society.
Ante, at 847-849. Why even the Ninth Amendment - which says only that "[t]he enumeration
in the Constitution, of certain rights, shall not be construed to deny or disparage
others retained by the people" - is, despite our contrary understanding for almost
200 years, a literally boundless source of additional, unnamed, unhinted-at "rights,"
definable and enforceable by us, through "reasoned judgment." Ante, at 848-849.
What makes all this relevant to the bothersome application of "political pressure"
against the Court are the twin facts that the American people love democracy and the
American people are not fools. As long as this Court thought (and the people thought)
that we Justices were doing essentially lawyers' work up here - reading text and discerning
our society's traditional understanding of that text - the public pretty much left
us alone. Texts and traditions are facts to study, not convictions to demonstrate
about. But if in reality, our process of constitutional adjudication consists primarily
of making value judgments; if we can ignore a long and clear tradition clarifying
an ambiguous text, as we did, for example, five days ago in declaring unconstitutional
invocations and benedictions at public high school graduation ceremonies, Lee v. Weisman,
505 U.S. 577 (1992); if, as I say, our pronouncement of constitutional law rests primarily
on value [505 U.S. 833, 1001] judgments, then a free and intelligent people's attitude
towards us can be expected to be (ought to be) quite different. The people know that
their value judgments are quite as good as those taught in any law school - maybe
better. If, indeed, the "liberties" protected by the Constitution are, as the Court
says, undefined and unbounded, then the people should demonstrate, to protest that
we do not implement their values instead of ours. Not only that, but the confirmation
hearings for new Justices should deteriorate into question-and-answer sessions in
which Senators go through a list of their constituents' most favored and most disfavored
alleged constitutional rights, and seek the nominee's commitment to support or oppose
them. Value judgments, after all, should be voted on, not dictated; and if our Constitution
has somehow accidentally committed them to the Supreme Court, at least we can have
a sort of plebiscite each time a new nominee to that body is put forward. JUSTICE
BLACKMUN not only regards this prospect with equanimity, he solicits it. Ante, at
943.
* * *
There is a poignant aspect to today's opinion. Its length, and what might be called
its epic tone, suggest that its authors believe they are bringing to an end a troublesome
era in the history of our Nation, and of our Court. "It is the dimension" of authority,
they say, to cal[l] the contending sides of national controversy to end their national
division by accepting a common mandate rooted in the Constitution. Ante, at 867.
There comes vividly to mind a portrait by Emanuel Leutze that hangs in the Harvard
Law School: Roger Brooke Taney, painted in 1859, the 82nd year of his life, the 24th
of his Chief Justiceship, the second after his opinion in Dred Scott. He is in black,
sitting in a shadowed red armchair, left hand resting upon a pad of paper in his lap,
right hand hanging limply, almost lifelessly, beside the inner arm of the chair. He
sits facing the viewer and staring straight out. There [505 U.S. 833, 1002] seems
to be on his face, and in his deep-set eyes, an expression of profound sadness and
disillusionment. Perhaps he always looked that way, even when dwelling upon the happiest
of thoughts. But those of us who know how the lustre of his great Chief Justiceship
came to be eclipsed by Dred Scott cannot help believing that he had that case - its
already apparent consequences for the Court and its soon-to-be-played-out consequences
for the Nation - burning on his mind. I expect that, two years earlier, he, too, had
thought himself call[ing] the contending sides of national controversy to end their
national division by accepting a common mandate rooted in the Constitution.
It is no more realistic for us in this case than it was for him in that to think
that an issue of the sort they both involved - an issue involving life and death,
freedom and subjugation - can be "speedily and finally settled" by the Supreme Court,
as President James Buchanan, in his inaugural address, said the issue of slavery in
the territories would be. See Inaugural Addresses of the Presidents of the United
States, S.Doc. No. 101-10, p. 126 (1989). Quite to the contrary, by foreclosing all
democratic outlet for the deep passions this issue arouses, by banishing the issue
from the political forum that gives all participants, even the losers, the satisfaction
of a fair hearing and an honest fight, by continuing the imposition of a rigid national
rule instead of allowing for regional differences, the Court merely prolongs and intensifies
the anguish.
We should get out of this area, where we have no right to be, and where we do neither
ourselves nor the country any good by remaining.
[ Footnote 1 ] The Court's suggestion, ante, at 847-848, that adherence to tradition
would require us to uphold laws against interracial marriage is entirely wrong. Any
tradition in that case was contradicted by a text - an Equal Protection Clause that
explicitly establishes racial equality as a constitutional value. See Loving v. Virginia,
388 U.S. 1, 9 (1967) ("In the case at bar, . . . we deal with statutes containing
racial classifications, and the fact of equal application does not immunize the statute
from the very heavy burden of justification which the Fourteenth Amendment has traditionally
required of state statutes drawn according to race"); see also id., at 13 (Stewart,
J., concurring in judgment). The enterprise launched in Roe v. Wade, 410 U.S. 113
(1973), by contrast, sought to establish - in the teeth of a clear, contrary tradition
- a value found nowhere in the constitutional text.
There is, of course, no comparable tradition barring recognition of a "liberty interest"
in carrying one's child to term free from state efforts to kill it. For that reason,
it does not follow that the Constitution does not [505 U.S. 833, 981] protect childbirth
simply because it does not protect abortion. The Court's contention, ante, at 859,
that the only way to protect childbirth is to protect abortion shows the utter bankruptcy
of constitutional analysis deprived of tradition as a validating factor. It drives
one to say that the only way to protect the right to eat is to acknowledge the constitutional
right to starve oneself to death.
[ Footnote 2 ] JUSTICE BLACKMUN's parade of adjectives is similarly empty: abortion
is among "`the most intimate and personal choices,'" ante, at 923; it is a matter
"central to personal dignity and autonomy," ibid.; and it involves "personal decisions
that profoundly affect bodily integrity, identity, and destiny," ante, at 927. JUSTICE
STEVENS is not much less conclusory: the decision to choose abortion is a matter of
"the highest privacy and the [505 U.S. 833, 984] most personal nature," ante, at 915;
it involves a "`difficult choice having serious and personal consequences of major
importance to [a woman's] future,'" ibid.; the authority to make this "traumatic and
yet empowering decisio[n]" is "an element of basic human dignity," ibid.; and it is
"nothing less than a matter of conscience," ibid.
[ Footnote 3 ] The joint opinion is clearly wrong in asserting, ante, at 874, that
"the Court's early abortion cases adhered to" he "undue burden" standard. The passing
use of that phrase in JUSTICE BLACKMUN's opinion for the Court in Bellotti v. Baird,
428 U.S. 132, 147 (1976) (Bellotti I), was not by way of setting forth the standard
of unconstitutionality, as JUSTICE O'CONNOR's later opinions did, but by way of expressing
the conclusion of unconstitutionality. Justice Powell for a time appeared to employ
a variant of "undue burden" analysis in several nonmajority opinions, see, e.g., Bellotti
v. Baird, 443 U.S. 622, 647 (1979) (Bellotti II); Carey v. Population Services International,
431 U.S. 678, 705 (1977) (opinion concurring in part and concurring in judgment),
but he too ultimately rejected that standard in his opinion for the Court in Akron
v. Akron Center for Reproductive Health, Inc., 462 U.S. 416, 420 , n. 1 (1983) (Akron
I). The joint opinion's reliance on Maher v. Roe, 432 U.S. 464, 473 (1977), and Harris
v. McRae, 448 U.S. 297, 314 (1980), is entirely misplaced, since those cases did not
involve regulation of abortion, but mere refusal to fund it. In any event, JUSTICE
O'CONNOR's earlier formulations have apparently now proved unsatisfactory to the three
Justices, who - in the name of stare decisis, no less - today find it necessary to
devise an entirely new version of "undue burden" analysis. See ante, at 877-879.
[ Footnote 4 ] The joint opinion further asserts that a law imposing an undue burden
on abortion decisions is not a "permissible" means of serving "legitimate" state interests.
Ante, at 877. This description of the undue burden standard in terms more commonly
associated with the rational basis test will come as a surprise even to those who
have followed closely our wanderings in this forsaken wilderness. See, e.g., Akron
I, supra, at 463 (O'CONNOR, J., dissenting) ("The `undue burden' . . . represents
the required threshold inquiry that must be conducted before this Court can require
a State to justify its legislative actions under the exacting `compelling state interest'
standard"); see also Hodgson v. Minnesota, 497 U.S. 417, 458 -460 (1990) (O'CONNOR,
J., concurring in part and concurring in judgment in part); Thornburgh v. American
College of Obstetricians and Gynecologists, 476 U.S. 747, 828 (1986) (O'CONNOR, J.,
dissenting). This confusing equation of the two standards is apparently designed to
explain how one of the Justices who joined the plurality opinion in Webster v. Reproductive
Health Services, 492 U.S. 490 (1989), which adopted the rational-basis test, could
join an opinion expressly adopting the undue burden test. See id., at 520 (rejecting
the view that abortion is a "fundamental right," instead inquiring whether a law regulating
the woman's "liberty interest" in abortion is "reasonably designed" to further "legitimate"
state ends). The same motive also apparently underlies the joint opinion's erroneous
citation of the plurality opinion in Ohio v. Akron Center for Reproductive Health,
497 U.S. 502, 506 (1990) (Akron II) (opinion of KENNEDY, J.), as applying the undue
burden test. See ante, at 876 (using this citation to support the proposition that
"two of us" - i.e., two of the authors of the joint opinion - have previously applied
this test). In fact, Akron II does not mention the undue burden standard until the
conclusion of the opinion, when it states that the statute at issue "does not impose
an undue, or otherwise unconstitutional, burden." 497 U.S., at 519 (emphasis added).
I fail to see how anyone can think that saying a statute does not impose an unconstitutional
burden under any standard, including [505 U.S. 833, 987] the undue burden test, amounts
to adopting the undue burden test as the exclusive standard. The Court's citation
of Hodgson as reflecting JUSTICE KENNEDY's and JUSTICE O'CONNOR's "shared premises,"
ante at 878, is similarly inexplicable, since the word "undue" was never even used
in the former's opinion in that case. I joined JUSTICE KENNEDY's opinions in both
Hodgson and Akron II; I should be grateful, I suppose, that the joint opinion does
not claim that I, too, have adopted the undue burden test.
[ Footnote 5 ] Of course, JUSTICE O'CONNOR was correct in her former view. The arbitrariness
of the viability line is confirmed by the Court's inability to offer any justification
for it beyond the conclusory assertion that it is only at that point that the unborn
child's life "can in reason and all fairness" [505 U.S. 833, 990] be thought to override
the interests of the mother. Ante, at 870. Precisely why is it that, at the magical
second when machines currently in use (though not necessarily available to the particular
woman) are able to keep an unborn child alive apart from its mother, the creature
is suddenly able (under our Constitution) to be protected by law, whereas, before
that magical second, it was not? That makes no more sense than according infants legal
protection only after the point when they can feed themselves.
[ Footnote 6 ] The joint opinion is not entirely faithful to this principle, however.
In approving the District Court's factual findings with respect to the spousal notice
provision, it relies extensively on nonrecord materials, and, in reliance upon them,
adds a number of factual conclusions of its own. Ante, at 891-893. Because this additional
factfinding pertains to matters that surely are "subject to reasonable dispute," Fed.Rule
Evid. 201(b), the joint opinion must be operating on the premise that these are "legislative,"
rather than "adjudicative," facts, see Rule 201(a). But if a court can find an undue
burden simply by selectively string-citing the right social science articles, I do
not see the point of emphasizing or requiring "detailed factual findings" in the District
Court.
[ Footnote 7 ] JUSTICE BLACKMUN's effort to preserve as much of Roe as possible leads
him to read the joint opinion as more "constan[t]" and "steadfast" than can be believed.
He contends that the joint opinion's "undue burden" standard requires the application
of strict scrutiny to "all non-de minimis" abortion regulations, ante, at 926, but
that could only be true if a "substantial obstacle," ante, at 877 (joint opinion),
were the same thing as a non-de minimis obstacle - which it plainly is not.