A Utah statute requires a physician to "[n]otify, if possible,"
the parents or guardian of a minor upon whom an abortion is to be
performed. Appellant, while an unmarried minor living with and
dependent on her parents, became pregnant. A physician advised her
that an abortion would be in her best medical interest but, because
of the statute, refused to perform the abortion without first
notifying her parents. Believing that she should proceed with the
abortion without notifying her parents, appellant instituted a suit
in state court seeking a declaration that the statute is
unconstitutional and an injunction against its enforcement. She
sought to represent a class consisting of unmarried minors "who are
suffering unwanted pregnancies and desire to terminate the
pregnancies but may not do so" because of their physicians'
insistence on complying with the statute. The trial court upheld
the statute as not unconstitutionally restricting a minor's right
of privacy to obtain an abortion or to enter into a doctor-patient
relationship. The Utah Supreme Court affirmed.
Held:
1. Since appellant did not allege or offer evidence that either
she or any member of her class is mature or emancipated, she lacks
standing to challenge the Utah statute as being unconstitutional on
its face on the ground of overbreadth in that it could be construed
to apply to all unmarried minor girls, including those who are
mature and emancipated.
Harris v. McRae, 448 U.
S. 297. Moreover, the State is bound by a ruling in
another case that the statute does not apply to emancipated minors,
and the Utah Supreme Court has had no occasion to consider the
statute's application to mature minors. Pp.
450 U. S.
405-407.
2. As applied to an unemancipated minor girl living with and
dependent upon her parents, and making no claim or showing as to
maturity or as to her relations with her parents, the Utah statute
serves important state interests, is narrowly drawn to protect only
those interests, and does not violate any guarantees of the
Constitution. Pp.
450 U. S.
407-413.
(a) Although a state may not constitutionally legislate a
blanket, unreviewable power of parents to veto their daughter's
abortion,
Bellotti v. Baird, 443 U.
S. 622;
Planned Parenthood of Central Mo. v.
Danforth, 428 U. S. 52, a
statute getting out a mere requirement of parental notice when
possible does not violate the constitutional rights of an immature,
dependent minor. Pp.
450 U. S.
407-410.
Page 450 U. S. 399
(b) The Utah statute does not give parents a veto power over the
minor's abortion decision. As applied to immature and dependent
minors, the statute serves important considerations of family
integrity and protecting adolescents, as well as providing an
opportunity for parents to supply essential medical and other
information to the physician. The statute is not unconstitutional
for failing to specify what information parents may furnish to
physicians, or to provide for a mandatory period of delay after the
physician notifies the parents; or because the State allows a
pregnant minor to consent to other medical procedures without
formal notice to her parents if she carries the child to term; or
because the notice requirement may inhibit some minors from seeking
abortions. Pp.
450 U. S.
411-413.
604 P.2d 907,
affirmed.
BURGER, C.J., delivered the opinion of the Court, in which
STEWART, WHITE, POWELL, and REHNQUIST, JJ., joined. POWELL, J.,
filed a concurring opinion, in which STWART, J., joined,
post, p.
450 U. S. 413.
STEVENS, J., filed an opinion concurring in the judgment,
post, p.
450 U. S. 420.
MARSHALL, J., filed a dissenting opinion, in which BRENNAN and
BLACKMUN, JJ., joined,
post, p.
450 U. S.
425.
CHIEF JUSTICE BURGER delivered the opinion of the Court.
The question presented in this case is whether a state statute
which requires a physician to "[n]otify, if possible,"
Page 450 U. S. 400
the parents of a dependent, unmarried minor girl prior to
performing an abortion on the girl violates federal constitutional
guarantees.
I
In the spring of 1978, appellant was an unmarried 15-year-old
girl living with her parents in Utah and dependent on them for her
support. She discovered she was pregnant. She consulted with a
social worker and a physician. The physician advised appellant that
an abortion would be in her best medical interest. However, because
of Utah Code Ann. § 76-7-304 (1978), he refused to perform the
abortion without first notifying appellant's parents.
Section 76-7-304, enacted in 1974, provides:
"To enable the physician to exercise his best medical judgment
[in considering a possible abortion], he shall:"
"(1) Consider all factors relevant to the wellbeing of the woman
upon whom the abortion is to be performed including, but not
limited to,"
"(a) Her physical, emotional and psychological health and
safety,"
"(b) Her age,"
"(c) Her familial situation."
"(2)
Notify, if possible, the parents or guardian of the
woman upon whom the abortion is to be performed, if she is a
minor or the husband of the woman, if she is married."
(Emphasis supplied.) [
Footnote
1]
Page 450 U. S. 401
Violation of this section is a misdemeanor punishable by
imprisonment for not more than one year or a fine of not more than
$1,000. [
Footnote 2]
Appellant believed "for [her] own reasons" that she should
proceed with the abortion without notifying her parents. According
to appellant, the social worker concurred in this decision.
[
Footnote 3] While still in the
first trimester of her pregnancy, appellant instituted this action
in the Third Judicial District Court of Utah. [
Footnote 4] She sought a declaration that §
77-304(2) is unconstitutional and an injunction prohibiting
appellees, the Governor and the Attorney General of Utah, from
enforcing the statute. Appellant sought to represent a class
consisting of unmarried "minor women who are suffering unwanted
pregnancies and desire to terminate the pregnancies but may not do
so" because of their physicians' insistence on complying with
§ 76-7-304(2). The trial judge declined to grant a temporary
restraining order or a preliminary injunction. [
Footnote 5]
The trial judge held a hearing at which appellant was the only
witness. Appellant affirmed the allegations of the complaint by
giving monosyllabic answers to her attorney's
Page 450 U. S. 402
leading questions. [
Footnote
6] However, when the State attempted to cross-examine appellant
about her reasons for not wishing to notify her parents,
appellant's counsel vigorously objected, [
Footnote 7]
Page 450 U. S. 403
insisting that "the specifics of the reasons are really
irrelevant to the Constitutional issue." [
Footnote 8] The only constitutionally permissible
prerequisites for performance of al abortion, he insisted, were the
desire of the girl and the medical
Page 450 U. S. 404
approval of a physician. [
Footnote 9] The trial judge sustained the objection,
tentatively construing the statute to require appellant's physician
to notify her parents "if he is able to physically contact
them."
Thereafter, the trial judge entered findings of fact and
conclusions of law. He concluded that appellant "is an appropriate
representative to represent the class she purports to represent."
[
Footnote 10] He construed
the statute to require notice to appellant's parents "if it is
physically possible." He concluded that § 76-7-304(2) "do[es]
not unconstitutionally restrict the right of privacy of a minor to
obtain an abortion or to enter into a doctor-patient relationship."
[
Footnote 11] Accordingly,
he dismissed the complaint.
On appeal, the Supreme Court of Utah unanimously upheld the
statute.
604 P.2d 907
(1979). Relying on our decisions in
Planned Parenthood of
Central Mo. v. Danforth, 428 U. S. 52
(1976),
Carey v. Population Services International,
431 U. S. 678
(1977), and
Bellotti v. Baird, 443 U.
S. 622 (1979) (
Bellotti II), the court
concluded that the statute serves "significant state interest[s] "
that are present with respect to minors but absent in the case of
adult women.
The court looked first to subsection (1) of § 77-304. This
provision, the court observed, expressly incorporates the factors
we identified in
Doe v. Bolton, 410 U.
S. 179 (1973), as pertinent to exercise of a physician's
best medical judgment in making an abortion decision. In
Doe, we stated:
"We agree with the District Court . . . that the medical
judgment may be exercised in the light of
all factors --
physical, emotional, psychological, familial, and the
woman's
Page 450 U. S. 405
age -- relevant to the wellbeing of the patient. All
these factors may relate to health. This allows the attending
physician the room he needs to make his best medical judgment."
Id. at
410 U. S. 192
(emphasis supplied). Section 76-7-304 (1) of the Utah statute
suggests that the legislature sought to reflect the language of
Doe.
The Utah Supreme Court held that notifying the parents of a
minor seeking an abortion is "substantially and logically related"
to the
Doe factors set out in § 76-7-304 (1) because
parents ordinarily possess information essential to a physician's
exercise of his best medical judgment concerning the child. 604
P.2d at 909-910. The court also concluded that encouraging an
unmarried pregnant minor to seek the advice of her parents in
making the decision of whether to carry her child to term promotes
a significant state interest in supporting the important role of
parents in childrearing.
Id. at 912. The court reasoned
that, since the statute allows no veto power over the minor's
decision, it does not unduly intrude upon a minor's rights.
The Utah Supreme Court also rejected appellant's argument that
the phrase "if possible" in § 76-7-304(2) should be construed
to give the physician discretion whether to notify appellant's
parents. The court concluded that the physician is required to
notify parents
"if, under the circumstances, in the exercise of reasonable
diligence, he can ascertain their identity and location and it is
feasible or practicable to give them notification."
The court added however, that "the time element is an important
factor, for there must be sufficient expedition to provide an
effective opportunity for an abortion." 604 P.2d at 913.
II
Appellant challenges the statute as unconstitutional on its
face. She contends it is overbroad in that it can be construed to
apply to all unmarried minor girls, including those who are mature
and emancipated. We need not reach that question,
Page 450 U. S. 406
since she did not allege or proffer any evidence that either she
or any member of her class is mature or emancipated. [
Footnote 12] The trial court found
that appellant "is unmarried, fifteen years of age, resides at
home, and is a dependent of her parents." That affords an
insufficient basis for a finding that she is either mature or
emancipated. Under
Harris v. McRae, 448 U.
S. 297,
448 U. S. 320
(1980), she therefore lacks "the personal stake in the controversy
needed to confer standing" to advance the overbreadth argument.
There are particularly strong reasons for applying established
rules of standing in this case. The United States District Court
for Utah has held that § 76-7-304(2) does not apply to
emancipated minors and that, if so applied, it would be
unconstitutional.
L. R. v. Hansen, Civil No. C-80078J
(Feb. 8, 1980). Since there was no appeal from that ruling, it is
controlling on the State. We cannot assume that the statute, when
challenged in a proper case, will not be construed also to exempt
demonstrably mature minors. [
Footnote 13]
See Bellotti v. Baird, 428 U.
S. 132,
428 U. S.
146-148 (1976) (
Bellotti I). Nor is there any
reason to assume that a minor in need of emergency treatment will
be treated in any way different from
Page 450 U. S. 407
a similarly situated adult. [
Footnote 14] The Utah Supreme Court has had no occasion
to consider the application of the statute to such situations. In
Bellotti I, supra, we unanimously declined to pass on
constitutional challenges to an abortion regulation statute because
the statute was
"susceptible of a construction by the state judiciary 'which
might avoid in whole or in part the necessity for federal
constitutional adjudication, or at least materially change the
nature of the problem.'"
Id. at
428 U. S. 147,
quoting
Harrison v. NAACP, 360 U.
S. 167,
360 U. S. 177
(1959).
See Kleppe v. New Mexico, 426 U.
S. 529,
426 U. S.
546-547 (1976);
Ashwander v. TVA, 297 U.
S. 288,
297 U. S.
346-347 (1936) (concurring opinion). We reaffirm that
approach, and find it controlling here insofar as appellant
challenges a purported statutory exclusion of mature and
emancipated minors.
The only issue before us, then, is the facial constitutionality
of a statute requiring a physician to give notice to parents, "if
possible," prior to performing an abortion on their minor daughter,
(a) when the girl is living with and dependent upon her parents,
(b) when she is not emancipated by marriage or otherwise, and (c)
when she has made no claim or showing as to her maturity or as to
her relations with her parents.
III
A
Appellant contends the statute violates the right to privacy
recognized in our prior cases with respect to abortions. She
Page 450 U. S. 408
places primary reliance on
Bellotti II, 443 U.S. at
443 U. S. 642,
443 U. S. 655.
In
Danforth, we struck down state statutes that imposed a
requirement of prior written
consent of the patient's
spouse and of a minor patient's parents as a prerequisite for an
abortion. We held that a state
"does not have the constitutional authority to give a third
party an absolute, and possibly arbitrary, veto over the decision
of the physician and his patient to terminate the patient's
pregnancy, regardless of the reason for withholding the
consent."
428 U.S. at
428 U. S. 74. We
emphasized, however,
"that our holding . . . does not suggest that every minor,
regardless of age or maturity, may give effective consent for
termination of her pregnancy."
Id. at
428 U. S. 75,
citing
Bellotti I, supra. There is no logical relationship
between the capacity to become pregnant and the capacity for mature
judgment concerning the wisdom of an abortion.
In
Bellotti II, dealing with a class of concededly
mature pregnant minors, we struck down a Massachusetts statute
requiring parental or judicial consent before an abortion could be
performed on any unmarried minor. There the State's highest court
had construed the statute to allow a court to overrule the minor's
decision even if the court found that the minor was capable of
making, and in fact had made, an informed and reasonable decision
to have an abortion. We held, among other things, that the statute
was unconstitutional for failure to allow mature minors to decide
to undergo abortions without parental consent. Four Justices
concluded that the flaws in the statute were that, as construed by
the state court, (a) it permitted overruling of a mature minor's
decision to abort her pregnancy; and (b)
"it requires parental consultation or notification in every
instance, without affording the pregnant minor an opportunity to
receive an independent judicial determination that she is mature
enough to
Page 450 U. S. 409
consent or that an abortion would be in her best interests."
443 U.S. at
443 U. S. 651.
Four other Justices concluded that the defect was in making the
abortion decision of a minor subject to veto by a third party,
whether parent or judge, "no matter how mature and capable of
informed decisionmaking" the minor might be.
Id. at
443 U. S.
653-656.
Although we have held that a state may not constitutionally
legislate a blanket, unreviewable power of parents to veto their
daughter's abortion, [
Footnote
15] a statute setting out a "mere requirement of parental
notice" does not violate the constitutional rights of an immature,
dependent minor. [
Footnote
16] Four Justices in
Bellotti II joined in
stating:
"[Plaintiffs] suggest . . . that the mere requirement of
parental notice [unduly burdens the right to seek an abortion]. As
stated in Part II above, however, parental notice and consent are
qualifications that typically may be imposed by the State on a
minor's right to make important decisions. As immature minors often
lack the ability to make fully informed choices that take account
of both immediate and long-range consequences, a State reasonably
may determine that parental consultation often is desirable and in
the best interest of the minor. It may further determine, as a
general proposition, that such consultation is particularly
desirable with respect to the abortion decision -- one that for
some people raises profound moral and religious concerns. . .
."
"'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
Page 450 U. S. 410
her parents in making the very important decision whether or not
to bear a child. That is a grave decision, and a girl of tender
years, under emotional stress, may be ill-equipped to make it
without mature advice and emotional support. It seems unlikely that
she will obtain adequate counsel and support from the attending
physician at an abortion clinic, where abortions for pregnant
minors frequently take place.'"
Id. at
443 U. S.
640-641 (footnotes omitted), quoting
Danforth,
428 U.S. at
428 U. S. 91
(concurring opinion).
Accord, 443 U.S. at
443 U. S. 657
(dissenting opinion).
In addition,
"constitutional interpretation has consistently recognized that
the parents' claim to authority in their own household to direct
the rearing of their children is basic in the structure of our
society."
Ginsberg v. New York, 390 U. S. 629,
390 U. S. 639
(1968). In
Quilloin v. Walcott, 434 U.
S. 246 (1978), the Court expanded on this theme:
"We have recognized on numerous occasions that the relationship
between parent and child is constitutionally protected.
See,
e.g., Wisconsin v. Yoder, 406 U. S. 205,
406 U. S.
231-233 (1972);
Stanley v. Illinois,
[
405 U.S.
645 (1972)];
Meyer v. Nebraska, 262 U. S.
390,
262 U. S. 399-401
(1923)."
"It is cardinal with us that the custody, care and nurture of
the child reside first in the parents whose primary function and
freedom include preparation for obligations the state can neither
supply nor hinder."
Id. at
434 U. S. 255,
quoting
Prince v. Massachusetts, 321 U.
S. 158,
321 U. S. 166
(1944).
See also Parham v. J. R., 442 U.
S. 584,
442 U. S. 602
(1979);
Pierce v. Society of Sisters, 268 U.
S. 510,
268 U. S. 535
(1925). We have recognized that parents have an important "guiding
role" to play in the upbringing of their children,
Bellotti II,
supra at
443 U. S.
633-639, which presumptively includes counseling them on
important decisions.
Page 450 U. S. 411
B
The Utah statute gives neither parents nor judges a veto power
over the minor's abortion decision. [
Footnote 17] As in
Bellotti I,
"we are concerned with a statute directed toward minors as to
whom there are unquestionably greater risks of inability to give an
informed consent."
428 U.S. at
428 U. S. 147.
As applied to immature and dependent minors, the statute plainly
serves the important considerations of family integrity [
Footnote 18] and protecting
adolescents [
Footnote 19]
which we identified in
Bellotti II. In addition, as
applied to that class, the statute serves a significant state
interest by providing an opportunity for parents to supply
essential medical and other information to a physician. The
medical, emotional, and psychological consequences of an abortion
are serious, and can be lasting; this is particularly so when the
patient is immature. [
Footnote
20] An adequate medical and psychological case history is
important to the physician. Parents can provide medical and
psychological data, refer the physician to other sources of medical
history, such as family physicians, and authorize family physicians
to give relevant data.
Page 450 U. S. 412
Appellant intimates that the statute's failure to declare, in
terms, a detailed description of what information parents may
provide to physicians, or to provide for a mandatory period of
delay after the physician notifies the parents, [
Footnote 21] renders the statute
unconstitutional. The notion that the statute must itemize
information to be supplied by parents finds no support in logic,
experience, or our decisions. And as the Utah Supreme Court
recognized, 604 P.2d at 913, time is likely to be of the essence in
an abortion decision. The Utah statute is reasonably calculated to
protect minors in appellant's class by enhancing the potential for
parental consultation concerning a decision that has potentially
traumatic and permanent consequences. [
Footnote 22]
Appellant also contends that the constitutionality of the
statute is undermined because Utah allows a pregnant minor to
consent to other medical procedures without formal notice to her
parents if she carries the child to term. [
Footnote 23] But a state's interests in
full-term pregnancies are sufficiently different to justify the
line drawn by the statutes.
Cf. Maher v. Roe, 432 U.
S. 464,
432 U. S.
473-474 (1977). If the pregnant girl elects to carry her
child to term, the
medical decisions to be made entail few
-- perhaps none -- of the potentially grave
Page 450 U. S. 413
emotional and psychological consequences of the decision to
abort.
That the requirement of notice to parents may inhibit some
minors from seeking abortions is not a valid basis to void the
statute as applied to appellant and the class properly before us.
The Constitution does not compel a state to fine-tune its statutes
so as to encourage or facilitate abortions. To the contrary, state
action "encouraging childbirth except in the most urgent
circumstances" is "rationally related to the legitimate
governmental objective of protecting potential life."
Harris v.
McRae, 448 U.S. at
448 U. S. 325.
Accord, Maher v. Roe, supra at
432 U. S.
473-474. [
Footnote
24]
As applied to the class properly before us, the statute plainly
serves important state interests, is narrowly drawn to protect only
those interests, and does not violate any guarantees of the
Constitution. [
Footnote 25]
The judgment of the Supreme Court of Utah is
Affirmed.
[
Footnote 1]
Whether parents of a minor are liable under Utah law for the
expense of an abortion and related aftercare is not disclosed by
the record.
Utah also provides by statute that no abortion may be performed
unless a "voluntary and informed written consent" is first obtained
by the attending physician from the patient. In order for such a
consent to be "voluntary and informed," the patient must be advised
at a minimum about available adoption services, about fetal
development, and about foreseeable complications and risks of an
abortion.
See Utah Code Ann. § 77-305 (1978). In
Planned Parenthood of Central Mo. v. Danforth,
428 U. S. 52,
428 U. S. 65-67
(1976), we rejected a constitutional attack on written consent
provisions.
[
Footnote 2]
Utah Code Ann. §§ 76-7-314(3), 76-3-204(1),
76-3-301(3) (1978).
[
Footnote 3]
Appellant's counsel stated in his jurisdictional statement and
again in his brief that the physician concluded not only that an
abortion would be in appellant's best interests, but also that
parental notification would not be in appellant's best interests.
However, at oral argument, counsel corrected this statement and
conceded that there is no evidence to support this assertion. Tr.
of Oral Arg. 8, 17.
[
Footnote 4]
The record does not reveal whether appellant proceeded with the
abortion.
[
Footnote 5]
The trial judge allowed appellant to proceed without appointment
of a guardian
ad litem. He noted that a guardian would be
required to notify the parents.
[
Footnote 6]
The testimony was as follows:
"BY MR. DOLOWITZ [appellant's counsel]:"
"Q At the time that the Complaint in this matter was signed, you
were pregnant?"
"A Yes."
"Q You had consulted with a counselor about that pregnancy?"
"A Yeah."
"Q You had determined after talking to the counselor that you
felt you should get an abortion?"
"A Yes."
"Q You felt that you did not want to notify your parents --
"
"A Right."
"Q -- of that decision? You did not feel for your own reasons
that you could discuss it with them?"
"A Right."
"Q After discussing the matter with a counselor, you still
believed that you should not discuss it with your parents?"
"A Right."
"Q And they shouldn't be notified?"
"A Right."
"Q After talking the matter over with a counselor, the counselor
concurred in your decision that your parents should not be
notified?"
"A Right."
"Q You were advised that an abortion couldn't be performed
without notifying them?"
"A Yes."
"Q You then came to me to see about filing a suit?"
"A Right."
"Q You and I discussed it as to whether or not you had a right
to do what you wanted to do?"
"A Yes."
"Q You decided that, after our discussion, you should still
proceed with the action to try to obtain an abortion without
notifying your parents?"
"A Right."
"Q Now, at the time that you signed the Complaint and spoke with
the counselor and spoke with me, you were in the first trimester of
pregnancy, within your first twelve weeks of pregnancy?"
"A Yes."
"Q You feel that, from talking to the counselor and thinking the
situation over and discussing it with me, that you could make the
decision on your own that you wished to abort the pregnancy?"
"A Yes."
"Q You are living at home?"
"A Yes."
"Q You still felt, even though you were living at home with your
parents, that you couldn't discuss the matter with them?"
"A Right."
Tr. 7.
[
Footnote 7]
"BY MR. McCARTHY [counsel for the State]:"
"Q . . . Are you still living at home?"
"A Yes."
"Q Are you dependent on your parents?"
"A Yes."
"Q All your money comes from them?"
"A Yes."
"Q How old are you now?"
"A Fifteen."
"Q Aside from the issue of abortion, do you have any reason to
feel that you can't talk to your parents about other problems?"
"A Yes."
"Q What are those reasons?"
"MR. DOLOWITZ: Now you are moving into the problem area that I
indicated. . . ."
Id. at 8.
[
Footnote 8]
Id. at 10. Appellant repeatedly pressed this point
despite the trial court's statements that it could "conceive of a
situation where a child probably wouldn't have to tell the parents"
and that the statute "might be [u]nconstitutional as it relates to
a particular fact situation but [c]onstitutional as it relates to
another fact situation."
Id. at 10, 17.
There is no evidence to support the "surmise" in the dissent,
post at
450 U. S. 438,
n. 24, that "appellant expects family conflict over the abortion
decision."
[
Footnote 9]
Tr. 18.
[
Footnote 10]
The trial judge adopted, verbatim, findings of fact and
conclusions of law prepared by appellant. The findings, the
conclusions, and the opinion of the State Supreme Court make no
mention whatsoever of the precise limits of the class.
[
Footnote 11]
The trial judge also ruled that the statute does not violate 42
U.S.C. § 1983.
[
Footnote 12]
In
Bellotti II, by contrast, the principal class
consisted of
"unmarried [pregnant] minors in Massachusetts
who have
adequate capacity to give a valid and informed consent [to
abortion], and who do not wish to involve their parents."
443 U.S. at
443 U. S. 626
(emphasis supplied). The courts considered the rights of "all
pregnant minors who might be affected" by the statute.
Id.
at
443 U. S. 627,
n. 5.
[
Footnote 13]
The record shows that the State unsuccessfully argued in the
trial court that it should be permitted to inquire into appellant's
degree of maturity. Tr. 11.
JUSTICE STEVENS and the dissent argue that the Utah Supreme
Court held that the statute may validly be applied to all members
of the class described in the complaint.
Post at
450 U. S. 421,
450 U. S. 430,
450 U. S. 431,
450 U. S.
432-433. However, as we have shown, neither of the state
courts mentioned the scope or limits of the class.
See
n 10,
supra.
Moreover, appellant's counsel prepared the findings and
conclusions. In addition to considerations of standing, we construe
the ambiguity against appellant.
[
Footnote 14]
There is no authority for the view expressed in the dissent that
the statute would apply to "minors with emergency health care
needs."
Post at
450 U. S.
450-451. Appellant does not so contend, and the Utah
Supreme Court in this case took pains to say that time is of the
essence in an abortion decision.
604 P.2d 907, 913
(1979). When the specific question was properly posed in
Bellotti II, the Massachusetts statute was construed by
the state court not to apply in such cases. 443 U.S. at
443 U. S.
630.
The same is true for minors with hostile home situations, a
class referred to by appellant's
amici curiae and by the
dissent,
post at
450 U. S.
437-441.
[
Footnote 15]
Bellotti II, 443 U.S. at
443 U. S.
642-643,
443 U. S.
653-656;
Danforth, 428 U.S. at
428 U. S.
74.
[
Footnote 16]
Bellotti II, supra, at
443 U. S. 640,
443 U. S. 649;
id. at
443 U. S. 657
(dissenting opinion);
Danforth, supra at
428 U. S. 90-91
(concurring opinion);
see Bellotti v. Baird, 428 U.
S. 132,
428 U. S. 145,
428 U. S. 147
(1976) (
Bellotti I);
cf. Carey v. Population Services
International, 431 U. S. 678,
431 U. S.
709-710 (1977).
[
Footnote 17]
The main premise of the dissent seems to be that a requirement
of notice to the parents is the functional equivalent of a
requirement of parental consent.
See post at
450 U. S.
437-441. In
Bellotti II, however, we expressly
declined to equate notice requirements with consent requirements.
443 U.S. at
443 U. S. 640,
443 U. S.
657.
[
Footnote 18]
Bellotti II, supra at
443 U. S.
637-639. The short shrift given by the dissent to
"parental authority and family integrity,"
post at
450 U. S. 447,
runs contrary to a long line of constitutional cases in this Court.
See cases cited
supra at
450 U. S.
410.
[
Footnote 19]
Bellotti II, supra at
443 U. S.
634-637.
[
Footnote 20]
Abortion is associated with an increased risk of complication in
subsequent pregnancies. Maine, Does Abortion Affect Later
Pregnancies?, 11 Family Planning Perspectives 98 (1979). The
emotional and psychological effects of the pregnancy and abortion
experience are markedly more severe in girls under 18 than in
adults. Wallerstein, Kurtz, & Bar-Din, Psychosocial Sequelae of
Therapeutic Abortion in Young Unmarried Women, 27
Arch.Gen.Psychiatry 828 (1972);
see also Babikian &
Goldman, A Study in Teen-Age Pregnancy, 128 Am.J.Psychiatry 765
(1971).
[
Footnote 21]
At least five States have enacted parental notification statutes
containing brief mandatory waiting periods.
See
La.Rev.Stat.Ann. § 40:1299.35.5 (West Supp. 1981) (24 hours'
actual notice or 72 hours' constructive notice except for
court-authorized abortions); Mass.Gen.Laws Ann., ch. 112, §
128 (West Supp. 1981) (24 hours); Me.Rev.Stat.Ann., Tit. 22, §
1597 (1980) (24 hours); N.D.Cent.Code § 14-02.1-03 (Supp.
1979) (24 hours); Tenn.Code Ann. § 39-302 (Supp. 1979) (two
days).
[
Footnote 22]
Members of the particular class now before us in this case have
no constitutional right to notify a court in lieu of notifying
their parents.
See Bellotti II, supra at
443 U. S. 647.
This case does not require us to decide in what circumstances a
state must provide alternatives to parental notification .
[
Footnote 23]
See Utah Code Ann. § 78-14-5(4)(f) (1977)
(permitting any female to give informed consent "to any health care
not prohibited by law . . . in connection with her pregnancy or
childbirth").
[
Footnote 24]
See also Bellotti II, 443 U.S. at
443 U. S.
643-644;
Bellotti I, 428 U.S. at
428 U. S.
148-149;
Danforth, 428 U.S. at
428 U. S. 65-67,
428 U. S. 79-81;
Connecticut v. Menillo, 423 U. S. 9,
423 U. S. 11
(1975);
West Side Women's Services, Inc. v. City of
Cleveland, 450 F.
Supp. 796, 798 (ND Ohio),
affirmance order, 582 F.2d
1281 (CA6),
cert. denied, 439 U.S. 983 (1978).
[
Footnote 25]
Appellant argues that the statute violates her right to secure
necessary treatment from a physician who, in the exercise of his
best medical judgment, does not believe the parents should be
notified. Since there is no evidence that the physician had such an
opinion, we decline to reach this question.
See supra at
450 U. S. 401,
n. 3, and
450 U. S.
405-407.
The dissenting opinion purports to see in the Court's opinion "a
clear signal" as to how the Court will decide a future case
concerning this or a similar statute, and goes on to forecast a
successful challenge on the merits. Today, of course, the Court's
function is to decide only the question properly presented in this
case, and there is no occasion to intimate or predict a view as to
the proper resolution of some future case. Speaking for the
unanimous Court in
Kleppe v. New Mexico, 426 U.
S. 529 (1976), JUSTICE MARSHALL took note of the
impropriety of deciding constitutional questions "in the absence of
an adequate and full-bodied record.'" Id. at
426 U. S. 546,
quoting Public Affairs Associates, Inc. v. Rickover,
369 U. S. 111,
369 U. S. 113
(1962).
JUSTICE POWELL, with whom JUSTICE STEWART joins, concurring.
I
This case requires the Court to consider again the divisive
questions raised by a state statute intended to encourage
Page 450 U. S. 414
parental involvement in the decision of a pregnant minor to have
an abortion.
See Planned Parenthood of Central Mo. v.
Danforth, 428 U. S. 52
(1976);
Bellotti v. Baird, 443 U.
S. 622 (1979) (
Bellotti II). I agree with the
Court that Utah Code Ann. § 76-7-304(2) (1978) does not
unconstitutionally burden this appellant's right to an abortion. I
join the opinion of the Court on the understanding that it leaves
open the question whether § 76-7-304(2) unconstitutionally
burdens the right of a mature minor or a minor whose best interests
would not be served by parental notification.
See ante at
450 U. S. 412,
n. 22. I write to make clear that I continue to entertain the views
on this question stated in my opinion in
Bellotti II.
See 450
U.S. 398fn2/8|>n. 8,
infra.
II
Section 76-7-304(2) requires that a physician "[n]otify, if
possible, the parents or guardian of the woman upon whom the
abortion is to be performed, if she is a minor." [
Footnote 2/1] Appellant attacks this notice
requirement on the ground that it burdens the right of a minor who
is emancipated, or who is mature enough to make the abortion
decision independently of parental involvement, or whose parents
will react obstructively upon notice.
See ante at
450 U. S. 405.
The threshold question, as the Court's opinion notes, is whether
appellant has standing to make such a challenge. Standing depends
initially on what the complaint alleges,
Warth v. Seldin,
422 U. S. 490,
422 U. S. 498,
422 U. S. 501
(1975), as courts have the power "only to redress or otherwise to
protect against injury to the complaining party."
Page 450 U. S. 415
Id. at
422 U. S. 499.
The complaint in this case was carefully drawn. Appellant's
allegations about herself and her familial situation are few and
laconic. She alleged that she did "not wish to inform her parents
of her condition, and believe[d] that it [was] in her best interest
that her parents not be informed of her condition." Complaint
� 6. She also alleged that she understood "what is involved
in her decision," � 9, and that the physician she consulted
had told her that "he could not and would not perform an abortion
upon her without informing her parents prior to aborting her."
� 7.
Appellant was 15 years of age, and lived at home with her
parents when she filed her complaint. She did not claim to be
mature, and made no allegations with respect to her relationship
with her parents. She did not aver that they would be obstructive
if notified, or advance any other reason why notice to her parents
would not be in her best interest. Similarly, the complaint
contains no allegation that the physician -- while apparently
willing to perform the abortion -- believed that notifying her
parents would have adverse consequences. In fact, nothing in the
record shows that the physician had any information about
appellant's parents or familial situation, or even that he had
examined appellant.
A
This case does not come to us on the allegations of the
complaint alone. An evidentiary hearing occurred after the trial
court had denied appellant's motion for a preliminary injunction.
Appellant was the only witness, and her testimony -- and statements
by her counsel -- make clear beyond any question that the "bare
bones" averments of the complaint were deliberate, and that
appellant is arguing that a mere notice requirement is invalid
per se, without regard to the minor's age, whether she is
emancipated, whether her parents are likely to be obstructive, or
whether there is some health or other reason why notification would
not be in the minor's best interests.
Page 450 U. S. 416
On direct examination, appellant merely verified the allegations
of her complaint by affirming each allegation as paraphrased for
her by her lawyer in a series of leading questions. [
Footnote 2/2] Her testimony on
cross-examination added nothing to the complaint. [
Footnote 2/3] In addition, appellant's lawyer
insistently objected to all questions by counsel for the State as
to the appellant's reasons for not wishing to notify her parents.
[
Footnote 2/4] The trial court, on
its own initiative, pressed unsuccessfully to elicit some reasons,
inquiring how it could "find out the validity of [appellant's]
reasons without [the State's lawyer] being permitted to
cross-examine her." Tr. 9. Appellant's lawyer replied:
"It is our position [c]onstitutionally that she has the right to
make [the abortion] decision and if she has consulted with a
counselor and the counselor concurs that those are valid reasons,
why then --"
"
* * * *"
"In terms of going beyond [the complaint allegations], our point
is that the specifics of
the reasons are really irrelevant to
the [c]onstitutional issue."
Id. at 9-10 (emphasis supplied).
Page 450 U. S. 417
When appellant's lawyer insisted that the facts with respect to
this particular minor were irrelevant, the trial court sustained
the validity of the statute. [
Footnote
2/5]
In sum, and as the Court's opinion emphasizes, appellant alleges
nothing more than that she desires an abortion, that she has
decided -- for reasons which she declined to reveal -- that it is
in her best interest not to notify her parents, and that a
physician would be willing to perform the abortion if notice were
not required. Although the trial court did not rule in terms of
standing, it is clear that these bald allegations do not confer
standing to claim that § 76-7-304(2) unconstitutionally
burdens the right either of a mature minor or of a minor whose best
interests would not be served by parental notification. [
Footnote 2/6] They confer standing only to
claim that § 767-304(2) is an unconstitutional burden upon an
unemancipated
Page 450 U. S. 418
minor who desires an abortion without parental notification, but
also desires not to explain to anyone her reasons either for
wanting the abortion or for not wanting to notify her parents.
[
Footnote 2/7]
B
On the facts of this case, I agree with the Court that §
767-304(2) is not an unconstitutional burden on appellant's right
to an abortion. Numerous and significant interests compete when a
minor decides whether or not to abort her
Page 450 U. S. 419
pregnancy. The right to make that decision may not be
unconstitutionally burdened.
Roe v. Wade, 410 U.
S. 113,
410 U. S. 154
(1973);
Planned Parenthood of Central Mo. v. Danforth, 428
U.S. at
428 U. S. 74-75.
In addition, the minor has an interest in effectuating her decision
to abort, if that is the decision she makes.
Id. at
428 U. S. 75;
Bellotti II, 443 U.S. at
443 U. S. 647.
The State, aside from the interest it has in encouraging
childbirth, rather than abortion,
cf. Maher v. Roe,
432 U. S. 464
(1977);
Harris v. McRae, 448 U. S. 297
(1980), has an interest in fostering such consultation as will
assist the minor in making her decision as wisely as possible.
Planned Parenthood of Central Mo. v. Danforth, supra at
428 U. S. 91
(STEWART, J., concurring);
post at
450 U. S.
422-423 (STEVENS, J., concurring in judgment). The State
also may have an interest in the family itself, the institution
through which "we inculcate and pass down many of our most
cherished values, moral and cultural."
Moore v. East
Cleveland, 431 U. S. 494,
431 U. S.
503-504 (1977). Parents have a traditional and
substantial interest in, as well as a responsibility for, the
rearing and welfare of their children, especially during immature
years.
Bellotti II, supra at
443 U. S.
637-639.
None of these interests is absolute. Even an adult woman's right
to an abortion is not unqualified.
Roe v. Wade, supra, at
410 U. S. 154.
Particularly when a minor becomes pregnant and considers an
abortion, the relevant circumstances may vary widely depending upon
her age, maturity, mental and physical condition, the stability of
her home if she is not emancipated, her relationship with her
parents, and the like. If we were to accept appellant's claim that
§ 77-304(2) is
per se an invalid burden on the
asserted right of a minor to make the abortion decision, the
circumstances which normally are relevant would -- as her counsel
insisted -- be immaterial.
Supra at
450 U. S. 417.
The Court would have to decide that the minor's wishes are
virtually absolute. To be sure, our cases have emphasized the
necessity to consult a physician. But we have never held with
respect to a minor that the opinion
Page 450 U. S. 420
of a single physician as to the need or desirability of an
abortion outweighs all state and parental interests. [
Footnote 2/8]
In sum, a State may not validly require notice to parents in all
cases, without providing an independent decisionmaker to whom a
pregnant minor can have recourse if she believes that she is mature
enough to make the abortion decision independently or that
notification otherwise would not be in her best interests. My
opinion in
Bellotti II, joined by three other Justices,
stated at some length the reasons why such a decisionmaker is
needed.
Bellotti II, supra at
443 U. S.
642-648. [
Footnote 2/9]
The circumstances relevant to the abortion decision by a minor can
and do vary so substantially that absolute rules -- requiring
parental notice in all cases or in none [
Footnote 2/10] -- would create an inflexibility that
often would allow for no consideration of the rights and interests
identified above. Our cases have never gone to this extreme, and,
in my view, should not.
[
Footnote 2/1]
Section 76-7-304 is quoted in full in the Court's opinion.
Ante at
450 U. S.
400.
[
Footnote 2/2]
Appellant's testimony on direct examination is quoted in full in
the Court's opinion.
Ante at
450 U. S.
402-403, n. 6.
[
Footnote 2/3]
Appellant's testimony on cross-examination is quoted in full in
the Court's opinion.
Ante at
450 U. S. 403,
n. 7.
[
Footnote 2/4]
After his direct examination of appellant and the State's brief
cross-examination, appellant's lawyer insisted repeatedly during
subsequent argument that "there is no relevancy to any other
facts," Tr. 17; that "the particular facts that come before a
[minor's doctor], are irrelevant,"
id. at 18; and that
"[t]he specific facts of any individual case, no matter how
ridiculous they are or how strong or weak they are, really become
irrelevant,"
ibid. In summarizing his position,
appellant's lawyer stated:
"Our position is that it is the doctor/patient relationship that
is the key. If the doctor determines he should go ahead with the
patient, then he should. The specific facts in any case, whether
[the doctor] is wrong or right, are [c]onstitutionally protected to
make that decision and go ahead and act on it. This is why I say it
is irrelevant."
Ibid.
[
Footnote 2/5]
At the end of the evidentiary hearing, appellant's lawyer framed
the trial court's ruling as follows:
"If your ruling is that 'if possible' [as used in the statute
means 'physically possible'], and there are no circumstances
whatever that justify the violation of the statute, then the issue
is closed."
Id. at 19.
[
Footnote 2/6]
Because this case is a class action, it might be presumed that
other members could raise the question whether a pregnant minor has
a right to abortion, without parental notice, upon a showing that
she is mature or that her parents will interfere with her abortion.
But the record in this case contains no facts to support a
presumption that the class includes such members. The only
complaint allegations about the class are that appellant's claims
"are typical of the claims of all members of the class," and that
the class consists of
"minor women who are suffering unwanted pregnancies and desire
to terminate the pregnancies but may not do so inasmuch as their
physicians will not perform an abortion upon them without
compliance with the provisions of Section 77-304(2)."
Complaint � 10. Thus, the record supports only the
conclusion that the class consists entirely of pregnant minors who
assert the identical claim that appellant presents: a
constitutional right to an abortion without notifying their
parents, and without claiming to be mature or that notification
would not be in their best interest. In short, the class members --
like appellant -- assert an absolute right to make this decision
themselves, independently of everyone except a physician.
[
Footnote 2/7]
The trial court entered findings of fact and conclusions of law
after the evidentiary hearing. Paragraph 7 of the trial court's
findings reads:
"The plaintiff consulted with a counselor to assist her in
deciding whether or not she should terminate her pregnancy. She
determined, after consultation with her counselor, that she should
secure an abortion, but was advised when consulting her physician
that, under the provisions of Section 76-7-304(2), Utah Code
Annotated, 1953, that he believed along with her that she should be
aborted and that he felt it was in her best medical interest to do
so, but he could not and would not perform an abortion upon her
without informing her parents prior to aborting her, because it was
required of him by that statute and he was unwilling to perform an
abortion upon her without complying with the provisions of the
statute even though he believed it was best to do so."
Civil No. C-78-2719 (Dec. 26, 1978).
Precisely what this paragraph finds is ambiguous. At the least,
it finds that appellant "consulted" a physician, and that the
physician agreed with appellant that an abortion would be in
appellant's best medical interest. The final portion of the finding
-- "he was unwilling to perform an abortion upon her without
complying with the provisions of the statute even though he
believed it was best to do so" -- could be rend to find that the
physician also agreed with appellant that "it was best" to "perform
an abortion upon her without complying with the provisio[n] "
requiring parental notice. Or, the final portion could be read to
find only that the physician would not perform an abortion without
complying with the statute, even though he believed that "it was
best" to abort appellant's pregnancy. In light of appellant's
limited allegations and testimony, and the legal argument of her
lawyer, the trial court's finding cannot be read as saying that the
physician determined that appellant's parents would react hostilely
or obstructively to notice of appellant's abortion decision.
[
Footnote 2/8]
While the medical judgment of a physician, of course, is to be
respected, there is no reason to believe as a general proposition
that even the most conscientious physician's interest in the
overall welfare of a minor can be equated with that of most
parents. Moreover, abortion clinics, now readily available in most
urban communities, may be operated on a commercial basis where
abortions often may be obtained "on demand."
See Planned
Parenthood of Central Mo. v. Danforth, 428 U. S.
52,
428 U. S. 91-92,
n. 2 (1976) (STEWART, J., concurring);
Bellotti II, 443
U.S. at
450 U. S. 641,
n. 21.
[
Footnote 2/9]
Although
Bellotti II involved a statute requiring
parental consent, the rationale of the plurality opinion with
respect to this need is applicable here.
[
Footnote 2/10]
The dissenting opinion of JUSTICE MARSHALL, which would hold the
Utah statute invalid on its face, elevates the decision of the
minor and her physician to an absolute status ignoring state and
parental interests.
JUSTICE STEVENS, concurring in the judgment.
As the Court points out, this is a class action in which the
appellant represents all unmarried
"'minor women who are suffering unwanted pregnancies and desire
to terminate the pregnancies, but may not do so' because of their
physicians' insistence on complying with § 77-304(2)"
of the Utah
Page 450 U. S. 421
Code.
Ante at
450 U. S. 401.
The Utah Supreme Court held that the statute may validly be applied
to all members of that class. This appeal therefore squarely
present the question whether that holding is consistent with the
Constitution of the United States. The Court, however, declines to
reach this question, and instead decides the narrower question
presented by the appellant's particular factual situation. Because
I believe we have a duty to answer the broader question decided by
the Utah Supreme Court, I am unable to join the opinion of the
Court.
In
Planned Parenthood of Central Mo. v. Danforth,
428 U. S. 52,
428 U. S. 72-75
(1976), the Court held that a pregnant minor's right to make the
decision to obtain an abortion may not be conditioned on parental
consent. My dissent from that holding,
id. at
428 U. S.
102-105, does not qualify my duty to respect it as a
part of our law.
See Bellotti v. Baird, 443 U.
S. 622,
443 U. S.
652-656 (1979) (STEVENS, J., concurring in judgment).
However, as I noted in
Bellotti, neither that case nor
Danforth
"determines the constitutionality of a statute which does no
more than require notice to the parents, without affording them or
any other third party an absolute veto."
443 U.S. at
443 U. S. 654,
n. 1. Since the outcome in this case is not controlled by
Danforth, the principles that I considered dispositive of
the parental consent issue in that case plainly dictate that the
Utah statute now before us be upheld.
The fact that a state statute may have some impact upon a
minor's exercise of his or her rights begins, rather than ends, the
constitutional inquiry. Once the statute's impact is identified, it
must be evaluated in light of the state interests underlying the
statute. The state interest that the Utah statute at issue in this
case attempts to advance is essentially the same state interest
considered in
Danforth. As I noted in
Danforth,
that interest is fundamental and substantial:
"The State's interest in the welfare of its young citizens
justifies a variety of protective measures. Because he
Page 450 U. S. 422
may not foresee the consequences of his decision, a minor may
not make an enforceable bargain. He may not lawfully work or travel
where he pleases, or even attend exhibitions of constitutionally
protected adult motion pictures. Persons below a certain age may
not marry without parental consent. Indeed, such consent is
essential even when the young woman is already pregnant. The
State's interest in protecting a young person from harm justifies
the imposition of restraints on his or her freedom even though
comparable restraints on adults would be constitutionally
impermissible. Therefore, the holding in
Roe v.
Wade [
410 U.S.
113 (1973)] that the abortion decision is entitled to
constitutional protection merely emphasizes the importance of the
decision; it does not lead to the conclusion that the state
legislature has no power to enact legislation for the purpose of
protecting a young pregnant woman from the consequences of an
incorrect decision."
"The abortion decision is, of course, more important than the
decision to attend or to avoid an adult motion picture, or the
decision to work long hours in a factory. It is not necessarily any
more important than the decision to run away from home or the
decision to marry. But even if it is the most important kind of a
decision a young person may ever make, that assumption merely
enhances the quality of the State's interest in maximizing the
probability that the decision be made correctly and with full
understanding of the consequences of either alternative."
428 U.S. at
428 U. S.
102-103.
In my opinion, the special importance of a young woman's
abortion decision, emphasized by JUSTICE MARSHALL in dissent,
post at
450 U. S.
435-436, provides a special justification for reasonable
state efforts intended to ensure that the decision be wisely made.
Such reasonable efforts surely may include a requirement that an
abortion be procured only after consultation
Page 450 U. S. 423
with a licensed physician. And, because "the most significant
consequences of the [abortion] decision are not medical in
character," 428 U.S. at
428 U. S. 103,
the State unquestionably has an interest in ensuring that a young
woman receive other appropriate consultation as well. In my
opinion, the quality of that interest is plainly sufficient to
support a state legislature's determination that such appropriate
consultation should include parental advice.
Of course, a conclusion that the Utah statute is invalid would
not prevent young pregnant women from voluntarily seeking the
advice of their parents prior to making the abortion decision. But
the State may legitimately decide that such consultation should be
made more probable by ensuring that parents are informed of their
daughter's decision:
"If there is no parental [notice] requirement, many minors will
submit to the abortion procedure without ever informing their
parents. An assumption that the parental reaction will be hostile,
disparaging, or violent no doubt persuades many children simply to
bypass parental counsel which would, in fact, be loving,
supportive, and, indeed, for some, indispensable. It is
unrealistic, in my judgment, to assume that every parent-child
relationship is either (a) so perfect that communication and accord
will take place routinely or (b) so imperfect that the absence of
communication reflects the child's correct prediction that the
parent will . . . [act] arbitrarily to further a selfish interest,
rather than the child's interest. A state legislature may conclude
that most parents will be primarily interested in the welfare of
their children [
Footnote 3/1] and
further, that the imposition
Page 450 U. S. 424
of a parental [notice] requirement is an appropriate method of
giving the parents an opportunity to foster that welfare by helping
a pregnant distressed child to make and to implement a correct
decision."
Id. at
428 U. S.
103-104 (STEVENS, J.).
Utah's interest in its parental notice statute is not diminished
by the fact that there can be no guarantee that meaningful
parent-child consultation will actually occur. Good faith
compliance with the statute's requirements would tend to facilitate
communication between daughters and parents regarding the abortion
decision. The possibility that some parents will not react with
compassion and understanding upon being informed of their
daughter's predicament, or that, even if they are receptive, they
will incorrectly advise her, does not undercut the legitimacy of
the State's attempt to establish a procedure that will enhance the
probability that a pregnant young woman exercise as wisely as
possible her right to make the abortion decision.
The fact that certain members of the class of unmarried "minor
women who are suffering unwanted pregnancies and desire to
terminate the pregnancies" may actually be emancipated or
sufficiently mature to make a well reasoned abortion
Page 450 U. S. 425
decision does not, in my view, undercut the validity of the Utah
statute. As I stated in
Danforth, a state legislature has
constitutional power to utilize, for purposes of implementing a
parental notice requirement, a yardstick based upon the
chronological age of unmarried pregnant women. That this yardstick
will be imprecise or even unjust in particular cases does not
render its use by a state legislature impermissible under the
Federal Constitution. 428 U.S. at
428 U. S.
104-105. Accordingly, I would reach the question
reserved by the Court, and hold that the Utah parental notice
statute is constitutionally valid as applied to all members of the
certified class. [
Footnote 3/2]
Because my view in this case, as in
Danforth, is that
the State's interest in protecting a young pregnant woman from the
consequences of an incorrect abortion decision is sufficient to
justify the parental notice requirement, I agree that the decision
of the Utah Supreme Court should be affirmed.
[
Footnote 3/1]
My conclusion, in this case and in
Danforth, that a
state legislature may rationally decide that most parents will,
when informed of their daughter's pregnancy, act with her welfare
in mind is consistent with the "pages of human experience that
teach that parents generally do act in the child's best interests"
relied upon by the Court in
Parham v. J. R., 442 U.
S. 584,
442 U. S.
602-603 (1979). It is also consistent with JUSTICE
BRENNAN's opinion in
Parham, which I joined.
Id.
at
442 U.S. 625-639.
As the Court noted in
Parham, the presumption that
parents act in the best interests of their children may be rebutted
by "experience and reality."
Id. at
442 U. S.
602-603. In my opinion, nothing in the fact that a minor
child has become pregnant, and therefore may be confronted with the
abortion decision, undercuts the general validity of the
presumption. However, when parents decide to surrender custody of
their child to a mental hospital, and thereby destroy the ongoing
family relationship, that very decision raises an inference that
parental authority is not being exercised in the child's best
interests.
See id. at
442
U.S. 631-632 (BRENNAN, J., dissenting in part). Accordingly,
while the abortion decision and the commitment decision are of
comparable gravity, reliance upon the "pages of human experience"
is, in my judgment, more appropriate in the former case than in the
latter.
[
Footnote 3/2]
The Court's unwillingness to decide whether the Utah statute may
constitutionally be applied to the entire class certified by the
state courts presumably rests on the assumption that requiring
notice to the parents of a mature or emancipated minor might
prevent such a minor from obtaining an abortion.
See ante
at
450 U. S. 406.
Almost by definition, however, a woman intellectually and
emotionally capable of making important decisions without parental
assistance also should be capable of ignoring any parental
disapproval. Furthermore, if every minor with the wisdom of an
adult has a constitutional right to be treated as an adult, a
uniform minimum voting age is surely suspect. Instead of simply
enforcing general rules promulgated by the legislature, perhaps the
judiciary should grant hearings to all young persons desirous of
establishing their status as mature, emancipated minors instead of
confining that privilege to unmarried pregnant young women.
JUSTICE MARSHALL, with whom JUSTICE BRENNAN and JUSTICE BLACKMUN
join, dissenting.
The decision of the Court is narrow. It finds shortcomings in
appellant's complaint, and therefore denies relief. Thus, the Court
sends out a clear signal that more carefully drafted pleadings
could secure both a plaintiff's standing to
Page 450 U. S. 426
challenge the overbreadth of Utah Code Ann. § 76-7-304(2)
(1978), and success on the merits. [
Footnote 4/1]
Nonetheless, I dissent. I believe that, even if the complaint is
defective, the majority's legal analysis is incorrect and it yields
an improper disposition here. More important, I cannot agree with
the majority's view of the complaint, or its standing analysis. I
therefore would reverse the judgment of the Supreme Court of
Utah.
I
The Court finds appellant's complaint defective because it fails
to allege that she is mature or emancipated, and neglects to
specify her reasons for wishing to avoid notifying her parents
about her abortion decision. As a result, the Court reason,
Page 450 U. S. 427
appellant lacks standing to challenge the overbreadth of the
Utah parental notification statute. [
Footnote 4/2]
The majority's standing analysis rests on prudential
concerns
Page 450 U. S. 428
and not on the constitutional limitations set by Art. III.
See Gladstone, Realtors v. Village of Bellwood,
441 U. S. 91,
441 U. S. 99-100
(1979);
Warth v. Seldin, 422 U. S. 490,
422 U. S.
498-499,
422 U. S.
517-518 (1975). For the Court does not question that
appellant's injury due to the statute's requirement falls within
the legally protected ambit of her privacy interest, and that the
relief requested would remedy the harm.
See ante at
450 U. S.
407-409 (majority opinion);
ante at
450 U. S. 418
419 (opinion of POWELL, J.). The Court decides only that appellant
cannot challenge the blanket nature of the statute, because she
neglected to allege that, by her personal characteristics, she is a
member of particular groups that undoubtedly deserve exemption from
a parental notice requirement. [
Footnote 4/3] Thus, the Court seems to apply the
familiar prudential principle that an individual should not be
heard to raise the rights of other persons. This principle, of
course, has not precluded standing in other instances where, as
here, the party has established the requisite and legally protected
interest capable of
Page 450 U. S. 429
redress through the relief requested. [
Footnote 4/4]
See, e.g., Duke Power Co. v. Carolina
Environmental Study Group, 438 U. S. 59,
438 U. S. 80-81
(1978);
Singleton v. Wulff, 428 U.
S. 106,
428 U. S.
113-118 (1976) (plurality opinion of BLACKMUN, J.);
Doe v. Bolton, 410 U. S. 179,
410 U. S.
188-189 (1973);
Griswold v. Connecticut,
381 U. S. 479,
381 U. S. 481
(1965);
NAACP v. Alabama ex rel. Patterson, 357 U.
S. 449,
357 U. S.
459-460 (1958);
Barrows v. Jackson,
346 U. S. 249,
346 U. S. 259
(1953).
I do not believe that prudential considerations should bar
standing here, for I am persuaded that appellant's complaint
establishes a claim that notifying her parents would not be in her
best interests. [
Footnote 4/5] She
alleged that she "believes that it is in her best interest that her
parents not be informed of her [pregnant] condition," Complaint
� 6, APP. 4, and that, after consulting with her physician,
attorney, and social worker, "she understands what is involved in
her decision" to seek an abortion, Complaint � 9, App. 4.
[
Footnote 4/6] This claim was
further
Page 450 U. S. 430
supported, albeit without detail, at the evidentiary hearing.
There appellant testified she did not feel she could discuss the
abortion decision with her parents even after she consulted a
social worker on the issue. Tr. 8, App. 26. [
Footnote 4/7] In my judgment, appellant has adequately
asserted that she has persistently held reasons for believing
parental notice would not be in her best interests. This provides a
sufficient basis for standing to raise the challenge in her
complaint. Appellant seeks to challenge a state statute, construed
definitively by the highest court of that State to permit no
exception to the notice requirement on the basis of any reasons
offered by the minor.
604 P.2d 907, 913
(Utah 1979). As standing is a jurisdictional issue, separate and
distinct from the merits, a court need not evaluate the
persuasiveness of her reasons for opposing parental notice to
conclude that appellant has a concrete interest in determining
whether the parental notice statute is valid. [
Footnote 4/8]
Page 450 U. S. 431
Yet even if the Court's view of appellant's complaint is
correct, and even if prudence calls for denying her standing to
raise the overbreadth claim, the Court erroneously concludes that
the class represented by appellant suffers the identical standing
disability. In so doing, the Court is apparently indifferent to the
federalism or comity issues arising when this Court presumes to
supervise the procedural determinations made by a state trial court
under state law. Even if application of federal law governing class
actions were appropriate in this case, the majority misapplies
federal law by disturbing the class definition as approved by the
trial court. The Court acknowledges,
ante at
450 U. S. 401,
450 U. S. 404
(BURGER, C.J.);
ante at
450 U. S. 417,
n. 6 (POWELL, J.), that the trial court granted appellant's motion
to represent a class, and it is undisputed that this class includes
all
"minor women who are suffering unwanted pregnancies and desire
to terminate the pregnancies but may not do so inasmuch as their
physicians will not perform an abortion upon them without
compliance with the provisions of Section 77-304(2)."
Complaint � 10, App. 5. This class, by definition,
includes all minor women, self-supporting or dependent,
sophisticated or naive, as long as the Utah statute interferes with
the ability of these women to decide with their physicians to
obtain abortions. If the Court is correct that appellant cannot
raise challenges based on the interest of emancipated or mature
minors, or others whose best interests call for avoiding parental
notification, the proper disposition under federal law would be a
remand. This remand would protect such class members by permitting
the trial court to determine whether appellant is a proper and
adequate class representative, and whether her claims are
sufficiently similar to the class to warrant the class action.
[
Footnote 4/9]
Page 450 U. S. 432
Since the trial court enjoys considerable latitude in approving
class actions, such a remand is appropriate only on those rare
occasions where the reviewing, court discerns an abuse of
discretion. [
Footnote 4/10] But
where an abuse of discretion is clear from the record, remand
should ensue, and could result in redefinition or dismissal of the
class, addition of other named plaintiffs to represent interests
appellant cannot advance, or creation of subclasses with additional
representative parties. [
Footnote
4/11] In contrast, it is improper to assume appellant
�450 U.S. 4 33� adequately represents the entire
class as defined by the trial court, but redefine the class
appellant is deemed to represent, and deny relief on that basis.
[
Footnote 4/12] Nonetheless, that
is exactly the course selected by the majority today.
I instead assume that appellant adequately represents the class
which the trial judge concluded she represents -- all minor women
seeking an abortion but finding the parental notice requirement an
obstacle. I then would find that their rights and interests can be
raised here by appellant in support of a facial challenge to the
Utah statute, and conduct the appropriate review of appellant's
claims.
Page 450 U. S. 434
II
Because the Court's treatment is so cursory, I review
appellant's claims with due attention to our precedents.
Our cases have established that a pregnant woman has a
fundamental right to choose whether to obtain an abortion or carry
the pregnancy to term.
Roe v. Wade, 410 U.
S. 113 (1973);
Doe v. Bolton, 410 U.
S. 179 (1973). [
Footnote
4/13] Her choice, like the deeply intimate decisions to marry,
[
Footnote 4/14] to procreate,
[
Footnote 4/15] and to use
contraceptives, [
Footnote 4/16]
is guarded from unwarranted state intervention by the right to
privacy. [
Footnote 4/17] Grounded
in the Due Process Clause of the Fourteenth Amendment, the right to
privacy [
Footnote 4/18] protects
both the woman's "interest in independence in making certain kinds
of important decisions"
Page 450 U. S. 435
and her "individual interest in avoiding disclosure of personal
matters."
Whalen v. Roe, 429 U. S. 589,
429 U. S.
599-600 (1977).
In the abortion context, we have held that the right to privacy
shields the woman from undue state intrusion in, and external
scrutiny of, her very personal choice. Thus, in
Roe v. Wade,
supra at
410 U. S. 164,
we held that, during the first trimester of the pregnancy, the
State's interest in protecting maternal health or the potential
life of the fetus could not override the right of the pregnant
woman and the attending physician to make the abortion decision
through private, unfettered consultation. We further emphasized the
restricted scope of permissible state action in this area when, in
Doe v. Bolton, supra, at
410 U. S.
198-200, we struck down state-imposed procedural
requirement that subjected the woman's private decision with her
physician to review by other physicians and a hospital
committee.
It is also settled that the right to privacy, like many
constitutional rights, [
Footnote
4/19] extends to minors.
Planned
Parenthood
Page 450 U. S. 436
of Central Mo. v. Danforth, 428 U. S.
52 (1976);
Bellotti v. Baird, 443 U.
S. 622,
443 U. S. 639
(1979) (
Bellotti II) (POWELL, J.);
id. at
443 U. S. 653
(STEVENS, J.);
T. H. v. Jones, 425 F.
Supp. 873, 881 (Utah 1975),
summarily aff'd on other
grounds, 425 U.S. 986 (1976). Indeed, because an unwanted
pregnancy is probably more of a crisis for a minor than for an
adult, as the abortion decision cannot be postponed until her
majority, "there are few situations in which denying a minor the
right to make an important decision will have consequences so grave
and indelible."
Bellotti II, supra at
443 U. S. 646
(POWELL, J.). [
Footnote 4/20]
Thus, for both the adult and the minor woman, state-imposed burdens
on the abortion decision can be justified only upon a showing that
the restrictions advance "important state interests."
Roe v.
Wade, 410 U.S. at
410 U. S. 154;
accord, Planned Parenthood of Central Mo. v. Danforth,
supra at
428 U. S. 61.
Before examining the state interests asserted here, it is necessary
first to consider Utah's claim that its statute does not "imping[e]
on a woman's decision to have an abortion" or "placr[e] obstacles
in the path of effectuating such a decision." Brief for Appellees
9. This requires an examination of whether the parental notice
requirement of the Utah statute imposes any burden on the abortion
decision.
The ideal of a supportive family so pervades our culture that it
may seem incongruous to examine "burdens" imposed by a statute
requiring parental notice of a minor daughter's
Page 450 U. S. 437
decision to terminate her pregnancy. [
Footnote 4/21] This Court has long deferred to the
bonds which join family members for mutual sustenance.
See
Pierce v. Society of Sisters, 268 U.
S. 510,
268 U. S.
534-535 (1925);
May v. Anderson, 345 U.
S. 528,
345 U. S. 533
(1953);
Griswold v. Connecticut, 381 U.S. at
381 U. S. 486;
Stanley v. Illinois, 405 U. S. 645,
405 U. S. 651
(1972);
Moore v. East Cleveland, 431 U.
S. 494,
431 U. S.
504-505 (1977) (plurality opinion of POWELL, J.).
Especially in times of adversity, the relationships within a family
can offer the security of constant caring and aid.
See id.
at
431 U. S. 505.
Ideally, a minor facing an important decision will naturally seek
advice and support from her parents, and they, in turn, will
respond with comfort and wisdom. [
Footnote 4/22] If the pregnant minor herself confides
in her family, she plainly relinquishes her right to avoid telling
or involving them. For a minor in that circumstance, the statutory
requirement of parental notice hardly imposes a burden.
Realistically, however, many families do not conform to this
ideal. Many minors, like appellant, oppose parental notice and seek
instead to preserve the fundamental, personal right to privacy. It
is for these minors that the parental notification requirement
creates a problem. In this context, involving the minor's parents
against her wishes [
Footnote
4/23] effectively cancels her right to avoid disclosure of her
personal choice.
See Whalen v. Roe, 429 U.S. at
429 U. S.
599-600. Moreover, the absolute notice requirement
publicizes her private consultation
Page 450 U. S. 438
with her doctor and interjects additional parties in the very
conference held confidential in
Roe v. Wade, supra at
410 U. S. 164.
Besides revealing a confidential decision, the parental notice
requirement may limit "access to the means of effectuating that
decision."
Carey v. Population Services International,
431 U. S. 678,
431 U. S. 688
(1977). Many minor women will encounter interference from their
parents after the state-imposed notification. [
Footnote 4/24] In addition to parental
disappointment
Page 450 U. S. 439
and disapproval, the minor may confront physical or emotional
abuse, withdrawal of financial support, or actual obstruction of
the abortion decision. Furthermore, the threat of parental notice
may cause some minor women to delay past the first trimester of
pregnancy, after which the health risks increase significantly.
[
Footnote 4/25] Other pregnant
minors may attempt to self-abort or to obtain an illegal abortion
rather than risk parental notification. [
Footnote 4/26] Still others may forsake
Page 450 U. S. 440
an abortion and bear an unwanted child, which, given the minor's
"probable education, employment skills, financial resources and
emotional maturity, . . . may be exceptionally burdensome."
Bellotti II, 443 U.S. at
443 U. S. 642
(POWELL, J.). The possibility that such problems may not occur in
particular cases does not alter the hardship created by the notice
requirement on its face. [
Footnote
4/27] And that hardship is not a mere disincentive created by
the State, [
Footnote 4/28] but is
instead an actual
Page 450 U. S. 441
state-imposed obstacle to the exercise of the minor woman's free
choice. [
Footnote 4/29] For the
class of pregnant minors represented by appellant. this obstacle is
so onerous as to bar the desired abortions. [
Footnote 4/30] Significantly, the interference
sanctioned by the statute does not operate in a neutral fashion. No
notice is required for other pregnancy-related medical care,
[
Footnote 4/31] so only the minor
women who wish to abort encounter the burden imposed by the
notification statute. Because the Utah requirement of mandatory
parental notice unquestionably burdens the minor's privacy right,
the proper analysis turns next to the State's proffered
justifications for the infringements posed by the statute.
III
As established by this Court in
Planned Parenthood of
Central Mo. v. Danforth, the statute cannot survive
appellant's challenge unless it is justified by a "significant
state interest." [
Footnote 4/32]
Further, the State must demonstrate that the means
Page 450 U. S. 442
it selected are closely tailored to serve that interest.
[
Footnote 4/33] Where regulations
burden the rights of pregnant adults, we have held that the State
legitimately may be concerned with "protection of health, medical
standards, and prenatal life."
Roe v. Wade, 410 U.S. at
410 U. S. 155.
We concluded, however, that, during the first trimester of
pregnancy, none of these interests sufficiently justifies state
interference with the decision reached by the pregnant woman and
her physician.
Id. at
410 U. S.
162-163. Nonetheless, appellees assert here that the
parental notice requirement advances additional state interests not
implicated by a pregnant adult's decision to abort. Specifically,
appellees contend that the notice requirement improves the
physician's medical judgment about a pregnant minor in two ways: it
permits the parents to provide additional information to the
physician and it encourages consultation between the parents and
the minor woman. Appellees also advance an independent state
interest in preserving parental rights and family autonomy. I
consider each of these asserted interests in turn. [
Footnote 4/34]
A
In upholding the statute, the Utah Supreme Court concluded that
the notification provision might encourage parental transmission of
"additional information, which might
Page 450 U. S. 443
prove invaluable to the physician in exercising his
best
medical judgment.'" [Footnote
4/35] Yet neither the Utah courts nor the statute itself
specifies the kind of information contemplated for this purpose,
nor why it is available to the parents but not to the minor woman
herself. Most parents lack the medical expertise necessary to
supplement the physician's medical judgment, and at best could
provide facts about the patient's medical history. It seems
doubtful that a minor mature enough to become pregnant and to seek
medical advice on her own initiative would be unable or unwilling
to provide her physician with information crucial to the abortion
decision. In addition, by law, the physician already is obligated
to obtain all information necessary to form his best medical
judgment, [Footnote 4/36] and
nothing bars consultation with the parents should the physician
find it necessary.
Page 450 U. S.
444
Even if mandatory parental notice serves a substantial state
purpose in this regard, the Utah statute fails to implement it.
Simply put, the statute, on its face, does not require or even
encourage the transfer of information; it does not even call for a
conversation between the physician and the parents. A letter from
the physician to the parents would satisfy the statute, as would a
brief telephone call made moments before the abortion. [
Footnote 4/37] Moreover, the statute is
patently underinclusive if its aim is the transfer of information
known to the parents but unavailable from the minor woman herself.
The statute specifically excludes married minors from the parental
notice requirement; only her husband need be told of the planned
abortion, Utah Code Ann. § 77-304(2) (1978), and Utah makes no
claim that he possesses any information valuable to the physician's
judgment but unavailable from the pregnant woman. Furthermore, no
notice is required for other pregnancy-related care sought by the
minor.
See Utah Code Ann. § 78-14-5(4)(f) (1977)
(authorizing woman of any age to consent to pregnancy-related
medical care). The minor woman may consent to surgical removal and
analysis of amniotic fluid, Caesarian delivery, and other medical
care related to pregnancy. The physician's decisions concerning
such procedures would be enhanced by parental information as much
as would the abortion decision, yet only the abortion decision
triggers the parental notice requirement. This result is especially
anomalous given the comparatively lesser health risks associated
with abortion as contrasted with other pregnancy-related medical
care. [
Footnote 4/38] Thus, the
statute not only fails to promote
Page 450 U. S. 445
the transfer of information as is claimed, it does not apply to
other closely related contexts in which such exchange of
information would be no less important. The goal of promoting
consultation between the physician and the parents of the pregnant
minor cannot sustain a statute that is so ill-fitted to serve it.
[
Footnote 4/39]
B
Appellees also claim the statute serves the legitimate purpose
of improving the minor's decision by encouraging consultation
between the minor woman and her parents. Appellees do not dispute
that the State cannot legally or
Page 450 U. S. 446
practically require such consultation. [
Footnote 4/40] Nor do appellees contest the fact that
the decision is ultimately the minor's to make. [
Footnote 4/41] Nonetheless, the State seeks
through the notice requirement to give parents the opportunity to
contribute to the minor woman's abortion decision.
Ideally, facilitation of supportive conversation would assist
the pregnant minor during an undoubtedly difficult experience.
Again, however, when measured against the rationality of the means
employed, the Utah statute simply fails to advance this asserted
goal. The statute imposes no requirement that the notice be
sufficiently timely to permit any discussion between the pregnant
minor and the parents. Moreover, appellant's claims require us to
examine the statute's purpose in relation to the parents who the
minor believes are likely to respond with hostility or opposition.
In this light, the statute is plainly overbroad. Parental
consultation hardly seems a legitimate state purpose where the
minor's pregnancy resulted from incest, where a hostile or abusive
parental response is assured, or where the minor's fears of such a
response deter her from the abortion she desires. The absolute
nature of the statutory requirement, with exception permitted only
if the parents are physically unavailable, violates the requirement
that regulations in this fundamentally personal area be carefully
tailored to serve a significant state interest. [
Footnote 4/42]
"The need to preserve the constitutional
Page 450 U. S. 447
right and the unique nature of the abortion decision, especially
when made by a minor, require a State to act with particular
sensitivity when it legislates to foster parental involvement in
this matter."
Bellotti II, 443 U.S. at
443 U. S. 642
(POWELL, J.). Because Utah's absolute notice requirement
demonstrates no such sensitivity, I cannot approve its interference
with the minor's private consultation with the physician during the
first trimester of her pregnancy.
C
Finally, appellees assert a state interest in protecting
parental authority and family integrity. [
Footnote 4/43] This Court, of course, has recognized
that the "primary role of the parents in the upbringing of their
children is now established beyond debate as an enduring American
tradition."
Wisconsin v. Yoder, 406 U.
S. 205,
406 U. S. 232
(1972).
See Prince v. Massachusetts, 321 U.
S. 158 (1944);
Meyer v. Nebraska, 262 U.
S. 390 (1923). Indeed,
"those who nurture [the child] and direct his destiny have the
right, coupled with the high duty, to recognize and prepare him for
additional obligations."
Pierce v. Society of Sisters, 268 U.S. at
268 U. S. 535.
Similarly, our decisions "have respected the private realm of
family life which the state cannot enter."
Prince v.
Massachusetts, supra at
321 U. S. 166.
See also Moore v. East Cleveland, 431 U.S. at
431 U. S.
505.
Page 450 U. S. 448
The critical thrust of these decisions has been to protect the
privacy of individual families from unwarranted state intrusion.
[
Footnote 4/44] Ironically,
appellees invoke these decisions in seeking to justify state
interference in the normal functioning of the family. Through its
notice requirement, the State in fact enters the private realm of
the family, rather than leaving unaltered the pattern of
interactions chosen by the family. Whatever its motive, state
intervention is hardly likely to resurrect parental authority that
the parents themselves are unable to preserve. [
Footnote 4/45] In rejecting a statute permitting
parental veto of the minor woman's abortion decision in
Planned
Parenthood of Central Mo. v. Danforth, 428 U.S. at
428 U. S. 75, we
found it difficult to conclude that
"providing a parent with absolute power to overrule a
determination, made by the physician and his minor patient, to
terminate the patient's pregnancy will serve to strengthen the
family unit. Neither is it likely that such veto power will enhance
parental authority or control where the minor and the nonconsenting
parent are so fundamentally in conflict, and the very existence of
the pregnancy already has fractured the family structure."
More recently, in
Bellotti II, supra, at
443 U. S. 638,
JUSTICE POWELL observed that efforts to guide the social and moral
development of young people are "in large part . . . beyond the
competence of impersonal political institutions."
Page 450 U. S. 449
Appellees maintain, however, that Utah's statute
"merely safeguards a reserved right which parents have to know
of the important activities of their children by attempting to
prevent a denial of the parental rights through deception."
Brief for Appellees 3. Casting its purpose this way does not
salvage the statute. For when the threat to parental authority
originates not from the State, but from the minor child, invocation
of "reserved" rights of parents cannot sustain blanket state
intrusion into family life such as that mandated by the Utah
statute. Such a result not only runs counter to the private domain
of the family which the State may not breach; it also conflicts
with the limits traditionally placed on parental authority.
Parental authority is never absolute, and has been denied legal
protection when its exercise threatens the health or safety of the
minor children.
E.g., Prince v. Massachusetts, supra at
321 U. S.
169-170. Indeed, legal protection for parental rights is
frequently tempered if not replaced by concern for the child's
interest. [
Footnote 4/46]
Whatever its importance elsewhere, parental authority deserves
de minimis legal reinforcement where the minor's exercise
of a fundamental right is burdened.
To decide this case, there is no need to determine whether
parental rights never deserve legal protection when their
assertion
Page 450 U. S. 450
conflicts with the minor's rights and interests. [
Footnote 4/47] I conclude that this
statute cannot be defended as a mere reinforcement of existing
parental rights, for the statute reaches beyond the legal limits of
those rights. The statute applies, without exception, to
emancipated minors, [
Footnote
4/48] mature minors, [
Footnote
4/49]
Page 450 U. S. 451
and minors with emergency health care needs, [
Footnote 4/50] all of whom, as Utah recognizes, by
law have long been entitled to medical care unencumbered by
parental involvement. Most
Page 450 U. S. 452
relevant to appellant's own claim, the statutory restriction
applies even where the minor's best interests -- as evaluated by
her physician -- call for an abortion. The Utah trial court found
as a fact that appellant's physician
"believed along with her that she should be aborted and that he
felt it was in her best medical interest to do so, but he could not
and would not perform an abortion upon her without informing her
parents prior to aborting her because it was required of him by
that statute, and he was unwilling to perform an abortion upon
Page 450 U. S. 453
her without complying with the provisions of the statute, even
though he believed it was best to do so."
Civ. No. 78-2719 (Dec. 26, 1978) (Findings of Fact 7). Even if
further review by adults other than her physician, counselor, and
attorney were necessary to assess the minor's best interests,
see Bellotti II, 443 U.S. at
443 U. S.
640-641,
443 U. S.
643-644 (opinion of POWELL, J.), Utah's rejection of any
exception to the notice requirement for a pregnant minor is plainly
overbroad. In
Bellotti II, we were unwilling to cut a
pregnant minor off from any avenue to obtain help beyond her
parents, and yet the Utah statute does just that.
In this area, I believe this Court must join the state courts
and legislatures which have acknowledged the undoubted social
reality: some minors, in some circumstances, have the capacity and
need to determine their health care needs without involving their
parents. As we recognized in
Planned Parenthood of Central Mo.
v. Danforth, 428 U.S. at
428 U. S.
75,
"[a]ny independent interest the parent may have in the
termination of the minor daughter's pregnancy is no more weighty
than the right of privacy of the competent minor mature enough to
have become pregnant. [
Footnote
4/51]"
Utah itself has allocated pregnancy-related health care
decisions entirely to the pregnant minor. [
Footnote 4/52] Where the physician has cause to doubt
the minor's actual ability to understand and consent, by law he
must pursue the requisites of the State's informed consent
procedures. [
Footnote 4/53] The
State cannot have a legitimate interest in adding to this scheme
mandatory parental notice of the minor's abortion decision. This
conclusion does not
Page 450 U. S. 454
affect parents' traditional responsibility to guide their
children's development, especially in personal and moral concerns.
I am persuaded that the Utah notice requirement is not necessary to
assure parents this traditional childrearing role, and that it
burdens the minor's fundamental right to choose with her physician
whether to terminate her pregnancy. [
Footnote 4/54]
IV
In its eagerness to avoid the clear application of our
precedents, the Court today relies on a mistaken view of class
action law and prudential standing requirements. The Court's
avoidance of the issue presented by the complaint nonetheless
leaves our precedents intact. Under those precedents, I have no
doubt that the challenged statute infringes upon the constitutional
right to privacy attached to a minor woman's decision to complete
or terminate her pregnancy. None of the reasons offered by the
State justifies this intrusion, for the statute is not tailored to
serve them. Rather than serving to enhance the physician's
judgment, in cases such as appellant's, the statute prevents
implementation of the physician's medical recommendation. Rather
than promoting the transfer of information held by parents to the
minor's physician, the statute neglects to require anything more
than a communication from the physician moments before the
abortion. Rather than respecting the private realm of family life,
the statute invokes the criminal justice machinery of the State in
an attempt to influence the interactions within the family.
Accordingly, I would reverse the judgment of the Supreme Court of
Utah insofar as it upheld the statute against constitutional
attack.
[
Footnote 4/1]
Under the majority's view, to assure standing, the plaintiff
pregnant minor simply need allege her desire to obtain an abortion,
her inability to do so because of the statute, and her view that
she is emancipated, mature, or that it is in her best interest to
have an abortion performed without notifying her parents. The
majority finds no standing problem where the complaint alleges that
the plaintiff is emancipated or mature, and thus reaffirms the
standing analysis employed in
Bellotti v. Baird,
443 U. S. 622
(1979) (
Bellotti II).
See ante at
450 U. S. 406,
n. 12. In addition, the Court relies in part on a decision by the
Federal District Court in Utah, which enjoined application of the
same Utah statute involved here to emancipated minors.
L. R. v.
Hansen, Civil NO. C-80-0078J (Feb. 8, 1980). The Court
apparently contemplates that similar challenges will meet with
success in the future. For example, the District Court in
L. R.
v. Hansen also accorded intervenor status and awarded
preliminary relief to a minor woman who, like appellant, is under
17 years old and is dependent upon a parent with whom she resides.
T he only difference between the allegations of the instant
appellant and those of that intervenor is the latter's express
allegation that parental notice would result in her expulsion from
home and destruction of her relationship with her parent.
L. R.
v. Hansen, Civil NO. C-80-0078J (Findings of Fact and
Conclusions of Law 4) (Oct. 24, 1980). Finally, the Court today
does not question our prior decision upholding the standing of
physicians to challenge abortion restrictions.
See
450
U.S. 398fn4/4|>n. 4,
infra.
[
Footnote 4/2]
In essence, the Court concludes that, because appellant
neglected to make specific allegations about herself and her
situation, she "lacks
the personal stake in the controversy
needed to confer standing' to advance the overbreadth argument,"
ante at 450 U. S. 406
(quoting Harris v. McRae, 448 U.
S. 297, 448 U. S. 320
(1980)). The majority thus assumes that a plaintiff raising an
overbreadth challenge to an abortion statute must allege that she
herself falls within the statute's overbroad reach. The quotation
from Harris actually refers to an entirely different kind
of standing issue: there, the plaintiffs lacked standing because
they failed to allege that they were in a position either to seek
abortions or to receive Medicaid, and thus they lacked the concrete
adverseness necessary to advance their challenge to the Medicaid
limit on abortion funding. None of the cases cited for this point
in Harris apply to the instant appeal. See O'Shea v.
Littleton, 414 U. S. 488
(1974) (plaintiffs lack standing because of failure to allege
specific injury); Bailey v. Patterson, 369 U. S.
31, 369 U. S. 32
(1962) (petitioners "lack standing to enjoin criminal prosecutions
under Mississippi's breach-of-peace statutes, since they do not
allege that they have been prosecuted or threatened with
prosecution under them").
A standing limitation on overbreadth challenges to an abortion
statute has roots in a context hardly analogous to the instant
case. For while we have frequently ruled that criminal defendants
lack standing to challenge a statute's overbreadth when their
conduct indisputedly falls within the statute's legitimate core,
e.g, United States v. National Dairy Products Corp.,
372 U. S. 29
(1963);
United States v. Harriss, 347 U.
S. 612 (1954);
Williams v. United States,
341 U. S. 97
(1951), these rulings bear little relationship to appellant's
challenge to a State's restriction of her exercise of a fundamental
right.
See Planned Parenthood of Central Mo. v. Danforth,
428 U. S. 52
(1976);
Doe v. Bolton, 410 U. S. 179
(1973). More relevant, I believe, is our analysis of standing to
claim that a statute's overbreadth affects fundamental liberties,
primarily those guaranteed by the First Amendment. Because of the
risk that exercise of personal freedoms may be chilled by broad
regulation, we permit facial overbreadth challenges without a
showing that the moving party's conduct falls within the protected
core.
Gooding v. Wilson, 405 U. S. 518
(1972);
Coates v. Cincinnati, 402 U.
S. 611 (1971);
United States v. Robel,
389 U. S. 258
(1967);
Shuttlesworth v. City of Birmingham, 394 U.
S. 147 (1969);
Cox v. Louisiana, 379 U.
S. 536 (1965);
Aptheker v. Secretary of State,
378 U. S. 500
(1964);
Kunz v. New York, 340 U.
S. 290 (1951).
See also United States v. Reese,
92 U. S. 214 (1876)
(facial challenge under Fifteenth Amendment).
[
Footnote 4/3]
See 450
U.S. 398fn4/1|>n. 1,
supra. The Court does not
question that exceptions from a parental notice requirement are
necessary for minors emancipated from the custody or control of
their parents,
see 450
U.S. 398fn4/48|>n. 48,
infra, and for minors able
to demonstrate their maturity for the purpose of choosing to have
an abortion,
ante at
450 U. S.
406-407.
See also Bellotti II, 443 U.S. at
443 U. S. 651
(POWELL, J.);
id. at
443 U. S. 653
(STEVENS, J.). Nor does the Court depart from the view, made
explicit in JUSTICE POWELL's opinion in
Bellotti II, supra
at
443 U. S. 651,
that a State cannot require parental notice when it would not be in
the minor's best interests to do so. This position is articulated
anew today by JUSTICE POWELL,
ante at
450 U. S. 420,
and bolstered by the majority, which acknowledges the need for
exception where parental notification interferes with emergency
medical treatment,
ante at
450 U. S. 407,
n. 14, and which leaves open the possibility of relief where the
minor makes a "claim or showing as to . . . her relations with her
parents,"
ante at
450 U. S. 407, or demonstrates a "hostile home
situatio[n],"
ante at
450 U. S. 407,
n. 14.
See also L. R. v. Hansen, Civil No. C-80-0078J
(Utah, Feb. 8, 1980, and Oct. 24, 1980).
[
Footnote 4/4]
It is especially noteworthy that we have not refrained from
according to physicians, threatened with the personal risk of
prosecution, standing to challenge abortion restrictions by
asserting the rights of any of their patients.
E.g., Planned
Parenthood of Central Mo. v. Danforth, supra at
428 U. S. 62;
Doe v. Bolton, supra; Griswold v. Connecticut,
381 U. S. 479
(1965).
[
Footnote 4/5]
In the instant case, application of the prudential rule causes
undue commingling of jurisdictional and merits issues. For here,
the third-party interests do not even come into play until
appellant wishes to rebut the State's interests, which themselves
are asserted only after appellant has established a burden on her
protected interests. First, the appellant must satisfy a court
that, on the merits, her fundamental right to privacy in consulting
her physician about an abortion is burdened by the Utah statute.
Only then need the State assert its countervailing state interests,
which here include promoting family autonomy and parental
authority. And only in rebuttal would appellant next challenge as
overbroad the means employed by the State, for the absolute ban
regulates the abortion decision of emancipated and mature minors,
and others whose best interests call for an abortion without
parental notice. Thus, in the name of prudence, the majority's
standing analysis depends upon its evaluation of the complicated
merits.
[
Footnote 4/6]
Appellant's consultation with three professionals casts
substantial doubt on JUSTICE POWELL's suggestion,
see ante
at
450 U. S. 418,
that appellant "desires not to explain to anyone her reasons either
for wanting the abortion or for not wanting to notify her
parents."
[
Footnote 4/7]
This portion of the transcript is set out in full
ante
at
450 U. S.
402-403, n. 6,
450 U. S. 403,
n. 7.
JUSTICE POWELL correctly reports,
ante at
450 U. S.
416-417, that the in-chambers hearing elicited from
appellant statements essentially identical to her complaint. And it
is also true that counsel for appellant objected to inquiries by
the appellees and the trial judge regarding appellant's exact
reasons for not wanting to talk with her parents about her
pregnancy or other matters. What JUSTICE POWELL neglects to note,
however, is that counsel's objections stemmed from the trial
court's own ruling that any facts specific to appellant's situation
would be irrelevant to the physician's duty under the statute to
notify her parents of an abortion decision. Because the trial judge
ruled that the statute and its sanctions would apply regardless of
the pregnant minor's personal reasons for opposing parental
notification, the judge sustained the objections to questions about
appellant's particular reasons. Tr. 14-20, App. 31-36. It is this
ruling that is the legal basis for the decision below, and not the
trial judge's preliminary comments cited by the majority,
ante at
450 U. S. 403,
n. 8.
[
Footnote 4/8]
I also doubt the wisdom in pinning a minor' success in
challenging a blanket parental notice requirement to consideration
of her particular situation by judges, as opposed to others who are
more regularly involved in the counseling of adolescents.
Cf.
Bellotti II, 443 U.S. at
443 U. S. 655
(STEVENS, J.).
[
Footnote 4/9]
As the Court observed in
Eisen v. Carlisle &
Jacquelin, 417 U. S. 156,
417 U. S. 176
(1974), the federal class action procedure
"was intended to insure that the judgment, whether favorable or
not, would bind all class members who did not request exclusion
from the suit."
The binding effect of the class action's disposition poses
serious due process concerns where the interests of class members
are not properly represented. 7A C. Wright & A. Miller, Federal
Practice and Procedure § 1765 (1972).
Where review of the claims asserted is impaired by an obvious
lack of homogeneity in the class approved by the trial court, the
reviewing court must remand "for reconsideration of the class
definition,"
Kremens v. Bartley, 431 U.
S. 119,
431 U. S.
134-135 (1977), and for a determination whether the
named plaintiff is a proper representative of the class,
Martin
v. Thompson Tractor Co., 486 F.2d 510, 511 (CA5 1973).
[
Footnote 4/10]
E.g., Bogus v. American Speech & Hearing Assn., 582
F.2d 277 (CA3 1978);
Dellums v. Powell, 184 U.S.App.D.C.
275, 566 F.2d 167 (1977),
cert. denied, 438 U.S. 916
(1978);
Barnett v. W. T. Grant Co., 518 F.2d 543 (CA4 1975);
Arkansas Ed. Assn. v. Board of Ed. of Portland, Arkansas School
Dist., 446 F.2d 763 (CA8 1971);
Gold Strike Stamp Co. v.
Christensen, 436 F.2d 791 (CA10 1970).
It is difficult to conclude that the trial judge below in fact
abused his discretion in approving the class. Other courts have
approved similar classes represented by similar named plaintiffs,
e.g., Gary-Northwest Indiana Women's Services v.
Bowen, 421 F.
Supp. 734 (ND Ind.1976) (unmarried pregnant 16-year-old proper
representative for class of unmarried pregnant minors under 18
challenging abortion restriction),
summarily aff'd, 429
U.S. 1067 (1977). Conflict within the class, moreover, seems
unlikely, for "it is difficult to imagine why any person in the
class appellant represents would have an interest in seeing [the
challenged statute] upheld."
Sosna v. Iowa, 419 U.
S. 393,
419 U. S. 403,
n. 13 (1975).
[
Footnote 4/11]
A class may need to be redefined,
e.g., Gesicki v.
Oswald, 336 F.
Supp. 371, 374 (SDNY 1971) (three-judge court), divided into
subclasses,
e.g., Francis v. Davidson, 340 F.
Supp. 351 (Md.1972) (three-judge court), or otherwise modified,
to adequately protect its members' interests.
See
generally 7 Wright & Miller,
supra, §§
1758-1771 (1972 and Supp. 1980).
The majority mistakenly assumes,
ante at
450 U. S. 406,
n. 13, that it is free to rewrite the class as approved by the
trial court because that court based its class definition on
submissions from the plaintiff. This assumption runs counter to the
general practice in both state and federal courts whereby the party
seeking class certification proposes a class definition which is
then subject to challenge by the opposing party.
See 1 H.
Newberg, Class Actions 644 (1977); 5
id. at 1376, 1403.
Appellees challenged the class without success, and the State
Supreme Court never questioned the trial court's approval of
appellant's class.
[
Footnote 4/12]
See ante at
450 U. S.
420-421 (opinion of STEVEN8, J.). JUSTICE POWELL
reasons,
ante at
450 U. S. 417,
n. 6, that the class members cannot raise the overbreadth claims
because the record fails to disclose that they wish to raise such
claims. In my view, the record is quite to the contrary. The class
members, through their class representative, unequivocally raised
in the complaint the overbreadth challenge to the Utah statute.
Complaint �17, App. 6. This claim, along with the other
allegations in the complaint, provided the context in which the
trial judge approved appellant a class representative. In so
approving, the trial court was obliged to ensure that appellant's
allegations would adequately protect the interests of the class
members, who would be bound by the judgment. If a reviewing court
subsequently alters the claims that can be asserted by the named
plaintiff, protection of the class interests requires a remand for
reconsideration of the adequacy of the named plaintiff as class
representative.
[
Footnote 4/13]
See also Carey v. Population Services International,
431 U. S. 678,
431 U. S.
684-685 (1977);
Griswold v. Connecticut, 381
U.S. at
381 U. S.
482-485.
[
Footnote 4/14]
Zablocki v. Redhail, 434 U. S. 374,
434 U. S.
384-386 (1978);
Loving v. Virginia,
388 U. S. 1,
388 U. S. 12
(1967).
[
Footnote 4/15]
Skinner v. Oklahoma ex rel. Williamson, 316 U.
S. 535 (1942).
See also Cleveland Board of Education
v. La Fleur, 414 U. S. 632
(1974).
[
Footnote 4/16]
Eisenstadt v. Baird, 405 U. S. 438,
405 U. S. 453
(1972);
Griswold v. Connecticut, supra; Carey v. Population
Services International, supra; Poe v. Ullman, 367 U.
S. 497,
367 U. S. 539
(1961) (Harlan, J., dissenting) (ban on contraception is
"intolerable and unjustifiable invasion of privacy in the conduct
of the most intimate concerns of an individual's personal
life").
[
Footnote 4/17]
See also Union Pacific R. Co. v. Botsford, 141 U.
S. 250,
141 U. S. 251
(1891) ("No 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, unless by clear and
unquestionable authority of law").
[
Footnote 4/18]
The right has often been termed "the right to be let alone."
See Olmstead v. United States, 277 U.
S. 438,
277 U. S. 478
(1928) (Brandeis, J., dissenting) (quoted with approval in
Stanley v. Georgia, 394 U. S. 557,
394 U. S. 564
(1969), and
Eisenstadt v. Baird, supra at
405 U. S.
453-454, n. 10). Defining the spheres within which the
government may not act without sufficient justification, the notion
of privacy "emanates from the totality of the constitutional scheme
under which we live."
Poe v. Ullman, supra at
367 U. S. 521
(Douglas, J., dissenting).
[
Footnote 4/19]
Constitutional rights do not mature and come into being
magically only when one attains the state-defined age of majority.
Minors, as well as adults, are protected by the Constitution and
possess constitutional rights.
See, e.g., Breed v. Jones,
421 U. S. 519
(1975);
Goss v Lopez, 419 U. S. 565
(1975);
Tinker v. Des Moines School Dist., 393 U.
S. 503 (1969);
In re Gault, 387 U. S.
1 (1967). The Court indeed, however, long has recognized
that the State has somewhat broader authority to regulate the
activities of children than of adults.
Prince v.
Massachusetts, 321 U.S. at
321 U. S. 170;
Ginsberg v. New York, 390 U. S. 629
(1968).
Planned Parenthood of Central Mo. v. Danforth, 428 U.S.
at
428 U. S. 74-75.
See also Brown v. Board of Education, 347 U.
S. 483 (1954) (children entitled to equal protection in
schools).
The privacy right does not necessarily guarantee that "every
minor, regardless of age or maturity, may give effective consent
for termination of her pregnancy."
Planned Parenthood of
Central Mo. v. Danforth, supra at
428 U. S. 75.
Utah, however, assigns this consent authority to a woman of any age
who seeks pregnancy-related medical care, Utah Code Ann. §
78-14-5(4)(f) (1977), subject to the State's informed consent
requirements,
see Utah Code Ann. § 76-7-305 (1978);
§ 78-14-5 (1977). This appeal does not present the broad issue
of when may a State require parental consent for a surgical
procedure on a minor child,
604 P.2d 907,
910, n. 5 (Utah 1979). At issue here is only the scope of the
minor's constitutional privacy right in the face of a statutory
parental notice requirement.
[
Footnote 4/20]
In striking down a related Utah prohibition against family
planning assistance for minors absent parental consent, a Federal
District Court reasoned that the
"financial, psychological and social problems arising from
teenage pregnancy and motherhood argue for our recognition of the
right of minors to privacy as being equal to that of adults."
T.H. v. Jones, 425 F.
Supp. 873, 881 (Utah 1975),
summarily aff'd on other
grounds, 425 U.S. 986 (1976).
[
Footnote 4/21]
Appellees also argue that
"[i]t is difficult to contemplate a relationship where the right
of privacy as formulated in the abortion context could be less
relevant than in the confines of the nuclear family."
Brief for Appellees 22. This view, however, was expressly
rejected in
Planned Parenthood of Central Mo. v. Danforth,
supra at
428 U. S.
75.
[
Footnote 4/22]
Realization of this ideal, however, must depend on the quality
of emotional attachments within the family, and not on legal
patterns imposed by the State.
See Quilloin v. Walcott,
434 U. S. 246,
434 U. S. 255
(1978);
Moore v. East Cleveland, 431 U.S. at
431 U. S.
506.
[
Footnote 4/23]
Nothing prevents the physician from encouraging the minor to
consult her parents; only the minor who strenuously objects will
remain burdened by the notice requirement.
[
Footnote 4/24]
The record here contains little about appellant's situation,
because the trial judge excluded any such evidence as irrelevant to
the facial challenge to the mandatory notice requirement. In light
of her claim that the notice requirement inhibits the exercise of
her right to choose an abortion, however, we may surmise that
appellant expects family conflict over the abortion decision.
Indeed, the transcript of the evidentiary hearing, quoted
ante at
450 U. S.
402-403, n. 6,
450 U. S. 403,
n. 7 (opinion of BURGER, C.J.), demonstrates that consultation with
her social worker, her physician, and her lawyer did not alter
appellant's steadfast belief that she could not discuss the issue
with her parents.
The records in other cases are also instructive as to the
interference posed by some parents to the exercise of some minor's
privacy right.
See L.R. v. Hansen, Civil No. C-80 0078J
(Utah, Oct. 24, 1980) (preliminary relief awarded to minor alleging
parent expelled from home minor sister who disclosed facts of
pregnancy and abortion);
see Women's Community Health Center,
Inc. v. Cohen, 477 F.
Supp. 542, 548 (Me.1979) (expert affidavits that some parents
"will pressure the minor, causing great emotional distress and
otherwise disrupting the family relationship");
Baird v.
Bellotti, 450 F.
Supp. 997, 1001 (Mass.1978) (uncontested evidence some parents
"would insist on an undesired marriage, or on continuance of the
pregnancy as punishment" or even physically harm the minor);
Wynn v. Carey, 582 F.2d 1375, 1388, n. 24 (CA7 1978)
(suggesting same problems);
In re Diane, 318
A.2d 629, 630 (Del.Ch.1974) (father opposes minor's abortion on
religious grounds);
State v. Koome, 84 Wash. 2d
901, 908,
530 P.2d
260, 265 (1975) (parent thinks forcing daughter to bear child
will deter her future pregnancies).
See Margaret S. v.
Edwards, 488 F.
Supp. 181 (ED La.1980). Parents also may oppose a minor's
decision not to abort.
E.g., In re Smith, 16 Md.App. 209,
295 A.2d 238 (1972).
See generally F. Furstenberg,
Unplanned Parenthood: The Social Consequences of Teenage
Childbearing 54 (1976); Jolly, Young, Female, and Outside the Law,
in Teenage Women in the Juvenile Justice System: Changing Values
97, 102 (1979) ("When a young girl becomes pregnant, many families
refuse to allow her back into their home"); Osofsky & Osofsky,
Teenage Pregnancy: Psychosocial Considerations, 21
Clin.Obstet.Gynecol. 1161, 1164-1165 (1978).
See also J.
Bedger, Teenage Pregnancy 123-124 (1980) (large majority of sampled
pregnant minors predict parental opposition to their
abortions).
[
Footnote 4/25]
Women's Community Health Center, Inc. v. Cohen, supra
at 548 (affidavits showing parental notice "may cause an adolescent
to delay seeking assistance with her pregnancy, increasing the
hazardousness of an abortion should she choose one"); Cates,
Adolescent Abortions in the United States, 1 J. Adolescent Health
Care 18, 24 (1980); Bracken & Kasl, Delay in Seeking Induced
Abortion: A Review and Theoretical Analysis, 121
Am.J.Obstet.Gynecol. 1008, 1013 (1975); Hofmann, Consent and
Confidentiality and Their Legal and Ethical Implications for
Adolescent Medicine, in Medical Care of the Adolescent 42, 51 (J.
Gallagher, F. Heald & D. Garell eds., 3d ed.1976).
If she decides to abort after the first trimester of pregnancy,
the minor faces more serious health risks.
Roe v. Wade,
410 U. S. 113,
410 U. S. 163
(1973); Benditt, Second-Trimester Abortion in the United States, 11
Family Planning Perspectives 358 (1979); Cates, Schulz, Crimes,
& Tyler, The Effect of Delay and Method Choice on the Risk of
Abortion Morbidity, 9 Family Planning Perspectives 266 (1977). If
she decides to bear the child, her health risks are also greater
than if she had first trimester abortion. Cates, 1 J.Adolescent
Health Care,
supra at 24; Cates & Tietze, Standardized
Mortality Rates Associated with Legal Abortion: United States
1972-1975, 10 Family Planning Perspectives 109 (1978) (abortion
within first 16 weeks of pregnancy safer than carrying pregnancy to
term); "The Earlier the Safer" Applies to all Abortions, 10 Family
Planning Perspectives 243 (1978).
See also Zackler,
Andelman, & Bauer, The Young Adolescent as an Obstetric Risk,
103 Am.J.Obstet.Gynecol. 305 (1969) (complications associated with
childbirth by minors).
[
Footnote 4/26]
Women's Community Health Center, Inc. v. Cohen, supra
at 548 (affidavits that minor may turn to illegal abortion, rather
than have parents notified).
See also Kahan, Baker, &
Freeman, The Effect of Legalized Abortion on Morbidity Resulting
from Criminal Abortion, 121 Am.J.Obstet.Gynecol. 114 (1975)
(illegal abortion rate drops when legal abortion available). The
minor may also seek to abort herself,
Alice v. Department of
Social Welfare, 55 Cal. App. 3d
1039, 1044, 128 Cal. Rptr. 374, 377 (1976); A. Holder, Legal
Issues in Pediatrics and Adolescent Medicine 285 (1977); or even
commit suicide,
see Teicher, A Solution to the Chronic
Problem of Living: Adolescent Attempted Suicide, in Current Issues
in Adolescent Psychiatry 129, 136 (J. Schoolar ed.1973) (study
showing that approximately one-fourth of female minors who attempt
suicide do so because they are or believe they are pregnant).
[
Footnote 4/27]
It is the presence of the notice requirement, and not merely its
implementation in a particular case, that signifies the intrusion.
Cf. Planned Parenthood of Central Mo v. Danforth,
428 U. S. 52 (1976)
(availability of veto, not exercise of veto, found
unconstitutional).
Despite the Court's objection today that we have in the past
"expressly declined to equate notice requirements with consent
requirements,"
ante at
450 U. S. 411,
n. 17, in
Bellotti II, the Court rejected a statute
authorizing judicial review of a minor's abortion decision -- as an
alternative to parental consent -- precisely because a parent
notified of the court action might interfere. Thus, JUSTICE POWELL
wrote for four Members of the Court:
"[A]s the District Court recognized, 'there are parents who
would obstruct, and perhaps altogether prevent, the minor's right
to go to court.' . . . There is no reason to believe that this
would be so in the majority of cases where consent is withheld. But
many parents hold strong views on the subject of abortion, and
young pregnant minors, especially those living at home, are
particularly vulnerable to their parents' efforts to obstruct both
an abortion and their access to court."
443 U.S. at
443 U. S.
647.
[
Footnote 4/28]
Thus, the notice requirement produces not only predictable
disincentives to choose to abort,
Harris v. McRae, 448
U.S. at
448 U. S. 338
(MARSHALL, J., dissenting);
id. at
448 U. S. 330
(BRENNAN, J., dissenting); but also "
direct state interference
with a protected activity,'" id. at 448 U. S. 315
(quoting with approval Maher v. Roe, 432 U.
S. 464, 432 U. S. 475
(1977)) .
[
Footnote 4/29]
See Doe v. Bolton, 410 U. S. 179
(1973) (invalidating procedural restrictions on availability of
abortions);
Carey v. Population Services International,
431 U.S. at
431 U. S.
687-689 (partial restrictions on access to
contraceptives subject to constitutional challenge). Regardless of
the personal views each of us may hold, the privacy right, by
definition, secures latitude of choice for the pregnant minor
without state approval of one decision over another. Thus, JUSTICE
STEVENS improperly inverts the reasoning of our decisions when he
reiterates his previous view that the importance of the abortion
decision points to a
"'state's interest in maximizing the probability that the
decision be made correctly and with full understanding of the
consequences of either alternative,'"
ante at
450 U. S. 422
(emphasis added) .
[
Footnote 4/30]
See text accompanying
450
U.S. 398fn4/8|>n. 8 and
see nn.
450
U.S. 398fn4/20|>20,
450
U.S. 398fn4/24|>24,
450
U.S. 398fn4/25|>25,
supra.
[
Footnote 4/31]
Utah permits pregnant minors to consent to any medical procedure
in connection with pregnancy and childbirth, but requires parental
notice only before an abortion.
Compare Utah Code Ann.
§ 78-14-5(4)(f) (1977)
with § 76-7-304(2)
(1978).
[
Footnote 4/32]
428 U.S. at
428 U. S. 75.
Cf. Zablocki v. Redhail, 434 U.S. at
434 U. S. 388;
NAACP v. Button, 371 U. S. 415,
371 U. S. 438
(1963). In
Roe v. Wade, this Court concluded that the
woman's privacy right may be tempered by "important [state]
interests," 410 U.S. at
410 U. S. 154,
but the Court ultimately applied the "compelling state interest"
test commonly used in reviewing state burdens on fundamental
rights.
Id. at
410 U. S. 155.
Although it may seem that the minors privacy right is somehow less
fundamental because it may be overcome by a "significant state
interest," the more sensible view is that state interests
inapplicable to adults may justify burdening the minors right.
Planned Parenthood of Central Mo. v. Danforth, supra at
428 U. S.
74-75.
[
Footnote 4/33]
E.g., Roe v. Wade, supra at
410 U. S. 155;
Griswold v. Connecticut, 381 U.S. at
371 U. S.
485.
[
Footnote 4/34]
Appellees also argue that the notice requirement furthers
legitimate state interests in enforcing Utah's criminal laws
against statutory rape, fornication, adultery, and incest. Brief
for Appellees 28-30. These interests were not asserted below, and
are too tenuous to be considered seriously here.
[
Footnote 4/35]
604 P.2d at 909-910.
[
Footnote 4/36]
Section 76-7-304 (1) requires the physician to
"Consider all factors relevant to the wellbeing of the woman
upon whom the abortion is to be performed including, but not
limited to,"
"(a) Her physical, emotional and psychological health and
safety,"
"(b) Her age,"
"(c) Her familial situation."
Violations of this requirement are punishable by a year's
imprisonment and $1,000 fine. Utah Code Ann. §§
76-3-204(1), 76-3-301(3), 76-7314(3) (1978). Criminal sanctions
also apply if the physician neglects to obtain the minor's informed
written consent, and such consent can be secured only after the
physician has notified the patient:
"(a) Of the names and addresses of two licensed adoption
agencies in the state of Utah and the services that can be
performed by those agencies, and nonagency adoption may be legally
arranged; and"
"(b) Of the details of development of unborn children and
abortion procedures, including any foreseeable complications,
risks, and the nature of the postoperative recuperation period;
and"
"(c) Of any other factors he deems relevant to a voluntary and
informed consent."
Utah Code Ann. § 76-7-305(2) (1978).
The risk of malpractice suits also ensures that the physician
will acquire whatever information he finds necessary before
performing the abortion.
See Utah Code Ann. § 78-14-5
(1977).
Moreover,
"[i]f a physician is licensed by the State, he is recognized by
the State as capable of exercising acceptable clinical judgment. If
he fails in this, professional censure and deprivation of his
license are available remedies."
Doe v. Bolton, 410 U.S. at
410 U. S.
199.
[
Footnote 4/37]
The parties conceded as much at oral argument. Tr. of Oral Arg.
18-19, 29, 48.
[
Footnote 4/38]
I am baffled by the majority's statement today that
"[i]f the pregnant girl elects to carry her child to term, the
medical decisions to be made entail few -- perhaps none -- of the
potentially grave and emotional and psychological consequences of
the decision to abort,"
ante at
450 U. S.
412-413. Choosing to participate in diagnostic tests
involves risks to both mother and child, and also may burden the
pregnant woman with knowledge that the child will be handicapped.
See 3 National Institutes of Health, Prevention of
Embryonic, Fetal, and Perinatal Disease 347-352 (R. Brent & M.
Harris eds.1976); Risks in the Practice of Modern Obstetrics 59-81,
369-370 (S. Aladjem ed.1975). The decision to undergo surgery to
save the child's life certainly carries as serious "emotional and
psychological consequences" for the pregnant adolescent as does the
decision to abort; in both instances, the minor confronts the task
of calculating not only medical risks, but also all the issues
involved in giving birth to a child.
See id. at 59-81. For
an unwed adolescent, these issues include her future educational
and job opportunities, as well as the more immediate problems of
finding financial and emotional support for offspring dependent
entirely on her.
Michael M. v. Sonoma County Superior Court,
post at
450 U. S. 470,
and nn. 3 and 4 (RENQUIST, J.) (plurality opinion). When surgery to
save the child's life poses greater risks to the mother's life, the
emotional and ethical dimensions of the medical care decision
assume crisis proportion. Of course, for minors, the mere fact of
pregnancy and the experience of childbirth can produce
psychological upheaval.
[
Footnote 4/39]
More flexible regulations which defer to the physician's
judgment but provide for parental notice in emergencies have been
proposed.
E.g., IJA-ABA Standards for Juvenile Justice,
Rights of Minors 4.2, 4.6, 4.8 (1980) (minor can consent to
pregnancy-related medical care; physician should seek to obtain
minor's permission to notify parent, and notify parent over minor's
objection only if failure to inform "could seriously jeopardize the
health of the minor").
[
Footnote 4/40]
604 P.2d at 912 ("the State has a special interest in
encouraging (but does not require) an unmarried pregnant minor to
seek the advice of her parents in making the important decision as
to whether or not to bear a child").
[
Footnote 4/41]
Ibid. (notification statute "does not
per se
impose any restriction on the minor as to her decision to terminate
her pregnancy").
Cf. Utah Code Ann. § 78-14-5(4)(f)
(1977) (woman of any age can consent to any medical care related to
pregnancy).
See generally Planned Parenthood of Central Mo. v.
Danforth, 428 U.S. at
428 U. S. 74 (State may not delegate absolute veto
authority to parents of pregnant minor seeking abortion).
[
Footnote 4/42]
State-sponsored counseling services, in contrast, could promote
family dialogue and also improve the minor's decisionmaking
process. Appellant H. L., for example, consulted with a counselor
who supported her decision. The role of counselors can be
significant in facilitating the pregnant woman's adjustment to
decisions related to her pregnancy.
See Smith, A Follow-Up
Study of Women Who Request Abortion, 43 Am.J.Orthopsychiatry 574,
583-585 (1973).
[
Footnote 4/43]
This interest, although not discussed by the state courts below,
was the subject of appellees' most vigorous argument before this
Court. The challenged provision does fall within the "Offenses
Against the Family" chapter of the Utah Criminal Code,
ante at
450 U. S. 400
(opinion of BURGER, C.J.), which also provides criminal sanctions
for bigamy, Utah Code Ann. § 767-101, incest, § 76-7-102,
adultery, § 76-7-103, fornication, § 76-7-104, and
nonsupport and sale of children, §§ 76-7-201 to 76-7-203
(1978).
[
Footnote 4/44]
Wynn v. Carey, 582 F.2d at 1385-1386; Note, The Minor's
Right of Privacy: Limitations on State Action after
Danforth and
Carey, 77 Colum.L.Rev. 1216, 1224
(1977).
[
Footnote 4/45]
"The fact that the minor became pregnant and sought an abortion
contrary to the parents' wishes indicates that whatever control the
parent once had over the minor has diminished, if not evaporated
entirely. And we believe that enforcing a single, albeit important,
parental decision -- at a time when the minor is near to majority
status -- by an instrument as blunt as a state statute is extremely
unlikely to restore parental control."
Poe v. Gerstein, 517 F.2d 787, 793-794 (CA5 1975),
summarily aff'd, 428 U.S. 901 (1976).
[
Footnote 4/46]
Thus, in
Prince v. Massachusetts, this Court held that
even parental rights protected by the First Amendment could be
limited by the State's interest in prohibiting child labor.
See
Wisconsin v. Yoder, 406 U. S. 205,
406 U. S.
233-234 (1972) (discussing
Prince). The State
traditionally exercises a
parens patriae function in
protecting those who cannot take care of themselves.
See
Ginsberg v. New York, 390 U. S. 629,
390 U. S. 641
(1968). Some of the earliest applications of
parens
patriae protected children against their "objectionable"
parents.
E.g., Wellesley v. Wellesley, 2 Bli.N.S. 124,
133-134, 4 Eng.Rep. 1078, 102 (H.L. 1828).
See generally
Kleinfeld, The Balance of Power Among Infants, Their Parents and
the State, Part III, 5 Family L. Q. 64, 66-71 (1971). Every State
has enacted legislation to defend children from parental abuse.
Wilcox, Child Abuse Laws: Past, Present, and Future, 21 J. Forensic
Sciences 71, 72 (1976).
[
Footnote 4/47]
The contexts in which this issue may arise are too varied to
support any general rule. Appellees cite our recent decision in
Parham v. J.R., 442 U. S. 584
(1979), to support their claim that parents should be presumed
competent to be involved in their minor daughter's abortion
decision. That decision is inapposite to this case in several
respects. First, the minor child in
Parham who was
committed to a mental hospital was presumed incompetent to make the
commitment decision himself.
Id. at
442 U.S. 623 (STEWART, J., concurring
in judgment). In contrast, appellant, by statute, is presumed
competent to make the decision about whether to complete or abort
her pregnancy. Furthermore, in
Parham, the Court placed
critical reliance on the ultimately determinative, independent
review of the commitment decision by medical experts. Here, the
physician's independent medical judgment -- that an abortion was in
appellant's best medical interest -- not only was not ultimate, it
was defeated by the notice requirement. Finally, as JUSTICE STEWART
emphasized in his opinion concurring in the judgment in
Parham, the pregnant minor has a "personal substantive . .
. right" to decide on an abortion.
Id. at
442 U.S. 623-624, n. 6.
[
Footnote 4/48]
Most States, through their legislature or courts, have adopted
the common law principle that a minor may become freed of the
disabilities of that status -- and at the same time release his
parents from their parental obligations -- prior to the actual date
of his majority. Certain acts, in and of themselves, may occasion
emancipation.
See, e.g., Cal.Civ.Code Ann. § 62 (West
1954 and Supp. 1981) (emancipation upon marriage or entry in Armed
Services); Utah Code Ann. § 15-2-1 (Supp. 1979) (emancipation
upon marriage);
Crook v. Crook, 80 Ariz. 275,
296 P.2d 951
(1956) (same). A minor may become partially emancipated if he is
partially self-supporting, but still entitled to some parental
assistance.
See Katz, Schroeder, & Sidman,
Emancipating Our Children -- Coming of Legal Age in America, 7
Fam.L.Q. 211, 215 (1973). Several States, by statute, permit
emancipation for a specific purpose, such as obtaining medical care
without parental consent,
e.g., Cal.Civ.Code Ann. §
34.6 (West Supp. 1981); Mont. Code Ann. § 41-1-402 (1979)
(woman of any age may consent to pregnancy-related medical care);
Utah Code Ann. § 78-14-5(4)(f) (1977) (same), § 26-6-39.1
(1976) (minor can consent to medical treatment for venereal
disease); Tex.Rev.Civ.Stat.Ann., Art. 4447i (Vernon 1976) (person
at least 13 years old may consent to medical treatment for drug
dependency).
See Pilpel, Minors' Rights to Medical Care,
36 Albany L.Rev. 462 (1972). Several States provide for
emancipation once the individual becomes a parent.
E.g.,
Ky.Rev.Stat. § 214.185(2) (1977). In Utah, minors who become
parents are authorized to make all medical care decisions for their
offspring. Utah Code Ann. § 7814-5(4)(a) (1977).
See
generally Cohen v. Delaware, L. & W. R. Co., 150 Misc.
450, 453-457, 269 N.Y.S. 667, 671-676 (1934);
L.R. v.
Hansen, No. C-80-0078J (Utah, Feb. 8, 1980) (self-supporting
minor seeking abortion is emancipated and mature); Goldstein,
Medical Care for the Child at Risk: On State Supervention of
Parental Autonomy, 86 Yale L.J. 645, 663 (1977) (recommending
objective criteria to avoid case-by-case determination of
emancipation).
[
Footnote 4/49]
The "mature minor" doctrine permits a child to consent to
medical treatment if he is capable of appreciating its nature and
consequences.
E.g., L.R. v. Hansen, supra, (this mature
minor "is capable of understanding her condition and making an
informed decision which she has done after carefully considering
the alternatives available to her and consulting the persons with
whom she felt she should consult" prior to abortion decision);
Ark.Stat.Ann. § 82-363(g) (1976).
See Lacey v. Laird,
166 Ohio St. 12, 139 N.E.2d 25 (1956) (physician not liable for
battery after acting with minor's consent);
Smith v.
Seibly, 72 Wash. 2d
16, 21-22,
431 P.2d
719, 723 (1967);
Younts v. St. Francis Hosp. & School
of Nursing, Inc., 205 Kan. 292, 300-301,
469 P.2d 330,
337 (1970).
Four Members of this Court embraced the "mature minor" concept
in striking down a statute requiring parental notice and consent to
a minor's abortion, regardless of her own maturity.
Bellotti
II, 443 U.S. at
443 U. S.
643-644, and nn. 22 and 23. In
Bellotti II,
JUSTICE POWELL's opinion for four Members of this Court suggested
that a statute could withstand constitutional attack if it
permitted case-by-case administrative or judicial determination of
a pregnant minor's capacity to make an abortion decision with her
physician and independent of her parents.
Ibid. Because
this view was expressed in a case not involving such a statute, and
because it would expose the minor to the arduous and public rigors
of administrative or judicial process, four other Members of this
Court rejected it as advisory and at odds with the privacy interest
at stake.
Id. at
443 U. S.
654-656, and n. 4 (STEVENS, J., joined by BRENNAN,
MARSHALL, and BLACKMUN, JJ.). Nonetheless, even under JUSTICE
POWELL's reasoning in
Bellotti II, the instant statute is
unconstitutional. Not only does it preclude case-by-case
consideration of the maturity of the minor, it also prevents
individualized review to determine whether parental notice would be
harmful to the minor.
[
Footnote 4/50]
E.g., Ky.Rev.Stat. § 214.185(3) (1977); Utah Code
Ann. § 2631-8 (1976); 1979 Utah Laws, ch. 98, § 7. The
need for emergency medical care may even overcome the religious
objections of the parents.
E.g., In re Clark, 21 Ohio
Op.2d 86, 89-90, 185 N.E.2d 128, 131-132 (Com.Pl., Lucas County
1962);
In re Sampson, 65 Misc.2d 658, 317 N.Y.S.2d 641
(Family Ct.),
aff'd, 37 App.Div.2d 668, 323 N.Y.S.2d 253
(1970); Mass.Gen.Laws. Ann., ch. 112, § 12F (West Supp. 1981);
Miss.Code Ann. § 41-41-7 (1972). Delay in treating
nonemergency health needs may, of course, produce an emergency,
and, for that reason, this Court found statutory provision for
emergency but not nonemergency care illogical.
Memorial
Hospital v. Maricopa County, 415 U. S. 250,
415 U. S. 261,
265 (1974). In asserting that the Utah statute would not apply to
minors with emergency health care needs, the Court fails to point
to anything in the statute, the record, or Utah case law to the
contrary. The Supreme Court of Utah addressed only one kind of
emergency: where the parents cannot be physically located in
sufficient time to permit performance of the abortion. 604 P.2d at
913. The court rejected any other emergency situation as an
exception to the statute when it declined to afford a broad
interpretation of the phrase, "if possible," which modifies the
notice requirement. Even where the emergency is simply that the
parents cannot be reached, the statute applies; the physician
subject to its sanction merely has been granted an affirmative
defense that he exercised "reasonable diligence" in attempting to
locate and notify the parents.
Ibid. The majority purports
to draw support for its view of the Utah statute on this point from
a Massachusetts statute, construed by the Massachusetts Supreme
Judicial Court,
see ante at
450 U. S. 407,
n. 14.
[
Footnote 4/51]
As one medical authority observed:
"One can well argue that an adolescent old enough to make the
decision to be sexually active . . . and who is then responsible
enough to seek professional assistance for his or her problem, is
ipso facto mature enough to consent to his own health
care."
Hofmann,
supra, 450
U.S. 398fn4/25|>n. 25, at 51.
See Goldstein, 86
Yale L.J. at 633.
[
Footnote 4/52]
Utah Code Ann. § 78-14-5(4)(f) (1977).
[
Footnote 4/53]
Utah Code Ann. § 76-7-305 (1978) requires voluntary and
informed written consent.
See 450
U.S. 398fn4/36|>n. 36,
supra.
[
Footnote 4/54]
Cf. Wynn v. Carey, 582 F.2d at 1388.