I join Parts I, II, III, V-A, V-C, and VI of the
joint opinion of JUSTICES O'CONNOR, KENNEDY, and SOUTER, ante.
Three years ago, in Webster v. Reproductive Health Services 492 U.S.
490 (1989), four Members of this Court appeared poised to "cas[t] into darkness the
hopes and visions of every woman in this country" who had come to believe that the
Constitution guaranteed her the right to reproductive choice. Id., at 557
(BLACKMUN, J., dissenting). See id., at 499 (plurality opinion of REHNQUIST, C. J.,
joined by White and Kennedy, JJ.); id., at 532 (SCALIA, J., concurring in part and
concurring in judgment). All that remained between the promise of Roe and the darkness of
the plurality was a single, flickering flame. Decisions since Webster gave little reason
to hope that this flame would cast much light. See, e.g., Ohio v. Akron Center for
Reproductive Health, 497 U.S. 502, 524 (1990) (BLACKMUN, J., dissenting). But now, just
when so many expected the darkness to fall, the flame has grown bright. [505 U.S. 833,
923]
I do not underestimate the significance of today's joint opinion.
Yet I remain steadfast in my belief that the right to reproductive choice is entitled to
the full protection afforded by this Court before Webster. And I fear for the darkness as
four Justices anxiously await the single vote necessary to extinguish the light.
I
Make no mistake, the joint opinion of Justices O'CONNOR, KENNEDY,
and SOUTER is an act of personal courage and constitutional principle. In contrast to
previous decisions in which Justices O'CONNOR and KENNEDY postponed reconsideration of Roe
v. Wade, 410 U.S. 113 (1973), the authors of the joint opinion today join JUSTICE STEVENS
and me in concluding that "the essential holding of Roe v. Wade should be retained
and once again reaffirmed." Ante at 846. In brief, five Members of this Court
today recognize that "the Constitution protects a woman's right to terminate her
pregnancy in its early stages." Ante, at 844.
A fervent view of individual liberty and the force of stare
decisis have led the Court to this conclusion. Ante, at 853. Today a majority
reaffirms that the Due Process Clause of the Fourteenth Amendment establishes "a
realm of personal liberty which the government may not enter," ante, at 847 -
a realm whose outer limits cannot be determined by interpretations of the Constitution
that focus only on the specific practices of States at the time the Fourteenth Amendment
was adopted. See ante, at 848-849. Included within this realm of liberty is
"the right of the individual, married or single, to be free from unwarranted
governmental intrusion into matters so fundamentally affecting a person as the decision
whether to bear or beget a child." Ante, at 851, quoting Eisenstadt v. Baird,
405 U.S. 438, 453 (1972) (emphasis in original). These matters, involving the most
intimate and personal choices a person may make in a lifetime, choices central to personal
dignity and autonomy, are central to the [505 U.S. 833, 924] liberty protected by
the Fourteenth Amendment. Ante, at 851 (emphasis added). Finally, the Court today
recognizes that, in the case of abortion, the liberty of the woman is at stake in a sense
unique to the human condition and so unique to the law. The mother who carries a child to
full term is subject to anxieties, to physical constraints, to pain that only she must
bear. Ante, at 852.
The Court's reaffirmation of Roe's central holding is also based on
the force of stare decisis. [N]o erosion of principle going to liberty or personal
autonomy has left Roe's central holding a doctrinal remnant; Roe portends no developments
at odds with other precedent for the analysis of personal liberty; and no changes of fact
have rendered viability more or less appropriate as the point at which the balance of
interests tips. Ante, at 860-861. Indeed, the Court acknowledges that Roe's
limitation on state power could not be removed without serious inequity to those who have
relied upon it or significant damage to the stability of the society governed by the rule
in question. Ante, at 855. In the 19 years since Roe was decided, that case has
shaped more than reproductive planning - [a]n entire generation has come of age free to
assume Roe's concept of liberty in defining the capacity of women to act in society, and
to make reproductive decisions. Ante, at 860. The Court understands that, having
"call[ed] the contending sides . . . to end their national division by accepting a
common mandate rooted in the Constitution," ante, at 867, a decision to
overrule Roe would seriously weaken the Court's capacity to exercise the judicial power
and to function as the Supreme Court of a Nation dedicated to the rule of law. Ante,
at 865. What has happened today should serve as a model for future Justices and a warning
to all who have tried to turn this Court into yet another political branch.
In striking down the Pennsylvania statute's spousal notification
requirement, the Court has established a framework [505 U.S. 833, 925] for evaluating
abortion regulations that responds to the social context of women facing issues of
reproductive choice. [Fn1] In determining the burden imposed by the challenged regulation,
the Court inquires whether the regulation's "purpose or effect is to place a
substantial obstacle in the path of a woman seeking an abortion before the fetus attains
viability." Ante, at 878 (emphasis added). The Court reaffirms: The proper
focus of constitutional inquiry is the group for whom the law is a restriction, not the
group for whom the law is irrelevant. Ante, at 894. Looking at this group, the
Court inquires, based on expert testimony, empirical studies, and common sense, whether,
in a large fraction of the cases in which [the restriction] is relevant, it will operate
as a substantial obstacle to a woman's choice to undergo an abortion. Ante, at 895.
A statute with this purpose is invalid because the means chosen by the State to further
the interest in potential life must be calculated to inform the woman's free choice, not
hinder it. Ante, at 877. And in applying its test, the Court remains sensitive to
the unique role of women in the decisionmaking process. Whatever may have been the
practice when the Fourteenth Amendment was adopted, the Court observes, [w]omen do not
lose their constitutionally protected liberty when they marry. The Constitution protects
all individuals, male or female, married or unmarried, from the abuse of governmental
power, even where that power is employed for the supposed benefit of a member of the
individual's family. Ante, at 898. [Fn2]
===========Begin Footnotes===========
[Fn 1] As I shall explain, the joint opinion and I disagree on the
appropriate standard of review for abortion regulations. I do agree, however that the
reasons advanced by the joint opinion suffice to invalidate the spousal notification
requirement under a strict scrutiny standard.
[Fn 2] I also join the Court's decision to uphold the medical
emergency provision. As the Court notes, its interpretation is consistent with the
essential holding of Roe that forbids a State from interfering with a woman's choice to
undergo an abortion procedure if continuing her pregnancy [505 U.S. 833, 926] would
constitute a threat to her health. Ante, at 880. As is apparent in my analysis
below, however, this exception does not render constitutional the provisions which I
conclude do not survive strict scrutiny.
===========End Footnotes===========
[505 U.S. 833, 926]
Lastly, while I believe that the joint opinion errs in failing to
invalidate the other regulations, I am pleased that the joint opinion has not ruled out
the possibility that these regulations may be shown to impose an unconstitutional burden.
The joint opinion makes clear that its specific holdings are based on the insufficiency of
the record before it. See, e.g., ante, at 885-886. I am confident that, in the
future, evidence will be produced to show that, in a large fraction of the cases in which
[these regulations are] relevant, [they] will operate as a substantial obstacle to a
woman's choice to undergo an abortion. Ante, at 895.
II
Today, no less than yesterday, the Constitution and decisions of
this Court require that a State's abortion restrictions be subjected to the strictest of
judicial scrutiny. Our precedents and the joint opinion's principles require us to subject
all non-de-minimis abortion regulations to strict scrutiny. Under this standard, the
Pennsylvania statute's provisions requiring content-based counseling, a 24-hour delay,
informed parental consent, and reporting of abortion-related information must be
invalidated.
A
The Court today reaffirms the long recognized rights of privacy and
bodily integrity. As early as 1891, the Court held, [n]o right is held more sacred, or is
more carefully guarded by the common law, than the right of every individual to the
possession and control of his own person, free from all restraint or interference of
others. . . . Union Pacific R. Co. v. Botsford, 141 U.S. 250, 251 (1891). Throughout this
century, this Court also has held that the fundamental right of privacy protects citizens
against governmental intrusion [505 U.S. 833, 927] in such intimate family matters as
procreation, childrearing, marriage, and contraceptive choice. See ante, at
847-849. These cases embody the principle that personal decisions that profoundly affect
bodily integrity, identity, and destiny should be largely beyond the reach of government.
Eisenstadt, 405 U.S., at 453. In Roe v. Wade, this Court correctly applied these
principles to a woman's right to choose abortion.
State restrictions on abortion violate a woman's right of privacy in
two ways. First, compelled continuation of a pregnancy infringes upon a woman's right to
bodily integrity by imposing substantial physical intrusions and significant risks of
physical harm. During pregnancy, women experience dramatic physical changes and a wide
range of health consequences. Labor and delivery pose additional health risks and physical
demands. In short, restrictive abortion laws force women to endure physical invasions far
more substantial than those this Court has held to violate the constitutional principle of
bodily integrity in other contexts. See, e.g., Winston v. Lee, 470 U.S. 753 (1985)
(invalidating surgical removal of bullet from murder suspect); Rochin v. California, 342
U.S. 165 (1952) (invalidating stomach-pumping). [Fn3]
=========Begin Footnotes=========
[Fn 3] As the joint opinion acknowledges, ante, at 857, this
Court has recognized the vital liberty interest of persons in refusing unwanted medical
treatment. Cruzan v. Director, Mo. Dept. of Health, 497 U.S. 261 (1990). Just as the Due
Process Clause protects the deeply personal decision of the individual to refuse medical
treatment, it also must protect the deeply personal decision to obtain medical treatment,
including a woman's decision to terminate a pregnancy.
=========End Footnotes=========
Further, when the State restricts a woman's right to terminate her
pregnancy, it deprives a woman of the right to make her own decision about reproduction
and family planning - critical life choices that this Court long has deemed central to the
right to privacy. The decision to terminate or continue a pregnancy has no less an impact
on a woman's life than decisions about contraception or marriage. 410 U.S., [505 U.S. 833,
928] at 153. Because motherhood has a dramatic impact on a woman's educational prospects,
employment opportunities, and self-determination, restrictive abortion laws deprive her of
basic control over her life. For these reasons, "the decision whether or not to beget
or bear a child" lies at "the very heart of this cluster of constitutionally
protected choices." Carey v. Population Services International, 431 U.S. 678, 685
(1977).
A State's restrictions on a woman's right to terminate her pregnancy
also implicate constitutional guarantees of gender equality. State restrictions on
abortion compel women to continue pregnancies they otherwise might terminate. By
restricting the right to terminate pregnancies, the State conscripts women's bodies into
its service, forcing women to continue their pregnancies, suffer the pains of childbirth,
and in most instances, provide years of maternal care. The State does not compensate women
for their services; instead, it assumes that they owe this duty as a matter of course.
This assumption - that women can simply be forced to accept the "natural" status
and incidents of motherhood - appears to rest upon a conception of women's role that has
triggered the protection of the Equal Protection Clause. See, e.g., Mississippi Univ. for
Women v. Hogan, 458 U.S. 718, 724-726 (1982); Craig v. Boren, 429 U.S. 190, 198-199
(1976). [Fn4] The joint opinion recognizes that these assumptions about women's place in
society "are no longer consistent with our [505 U.S. 833, 929] understanding of the
family, the individual, or the Constitution." Ante, at 897.
=========Begin Footnotes=========
[Fn 4] A growing number of commentators are recognizing this point.
See, e.g., L. Tribe, American Constitutional Law 15-10, pp. 1353-1359 (2d ed. 1988);
Siegel, Reasoning from the Body: A Historical Perspective on Abortion Regulation and
Questions of Equal Protection, 44 Stan.L.Rev. 261, 350-380 (1992); Sunstein, Neutrality in
Constitutional Law (With Special Reference to Pornography, Abortion, and Surrogacy), 92
Colum.L.Rev. 1, 31-44 (1992); MacKinnon, Reflections on Sex Equality Under Law, 100 Yale
L.J. 1281, 1308-1324 (1991); cf. Rubenfeld, The Right of Privacy, 102 Harv.L.Rev. 737,
788-791 (1989) (similar analysis under the rubric of privacy); MacKinnon, Reflections on
Sex Equality Under Law, 100 Yale L. J. 1281, 1308-1324 (1991).
=========End Footnotes=========
B
The Court has held that limitations on the right of privacy are
permissible only if they survive "strict" constitutional scrutiny - that is,
only if the governmental entity imposing the restriction can demonstrate that the
limitation is both necessary and narrowly tailored to serve a compelling governmental
interest. Griswold v. Connecticut, 381 U.S. 479, 485 (1965). We have applied this
principle specifically in the context of abortion regulations. Roe v. Wade, 410 U.S., at
155. [Fn5]
==========Begin Footnotes==========
[Fn 5] To say that restrictions on a right are subject to strict
scrutiny is not to say that the right is absolute. Regulations can be upheld if they have
no significant impact on the woman's exercise of her right and are justified by important
state health objectives. See, e.g., Planned Parenthood of Central Mo. v. Danforth, 428
U.S. 52, 65-67, 79-81 (1976) (upholding requirements of a woman's written consent and
record-keeping). But the Court today reaffirms the essential principle of Roe that a woman
has the right "to choose to have an abortion before viability and to obtain it
without undue interference from the State." Ante, at 846. Under Roe, any more
than de minimis interference is undue.
==========End Footnotes==========
Roe implemented these principles through a framework that was
designed to ensure that the woman's right to choose not become so subordinate to the
State's interest in promoting fetal life that her choice exists in theory, but not in
fact, ante, at 872. Roe identified two relevant state interests: "an interest
in preserving and protecting the health of the pregnant woman" and an interest in
"protecting the potentiality of human life." 410 U.S., at 162. With respect to
the State's interest in the health of the mother, "the `compelling' point . . . is at
approximately the end of the first trimester," because it is at that point that the
mortality rate in abortion approaches that in childbirth. Id., at 163. With respect
to the State's interest in potential life, "the `compelling' point is at
viability," because it is at that point that the [505 U.S. 833, 930] fetus
"presumably has the capability of meaningful life outside the mother's womb."
Ibid. In order to fulfill the requirement of narrow tailoring, "the State is
obligated to make a reasonable effort to limit the effect of its regulations to the period
in the trimester during which its health interest will be furthered. Akron v. Akron Center
for Reproductive Health, Inc., 462 U.S. 416, 434 (1983).
In my view, application of this analytical framework is no less
warranted than when it was approved by seven Members of this Court in Roe. Strict scrutiny
of state limitations on reproductive choice still offers the most secure protection of the
woman's right to make her own reproductive decisions, free from state coercion. No
majority of this Court has ever agreed upon an alternative approach. The factual premises
of the trimester framework have not been undermined, see Webster, 492 U.S., at 553
(BLACKMUN, J., dissenting), and the Roe framework is far more administrable, and far less
manipulable, than the "undue burden" standard adopted by the joint opinion.
Nonetheless, three criticisms of the trimester framework continue to
be uttered. First, the trimester framework is attacked because its key elements do not
appear in the text of the Constitution. My response to this attack remains the same as it
was in Webster:
"Were this a true concern, we would have to abandon most of our
constitutional jurisprudence. [T]he "critical elements" of countless
constitutional doctrines nowhere appear in the Constitution's text. . . . The Constitution
makes no mention, for example, of the First Amendment's "actual malice" standard
for proving certain libels, see New York Times Co. v. Sullivan, 376 U.S. 254 (1964). . . .
Similarly, the Constitution makes no mention of the rational basis test, or the specific
verbal formulations of intermediate and strict scrutiny by which this Court evaluates
claims under the Equal Protection Clause. The reason is simple. Like the Roe framework,
these [505 U.S. 833, 931] tests or standards are not, and do not purport to be, rights
protected by the Constitution. Rather, they are judge-made methods for evaluating and
measuring the strength and scope of constitutional rights or for balancing the
constitutional rights of individuals against the competing interests of government. Id.,
at 548.
The second criticism is that the framework more closely resembles a
regulatory code than a body of constitutional doctrine. Again, my answer remains the same
as in Webster:
"[I]f this were a true and genuine concern, we would have to
abandon vast areas of our constitutional jurisprudence. . . . Are [the distinctions
entailed in the trimester framework] any finer, or more "regulatory," than the
distinctions we have often drawn in our First Amendment jurisprudence, where, for example,
we have held that a "release time" program permitting public school students to
leave school grounds during school hours to receive religious instruction does not violate
the Establishment Clause, even though a release time program permitting religious
instruction on school grounds does violate the Clause? Compare Zorach v. Clauson, 343 U.S.
306 (1952), with Illinois ex rel. McCollum v. Board of Education of School Dist. No. 71,
Champaign County, 333 U.S. 203 (1948). . . . Similarly, in a Sixth Amendment case, the
Court held that, although an overnight ban on attorney-client communication violated the
constitutionally guaranteed right to counsel, Geders v. United States, 425 U.S. 80 (1976),
that right was not violated when a trial judge separated a defendant from his lawyer
during a 15-minute recess after the defendant's direct testimony. Perry v. Leeke, 488 U.S.
272 (1989).
"That numerous constitutional doctrines result in narrow
differentiations between similar circumstances does [505 U.S. 833, 932] not mean that this
Court has abandoned adjudication in favor of regulation. Id., at 549-550.
The final, and more genuine, criticism of the trimester framework is
that it fails to find the State's interest in potential human life compelling throughout
pregnancy. No Member of this Court - nor for that matter, the Solicitor General, Tr. of
Oral Arg. 42 - has ever questioned our holding in Roe that an abortion is not "the
termination of life entitled to Fourteenth Amendment protection." 410 U.S., at 159.
Accordingly, a State's interest in protecting fetal life is not grounded in the
Constitution. Nor, consistent with our Establishment Clause, can it be a theological or
sectarian interest. See Thornburgh v. American College of Obtetricians and Gynecologists,
476 U.S. 778, 747, (1986) (STEVENS, J., concurring). It is, instead, a legitimate interest
grounded in humanitarian or pragmatic concerns. See ante, at 914-915 (STEVENS, J.,
concurring in part and dissenting in part).
But while a State has "legitimate interests from the outset of
the pregnancy in protecting the health of the woman and the life of the fetus that may
become a child," ante, at 846, legitimate interests are not enough. To
overcome the burden of strict scrutiny, the interests must be compelling. The question
then is how best to accommodate the State's interest in potential human life with the
constitutional liberties of pregnant women. Again, I stand by the views I expressed in
Webster:
"I remain convinced, as six other Members of this Court 16
years ago were convinced, that the Roe framework, and the viability standard in
particular, fairly, sensibly, and effectively functions to safeguard the constitutional
liberties of pregnant women while recognizing and accommodating the State's interest in
potential human life. The viability line reflects the biological facts and truths of fetal
development; it marks that threshold moment prior to which a fetus cannot survive separate
from the [505 U.S. 833, 933] woman and cannot reasonably and objectively be regarded as a
subject of rights or interests distinct from, or paramount to, those of the pregnant
woman. At the same time, the viability standard takes account of the undeniable fact that,
as the fetus evolves into its postnatal form, and as it loses its dependence on the
uterine environment, the State's interest in the fetus' potential human life, and in
fostering a regard for human life in general, becomes compelling. As a practical matter,
because viability follows "quickening" - the point at which a woman feels
movement in her womb - and because viability occurs no earlier than 23 weeks gestational
age, it establishes an easily applicable standard for regulating abortion, while providing
a pregnant woman ample time to exercise her fundamental right with her responsible
physician to terminate her pregnancy. 492 U.S., at 553-554. [Fn6]
==========Begin Footnotes==========
[Fn 6] The joint opinion agrees with Roe's conclusion that viability
occurs at 23 or 24 weeks at the earliest. Compare ante, at 860 with Roe v. Wade,
410 U.S. 113, 160 (1973).
==========End Footnotes==========
Roe's trimester framework does not ignore the State's interest in
prenatal life. Like JUSTICE STEVENS, ante, at 916, I agree that the State may take
steps to ensure that a woman's choice "is thoughtful and informed," ante,
at 872, and that States are free to enact laws to provide a reasonable framework for a
woman to make a decision that has such profound and lasting meaning. Ante, at 873.
But
"[s]erious questions arise . . . when a State attempts to
"persuade the woman to choose childbirth over abortion." Ante, at 878.
Decisional autonomy must limit the State's power to inject into a woman's most personal
deliberations its own views of what is best. The State may promote its preferences by
funding childbirth, by creating and maintaining alternatives to abortion, and by espousing
the virtues of family; but it must respect [505 U.S. 833, 934] the individual's freedom to
make such judgments. Ante, at 916 (STEVENS, J., concurring in part and dissenting
in part) (internal quotation marks omitted).
As the joint opinion recognizes, the means chosen by the State to
further the interest in potential life must be calculated to inform the woman's free
choice, not hinder it. Ante, at 877.
In sum, Roe's requirement of strict scrutiny as implemented through
a trimester framework should not be disturbed. No other approach has gained a majority,
and no other is more protective of the woman's fundamental right. Lastly, no other
approach properly accommodates the woman's constitutional right with the State's
legitimate interests.
C
Application of the strict scrutiny standard results in the
invalidation of all the challenged provisions. Indeed, as this Court has invalidated
virtually identical provisions in prior cases, stare decisis requires that we again
strike them down.
This Court has upheld informed and written consent requirements only
where the State has demonstrated that they genuinely further important health-related
state concerns. See Planned Parenthood of Central Mo. v. Danforth, 428 U.S. 65-67, 52,
(1976). A State may not, under the guise of securing informed consent, "require the
delivery of information `designed to influence the woman's informed choice between
abortion or childbirth.'" Thornburgh, 476 U.S., at 760 quoting Akron, 462 U.S., at
443-444. Rigid requirements that a specific body of information be imparted to a woman in
all cases, regardless of the needs of the patient, improperly intrude upon the discretion
of the pregnant woman's physician. and thereby impose an "`undesired and
uncomfortable straitjacket.'" Thornburgh, 476 U.S., at 762, quoting Danforth, 428
U.S., at 67, n. 8.
Measured against these principles, some aspects of the Pennsylvania
informed consent scheme are unconstitutional. [505 U.S. 833, 935] While it is
unobjectionable for the Commonwealth to require that the patient be informed of the nature
of the procedure, the health risks of the abortion and of childbirth, and the probable
gestational age of the unborn child, compare Pa. Cons. Stat. §§ 3205(a)(1)(i)-(iii)
(1990) with Akron, 462 U.S., at 446, n. 37, I remain unconvinced that there is a vital
state need for insisting that the information be provided by a physician, rather than a
counselor. Id., at 448. The District Court found that the physician-only
requirement necessarily would increase costs to the plaintiff clinics, costs that
undoubtedly would be passed on to patients. And because trained women counselors are often
more understanding than physicians, and generally have more time to spend with patients,
see App. 366-387, the physician-only disclosure requirement is not narrowly tailored to
serve the Commonwealth's interest in protecting maternal health.
Sections 3205(a)(2)(i) (iii) of the Act further requires that the
physician or a qualified nonphysician inform the woman that printed materials are
available from the Commonwealth that describe the fetus and provide information about
medical assistance for childbirth, information about child support from the father, and a
list of agencies offering adoption and other services as alternatives to abortion.
Thornburgh invalidated biased patient counseling requirements virtually identical to the
one at issue here. What we said of those requirements fully applies in this case:
"[T]he listing of agencies in the printed Pennsylvania form
presents serious problems; it contains names of agencies that well may be out of step with
the needs of the particular woman, and thus places the physician in an awkward position
and infringes upon his or her professional responsibilities. Forcing the physician or
counselor to present the materials and the list to the woman makes him or her in effect an
agent of the State in treating the woman and places his or her imprimatur upon both the
materials and the list. All this is, or [505 U.S. 833, 936] comes close to being, state
medicine imposed upon the woman, not the professional medical guidance she seeks, and it
officially structures - as it obviously was intended to do - the dialogue between the
woman and her physician.
"The requirements . . . that the woman be advised that medical
assistance benefits may be available, and that the father is responsible for financial
assistance in the support of the child similarly are poorly disguised elements of
discouragement for the abortion decision. Much of this . . ., for many patients, would be
irrelevant and inappropriate. For a patient with a life-threatening pregnancy, the
"information," in its very rendition, may be cruel as well as destructive of the
physician-patient relationship. As any experienced social worker or other counselor knows,
theoretical financial responsibility often does not equate with fulfillment. . . . Under
the guise of informed consent, the Act requires the dissemination of information that is
not relevant to such consent, and, thus, it advances no legitimate state interest."
476 U.S., at 762.
"This type of compelled information is the antithesis of
informed consent," id., at 764, and goes far beyond merely describing the
general subject matter relevant to the woman's decision. That the Commonwealth does not,
and surely would not, compel similar disclosure of every possible peril of necessary
surgery or of simple vaccination, reveals the antiabortion character of the statute and
its real purpose." Ibid. [Fn7]
==========Begin Footnotes==========
[Fn 7] While I do not agree with the joint opinion's conclusion that
these provisions should be upheld, the joint opinion has remained faithful to principles
this Court previously has announced in examining counseling provisions. For example, the
joint opinion concludes that the "information the State requires to be made available
to the woman" must be "truthful and not misleading." Ante, at 882.
Because the State's information must be "calculated to inform the woman's free
choice, not hinder [505 U.S. 833, 937] it," ante, at 877, the measures must be
designed to ensure that a woman's choice is "mature and informed," ante,
at 883, not intimidated, imposed, or impelled. To this end, when the State requires the
provision of certain information, the State may not alter the manner of
presentation in order to inflict "psychological abuse," ante, at 893,
designed to shock or unnerve a woman seeking to exercise her liberty right. This, for
example, would appear to preclude a State from requiring a woman to view graphic
literature or films detailing the performance of an abortion operation. Just as a visual
preview of an operation to remove an appendix plays no part in a physician's securing
informed consent to an appendectomy, a preview of scenes appurtenant to any major medical
intrusion into the human body does not constructively inform the decision of a woman of
the State's interest in the preservation of the woman's health or demonstrate the State's
"profound respect for the life of the unborn." Ante, at 877.
==========End Footnotes==========
[505 U.S. 833, 937]
The 24-hour waiting period following the provision of the foregoing
information is also clearly unconstitutional. The District Court found that the mandatory
24-hour delay could lead to delays in excess of 24 hours, thus increasing health risks,
and that it would require two visits to the abortion provider, thereby increasing travel
time, exposure to further harassment, and financial cost. Finally, the District Court
found that the requirement would pose especially significant burdens on women living in
rural areas and those women that have difficulty explaining their whereabouts. 744 F.
Supp. 1323, 1378-1379 (ED pa. 1990). In Akron, this Court invalidated a similarly
arbitrary or inflexible waiting period because, as here, it furthered no legitimate state
interest. [Fn8]
==========Begin Footnotes==========
[Fn 8] The Court's decision in Hodgson v. Minnesota, 497 U.S. 417
(1990), validating a 48-hour waiting period for minors seeking an abortion to permit
parental involvement does not alter this conclusion. Here the 24-hour delay is imposed on
an adult woman. See id., at 449-450, n. 35; Ohio v. Akron Center for
Reproductive Health, Inc., 497 U.S. 502, (1990). Moreover, the statute in Hodgson did not
require any delay once the minor obtained the affirmative consent of either a parent or
the court.
==========End Footnotes==========
As JUSTICE STEVENS insightfully concludes, the mandatory delay rests
either on outmoded or unacceptable assumptions about the decisionmaking capacity of women
or the belief that the decision to terminate the pregnancy is [505 U.S. 833, 938]
presumptively wrong. Ante, at 918-919. The requirement that women consider this
obvious and slanted information for an additional 24 hours contained in these provisions
will only influence the woman's decision in improper ways. The vast majority of women will
know this information - of the few that do not, it is less likely that their minds will be
changed by this information than it will be either by the realization that the State
opposes their choice or the need once again to endure abuse and harassment on return to
the clinic. [Fn9]
==========Begin Footnotes==========
[Fn 9] Because this information is so widely known, I am confident
that a developed record can be made to show that the 24-hour delay, in a large fraction of
the cases in which [the restriction] is relevant, . . . will operate as a substantial
obstacle to a woman's choice to undergo an abortion. Ante, at 895.
==========End Footnotes==========
Except in the case of a medical emergency, § 3206 requires a
physician to obtain the informed consent of a parent or guardian before performing an
abortion on an unemancipated minor or an incompetent woman. Based on evidence in the
record, the District Court concluded that, in order to fulfill the informed consent
requirement, generally accepted medical principles would require an in-person visit by the
parent to the facility. 744 F. Supp., at 1382.Although the Court "has recognized that
the State has somewhat broader authority to regulate the activities of children than of
adults," the State nevertheless must demonstrate that there is a "significant
State interest in conditioning an abortion . . . that is not present in the case of an
adult." Danforth, 428 U.S., at 74-75 (emphasis added). The requirement of an
in-person visit would carry with it the risk of a delay of several days or possibly weeks,
even where the parent is willing to consent. While the State has an interest in
encouraging parental involvement in the minor's abortion decision, § 3206 is not narrowly
drawn to serve that interest. [Fn10]
==========Begin Footnotes==========
[Fn 10] The judicial-bypass provision does not cure this violation.
Hodgson is distinguishable, since this case involves more than parental involvement or
approval - rather, the Pennsylvania law requires that the parent receive information
designed to discourage abortion in a face-to-face meeting with [505 U.S. 833, 939] the
physician. The bypass procedure cannot ensure that the parent would obtain the
information, since, in many instances, the parent would not even attend the hearing. A
State may not place any restriction on a young woman's right to an abortion, however
irrational, simply because it has provided a judicial bypass.
==========End Footnotes==========
[505 U.S. 833, 939]
Finally, the Pennsylvania statute requires every facility performing
abortions to report its activities to the Commonwealth. Pennsylvania contends that this
requirement is valid under Danforth, in which this Court held that recordkeeping and
reporting requirements that are reasonably directed to the preservation of maternal
health, and that properly respect a patient's confidentiality, are permissible. Id.,
at 79-81. The Commonwealth attempts to justify its required reports on the ground that the
public has a right to know how its tax dollars are spent. A regulation designed to inform
the public about public expenditures does not further the Commonwealth's interest in
protecting maternal health. Accordingly, such a regulation cannot justify a legally
significant burden on a woman's right to obtain an abortion.
The confidential reports concerning the identities and medical
judgment of physicians involved in abortions at first glance may seem valid, given the
Commonwealth's interest in maternal health and enforcement of the Act. The District Court
found, however, that, notwithstanding the confidentiality protections, many physicians,
particularly those who have previously discontinued performing abortions because of
harassment, would refuse to refer patients to abortion clinics if their names were to
appear on these reports. 744 F. Supp., at 1392. The Commonwealth has failed to show that
the name of the referring physician either adds to the pool of scientific knowledge
concerning abortion or is reasonably related to the Commonwealth's interest in maternal
health. I therefore agree with the District Court's conclusion that the confidential
reporting requirements are unconstitutional [505 U.S. 833, 940] insofar as they require
the name of the referring physician and the basis for his or her medical judgment.
In sum, I would affirm the judgment in No. 91-902 and reverse the
judgment in No. 91-744 and remand the cases for further proceedings.
III
At long last, THE CHIEF JUSTICE and those who have joined him admit
it. Gone are the contentions that the issue need not be (or has not been) considered.
There, on the first page, for all to see, is what was expected: We believe that Roe was
wrongly decided, and that it can and should be overruled consistently with our traditional
approach to stare decisis in constitutional cases. Post, at 944. If there is
much reason to applaud the advances made by the joint opinion today, there is far more to
fear from THE CHIEF JUSTICE's opinion.
THE CHIEF JUSTICE's criticism of Roe follows from his stunted
conception of individual liberty. While recognizing that the Due Process Clause protects
more than simple physical liberty, he then goes on to construe this Court's personal
liberty cases as establishing only a laundry list of particular rights, rather than a
principled account of how these particular rights are grounded in a more general right of
privacy. Post, at 951. This constricted view is reinforced by THE CHIEF JUSTICE's
exclusive reliance on tradition as a source of fundamental rights. He argues that the
record in favor of a right to abortion is no stronger than the record in Michael H. v.
Gerald D., 491 U.S. 110 (1989), where the plurality found no fundamental right to
visitation privileges by an adulterous father, or in Bowers v. Hardwick, 478 U.S. 186
(1986), where the Court found no fundamental right to engage in homosexual sodomy, or in a
case involving the "`firing [of] a gun . . . into another person's body.'"
Post, at 951-952. In THE CHIEF JUSTICE's world, a woman considering whether to
terminate a pregnancy is entitled to no more protection than adulterers, murderers, and
so-called sexual [505 U.S. 833, 941] deviates. [Fn11] Given THE CHIEF JUSTICE's exclusive
reliance on tradition, people using contraceptives seem the next likely candidate for his
list of outcasts.
==========Begin Footnotes==========
[Fn 11] Obviously, I do not share The CHIEF JUSTICE's views of
homosexuality as sexual deviance. See Bowers, 478 U.S., at 202-203, n. 2.
==========End Footnotes==========
Even more shocking than THE CHIEF JUSTICE's cramped notion of
individual liberty is his complete omission of any discussion of the effects that
compelled childbirth and motherhood have on women's lives. The only expression of concern
with women's health is purely instrumental - for THE CHIEF JUSTICE, only women's psychological
health is a concern, and only to the extent that he assumes that every woman who decides
to have an abortion does so without serious consideration of the moral implications of
their decision. Post, at 967-968. In short, THE CHIEF JUSTICE's view of the State's
compelling interest in maternal health has less to do with health than it does with
compelling women to be maternal.
Nor does THE CHIEF JUSTICE give any serious consideration to the
doctrine of stare decisis. For THE CHIEF JUSTICE, the facts that gave rise to Roe
are surprisingly simple: women become pregnant, there is a point somewhere, depending on
medical technology, where a fetus becomes viable, and women give birth to children.
Post, at 955. This characterization of the issue thus allows THE CHIEF JUSTICE quickly
to discard the joint opinion's reliance argument by asserting that "reproductive
planning could take virtually immediate account of" a decision overruling Roe.
Post, at 956. (internal quotation marks omitted).
THE CHIEF JUSTICE's narrow conception of individual liberty and stare
decisis leads him to propose the same standard of review proposed by the plurality in
Webster. States may regulate abortion procedures in ways rationally related to a
legitimate state interest. Williamson v. Lee Optical of Oklahoma, Inc., 348 U.S. 483, 491
(1955); cf. Stanley v. Illinois, 405 U.S. 645, 651-653 (1972). Post, at 966. THE
[505 U.S. 833, 942] CHIEF JUSTICE then further weakens the test by providing an
insurmountable requirement for facial challenges: Petitioners must "`show that no set
of circumstances exists under which the [provision] would be valid.'" Post, at
973, quoting Ohio v. Akron Center for Reproductive Health, 497 U.S., at 514. In short, in
his view, petitioners must prove that the statute cannot constitutionally be applied to anyone.
Finally, in applying his standard to the spousal-notification provision, THE CHIEF JUSTICE
contends that the record lacks any "hard evidence" to support the joint
opinion's contention that a "large fraction" of women who prefer not to notify
their husbands involve situations of battered women and unreported spousal assault.
Post, at 974, n. 2. Yet throughout the explication of his standard, THE CHIEF JUSTICE
never explains what hard evidence is, how large a fraction is required, or how a battered
women is supposed to pursue an as-applied challenge.
Under his standard, States can ban abortion if that ban is
rationally related to a legitimate state interest - a standard which the United States
calls "deferential, but not toothless." Yet when pressed at oral argument to
describe the teeth, the best protection that the Solicitor General could offer to women
was that a prohibition, enforced by criminal penalties, with no exception for the life
of the mother, "could raise very serious questions." Tr. of Oral Arg. 48.
Perhaps, the Solicitor General offered, the failure to include an exemption for the life
of the mother would be "arbitrary and capricious." Id., at 49. If, as THE
CHIEF JUSTICE contends, the undue burden test is made out of whole cloth, the so-called
"arbitrary and capricious" limit is the Solicitor General's "new
clothes."
Even if it is somehow "irrational" for a State to require
a woman to risk her life for her child, what protection is offered for women who become
pregnant through rape or incest? Is there anything arbitrary or capricious about a [505
U.S. 833, 943] State's prohibiting the sins of the father from being visited upon his
offspring?[Fn12]
==========Begin Footnotes==========
[Fn 12] JUSTICE SCALIA urges the Court to "get out of this
area," post, at 1002, and leave questions regarding abortion entirely to the
States, post, at 999-1002. Putting aside the fact that what he advocates is nothing
short of an abdication by the Court of its constitutional responsibilities, JUSTICE SCALIA
is uncharacteristically naive if he thinks that overruling Roe and holding that
restrictions on a woman's right to an abortion are subject only to rational basis review
will enable the Court henceforth to avoid reviewing abortion-related issues. State efforts
to regulate and prohibit abortion in a post-Roe world undoubtedly would raise a host of
distinct and important constitutional questions meriting review by this Court. For
example, does the Eighth Amendment impose any limits on the degree or kind of punishment a
State can inflict upon physicians who perform, or women who undergo, abortions? What
effect would differences among States in their approaches to abortion have on a woman's
right to engage in interstate travel? Does the First Amendment permit States that choose
not to criminalize abortion to ban all advertising providing information about where and
how to obtain abortions?
==========End Footnotes==========
But, we are reassured, there is always the protection of the
democratic process. While there is much to be praised about our democracy, our country,
since its founding, has recognized that there are certain fundamental liberties that are
not to be left to the whims of an election. A woman's right to reproductive choice is one
of those fundamental liberties. Accordingly, that liberty need not seek refuge at the
ballot box.
IV
In one sense, the Court's approach is worlds apart from that of THE
CHIEF JUSTICE and JUSTICE SCALIA. And yet, in another sense, the distance between the two
approaches is short - the distance is but a single vote.
I am 83 years old. I cannot remain on this Court forever, and when I
do step down, the confirmation process for my successor well may focus on the issue before
us today. That, I regret, may be exactly where the choice between the two worlds will be
made.