MR. JUSTICE BLACKMUN delivered the opinion of the Court.
MR. JUSTICE REHNQUIST, dissenting.
MR. JUSTICE
STEWART, concurring.
A pregnant single woman (Roe) brought a
class action challenging the constitutionality of the Texas criminal abortion
laws, which proscribe procuring or attempting an abortion except on medical
advice for the purpose of saving the mother's life. A licensed physician (Hallford),
who had two state abortion prosecutions pending against him, was permitted to
intervene. A childless married couple (the Does), the wife not being pregnant,
separately attacked the laws, basing alleged injury on the future possibilities
of contraceptive failure, pregnancy, unpreparedness for parenthood, and
impairment of the wife's health. A three-judge District Court, which
consolidated the actions, held that Roe and Hallford, and members of their
classes, had standing to sue and presented justiciable controversies. Ruling
that declaratory, though not injunctive, relief was warranted, the court
declared the abortion statutes void as vague and overbroadly infringing those
plaintiffs' Ninth and Fourteenth Amendment rights. The court ruled the Does'
complaint not justiciable. Appellants directly appealed to this Court on the
injunctive rulings, and appellee cross-appealed from the District Court's grant
of declaratory relief to Roe and Hallford. Held:
1. While 28 U. S. C. § 1253 authorizes no
direct appeal to this Court from the grant or denial of declaratory relief
alone, review is not foreclosed when the case is properly before the Court on
appeal from specific denial of injunctive relief and the arguments as to both
injunctive and declaratory relief are necessarily identical. P. 123.
2. Roe has standing to sue; the Does and
Hallford do not. Pp. 123-129.
(a) Contrary to appellee's contention, the
natural termination of Roe's pregnancy did not moot her suit. Litigation
involving pregnancy, which is "capable of repetition, yet evading review," is an
exception to the usual federal rule that an actual controversy must exist at
review stages and not simply when the action is initiated. Pp. 124-125.
(b) The District Court correctly refused
injunctive, but erred in granting declaratory, relief to Hallford, who alleged
no federally protected right not assertable as a defense against the good-faith
state prosecutions pending against him. Samuels v. Mackell, 401 U.S. 66. Pp.
125-127.
(c) The Does' complaint, based as it is on
contingencies, any one or more of which may not occur, is too speculative to
present an actual case or controversy. Pp. 127-129.
3. State criminal abortion laws, like those
involved here, that except from criminality only a life-saving procedure on the
mother's behalf without regard to the stage of her pregnancy and other interests
involved violate the Due Process Clause of the Fourteenth Amendment, which
protects against state action the right to privacy, including a woman's
qualified right to terminate her pregnancy. Though the State cannot override
that right, it has legitimate interests in protecting both the pregnant woman's
health and the potentiality of human life, each of which interests grows and
reaches a "compelling" point at various stages of the woman's approach to term.
Pp. 147-164.
(a) For the stage prior to approximately
the end of the first trimester, the abortion decision and its effectuation must
be left to the medical judgment of the pregnant woman's attending physician. Pp.
163, 164.
(b) For the stage subsequent to
approximately the end of the first trimester, the State, in promoting its
interest in the health of the mother, may, if it chooses, regulate the abortion
procedure in ways that are reasonably related to maternal health. Pp. 163, 164.
(c) For the stage subsequent to viability
the State, in promoting its interest in the potentiality of human life, may, if
it chooses, regulate, and even proscribe, abortion except where necessary, in
appropriate medical judgment, for the preservation of the life or health of the
mother. Pp. 163-164; 164-165.
4. The State may define the term
"physician" to mean only a physician currently licensed by the State, and may
proscribe any abortion by a person who is not a physician as so defined. P. 165.
5. It is unnecessary to decide the
injunctive relief issue since the Texas authorities will doubtless fully
recognize the Court's ruling that the Texas criminal abortion statutes are
unconstitutional. P. 166.
MR. JUSTICE BLACKMUN delivered the
opinion of the Court.
This Texas federal appeal and its Georgia
companion, Doe v. Bolton, post, p. 179, present constitutional challenges to
state criminal abortion legislation. The Texas statutes under attack here are
typical of those that have been in effect in many States for approximately a
century. The Georgia statutes, in contrast, have a modern cast and are a
legislative product that, to an extent at least, obviously reflects the
influences of recent attitudinal change, of advancing medical knowledge and
techniques, and of new thinking about an old issue.
We forthwith acknowledge our awareness of
the sensitive and emotional nature of the abortion controversy, of the vigorous
opposing views, even among physicians, and of the deep and seemingly absolute
convictions that the subject inspires. One's philosophy, one's experiences,
one's exposure to the raw edges of human existence, one's religious training,
one's attitudes toward life and family and their values, and the moral standards
one establishes and seeks to observe, are all likely to influence and to color
one's thinking and conclusions about abortion.
In addition, population growth, pollution,
poverty, and racial overtones tend to complicate and not to simplify the
problem.
Our task, of course, is to resolve the
issue by constitutional measurement, free of emotion and of predilection. We
seek earnestly to do this, and, because we do, we have inquired into, and in
this opinion place some emphasis upon, medical and medical-legal history and
what that history reveals about man's attitudes toward the abortion procedure
over the centuries. We bear in mind, too, Mr. Justice Holmes' admonition in his
now-vindicated dissent in Lochner v. New York, 198 U.S. 45, 76 (1905):
"[The Constitution] is made for people of
fundamentally differing views, and the accident of our finding certain opinions
natural and familiar or novel and even shocking ought not to conclude our
judgment upon the question whether statutes embodying them conflict with the
Constitution of the United States."
I
The Texas statutes that concern us here are
Arts. 1191-1194 and 1196 of the State's Penal Code.
1 These
make it a crime to "procure an abortion," as therein defined, or to attempt one,
except with respect to "an abortion procured or attempted by medical advice for
the purpose of saving the life of the mother." Similar statutes are in existence
in a majority of the States. 2
Texas first enacted a criminal abortion
statute in 1854. Texas Laws 1854, c. 49, § 1, set forth in 3 H. Gammel, Laws of
Texas 1502 (1898). This was soon modified into language that has remained
substantially unchanged to the present time. See Texas Penal Code of 1857, c. 7,
Arts. 531-536; G. Paschal, Laws of Texas, Arts. 2192-2197 (1866); Texas Rev.
Stat., c. 8, Arts. 536-541 (1879); Texas Rev. Crim. Stat., Arts. 1071-1076
(1911). The final article in each of these compilations provided the same
exception, as does the present Article 1196, for an abortion by "medical advice
for the purpose of saving the life of the mother."
3
II
Jane Roe,
4
a single woman who was residing in Dallas County, Texas, instituted this federal
action in March 1970 against the District Attorney of the county. She sought a
declaratory judgment that the Texas criminal abortion statutes were
unconstitutional on their face, and an injunction restraining the defendant from
enforcing the statutes.
Roe alleged that she was unmarried and
pregnant; that she wished to terminate her pregnancy by an abortion "performed
by a competent, licensed physician, under safe, clinical conditions"; that she
was unable to get a "legal" abortion in Texas because her life did not appear to
be threatened by the continuation of her pregnancy; and that she could not
afford to travel to another jurisdiction in order to secure a legal abortion
under safe conditions. She claimed that the Texas statutes were
unconstitutionally vague and that they abridged her right of personal privacy,
protected by the First, Fourth, Fifth, Ninth, and Fourteenth Amendments. By an
amendment to her complaint Roe purported to sue "on behalf of herself and all
other women" similarly situated.
James Hubert Hallford, a licensed
physician, sought and was granted leave to intervene in Roe's action. In his
complaint he alleged that he had been arrested previously for violations of the
Texas abortion statutes and that two such prosecutions were pending against him.
He described conditions of patients who came to him seeking abortions, and he
claimed that for many cases he, as a physician, was unable to determine whether
they fell within or outside the exception recognized by Article 1196. He alleged
that, as a consequence, the statutes were vague and uncertain, in violation of
the Fourteenth Amendment, and that they violated his own and his patients'
rights to privacy in the doctor-patient relationship and his own right to
practice medicine, rights he claimed were guaranteed by the First, Fourth,
Fifth, Ninth, and Fourteenth Amendments.
John and Mary Doe,
5
a married couple, filed a companion complaint to that of Roe. They also named
the District Attorney as defendant, claimed like constitutional deprivations,
and sought declaratory and injunctive relief. The Does alleged that they were a
childless couple; that Mrs. Doe was suffering from a "neural-chemical" disorder;
that her physician had "advised her to avoid pregnancy until such time as her
condition has materially improved" (although a pregnancy at the present time
would not present "a serious risk" to her life); that, pursuant to medical
advice, she had discontinued use of birth control pills; and that if she should
become pregnant, she would want to terminate the pregnancy by an abortion
performed by a competent, licensed physician under safe, clinical conditions. By
an amendment to their complaint, the Does purported to sue "on behalf of
themselves and all couples similarly situated."
The two actions were consolidated and heard
together by a duly convened three-judge district court. The suits thus presented
the situations of the pregnant single woman, the childless couple, with the wife
not pregnant, and the licensed practicing physician, all joining in the attack
on the Texas criminal abortion statutes. Upon the filing of affidavits, motions
were made for dismissal and for summary judgment. The court held that Roe and
members of her class, and Dr. Hallford, had standing to sue and presented
justiciable controversies, but that the Does had failed to allege facts
sufficient to state a present controversy and did not have standing. It
concluded that, with respect to the requests for a declaratory judgment,
abstention was not warranted. On the merits, the District Court held that the
"fundamental right of single women and married persons to choose whether to have
children is protected by the Ninth Amendment, through the Fourteenth Amendment,"
and that the Texas criminal abortion statutes were void on their face because
they were both unconstitutionally vague and constituted an overbroad
infringement of the plaintiffs' Ninth Amendment rights. The court then held that
abstention was warranted with respect to the requests for an injunction. It
therefore dismissed the Does' complaint, declared the abortion statutes void,
and dismissed the application for injunctive relief. 314 F.Supp. 1217, 1225 (ND
Tex. 1970).
The plaintiffs Roe and Doe and the
intervenor Hallford, pursuant to 28 U. S. C. § 1253, have appealed to this Court
from that part of the District Court's judgment denying the injunction. The
defendant District Attorney has purported to cross-appeal, pursuant to the same
statute, from the court's grant of declaratory relief to Roe and Hallford. Both
sides also have taken protective appeals to the United States Court of Appeals
for the Fifth Circuit. That court ordered the appeals held in abeyance pending
decision here. We postponed decision on jurisdiction to the hearing on the
merits. 402 U.S. 941 (1971).
III
It might have been preferable if the
defendant, pursuant to our Rule 20, had presented to us a petition for
certiorari before judgment in the Court of Appeals with respect to the granting
of the plaintiffs' prayer for declaratory relief. Our decisions in Mitchell v.
Donovan, 398 U.S. 427 (1970), and Gunn v. University Committee, 399 U.S. 383
(1970), are to the effect that § 1253 does not authorize an appeal to this Court
from the grant or denial of declaratory relief alone. We conclude, nevertheless,
that those decisions do not foreclose our review of both the injunctive and the
declaratory aspects of a case of this kind when it is properly here, as this one
is, on appeal under § 1253 from specific denial of injunctive relief, and the
arguments as to both aspects are necessarily identical. See Carter v. Jury
Comm'n, 396 U.S. 320 (1970); Florida Lime Growers v. Jacobsen, 362 U.S. 73,
80-81 (1960). It would be destructive of time and energy for all concerned were
we to rule otherwise. Cf. Doe v. Bolton, post, p. 179.
IV
We are next confronted with issues of
justiciability, standing, and abstention. Have Roe and the Does established that
"personal stake in the outcome of the controversy," Baker v. Carr, 369 U.S. 186,
204 (1962), that insures that "the dispute sought to be adjudicated will be
presented in an adversary context and in a form historically viewed as capable
of judicial resolution," Flast v. Cohen, 392 U.S. 83, 101 (1968), and Sierra
Club v. Morton, 405 U.S. 727, 732 (1972)? And what effect did the pendency of
criminal abortion charges against Dr. Hallford in state court have upon the
propriety of the federal court's granting relief to him as a plaintiff-intervenor?
A. Jane Roe. Despite the use of the pseudonym, no suggestion is made that Roe is
a fictitious person. For purposes of her case, we accept as true, and as
established, her existence; her pregnant state, as of the inception of her suit
in March 1970 and as late as May 21 of that year when she filed an alias
affidavit with the District Court; and her inability to obtain a legal abortion
in Texas.
Viewing Roe's case as of the time of its
filing and thereafter until as late as May, there can be little dispute that it
then presented a case or controversy and that, wholly apart from the class
aspects, she, as a pregnant single woman thwarted by the Texas criminal abortion
laws, had standing to challenge those statutes. Abele v. Markle, 452 F.2d 1121,
1125 (CA2 1971); Crossen v. Breckenridge, 446 F.2d 833, 838-839 (CA6 1971); Poe
v. Menghini, 339 F.Supp. 986, 990-991 (Kan. 1972). See Truax v. Raich, 239 U.S.
33 (1915). Indeed, we do not read the appellee's brief as really asserting
anything to the contrary. The "logical nexus between the status asserted and the
claim sought to be adjudicated," Flast v. Cohen, 392 U.S., at 102, and the
necessary degree of contentiousness, Golden v. Zwickler, 394 U.S. 103 (1969),
are both present.
The appellee notes, however, that the
record does not disclose that Roe was pregnant at the time of the District Court
hearing on May 22, 1970,
6 or on
the following June 17 when the court's opinion and judgment were filed. And he
suggests that Roe's case must now be moot because she and all other members of
her class are no longer subject to any 1970 pregnancy.
The usual rule in federal cases is that an
actual controversy must exist at stages of appellate or certiorari review, and
not simply at the date the action is initiated. United States v. Munsingwear,
Inc., 340 U.S. 36 (1950); Golden v. Zwickler, supra; SEC v. Medical Committee
for Human Rights, 404 U.S. 403 (1972).
But when, as here, pregnancy is a
significant fact in the litigation, the normal 266-day human gestation period is
so short that the pregnancy will come to term before the usual appellate process
is complete. If that termination makes a case moot, pregnancy litigation seldom
will survive much beyond the trial stage, and appellate review will be
effectively denied. Our law should not be that rigid. Pregnancy often comes more
than once to the same woman, and in the general population, if man is to
survive, it will always be with us. Pregnancy provides a classic justification
for a conclusion of nonmootness. It truly could be "capable of repetition, yet
evading review." Southern Pacific Terminal Co. v. ICC, 219 U.S. 498, 515 (1911).
See Moore v. Ogilvie, 394 U.S. 814, 816 (1969); Carroll v. Princess Anne, 393
U.S. 175, 178-179 (1968); United States v. W. T. Grant Co., 345 U.S. 629,
632-633 (1953).
We, therefore, agree with the District
Court that Jane Roe had standing to undertake this litigation, that she
presented a justiciable controversy, and that the termination of her 1970
pregnancy has not rendered her case moot.
B. Dr. Hallford. The doctor's position is
different. He entered Roe's litigation as a plaintiff-intervenor, alleging in
his complaint that he:
"In the past has been arrested for
violating the Texas Abortion Laws and at the present time stands charged by
indictment with violating said laws in the Criminal District Court of Dallas
County, Texas to-wit: (1) The State of Texas vs. James H. Hallford, No.
C-69-5307-IH, and (2) The State of Texas vs. James H. Hallford, No. C-69-2524-H.
In both cases the defendant is charged with abortion . . . ."
In his application for leave to intervene,
the doctor made like representations as to the abortion charges pending in the
state court. These representations were also repeated in the affidavit he
executed and filed in support of his motion for summary judgment.
Dr. Hallford is, therefore, in the position
of seeking, in a federal court, declaratory and injunctive relief with respect
to the same statutes under which he stands charged in criminal prosecutions
simultaneously pending in state court. Although he stated that he has been
arrested in the past for violating the State's abortion laws, he makes no
allegation of any substantial and immediate threat to any federally protected
right that cannot be asserted in his defense against the state prosecutions.
Neither is there any allegation of harassment or bad-faith prosecution. In order
to escape the rule articulated in the cases cited in the next paragraph of this
opinion that, absent harassment and bad faith, a defendant in a pending state
criminal case cannot affirmatively challenge in federal court the statutes under
which the State is prosecuting him, Dr. Hallford seeks to distinguish his status
as a present state defendant from his status as a "potential future defendant"
and to assert only the latter for standing purposes here.
We see no merit in that distinction. Our
decision in Samuels v. Mackell, 401 U.S. 66 (1971), compels the conclusion that
the District Court erred when it granted declaratory relief to Dr. Hallford
instead of refraining from so doing. The court, of course, was correct in
refusing to grant injunctive relief to the doctor. The reasons supportive of
that action, however, are those expressed in Samuels v. Mackell, supra, and in
Younger v. Harris, 401 U.S. 37 (1971); Boyle v. Landry, 401 U.S. 77 (1971);
Perez v. Ledesma, 401 U.S. 82 (1971); and Byrne v. Karalexis, 401 U.S. 216
(1971). See also Dombrowski v. Pfister, 380 U.S. 479 (1965). We note, in
passing, that Younger and its companion cases were decided after the three-judge
District Court decision in this case.
Dr. Hallford's complaint in intervention,
therefore, is to be dismissed.
7 He is
remitted to his defenses in the state criminal proceedings against him. We
reverse the judgment of the District Court insofar as it granted Dr. Hallford
relief and failed to dismiss his complaint in intervention.
C. The Does. In view of our ruling as to
Roe's standing in her case, the issue of the Does' standing in their case has
little significance. The claims they assert are essentially the same as those of
Roe, and they attack the same statutes. Nevertheless, we briefly note the Does'
posture.
Their pleadings present them as a childless
married couple, the woman not being pregnant, who have no desire to have
children at this time because of their having received medical advice that Mrs.
Doe should avoid pregnancy, and for "other highly personal reasons." But they
"fear . . . they may face the prospect of becoming parents." And if pregnancy
ensues, they "would want to terminate" it by an abortion. They assert an
inability to obtain an abortion legally in Texas and, consequently, the prospect
of obtaining an illegal abortion there or of going outside Texas to some place
where the procedure could be obtained legally and competently.
We thus have as plaintiffs a married couple
who have, as their asserted immediate and present injury, only an alleged
"detrimental effect upon [their] marital happiness" because they are forced to
"the choice of refraining from normal sexual relations or of endangering Mary
Doe's health through a possible pregnancy." Their claim is that sometime in the
future Mrs. Doe might become pregnant because of possible failure of
contraceptive measures, and at that time in the future she might want an
abortion that might then be illegal under the Texas statutes.
This very phrasing of the Does' position
reveals its speculative character. Their alleged injury rests on possible future
contraceptive failure, possible future pregnancy, possible future unpreparedness
for parenthood, and possible future impairment of health. Any one or more of
these several possibilities may not take place and all may not combine. In the
Does' estimation, these possibilities might have some real or imagined impact
upon their marital happiness. But we are not prepared to say that the bare
allegation of so indirect an injury is sufficient to present an actual case or
controversy. Younger v. Harris, 401 U.S., at 41-42; Golden v. Zwickler, 394
U.S., at 109-110; Abele v. Markle, 452 F.2d, at 1124-1125; Crossen v.
Breckenridge, 446 F.2d, at 839. The Does' claim falls far short of those
resolved otherwise in the cases that the Does urge upon us, namely, Investment
Co. Institute v. Camp, 401 U.S. 617 (1971); Data Processing Service v. Camp, 397
U.S. 150 (1970); and Epperson v. Arkansas, 393 U.S. 97 (1968). See also Truax v.
Raich, 239 U.S. 33 (1915).
The Does therefore are not appropriate
plaintiffs in this litigation. Their complaint was properly dismissed by the
District Court, and we affirm that dismissal.
V
The principal thrust of appellant's attack
on the Texas statutes is that they improperly invade a right, said to be
possessed by the pregnant woman, to choose to terminate her pregnancy. Appellant
would discover this right in the concept of personal "liberty" embodied in the
Fourteenth Amendment's Due Process Clause; or in personal, marital, familial,
and sexual privacy said to be protected by the Bill of Rights or its penumbras,
see Griswold v. Connecticut, 381 U.S. 479 (1965); Eisenstadt v. Baird, 405 U.S.
438 (1972); id., at 460 (WHITE, J., concurring in result); or among those rights
reserved to the people by the Ninth Amendment, Griswold v. Connecticut, 381
U.S., at 486 (Goldberg, J., concurring). Before addressing this claim, we feel
it desirable briefly to survey, in several aspects, the history of abortion, for
such insight as that history may afford us, and then to examine the state
purposes and interests behind the criminal abortion laws.
VI
It perhaps is not generally appreciated
that the restrictive criminal abortion laws in effect in a majority of States
today are of relatively recent vintage. Those laws, generally proscribing
abortion or its attempt at any time during pregnancy except when necessary to
preserve the pregnant woman's life, are not of ancient or even of common-law
origin. Instead, they derive from statutory changes effected, for the most part,
in the latter half of the 19th century.
1. Ancient attitudes. These are not capable
of precise determination. We are told that at the time of the Persian Empire
abortifacients were known and that criminal abortions were severely punished.
8
We are also told, however, that abortion was practiced in Greek times as well as
in the Roman Era, 9
and that "it was resorted to without scruple."
10 The Ephesian, Soranos,
often described as the greatest of the ancient gynecologists, appears to have
been generally opposed to Rome's prevailing free-abortion practices. He found it
necessary to think first of the life of the mother, and he resorted to abortion
when, upon this standard, he felt the procedure advisable.
11 Greek
and Roman law afforded little protection to the unborn. If abortion was
prosecuted in some places, it seems to have been based on a concept of a
violation of the father's right to his offspring. Ancient religion did not bar
abortion. 12
2. The Hippocratic Oath. What then of the
famous Oath that has stood so long as the ethical guide of the medical
profession and that bears the name of the great Greek (460(?)-377(?) B. C.), who
has been described as the Father of Medicine, the "wisest and the greatest
practitioner of his art," and the "most important and most complete medical
personality of antiquity," who dominated the medical schools of his time, and
who typified the sum of the medical knowledge of the past?
13
The Oath varies somewhat according to the particular translation, but in any
translation the content is clear: "I will give no deadly medicine to anyone if
asked, nor suggest any such counsel; and in like manner I will not give to a
woman a pessary to produce abortion,"
14 or "I will neither
give a deadly drug to anybody if asked for it, nor will I make a suggestion to
this effect. Similarly, I will not give to a woman an abortive remedy."
15
Although the Oath is not mentioned in any
of the principal briefs in this case or in Doe v. Bolton, post, p. 179, it
represents the apex of the development of strict ethical concepts in medicine,
and its influence endures to this day. Why did not the authority of Hippocrates
dissuade abortion practice in his time and that of Rome? The late Dr. Edelstein
provides us with a theory:
16 The Oath was not
uncontested even in Hippocrates' day; only the Pythagorean school of
philosophers frowned upon the related act of suicide. Most Greek thinkers, on
the other hand, commended abortion, at least prior to viability. See Plato,
Republic, V, 461; Aristotle, Politics, VII, 1335b 25. For the Pythagoreans,
however, it was a matter of dogma. For them the embryo was animate from the
moment of conception, and abortion meant destruction of a living being. The
abortion clause of the Oath, therefore, "echoes Pythagorean doctrines," and "in
no other stratum of Greek opinion were such views held or proposed in the same
spirit of uncompromising austerity."
17
Dr. Edelstein then concludes that the Oath
originated in a group representing only a small segment of Greek opinion and
that it certainly was not accepted by all ancient physicians. He points out that
medical writings down to Galen (A. D. 130-200) "give evidence of the violation
of almost every one of its injunctions."
18 But with the end of
antiquity a decided change took place. Resistance against suicide and against
abortion became common. The Oath came to be popular. The emerging teachings of
Christianity were in agreement with the Pythagorean ethic. The Oath "became the
nucleus of all medical ethics" and "was applauded as the embodiment of truth."
Thus, suggests Dr. Edelstein, it is "a Pythagorean manifesto and not the
expression of an absolute standard of medical conduct."
19
This, it seems to us, is a satisfactory and
acceptable explanation of the Hippocratic Oath's apparent rigidity. It enables
us to understand, in historical context, a long-accepted and revered statement
of medical ethics.
3. The common law. It is undisputed that at
common law, abortion performed before "quickening" -- the first recognizable
movement of the fetus in utero, appearing usually from the 16th to the 18th week
of pregnancy 20
-- was not an indictable offense. 21
The absence of a common-law crime for pre-quickening abortion appears to have
developed from a confluence of earlier philosophical, theological, and civil and
canon law concepts of when life begins. These disciplines variously approached
the question in terms of the point at which the embryo or fetus became "formed"
or recognizably human, or in terms of when a "person" came into being, that is,
infused with a "soul" or "animated." A loose consensus evolved in early English
law that these events occurred at some point between conception and live birth.
22
This was "mediate animation." Although Christian theology and the canon law came
to fix the point of animation at 40 days for a male and 80 days for a female, a
view that persisted until the 19th century, there was otherwise little agreement
about the precise time of formation or animation. There was agreement, however,
that prior to this point the fetus was to be regarded as part of the mother, and
its destruction, therefore, was not homicide. Due to continued uncertainty about
the precise time when animation occurred, to the lack of any empirical basis for
the 40-80-day view, and perhaps to Aquinas' definition of movement as one of the
two first principles of life, Bracton focused upon quickening as the critical
point. The significance of quickening was echoed by later common-law scholars
and found its way into the received common law in this country.
Whether abortion of a quick fetus was a
felony at common law, or even a lesser crime, is still disputed. Bracton,
writing early in the 13th century, thought it homicide.
23 But the
later and predominant view, following the great common-law scholars, has been
that it was, at most, a lesser offense. In a frequently cited passage, Coke took
the position that abortion of a woman "quick with child" is "a great misprision,
and no murder." 24
Blackstone followed, saying that while abortion after quickening had once been
considered manslaughter (though not murder), "modern law" took a less severe
view. 25
A recent review of the common-law precedents argues, however, that those
precedents contradict Coke and that even post-quickening abortion was never
established as a common-law crime.
26 This is of some importance because while
most American courts ruled, in holding or dictum, that abortion of an
unquickened fetus was not criminal under their received common law,
27 others
followed Coke in stating that abortion of a quick fetus was a "misprision," a
term they translated to mean "misdemeanor."
28 That
their reliance on Coke on this aspect of the law was uncritical and, apparently
in all the reported cases, dictum (due probably to the paucity of common-law
prosecutions for post-quickening abortion), makes it now appear doubtful that
abortion was ever firmly established as a common-law crime even with respect to
the destruction of a quick fetus.
4. The English statutory law. England's first criminal abortion statute, Lord Ellenborough's Act, 43 Geo. 3, c. 58, came in 1803. It made abortion of a quick fetus, § 1, a capital crime, but in § 2 it provided lesser penalties for the felony of abortion before quickening, and thus preserved the "quickening" distinction. This contrast was continued in the general revision of 1828, 9 Geo. 4, c. 31, § 13. It disappeared, however, together with the death penalty, in 1837, 7 Will. 4 & 1 Vict., c. 85, § 6, and did not reappear in the Offenses Against the Person Act of 1861, 24 & 25 Vict., c. 100, § 59, that formed the core of English anti-abortion law until the liberalizing reforms of 1967. In 1929, the Infant Life (Preservation) Act, 19 & 20 Geo. 5, c. 34, came into being. Its emphasis was upon the destruction of "the life of a child capable of being born alive." It made a willful act performed with the necessary intent a felony. It contained a proviso that one was not to be found guilty of the offense "unless it is proved that the act which caused the death of the child was not done in good faith for the purpose only of preserving the life of the mother."
A seemingly notable development in the
English law was the case of Rex v. Bourne, [1939] 1 K. B. 687. This case
apparently answered in the affirmative the question whether an abortion
necessary to preserve the life of the pregnant woman was excepted from the
criminal penalties of the 1861 Act. In his instructions to the jury, Judge
Macnaghten referred to the 1929 Act, and observed that that Act related to "the
case where a child is killed by a wilful act at the time when it is being
delivered in the ordinary course of nature." Id., at 691. He concluded that the
1861 Act's use of the word "unlawfully," imported the same meaning expressed by
the specific proviso in the 1929 Act, even though there was no mention of
preserving the mother's life in the 1861 Act. He then construed the phrase
"preserving the life of the mother" broadly, that is, "in a reasonable sense,"
to include a serious and permanent threat to the mother's health, and instructed
the jury to acquit Dr. Bourne if it found he had acted in a good-faith belief
that the abortion was necessary for this purpose. Id., at 693-694. The jury did
acquit.
Recently, Parliament enacted a new abortion
law. This is the Abortion Act of 1967, 15 & 16 Eliz. 2, c. 87. The Act permits a
licensed physician to perform an abortion where two other licensed physicians
agree (a) "that the continuance of the pregnancy would involve risk to the life
of the pregnant woman, or of injury to the physical or mental health of the
pregnant woman or any existing children of her family, greater than if the
pregnancy were terminated," or (b) "that there is a substantial risk that if the
child were born it would suffer from such physical or mental abnormalities as to
be seriously handicapped." The Act also provides that, in making this
determination, "account may be taken of the pregnant woman's actual or
reasonably foreseeable environment." It also permits a physician, without the
concurrence of others, to terminate a pregnancy where he is of the good-faith
opinion that the abortion "is immediately necessary to save the life or to
prevent grave permanent injury to the physical or mental health of the pregnant
woman."
5. The American law. In this country, the
law in effect in all but a few States until mid-19th century was the
pre-existing English common law. Connecticut, the first State to enact abortion
legislation, adopted in 1821 that part of Lord Ellenborough's Act that related
to a woman "quick with child."
29 The death penalty was
not imposed. Abortion before quickening was made a crime in that State only in
1860. 30
In 1828, New York enacted legislation
31 that, in two respects,
was to serve as a model for early anti-abortion statutes. First, while barring
destruction of an unquickened fetus as well as a quick fetus, it made the former
only a misdemeanor, but the latter second-degree manslaughter. Second, it
incorporated a concept of therapeutic abortion by providing that an abortion was
excused if it "shall have been necessary to preserve the life of such mother, or
shall have been advised by two physicians to be necessary for such purpose." By
1840, when Texas had received the common law,
32 only eight American
States had statutes dealing with abortion.
33 It was
not until after the War Between the States that legislation began generally to
replace the common law. Most of these initial statutes dealt severely with
abortion after quickening but were lenient with it before quickening. Most
punished attempts equally with completed abortions. While many statutes included
the exception for an abortion thought by one or more physicians to be necessary
to save the mother's life, that provision soon disappeared and the typical law
required that the procedure actually be necessary for that purpose.
Gradually, in the middle and late 19th
century the quickening distinction disappeared from the statutory law of most
States and the degree of the offense and the penalties were increased. By the
end of the 1950's, a large majority of the jurisdictions banned abortion,
however and whenever performed, unless done to save or preserve the life of the
mother. 34
The exceptions, Alabama and the District of Columbia, permitted abortion to
preserve the mother's health. 35
Three States permitted abortions that were not "unlawfully" performed or that
were not "without lawful justification," leaving interpretation of those
standards to the courts. 36
In the past several years, however, a trend toward liberalization of abortion
statutes has resulted in adoption, by about one-third of the States, of less
stringent laws, most of them patterned after the ALI Model Penal Code, § 230.3,
37
set forth as Appendix B to the opinion in Doe v. Bolton, post, p. 205.
It is thus apparent that at common law, at
the time of the adoption of our Constitution, and throughout the major portion
of the 19th century, abortion was viewed with less disfavor than under most
American statutes currently in effect. Phrasing it another way, a woman enjoyed
a substantially broader right to terminate a pregnancy than she does in most
States today. At least with respect to the early stage of pregnancy, and very
possibly without such a limitation, the opportunity to make this choice was
present in this country well into the 19th century. Even later, the law
continued for some time to treat less punitively an abortion procured in early
pregnancy.
6. The position of the American Medical
Association. The anti-abortion mood prevalent in this country in the late 19th
century was shared by the medical profession. Indeed, the attitude of the
profession may have played a significant role in the enactment of stringent
criminal abortion legislation during that period.
An AMA Committee on Criminal Abortion was
appointed in May 1857. It presented its report, 12 Trans. of the Am. Med. Assn.
73-78 (1859), to the Twelfth Annual Meeting. That report observed that the
Committee had been appointed to investigate criminal abortion "with a view to
its general suppression." It deplored abortion and its frequency and it listed
three causes of "this general demoralization":
"The first of these causes is a wide-spread
popular ignorance of the true character of the crime -- a belief, even among
mothers themselves, that the foetus is not alive till after the period of
quickening.
"The second of the agents alluded to is the
fact that the profession themselves are frequently supposed careless of foetal
life . . . .
"The third reason of the frightful extent
of this crime is found in the grave defects of our laws, both common and
statute, as regards the independent and actual existence of the child before
birth, as a living being. These errors, which are sufficient in most instances
to prevent conviction, are based, and only based, upon mistaken and exploded
medical dogmas. With strange inconsistency, the law fully acknowledges the
foetus in utero and its inherent rights, for civil purposes; while personally
and as criminally affected, it fails to recognize it, and to its life as yet
denies all protection." Id., at 75-76. The Committee then offered, and the
Association adopted, resolutions protesting "against such unwarrantable
destruction of human life," calling upon state legislatures to revise their
abortion laws, and requesting the cooperation of state medical societies "in
pressing the subject." Id., at 28, 78.
In 1871 a long and vivid report was
submitted by the Committee on Criminal Abortion. It ended with the observation,
"We had to deal with human life. In a matter of less importance we could
entertain no compromise. An honest judge on the bench would call things by their
proper names. We could do no less." 22 Trans. of the Am. Med. Assn. 258 (1871).
It proffered resolutions, adopted by the Association, id., at 38-39,
recommending, among other things, that it "be unlawful and unprofessional for
any physician to induce abortion or premature labor, without the concurrent
opinion of at least one respectable consulting physician, and then always with a
view to the safety of the child -- if that be possible," and calling "the
attention of the clergy of all denominations to the perverted views of morality
entertained by a large class of females -- aye, and men also, on this important
question."
Except for periodic condemnation of the
criminal abortionist, no further formal AMA action took place until 1967. In
that year, the Committee on Human Reproduction urged the adoption of a stated
policy of opposition to induced abortion, except when there is "documented
medical evidence" of a threat to the health or life of the mother, or that the
child "may be born with incapacitating physical deformity or mental deficiency,"
or that a pregnancy "resulting from legally established statutory or forcible
rape or incest may constitute a threat to the mental or physical health of the
patient," two other physicians "chosen because of their recognized professional
competence have examined the patient and have concurred in writing, " and the
procedure "is performed in a hospital accredited by the Joint Commission on
Accreditation of Hospitals." The providing of medical information by physicians
to state legislatures in their consideration of legislation regarding
therapeutic abortion was "to be considered consistent with the principles of
ethics of the American Medical Association." This recommendation was adopted by
the House of Delegates. Proceedings of the AMA House of Delegates 40-51 (June
1967).
In 1970, after the introduction of a
variety of proposed resolutions, and of a report from its Board of Trustees, a
reference committee noted "polarization of the medical profession on this
controversial issue"; division among those who had testified; a difference of
opinion among AMA councils and committees; "the remarkable shift in testimony"
in six months, felt to be influenced "by the rapid changes in state laws and by
the judicial decisions which tend to make abortion more freely available;" and a
feeling "that this trend will continue." On June 25, 1970, the House of
Delegates adopted preambles and most of the resolutions proposed by the
reference committee. The preambles emphasized "the best interests of the
patient," "sound clinical judgment," and "informed patient consent," in contrast
to "mere acquiescence to the patient's demand." The resolutions asserted that
abortion is a medical procedure that should be performed by a licensed physician
in an accredited hospital only after consultation with two other physicians and
in conformity with state law, and that no party to the procedure should be
required to violate personally held moral principles.
38
Proceedings of the AMA House of Delegates 220 (June 1970). The AMA Judicial
Council rendered a complementary opinion.
39
7. The position of the American Public
Health Association. In October 1970, the Executive Board of the APHA adopted
Standards for Abortion Services. These were five in number:
"a. Rapid and simple abortion referral must
be readily available through state and local public health departments, medical
societies, or other nonprofit organizations.
"b. An important function of counseling
should be to simplify and expedite the provision of abortion services; it should
not delay the obtaining of these services.
" c. Psychiatric consultation should not be
mandatory. As in the case of other specialized medical services, psychiatric
consultation should be sought for definite indications and not on a routine
basis.
"d. A wide range of individuals from
appropriately trained, sympathetic volunteers to highly skilled physicians may
qualify as abortion counselors.
"e. Contraception and/or sterilization
should be discussed with each abortion patient." Recommended Standards for
Abortion Services, 61 Am. J. Pub. Health 396 (1971).
Among factors pertinent to life and health
risks associated with abortion were three that "are recognized as important":
"a. the skill of the physician,
"b. the environment in which the abortion
is performed, and above all
" c. the duration of pregnancy, as
determined by uterine size and confirmed by menstrual history." Id., at 397.
It was said that "a well-equipped hospital"
offers more protection "to cope with unforeseen difficulties than an office or
clinic without such resources. . . . The factor of gestational age is of
overriding importance." Thus, it was recommended that abortions in the second
trimester and early abortions in the presence of existing medical complications
be performed in hospitals as inpatient procedures. For pregnancies in the first
trimester, abortion in the hospital with or without overnight stay "is probably
the safest practice." An abortion in an extramural facility, however, is an
acceptable alternative "provided arrangements exist in advance to admit patients
promptly if unforeseen complications develop." Standards for an abortion
facility were listed. It was said that at present abortions should be performed
by physicians or osteopaths who are licensed to practice and who have "adequate
training." Id., at 398.
8. The position of the American Bar
Association. At its meeting in February 1972 the ABA House of Delegates
approved, with 17 opposing votes, the Uniform Abortion Act that had been drafted
and approved the preceding August by the Conference of Commissioners on Uniform
State Laws. 58 A. B. A. J. 380 (1972). We set forth the Act in full in the
margin. 40
The Conference has appended an enlightening Prefatory Note.
41
VII
Three reasons have been advanced to explain
historically the enactment of criminal abortion laws in the 19th century and to
justify their continued existence.
It has been argued occasionally that these
laws were the product of a Victorian social concern to discourage illicit sexual
conduct. Texas, however, does not advance this justification in the present
case, and it appears that no court or commentator has taken the argument
seriously. 42
The appellants and amici contend, moreover, that this is not a proper state
purpose at all and suggest that, if it were, the Texas statutes are overbroad in
protecting it since the law fails to distinguish between married and unwed
mothers.
A second reason is concerned with abortion
as a medical procedure. When most criminal abortion laws were first enacted, the
procedure was a hazardous one for the woman.
43
This was particularly true prior to the development of antisepsis. Antiseptic
techniques, of course, were based on discoveries by Lister, Pasteur, and others
first announced in 1867, but were not generally accepted and employed until
about the turn of the century. Abortion mortality was high. Even after 1900, and
perhaps until as late as the development of antibiotics in the 1940's, standard
modern techniques such as dilation and curettage were not nearly so safe as they
are today. Thus, it has been argued that a State's real concern in enacting a
criminal abortion law was to protect the pregnant woman, that is, to restrain
her from submitting to a procedure that placed her life in serious jeopardy.
Modern medical techniques have altered this
situation. Appellants and various amici refer to medical data indicating that
abortion in early pregnancy, that is, prior to the end of the first trimester,
although not without its risk, is now relatively safe. Mortality rates for women
undergoing early abortions, where the procedure is legal, appear to be as low as
or lower than the rates for normal childbirth.
44
Consequently, any interest of the State in protecting the woman from an
inherently hazardous procedure, except when it would be equally dangerous for
her to forgo it, has largely disappeared. Of course, important state interests
in the areas of health and medical standards do remain. The State has a
legitimate interest in seeing to it that abortion, like any other medical
procedure, is performed under circumstances that insure maximum safety for the
patient. This interest obviously extends at least to the performing physician
and his staff, to the facilities involved, to the availability of after-care,
and to adequate provision for any complication or emergency that might arise.
The prevalence of high mortality rates at illegal "abortion mills" strengthens,
rather than weakens, the State's interest in regulating the conditions under
which abortions are performed. Moreover, the risk to the woman increases as her
pregnancy continues. Thus, the State retains a definite interest in protecting
the woman's own health and safety when an abortion is proposed at a late stage
of pregnancy.
The third reason is the State's interest --
some phrase it in terms of duty -- in protecting prenatal life. Some of the
argument for this justification rests on the theory that a new human life is
present from the moment of conception.
45 The
State's interest and general obligation to protect life then extends, it is
argued, to prenatal life. Only when the life of the pregnant mother herself is
at stake, balanced against the life she carries within her, should the interest
of the embryo or fetus not prevail. Logically, of course, a legitimate state
interest in this area need not stand or fall on acceptance of the belief that
life begins at conception or at some other point prior to live birth. In
assessing the State's interest, recognition may be given to the less rigid claim
that as long as at least potential life is involved, the State may assert
interests beyond the protection of the pregnant woman alone.
Parties challenging state abortion laws
have sharply disputed in some courts the contention that a purpose of these
laws, when enacted, was to protect prenatal life.
46
Pointing to the absence of legislative history to support the contention, they
claim that most state laws were designed solely to protect the woman. Because
medical advances have lessened this concern, at least with respect to abortion
in early pregnancy, they argue that with respect to such abortions the laws can
no longer be justified by any state interest. There is some scholarly support
for this view of original purpose.
47 The few state courts called upon to
interpret their laws in the late 19th and early 20th centuries did focus on the
State's interest in protecting the woman's health rather than in preserving the
embryo and fetus. 48
Proponents of this view point out that in many States, including Texas,
49 by
statute or judicial interpretation, the pregnant woman herself could not be
prosecuted for self-abortion or for cooperating in an abortion performed upon
her by another. 50
They claim that adoption of the "quickening" distinction through received common
law and state statutes tacitly recognizes the greater health hazards inherent in
late abortion and impliedly repudiates the theory that life begins at
conception.
It is with these interests, and the weight
to be attached to them, that this case is concerned.
VIII
The Constitution does not explicitly
mention any right of privacy. In a line of decisions, however, going back
perhaps as far as Union Pacific R. Co. v. Botsford, 141 U.S. 250, 251 (1891),
the Court has recognized that a right of personal privacy, or a guarantee of
certain areas or zones of privacy, does exist under the Constitution. In varying
contexts, the Court or individual Justices have, indeed, found at least the
roots of that right in the First Amendment, Stanley v. Georgia, 394 U.S. 557,
564 (1969); in the Fourth and Fifth Amendments, Terry v. Ohio, 392 U.S. 1, 8-9
(1968), Katz v. United States, 389 U.S. 347, 350 (1967), Boyd v. United States,
116 U.S. 616 (1886), see Olmstead v. United States, 277 U.S. 438, 478 (1928) (Brandeis,
J., dissenting); in the penumbras of the Bill of Rights, Griswold v.
Connecticut, 381 U.S., at 484-485; in the Ninth Amendment, id., at 486
(Goldberg, J., concurring); or in the concept of liberty guaranteed by the first
section of the Fourteenth Amendment, see Meyer v. Nebraska, 262 U.S. 390, 399
(1923). These decisions make it clear that only personal rights that can be
deemed "fundamental" or "implicit in the concept of ordered liberty," Palko v.
Connecticut, 302 U.S. 319, 325 (1937), are included in this guarantee of
personal privacy. They also make it clear that the right has some extension to
activities relating to marriage, Loving v. Virginia, 388 U.S. 1, 12 (1967);
procreation, Skinner v. Oklahoma, 316 U.S. 535, 541-542 (1942); contraception,
Eisenstadt v. Baird, 405 U.S., at 453-454; id., at 460, 463-465 (WHITE, J.,
concurring in result); family relationships, Prince v. Massachusetts, 321 U.S.
158, 166 (1944); and child rearing and education, Pierce v. Society of Sisters,
268 U.S. 510, 535 (1925), Meyer v. Nebraska, supra.
This right of privacy, whether it be
founded in the Fourteenth Amendment's concept of personal liberty and
restrictions upon state action, as we feel it is, or, as the District Court
determined, in the Ninth Amendment's reservation of rights to the people, is
broad enough to encompass a woman's decision whether or not to terminate her
pregnancy. The detriment that the State would impose upon the pregnant woman by
denying this choice altogether is apparent. Specific and direct harm medically
diagnosable even in early pregnancy may be involved. Maternity, or additional
offspring, may force upon the woman a distressful life and future. Psychological
harm may be imminent. Mental and physical health may be taxed by child care.
There is also the distress, for all concerned, associated with the unwanted
child, and there is the problem of bringing a child into a family already
unable, psychologically and otherwise, to care for it. In other cases, as in
this one, the additional difficulties and continuing stigma of unwed motherhood
may be involved. All these are factors the woman and her responsible physician
necessarily will consider in consultation.
On the basis of elements such as these,
appellant and some amici argue that the woman's right is absolute and that she
is entitled to terminate her pregnancy at whatever time, in whatever way, and
for whatever reason she alone chooses. With this we do not agree. Appellant's
arguments that Texas either has no valid interest at all in regulating the
abortion decision, or no interest strong enough to support any limitation upon
the woman's sole determination, are unpersuasive. The Court's decisions
recognizing a right of privacy also acknowledge that some state regulation in
areas protected by that right is appropriate. As noted above, a State may
properly assert important interests in safeguarding health, in maintaining
medical standards, and in protecting potential life. At some point in pregnancy,
these respective interests become sufficiently compelling to sustain regulation
of the factors that govern the abortion decision. The privacy right involved,
therefore, cannot be said to be absolute. In fact, it is not clear to us that
the claim asserted by some amici that one has an unlimited right to do with
one's body as one pleases bears a close relationship to the right of privacy
previously articulated in the Court's decisions. The Court has refused to
recognize an unlimited right of this kind in the past. Jacobson v.
Massachusetts, 197 U.S. 11 (1905) (vaccination); Buck v. Bell, 274 U.S. 200
(1927) (sterilization).
We, therefore, conclude that the right of
personal privacy includes the abortion decision, but that this right is not
unqualified and must be considered against important state interests in
regulation.
We note that those federal and state courts
that have recently considered abortion law challenges have reached the same
conclusion. A majority, in addition to the District Court in the present case,
have held state laws unconstitutional, at least in part, because of vagueness or
because of overbreadth and abridgment of rights. Abele v. Markle, 342 F.Supp.
800 (Conn. 1972), appeal docketed, No. 72-56; Abele v. Markle, 351 F.Supp. 224
(Conn. 1972), appeal docketed, No. 72-730; Doe v. Bolton, 319 F.Supp. 1048 (ND
Ga. 1970), appeal decided today, post, p. 179; Doe v. Scott, 321 F.Supp. 1385
(ND Ill. 1971), appeal docketed, No. 70-105; Poe v. Menghini, 339 F.Supp. 986
(Kan. 1972); YWCA v. Kugler, 342 F.Supp. 1048 (NJ 1972); Babbitz v. McCann, 310
F.Supp. 293 (ED Wis. 1970), appeal dismissed, 400 U.S. 1 (1970); People v.
Belous, 71 Cal. 2d 954, 458 P. 2d 194 (1969), cert. denied, 397 U.S. 915 (1970);
State v. Barquet, 262 So. 2d 431 (Fla. 1972).
Others have sustained state statutes.
Crossen v. Attorney General, 344 F.Supp. 587 (ED Ky. 1972), appeal docketed, No.
72-256; Rosen v. Louisiana State Board of Medical Examiners, 318 F.Supp. 1217
(ED La. 1970), appeal docketed, No. 70-42; Corkey v. Edwards, 322 F.Supp. 1248 (WDNC
1971), appeal docketed, No. 71-92; Steinberg v. Brown, 321 F.Supp. 741 (ND Ohio
1970); Doe v. Rampton (Utah 1971), appeal docketed, No. 71-5666; Cheaney v.
State, Ind. , 285 N. E. 2d 265 (1972); Spears v. State, 257 So. 2d 876 (Miss.
1972); State v. Munson, 86 S. D. 663, 201 N. W. 2d 123 (1972), appeal docketed,
No. 72-631.
Although the results are divided, most of
these courts have agreed that the right of privacy, however based, is broad
enough to cover the abortion decision; that the right, nonetheless, is not
absolute and is subject to some limitations; and that at some point the state
interests as to protection of health, medical standards, and prenatal life,
become dominant. We agree with this approach.
Where certain "fundamental rights" are
involved, the Court has held that regulation limiting these rights may be
justified only by a "compelling state interest," Kramer v. Union Free School
District, 395 U.S. 621, 627 (1969); Shapiro v. Thompson, 394 U.S. 618, 634
(1969), Sherbert v. Verner, 374 U.S. 398, 406 (1963), and that legislative
enactments must be narrowly drawn to express only the legitimate state interests
at stake. Griswold v. Connecticut, 381 U.S., at 485; Aptheker v. Secretary of
State, 378 U.S. 500, 508 (1964); Cantwell v. Connecticut, 310 U.S. 296, 307-308
(1940); see Eisenstadt v. Baird, 405 U.S., at 460, 463-464 (WHITE, J.,
concurring in result).
In the recent abortion cases, cited above,
courts have recognized these principles. Those striking down state laws have
generally scrutinized the State's interests in protecting health and potential
life, and have concluded that neither interest justified broad limitations on
the reasons for which a physician and his pregnant patient might decide that she
should have an abortion in the early stages of pregnancy. Courts sustaining
state laws have held that the State's determinations to protect health or
prenatal life are dominant and constitutionally justifiable.
IX
The District Court held that the appellee
failed to meet his burden of demonstrating that the Texas statute's infringement
upon Roe's rights was necessary to support a compelling state interest, and
that, although the appellee presented "several compelling justifications for
state presence in the area of abortions," the statutes outstripped these
justifications and swept "far beyond any areas of compelling state interest."
314 F.Supp., at 1222-1223. Appellant and appellee both contest that holding.
Appellant, as has been indicated, claims an absolute right that bars any state
imposition of criminal penalties in the area. Appellee argues that the State's
determination to recognize and protect prenatal life from and after conception
constitutes a compelling state interest. As noted above, we do not agree fully
with either formulation.
A. The appellee and certain amici argue
that the fetus is a "person" within the language and meaning of the Fourteenth
Amendment. In support of this, they outline at length and in detail the
well-known facts of fetal development. If this suggestion of personhood is
established, the appellant's case, of course, collapses, for the fetus' right to
life would then be guaranteed specifically by the Amendment. The appellant
conceded as much on reargument.
51 On the other hand, the
appellee conceded on reargument 52
that no case could be cited that holds that a fetus is a person within the
meaning of the Fourteenth Amendment.
The Constitution does not define "person"
in so many words. Section 1 of the Fourteenth Amendment contains three
references to "person." The first, in defining "citizens," speaks of "persons
born or naturalized in the United States." The word also appears both in the Due
Process Clause and in the Equal Protection Clause. "Person" is used in other
places in the Constitution: in the listing of qualifications for Representatives
and Senators, Art. I, § 2, cl. 2, and § 3, cl. 3; in the Apportionment Clause,
Art. I, § 2, cl. 3;
53 in the Migration and Importation provision,
Art. I, § 9, cl. 1; in the Emolument Clause, Art. I, § 9, cl. 8; in the Electors
provisions, Art. II, § 1, cl. 2, and the superseded cl. 3; in the provision
outlining qualifications for the office of President, Art. II, § 1, cl. 5; in
the Extradition provisions, Art. IV, § 2, cl. 2, and the superseded Fugitive
Slave Clause 3; and in the Fifth, Twelfth, and Twenty-second Amendments, as well
as in §§ 2 and 3 of the Fourteenth Amendment. But in nearly all these instances,
the use of the word is such that it has application only postnatally. None
indicates, with any assurance, that it has any possible pre-natal application.
54
All this, together with our observation,
supra, that throughout the major portion of the 19th century prevailing legal
abortion practices were far freer than they are today, persuades us that the
word "person," as used in the Fourteenth Amendment, does not include the unborn.
55
This is in accord with the results reached in those few cases where the issue
has been squarely presented. McGarvey v. Magee-Womens Hospital, 340 F.Supp. 751
(WD Pa. 1972); Byrn v. New York City Health & Hospitals Corp., 31 N. Y. 2d 194,
286 N. E. 2d 887 (1972), appeal docketed, No. 72-434; Abele v. Markle, 351
F.Supp. 224 (Conn. 1972), appeal docketed, No. 72-730. Cf. Cheaney v. State,
Ind., at , 285 N. E. 2d, at 270; Montana v. Rogers, 278 F.2d 68, 72 (CA7 1960),
aff'd sub nom. Montana v. Kennedy, 366 U.S. 308 (1961); Keeler v. Superior
Court, 2 Cal. 3d 619, 470 P. 2d 617 (1970); State v. Dickinson, 28 Ohio St. 2d
65, 275 N. E. 2d 599 (1971). Indeed, our decision in United States v. Vuitch,
402 U.S. 62 (1971), inferentially is to the same effect, for we there would not
have indulged in statutory interpretation favorable to abortion in specified
circumstances if the necessary consequence was the termination of life entitled
to Fourteenth Amendment protection.
This conclusion, however, does not of
itself fully answer the contentions raised by Texas, and we pass on to other
considerations.
B. The pregnant woman cannot be isolated in
her privacy. She carries an embryo and, later, a fetus, if one accepts the
medical definitions of the developing young in the human uterus. See Dorland's
Illustrated Medical Dictionary 478-479, 547 (24th ed. 1965). The situation
therefore is inherently different from marital intimacy, or bedroom possession
of obscene material, or marriage, or procreation, or education, with which
Eisenstadt and Griswold, Stanley, Loving, Skinner, and Pierce and Meyer were
respectively concerned. As we have intimated above, it is reasonable and
appropriate for a State to decide that at some point in time another interest,
that of health of the mother or that of potential human life, becomes
significantly involved. The woman's privacy is no longer sole and any right of
privacy she possesses must be measured accordingly.
Texas urges that, apart from the Fourteenth
Amendment, life begins at conception and is present throughout pregnancy, and
that, therefore, the State has a compelling interest in protecting that life
from and after conception. We need not resolve the difficult question of when
life begins. When those trained in the respective disciplines of medicine,
philosophy, and theology are unable to arrive at any consensus, the judiciary,
at this point in the development of man's knowledge, is not in a position to
speculate as to the answer.
It should be sufficient to note briefly the
wide divergence of thinking on this most sensitive and difficult question. There
has always been strong support for the view that life does not begin until live
birth. This was the belief of the Stoics.
56 It appears to be the
predominant, though not the unanimous, attitude of the Jewish faith.
57 It may
be taken to represent also the position of a large segment of the Protestant
community, insofar as that can be ascertained; organized groups that have taken
a formal position on the abortion issue have generally regarded abortion as a
matter for the conscience of the individual and her family.
58 As we
have noted, the common law found greater significance in quickening. Physicians
and their scientific colleagues have regarded that event with less interest and
have tended to focus either upon conception, upon live birth, or upon the
interim point at which the fetus becomes "viable," that is, potentially able to
live outside the mother's womb, albeit with artificial aid.
59
Viability is usually placed at about seven months (28 weeks) but may occur
earlier, even at 24 weeks. 60
The Aristotelian theory of "mediate animation," that held sway throughout the
Middle Ages and the Renaissance in Europe, continued to be official Roman
Catholic dogma until the 19th century, despite opposition to this "ensoulment"
theory from those in the Church who would recognize the existence of life from
the moment of conception. 61
The latter is now, of course, the official belief of the Catholic Church. As one
brief amicus discloses, this is a view strongly held by many non-Catholics as
well, and by many physicians. Substantial problems for precise definition of
this view are posed, however, by new embryological data that purport to indicate
that conception is a "process" over time, rather than an event, and by new
medical techniques such as menstrual extraction, the "morning-after" pill,
implantation of embryos, artificial insemination, and even artificial wombs.
62
In areas other than criminal abortion, the
law has been reluctant to endorse any theory that life, as we recognize it,
begins before live birth or to accord legal rights to the unborn except in
narrowly defined situations and except when the rights are contingent upon live
birth. For example, the traditional rule of tort law denied recovery for
prenatal injuries even though the child was born alive.
63 That
rule has been changed in almost every jurisdiction. In most States, recovery is
said to be permitted only if the fetus was viable, or at least quick, when the
injuries were sustained, though few courts have squarely so held.
64 In a
recent development, generally opposed by the commentators, some States permit
the parents of a stillborn child to maintain an action for wrongful death
because of prenatal injuries. 65
Such an action, however, would appear to be one to vindicate the parents'
interest and is thus consistent with the view that the fetus, at most,
represents only the potentiality of life. Similarly, unborn children have been
recognized as acquiring rights or interests by way of inheritance or other
devolution of property, and have been represented by guardians ad litem.
66
Perfection of the interests involved, again, has generally been contingent upon
live birth. In short, the unborn have never been recognized in the law as
persons in the whole sense.
X
In view of all this, we do not agree that,
by adopting one theory of life, Texas may override the rights of the pregnant
woman that are at stake. We repeat, however, that the State does have an
important and legitimate interest in preserving and protecting the health of the
pregnant woman, whether she be a resident of the State or a nonresident who
seeks medical consultation and treatment there, and that it has still another
important and legitimate interest in protecting the potentiality of human life.
These interests are separate and distinct. Each grows in substantiality as the
woman approaches term and, at a point during pregnancy, each becomes
"compelling."
With respect to the State's important and
legitimate interest in the health of the mother, the "compelling" point, in the
light of present medical knowledge, is at approximately the end of the first
trimester. This is so because of the now-established medical fact, referred to
above at 149, that until the end of the first trimester mortality in abortion
may be less than mortality in normal childbirth. It follows that, from and after
this point, a State may regulate the abortion procedure to the extent that the
regulation reasonably relates to the preservation and protection of maternal
health. Examples of permissible state regulation in this area are requirements
as to the qualifications of the person who is to perform the abortion; as to the
licensure of that person; as to the facility in which the procedure is to be
performed, that is, whether it must be a hospital or may be a clinic or some
other place of less-than-hospital status; as to the licensing of the facility;
and the like.
This means, on the other hand, that, for
the period of pregnancy prior to this "compelling" point, the attending
physician, in consultation with his patient, is free to determine, without
regulation by the State, that, in his medical judgment, the patient's pregnancy
should be terminated. If that decision is reached, the judgment may be
effectuated by an abortion free of interference by the State.
With respect to the State's important and
legitimate interest in potential life, the "compelling" point is at viability.
This is so because the fetus then presumably has the capability of meaningful
life outside the mother's womb. State regulation protective of fetal life after
viability thus has both logical and biological justifications. If the State is
interested in protecting fetal life after viability, it may go so far as to
proscribe abortion during that period, except when it is necessary to preserve
the life or health of the mother.
Measured against these standards, Art. 1196
of the Texas Penal Code, in restricting legal abortions to those "procured or
attempted by medical advice for the purpose of saving the life of the mother,"
sweeps too broadly. The statute makes no distinction between abortions performed
early in pregnancy and those performed later, and it limits to a single reason,
"saving" the mother's life, the legal justification for the procedure. The
statute, therefore, cannot survive the constitutional attack made upon it here.
This conclusion makes it unnecessary for us
to consider the additional challenge to the Texas statute asserted on grounds of
vagueness. See United States v. Vuitch, 402 U.S., at 67-72.
XI
To summarize and to repeat:
1. A state criminal abortion statute of the
current Texas type, that excepts from criminality only a lifesaving procedure on
behalf of the mother, without regard to pregnancy stage and without recognition
of the other interests involved, is violative of the Due Process Clause of the
Fourteenth Amendment.
(a) For the stage prior to approximately
the end of the first trimester, the abortion decision and its effectuation must
be left to the medical judgment of the pregnant woman's attending physician.
(b) For the stage subsequent to
approximately the end of the first trimester, the State, in promoting its
interest in the health of the mother, may, if it chooses, regulate the abortion
procedure in ways that are reasonably related to maternal health.
(c) For the stage subsequent to viability,
the State in promoting its interest in the potentiality of human life may, if it
chooses, regulate, and even proscribe, abortion except where it is necessary, in
appropriate medical judgment, for the preservation of the life or health of the
mother.
2. The State may define the term
"physician," as it has been employed in the preceding paragraphs of this Part XI
of this opinion, to mean only a physician currently licensed by the State, and
may proscribe any abortion by a person who is not a physician as so defined.
In Doe v. Bolton, post, p. 179, procedural
requirements contained in one of the modern abortion statutes are considered.
That opinion and this one, of course, are to be read together.
67
This holding, we feel, is consistent with
the relative weights of the respective interests involved, with the lessons and
examples of medical and legal history, with the lenity of the common law, and
with the demands of the profound problems of the present day. The decision
leaves the State free to place increasing restrictions on abortion as the period
of pregnancy lengthens, so long as those restrictions are tailored to the
recognized state interests. The decision vindicates the right of the physician
to administer medical treatment according to his professional judgment up to the
points where important state interests provide compelling justifications for
intervention. Up to those points, the abortion decision in all its aspects is
inherently, and primarily, a medical decision, and basic responsibility for it
must rest with the physician. If an individual practitioner abuses the privilege
of exercising proper medical judgment, the usual remedies, judicial and
intra-professional, are available.
XII
Our conclusion that Art. 1196 is
unconstitutional means, of course, that the Texas abortion statutes, as a unit,
must fall. The exception of Art. 1196 cannot be struck down separately, for then
the State would be left with a statute proscribing all abortion procedures no
matter how medically urgent the case.
Although the District Court granted
appellant Roe declaratory relief, it stopped short of issuing an injunction
against enforcement of the Texas statutes. The Court has recognized that
different considerations enter into a federal court's decision as to declaratory
relief, on the one hand, and injunctive relief, on the other. Zwickler v. Koota,
389 U.S. 241, 252-255 (1967); Dombrowski v. Pfister, 380 U.S. 479 (1965). We are
not dealing with a statute that, on its face, appears to abridge free
expression, an area of particular concern under Dombrowski and refined in
Younger v. Harris, 401 U.S., at 50.
We find it unnecessary to decide whether
the District Court erred in withholding injunctive relief, for we assume the
Texas prosecutorial authorities will give full credence to this decision that
the present criminal abortion statutes of that State are unconstitutional.
The judgment of the District Court as to
intervenor Hallford is reversed, and Dr. Hallford's complaint in intervention is
dismissed. In all other respects, the judgment of the District Court is
affirmed. Costs are allowed to the appellee.
It is so ordered.
---- Begin EndNotes ----
1
"Article 1191. Abortion
"If any person shall designedly administer
to a pregnant woman or knowingly procure to be administered with her consent any
drug or medicine, or shall use towards her any violence or means whatever
externally or internally applied, and thereby procure an abortion, he shall be
confined in the penitentiary not less than two nor more than five years; if it
be done without her consent, the punishment shall be doubled. By 'abortion' is
meant that the life of the fetus or embryo shall be destroyed in the woman's
womb or that a premature birth thereof be caused.
"Art. 1192. Furnishing the means
"Whoever furnishes the means for procuring
an abortion knowing the purpose intended is guilty as an accomplice.
"Art. 1193. Attempt at abortion
"If the means used shall fail to produce an
abortion, the offender is nevertheless guilty of an attempt to produce abortion,
provided it be shown that such means were calculated to produce that result, and
shall be fined not less than one hundred nor more than one thousand dollars.
"Art. 1194. Murder in producing abortion
"If the death of the mother is occasioned
by an abortion so produced or by an attempt to effect the same it is murder."
"Art. 1196. By medical advice
"Nothing in this chapter applies to an
abortion procured or attempted by medical advice for the purpose of saving the
life of the mother."
The foregoing Articles, together with Art.
1195, compose Chapter 9 of Title 15 of the Penal Code. Article 1195, not
attacked here, reads:
"Art. 1195. Destroying unborn child
"Whoever shall during parturition of the
mother destroy the vitality or life in a child in a state of being born and
before actual birth, which child would otherwise have been born alive, shall be
confined in the penitentiary for life or for not less than five years."
2
Ariz. Rev. Stat. Ann. § 13-211 (1956); Conn. Pub. Act No. 1 (May 1972 special
session) (in 4 Conn. Leg. Serv. 677 (1972)), and Conn. Gen. Stat. Rev. §§ 53-29,
53-30 (1968) (or unborn child); Idaho Code § 18-601 (1948); Ill. Rev. Stat., c.
38, § 23-1 (1971); Ind. Code § 35-1-58-1 (1971); Iowa Code § 701.1 (1971); Ky.
Rev. Stat. § 436.020 (1962); La. Rev. Stat. § 37:1285 (6) (1964) (loss of
medical license) (but see § 14:87 (Supp. 1972) containing no exception for the
life of the mother under the criminal statute); Me. Rev. Stat. Ann., Tit. 17, §
51 (1964); Mass. Gen. Laws Ann., c. 272, § 19 (1970) (using the term
"unlawfully," construed to exclude an abortion to save the mother's life, Kudish
v. Bd. of Registration, 356 Mass. 98, 248 N. E. 2d 264 (1969)); Mich. Comp. Laws
§ 750.14 (1948); Minn. Stat. § 617.18 (1971); Mo. Rev. Stat. § 559.100 (1969);
Mont. Rev. Codes Ann. § 94-401 (1969); Neb. Rev. Stat. § 28-405 (1964); Nev.
Rev. Stat. § 200.220 (1967); N. H. Rev. Stat. Ann. § 585:13 (1955); N. J. Stat.
Ann. § 2A:87-1 (1969) ("without lawful justification"); N. D. Cent. Code §§
12-25-01, 12-25-02 (1960); Ohio Rev. Code Ann. § 2901.16 (1953); Okla. Stat.
Ann., Tit. 21, § 861 (1972-1973 Supp.); Pa. Stat. Ann., Tit. 18, §§ 4718, 4719
(1963) ("unlawful"); R. I. Gen. Laws Ann. § 11-3-1 (1969); S. D. Comp. Laws Ann.
§ 22-17-1 (1967); Tenn. Code Ann. §§ 39-301, 39-302 (1956); Utah Code Ann. §§
76-2-1, 76-2-2 (1953); Vt. Stat. Ann., Tit. 13, § 101 (1958); W. Va. Code Ann. §
61-2-8 (1966); Wis. Stat. § 940.04 (1969); Wyo. Stat. Ann. §§ 6-77, 6-78 (1957).
3
Long ago, a suggestion was made that the Texas statutes were unconstitutionally
vague because of definitional deficiencies. The Texas Court of Criminal Appeals
disposed of that suggestion peremptorily, saying only,
"It is also insisted in the motion in
arrest of judgment that the statute is unconstitutional and void in that it does
not sufficiently define or describe the offense of abortion. We do not concur in
respect to this question." Jackson v. State, 55 Tex. Cr. R. 79, 89, 115 S. W.
262, 268 (1908).
The same court recently has held again that
the State's abortion statutes are not unconstitutionally vague or overbroad.
Thompson v. State (Ct. Crim. App. Tex. 1971), appeal docketed, No. 71-1200. The
court held that "the State of Texas has a compelling interest to protect fetal
life"; that Art. 1191 "is designed to protect fetal life"; that the Texas
homicide statutes, particularly Art. 1205 of the Penal Code, are intended to
protect a person "in existence by actual birth" and thereby implicitly recognize
other human life that is not "in existence by actual birth"; that the definition
of human life is for the legislature and not the courts; that Art. 1196 "is more
definite than the District of Columbia statute upheld in [United States v.]
Vuitch" (402 U.S. 62); and that the Texas statute "is not vague and indefinite
or overbroad." A physician's abortion conviction was affirmed.
In Thompson, n. 2, the court observed that
any issue as to the burden of proof under the exemption of Art. 1196 "is not
before us." But see Veevers v. State, 172 Tex. Cr. R. 162, 168-169, 354 S. W. 2d
161, 166-167 (1962). Cf. United States v. Vuitch, 402 U.S. 62, 69-71 (1971).
4
The name is a pseudonym.
5
These names are pseudonyms.
6
The appellee twice states in his brief that the hearing before the District
Court was held on July 22, 1970. Brief for Appellee 13. The docket entries, App.
2, and the transcript, App. 76, reveal this to be an error. The July date
appears to be the time of the reporter's transcription. See App. 77.
7
We need not consider what different result, if any, would follow if Dr.
Hallford's intervention were on behalf of a class. His complaint in intervention
does not purport to assert a class suit and makes no reference to any class
apart from an allegation that he "and others similarly situated" must
necessarily guess at the meaning of Art. 1196. His application for leave to
intervene goes somewhat further, for it asserts that plaintiff Roe does not
adequately protect the interest of the doctor "and the class of people who are
physicians . . . [and] the class of people who are . . . patients . . . ." The
leave application, however, is not the complaint. Despite the District Court's
statement to the contrary, 314 F.Supp., at 1225, we fail to perceive the
essentials of a class suit in the Hallford complaint.
8
A. Castiglioni, A History of Medicine 84 (2d ed. 1947), E. Krumbhaar, translator
and editor (hereinafter Castiglioni).
9
J. Ricci, The Genealogy of Gynaecology 52, 84, 113, 149 (2d ed. 1950)
(hereinafter Ricci); L. Lader, Abortion 75-77 (1966) (hereinafter Lader); K.
Niswander, Medical Abortion Practices in the United States, in Abortion and the
Law 37, 38-40 (D. Smith ed. 1967); G. Williams, The Sanctity of Life and the
Criminal Law 148 (1957) (hereinafter Williams); J. Noonan, An Almost Absolute
Value in History, in The Morality of Abortion 1, 3-7 (J. Noonan ed. 1970)
(hereinafter Noonan); Quay, Justifiable Abortion -- Medical and Legal
Foundations (pt. 2), 49 Geo. L. J. 395, 406-422 (1961) (hereinafter Quay).
10
L. Edelstein, The Hippocratic Oath 10 (1943) (hereinafter Edelstein). But see
Castiglioni 227.
11
Edelstein 12; Ricci 113-114, 118-119; Noonan 5.
12
Edelstein 13-14.
13
Castiglioni 148.
14
Id., at 154.
15
Edelstein 3.
16
Id., at 12, 15-18.
17
Id., at 18; Lader 76.
18
Edelstein 63.
19
Id., at 64.
20
Dorland's Illustrated Medical Dictionary 1261 (24th ed. 1965).
21
E. Coke, Institutes III *50; 1 W. Hawkins, Pleas of the Crown, c. 31, § 16 (4th
ed. 1762); 1 W. Blackstone, Commentaries *129-130; M. Hale, Pleas of the Crown
433 (1st Amer. ed. 1847). For discussions of the role of the quickening concept
in English common law, see Lader 78; Noonan 223-226; Means, The Law of New York
Concerning Abortion and the Status of the Foetus, 1664-1968: A Case of Cessation
of Constitutionality (pt. 1), 14 N. Y. L. F. 411, 418-428 (1968) (hereinafter
Means I); Stern, Abortion: Reform and the Law, 59 J. Crim. L. C. & P. S. 84
(1968) (hereinafter Stern); Quay 430-432; Williams 152.
22
Early philosophers believed that the embryo or fetus did not become formed and
begin to live until at least 40 days after conception for a male, and 80 to 90
days for a female. See, for example, Aristotle, Hist. Anim. 7.3.583b; Gen. Anim.
2.3.736, 2.5.741; Hippocrates, Lib. de Nat. Puer., No. 10. Aristotle's thinking
derived from his three-stage theory of life: vegetable, animal, rational. The
vegetable stage was reached at conception, the animal at "animation," and the
rational soon after live birth. This theory, together with the 40/80 day view,
came to be accepted by early Christian thinkers.
The theological debate was reflected in the
writings of St. Augustine, who made a distinction between embryo inanimatus, not
yet endowed with a soul, and embryo animatus. He may have drawn upon Exodus
21:22. At one point, however, he expressed the view that human powers cannot
determine the point during fetal development at which the critical change
occurs. See Augustine, De Origine Animae 4.4 (Pub. Law 44.527). See also W.
Reany, The Creation of the Human Soul, c. 2 and 83-86 (1932); Huser, The Crime
of Abortion in Canon Law 15 (Catholic Univ. of America, Canon Law Studies No.
162, Washington, D. C., 1942).
Galen, in three treatises related to
embryology, accepted the thinking of Aristotle and his followers. Quay 426-427.
Later, Augustine on abortion was incorporated by Gratian into the Decretum,
published about 1140. Decretum Magistri Gratiani 2.32.2.7 to 2.32.2.10, in 1
Corpus Juris Canonici 1122, 1123 (A. Friedburg, 2d ed. 1879). This Decretal and
the Decretals that followed were recognized as the definitive body of canon law
until the new Code of 1917.
For discussions of the canon-law treatment,
see Means I, pp. 411-412; Noonan 20-26; Quay 426-430; see also J. Noonan,
Contraception: A History of Its Treatment by the Catholic Theologians and
Canonists 18-29 (1965).
23
Bracton took the position that abortion by blow or poison was homicide "if the
foetus be already formed and animated, and particularly if it be animated." 2 H.
Bracton, De Legibus et Consuetudinibus Angliae 279 (T. Twiss ed. 1879), or, as a
later translation puts it, "if the foetus is already formed or quickened,
especially if it is quickened," 2 H. Bracton, On the Laws and Customs of England
341 (S. Thorne ed. 1968). See Quay 431; see also 2 Fleta 60-61 (Book 1, c. 23)
(Selden Society ed. 1955).
24
E. Coke, Institutes III *50.
25
1 W. Blackstone, Commentaries *129-130.
26
Means, The Phoenix of Abortional Freedom: Is a Penumbral or Ninth-Amendment
Right About to Arise from the Nineteenth-Century Legislative Ashes of a
Fourteenth-Century Common-Law Liberty?, 17 N. Y. L. F. 335 (1971) (hereinafter
Means II). The author examines the two principal precedents cited marginally by
Coke, both contrary to his dictum, and traces the treatment of these and other
cases by earlier commentators. He concludes that Coke, who himself participated
as an advocate in an abortion case in 1601, may have intentionally misstated the
law. The author even suggests a reason: Coke's strong feelings against abortion,
coupled with his determination to assert common-law (secular) jurisdiction to
assess penalties for an offense that traditionally had been an exclusively
ecclesiastical or canon-law crime. See also Lader 78-79, who notes that some
scholars doubt that the common law ever was applied to abortion; that the
English ecclesiastical courts seem to have lost interest in the problem after
1527; and that the preamble to the English legislation of 1803, 43 Geo. 3, c.
58, § 1, referred to in the text, infra, at 136, states that "no adequate means
have been hitherto provided for the prevention and punishment of such offenses."
27
Commonwealth v. Bangs, 9 Mass. 387, 388 (1812); Commonwealth v. Parker, 50 Mass.
(9 Metc.) 263, 265-266 (1845); State v. Cooper, 22 N. J. L. 52, 58 (1849);
Abrams v. Foshee, 3 Iowa 274, 278-280 (1856); Smith v. Gaffard, 31 Ala. 45, 51
(1857); Mitchell v. Commonwealth, 78 Ky. 204, 210 (1879); Eggart v. State, 40
Fla. 527, 532, 25 So. 144, 145 (1898); State v. Alcorn, 7 Idaho 599, 606, 64 P.
1014, 1016 (1901); Edwards v. State, 79 Neb. 251, 252, 112 N. W. 611, 612
(1907); Gray v. State, 77 Tex. Cr. R. 221, 224, 178 S. W. 337, 338 (1915);
Miller v. Bennett, 190 Va. 162, 169, 56 S. E. 2d 217, 221 (1949). Contra, Mills
v. Commonwealth, 13 Pa. 631, 633 (1850); State v. Slagle, 83 N. C. 630, 632
(1880).
28
See Smith v. State, 33 Me. 48, 55 (1851); Evans v. People, 49 N. Y. 86, 88
(1872); Lamb v. State, 67 Md. 524, 533, 10 A. 208 (1887).
29
Conn. Stat., Tit. 20, § 14 (1821).
30
Conn. Pub. Acts, c. 71, § 1 (1860).
31
N. Y. Rev. Stat., pt. 4, c. 1, Tit. 2, Art. 1, § 9, p. 661, and Tit. 6, § 21, p.
694 (1829).
32
Act of Jan. 20, 1840, § 1, set forth in 2 H. Gammel, Laws of Texas 177-178
(1898); see Grigsby v. Reib, 105 Tex. 597, 600, 153 S. W. 1124, 1125 (1913).
33
The early statutes are discussed in Quay 435-438. See also Lader 85-88; Stern
85-88; and Means II 375-376.
34
Criminal abortion statutes in effect in the States as of 1961, together with
historical statutory development and important judicial interpretations of the
state statutes, are cited and quoted in Quay 447-520. See Comment, A Survey of
the Present Statutory and Case Law on Abortion: The Contradictions and the
Problems, 1972 U. Ill. L. F. 177, 179, classifying the abortion statutes and
listing 25 States as permitting abortion only if necessary to save or preserve
the mother's life.
35
Ala. Code, Tit. 14, § 9 (1958); D. C. Code Ann. § 22-201 (1967).
36
Mass. Gen. Laws Ann., c. 272, § 19 (1970); N. J. Stat. Ann. § 2A:87-1 (1969);
Pa. Stat. Ann., Tit. 18, §§ 4718, 4719 (1963).
37
Fourteen States have adopted some form of the ALI statute. See Ark. Stat. Ann.
§§ 41-303 to 41-310 (Supp. 1971); Calif. Health & Safety Code §§ 25950-25955.5
(Supp. 1972); Colo. Rev. Stat. Ann. §§ 40-2-50 to 40-2-53 (Cum. Supp. 1967);
Del. Code Ann., Tit. 24, §§ 1790-1793 (Supp. 1972); Florida Law of Apr. 13,
1972, c. 72-196, 1972 Fla. Sess. Law Serv., pp. 380-382; Ga. Code §§ 26-1201 to
26-1203 (1972); Kan. Stat. Ann. § 21-3407 (Supp. 1971); Md. Ann. Code, Art. 43,
§§ 137-139 (1971); Miss. Code Ann. § 2223 (Supp. 1972); N. M.
Stat. Ann. §§ 40A-5-1 to 40A-5-3 (1972); N.
C. Gen. Stat. § 14-45.1 (Supp. 1971); Ore. Rev. Stat. §§ 435.405 to 435.495
(1971); S. C. Code Ann. §§ 16-82 to 16-89 (1962 and Supp. 1971); Va. Code Ann.
§§ 18.1-62 to 18.1-62.3 (Supp. 1972). Mr. Justice Clark described some of these
States as having "led the way." Religion, Morality, and Abortion: A
Constitutional Appraisal, 2 Loyola U. (L. A.) L. Rev. 1, 11 (1969).
By the end of 1970, four other States had
repealed criminal penalties for abortions performed in early pregnancy by a
licensed physician, subject to stated procedural and health requirements. Alaska
Stat. § 11.15.060 (1970); Haw. Rev. Stat. § 453-16 (Supp. 1971); N. Y. Penal
Code § 125.05, subd. 3 (Supp. 1972-1973); Wash. Rev. Code §§ 9.02.060 to
9.02.080 (Supp. 1972). The precise status of criminal abortion laws in some
States is made unclear by recent decisions in state and federal courts striking
down existing state laws, in whole or in part.
38
"Whereas, Abortion, like any other medical procedure, should not be performed
when contrary to the best interests of the patient since good medical practice
requires due consideration for the patient's welfare and not mere acquiescence
to the patient's demand; and
"Whereas, The standards of sound clinical
judgment, which, together with informed patient consent should be determinative
according to the merits of each individual case; therefore be it
"RESOLVED, That abortion is a medical
procedure and should be performed only by a duly licensed physician and surgeon
in an accredited hospital acting only after consultation with two other
physicians chosen because of their professional competency and in conformance
with standards of good medical practice and the Medical Practice Act of his
State; and be it further
"RESOLVED, That no physician or other
professional personnel shall be compelled to perform any act which violates his
good medical judgment. Neither physician, hospital, nor hospital personnel shall
be required to perform any act violative of personally-held moral principles. In
these circumstances good medical practice requires only that the physician or
other professional personnel withdraw from the case so long as the withdrawal is
consistent with good medical practice." Proceedings of the AMA House of
Delegates 220 (June 1970).
39
"The Principles of Medical Ethics of the AMA do not prohibit a physician from
performing an abortion that is performed in accordance with good medical
practice and under circumstances that do not violate the laws of the community
in which he practices.
"In the matter of abortions, as of any
other medical procedure, the Judicial Council becomes involved whenever there is
alleged violation of the Principles of Medical Ethics as established by the
House of Delegates."
40
"UNIFORM ABORTION ACT
"SECTION 1. [Abortion Defined; When Authorized.]
"(a) 'Abortion' means the termination of
human pregnancy with an intention other than to produce a live birth or to
remove a dead fetus.
"(b) An abortion may be performed in this
state only if it is performed:
"(1) by a physician licensed to practice
medicine [or osteopathy] in this state or by a physician practicing medicine [or
osteopathy] in the employ of the government of the United States or of this
state, [and the abortion is performed [in the physician's office or in a medical
clinic, or] in a hospital approved by the [Department of Health] or operated by
the United States, this state, or any department, agency, or political
subdivision of either;] or by a female upon herself upon the advice of the
physician; and
"(2) within [20] weeks after the
commencement of the pregnancy [or after [20] weeks only if the physician has
reasonable cause to believe (i) there is a substantial risk that continuance of
the pregnancy would endanger the life of the mother or would gravely impair the
physical or mental health of the mother, (ii) that the child would be born with
grave physical or mental defect, or (iii) that the pregnancy resulted from rape
or incest, or illicit intercourse with a girl under the age of 16 years].
"SECTION 2. [Penalty.] Any person who
performs or procures an abortion other than authorized by this Act is guilty of
a [felony] and, upon conviction thereof, may be sentenced to pay a fine not
exceeding [$ 1,000] or to imprisonment [in the state penitentiary] not exceeding
[5 years], or both.
"SECTION 3. [Uniformity of Interpretation.]
This Act shall be construed to effectuate its general purpose to make uniform
the law with respect to the subject of this Act among those states which enact
it.
"SECTION 4. [Short Title.] This Act may be
cited as the Uniform Abortion Act.
"SECTION 5. [Severability.] If any
provision of this Act or the application thereof to any person or circumstance
is held invalid, the invalidity does not affect other provisions or applications
of this Act which can be given effect without the invalid provision or
application, and to this end the provisions of this Act are severable.
"SECTION 6. [Repeal.] The following acts
and parts of acts are repealed:
"(1)
"(2)
"(3)
"SECTION 7. [Time of Taking Effect.] This
Act shall take effect -- -- -- -- -- -- ."
41
"This Act is based largely upon the New York abortion act following a review of
the more recent laws on abortion in several states and upon recognition of a
more liberal trend in laws on this subject. Recognition was given also to the
several decisions in state and federal courts which show a further trend toward
liberalization of abortion laws, especially during the first trimester of
pregnancy.
"Recognizing that a number of problems
appeared in New York, a shorter time period for 'unlimited' abortions was
advisable. The time period was bracketed to permit the various states to insert
a figure more in keeping with the different conditions that might exist among
the states. Likewise, the language limiting the place or places in which
abortions may be performed was also bracketed to account for different
conditions among the states. In addition, limitations on abortions after the
initial 'unlimited' period were placed in brackets so that individual states may
adopt all or any of these reasons, or place further restrictions upon abortions
after the initial period.
"This Act does not contain any provision
relating to medical review committees or prohibitions against sanctions imposed
upon medical personnel refusing to participate in abortions because of religious
or other similar reasons, or the like. Such provisions, while related, do not
directly pertain to when, where, or by whom abortions may be performed; however,
the Act is not drafted to exclude such a provision by a state wishing to enact
the same."
42
See, for example, YWCA v. Kugler, 342 F.Supp. 1048, 1074 (N. J. 1972); Abele v.
Markle, 342 F.Supp. 800, 805-806 (Conn. 1972) (Newman, J., concurring in
result), appeal docketed, No. 72-56; Walsingham v. State, 250 So. 2d 857, 863
(Ervin, J., concurring) (Fla. 1971); State v. Gedicke, 43 N. J. L. 86, 90
(1881); Means II 381-382.
43
See C. Haagensen & W. Lloyd, A Hundred Years of Medicine 19 (1943).
44
Potts, Postconceptive Control of Fertility, 8 Int'l J. of G. & O. 957, 967
(1970) (England and Wales); Abortion Mortality, 20 Morbidity and Mortality 208,
209 (June 12, 1971) (U.S. Dept. of HEW, Public Health Service) (New York City);
Tietze, United States: Therapeutic Abortions, 1963-1968, 59 Studies in Family
Planning 5, 7 (1970); Tietze, Mortality with Contraception and Induced Abortion,
45 Studies in Family Planning 6 (1969) (Japan, Czechoslovakia, Hungary); Tietze
& Lehfeldt, Legal Abortion in Eastern Europe, 175 J. A. M. A. 1149, 1152 (April
1961). Other sources are discussed in Lader 17-23.
45
See Brief of Amicus National Right to Life Committee; R. Drinan, The
Inviolability of the Right to Be Born, in Abortion and the Law 107 (D. Smith ed.
1967); Louisell, Abortion, The Practice of Medicine and the Due Process of Law,
16 U. C. L. A. L. Rev. 233 (1969); Noonan 1.
46
See, e. g., Abele v. Markle, 342 F.Supp. 800 (Conn. 1972), appeal docketed, No.
72-56.
47
See discussions in Means I and Means II.
48
See, e. g., State v. Murphy, 27 N. J. L. 112, 114 (1858).
49 Watson v. State, 9 Tex. App. 237, 244-245 (1880); Moore v. State, 37 Tex. Cr. R. 552, 561, 40 S. W. 287, 290 (1897); Shaw v. State, 73 Tex. Cr. R. 337, 339, 165 S. W. 930, 931 (1914); Fondren v. State, 74 Tex. Cr. R. 552, 557, 169 S. W. 411, 414 (1914); Gray v. State, 77 Tex. Cr. R. 221, 229, 178 S. W. 337, 341 (1915). There is no immunity in Texas for the father who is not married to the mother. Hammett v. State, 84 Tex. Cr. R. 635, 209 S. W. 661 (1919); Thompson v. State (Ct. Crim. App. Tex. 1971), appeal docketed, No. 71-1200.
50
See Smith v. State, 33 Me., at 55; In re Vince, 2 N. J. 443, 450, 67 A. 2d 141,
144 (1949). A short discussion of the modern law on this issue is contained in
the Comment to the ALI's Model Penal Code § 207.11, at 158 and nn. 35-37 (Tent.
Draft No. 9, 1959).
51
Tr. of Oral Rearg. 20-21.
52
Tr. of Oral Rearg. 24.
53
We are not aware that in the taking of any census under this clause, a fetus has
ever been counted.
54
When Texas urges that a fetus is entitled to Fourteenth Amendment protection as
a person, it faces a dilemma. Neither in Texas nor in any other State are all
abortions prohibited. Despite broad proscription, an exception always exists.
The exception contained in Art. 1196, for an abortion procured or attempted by
medical advice for the purpose of saving the life of the mother, is typical. But
if the fetus is a person who is not to be deprived of life without due process
of law, and if the mother's condition is the sole determinant, does not the
Texas exception appear to be out of line with the Amendment's command?
There are other inconsistencies between
Fourteenth Amendment status and the typical abortion statute. It has already
been pointed out, n. 49, supra, that in Texas the woman is not a principal or an
accomplice with respect to an abortion upon her. If the fetus is a person, why
is the woman not a principal or an accomplice? Further, the penalty for criminal
abortion specified by Art. 1195 is significantly less than the maximum penalty
for murder prescribed by Art. 1257 of the Texas Penal Code. If the fetus is a
person, may the penalties be different?
55
Cf. the Wisconsin abortion statute, defining "unborn child" to mean "a human
being from the time of conception until it is born alive," Wis. Stat. § 940.04
(6) (1969), and the new Connecticut statute, Pub. Act No. 1 (May 1972 special
session), declaring it to be the public policy of the State and the legislative
intent "to protect and preserve human life from the moment of conception."
56
Edelstein 16.