Doe v. Bolton 8212 40

Decision Date13 December 1971
Docket NumberNo. 70,70
PartiesMary DOE et al., Appellants, v. Arthur K. BOLTON, as Attorney General of the State of Georgia, et al. —40
CourtU.S. Supreme Court
Syllabus

Georgia law proscribes an abortion except as performed by a duly licensed Georgia physician when necessary in 'his best clinical judgment' because continued pregnancy would endanger a pregnant woman's life or injure her health; the fetus would likely be born with a serious defect; or the pregnancy resulted from rape. § 26—1202(a) of Ga. Criminal Code. In addition to a requirement that the patient be a Georgia resident and certain other requirements, the statutory scheme poses three procedural conditions in § 26—1202(b): (1) that the abortion be performed in a hospital accredited by the Joint Commission on Accreditation of Hospitals (JCAH); (2) that the procedure be approved by the hospital staff abortion committee; and (3) that the performing physician's judgment be confirmed by independent examinations of the patient by two other licensed physicians. Appellant Doe, an indigent married Georgia citizen, who was denied an abortion after eight weeks of pregnancy for failure to meet any of the § 26 1202(a) conditions, sought declaratory and injunctive relief, contending that the Georgia laws were unconstitutional. Others joining in the complaint included Georgia-licensed physicians (who claimed that the Georgia statutes 'chilled and deterred' their practices), registered nurses, clergymen, and social workers. Though holding that all the plaintiffs had standing, the District Court ruled that only Doe presented a justiciable controversy. In Doe's case the court gave declaratory, but not injunctive, relief, invalidating as an infringement of privacy and personal liberty the limitation to the three situations specified in § 26—1202(a) and certain other provisions but holding that the State's interest in health protection and the existence of a 'potential of independent human existence' justified regulation through § 26 1202(b) of the 'manner of performance as well as the quality of the final decision to abort.' The appellants, claiming entitlement to broader relief, directly appealed to this Court. Held:

1. Doe's case presents a live, justiciable controversy and she has standing to sue, Roe v. Wade, 410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147, as do the physician- -appellants (who, unlike the physician in Wade, were not charged with abortion violations), and it is therefore unnecessary to resolve the issue of the other appellants' standing. Pp. 187—189.

2. A woman's constitutional right to an abortion is not absolute. Roe v. Wade, supra. P. 189.

3. The requirement that a physician's decision to perform an abortion must rest upon 'his best clinical judgment' of its necessity is not unconstitutionally vague, since that judgment may be made in the light of all the attendant circumstances. United States v. Vuitch, 402 U.S. 62, 71—72, 91 S.Ct. 1294, 1298—1299, 28 L.Ed.2d 601. Pp. 191—192.

4. The three procedural conditions in § 26—1202(b) violate the Fourteenth Amendment. Pp. 192—200.

(a) The JCAH-accreditation requirement is invalid, since the State has not shown that only hospitals (let alone those with JCAH accreditation) meet its interest in fully protecting the patient; and a hospital requirement failing to exclude the first trimester of pregnancy would be invalid on that ground alone, see Roe v. Wade, supra. Pp. 193—195.

(b) The interposition of a hospital committee on abortion, a procedure not applicable as a matter of state criminal law to other surgical situations, is unduly restrictive of the patient's rights, which are already safeguarded by her personal physician. Pp. 195—198.

(c) Required acquiescence by two copractitioners also has no rational connection with a patient's needs and unduly infringes on her physician's right to practice. Pp. 198—200.

5. The Georgia residence requirement violates the Privileges and Immunities Clause by denying protection to persons who enter Georgia for medical services there. Pp. 200.

6. Appellants' equal protection argument centering on the three procedural conditions in § 26—1202(b), invalidated on other grounds, is without merit. Pp. 200—201.

7. No ruling is made on the question of injunctive relief. Cf. Roe v. Wade, supra. P. 201.

D.C., 319 F.Supp. 1048, modified and affirmed.

Margie Pitts Hames, Atlanta, Ga., for appellants.

Dorothy T. Beasley, Atlanta, Ga., for appellees.

Mr. Justice BLACKMUN delivered the opinion of the Court.

In this appeal, the criminal abortion statutes recently enacted in Georgia are challenged on constitutional grounds. The statutes are §§ 26—1201 through 26—1203 of the State's Criminal Code, formulated by Georgia Laws, 1968 Session, pp. 1249, 1277 1280. In Roe v. Wade, 410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147, we today have struck down, as constitutionally defective, the Texas criminal abortion statutes that are representative of provisions long in effect in a majority of our States. The Georgia legislation, however, is different and merits separate consideration.

I

The statutes in question are reproduced as Appendix A, post, p. 202.1 As the appellants acknowledge,2 the 1968 statutes are patterned upon the American Law Institute's Model Penal Code, § 230.3 (Proposed Official Draft, 1962), reproduced as Appendix B, post, p. 205. The ALI proposal has served as the model for recent legislation in approximately one-fourth of our States. 3 The new Georgia provisions replaced statutory law that had been in effect for more than 90 years. Georgia Laws 1876, No. 130, § 2, at 113.4 The predecessor statute paralleled the Texas legislation considered in Roe v. Wade, supra, and made all abortions criminal except those necessary 'to preserve the life' of the pregnant woman. The new statutes have not been tested on constitutional grounds in the Georgia state courts.

Section 26—1201, with a referenced exception, makes abortion a crime, and § 26—1203 provides that a person convicted of that crime shall be punished by imprisonment for not less than one nor more than 10 years. Section 26—1202(a) states the exception and removes from § 1201's definition of criminal abortion, and thus makes noncriminal, an abortion 'performed by a physician duly licensed' in Georgia when, 'based upon his best clinical judgment . . . an abortion is necessary because:

'(1) A continuation of the pregnancy would endanger the life of the pregnant woman or would seriously and permanently injure her health; or

'(2) The fetus would very likely be born with a grave, permanent, and irremediable mental or physical defect; or

'(3) The pregnancy resulted from forcible or statutory rape.'5

Section 26—1202 also requires, by numbered subdivisions of its subsection (b), that, for an abortion to be author- ized or performed as a noncriminal procedure, additional conditions must be fulfilled. These are (1) and (2) residence of the woman in Georgia; (3) reduction to writing of the performing physician's medical judgment that an abortion is justified for one or more of the reasons specified by § 26—1202(a), with written concurrence in that judgment by at least two other Georgia-licensed physicians, based upon their separate personal medical examinations of the woman; (4) performance of the abortion in a hospital licensed by the State Board of Health and also accredited by the Joint Commission on Accreditation of Hospitals; (5) advance approval by an abortion committee of not less than three members of the hospital's staff; (6) certifications in a rape situation; and (7), (8), and (9) maintenance and confidentiality of records. There is a provision (subsection (c)) for judicial determination of the legality of a proposed abortion on petition of the judicial circuit law officer or of a close relative, as therein defined, of the unborn child, and for expeditious hearing of that petition. There is also a provision (subsection (e)) giving a hospital the right not to admit an abortion patient and giving any physician and any hospital employee or staff member the right, on moral or religious grounds, not to participate in the procedure.

II

On April 16, 1970, Mary Doe,6 23 other individuals (nine described as Georgia-licensed physicians, seven as nurses registered in the State, five as clergymen, and two as social workers), and two nonprofit Georgia corporations that advocate abortion reform instituted this federal action in the Northern District of Georgia against the State's attorney general, the district attorney of Fulton County, and the chief of police of the city of Atlanta. The plaintiffs sought a declaratory judgment that the Georgia abortion statutes were unconstitutional in their entirety. They also sought injunctive relief restraining the defendants and their successors from enforcing the statutes.

Mary Doe alleged:

(1) She was a 22-year-old Georgia citizen, married, and nine weeks pregnant. She had three living children. The two older ones had been placed in a foster home because of Doe's poverty and inability to care for them. The youngest, born July 19, 1969, had been placed for adoption. Her husband had recently abandoned her and she was forced to live with her indigent parents and their eight children. She and her husband, however, had become reconciled. He was a construction worker employed only sporadically. She had been a mental patient at the State Hospital. She had been advised that an abortion could be performed on her with less danger to her health than if she gave birth to the child she was carrying. She would be unable to care for or support the new child.

(2) On March 25, 1970, she applied to the Abortion Committee of Grady Memorial Hospital, Atlanta, for a therapeutic abortion under § 26—1202. Her application was denied 16 days later, on April 10, when she was...

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