Carhart v. Gonzales

• Decision Date: 08 July 2005
• Docket Number: No. 04-3379.,04-3379.
• Citation: 413 F.3d 791
• Parties: LeRoy CARHART, M.D., on behalf of themselves and the patients they serve; William G. Fitzhugh, M.D., on behalf of themselves and the patients they serve; William H. Knorr, M.D., on behalf of themselves and the patients they serve; Jill L. Vibhakar, M.D., on behalf of themselves and the patients they serve, Appellees, v. Alberto GONZALES, in his official capacity as Attorney General of the United States, and his employees, agents, and successors in office,<SMALL><SUP>*</SUP></SMALL> Appellant, and Susan Frietsche; David S. Cohen; Stacey I. Young, Interested Parties. Margie Riley, et al.,<SMALL><SUP>**</SUP></SMALL> Amici on Behalf of Appellee.
• Court: U.S. Court of Appeals — Eighth Circuit

413 F.3d 791

LeRoy CARHART, M.D., on behalf of themselves and the patients they serve; William G. Fitzhugh, M.D., on behalf of themselves and the patients they serve; William H. Knorr, M.D., on behalf of themselves and the patients they serve; Jill L. Vibhakar, M.D., on behalf of themselves and the patients they serve, Appellees, v. Alberto GONZALES, in his official capacity as Attorney General of the United States, and his employees, agents, and successors in office,^* Appellant, and Susan Frietsche; David S. Cohen; Stacey I. Young, Interested Parties Margie Riley, et al.,^** Amici on Behalf of Appellee.

No. 04-3379.

United States Court of Appeals, Eighth Circuit.

Submitted: April 14, 2005.

Filed: July 8, 2005.

Gregory G. Katsas, argued, U.S. Dept. of Justice, Washington, DC (Michael G. Heavican, U.S. Atty., Lincoln, NE, Peter D. Keisler, Asst. Atty. Gen., Marleigh D. Dover, U.S. Dept. of Justice, Catherine Y. Hancock, Teal Luthy Miller, and Jeffrey A. Wadsworth, Washington, DC, on brief), for appellant.

Priscilla J. Smith, argued, New York City (Janet Crepps and Nan Strauss, New York City, on brief), for appellee.

Before LOKEN, Chief Judge, FAGG, and BYE, Circuit Judges.

BYE, Circuit Judge.

This case presents a challenge to the federal Partial-Birth Abortion Ban Act of 2003, Pub.L. No. 108-105, 117 Stat. 1201 (codified at 18 U.S.C. § 1531). The day the President signed the Act into law, plaintiffs filed suit in the United States District Court for the District of Nebraska seeking an injunction against enforcement of the Act. After a trial, the district court¹ held the Act unconstitutional on several grounds. The government appeals. We affirm the judgment of the district court.

I

A

In 2000, the Supreme Court handed down its decision in Stenberg v. Carhart, 530 U.S. 914, 120 S.Ct. 2597, 147 L.Ed.2d 743 (2000), which found Nebraska's partial-birth abortion ban unconstitutional for two separate reasons. First, the Court determined the law was unconstitutional because it did not contain an exception to preserve the health of the mother. Second the Court determined the law was worded so broadly it covered the vast majority of late-term abortions and thus imposed an undue burden on the right to abortion itself.

In the eight years before the Court's decision in Stenberg, at least thirty states passed laws banning partial-birth abortions. See id. at 983, 120 S.Ct. 2597 (Thomas, J., dissenting). In 1996 and 1997, Congress enacted prohibitions on partial-birth abortions, however, President Clinton vetoed them. Id. at 994 n. 11, 120 S.Ct. 2597 (Thomas, J., dissenting). In 2003, Congress enacted, and President George W. Bush signed, the Partial-Birth Abortion Ban Act of 2003. The Act exposes "[a]ny physician who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus" to up to two years of imprisonment. 18 U.S.C. § 1531(a). The Act goes on to define a "partial-birth abortion" as an abortion in which the person performing the abortion:

(A) deliberately and intentionally vaginally delivers a living fetus until, in the case of a head first presentation, the entire fetal head is outside the body of the mother, or, in the case of a breech presentation, any part of the fetal trunk past the navel is outside the body of the mother, for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus; and

(B) performs the overt act, other than completion of delivery, that kills the partially delivered living fetus....

Id. § 1531(b)(1).

The Act contains an exception allowing the performance of "a partial-birth abortion that is necessary to save the life of the mother." Id. § 1531(a). The Act does not, however, contain an exception for the preservation of the health of the mother.

Presumably recognizing that the Act is similar (though not identical) to the Nebraska law found unconstitutional in Stenberg, Congress made several findings and declarations in the Act. Congress "f[ound] and declare[d]" that "under well-settled Supreme Court jurisprudence, the United States Congress is not bound to accept the same factual findings that the Supreme Court was bound to accept in Stenberg." Partial-Birth Abortion Ban Act of 2003 § 2(8), 117 Stat. at 1202. Congress concluded that a "moral, medical, and ethical consensus exists that the practice of performing a partial-birth abortion ... is a gruesome and inhumane procedure that is never medically necessary and should be prohibited." § 2(1), 117 Stat. at 1201. In addition to determining there is "substantial evidence" that partial-birth abortions are never medically necessary, Congress also concluded partial-birth abortions "pose[] serious risks to the health of the mother undergoing the procedure." §§ 2(13), 2(14), 117 Stat. at 1203-04.

After a trial, the district court found the Act unconstitutional on two separate grounds. First, the district court concluded Congress's finding regarding a medical consensus was unreasonable and thus the Act was unconstitutional due to its lack of health exception. Second, the district court concluded the Act covered the most common late-term abortion procedure and thus imposed an undue burden on the right to an abortion.

B

The procedures in question in this case are used during late-term abortions and we therefore must, for context, present some basic information regarding these procedures. There are three primary methods of late-term abortions: medical induction; dilation and evacuation (D &amp E); and dilation and extraction (D & X). In a medical induction, formerly the most common method of second-trimester abortion, a physician uses medication to induce premature labor. Stenberg, 530 U.S. at 924, 120 S.Ct. 2597. In a D & E, now the most common procedure, the physician causes dilation of the woman's cervix and then "the physician reaches into the woman's uterus with an instrument, grasps an extremity of the fetus, and pulls." Women's Med. Prof'l Corp. v. Taft, 353 F.3d 436, 439 (6th Cir.2003). "When the fetus lodges in the cervix, the traction between the grasping instrument and the cervix causes dismemberment and eventual death, although death may occur prior to dismemberment." Id. This process is repeated until the entire fetus has been removed.

D & X and a process called intact D & E are what are "now widely known as partial birth abortion." Id. In these procedures, the fetus is removed "intact" in a single pass. If the fetus presents head first, the physician collapses the skull of the fetus and then removes the "intact" fetus. Stenberg, 530 U.S. at 927, 120 S.Ct. 2597. This is what is known as an intact D & E. If the fetus presents feet first, the physician "pulls the fetal body through the cervix, collapses the skull, and extracts the fetus through the cervix." Id. This is the D & X procedure. "Despite the technical differences" between an intact D & E and a D & X, they are "sufficiently similar for us to use the terms interchangeably." Id. at 928, 120 S.Ct. 2597.

II

As a preliminary matter, although the plaintiffs purported to bring a facial challenge to the Act, the district court expressed confusion over whether its judgment declared the Act facially unconstitutional or unconstitutional as applied to the plaintiffs. See Carhart v. Ashcroft, 331 F.Supp.2d 805, 1042-47 (D.Neb.2004) (stating the district court "do[es] not know" if its ruling was facial or as applied and leaving "that for others to determine"). This is a question of law and we therefore review it de novo. See, e.g., United States v. Jeffries, 405 F.3d 682, 684 (8th Cir.2005). The traditional standard for evaluating a facial challenge was set forth in United States v. Salerno, 481 U.S. 739, 107 S.Ct. 2095, 95 L.Ed.2d 697 (1987). In Salerno, the Supreme Court explained that a "facial challenge to a legislative Act is, of course, the most difficult challenge to mount successfully, since the challenger must establish that no set of circumstances exists under which the Act would be valid." Id. at 745, 107 S.Ct. 2095. In Stenberg, however, the Supreme Court struck down Nebraska's partial-birth abortion ban as facially unconstitutional without applying the Salerno standard. In fact, the approach taken in Stenberg was fundamentally inconsistent with Salerno's "no set of circumstances" test in that it regarded rarity of the need for a particular procedure as "not highly relevant." Stenberg, 530 U.S. at 934, 120 S.Ct. 2597. The Salerno test is also inconsistent with the general undue burden analysis for abortion statutes set forth in Planned Parenthood v. Casey, 505 U.S. 833, 112 S.Ct. 2791, 120 L.Ed.2d 674 (1992). This has led the vast majority of circuit courts to apply these abortion-specific standards in place of Salerno. See Planned Parenthood of N. New England v. Heed, 390 F.3d 53, 57-59 (1st Cir.2004) (collecting cases), cert. granted sub nom. Ayotte v. Planned Parenthood, ___ U.S. ___, 125 S.Ct. 2294, ___ L.Ed.2d ___ (May 23, 2005); Richmond Med. Ctr. for Women v. Hicks, 409 F.3d 619, 627-28 (4th Cir.2005) (same). We have previously declined to apply the "no set of circumstances" test in the context of facial challenges to abortion restrictions in Planned Parenthood, Sioux Falls Clinic v. Miller, 63 F.3d 1452, 1458 (8th Cir.1995), where we explained we would "follow what the Supreme Court actually did—rather than what it failed to say" and thus applied Casey's undue burden test. We will again follow what the Supreme Court "actually did" and apply the test from Stenberg rather than the one from Salerno. We therefore join every circuit that has addressed the question. See Hicks, 409 F.3d at 628; Planned Parenthood of Idaho, Inc. v. Wasden, 376 F.3d 908, 921 n. 10 (9th Cir.2004); Planned Parenthood of the Rocky Mountains Servs., Corp. v. Owens, 287 F.3d 910, 919 (10th Cir.2002). Thus, if the Act fails the Stenberg test, it must be held facially...