American Academy of Pediatrics v. Lungren

• Court: California Supreme Court
• Writing for the Court: GEORGE; KENNARD; MOSK; BAXTER; BROWN
• Citation: American Academy of Pediatrics v. Lungren, 16 Cal.4th 307, 66 Cal.Rptr.2d 210, 940 P.2d 797 (Cal. 1997)
• Decision Date: 05 August 1997
• Docket Number: No. S041459,S041459
• Parties: , 940 P.2d 797, 97 Cal. Daily Op. Serv. 6151, 97 Daily Journal D.A.R. 10,141 AMERICAN ACADEMY OF PEDIATRICS et al., Plaintiffs and Respondents, v. Daniel E. LUNGREN, as Attorney General, etc., et al., Defendants and Appellants.

Page 210

66 Cal.Rptr.2d 210

16 Cal.4th 307, 940 P.2d 797, 97 Cal.

Daily Op. Serv. 6151,

97 Daily Journal D.A.R. 10,141

AMERICAN ACADEMY OF PEDIATRICS et al., Plaintiffs and Respondents, v. Daniel E. LUNGREN, as Attorney General, etc., et al Defendants and Appellants.

No. S041459.

Supreme Court of California.

Aug. 5, 1997.

Daniel E. Lungren, Attorney General, Robert L. Mukai, Chief Assistant Attorney General, Charlton G. Holland III, Assistant Attorney General, Stephanie Wald and Ralph M. Johnson, Deputy Attorneys General, for Defendants and Appellants.

Larry P. Arnn, Edward J. Erler, Ernest O. Vincent, Samuel B. Casey, Frank J. Fisher, Anne J. Kindt, William P. Clark, Alister McAlister, Clarke D. Forsythe, Paul Benjamin Linton, Reed & Brown, Stephen W. Reed and Michael J. Coppess as Amici Curiae on behalf of Defendants and Appellants.

Abigail English, Margaret C. Crosby, Carol Sobel, Morrison & Foerster, Linda E. Shostak, Annette P. Carnegie and Lori A. Schechter for Plaintifs and Respondents.

Louise H. Renne, City Attorney (San Francisco), Paula Jesson, Deputy City Attorney, Dawn M. Schock, Mary Ann Soden, Mark I. Schickman, Amitai Schwartz, Jone Lemos Jackson, Renee Nordstrand, Jean A. Martin, Jenny E. Skoble, Catherine A. Porter, Janine Reagan, Elizabeth Mohr, Elizabeth E. Bader, Gilbert Gaynor, Geraldine Jaffe, Robert F. Kane, Joseph R. Grodin, Farella, Braun & Martell, Ann G. Daniels, Jill A. Thompson, Claudia A. Lewis, Steel, Clarence & Buckley, Nanci Clarence, Martin

Guggenheim, McCutchen, Doyle & Enersen, McCutchen, Doyle, Brown & Enersen, Leslie G. Landau, Brandt Andersson, Beth H. Parker, Hope A. Schmeltzer, Shashikala Bhat, Howard, Rice, Nemerovski, Canady, Falk & Rabkin, Ethan P. Schulman, Lewis D'Amato, Brisbois & Bisgaard and Paula F. Henry as Amici Curiae on behalf of Plaintiffs and Respondents.

GEORGE, Chief Justice.

In this case we must determine the validity, under the California Constitution, of a statutory provision that requires a pregnant minor (whether just short of her eighteenth birthday, or several years younger) to secure parental consent or judicial authorization before she may obtain an abortion. The trial court, after a lengthy court trial, concluded that the statute was unconstitutional, and the Court of Appeal unanimously agreed with that ruling and affirmed the judgment.

As in past cases involving the controversial subject of abortion, we emphasize at the outset that the morality of abortion is not at issue in this case. "The morality of abortion is not a legal or constitutional issue; it is a matter of philosophy, of ethics, and of theology. It is a subject upon which reasonable people can, and do, adhere to vastly divergent convictions and principles." (Committee to Defend Reproductive Rights v. Myers (1981) 29 Cal.3d 252, 284, 172 Cal.Rptr. 866, 625 P.2d 779.) Our decision in this case does not turn upon the personal views of any justice with regard to that moral issue.

Nor is the desirability of parental involvement in a minor's decision whether to obtain an abortion or instead to give birth to a child in question here. No one would doubt the value to a pregnant minor of wise and caring parental guidance and support as she confronts a decision that will affect the rest of her life, assuming such support is available and the minor is willing to seek it. The statute at issue, however, applies not only to a pregnant minor who is willing to seek parental advice and consent, but rather has its most significant impact in those instances in which a pregnant minor is too frightened or too embarrassed to disclose her condition to a parent (or to a court).

The question before us is not whether, as a matter of policy, the challenged statute is wise or beneficial, but instead whether it is constitutional. We determine the validity of the legislative measure by applying the relevant legal principles embodied in the California Constitution, the preeminent expression of California law enacted by the people.

For the reasons explained hereafter, we conclude that both the trial court and the Court of Appeal correctly determined that the statute at issue violates the right of privacy guaranteed by article I, section 1, of the California Constitution. Accordingly, we shall affirm the judgment rendered by the Court of Appeal. ¹

I

The statutory provision in question--Assembly Bill No. 2274, 1987-1988 Regular Session (hereafter Assembly Bill 2274)--was enacted in 1987, but it has never been enforced because its application has been stayed by the lower courts pending determination of its validity. This measure constitutes just one part of a comprehensive statutory scheme governing the conditions and circumstances under which medical, surgical, and hospital care may be provided to minors in California. To place the challenged legislation in proper perspective, we review the history and evolution of the related California statutory provisions in this area.

At common law, minors generally were considered to lack the legal capacity to give valid consent to medical treatment or services, and consequently a parent, guardian, or other legally authorized person generally was required to provide the requisite consent. In the absence of an emergency, a physician who provided medical care to a minor without such parental or other legally authorized consent could be sued for battery. (See generally IJA-ABA Joint Com. on Juvenile Justice Standards, Standards Relating to Rights of Minors (1984) std. 4.1, com., p. 51.) As with other common law rules relating to the legal "disability" of minority, the purpose of the general common law rule regarding medical care was to protect the health and welfare of minors, safeguarding them from the potential overreaching of third parties or the improvidence of their own immature decisionmaking, and leaving decisions concerning the minor's medical care in the hands of his or her parents, who were presumed to be in the best position to protect the health of their child. (See, e.g., Bonner v. Moran (D.C.Cir.1941) 126 F.2d 121, 122-123.)

The requirement that medical care be provided to a minor only with the consent of the minor's parent or guardian remains the general rule, both in California and throughout the United States. (See, e.g., Cobbs v. Grant (1972) 8 Cal.3d 229, 243-244, 104 Cal.Rptr. 505, 502 P.2d 1; Rainer v. Community Memorial Hosp. (1971) 18 Cal.App.3d 240, 251, fn. 14, 95 Cal.Rptr. 901; see generally Annot. (1989) 67 A.L.R.4th 511, 516-517.) Over the past half-century, however, a number of significant statutory developments in California have modified the general rule relating to the provision of medical care to minors.

One development involves the Legislature's enactment of a number of discrete, so-called "medical emancipation" statutes, each of which has designated a general category of minors who--although not legally emancipated for all purposes--nonetheless are authorized to obtain medical, surgical, or hospital care in all contexts, without parental consent. In 1961, the Legislature enacted statutory provisions authorizing (1) any lawfully married minor, and (2) any minor on active duty with any of the United States armed services, to consent to all hospital, medical, and surgical care without parental approval (Stats.1961, ch. 1407, § 1, p. 3212 [enacting former Civ.Code, § 25.6]; Stats.1961, ch. 1407, § 2, p. 3213 [enacting former Civ.Code, § 25.7].) ² And in 1968, the Legislature adopted a somewhat broader medical emancipation statute, providing that "a minor 15 years of age or older who is living separate and apart from his parents or legal guardian, whether with or without the consent of a parent or guardian and regardless of the duration of such separate residence, and who is managing his own financial affairs, regardless of the source of his income," may consent to any hospital, medical, or surgical care without parental approval. (Stats.1968, ch. 371, § 1, p. 785 [enacting former Civ.Code, § 34.6, now Fam.Code, § 6922]; see Carter v. Cangello (1980) 105 Cal.App.3d 348, 164 Cal.Rptr. 361.)

In addition to this first category of what might be characterized as "general medical emancipation" statutes, California has adopted a considerable number of additional statutory provisions that fall within a second category of what might be termed "limited medical emancipation" statutes, i.e., statutes that authorize minors, without parental consent, to obtain medical care only for specific, designated conditions, without authorizing the minor to consent to medical care for other medical needs. These limited medical emancipation statutes identify circumstances in which a minor in need of medical care may be reluctant, for a variety of reasons, to inform his or her parents of the situation or condition that has created the minor's need for such care, and in which, because of such reluctance, there is a substantial risk that minors will fail to seek medical care--"to the detriment of themselves, their families, and society" (Wadlington, Medical Decision Making for and by Children: Tensions Between Parent, State and Child (1994) 1994 U. Ill. L.Rev. 311, 323-324)--were minors required to inform their parents and obtain parental consent before being allowed to receive medical care. (See generally Wadlington, Consent to Medical Care for Minors, in Children's Competence to Consent (Melton et al. edits.1983) pp. 61-64.)

Over the past 40 years, California has enacted a variety of such limited medical emancipation statutes. The initial statute falling within this category--the amended version of which is challenged in this case--was enacted in 1953 and authorized an unmarried pregnant minor, without parental consent, to obtain hospital, medical, and surgical care related to pregnancy. (Stats.1953, ch. 1654, § 1, p. 3383, enacting former Civ.Code, § 34.5, now Fam.Code, § 6925.) (We shall review the specific language and evolution of ...