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.
57 Lader 97-99; D. Feldman,
Birth Control in Jewish Law 251-294 (1968). For a stricter view,
see I. Jakobovits, Jewish Views on Abortion, in Abortion and the
Law 124 (D. Smith ed. 1967).
58 Amicus Brief for the American
Ethical Union et al. For the position of the National Council
of Churches and of other denominations, see Lader 99-101.
59 L. Hellman & J. Pritchard,
Williams Obstetrics 493 (14th ed. 1971); Dorland's Illustrated
Medical Dictionary 1689 (24th ed. 1965).
60 Hellman & Pritchard,
supra, n. 59, at 493.
61 For discussions of the
development of the Roman Catholic position, see D. Callahan, Abortion:
Law, Choice, and Morality 409-447 (1970); Noonan 1.
62 See Brodie, The New Biology
and the Prenatal Child, 9 J. Family L. 391, 397 (1970); Gorney,
The New Biology and the Future of Man, 15 U. C. L. A. L. Rev.
273 (1968); Note, Criminal Law -- Abortion -- The "Morning-After
Pill" and Other Pre-Implantation Birth-Control Methods and
the Law, 46 Ore. L. Rev. 211 (1967); G. Taylor, The Biological
Time Bomb 32 (1968); A. Rosenfeld, The Second Genesis 138-139
(1969); Smith, Through a Test Tube Darkly: Artificial Insemination
and the Law, 67 Mich. L. Rev. 127 (1968); Note, Artificial Insemination
and the Law, 1968 U. Ill. L. F. 203.
63 W. Prosser, The Law of
Torts 335-338 (4th ed. 1971); 2 F. Harper & F. James, The
Law of Torts 1028-1031 (1956); Note, 63 Harv. L. Rev. 173 (1949).
64 See cases cited in Prosser,
supra, n. 63, at 336-338; Annotation, Action for Death of Unborn
Child, 15 A. L. R. 3d 992 (1967).
65 Prosser, supra, n. 63,
at 338; Note, The Law and the Unborn Child: The Legal and Logical
Inconsistencies, 46 Notre Dame Law. 349, 354-360 (1971).
66 Louisell, Abortion, The
Practice of Medicine and the Due Process of Law, 16 U. C. L. A.
L. Rev. 233, 235-238 (1969); Note, 56 Iowa L. Rev. 994, 999-1000
(1971); Note, The Law and the Unborn Child, 46 Notre Dame Law.
349, 351-354 (1971).
67 Neither in this opinion
nor in Doe v. Bolton, post, p. 179, do we discuss the father's
rights, if any exist in the constitutional context, in the abortion
decision. No paternal right has been asserted in either of the
cases, and the Texas and the Georgia statutes on their face take
no cognizance of the father. We are aware that some statutes recognize
the father under certain circumstances. North Carolina, for example,
N. C. Gen. Stat. § 14-45.1 (Supp. 1971), requires written
permission for the abortion from the husband when the woman is
a married minor, that is, when she is less than 18 years of age,
41 N. C. A. G. 489 (1971); if the woman is an unmarried minor,
written permission from the parents is required. We need not now
decide whether provisions of this kind are constitutional.
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