The Supreme Court's spring term: abortion, the right to die, and the decline of privacy rights

Wing analyzes the constitutional significance and the important long-term implications for health policy of three 1990 U.S. Supreme Court decisions: Hodgson v. Minnesota, Ohio v. Akron Center for Reproductive Health, and Cruzan v. Director, Missouri Department of Health. Hodgson and Ohio upheld state statutes requiring parental notification of a minor's impending abortion. Cruzan upheld a state court decision refusing to allow the family of a patient in a persistent vegetative state to discontinue life-sustaining treatment. Wing argues that these decisions reach far beyond "the abortion issue" or "the right to die." Not only have they narrowed the constitutional protection of individual privacy, but they allow states to regulate activities like abortion in a manner that indicates that the Court is prepared to repeal the notion that individual privacy is entitled to enhanced judicial protection.     

"Pro-life" absolutes, feminist challenges: the fundamentalist narrative of Irish abortion law 1986-1992

This article asks how Irish abortion law developed to the point of stopping a young pregnant rape victim from travelling abroad to have an abortion in 1992 (Attorney General v.X). The author argues that this case, which ultimately saw the Irish Supreme Court overturn that decision and recognize the young woman's right to abortion, was the last chapter of the fundamentalist narrative of Irish abortion law. The feminist critique of that law needs to consider its particular fundamentalist aspects in order to clarify the obstacles posed to the struggle for Irish women's reproductive freedom. The author argues that a fundamentalist narrative ordered the post-colonial and patriarchal conditions of Irish society so as to call for the legal recognition of an absolute right to life of the "unborn." The Supreme Court's interpretation of the constitutional right to life of the fetus in three cases during the 1980s is evidence that Irish abortion law was constructed through a fundamentalist narrative until that narrative was rejected in the Supreme Court decision in Attorney General v. X.     

A trojan horse goes to court: Bolger v. Youngs Drug Products Corp

In Bolger v. Youngs Drug Products Corp., the Supreme Court held that a statute prohibiting the mailing of unsolicited advertisements for contraceptives was unconstitutional as applied to Young's advertisements for condoms. The decision rested on a balancing of the first amendment's grant of free speech with the Government's interest in safeguarding an individual's privacy. The Court noted that the advertisements promoted the flow of information on contraception, and pertained to constitutionally protected private activity. This Case Comment argues that the Court's decision is sound and criticizes the view of the concurring opinion that shielding individuals from potentially offensive speech is a substantial governmental interest. The Comment concludes that the Court's decision expands upon precedent which established an individual's right of privacy regarding the use of contraceptives.     

COERCIVE AND NONCOERCIVE ABORTION DETERRENCE POLICIES: A Comparative State Analysis

The Supreme Court's decision in Roe v. Wade ( 1973) limited the authority of states to prohibit abortions during the first two trimesters of pregnancy. Although they can no longer prohibit abortions, state legislatures have adopted a variety of coercive and noncoercive policies that might operate to alter the utilities associated with having or providing abortions. This article analyzes the relative impacts of these policies on two measures of abortion behavior: (1) state abortion rates in 1976 and (2) trends in states' abortion rates from 1973 to 1976. Multiple regression analysis reveals that neither coercive nor noncoercive policies are strongly related to these aggregate measures of abortion behavior .     

Abortion legislation after Webster v. Reproductive Health Services: model statutes and commentaries

The following Article analyzes the United States Supreme Court's examination of abortion rights in Webster v. Reproductive Health Services. The Article then proposes model statutes restricting abortion in light of the Webster decision. The Cumberland Law Review invites and encourages commentary on both sides of the issue.     

Roe v. Wade and the history of abortion regulation

In "Roe," the Supreme Court found that the privacy right in the 14th amendment's view of "personal liberty" encompasses a woman's right to choose an abortion. The Court found that "abortion is a fundamental right." These conclusions are mistaken. The Court's analysis of "the history of abortion regulation" had a lot of errors and did not consider the state of technology in which abortion evolved. Sir Edward Coke, a 16th and 17th century jurist, said that abortion was a "great misprison." Quickening, the point at which a woman feels life, was used to determine fetal viability. State courts, therefore, viewed "abortion after quickening as common law crime." By the end of 1868, 30 to the then 37 states had passed laws restricting abortion. The Supreme Court said that the 19th century laws were passed to guard the mother's health "against the dangers of unsafe operation." In the 15 months before "Roe," 5 state courts said that their abortion laws were constitutional. They said that this was "intended to protect the lives of unborn children." Therefore, the Court's belief that "the state courts focused on the State's interest in protecting "the health of the mother" was unexplainable. The Court said that in many states the woman couldn't "be prosecuted for self-abortion." 17 states did "incriminate the woman's participation in her own abortion," but the Court did not note this. The Court's premise about the greater hazards of late abortions is mistaken. The states were concerned, in the late 19th century, about whether the attempted abortion caused the death of a child. The "right to an abortion" can only be seen as "fundamental" if it is "implicit" in the "ordered liberty" concept or "deeply rooted" in US tradition and history. "Roe" struck down the abortion laws of all 50 states and should be overturned.     

Brief for 885 law professors in support of maintaining adherence to the Roe decision

This brief opposes the overturn of "Roe v. Wade" and resists weakening "Roe's central holding" that would allow states to overturn legal abortion. The brief was written for 885 law professors. "Roe" was not a "constitutional aberration," or "an exercise of raw, judicial power." Some members of the Supreme Court seem to think that the state has "an overriding interest" in protecting fetal life. Some Court members have questioned "Roe's" trimester framework. A person's decision to abort should be done privately. If women are not free to choose abortion, they will not have equality. There is an absence of "express rights of privacy and procreational freedom" in the Constitution. "Roe" was 1 instance of the Court's recognition of constitutional rights that are not named explicitly. Historical materials are drawn on to show the link between trends in society and the "judicial recognition of unenumerated rights." The most serious questions about "Roe" deal with its trimester framework. Justice Blackmun's majority opinion said that the 1st trimester of pregnancy was personal. "Roe" said that abortions created a medical risk at the beginning of the 2nd trimester. Therefore, the government was more interested in the health of the mother at that time. The state could then regulate abortion "in ways that are reasonable related to maternal health." The start of the 3rd trimester was when the fetus was viable. The right of a woman to end her pregnancy "offends powerful moral forces." Some of "Roe's" critics had their scientific facts wrong. Medical authorities think Justice O'Connor is mistaken when she says that "Roe" is "on a collision course with itself." The 23rd to 24th week of pregnancies where the fetal organs can "sustain life outside the womb." This has not changed since "Roe" was decided in 1973, nor is it likely to in the future. Some "amici" believe that the state can never have an interest in the fetus. The state can not have an interest in the fetus distinct from the woman who will give birth to it. During previability, restricting a woman's procreational rights would not be scientifically supportable. The state does have an interest in "upholding the value of human life." "Roe" is "within the mainstream" of constitutional jurisprudence and should be reaffirmed.     

Expertise in law, medicine, and health care

As the practice of science-based medical evidence has challenged the medical profession to consider the scientific bases for its methods and procedures, on a seemingly parallel path, the United States Supreme Court's 1993 decision in Daubert v. Merrell Dow Pharmaceuticals has challenged the legal system to consider the science underlying claims of medical expertise. This article examines how the legal system has responded to that challenge and why the response has been more limited than many had expected; the implications of the legal system's approach to scrutiny of claims of medical expertise for the practice of science-based medical evidence; and, the central elements of any meaningful change in legal assessments of expertise in medicine and health care.     

Brief for bioethicists for privacy as amicus curiae supporting appellees

Amicus, an ad hoc group of philosophers, theologians, attorneys, and physicians, believe that adults should consult their doctor when making personal decisions. The doctor-patient relationship would be protected under the Constitution. In "Griswold v. Connecticut," the Supreme Court said that a state law which forbid married couples from using contraceptives was unconstitutional; that the couples should have a right to privacy. In "Roe," the Supreme Court recognized that a patient and her doctor should have privacy. In "Doe v. Bolton," the Supreme Court found that the State of Georgia was violating the patients' and physician's freedom. In "Planned Parenthood of Missouri v. Danforth," the Supreme Court said that a general informed consent provision was alright because it did not take away the abortion decision. The post- Roe state laws were ways to control doctors and patients so that a particular philosophical view could be imposed. The major question in Webster is whether personal decisions should be made by doctors and patients or the state. Both parties must agree to the decision. Section 188.205 of the Missouri law was before the Court in Webster. This section makes it illegal for public funds to be used to encourage a woman to have an abortion that wasn't necessary to save her life. There are medical conditions for which abortion is reasonable - Tay-Sachs disease, for instance. The child usually dies by 3 years of age. Without genetic screening, many at-risk couples would abort all pregnancies. 95% of all prenatal screenings are negative. State medical treatment decisions are arbitrary and impersonal. Having control over important personal decisions is necessary for freedom.     

Governmental Rejections of Ombudsman Findings: What Role for the Courts?

This article discusses the recent Bradley litigation before the High Court and Court of Appeal, in which applicants sought judicial review of a Government Minister's decision to reject findings made by the Parliamentary Commissioner for Administration in her report, 'Trusting in the Pensions Promise'. The article critically analyses the Court of Appeal's approach to reviewing the Minister's decision, focusing on the standard of review applied and placing the Court's approach in the wider context of the Ombudsman process, which is inherently political.     

Police hiring and retention of sexual minorities in Georgia and Texas after Lawrence v. Texas

In this telephone interview study, hiring and retention policies and practices relevant to sexual minority officers among twenty selected police departments in Georgia and Texas were examined. The authors examined policies and practices in place before and after the U.S. Supreme Court's 2003 decision in Lawrence v. Texas, in which the Court struck down Texas' sodomy law on grounds that it violated due process and the right to privacy, in effect decriminalizing homosexual conduct throughout the nation. Conclusions and policy implications for law enforcement hiring practices in light of this landmark decision are discussed.     

The Tarasoff dilemma in criminal court.

The duty to protect, or Tarasoff duty, has been conceptualized as arising solely in the context of a clinical setting. A recent California Supreme Court ruling in People v. Clark adds legal, clinical, and ethical dilemmas to the oftentimes contentious Tarasoff issue. Though the Tarasoff issue is but a minor legal point in Clark, a possible consequence of Clark is that a Tarasoff warning could be deemed nonconfidential and admissible in a criminal trial. Psychotherapists could therefore be testifying in criminal courts as prosecution witnesses. While the possibility of a chilling effect on patients' disclosure of violent ideation in the context of psychotherapy first caused apprehension after the California Supreme Court's 1976 decision in Tarasoff v. Regents of the University of California, this same Court's ruling in People v. Clark some 14 years later may ensure that this fear finally becomes realized.     

Access to health care and equal protection of the law: the need for a new heightened scrutiny

Proposals to reduce national expenditures for health care under Medicare and other programs raise questions about the limits on legislative power to distribute health care benefits. The constitutional guarantee of equal protection has been a weak source of protection for the sick, largely because they fail to qualify for special scrutiny under traditional equal protection analysis. Recent decisions of the United States Supreme Court suggest that the Justices seek a newer, more flexible approach to reviewing claims of unequal protection. This Article examines the application of the equal protection guarantee to health-related claims. It argues that traditional equal protection analysis is too rigid and newer rationality review too imprecise to provide just eligibility determinations. The Article concludes that courts should subject claims of unequal protection in the health care context to heightened scrutiny, as health care plays a special role in assuring equality of opportunity.     

The risk of birth defects: Jacobs v. Theimer and parents' right to know.

This Article discusses the Texas Supreme Court's holding in Jacobs v. Theimer that the parents of a defective child had a cause of action for damages against a physician for alleged negligent failure to inform the mother during pregnancy that she had contracted rubella and therefore might have a defective child, thereby causing her to lose the opportunity to have an abortion. The Article raises a number of questions that post-Jacobs courts probably will confront concerning the duty of physicians and genetic counselors to keep their clients informed; describes some social and medical developments--including recent progress in medical genetics and prenatal diagnosis--which are likely to make Jacobs a significant precedent; evaluates the court's decision to allow a damage suit only for the costs of treating and caring for the child's defects; and briefly addresses the question of whether the Jacobs case comes within the sphere of suits for what has come to be known as "wrongful birth" and "wrongful life."     

Taking Abortion Rights Seriously: Whole Woman's Health v Hellerstedt

In Whole Woman's Health v Hellerstedt the Supreme Court of the United States passed down its most important decision on abortion for just under a decade. By a majority of 5‐3, the Court ruled that two provisions in a Texas law regulating abortion on grounds of women's health were constitutionally invalid, placing a ‘substantial obstacle’ in the way of women seeking to exercise their right to abortion. This comment delineates the key ways in which the Court's application of the standard of constitutional review under Planned Parenthood v Casey (1992) to the Texas provisions marks a landmark development for the protection of the constitutional right to abortion established in Roe v Wade, not the least by making clear that state abortion regulations which cite ‘women's health’ justifications should not pass constitutional review where those justifications lack a credible factual basis.     

Roe v. Wade is constitutionally unprincipled and logically incoherent: a brief in support of judicial restraint

This "amicus curiae" brief was submitted by the Center for Judicial Studies and 56 members of Congress. They were concerned that "Roe" expands powers that belong to Congress and the states into the realm of federal government. Part I of the brief dealt with Missouri's claim that the laws that were at issue in "Webster" were permitted under "Roe" and shouldn't have been made invalid by lower courts. Most of the brief was in Part II. The thrust of it was that "Roe" was not based on any principle and is incoherent internally; "Roe" said that a privacy right existed under the US constitution. However, "Roe" didn't define this right of personal privacy. "Roe" cited a "line of decisions" to prove this point. However, none of the cases that "Roe" cited pretended to be based on the "right to privacy." They dealt with other issues. "Botsford" was said to be the beginning of the constitutional privacy right. It dealt with a "common law rule of evidence," not a right that was in the constitution. Therefore, it did not define the privacy right. "The process by which "Roe" moved from privacy to abortion was unfounded by judicial fiat." "Roe" said that it was protected by "the compelling interest standard," but did not give a reason why this was so. In "Roe," the woman';s interest in getting an abortion was analyzed in medical terms. But when talking about the State's interest in protecting potential human life, medical considerations were not controlling. Part III of the brief asked that "Roe" be overturned because it said that "a privacy right to abortion" was "devoid of any linkage to the text or history of the constitution." "Roe" should be abandoned because its "inadequacies" are "basic".     

Balancing in a crisis? Bioterrorism, public health and privacy

Post-September 11, the government has been rapidly funding public health initiatives to bolster the Nation's ability to respond to bioterrorist attacks. While the infusion of money into the public health system is laudable, the pressure to enact legislation quickly has resulted in laws and policies that ignore privacy and civil liberties and that favor anti-bioterror initiatives over more common public health concerns. A public health agenda that ignores privacy and civil liberties will undermine public trust, leading people to not fully participate in critical public health activities. Our Nation is far more likely to succeed in preventing and responding to a potential act of bioterrorism if we embrace the principle that advancing public health and preserving individual liberties are symbiotic and inextricable.     

Speech, privacy, and the power of the purse: lessons from the abortion "gag rule" case.

In Rust v. Sullivan, 59 U.S.L.W. 4451 (1991), the US Supreme Court ruled that neither the privacy interests of family planning clients nor the 1st Amendment interests of their counselors prevented the government from banning all discussion of abortions in federally funded family planning clinics. In doing so, the Court also reaffirmed its view that the state and federal legislatures have virtually unlimited discretion in limiting or conditioning social welfare programs, a view having even greater long-term implications for American health policy than the implications of Rust for the constitutional protection of abortion. Rust upheld the Department of Health and Human Services' 1988 directive prohibiting the use of any funds from Title X of the Public Health Service Act (authorizing family planning programs) in programs where abortion is a method of family planning. This means that a clinician may lawfully respond to a client's inquiry about abortion only with a denial that abortion is an option. Thus, while allowing women the constitutional protection to chose an abortion, the Court has allowed the legislature to freely use the power of the purse to discourage or prevent the choice of abortion. Rust's greatest impact may well be in its acceptance of the enormous power wielded by the government over funded activities, especially in health policy. Justice Rehnquist believes there is not constitutional right to health, welfare, or any other government benefit; the legislative branches of the government cannot be required by judicial interpretation of the Constitution to provide any particular benefit or service to anyone. Even when the government chooses to fund a particular benefit, it is free to condition that benefit with virtually no judicially enforceable limits on that discretion.     

United States v. Lyons: toward a new conception of legal insanity

In United States v. Lyons (1984), the U.S. Fifth Circuit Court altered its definition of legal insanity to conform with recent recommendations of the American Bar Association and the American Psychiatric Association. This paper briefly reviews the social and legal context of the Court's ruling. The author then discusses the insanity defense's rationale and suggests an interpretation of the Court's new definition that should guide psychiatric testimony.