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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. 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.
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."
II.
Jane Roe, 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, 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:
"[I]n 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. [410 U.S. 113,
126] 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. 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); [410 U.S. 113, 129] 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. We are also told, however, that abortion
was practiced in Greek times as well as in the Roman Era, and
that "it was resorted to without scruple." 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. 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.
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? 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," 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."
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: 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 "[i]n no other stratum of Greek opinion were such views
held or proposed in the same spirit of uncompromising austerity."
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." 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."
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 —was
not an indictable offense. 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. 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. 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 childe" is "a great misprision,
and no murder." Blackstone followed, saying that while
abortion after quickening had once been considered manslaughter
(though not murder), "modern law" took a less severe
view. 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. 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, others followed
Coke in stating that abortion of a quick fetus was a "misprision,"
a term they translated to mean "misdemeanor." 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. 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 willful act at the time when it is being delivered
in the ordinary course of nature." 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. 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." The death penalty was not imposed. Abortion
before quickening was made a crime in that State only in 1860.
In 1828, New York enacted legislation 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, only eight American States had
statutes dealing with abortion. 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. The
exceptions, Alabama and the District of Columbia, permitted
abortion to preserve the mother's health. Three States permitted
abortions that were not "unlawfully" performed or
that were not "without lawful justification," leaving
interpretation of those standards to the courts. 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."
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."
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 counselling
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."
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."
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. The Conference has
appended an enlightening Prefatory Note.
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. 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.
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. 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.
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. 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. 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.
Proponents of this view point out that in many States, including
Texas, 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. 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 [410 U.S.
113, 153] (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, [410 U.S. 113, 155] 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 [410 U.S. 113,
156] 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. On the other hand, the appellee
conceded on reargument 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; 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.
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 [410
U.S. 113, 159] 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. It appears to be the predominant, though not
the unanimous, attitude of the Jewish faith. 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. 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. Viability is
usually placed at about seven months (28 weeks) but may occur
earlier, even at 24 weeks. 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. 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.
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. 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. 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. 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. 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 life-saving
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. 6
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 [410 U.S.
113, 167] of the District Court is affirmed. Costs are allowed
to the appellee.
It is so ordered.
MR. JUSTICE STEWART, concurring.
In 1963, this Court, in Ferguson v. Skrupa,
372 U.S. 726 , purported to sound the death knell for the doctrine
of substantive due process, a doctrine under which many state
laws had in the past been held to violate the Fourteenth Amendment.
As Mr. Justice Black's opinion for the Court in Skrupa put it:
"We have returned to the original constitutional proposition
that courts do not substitute their social and economic beliefs
for the judgment of legislative bodies, who are elected to pass
laws." Id., at 730. 1
Barely two years later, in Griswold v. Connecticut,
381 U.S. 479 , the Court held a Connecticut birth control law
unconstitutional. In view of what had been so recently said
in Skrupa, the Court's opinion in Griswold understandably did
its best to avoid reliance on the Due Process Clause of the
Fourteenth Amendment as the ground for decision. Yet, the Connecticut
law did not violate any provision of the Bill of Rights, nor
any other specific provision of the Constitution. 2 So it was
clear [410 U.S. 113, 168] to me then, and it is equally clear
to me now, that the Griswold decision can be rationally understood
only as a holding that the Connecticut statute substantively
invaded the "liberty" that is protected by the Due
Process Clause of the Fourteenth Amendment. As so understood,
Griswold stands as one in a long line of pre-Skrupa cases decided
under the doctrine of substantive due process, and I now accept
it as such.
"In a Constitution for a free people,
there can be no doubt that the meaning of `liberty' must be
broad indeed." Board of Regents v. Roth, 408 U.S. 564,
572 . The Constitution nowhere mentions a specific right of
personal choice in matters of marriage and family life, but
the "liberty" protected by the Due Process Clause
of the Fourteenth Amendment covers more than those freedoms
explicitly named in the Bill of Rights. See Schware v. Board
of Bar Examiners, 353 U.S. 232, 238 -239; Pierce v. Society
of Sisters, 268 U.S. 510, 534 -535; Meyer v. Nebraska, 262 U.S.
390, 399 -400. Cf. Shapiro v. Thompson, 394 U.S. 618, 629 -630;
United States v. Guest, 383 U.S. 745, 757 -758; Carrington v.
Rash, 380 U.S. 89, 96 ; Aptheker v. Secretary of State, 378
U.S. 500, 505 ; Kent v. Dulles, 357 U.S. 116, 127 ; Bolling
v. Sharpe, 347 U.S. 497, 499 -500; Truax v. Raich, 239 U.S.
33, 41 .
As Mr. Justice Harlan once wrote: "[T]he
full scope of the liberty guaranteed by the Due Process Clause
cannot be found in or limited by the precise terms of the specific
guarantees elsewhere provided in the Constitution. This `liberty'
is not a series of isolated points pricked out in terms of the
taking of property; the freedom of speech, press, and religion;
the right to keep and bear arms; the freedom from unreasonable
searches and seizures; and so on. It is a rational continuum
which, broadly speaking, includes a freedom from all substantial
arbitrary impositions and purposeless restraints . . . and which
also recognizes, what a reasonable and sensitive judgment must,
that certain interests require particularly careful scrutiny
of the state needs asserted to justify their abridgment."
Poe v. Ullman, 367 U.S. 497, 543 (opinion dissenting from dismissal
of appeal) (citations omitted). In the words of Mr. Justice
Frankfurter, "Great concepts like . . . `liberty' . . .
were purposely left to gather meaning from experience. For they
relate to the whole domain of social and economic fact, and
the statesmen who founded this Nation knew too well that only
a stagnant society remains unchanged." National Mutual
Ins. Co. v. Tidewater Transfer Co., 337 U.S. 582, 646 (dissenting
opinion).
Several decisions of this Court make clear
that freedom of personal choice in matters of marriage and family
life is one of the liberties protected by the Due Process Clause
of the Fourteenth Amendment. Loving v. Virginia, 388 U.S. 1,
12 ; Griswold v. Connecticut, supra; Pierce v. Society of Sisters,
supra; Meyer v. Nebraska, supra. See also Prince v. Massachusetts,
321 U.S. 158, 166 ; Skinner v. Oklahoma, 316 U.S. 535, 541 .
As recently as last Term, in Eisenstadt v. Baird, 405 U.S. 438,
453 , we recognized "the right of the individual, married
or single, to be free from unwarranted governmental intrusion
into matters so fundamentally affecting a person as the decision
whether to bear or beget a child." That right necessarily
includes the right of a woman to decide whether or not to terminate
her pregnancy. "Certainly the interests of a woman in giving
of her physical and emotional self during pregnancy and the
interests that will be affected throughout her life by the birth
and raising of a child are of a far greater degree of significance
and personal intimacy than the right to send a child to private
school protected in Pierce v. Society of Sisters, 268 U.S. 510
(1925), or the right to teach a foreign language protected in
Meyer v. Nebraska, 262 U.S. 390 (1923)." Abele v. Markle,
351 F. Supp. 224, 227 (Conn. 1972).
Clearly, therefore, the Court today is correct
in holding that the right asserted by Jane Roe is embraced within
the personal liberty protected by the Due Process Clause of
the Fourteenth Amendment.
It is evident that the Texas abortion statute
infringes that right directly. Indeed, it is difficult to imagine
a more complete abridgment of a constitutional freedom than
that worked by the inflexible criminal statute now in force
in Texas. The question then becomes whether the state interests
advanced to justify this abridgment can survive the "particularly
careful scrutiny" that the Fourteenth Amendment here requires.
The asserted state interests are protection
of the health and safety of the pregnant woman, and protection
of the potential future human life within her. These are legitimate
objectives, amply sufficient to permit a State to regulate abortions
as it does other surgical procedures, and perhaps sufficient
to permit a State to regulate abortions more stringently or
even to prohibit them in the late stages of pregnancy. But such
legislation is not before us, and I think the Court today has
thoroughly demonstrated that these state interests cannot constitutionally
support the broad abridgment of personal liberty worked by the
existing Texas law. Accordingly, I join the Court's opinion
holding that that law is invalid under the Due Process Clause
of the Fourteenth Amendment.
MR. JUSTICE REHNQUIST, dissenting.
The Court's opinion brings to the decision
of this troubling question both extensive historical fact and
a wealth of legal scholarship. While the opinion thus commands
my respect, I find myself nonetheless in fundamental disagreement
with those parts of it that invalidate the Texas statute in
question, and therefore dissent.
I.
The Court's opinion decides that a State may
impose virtually no restriction on the performance of abortions
during the first trimester of pregnancy. Our previous decisions
indicate that a necessary predicate for such an opinion is a
plaintiff who was in her first trimester of pregnancy at some
time during the pendency of her law-suit. While a party may
vindicate his own constitutional rights, he may not seek vindication
for the rights of others. Moose Lodge v. Irvis, 407 U.S. 163
(1972); Sierra Club v. Morton, 405 U.S. 727 (1972). The Court's
statement of facts in this case makes clear, however, that the
record in no way indicates the presence of such a plaintiff.
We know only that plaintiff Roe at the time of filing her complaint
was a pregnant woman; for aught that appears in this record,
she may have been in her last trimester of pregnancy as of the
date the complaint was filed.
Nothing in the Court's opinion indicates that
Texas might not constitutionally apply its proscription of abortion
as written to a woman in that stage of pregnancy. Nonetheless,
the Court uses her complaint against the Texas statute as a
fulcrum for deciding that States may impose virtually no restrictions
on medical abortions performed during the first trimester of
pregnancy. In deciding such a hypothetical lawsuit, the Court
departs from the longstanding admonition that it should never
"formulate a rule of constitutional law broader than is
required by the precise facts to which it is to be applied."
Liverpool, New York & Philadelphia S. S. Co. v. Commissioners
of Emigration, 113 U.S. 33, 39 (1885). See also Ashwander v.
TVA, 297 U.S. 288, 345 (1936) (Brandeis, J., concurring).
II.
Even if there were a plaintiff in this case
capable of litigating the issue which the Court decides, I would
reach a conclusion opposite to that reached by the Court. I
have difficulty in concluding, as the Court does, that the right
of "privacy" is involved in this case. Texas, by the
statute here challenged, bars the performance of a medical abortion
by a licensed physician on a plaintiff such as Roe. A transaction
resulting in an operation such as this is not "private"
in the ordinary usage of that word. Nor is the "privacy"
that the Court finds here even a distant relative of the freedom
from searches and seizures protected by the Fourth Amendment
to the Constitution, which the Court has referred to as embodying
a right to privacy. Katz v. United States, 389 U.S. 347 (1967).
If the Court means by the term "privacy"
no more than that the claim of a person to be free from unwanted
state regulation of consensual transactions may be a form of
"liberty" protected by the Fourteenth Amendment, there
is no doubt that similar claims have been upheld in our earlier
decisions on the basis of that liberty. I agree with the statement
of MR. JUSTICE STEWART in his concurring opinion that the "liberty,"
against deprivation of which without due process the Fourteenth
Amendment protects, embraces more than the rights found in the
Bill of Rights. But that liberty is not guaranteed absolutely
against deprivation, only against deprivation without due process
of law. The test traditionally applied in the area of social
and economic legislation is whether or not a law such as that
challenged has a rational relation to a valid state objective.
Williamson v. Lee Optical Co., 348 U.S. 483, 491 (1955). The
Due Process Clause of the Fourteenth Amendment undoubtedly does
place a limit, albeit a broad one, on legislative power to enact
laws such as this. If the Texas statute were to prohibit an
abortion even where the mother's life is in jeopardy, I have
little doubt that such a statute would lack a rational relation
to a valid state objective under the test stated in Williamson,
supra. But the Court's sweeping invalidation of any restrictions
on abortion during the first trimester is impossible to justify
under that standard, and the conscious weighing of competing
factors that the Court's opinion apparently substitutes for
the established test is far more appropriate to a legislative
judgment than to a judicial one.
The Court eschews the history of the Fourteenth
Amendment in its reliance on the "compelling state interest"
test. See Weber v. Aetna Casualty & Surety Co., 406 U.S.
164, 179 (1972) (dissenting opinion). But the Court adds a new
wrinkle to this test by transposing it from the legal considerations
associated with the Equal Protection Clause of the Fourteenth
Amendment to this case arising under the Due Process Clause
of the Fourteenth Amendment. Unless I misapprehend the consequences
of this transplanting of the "compelling state interest
test," the Court's opinion will accomplish the seemingly
impossible feat of leaving this area of the law more confused
than it found it.
While the Court's opinion quotes from the
dissent of Mr. Justice Holmes in Lochner v. New York, 198 U.S.
45, 74 (1905), the result it reaches is more closely attuned
to the majority opinion of Mr. Justice Peckham in that case.
As in Lochner and similar cases applying substantive due process
standards to economic and social welfare legislation, the adoption
of the compelling state interest standard will inevitably require
this Court to examine the legislative policies and pass on the
wisdom of these policies in the very process of deciding whether
a particular state interest put forward may or may not be "compelling."
The decision here to break pregnancy into three distinct terms
and to outline the permissible restrictions the State may impose
in each one, for example, partakes more of judicial legislation
than it does of a determination of the intent of the drafters
of the Fourteenth Amendment.
The fact that a majority of the States reflecting,
after all, the majority sentiment in those States, have had
restrictions on abortions for at least a century is a strong
indication, it seems to me, that the asserted right to an abortion
is not "so rooted in the traditions and conscience of our
people as to be ranked as fundamental," Snyder v. Massachusetts,
291 U.S. 97, 105 (1934). Even today, when society's views on
abortion are changing, the very existence of the debate is evidence
that the "right" to an abortion is not so universally
accepted as the appellant would have us believe.
To reach its result, the Court necessarily
has had to find within the scope of the Fourteenth Amendment
a right that was apparently completely unknown to the drafters
of the Amendment. As early as 1821, the first state law dealing
directly with abortion was enacted by the Connecticut Legislature.
Conn. Stat., Tit. 22, 14, 16. By the time of the adoption of
the Fourteenth Amendment in 1868, there were at least 36 laws
enacted by state or territorial legislatures limiting abortion.
1 While many States have amended or updated their laws, 21 of
the laws on the books in 1868 remain in effect today. 2 Indeed,
the Texas statute struck down today was, as the majority notes,
first enacted in 1857 and "has remained substantially unchanged
to the present time." Ante, at 119.
There apparently was no question concerning
the validity of this provision or of any of the other state
statutes when the Fourteenth Amendment was adopted. The only
conclusion possible from this history is that the drafters did
not intend to have the Fourteenth Amendment withdraw from the
States the power to legislate with respect to this matter.
III.
Even if one were to agree that the case that
the Court decides were here, and that the enunciation of the
substantive constitutional law in the Court's opinion were proper,
the actual disposition of the case by the Court is still difficult
to justify. The Texas statute is struck down in toto, even though
the Court apparently concedes that at later periods of pregnancy
Texas might impose these selfsame statutory limitations on abortion.
My understanding of past practice is that a statute found to
be invalid as applied to a particular plaintiff, but not unconstitutional
as a whole, is not simply "struck down" but is, instead,
declared unconstitutional as applied to the fact situation before
the Court. Yick Wo v. Hopkins, 118 U.S. 356 (1886); Street v.
New York, 394 U.S. 576 (1969).
For all of the foregoing reasons, I respectfully
dissent.
Source: Roe v. Wade, 410 U.S. 113 (1973).
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