H. L. v. Matheson

450 U.S. 398, 101 S. Ct. 1164, 67 L. Ed. 2d 388, 1981 U.S. LEXIS 81, 49 U.S.L.W. 4255

• Court: Supreme Court of the United States
• Decided: March 23, 1981
• Docket: 79-5903
• Status: Published

Opinions

Chief Justice Burger

delivered the opinion of the Court.

The question presented in this case is whether a state statute which requires a physician to “[njotify, if possible,” the parents of a dependent, unmarried minor girl prior to performing an abortion on the girl violates federal constitutional guarantees.

I

In the spring of 1978, appellant was an unmarried 15-year-old girl living with her parents in Utah and dependent on them for her support. She discovered she was pregnant. She consulted with a social worker and a physician. The physician advised appellant that an abortion would be in her best medical interest. However, because of Utah Code Ann. § 76-7-304 (1978), he refused to perform the abortion without first notifying appellant’s parents.

Section 76-7-304, enacted in 1974, provides:

“To enable the physician to exercise his best medical judgment [in considering a possible abortion], he shall:

“(1) Consider all factors relevant to the well-being of the woman upon whom the abortion is to be performed including, but not limited to,

“(a) Her physical, emotional and psychological health and safety,

“(b) Her age,

“(c) Her familial situation.

“(2) Notify, if possible, the parents or guardian of the woman upon whom the abortion is to be performed, if she is a minor or the husband of the woman, if she is married.” (Emphasis supplied.)¹

Violation of this section is a misdemeanor punishable by-imprisonment for not more than one year or a fine of not more than $1,000.²

Appellant believed “for [her] own reasons” that she should proceed with the abortion without notifying her parents. According to appellant, the social worker concurred in this decision.³ While still in the first trimester of her pregnancy, appellant instituted this action in the Third Judicial District Court of Utah.⁴ She sought a declaration that § 76-7-304 (2) is unconstitutional and an injunction prohibiting appellees, the Governor and the Attorney General o'f Utah, from enforcing the statute. Appellant sought to represent a class consisting of unmarried “minor women who are suffering unwanted pregnancies and desire to terminate the pregnancies but may not do so” because of their physicians’ insistence on complying with § 76-7-304 (2). The trial judge declined to grant a temporary restraining order or a preliminary injunction.⁵

The trial judge held a hearing at which appellant was the only witness. Appellant affirmed the allegations of the complaint by giving monosyllabic answers to her attorney’s leading questions.⁶ However, when the State attempted to cross-examine appellant about her reasons for not wishing to notify her parents, appellant’s counsel vigorously objected,⁷ insisting that “the specifics of the reasons are really irrelevant to the Constitutional issue.” ⁸ The only constitutionally permissible prerequisites for performance of an abortion, he insisted, were the desire of the girl and the medical approval of a physician.⁹ The trial judge sustained the objection, tentatively construing the statute to require appellant’s physician to notify her parents “if he is able to physically contact them.”

Thereafter, the trial judge entered findings of fact and conclusions of law. He concluded that appellant “is an appropriate representative to represent the class she purports to represent.” ¹⁰ He construed the statute to require notice to appellant’s parents “if it is physically possible.” He concluded that § 76-7-304 (2) “do[es] not unconstitutionally restrict the right of privacy of a minor to obtain an abortion or to enter into a doctor-patient relationship.”¹¹ Accordingly, he dismissed the complaint.

On appeal, the Supreme Court of Utah unanimously upheld the statute. 604 P. 2d 907 (1979). Relying on our decisions in Planned Parenthood of Central Mo. v. Danforth, 428 U. S. 52 (1976), Carey v. Population Services International, 431 U. S. 678 (1977), and Bellotti v. Baird, 443 U. S. 622 (1979) (Bellotti II), the court concluded that the statute serves “significant state interest[s]” that are present with respect to minors but absent in the case of adult women.

The court looked first to subsection (1) of § 76-7-304. This provision, the court observed, expressly incorporates the factors we identified in Doe v. Bolton, 410 U. S. 179 (1973), as pertinent to exercise of a physician’s best medical judgment in making an abortion decision. In Doe, we stated:

“We agree with the District Court . . . that the medical judgment may be exercised in the light of all factors— physical, emotional, psychological, familial, and the wom-art’s age — relevant to the well-being of the patient. All these factors may relate to health. This allows the attending physician the room he needs to make his best medical judgment.” Id., at 192 (emphasis supplied).

Section 76-7-304 (1) of the Utah statute suggests that the legislature sought to reflect the language of Doe.

The Utah Supreme Court held that notifying the parents of a minor seeking an abortion is “substantially and logically related” to the Doe factors set out in § 76-7-304 (1) because parents ordinarily possess information essential to a physician’s exercise of his best medical judgment concerning the child. 604 P. 2d, at 909-910. The court also concluded that encouraging an unmarried pregnant minor to seek the advice of her parents in making the decision of whether to carry her child to term promotes a significant state interest in supporting the important role of parents in child-rearing. Id., at 912. The court reasoned that since the statute allows no veto power over the minor’s decision, it does not unduly intrude upon a minor’s rights.

The Utah Supreme Court also rejected appellant’s argument that the phrase “if possible” in § 76-7-304 (2) should be construed to give the physician discretion whether to notify appellant’s parents. The court concluded that the physician is required to notify parents “if under the circumstances, in the exercise of reasonable diligence, he can ascertain their identity and location and it is feasible or practicable to give them notification.” The court added, however, that “the time element is an important factor, for there must be sufficient expedition to provide an effective opportunity for an abortion.” 604 P. 2d, at 913.

II

Appellant challenges the statute as unconstitutional on its face. She contends it is overbroad in that it can be construed to apply to all unmarried minor girls, including those who are mature and emancipated. We need not reach that question since she did not allege or proffer any evidence that either she or any member of her class is mature or emancipated.¹² The trial court found that appellant “is unmarried, fifteen years of age, resides at home and is a dependent of her parents.” That affords an insufficient basis for a finding that she is either mature or emancipated. Under Harris v. McRae, 448 U. S. 297, 320 (1980), she therefore lacks “the personal stake in the controversy needed to confer standing” to advance the overbreadth argument.

There are particularly strong reasons for applying established rules of standing in this case. The United States District Court for Utah has held that § 76-7-304 (2) does not apply to emancipated minors and that, if so applied, it would be unconstitutional. L. R. v. Hansen, Civil No. C-80-0078J (Feb. 8, 1980). Since there was no appeal from that ruling, it is controlling on the State. We cannot assume that the statute, when challenged in a proper case, will not be construed also to exempt demonstrably mature minors.¹³ See Bellotti v. Baird, 428 U. S. 132, 146-148 (1976) (Bellotti I). Nor is there any reason to assume that a minor in need of emergency treatment will be treated in any way different from a similarly situated adult.¹⁴ The Utah Supreme Court has had no occasion to consider the application of the statute to such situations. In Bellotti I, supra, we unanimously declined to pass on constitutional challenges to an abortion regulation statute because the statute was “susceptible of a construction by the state judiciary ‘which might avoid in whole or in part the necessity for federal constitutional adjudication, or at least materially change the nature of the problem.'" Id., at 147, quoting Harrison v. NAACP, 360 U. S. 167, 177 (1969). See Kleppe v. New Mexico, 426 U. S. 529, 546-647 (1976); Ashwander v. TV A, 297 U. S. 288, 346-347 (1936) (concurring opinion). We reaffirm that approach and find it controlling here insofar as appellant challenges a purported statutory exclusion of mature and emancipated minors.

The only issue before us, then, is the facial constitutionality of a statute requiring a physician to give notice to parents, “if possible," prior to performing an abortion on their minor daughter, (a) when the girl is living with and dependent upon her parents, (b) when she is not emancipated by marriage or otherwise, and (c) when she has made no claim or showing as to her maturity or as to her relations with her parents.

Ill

A

Appellant contends the statute violates the right to privacy recognized in our prior cases with respect to abortions. She places primary reliance on Bellotti II, 443 U. S., at 642, 655. In Danforth, we struck down state statutes that imposed a requirement of prior written consent of the patient’s spouse and of a minor patient’s parents as a prerequisite for an abortion. We held that a state

“does not have the constitutional authority to .give a third party an absolute, and possibly arbitrary, veto over the decision of the physician and his patient to terminate the patient’s pregnancy, regardless of the reason for withholding the consent.” 428 U. S., at 74.

We emphasized, however, “that our holding . . . does not suggest that every minor, regardless of age or maturity, may give effective consent for termination of her pregnancy.” Id., at 75, citing Bellotti I, supra. There is no logical relationship between the capacity to become pregnant and the capacity for mature judgment concerning the wisdom of an abortion.

In Bellotti II, dealing with a class of concededly mature pregnant minors, we struck down a Massachusetts statute requiring parental or judicial consent before an abortion could be performed on any unmarried minor. There the State’s highest court had construed the statute to allow a court to overrule the minor’s decision even if the court found that the minor was capable of making, and in fact had made, an informed and reasonable decision to have an abortion. We held, among other things, that the statute was unconstitutional for failure to allow mature minors to decide to undergo abortions without parental consent. Four Justices concluded that the flaws in the statute were that, as construed by the state court, (a) it permitted overruling of a mature minor’s decision to abort her pregnancy; and (b) “it requires parental consultation or notification in every instance, without affording the pregnant minor an opportunity to receive an independent judicial determination that she is mature enough to consent or that an abortion would be in her best interests.” 443 U. S., at 651. Four other Justices concluded that the defect was in making the abortion decision of a minor subject to veto by a third party, whether parent or judge, “no matter how mature and capable of informed decisionmaking” the minor might be. Id., at 653-656.

Although we have held that a state may not constitutionally legislate a blanket, unreviewable power of parents to veto their daughter’s abortion,¹⁵ a statute setting out a “mere requirement of parental notice” does not violate the constitutional rights of an immature, dependent minor.¹⁶ Four Justices in Bellotti II joined in stating:

“[Plaintiffs] suggest . . . that the mere requirement of parental notice [unduly burdens the right to seek an abortion]. As stated in Part II above, however, parental notice and consent are qualifications that typically may be imposed by the State on a minor’s right to make important decisions. As immature minors often lack the ability to make fully informed choices that take account of both immediate and long-range consequences, a State reasonably may determine that parental consultation often is desirable and in the best interest of the minor. It may further determine, as a general proposition, that such consultation is particularly desirable with respect to the abortion decision — one that for some people raises profound moral and religious concerns. . . .

“ ‘There can be little doubt that the State furthers a constitutionally permissible end by encouraging an unmarried pregnant minor to seek the help and advice of her parents in making the very important decision whether or not to bear a child. That is a grave decision, and a girl of tender years, under emotional stress, may be ill-equipped to make it without mature advice and emotional support. It seems unlikely that she will obtain adequate counsel and support from the attending physician at an abortion clinic, where abortions for pregnant minors frequently take place.’ ” Id., at 640-641 (footnotes omitted), quoting Danforth, 428 U. S., at 91 (concurring opinion).

Accord, 443 U. S., at 657 (dissenting opinion).

In addition, “constitutional interpretation has consistently recognized that the parents’ claim to authority in their own household to direct the rearing of their children is basic in the structure of our society.” Ginsberg v. New York, 390 U. S. 629, 639 (1968). In Quilloin v. Walcott, 434 U. S. 246 (1978), the Court expanded on this theme:

“We have recognized on numerous occasions that the relationship between parent and child is constitutionally protected. See, e. g., Wisconsin v. Yoder, 406 U. S. 205, 231-233 (1972); Stanley v. Illinois, [405 U. S. 645 (1972)]; Meyer v. Nebraska, 262 U. S. 390, 399-401 (1923). Tt is cardinal with us that the custody, care and nurture of the child reside first in the parents, whose primary function and freedom include preparation for obligations the state can neither supply nor hinder.’ ” Id., at 255, quoting Prince v. Massachusetts, 321 U. S. 158, 166 (1944).

See also Parham v. J. R., 442 U. S. 584, 602 (1979); Pierce v. Society of Sisters, 268 U. S. 510, 535 (1925). We have recognized that parents have an important “guiding role” to play in the upbringing of their children, Bellotti II, supra, at 633-639, which presumptively includes counseling them on important decisions.

B

The Utah statute gives neither parents nor judges a veto power over the minor’s abortion decision.¹⁷ As in Bellotti I, “we are concerned with a statute directed toward minors, as to whom there are unquestionably greater risks of inability to give an informed consent.” 428 U. S., at 147. As applied to immature and dependent minors, the statute plainly serves the important considerations of family integrity¹⁸ and protecting adolescents¹⁹ which we identified in Bellotti II. In addition, as applied to that class, the statute serves a significant state interest by providing an opportunity for parents to supply essential medical and other information to a physician. The medical, emotional, and psychological consequences of an abortion are serious and can be lasting; this is particularly so when the patient is immature.²⁰ An adequate medical and psychological case history is important to the physician. Parents can provide medical and psychological data, refer the physician to other sources of medical history, such as family physicians, and authorize family physicians to give relevant data.

Appellant intimates that the statute’s failure to declare, in terms, a detailed description of what information parents may provide to physicians, or to provide for a mandatory period of delay after the physician notifies the parents,²¹ renders the statute unconstitutional. The notion that the statute must itemize information to be supplied by parents finds no support in logic, experience, or our decisions. And as the Utah Supreme Court recognized, 604 P. 2d, at 913, time is likely to be of the essence in an abortion decision. The Utah statute is reasonably calculated to protect minors in appellant’s class by enhancing the potential for parental consultation concerning a decision that has potentially traumatic and permanent consequences.²²

Appellant also contends that the constitutionality of the statute is undermined because Utah allows a pregnant minor to consent to other medical procedures without formal notice to her parents if she carries the child to term.²³ But a state’s interests in full-term pregnancies are sufficiently different to justify the line drawn by the statutes. Cf. Maher v. Roe, 432 U. S. 464, 473-474 (1977). If the pregnant girl elects to carry her child to term, the medical decisions to be made entail few — perhaps none — of the potentially grave emotional and psychological consequences of the decision to abort.

That the requirement of notice to parents may inhibit some minors from seeking abortions is not a valid basis to void the statute as applied to appellant and the class properly before us. The Constitution does not compel a state to fine-tune its statutes so as to encourage or facilitate abortions. To the contrary, state action “encouraging childbirth except in the most urgent circumstances” is “rationally related to the legitimate governmental objective of protecting potential life.” Harris v. McRae, 448 U. S., at 325. Accord, Maher v. Roe, supra, at 473-474.²⁴

As applied to the class properly before us, the statute plainly serves important state interests, is narrowly drawn to protect only those interests, and does not violate any guarantees of the Constitution.²⁵ The judgment of the Supreme Court of Utah is

Affirmed.

1 Whether parents of a minor are liable under Utah law for the expense of an abortion and related aftercare is not disclosed by the record.

Utah also provides by statute that no abortion may be performed unless a “voluntary and informed written consent” is first obtained by the attending physician from the patient. In order for such a consent to be “voluntary and informed,” the patient must be advised at a minimum about available adoption services, about fetal development, and about foreseeable complications and risks of an abortion. See Utah Code Ann. §76-7-305 (1978). In Planned Parenthood of Central Mo. v. Danforth, 428 U. S. 52, 65-67 (1976), we rejected a constitutional attack on written consent provisions.

2 Utah Code Ann. §§76-7-314 (3), 76-3-204 (1), 76-3-301 (3) (1978).

3 Appellant’s counsel stated in his jurisdictional statement and again in his brief that the physician concluded not only that an abortion would be in appellant’s best interests, but also that parental notification would not be in appellant’s best interests. However, at oral argument, counsel corrected this statement and conceded that there is no evidence to support this assertion. Tr. of Oral Arg. 8, 17.

4 The record does not reveal whether appellant proceeded with the abortion.

5 The trial judge allowed appellant to proceed without appointment of a guardian ad litem. He noted that a guardian would be required to notify the parents.

6 The testimony was as follows:

“BY MR. DOLOWITZ [appellant’s counsel]:

“Q At the time that the Complaint in this matter was signed, you were pregnant?

“A Yes.

“Q You had consulted with a counselor about that pregnancy?

“A Yeah.

“Q You had determined after talking to the counselor that you felt you should get an abortion?

“Q You felt that you did not want to notify your parents—

“A Right.

“Q —of that decision? You did not feel for your own reasons that you could discuss it with them?

“Q After discussing the matter with a counselor, you still believed that you should not discuss it with your parents?

“Q And they shouldn’t be notified?

“Q After talking the matter over with a counselor, the counselor concurred in your decision that your parents should not be notified?

“Q You were advised that an abortion couldn’t be performed without notifying them?

“Q You then came to me to see about filing a suit?

“Q You and I discussed it as to whether or not you had a right to do what you wanted to do?

“Q You decided that, after our discussion, you should still proceed with the action to try to obtain an abortion without notifying your parents ?

“Q Now, at the time that you signed the Complaint and spoke with the counselor and spoke with me, you were in the first trimester of pregnancy, within your first twelve weeks of pregnancy?

“A Yes.

“Q You feel that, from talking to the counselor and thinking the situation over and discussing it with me, that you could make the decision on your own that you wished to abort the pregnancy?

“Q You are living at home?

“Q You still felt, even though you were living at home with your parents, that you couldn’t discuss the matter with them?

“A Right.”

Tr. 5-7.

7 “BY MR. McCarthy [counsel for the State]:

“Q . . . Are you still living at home?

“Q Are you dependent on your parents?

“Q All your money comes from them?

“Q How old are you now?

“A Fifteen.

“Q Aside from the issue of abortion, do you have any reason to feel that you can’t talk to your parents about other problems?

“Q What are those reasons?

“MR. DOLOWITZ: Now you are moving into the problem area that I indicated. . . .”

Id., at 8.

8 Id., at 10. Appellant repeatedly pressed this point despite the trial court’s statements that it could “conceive of a situation where a child probably wouldn’t have to tell the parents” and that the statute “might be [unconstitutional as it relates to a particular fact situation but [constitutional as it relates to another fact situation.” Id., at 10, 17.

There is no evidence to support the “surmise” in the dissent, post, at 438, n. 24, that “appellant expects family conflict over the abortion decision.”

9 Tr. 18.

10 The trial judge adopted, verbatim, findings of fact and conclusions of law prepared by appellant. The findings, the conclusions, and the opinion of the State Supreme Court make no mention whatsoever of the precise limits of the class.

11 The trial judge also ruled that the statute does not violate 42 U. S. C. § 1983.

12 In Bellotti II, by contrast, the principal class consisted of “unmarried [pregnant] minors in Massachusetts who have adequate capacity to give a valid and informed consent [to abortion], and who do not wish to involve their parents.” 443 U. S., at 626 (emphasis supplied). The courts considered the rights of “all pregnant minors who might be affected” by the statute. Id., at 627, n. 5.

13 The record shows that the State unsuccessfully argued in the trial court that it should be permitted to inquire into appellant’s degree of maturity. Tr. 11.

Justice Stevens and the dissent argue that the Utah Supreme Court held that the statute may validly be applied to all members of the class described in the complaint. Post, at 421, 430, 431, 432-433. However, as we have shown, neither of the state courts mentioned the scope or limits of the class. See n. 10, supra. Moreover, appellant’s counsel prepared the findings and conclusions. In addition to considerations of standing, we construe the ambiguity against appellant.

14 There is no authority for the view expressed in the dissent that the statute would apply to "minors with emergency health care needs.” Post, at 450-451. Appellant does not so contend, and the Utah Supreme Court in this case took pains to say that time is of the essence in an abortion decision. 604 P. 2d 907, 913 (1979). When the specific question was properly posed in Bellotti II, the Massachusetts statute was construed by the state court not to apply in such cases. 443 U. S., at 630.

The same is true for minors with hostile home situations, a class referred to by appellant’s amici curiae and by the dissent, post, at 437-441.

15 Bellotti II, 443 U. S., at 642-643, 653-656; Danforth, 428 U. S., at 74.

16 Bellotti II, supra, at 640, 649; id., at 657 (dissenting opinion); Danforth, supra, at 90-91 (concurring opinion); see Bellotti v. Baird, 428 U. S. 132, 145, 147 (1976) (Bellotti I); cf. Carey v. Population Services International, 431 U. S. 678, 709-710 (1977).

17 The main premise of the dissent seems to be that a requirement of notice to the parents is the functional equivalent of a requirement of parental consent. See post, at 437-441. In Bellotti II, however, we expressly declined to equate notice requirements with consent requirements. 443 U. S., at 640, 657.

18 Bellotti II, supra, at 637-639. The short shrift given by the dissent to “parental authority and family integrity,” post, at 447, runs contrary to a long line of constitutional cases in this Court. See cases cited supra, at 410.

19 Bellotti II, supra, at 634-637.

20 Abortion is associated with an increased risk of complication in subsequent pregnancies. Maine, Does Abortion Affect Later Pregnancies?, 11 Family Planning Perspectives 98 (1979). The emotional and psychological effects of the pregnancy and abortion experience are markedly more severe in girls under 18 than in adults. Wallerstein, Kurtz, & Bar-Din, Psychosocial Sequelae of Therapeutic Abortion in Young Unmarried Women, 27 Arch. Gen. Psychiatry 828 (1972); see also Babikian & Goldman, A Study in Teen-Age Pregnancy, 128 Am. J. Psychiatry 755 (1971).

21 At least five States have enacted parental notification statutes containing brief mandatory waiting periods. See La. Rev. Stat. Ann. §40:-1299.35.5 (West Supp. 1981) (24 hours’ actual notice or 72 hours’ constructive notice except for court-authorized abortions); Mass. Gen. Laws Ann., ch. 112, § 12S (West Supp. 1981) (24 hours); Me. Rev. Stat. Ann., Tit. 22, § 1597 (1980) (24 hours); N. D. Cent. Code § 14-02.1-03 (Supp. 1979) (24 hours); Tenn. Code Ann. §39-302 (Supp. 1979) (two days).

22 Members of the particular class now before us in this case have no constitutional right to notify a court in lieu of notifying their parents. See Bellotti II, supra, at 647. This case does not require us to decide in what circumstances a state must provide alternatives to parental notification.

23 See Utah Code Ann. § 78-14-5 (4) (f) (1977) (permitting any female to give informed consent “to any health care not prohibited by law . . . in connection with her pregnancy or childbirth”).

24 See also Bellotti II, 443 U. S., at 643-644; Bellotti I, 428 U. S., at 148-149; Danforth, 428 U. S., at 65-67, 79-81; Connecticut v. Menillo, 423 U. S. 9, 11 (1975); West Side Women’s Services, Inc. v. City of Cleveland, 450 F. Supp. 796, 798 (ND Ohio), affirmance order, 582 F. 2d 1281 (CA6), cert. denied, 439 U. S. 983 (1978).

25 Appellant argues that the statute violates her right to secure necessary treatment from a physician who, in the exercise of his best medical judgment, does not believe the parents should be notified. Since there is no evidence that the physician had such an opinion, we decline to reach this question. See supra, at 401, n. 3, and 405-407.

The dissenting opinion purports to see in the Court’s opinion “a clear signal” as to how the Court will decide a future case concerning this or a similar statute, and goes on to forecast a successful challenge on the merits. Today, of course, the Court’s function is to decide only the question properly presented in this case, and there is no occasion to intimate or predict a view as to the proper resolution of some future case. Speaking for the unanimous Court in Kleppe v. New Mexico, 426 U. S. 529 (1976), Justice Marshall took note of the impropriety of deciding constitutional questions “in the absence of ‘an adequate and full-bodied record.’ ” Id., at 546, quoting Public Affairs Associates, Inc. v. Rickover, 369 U. S. Ill, 113 (1962).