Wednesday, April 11, 2007

Eighth Circuit En Banc Argument Today on South Dakota "Fetus is a Human Being" Informed Consent Law

Last October, in Planned Parenthood v. Rounds, a 2-1 panel of the Eighth Circuit upheld a preliminary injunction against enforcement of South Dakota's informed consent abortion law. In January of this year, the court agreed to rehear the case en banc. The oral argument is today. A number of provisions of the law are at issue, but the key ones require that at least 2 hours before the performance of an abortion, a doctor must inform the patient:

. . .
(b) That the abortion will terminate the life of a whole, separate, unique, living human being;

(c) That [the patient] has an existing relationship with that unborn human being and that the relationship enjoys protection under the United States Constitution and under the laws of South Dakota;
(d) That by having an abortion, her existing relationship and her existing constitutional rights with regards to that relationship will be terminated . . . .

The law is challenged as an infringement of the doctor's right to freedom of speech and a patient's right to an abortion free of undue interference by the state. In principle, the case ought to be loaded in favor of the panel decision because the standard of review of a district court's grant of a preliminary injunction---whether there was an abuse of discretion---is deferential. But in practice, the court is likely to treat the matter as presenting legal questions resolvable de novo.

The Eighth Circuit panel opinion found the Supreme Court's upholding of the requirement that women be informed about the availability of pro-life information in Planned Parenthood v. Casey inapposite because there the doctor himself or herself was not required to provide that information. Here, by contrast, the panel said, was a case in which a doctor was being required to follow the state's ideological script. (Unlike in Rust v. Sullivan, cited by neither the majority nor the dissent, the compliance with the script is not made a condition of funding.) The dissenting judge on the panel (Judge Gruender) and the state in its written submissions, dispute the characterization of the required disclosures as "ideological," deeming them basically factual.

To my mind, Judge Gruender's better argument (which he also makes in his panel dissent) is that the state is permitted, in an informed consent law, to require the provision of "ideological" information. This is certainly suggested by language in Casey --- e.g., "the State may enact rules and regulations designed to encourage her to know that there are philosophic and social arguments of great weight that can be brought to bear in favor of continuing the pregnancy to full term" --- and it makes practical sense. If, for example, a state legalized physician-assisted suicide, I would think it permissible for the state to require a physician, as part of getting informed consent, to warn the patient that suicide is irreversible (duh) and more importantly, to express the view that life is precious. So the real issue in this case is not whether the message is ideological but whether the particular ideological message --- and the requirement that a woman seeking an abortion sign each page of the message --- exerts undue pressure.

9 comments:

egarber said...

Here, by contrast, the panel said, was a case in which a doctor was being required to follow the state's ideological script.

I guess one question I want answered is: under the law, is the doctor allowed to voluntarily offer a contrary view? Meaning, after he / she reads the ideological material required by the state, can he / she then say, "but many in the medical profession don't agree that a pre-viable fetus is a 'human being'"?

From a First Amendment perspective, it's one thing to force a stock recitation; it would seem to be quite another to compel broad silence.

Michael C. Dorf said...

There is a dispute as to whether the doctor can offer contradictory advice. The plaintiffs say no; the state says yes. (It's interesting how for purposes of their constitutional arguments, each side characterizes the law in a way that is contrary to their likely views if the law were to be enforced.)

egarber said...

So if it turns out a doctor is free under the law to offer something contrary, does that nullify the first amendment claim?

Maybe in that scenario, it becomes like a doctor being forced to say that drinking alcohol is harmful to your health -- but he throws in his own comment that drinking in moderation won't hurt you.

Or are there different zones of depth within the idea of "medical privacy"?

(Go Braves -- now 6-1 :) )

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