Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-14-01891/USCOURTS-ca8-14-01891-0/pdf.json

Nature of Suit Code: 950
Nature of Suit: Constitutionality of State Statutes
Cause of Action: 

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United States Court of Appeals

For the Eighth Circuit

___________________________

No. 14-1891

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Louis Jerry Edwards, M.D., on behalf of himself and his patients; Tom Tvedten,

M.D., on behalf of himself and his patients

lllllllllllllllllllll Plaintiffs - Appellees

v.

Joseph M. Beck, M.D., President of the Arkansas State Medical Board, and his

successors in office, in their official capacity; Omar Atiq, M.D., officer and

member of the Arkansas State Medical Board, and his successors in office, in their

official capacity; Harold B. Betton, M.D., officer and member of the Arkansas

State Medical Board, and his successors in office, in their official capacity; Steven

L. Cathey, M.D., officer and member of the Arkansas State Medical Board, and his

successors in office, in their official capacity; Jim Citty, M.D., officer and member

of the Arkansas State Medical Board, and his successors in office, in their official

capacity; Bob Cogburn, M.D., officer and member of the Arkansas State Medical

Board, and his successors in office, in their official capacity; William F. Dudding,

M.D., officer and member of the Arkansas State Medical Board, and his

successors in office, in their official capacity; Roger Harmon, M.D., officer and

member of the Arkansas State Medical Board, and his successors in office, in their

official capacity; John E. Hearnsberger, II, M.D., officer and member of the

Arkansas State Medical Board, and his successors in office, in their official

capacity; Verly Hodges, D.O., officer and member of the Arkansas State Medical

Board, and his successors in office, in their official capacity; Scott Pace,

Pharm.D., J.D., officer and member of the Arkansas State Medical Board, and his

successors in office, in their official capacity; John H. Scribner, M.D., officer and

member of the Arkansas State Medical Board, and his successors in office, in their

official capacity; Sylvia D. Simon, M.D., officer and member of the Arkansas 

Appellate Case: 14-1891 Page: 1 Date Filed: 05/27/2015 Entry ID: 4278822 
State Medical Board, and her successors in office, in their official capacity; John .

Weiss, M.D., officer and member of the Arkansas State Medical Board, and his

successors in office, in their official capacity

lllllllllllllllllllll Defendants - Appellants

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Curtis James Neeley, Jr.; Women Injured by Abortion; An Abortion Survivor;

Liberty Council, Inc.; Concepts of Truth, Inc.

lllllllllllllllllllllAmici on Behalf of Appellant(s)

Physicians for Reproductive Health; National Abortion Federation; American

Public Health Association

lllllllllllllllllllllAmici on Behalf of Appellee(s)

____________

Appeal from United States District Court 

for the Eastern District of Arkansas - Little Rock

____________

 Submitted: January 13, 2015

 Filed: May 27, 2015

[Published]

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Before SMITH, BENTON, and SHEPHERD, Circuit Judges.

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PER CURIAM. 

The Arkansas State Medical Board (the State) appeals from a summary

judgment permanently enjoining certain sections of the Arkansas Human Heartbeat

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Protection Act. Ark. Code Ann. §§ 20-16-1301 to 1307 (2013). Having jurisdiction

under 28 U.S.C. § 1291, this court affirms.

I. 

The Act provides that a licensed physician “shall not perform an abortion on

a pregnant woman before the person tests the pregnant woman to determine whether

the fetus that a pregnant woman is carrying possesses a detectible heartbeat.” Ark.

Code Ann. § 20-16-1303(a) (footnote omitted). Further, a physician “shall not

perform an abortion on a pregnant woman with the specific intent of causing or

abetting the termination of the life of an unborn human individual whose heartbeat

has been detected under § 20-15-1303 and istwelve (12) weeks or greater gestation.”

§ 20-16-1304(a). If a physician violatessection 1304, his or her medical license shall

be revoked. § 20-16-1304(b). The Act provides exceptions to protect the life of the

mother, for a pregnancy resulting from rape or incest, or for a medical emergency. 

§ 20-16-1305. The Act requires informed disclosures about the existence of a

heartbeat and the probability of bringing the unborn to term. § 20-16-1303(d), (e).

Two Arkansas physicians, on behalf of themselves and their patients,

challenged the constitutionality of the Act, seeking a permanent injunction. The

district court granted a temporary injunction. Edwards v. Beck, 946 F. Supp. 2d 843, 1

851 (E.D. Ark. 2013). The State moved for partial summary judgment, arguing the

testing and disclosure provisions were valid and severable. The plaintiffs submitted

affidavitsthat a fetusis generally not viable until 24 weeks’ gestation, is never viable

at 12 weeks, and, in all normally-progressing pregnancies, has a detectable heartbeat

by 12 weeks.

The Honorable Susan Webber Wright, United States District Judge for the

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Eastern District of Arkansas.

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The State left the plaintiffs’ factual allegations uncontroverted. The only

factual record presented in this case was by plaintiffs, the two-page declaration of Dr.

Janet Cathey. Dr. Cathey stated that “[a]t twelve (12) weeks of pregnancy, a fetus

cannot in any circumstance survive outside the uterus. Thus, a fetus at 12 weeks is

not and cannot be viable.” (Cathey Dec. at 2.) As the district court noted, “the State

offered no competing evidence challenging Dr. Cathey’s testimony or the statistical

data referenced in Plaintiffs’ brief.” (Order at 8.) The district court granted summary

judgment, permanently enjoining sections 20-16-1303(d)(3) and 20-16-1304. 

Edwards v. Beck, 8 F. Supp. 3d 1091, 1102 (E.D. Ark. 2014).

The court granted summary judgment to the State on the rest of the Act, finding

the testing and informed disclosures valid and severable. See Webster v.

Reproductive Health Services, 492 U.S. 490, 519-20 (1989) (upholding Missouri’s

20-week viability testing requirement); Planned Parenthood Minn., N.D., S.D. v.

Rounds, 530 F.3d 724, 734-35 (8th Cir. 2008) (en banc) (“[W]hile the State cannot

compel an individual simply to speak the State’s ideological message, it can use its

regulatory authority to require a physician to provide truthful, non-misleading

information relevant to a patient’s decision to have an abortion, even if that

information might also encourage the patient to choose childbirth over abortion.”). 

The State appeals the district court’s grant of summary judgment and permanent

injunction of sections 20-16-1303(d)(3) and 20-16-1304.

This court reviews summary judgment de novo, and a permanent injunction for

abuse of discretion. Roach v. Stouffer, 560 F.3d 860, 864 (8th Cir. 2009).

In 1992, the Supreme Court “reaffirm[ed]” the “right of the woman to choose

to have an abortion before viability and to obtain it without undue interference from

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the State.” Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833, 846

(1992). Since then, that principle has been “accepted as controlling” by a majority

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of the Court. See Gonzales v. Carhart, 550 U.S. 124, 156 (2007); see also id. at 187

(Ginsburg, J., dissenting) (recognizing that the Court “merely ‘assume[d]’ for the

moment” the “continuing vitality” of the rule and criticizing the Court for not

“retain[ing]” or “reaffirm[ing]” the principle). Like the Court in Gonzales, “[w]e

assume the . . . principles [from Casey] for the purposes of this opinion.” Id. at 146. 

A state also retains interests in fostering maternal health and protecting unborn life,

which justify regulations that are not an undue burden on a woman’s ability to

terminate her pregnancy before viability. Casey, 505 U.S. at 877-78. A regulation

is an undue burden if it “has the purpose or effect of placing a substantial obstacle in

the path of a woman seeking an abortion of a nonviable fetus.” Id. at 877.

The State tries to frame the law as a regulation, not a ban, on pre-viability

abortions because they are available during the first 12 weeks (and thereafter if within

the exceptions). Whether or not “exceptions are made for particular circumstances,

a State may not prohibit any woman from making the ultimate decision to terminate

her pregnancy before viability.” Id. at 879. By banning abortions after 12 weeks’

gestation, the Act prohibits women from making the ultimate decision to terminate

a pregnancy at a point before viability. Because the State made no attempt to refute

the plaintiffs’ assertions of fact, the district court’s summary judgment order must be

affirmed. See Fed. R. Civ. P. 56(a) (“The court shall grant summary judgment if the

movant shows that there is no genuine dispute as to any material fact and the movant

is entitled to judgment as a matter of law.”) and (e)(2) (“If a party . . . failsto properly

The other principles “reaffirm[ed]” in Casey include “a confirmation of the

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State’s power to restrict abortions after fetal viability, if the law contains exceptions

for pregnancies which endanger the woman’s life or health” and “the State has

legitimate interests from the outset of the pregnancy in protecting the health of the

woman and the life of the fetus that may become a child.” Casey, 505 U.S. at 846.

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address another party’s assertion of fact as required by Rule 56(c), the court may . .

. consider the fact undisputed for purposes of the motion.”). See also Casey, 505 U.S.

at 874.

II.

As an intermediate court of appeals, this court is bound by the Supreme Court’s

decisions in Casey and the “assum[ption]” of Casey’s “principles” in Gonzales. See

Gonzales, 550 U.S. at 146. However, undeniably, medical and technological

advances along with mankind’s ever increasing knowledge of prenatal life since the

Court decided Roe v. Wade, 410 U.S. 113 (1973) and Casey make application of

Casey’s viability standard more difficult and render more critical the parties’

obligation to assure that the court has the benefit of an adequate scientific record in

cases where the standard is applied.

“The Supreme Court has recognized that viability varies among pregnancies

and that improvements in medical technology will both push later in pregnancy the

point at which abortion is safer than childbirth and advance earlier in gestation the

point of fetal viability.” Isaacson v. Horne, 716 F.3d 1213, 1224 (9th Cir. 2013)

(citing Casey, 505 U.S. at 860). The viability standard “is clearly on a collision

course with itself.” City of Akron v. Akron Ctr. for Reprod. Health, Inc., 462 U.S.

416, 458 (1983) (O’Connor, J., dissenting). “As medicalscience becomes better able

to provide for the separate existence of the fetus, the point of viability is moved

further back toward conception.” Id. (O’Connor, J., dissenting). 

And we have witnessed in the four decades since the Court decided Roe how 

scientific advancements havemoved the viability point back. When Roe was decided,

“[v]iability [was] usually placed at about seven months (28 weeks) but [could] occur

earlier, even at 24 weeks.” Roe, 410 U.S. at 160 (footnote omitted). But the joint

opinion in Casey recognized “how time has overtaken some of Roe’s factual

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assumptions,” including that “advances in neonatal care have advanced viability to

a point somewhat earlier.” Casey, 505 U.S. at 860 (citations omitted). And, in the

present case, Dr. Janet Cathey, a board-certified obstetrician and gynecologist,

averred that “viability generally is not possible until at least 24 weeks” but recognized

that the “viability determination varies on an individual basis.” (Emphasis added.) 

Indeed, real-life events have proven the individuality of the viability determination

to be true.

Greater survival rates among pre-terminfants born at earlier stages push

back the viability line. In October, 2006, Amillia Taylor was born at

twenty-one weeks and six days, and has thus far been resilient in the

face of minimal odds ofsurvival. This isthe youngest fetusto have ever

survived delivery, raising new questions about where the viability line

should be drawn.

Kevin J. Mitchell, Guarding the Threshold of Birth, 20 Regent U. L. Rev. 257, 264

n.30 (2008) (citing Pat Wingert, The Baby Who’s Not Supposed to be Alive,

N E W S W E E K , M a r . 5 , 2 0 0 7 , a t 5 9 , a v a i l a b l e a t

http://www.msnbc.msn.com/id/17304274/site/newsweek); see also AidaEdemariam,

Against All Odds, Guardian (Feb. 20, 2007), available at

http://www.theguardian.com/society/2007/feb/21/health.lifeandhealth (last visited

April 28, 2015) (“There is something otherworldly about the picture that appeared

around the world yesterday: two tiny brown-pink feet, almost translucent, poking

through an adult’s fingers. You had to look twice to be sure that they were indeed

feet. They belong to Amillia Taylor, who was born in Miami last October, 21 weeks

and six days after conception. She weighed less than 10oz at birth-not even as much

astwo ordinary bars ofsoap-and she wasjust 9 incheslong. Amillia, who is expected

to be discharged from hospital in the next couple of days, is officially the most

premature baby ever to have survived.”).

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“Since Roe was decided in 1973, advances in medical and scientific technology

have greatly expanded our knowledge of prenatal life.” Hamilton v. Scott, 97 So. 3d

728, 742 (Ala. 2012) (Parker, J., concurring specially). The viability standard “is

inherently tied to the state of medical technology that exists whenever particular

litigation ensues.” City of Akron, 462 U.S. at 458 (O’Connor, J., dissenting). As

shown supra, states in the 1970s lacked the power to ban an abortion of a 24-weekold-fetus because thatfetus would have not satisfied the viability standard ofthat time

period. See Roe, 410 U.S. at 160 (placing viability at “seven months (28 weeks)”).

Today, however, thatsame fetus would be considered “viable,” and states would have

the “power to restrict [such] abortions.” Casey, 505 U.S. at 846. 

Because a viability determination necessarily calls for a case-by-case

determination and changes over time based on medical advancements, “legislatures

are better suited to make the necessary factual judgmentsin this area.” City of Akron,

462 U.S. at 458 (O’Connor, J., dissenting). Unfortunately, the viability standard

“forces legislatures, as a matter of constitutional law, to speculate about what

constitutes [viability] at any given time.” Id. (O’Connor, J., dissenting). Courts are

ill-suited to second-guess these legislative judgments. See id. (O’Connor, J.,

dissenting) (“Without the necessary expertise or ability, courts must then pretend to

act as science review boards and examine those legislative judgments.”). To

substitute its own preference to that of the legislature in this area is not the proper role

of a court. See Federalist No. 78 (“It can be of no weight to say that the courts, on the

pretense of a repugnancy, may substitute their own pleasure to the constitutional

intentions of the legislature. This might as well happen in the case of two

contradictory statutes; or it might as well happen in every adjudication upon any

single statute. The courts must declare the sense of the law; and if they should be

disposed to exercise WILL instead of JUDGMENT, the consequence would equally

be the substitution of their pleasure to that of the legislative body. The observation,

if it prove any thing, would prove that there ought to be no judges distinct from that

body.”). 

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This case underscores the importance of the parties, particularly the state,

developing the record in a meaningful way so as to present a real opportunity for the

court to examine viability, case by case, as viability steadily moves back towards

conception.

* * * * * * *

The judgment is affirmed.

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