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CHILD INTERSTATE ABORTION NOTIFICATION ACT

HEARING

BEFORE THE

SUBCOMMITTEE ON THE CONSTITUTION

OF THE

COMMITTEE ON THE JUDICIARY 

HOUSE OF REPRESENTATIVES

ONE HUNDRED NINTH CONGRESS

FIRST SESSION

ON

H.R. 748

MARCH 3, 2005

Serial No. 109–3

Printed for the use of the Committee on the Judiciary

(

Available via the World Wide Web: http://www.house.gov/judiciary 

(II)

COMMITTEE ON THE JUDICIARY 

F. JAMES SENSENBRENNER, JR., Wisconsin, Chairman 

HENRY J. HYDE, Illinois 

HOWARD COBLE, North Carolina 

LAMAR SMITH, Texas 

ELTON GALLEGLY, California 

BOB GOODLATTE, Virginia 

STEVE CHABOT, Ohio 

DANIEL E. LUNGREN, California 

WILLIAM L. JENKINS, Tennessee 

CHRIS CANNON, Utah 

SPENCER BACHUS, Alabama 

BOB INGLIS, South Carolina 

JOHN N. HOSTETTLER, Indiana 

MARK GREEN, Wisconsin 

RIC KELLER, Florida 

DARRELL ISSA, California 

JEFF FLAKE, Arizona 

MIKE PENCE, Indiana 

J. RANDY FORBES, Virginia 

STEVE KING, Iowa 

TOM FEENEY, Florida 

TRENT FRANKS, Arizona 

LOUIE GOHMERT, Texas 

JOHN CONYERS, JR., Michigan 

HOWARD L. BERMAN, California 

RICK BOUCHER, Virginia 

JERROLD NADLER, New York 

ROBERT C. SCOTT, Virginia 

MELVIN L. WATT, North Carolina 

ZOE LOFGREN, California 

SHEILA JACKSON LEE, Texas 

MAXINE WATERS, California 

MARTIN T. MEEHAN, Massachusetts 

WILLIAM D. DELAHUNT, Massachusetts 

ROBERT WEXLER, Florida 

ANTHONY D. WEINER, New York 

ADAM B. SCHIFF, California 

LINDA T. SA ́ NCHEZ, California 

ADAM SMITH, Washington 

CHRIS VAN HOLLEN, Maryland

PHILIP G. KIKO, Chief of Staff-General Counsel 

PERRY H. APELBAUM, Minority Chief Counsel 

SUBCOMMITTEE ON THE CONSTITUTION

STEVE CHABOT, Ohio, Chairman

TRENT FRANKS, Texas 

WILLIAM L. JENKINS, Tennessee 

SPENCER BACHUS, Alabama 

JOHN N. HOSTETTLER, Indiana 

MARK GREEN, Wisconsin 

STEVE KING, Iowa 

TOM FEENEY, Florida 

JERROLD NADLER, New York 

JOHN CONYERS, JR., Michigan 

ROBERT C. SCOTT, Virginia 

MELVIN L. WATT, North Carolina 

CHRIS VAN HOLLEN, Maryland

PAUL B. TAYLOR, Chief Counsel 

E. STEWART JEFFRIES, Counsel 

HILARY FUNK, Counsel 

MINDY BARRY, Full Committee Counsel 

DAVID LACHMANN, Minority Professional Staff Member 

(III)

C O N T E N T S 

MARCH 3, 2005

OPENING STATEMENT 

Page 

The Honorable Steve Chabot, a Representative in Congress from the State 

of Ohio, and Chairman, Subcommittee on the Constitution ............................ 1

The Honorable Jerrold Nadler, a Representative in Congress from the State 

of New York, and Ranking Member, Subcommittee on the Constitution ....... 2

WITNESSES 

Mrs. Marcia Carroll, Lancaster, PA 

Oral Testimony ..................................................................................................... 6

Prepared Statement ............................................................................................. 8

Mr. Richard S. Myers, Professor of Law, Ave Maria School of Law, Ann 

Arbor, MI 

Oral Testimony ..................................................................................................... 9

Prepared Statement ............................................................................................. 11

Mr. Warren Seigel, M.D., FAAP, FSAM, Director of Adolescent Medicine, 

Chairman of Pediatrics, Coney Island Hospital, Brooklyn, NY 

Oral Testimony ..................................................................................................... 14

Prepared Statement ............................................................................................. 16

Ms. Teresa Stanton Collett, Professor of Law, University of St. Thomas School 

of Law, Minneapolis, MN 

Oral Testimony ..................................................................................................... 19

Prepared Statement ............................................................................................. 21

APPENDIX 

MATERIAL SUBMITTED FOR THE HEARING RECORD

Prepared Statement of the Honorable Steve Chabot, a Representative in 

Congress from the State of Ohio, and Chairman, Subcommittee on the 

Constitution .......................................................................................................... 49

Prepared Statement of the Honorable Jerrold Nadler, a Representative in 

Congress from the State of New York, and Ranking Member, Subcommittee 

on the Constitution .............................................................................................. 50

Prepared Statement of the Honorable Steve King, a Representative in Congress from the State of Iowa ............................................................................... 51

Prepared Statement of the Honorable Ileana Ros-Lehtinen, a Representative 

in Congress from the State of Florida ................................................................ 51

Prepared Statement of Dr. John C. Harrison, Professor of Law, University 

of Virginia ............................................................................................................. 52

Abortion form for Ashley Carroll, signed by her doctor, Dr. Kaji and materials 

related to Dr. Kaji and Brighan clinics submitted by Chairman Steve 

Chabot ................................................................................................................... 54

(1)

CHILD INTERSTATE ABORTION 

NOTIFICATION ACT 

THURSDAY, MARCH 3, 2005

HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON THE CONSTITUTION, COMMITTEE ON THE JUDICIARY, Washington, DC.

The Subcommittee met, pursuant to notice, at 2:34 p.m., in Room 

2141, Rayburn House Office Building, Hon. Steve Chabot (Chair of 

the Subcommittee) presiding. 

Mr. CHABOT. Good afternoon. The Committee will come to order. 

This is the Subcommittee on the Constitution. I would like to 

thank everyone for being here this afternoon for this very important legislative hearing. 

Today, the House Constitution Subcommittee will examine H.R. 

748, the ‘‘Child Interstate Abortion Notification Act,’’ commonly 

known as CIANA, which was recently introduced by my colleague, 

the distinguished gentlelady from Florida, Congresswoman Ileana 

Ros-Lehtinen. I would also like to thank Congresswoman RosLehtinen for her leadership on this issue. 

CIANA’s predecessor, the ‘‘Child Custody Protection Act,’’ also introduced by Congresswoman Ros-Lehtinen, received broad support, 

passing the House on three separate occasions, including the 105th, 

106th, and 107th Congresses. This hearing is the first step in ensuring that CIANA not only passes the House in the 109th Congress, but this time, it is enacted into law. 

We have an expert panel with us here this afternoon and I would 

like to thank them for taking the time to share their knowledge 

and expertise with us. 

Obtaining an abortion is a life-altering event, as we have heard 

and seen on numerous occasions. The medical, physical, and emotional impact on women can be long-lasting. CIANA would ensure 

that young girls who are seeking an abortion receive the care and 

support they need by enforcing existing State parental notification 

laws and providing for a Federal notification law that protects parental rights when a minor crosses State lines into a State without 

a notification law. 

CIANA would make it a Federal offense to cause the circumvention of a valid State parental consent or notification law by knowingly transporting a minor across a State line with the intent that 

she obtain an abortion. 

In addition, CIANA would build on the ‘‘Child Custody Protection 

Act’’ by also requiring that an abortion provider in a State without 

a parental involvement law notify a parent, or, if necessary, a legal 

2

guardian before performing an abortion on a minor girl who is a 

resident of a different State. This requirement would be applicable 

unless the minor has already received authorization from a judge 

in her home State, pursuant to a judicial bypass procedure, or unless she falls into one of the carefully drafted exceptions to cover 

cases of abuse or medical emergencies. 

Statistics show that approximately 80 percent of the public favors parental notification laws. Forty-four States have enacted 

some form of a parental notification statute. Twenty-three of these 

States currently enforce statutes that require the consent or notification of at least one parent or court authorization before a young 

girl can obtain an abortion. Such laws reflect widespread agreement that the parents of a pregnant minor are best suited to provide counsel, guidance, and support as she decides whether to continue her pregnancy or to undergo an abortion. 

Despite widespread support for parental involvement laws and 

clear public policy considerations justifying them, substantial evidence exists that such laws are regularly evaded by individuals 

who transport minors to abortion providers in States that do not 

have parental notification or consent laws. 

Confused and frightened young girls are routinely assisted by 

adults in obtaining abortions and are encouraged to avoid parental 

involvement by crossing State lines. Often, these girls are guided 

by those who do not share the love and affection that most parents 

have for their children. Personal accounts indicate that sexual 

predators recognize the advantage they have over their victims and 

use this influence to encourage abortions in order to eliminate critical evidence of their criminal conduct, and in turn, allowing the 

abuse to continue undetected. 

Furthermore, when parents are not involved in the abortion decisions of a child, the risks to the child’s health significantly increase. Parental involvement will ensure that parents have the opportunity to provide abortion providers with the minor’s complete 

medical history and necessary information prior to the performance 

of an abortion, information that may have life or death consequences for the minor. Parental involvement in the after-care of 

a minor’s abortion procedure is also critical in preventing or curtailing complications, such as infection, perforation, or depression, 

which if left untreated can be fatal. 

Public policy is clear that parents should be involved in decisions 

that their daughters make regarding abortion. CIANA will assist 

in enforcing existing parental involvement laws that meet the relevant constitutional criteria and will provide for parental involvement when minors cross State lines to have abortions in States 

without parental involvement laws. The safety of young girls and 

the rights of parents demand no less. 

Again, I would like to thank our witnesses for being here today 

and I would now yield to the gentleman from New York, the Ranking Member, Mr. Nadler, for making an opening statement. 

Mr. NADLER. Thank you, Mr. Chairman. 

When we last considered this legislation, I did not believe that 

the authors could possibly come up with a bill that would be more 

dangerous, more destructive of the well-being and the rights of 

young women than last year’s bill. I am humbled to admit that I 

3

suffered from a paucity of imagination that clearly does not afflict 

some on the other side of the aisle. 

I am really stunned by this latest crazy quilt of restrictions 

which has obviously but one purpose, to impede the practice of 

medicine, to ensure that young women will have as few options as 

possible, and to teach those States, like mine, New York, that do 

not believe the best way to promote adolescent health and deal 

with the very real problems these young women often experience 

is with draconian laws that prevent doctors and caring, responsible 

adults from helping these young women who may have nowhere 

else to turn. 

Often, that adult is a grandparent, a brother or a sister, or a 

member of the Clergy. In some cases, the young women may not 

be able to go to their parents. We all want young women to seek 

guidance and help from their parents, but sometimes, that may be 

impossible. Sometimes, indeed, the parents may pose a threat to 

the life and health of the young woman. 

That is what happened to Spring Adams, a 13-year-old from 

Idaho. She was shot to death by her father after he found out that 

she planned to terminate her pregnancy, a pregnancy that was 

caused by his acts of incest. A law that would require her to tell 

him does not seem to make much sense. 

I know that some of my colleagues might not see a problem forcing a doctor to ring Mr. Adams’ doorbell to tell him they are planning to perform an abortion on his daughter. There has been longstanding and vigorous opposition to laws, including the Freedom of 

Access to Clinic Entrances Act, which aim to protect doctors and 

their patients from possibly violent fanatics. 

This bill also uses an overly-narrow definition of medical emergency, one that seems to have been lifted from one of Attorney 

General Gonzales’s infamous torture memos. Quote, ‘‘The prohibition of Subsection (a) does not apply if the abortion was necessary 

to save the life of the minor because her life was endangered by 

a physical disorder, physical injury, or physical illness, including a 

life-endangering physical condition caused by or arising from the 

pregnancy itself,’’ close quote. 

This clearly falls far short of the Supreme Court’s requirement 

that any restriction on the right to choose must have an explicit 

exception to protect the life and an explicit exception to protect the 

health of the woman. There are many things that threaten the 

health of a woman that fall far short of endangering her life. The 

only health threat recognized here is a life-endangering health 

threat. A health threat that doesn’t endanger her life but may be 

a severe one is not recognized in this exception, and yet, clearly, 

that is necessary to salvage the constitutionality of this bill under 

the Supreme Court decisions, if anybody cares about the constitutionality of this bill. 

There are many things, as I said before, far short of death that 

threatens a young woman. She deserves prompt and professional 

medical care and the Constitution still protects her right to receive 

that care. 

Congress should not be tempted to play doctor. It is always bad 

medicine for women. 

4

We want to encourage families to work together to face difficult 

situations and we want to provide young women facing these lifealtering decisions with all the help that we can. In an ideal world, 

loving, supportive, and understanding families would join together 

to face these challenges. That is what happens in the majority of 

cases, with or without a law. 

But we do not live in a perfect world. Some parents are violent. 

Some parents are rapists. Some young people can turn to their 

Clergy, to a grandparent, a sibling, or some other trusted adult 

who do not feel safe in turning to a parent. We should not turn 

these people into criminals simply because they are trying to help 

a young woman in a dire situation. 

This bill is the wrong way to deal with a very real problem. 

There is also one other major concern with this bill. This bill attempts to say, at least in the provision that was in last year’s bill 

that makes it illegal to, quote, ‘‘transport a minor across State lines 

for the purpose of getting an abortion,’’ unquote, if she doesn’t need 

parental consent or notification in the State where she will get it 

but she did in the State she is leaving, this tries to use the power 

of the Federal Government to put the law of the State which she 

is leaving on her back and make her carry it with her to a different 

State. 

I know of no other law which, in effect, uses the power of the 

government to enforce the law of one State in the boundaries of another State which has not chosen to have that law. The only other 

law I can think of that does that is a law that was enacted sometime ago called the ‘‘Fugitive Slave Act’’, and that was repealed by 

subsequent history. 

I want to join the Chairman in welcoming our witnesses and I 

look forward to hearing their testimony. Thank you. I yield back. 

Mr. CHABOT. Thank you. 

Are there other Members that would like to make opening statements? If not, I will introduce the panel of witnesses here this 

afternoon, and we do have a very distinguished panel. 

Our first witness today is Ms. Marcia Carroll, a mother from 

Pennsylvania who will share with us her own experience surrounding her minor daughter’s abortion. 

Our second witness is Richard Myers, Professor of Law at Ave 

Maria School of Law. Among other courses, Professor Myers teaches Constitutional Law, Federal Jurisdiction, first amendment, and 

Conflict of Laws. Prior to joining the Ave Maria faculty, Professor 

Myers taught at Case Western Reserve University School of Law 

and the University of Detroit Mercy School of Law. Professor Myers 

began his legal career by clerking for Judge John Kilkenny of the 

United States Court of Appeals for the Ninth Circuit. Professor 

Myers also worked for Jones, Day, Reavis and Pogue in several 

cases before the United States Supreme Court, and so we welcome 

you here this afternoon. 

Our third witness is Dr. Warren Seigel. Dr. Seigel is the Chairman of Pediatrics and the Director of Adolescent Medicine at Coney 

Island Hospital in Brooklyn, New York. In addition to Coney Island 

Hospital, Dr. Seigel is affiliated with Maimonides Medical Center, 

Lutheran Medical Center, the Brooklyn Hospital Center, the New 

York Methodist Hospital, and Wyckoff Heights Medical Center. Dr. 

5

Seigel also serves as the president of the New York State Chapter, 

District 2, of the American Academy of Pediatrics and is a Society 

for Adolescent Medicine Fellow. We welcome you here, Dr. Seigel. 

Our final witness is Professor Teresa Stanton Collett. From 1990 

to 2003, Professor Collett was a Professor of Law at South Texas 

College of Law, where she taught various legal courses. Since 2003, 

she has served as a Professor of Law at University of St. Thomas 

College of Law, teaching bioethics, property, and professional responsibility. Professor Collett has also served as a visiting professor at Notre Dame Law School, Washington University School of 

Law in St. Louis, the University of Texas School of Law, the University of Houston Law Center, and the University of Oklahoma 

College of Law. Prior to joining South Texas College of Law, Professor Collett was affiliated with the law firm of Crow and 

Dunleavy in Oklahoma City, Oklahoma. 

We welcome all our witnesses here this afternoon. It is the practice of this Committee to swear in all witnesses—— Mr. NADLER. Before we do, Mr. Chairman—— Mr. CHABOT. Yes? 

Mr. NADLER. Mr. Chairman, I want to join you in welcoming in 

particular Dr. Seigel, who is the Director of Adolescent Medicine 

and Chair of Pediatrics at Coney Island Hospital, which is in my 

district in Brooklyn and just a short walk away from my Brooklyn 

district office. Dr. Seigel founded the Division of Adolescent Medicine at Coney Island Hospital. He also serves as the Director of Adolescent Medicine at Maimonides Children’s Medical Center, at 

Methodist Hospital, and at Lutheran Medical Center. How he finds 

time to serve at all these medical centers escapes me, but some 

people use their time better than some of us. All of these are outstanding medical institutions serving the people of the fourth largest city in America, namely the City of Brooklyn. 

He is a respected authority on the care and treatment of young 

people, especially adolescents. He has worked in our community 

facing the real problems of real people every day. I believe his perspective will help inform this Committee’s work, and I am pleased 

to join you in welcoming him. 

Mr. CHABOT. I am sure that all the other witnesses will also be 

able to inform the Committee, as well, and we welcome your introduction. 

It is the practice of this Committee, as I mentioned, to swear in 

the witnesses, so if you would all please stand and raise your right 

hands. 

Do you swear that the testimony that you are about to give, that 

you will tell the truth, the whole truth, and nothing but the truth, 

so help you, God? 

Mrs. CARROLL. I do. 

Mr. MYERS. I do. 

Dr. SEIGEL. I do. 

Ms. COLLETT. I do. 

Mr. CHABOT. Thank you. You can be seated. 

Without objection, all Members will have five legislative days 

with which to submit additional materials for the record. 

As you probably know, you have been familiarized by our staff, 

but each witness will have 5 minutes to testify before the ComVerDate 0ct 09 2002 11:01 May 16, 2005 Jkt 000000 PO 00000 Frm 00009 Fmt 6633 Sfmt 6601 G:\WORK\CONST\030305\99583.000 HJUD1 PsN: 99583
6

mittee. There are a couple of lights there on your desk. The green 

light will be on until 4 minutes have elapsed, at which time the 

yellow light will come on. It tells you that you have 1 minute to 

come up, and then the red light will come on and we appreciate 

that you wrap up your testimony. We will give you a little leeway, 

but not too much because we are on a relatively tight schedule. 

We will begin with you, Mrs. Carroll. 

TESTIMONY OF MARCIA CARROLL, LANCASTER, PA 

Mrs. CARROLL. Good afternoon. My name is Marcia Carroll and 

I am from Lancaster, Pennsylvania, and I would like to begin by 

thanking you for inviting me here to speak and to share my family’s story. The following is a horrifying series of events centered 

around my 14-year-old daughter. 

On Christmas Eve 2004, my daughter informed me that she was 

pregnant. I assured her that I would seek out all resources and 

help that was available. As a parent, her father and I would stand 

beside her and support any decision she made. 

We scheduled appointments with her pediatrician, her private 

counselor, and her school nurse. I followed all their advice and recommendations. They referred us to Healthy Beginnings Plus, Lancaster Family Services, and the WIC program. They discussed all 

her options with her. I purposely allowed my daughter to speak 

alone with professionals so that she would speak her mind and not 

just to say what she thought I wanted to hear. 

My daughter chose to have the baby and raise it. My family fully 

supported my daughter’s decision to keep her baby and offered her 

our love and support. 

Subsequently, her boyfriend’s family began to harass my daughter and my family. They started showing up at our house to express their desire for my daughter to have an abortion. When that 

did not work, his grandmother started calling my daughter without 

my knowledge. They would tell her if she kept the baby, she 

couldn’t see her boyfriend again. They threatened to move out of 

the State. 

I told his family that my daughter had our full support in her 

decision to keep the baby. She also had the best doctors, counselors, and professionals to help her through the pregnancy. We all 

had her best interests in mind. 

The behavior of the boy’s family began to concern me to the point 

where I called my local police department for advice. Additionally, 

I called the number for an abortion center to see how old you have 

to be to have an abortion in our State. 

I felt safe when they told me my minor daughter had to be 16 

years of age in the State of Pennsylvania to have an abortion without parental consent. I found out later that the Pennsylvania Abortion Control Act actually says that parental consent is needed for 

a minor under 18 years of age. It never occurred to me that I would 

need to check the laws of other States around me. I thought as a 

resident of the State of Pennsylvania that she was protected by 

Pennsylvania State laws. Boy, was I ever wrong. 

On February 16, I sent my daughter to her bus stop with two 

dollars of lunch money. I thought she was safe at school. She and 

her boyfriend even had a prenatal class scheduled after school. 

7

However, what really happened was that her boyfriend and his 

family met with her down the road from her bus stop and called 

a taxi. The adults put the children in the taxi to take them to the 

train station. His stepfather met the children at the train station, 

where he had to purchase my daughter’s ticket, since she was only 

14. They put the children on the train from Lancaster to Philadelphia. From there, they took two subways to New Jersey. That is 

where his family met the children and took them to the abortion 

clinic, where one of the adults had made the appointment. 

When my daughter started to cry and have second thoughts, they 

told her they would leave her in New Jersey. They planned, paid 

for, coerced, harassed, and threatened her into having the abortion. 

They left her alone during the abortion and went to eat lunch. 

After the abortion, his stepfather and grandmother drove my 

daughter home from New Jersey and dropped her off down the 

road from our home. My daughter told me that on the way home, 

she started to cry. They got angry at her and told her there was 

nothing to cry about. 

Anything could have happened to my daughter at the abortion 

facility or on the ride back home. These people did not know my 

daughter’s medical history, yet they took her across State lines to 

have a medical procedure without my knowledge or consent. Our 

family will be responsible for the medical and psychological consequences for my daughter as a result of this procedure that was 

completed unbeknownst to me. 

I was so devastated that this could be done that I called the local 

police department to see what could be done. They were just as 

shocked and surprised as I was that there was nothing that could 

be done in this horrible situation. 

The State of Pennsylvania does have a parental consent law. 

Something has to be done to prevent this from happening to other 

families. This is just not acceptable to me and should not happen 

to families in this country. If your child goes to her school clinic 

for a headache, a registered nurse cannot give her a Tylenol or Aspirin without a parent’s written permission. 

As a consequence of my daughter being taken out of State for an 

abortion without parental knowledge, she is suffering intense grief. 

My daughter cries herself to sleep at night and lives with this 

every day. 

I think about what I could have or should have done to keep her 

safe. Everybody tells me I did everything I could or should have 

done. It doesn’t make me feel any better, knowing everything I did 

was not enough to protect my daughter. 

It does ease my mind to know that, with your help, we can make 

a difference and change the law to protect other girls and their 

families. I urge your support for the ‘‘Child Interstate Abortion Notification Act’’. It is critical that this law passes in Congress. The 

rights of parents to protect the health and welfare of their minor 

daughters needs to be protected. No one should be able to circumvent State laws by performing an abortion in another State on 

a minor daughter without parental consent. 

Thank you for your time. 

Mr. CHABOT. Thank you very much, Mrs. Carroll. 

Mrs. CARROLL. Thank you. 

8

[The prepared statement of Mrs. Carroll follows:]

PREPARED STATEMENT OF MARCIA CARROLL

Good afternoon, my name is Marcia Carroll. I am from Lancaster, Pennsylvania. 

I would like to begin by thanking you for inviting me here to speak and share my 

family’s story. The following is a horrifying series of events centered around my 

fourteen year old daughter. 

On Christmas Eve 2004, my daughter informed me she was pregnant. I assured 

her I would seek out all resources and help that was available. As her parents, her 

father and I would stand beside her and support any decision she made. 

We scheduled appointments with her pediatrician, her private counselor, and her 

school nurse. I followed all of their advice and recommendations. They referred us 

to Healthy Beginnings Plus, Lancaster Family Services, and the WIC program. They 

discussed all her options with her. I purposefully allowed my daughter to speak 

alone with professionals so that she would speak her mind and not just say what 

she thought I wanted to hear. 

My daughter chose to have the baby and raise it. My family fully supported my 

daughter’s decision to keep her baby and offered her our love and support. 

Subsequently, her boyfriend’s family began to harass my daughter and my family. 

They started showing up at our house to express their desire for my daughter to 

have an abortion. When that did not work, his grandmother started calling my 

daughter without my knowledge. They would tell her that if she kept the baby, she 

couldn’t see her boyfriend again. They threatened to move out of state. 

I told his family that my daughter had our full support in her decision to keep 

the baby. She also had the best doctors, counselors, and professionals to help her 

through the pregnancy. We all had her best interests in mind. 

The behavior of the boy’s family began to concern me to the point where I called 

my local police department for advice. Additionally, I called the number for an abortion center to see how old you have to be to have an abortion in our state. 

I felt safe when they told me my minor daughter had to be 16 years of age in 

the state of Pennsylvania to have an abortion without parental consent. I found out 

later that the Pennsylvania Abortion Control Act actually says that parental consent is needed for a minor under 18 years of age. It never occurred to me that I 

would need to check the laws of other states around me. I thought as a resident 

of the state of Pennsylvania that she was protected by Pennsylvania state laws. Boy, 

was I ever wrong. 

On Feb. 16th, I sent my daughter to her bus stop with $2.00 of lunch money. I 

thought she was safe at school. She and her boyfriend even had a prenatal class 

scheduled after school. 

However, what really happened was that her boyfriend and his family met with 

her down the road from her bus stop and called a taxi. The adults put the children 

in the taxi to take them to the train station. His stepfather met the children at the 

train station, where he had to purchase my daughter’s ticket since she was only 

fourteen. They put the children on the train from Lancaster to Philadelphia. From 

there, they took two subways to New Jersey. That is where his family met the children and took them to the abortion clinic, where one of the adults had made the 

appointment. 

When my daughter started to cry and have second thoughts, they told her they 

would leave her in New Jersey. They planned, paid for, coerced, harassed, and 

threatened her into having the abortion. They left her alone during the abortion and 

went to eat lunch. 

After the abortion, his stepfather and grandmother drove my daughter home from 

New Jersey and dropped her off down the road from our house. 

My daughter told me that on the way home she started to cry, they got angry 

at her and told her there was nothing to cry about. 

Anything could have happened to my daughter at the abortion facility or on the 

ride back home. These people did not know my daughter’s medical history, yet they 

took her across state lines to have a medical procedure without my knowledge or 

consent. Our family will be responsible for the medical and psychological consequences for my daughter as a result of this procedure that was completed unbeknownst to me. 

I was so devastated that this could have been done that I called the local police 

department to see what could be done. They were just as shocked and surprised as 

I was that there was nothing that could be done in this horrible situation. 

The state of Pennsylvania does have a parental consent law. Something has to 

be done to prevent this from happening to other families. This is just not acceptable 

to me and should not happen to families in this country. If your child goes to her 

9

school clinic for a headache, a registered nurse can’t give her a Tylenol or aspirin 

without a parent’s written permission. 

As a consequence of my daughter being taken out of our state for an abortion 

without parental knowledge, she is suffering intense grief. My daughter cries herself 

to sleep at night and lives with this everyday. 

I think about what I could or should have done to keep her safe. Everybody tells 

me I did everything I could have and should have done. It doesn’t make me feel 

any better, knowing everything I did was not enough to protect my daughter. 

It does ease my mind to know with your help that we can make a difference and 

change the law to protect other girls and their families. I urge your support for The 

Child Interstate Abortion Notification Act. It is critical that this law passes in Congress. The right of parents to protect the health and welfare of their minor daughters needs to be protected. No one should be able to circumvent state laws by performing an abortion in another state on a minor daughter without parental consent. 

Thank you for your time.

Mr. CHABOT. Professor Myers, you are recognized for 5 minutes. 

TESTIMONY OF RICHARD S. MYERS, PROFESSOR OF LAW,

AVE MARIA SCHOOL OF LAW, ANN ARBOR, MI 

Mr. MYERS. Thank you, Mr. Chairman. My name is Richard 

Myers. I have been teaching and writing about constitutional law 

for nearly 20 years. I am currently a professor at Ave Maria School 

of Law in Ann Arbor, Michigan. I am also President of University 

Faculty for Life. My testimony is on my individual behalf and 

doesn’t necessarily reflect the position of my employer or any other 

organization. 

I am pleased to have been invited to address the constitutional 

issues raised by H.R. 748. I have been asked to address two constitutional questions. One, is the act a proper exercise of one of 

Congress’s enumerated powers, and two, does the act violate principles of Federalism, perhaps by endorsing the view that States 

may legislate in an extra-territorial manner? 

First, it is basic constitutional law that Congress only has enumerated powers, but despite recent cases affirming that there are 

some judicially enforceable limits on the scope of the Commerce 

power, this act is well within Congressional authority. These recent 

cases, Lopez and Morrison, have dealt with Congressional efforts to 

reach non-economic local activity under the theory that the local 

activity had a substantial effect on interstate commerce. 

These recent developments, however, do not raise any concern 

about whether the act is within the Congressional power to regulate commerce among the several States. The Court has long affirmed that Congressional power to prohibit transportation of items 

of interstate commerce. To transport another person across State 

lines is to engage in commerce among the States and is thus within 

Congressional power to regulate such commerce. 

In Darby and other cases, the Supreme Court has clearly established that this power doesn’t depend on Congress legislating in 

furtherance of the policy of the destination State. Moreover, the 

motive and purpose of a regulation of interstate commerce are matters for the legislative judgment, upon the exercise of which the 

Constitution places no restriction and over which the courts are 

given no control. 

The abortion notification portion of the act is also a proper exercise of the Commerce power. Although this portion of the act 

doesn’t focus on transporting a minor across State lines, this portion of the act is clearly a regulation of an economic transaction. 

10

The many court cases upholding the constitutionality of the ‘‘Freedom of Access to Clinic Entrances Act’’ make it clear that the abortion industry is a major interstate industry that Congress may 

properly regulate. Some lower court cases have probably pushed 

Congressional authority too far in this area, but surely, recent 

cases such as Lopez and Morrison create no obstacle to Congressional regulation of the clearly economic side of the abortion industry. 

The second area I would like to focus on deals with the arguments that this Act violates principles of federalism, in large part 

because it allegedly permits a State to legislate in an 

extraterritorial manner. As Congressman Nadler mentioned, some 

critics say that what this does is force a woman to carry the restrictive laws of her home State on their backs as they go to new 

States. 

It seems clear that if you look at the testimony, for example, by 

Professor Rubin last summer, that this objection is principally driven by opposition to the substantive vision of the act, that is, the 

idea of protecting the rights of parents to be involved in the decisions that profoundly affect their children, and that the objection 

is not so much to the understanding of federalism that is presented. If one focuses—if one removes the negative labels, and keep 

in mind that the transportation portions of the act simply are designed to prevent the evasion of the law of the minor’s home State, 

then it seems clear that the Act reinforces a proper conception of 

federalism. 

The basic idea to prevent people from evading the laws of the 

home States when the home State is attempting to advance entirely properly objectives that are at the core of its sovereign authority is quite common. Strangely, the critics of this position adopt 

a strict territorial view of State power that was characteristic of 

American legal thought in the late 19th and early 20th century, 

but has been largely abandoned. 

The same sort of mistaken objection has recently been made in 

the area of marriage. So some modern critics argue that it is unconstitutional for a State to refuse to recognize a marriage that is 

valid under the law of the State of celebration. Such a refusal, 

these critics say, is supposedly an unconstitutional effort to extend 

the regulatory reach of the couples’ home State. Yet even in the absence of Federal law, like the ‘‘Defense of Marriage Act’’, this type 

of State policy, refusing to recognize a marriage that evades the 

law of the couples’ home State, has long been regarded as appropriate, for hundreds of years in this country. The proper principles 

of federalism and longstanding law support a State’s authority to 

avoid evasion of its laws. 

This is even more secure when we are not dealing simply with 

a State law that is being interpreted to apply when some of the relevant events take place outside the State. Here, of course, we are 

dealing with proposed Federal law, and as Professor Mark Rosen 

testified last year before Congress, the Federal Government is the 

appropriate entity of government to umpire these conflicts between 

State regulatory authority. 

Moreover, there is no right to travel problem presented by the 

Act. Most of the arguments here, I think, are simply not applicable. 

11

I see my time is up. I don’t know if I—I can just conclude 

that——

Mr. CHABOT. You can wrap it up, if you would like to. 

Mr. MYERS. The right to travel argument, I think, is just completely a misnomer. The only objection that has any cogency at all 

is that the Supreme Court has said that the right of travel protects 

the right of a citizen of one State to be treated as a welcome visitor 

rather than unfriendly alien when they travel to another State. 

But this component of the right to travel simply has no application here. This is protected by article IV of the Constitution and it 

really deals with discrimination against a citizen of a State simply 

because of their place of origin. It is designed to prevent States 

from having unreflective bias against out-of-Staters based on their 

place of origin. This act doesn’t do that at all. What it is designed 

to do is to allow States to further the substantive policy of the 

home State, and so a destination State here has a reason to treat 

the minor differently, not simply because of their place of origin, 

but to reinforce the law of their home State. And so the right to 

travel argument doesn’t have any application at all. 

Thank you very much. 

Mr. CHABOT. Thank you very much. 

[The prepared statement of Mr. Myers follows:]

PREPARED STATEMENT OF RICHARD S. MYERS

I am pleased to have been invited to address the constitutional issues raised by 

H. R. 748, the Child Interstate Abortion Notification Act (hereinafter ‘‘Act’’). I have 

been asked to address two constitutional questions: (1) is the Act a proper exercise 

of one of Congress’s enumerated powers, and (2) does the Act violate principles of 

federalism, perhaps by endorsing the view that states may legislate in an 

extraterritorial manner. 

First, ‘‘[t]he Constitution creates a Federal Government of enumerated powers.’’ United States v. Lopez, 514 U. S. 549, 552 (1995). But despite recent cases affirming 

that there are judicially enforceable limits on the scope of the commerce power, see, 

e.g., Lopez, United States v. Morrison, 529 U. S. 598 (2000), the Act is well within 

Congressional authority. These recent cases have dealt with Congressional efforts 

to reach noneconomic local activity under the theory that the local activity had a 

substantial effect on interstate commerce. The scope of these limits on Congressional power is currently before the Supreme Court. See Raich v. Ashcroft, 352 F. 

3d 1222 (9th Cir. 2003), cert. granted, 124 S. Ct. 2909 (2004). 

These recent developments do not, however, raise any concern about whether the 

Act is within Congressional power to regulate commerce among the several states. 

The Court has long affirmed Congressional power to prohibit interstate transportation of items of commerce. United States v. Darby, 312 U. S. 100 (1941); Champion 

v. Ames, 188 U. S. 321 (1903). To transport another person across state lines is to 

engage in commerce among the states and is, thus, within Congressional power to 

regulate such commerce. Cleveland v. United States, 329 U. S. 14 (1946); Caminetti 

v. United States, 242 U. S. 470 (1917); Hoke v. United States, 227 U. S. 308 (1913). 

The landmark case of United States v. Darby, 312 U.S. 100 (1941), makes this 

point clear. In Darby, the Court made it clear that Congressional power ‘‘extends 

not only to those regulations which aid, foster and protect the commerce, but embraces those which prohibit it.’’ 312 U. S. at 113. In Darby and in other cases, the 

Court has clearly established that this power does not depend on Congress legislating in furtherance of the policy of the destination state. As the Darby Court stated: ‘‘The power of Congress over interstate commerce . . . can neither be enlarged 

nor diminished by the exercise or non-exercise of state power. Congress, following 

its own conception of public policy concerning the restrictions which may appropriately be imposed on interstate commerce, is free to exclude from the commerce 

articles whose use in the states for which they are destined it may conceive to be 

injurious to the public health, morals or welfare, even though the state has not 

sought to regulate their use.’’ Id. at 114 (citations omitted). The Court was willing 

to sustain the federal law involved even on the assumption that Congress was primarily concerned about the local activity and not the interstate transport itself. As 

12

the Darby Court stated: ‘‘The motive and purpose of a regulation of interstate commerce are matters for the legislative judgment upon the exercise of which the Constitution places no restriction and over which the courts are given no control.’’ Id. 

at 115. 

Moreover, as John Harrison stated in his testimony on a prior bill prohibiting 

interstate transport of a minor to evade the parental involvement law in the minor’s home state: ‘‘This legislation, unlike the child labor statute at issue in Hammer v. 

Dagenhart, does not rest primarily on a congressional policy independent of that of 

the State that has primary jurisdiction to regulate the subject matter involved. 

Rather, in legislation like this Congress would be seeking to ensure that the laws 

of the State primarily concerned, the State in which the minor resides, are complied 

with. In so doing Congress would be dealing with a problem that arises from the 

federal union, not making its own decisions concerning local matters such as domestic relations or abortion.’’ Hearing on H.R. 1755 (The Child Custody Protection Act) 

before the Subcommittee on the Constitution of the Committee on the Judiciary, 

House of Representatives, 108th Congress, 2d Session 51 (July 20, 2004)(statement 

of John C. Harrison). 

The abortion notification portion of the Act is also a proper exercise of the commerce power. Although this portion of the Act does not focus on transporting the 

minor across state lines, this portion of the Act is a regulation of an economic transaction. The many court cases upholding the constitutionality of the Freedom of Access to Clinic Entrances Act (FACE) make it clear that the abortion industry is a 

major interstate industry that Congress may properly regulate. Some lower court 

cases have probably pushed Congressional authority too far, see United States v. 

Bird, 2005 U.S. App. LEXIS (%th Cir. February 28, 2005); Norton v. Ashcroft, 298 

F. 3d 547 (6th Cir. 2002), cert. denied, 537 U. S. 1172 (2003); United States v. 

Gregg, 226 F. 3d 253 (3d Cir. 2000), cert.denied, 523 U. S. 971 (2001), by upholding 

FACE even when noncommercial activity was involved, but surely recent cases such 

as Lopez and Morrison create no obstacle to Congressional regulation of the clearly 

economic side of the abortion industry. 

Second, opponents of this law contend that it is inconsistent with principles of federalism, in large part because it allegedly permits a state to legislate in an 

extraterritorial manner. This objection was set forth by Peter Rubin in his testimony before the Senate Judiciary Committee in June 2004. He stated: ‘‘The proposed law amounts to a statutory attempt to force a most vulnerable class of young 

women to carry the restrictive laws of their home states strapped to their backs, 

bearing the great weight of those laws like the bars of a prison that follows them 

wherever they go (unless they are willing to go alone). Such a law violates the basic 

premises upon which our federal system is constructed. . . . [According to Rubin,] 

the proposition that a state may not project its laws into other states by following 

its citizens there is bedrock in our federal system.’’ The Child Custody Protection 

Act: Protecting Parents’ Rights and Children’s Lives: Hearing on S. 851 before the 

Senate Committee on the Judiciary, 108th Congress, 2d Session 2–3 (June 3, 

2004)(statement of Peter J. Rubin). 

It seems clear that opposition to the substantive vision of the Act (that is, to protect the rights of parents to be involved in decisions that profoundly affect their children) is driving much of this analysis. It is important and more conducive to a 

sound analysis of the relevant constitutional principles to remove the negatives labels and to keep in mind that the transportation portions of the Act simply are designed to prevent the evasion of the law of the minor’s home state. As others have 

explained, so understood this Act reinforces a proper conception of federalism. 

This point was well-expressed by Mark Rosen in his testimony before this Subcommittee in July 2004. He stated: ‘‘one of the great benefits of federalism is that 

with respect to policies that are not foreclosed by the Federal constitutional law or 

Federal statutory law, there can be diversity of approaches that States take, and 

when you have a law that by its nature can readily be circumvented through travel, 

as parental notification laws can be, then a Federal statute that helps to ensure the 

efficacy of constitutional policies does not undermine federalism, but helps to enhance the diversity across States with regard to policies that they’re able to pursue.’’

Hearing on H. R. 1755 (The Child Custody Protection Act) before the Subcommittee 

on the Constitution of the Committee on the Judiciary, House of Representatives, 

108th Congress, 2d Session 10 (July 20, 2004)(statement of Mark D. Rosen). See 

Mark D. Rosen, Extraterritoriality and Political Heterogeneity in American Federalism, 150 U. Pa. L. Rev. 855 (2002). 

The basic idea—to prevent people from evading the laws of their home states 

when the home state is attempting to advance entirely proper objectives that are 

at the core of its sovereign authority—is quite common. Strangely, the critics adopt 

a strict territorial view of state power that was characteristic of American legal 

13

thought in the late 19th century and the early 20th century, but has been largely 

abandoned. The same sort of mistaken objection has recently been made in the area 

of marriage. So, some modern critics, most of whom are not experts in the relevant 

field of law, argue that it is unconstitutional for a state to refuse to recognize a marriage that is valid under the law of the state of celebration. Such a refusal is, supposedly, an unconstitutional effort to extend the regulatory reach of the couples’ home state. Yet, even in the absence of federal law, such a state policy—that is, to 

refuse to respect the couples’ efforts to evade the law of their home state—has long 

been regarded as appropriate. For discussion of this issue, see Richard S. Myers, 

The Public Policy Doctrine and Interjurisdictional Recognition of Civil Unions and 

Domestic Partnerships, 3 Ave Maria L. Rev. (2005)(forthcoming); Richard S. Myers, 

Same-Sex ‘‘Marriage and the Public Policy Doctrine, 32 Creighton L. Rev. 45 (1998). 

It is quite clear that the real objection is not to a proper understanding of the 

constitutional principles underlying our system of federalism but, rather, to the substantive policy implicated. So, critics of the standard view that states are permitted 

to refuse to recognize marriages that violate the strong public policy of the couples’ home state are, it seems safe to say, primarily driven by their opposition to the substantive policies of the states with a traditional view of marriage, even if that traditional view enjoys widespread public support, perhaps evidenced by the policy having been adopted by wide majorities of the voting populations in these states. In the 

context presented here today, the same dynamic seems at work. The real opposition 

to the Act is not to its understanding of federalism but to the substantive policy 

(promoting parental involvement in the decision by a minor whether to have an 

abortion) that the legislation seems designed to permit states to pursue. 

States that have the requisite contacts to the individuals and/or the events involved are permitted to apply their own law. We see this even in the area of contracts where a respect for private ordering has long-standing support in our legal 

traditions. Even here, states do not allow individuals blanket authority to evade the 

laws of a state that is competent to legislate on the matter under review. Travel 

to a state with different law or drafting a choice of law clause to select law that 

is desired by the parties do not invariably result in successful evasion. A forum 

state will reject such an attempt when the other state’s law is contrary to the fundamental policy of the state whose law the parties are attempting to avoid. This outcome is reflected in the Restatement (Second) of Conflict of Laws section 187 (1971) 

and in the laws of nearly every state. See Myers, 3 Ave Maria L. Rev. 

(2005)(forthcoming); Myers, 32 Creighton L. Rev. at 52–55. 

These principles are quite basic and are quite commonly accepted. As the current 

debate about the interjurisdictional recognition of same-sex ‘‘marriages’’ and quasimarital statuses indicates, these principles are challenged when opponents’ principal objection is to the substantive policy of the state whose law is being evaded. 

But basic principles of federalism and long-standing law support a state’s authority 

to avoid evasion of its laws. 

This is even more secure when we are not dealing simply with a state law that 

is being interpreted to apply when some of the relevant events take place outside 

the state. Here, of course, we are dealing with a proposed federal law, and as Mark 

Rosen stated, ‘‘[a]s a structural matter, a federal government that umpires the sister states’ regulatory powers vis-a-vis one another is eminently sensible, and several 

constitutional provisions . . . empower Congress to serve that function.’’ Rosen 

Statement, supra, at 15. 

Moreover, there is no ‘‘right to travel’’ problem presented by the Act. The Supreme 

Court has recently considered the right to travel in a case, Saenz v. Roe, 526 U. 

S. 489 (1999), that seems to have been given rather limited scope by subsequent 

cases. In any event, Saenz v. Roe does not suggest that the Act is constitutionally 

infirm. Saenz explained that there are three components to the ‘‘right to travel’’ recognized by the Supreme Court. The first component, the right to enter and leave 

a sister State is not at all implicated by the Act. See Rosen Statement, supra, at 

15. The third component, the right of a new citizen to be treated the same as other 

citizens of the State, is not at all implicated either because the Act deals with situations where the minor has not changed her state citizenship. The second component 

of the right to travel, the right to be treated as a welcome visitor rather than an 

unfriendly alien, is not violated by the Act. This second component of the right to 

travel is protected by the Privileges and Immunities Clause of Article IV of the Constitution. This Clause prevents ‘‘discrimination against citizens of other States 

where there is no substantial reason for the discrimination beyond the mere fact 

that they are citizens of other States. But it does not preclude disparity of treatment 

in the many situations where there are perfectly valid independent reasons for it.’’

Toomer v. Witsell, 334 U. S. 385, 396 (1948). The kind of discrimination that is constitutionally suspect is discrimination against out-of staters, simply because of their 

14

place of origin. That is not at all what the Act attempts to reinforce. The Act is not 

trying to affirm unreflective bias against non-citizens; rather, the Act is designed 

to aid states in their efforts to have important substantive policies with regard to 

their residents followed. Because there is, then, a reason (defined by the law of the 

minor’s home state) apart from the minor’status as an out-of stater to treat the 

minor differently, the presumption against discrimination is not at all implicated. 

See Myers, 32 Creighton L. Rev. at 56–59 (discussing this issue in the context of 

interjurisdictional recognition of same-sex ‘‘marriages’’). 

In conclusion, the two constitutional questions I have reviewed do not present any 

significant obstacle to passage of the Act. The Act is well within the scope of Congressional authority and is perfectly consistent with principles of federalism. Those 

who oppose this Act would be well-advised to focus their attention on the substance 

of the legislation.

Mr. CHABOT. Dr. Seigel, you are recognized. 

TESTIMONY OF WARREN SEIGEL, M.D., FAAP, FSAM, DIRECTOR 

OF ADOLESCENT MEDICINE, CHAIRMAN OF PEDIATRICS, 

CONEY ISLAND HOSPITAL, BROOKLYN, NY 

Dr. SEIGEL. Good afternoon. Thank you to Chairman Chabot, 

Ranking Member Nadler, and Members of the Subcommittee on 

the Constitution for allowing me to appear before you today. 

My name is Dr. Warren Seigel. I am Director of Adolescent Medicine and Chair of Pediatrics at Coney Island Hospital. I also serve, 

as has already been noted, as the Director of Adolescent Medicine 

at various institutions in Brooklyn. I am board certified in both pediatrics and adolescent medicine, and among my other medical association involvements, I am currently the President of the New 

York State Chapter 2, District 2, of the American Academy of Pediatrics. 

I am submitting testimony today as a resident of New York 

State, an experienced health care provider, a leader in the American Academy of Pediatrics and the Society for Adolescent Medicine, and a member of Physicians for Reproductive Choice and 

Health, known as PRCH. PRCH is a national nonprofit organization created to enable concerned physicians to take a more active 

and visible role in supporting universal, evidence-based reproductive health. PRCH is committed to ensuring that all people have 

the knowledge, access to quality services, and freedom of choice to 

make their own reproductive health decisions. 

I submit this testimony to you today on behalf of the PRCH 

Board of Directors and our more than 6,500 physician and non-physician members to express our opposition to H.R. 748, known as the 

‘‘Child Interstate Abortion Notification Act,’’ or CIANA. This bill 

puts young women’s lives at risk. It makes criminals out of caring 

physicians. And it affects the care of all patients. 

I recognize that parents ideally should be, and indeed usually 

are, involved in health decisions regarding their children. However, 

the ‘‘Child Interstate Abortion Notification Act’’ does nothing to 

promote such communication. Instead, CIANA places incredible 

burdens on young women and physicians, infringes on the rights of 

adolescents to health care that does not violate their safety and 

health, makes caring family, friends, and doctors criminals, and 

could be detrimental to the health and emotional well-being of all 

patients. 

As a pediatrician, I believe CIANA will create insurmountable 

obstacles for adolescents. Young women seeking abortions in a 

15

State other than their home State will be forced to comply with the 

parental notification laws in both States. They will also have to 

navigate through the complex and emotionally draining judicial bypass procedure in both States. This will cause delays that may be 

harmful to the young woman’s health by forcing her to undergo a 

later-term procedure. 

The American Medical Association states that a delay in receiving care will, quote, ‘‘increase the gestational age at which the induced pregnancy termination occurs, thereby also increasing the 

risk associated with the procedure,’’ unquote. Requiring adolescents 

to comply with laws in more than one State will certainly increase 

the delay in receiving care. 

CIANA also requires parental notification for young women receiving abortions in States where they are not permanent residents. Young women who are not trying to circumvent parental notification laws but are, in fact, living temporarily in a State for college or boarding school or other reasons will need to seek the care 

that is closest to them. CIANA would prohibit these women from 

the most accessible health care available to them. 

Women from States with no parental notification legislation face 

an additional burden. Even if a young woman is not subject to any 

parental notification laws in either the State where she is from or 

the State where she is accessing care, CIANA will require parental 

notification. Thus, in States with no parental notification legislation, young women will not have access to the judicial bypass option, either. 

When judicial bypass is available, however, the delays it may 

cause are compounded by a mandatory delay period of at least 24 

hours, which is required by CIANA. Mandatory delay periods create additional expenses for both young women and their families, 

requiring overnight stays in hotels and missed days from work or 

school. 

As I mentioned previously, young women as a population are already more likely to seek abortion later in their pregnancy. The 

Centers for Disease Control have shown that adolescents obtain 30 

percent of all abortions performed after the first trimester, and 

younger women are more likely to obtain abortions at 21 weeks or 

more gestation. Mandatory delays will only serve to increase these 

trends. 

CIANA also requires a mandatory delay even if a parent is 

present and consenting. If this legislation is about parental notification, then what is the purpose of this delay if not to keep women 

from accessing the care that they need in a timely manner? 

I am also concerned that CIANA places extreme and unreasonable burdens on physicians and the other patients they treat. Physicians will be required to have detailed knowledge of the parental 

notification laws in the 49 States where they do not even practice. 

It is already time consuming to keep up with the laws of my own 

State. What this proposed legislation doesn’t take into account is 

the amount of time it is going to take for physicians to go out and 

earn a law degree. If I were required to keep up to date on the 

complex and often changing laws of the other 49 States, it would 

severely cut into the time that I could spend giving quality care to 

my other patients. The impossibility of this effort means that alVerDate 0ct 09 2002 11:01 May 16, 2005 Jkt 000000 PO 00000 Frm 00019 Fmt 6633 Sfmt 6601 G:\WORK\CONST\030305\99583.000 HJUD1 PsN: 99583
16

though I will in good faith try to obey the law, I face being 

criminalized for inadvertently violating this burdensome and ridiculous requirement. 

I see my time is up. May I sum up? 

Mr. CHABOT. Yes, go ahead and sum up, Doctor. 

Dr. SEIGEL. Thank you. Physicians will be required in some cases 

to travel to the home State of young women to give notification in 

person to the parents. This means seeing the young women, leaving the practice to travel to another State to provide in-person notice, returning to the practice, and then performing the procedure, 

all this for one patient. What becomes of all the other patients seeing their physician for other health care issues during this time? 

This requirement will not only increase the delay for the procedure, 

but is simply impossible for a physician to carry out, thereby denying a young woman her right to an abortion. 

The American Academy of Pediatrics is a national medical organization representing the 60,000 physician leaders in pediatrics, of 

which I am a proud member and leader. We have adopted the following statement regarding mandatory parental notification, and I 

quote, ‘‘Adolescents should be strongly encouraged to involve their 

parents and other trusted adults in decisions regarding pregnancy 

termination, and the majority of them voluntarily do so. Legislation 

mandating parental involvement does not achieve the intended 

benefit of promoting family communication, but it does increase the 

risk of harm to the adolescent by delaying access to appropriate 

medical care,’’ unquote. 

This legislation will decrease the ability of physicians to provide 

quality care to all of their patients by immersing them in legal 

questions, travel time, and mandatory delay purposes. It is for all 

of these reasons that we must protect the rights of young women 

to access safe, affordable, and appropriate health care. We must 

make it easier for physicians to provide medical services, not make 

it more difficult. 

As a physician, I believe that this legislation represents bad medicine and places politics before the health of our youth. Leading 

medical organizations and scientific evidence overwhelmingly agree 

that this legislation would negatively impact the health of adolescents. It is for this reason that I appear in opposition to H.R. 748. 

Thank you. 

Mr. CHABOT. Thank you. 

[The prepared statement of Dr. Seigel follows:]

PREPARED STATEMENT OF WARREN SEIGEL

Thank you to Chairman Chabot, Ranking Member Nadler, and members of the 

Subcommittee on the Constitution for allowing me to appear before you today. 

My name is Dr. Warren Seigel. I am Director of Adolescent Medicine and Chair 

of Pediatrics at Coney Island Hospital, where I founded the Division of Adolescent 

Medicine. I also serve as the Director of Adolescent Medicine at Maimonides Children’s Medical Center, Methodist Hospital and Lutheran Medical Center. I am 

Board certified in both Pediatrics and Adolescent Medicine and, among my other 

medical association involvement, am currently the President of New York State 

Chapter 2—District II of the American Academy of Pediatrics. 

I am submitting testimony today as a resident of New York State, an experienced 

health care provider, a leader in the American Academy of Pediatrics and the Society for Adolescent Medicine and a member of Physicians for Reproductive Choice 

and Health(r), or PRCH. PRCH is a national non profit organization created to enable concerned physicians to take a more active and visible role in supporting uniVerDate 0ct 09 2002 11:01 May 16, 2005 Jkt 000000 PO 00000 Frm 00020 Fmt 6633 Sfmt 6621 G:\WORK\CONST\030305\99583.000 HJUD1 PsN: 99583
17

versal, evidence-based reproductive health. PRCH is committed to ensuring that all 

people have the knowledge, access to quality services and freedom of choice to make 

their own reproductive health decisions. 

I submit this testimony to you today on behalf of the PRCH Board of Directors 

and our more than 6,500 physician and non-physician members to express our opposition to H.R. 748, known as the Child Interstate Abortion Notification Act, or 

CIANA. This bill puts young women’s lives at risk, makes criminals out of caring 

physicians, and affects the care of all patients. 

I recognize that parents ideally should be—and usually are—involved in health 

decisions regarding their children. However, the Child Interstate Abortion Notification Act does nothing to promote such communication. Instead, CIANA places incredible burdens on both young women and physicians; infringes on the rights of 

adolescents to health care that does not violate their safety and health; makes caring family, friends and doctors criminals; and could be detrimental to the health and 

emotional well-being of all patients. 

As a pediatrician, I believe CIANA will create insurmountable obstacles for adolescents. Young women seeking abortions in a state other than their home state will 

be forced to comply with the parental notification laws in both states. They will also 

have to navigate through the complex and emotionally draining judicial bypass procedure in both states. This will cause delays that may be harmful to the young woman’s health by forcing her to undergo a later-term procedure. The American Medical 

Association states that a delay in receiving care will ‘‘increase the gestational age 

at which the induced pregnancy termination occurs, thereby also increasing the risk 

associated with the procedure.’’ Requiring adolescents to comply with laws in more 

than one state will certainly increase the delay in receiving care. 

CIANA also requires parental notification for young women receiving abortions in 

states where they are not permanent residents. Young women who are not trying 

to circumvent parental notification laws but are, in fact, living temporarily in a 

state for college, boarding school or other reasons will need to seek the care that 

is closest to them. CIANA would prohibit these women from the most available 

health care. 

Women from states with no parental notification legislation face an additional 

burden. Even if a young woman is not subject to any parental notification laws in 

either the state where she is from or the state where she is accessing care, CIANA 

will require parental notification. Judicial bypass procedures only exist in states 

with parental notification laws in place. Thus, in states with no parental notification 

legislation, young women will not have access to the judicial bypass option. 

When judicial bypass is available, the delays it may cause are compounded by a 

mandatory delay period of at least 24 hour, which is required by CIANA. Mandatory 

delay periods create additional expenses for both young women and their families, 

requiring overnight stays in hotels and missed work or school. As mentioned previously, delaying the abortion procedure may increase the health risk for the young 

woman. Additionally, young women as a population are already more likely to be 

seeking abortion later in their pregnancy. The Centers for Disease Control have 

shown that adolescents obtain 30% of all abortions performed after the first trimester, and younger women are more likely to obtain abortions at 21 weeks or more 

gestation. Mandatory delays will only serve to increase these trends. CIANA also 

requires a mandatory delay even if a parent is present and consenting. If this legislation is about parental notification, then what is the purpose of this delay if not 

to keep young women from accessing the care that they need in a timely manner? 

I am also concerned that CIANA places extreme and unreasonable burdens on 

physicians and the other patients they treat. Physicians will be required to have detailed knowledge of the parental notification laws in the 49 states where they do 

not practice. It is already time consuming to keep up with the laws of my own state. 

What this proposed legislation doesn’t take into account is the amount of time it 

is going to take for physicians to get law degrees. If I were required to keep upto-date on the complex and often changing laws of the other 49 states, it would severely cut into the time that I could spend giving quality care to my other patients. 

The impossibility of this effort means that although I will in good faith try to obey 

the law, I face being criminalized for inadvertently violating this burdensome and 

ridiculous requirement. 

Physicians will be required in some cases to travel to the home state of the young 

woman to give notification in person to the parents. This means seeing the young 

woman, leaving their practice to travel to another state to provide in-person notice, 

returning to their practice, and then performing the procedure—all this for just one

patient. What becomes of all the other patients seeing their physician for other 

health care issues during this time? This requirement will not only increase the 

18

delay for the procedure but is simply impossible for a physician to carry out, thereby 

denying a young woman her right to an abortion. 

This bill will grind medical practices to a halt, thereby affecting all types of care 

that all patients are receiving. Additionally, this legislation does not propose any 

standards or procedures for inter-state reporting, and will place heavy bureaucratic 

burdens on physicians who are trying to comply with the law. CIANA makes it impossible for a physician to perform an abortion without neglecting the care of other 

patients, and is clearly not about protecting young women but simply and blatantly 

about ending access to abortions—period. 

This legislation contains an inadequate exception to protect a young woman’s life 

and no exception to protect her health. This is unconstitutional according to Supreme Court decisions in Roe v. Wade, Planned Parenthood v. Casey and Stenberg 

v. Carhart. CIANA does not take into account psychological factors that may threaten a woman’s life and will not consider an exception where her health is concerned. 

Although this legislation is supposedly aimed at increasing parent-child communication, the government cannot mandate healthy families and, indeed, it is dangerous to attempt to do so. Research has shown that the overwhelming majority of 

adolescents already tell their parents before receiving an abortion. In fact, the 

younger the woman is, the more likely she is to tell her parent. The American Academy of Pediatrics, a national medical organization representing the 60,000 physician 

leaders in pediatric medicine—of which I am a member and leader—has adopted the 

following statement regarding mandatory parental notification:

Adolescents should be strongly encouraged to involve their parents and other 

trusted adults in decisions regarding pregnancy termination, and the majority 

of them voluntarily do so. Legislation mandating parental involvement does not 

achieve the intended benefit of promoting family communication, but it does increase the risk of harm to the adolescent by delaying access to appropriate medical care (emphasis added).

It is important to consider why a minority of young women cannot inform their 

parents. The threat of physical or emotional abuse upon disclosure of the pregnancy 

to their parents or a pregnancy that is the result of incest make it impossible for 

these adolescents to inform their parents. Under CIANA, young women would be 

forced to put themselves in dangerous situations in order to receive medical care. 

Young women have many reasons for needing to travel out of state to have an 

abortion. Eighty-seven percent of U.S. counties have no abortion provider. In some 

states, there is only one provider available. In cases like these, the nearest abortion 

provider may be in another state. Financially, an abortion may be more affordable 

at a facility in another state. As I mentioned before, an adolescent may be temporarily residing in another state and need local care. CIANA penalizes young women 

for seeking the closest and most affordable health care. 

This legislation will decrease the ability of physicians to provide quality care to 

all of their patients by immersing them in legal questions, travel time and mandatory delay periods. Increasing these penalties will have the added effect of decreasing the number of adolescents that seek health care for any reproductive health 

need. Mandatory, burdensome and confusing legislation may lead to an increased 

distrust of the physicians who must now enforce this legislation. In addition to minimizing care for all other patients, this may lead to decreased access of contraceptives, later term abortions among a population already having later abortions and 

an increase in illegal or self-induced abortions—all of which are detrimental to a 

young woman’s health. 

Physicians for Reproductive Choice and Health(r) is in absolute agreement with 

leading medical organizations on this issue. The American Medical Association, the 

American College of Obstetricians and Gynecologists, the American College of Physicians and the American Public Health Association all oppose mandatory parentalinvolvement laws because they endanger the health of adolescents and pose undue 

burdens on physicians. Additionally, the American Academy of Pediatrics and the 

Society for Adolescent Medicine have opposed similar legislation, entitled the Child 

Custody Protection Act, currently under consideration in the Senate as S. 8, because 

of the harm it may cause adolescents. 

It is for all of these reasons that we must protect the rights of young women to 

access safe, affordable and appropriate health care. We must make it easier for physicians to provide needed services, not more difficult. As a physician, I believe that 

this legislation represents bad medicine and places politics before the health of our 

youth. Practicing physicians and scientific evidence overwhelmingly agree that this 

legislation would negatively impact the health of adolescents. It is for this reason 

that I appear in opposition to H.R. 748. 

19

APPENDIX: 

Council on Scientific Affairs, American Medical Association. Induced termination of 

pregnancy before and after Roe v. Wade: trends in the mortality and morbidity 

of women. JAMA 1992;268:3231–3239.

American Academy of Pediatrics, Committee on Adolescence. The adolescent’s right 

to confidential care when considering abortion. Pediatrics.1996;97:746–751.

Elam-Evans LD, Strauss LT, Herndon J, Parker WY, Bowens SV, Zane S, et al. 

Abortion surveillance—United States, 2000. MMWR CDC Surveill Summ 

2003;52(SS–12):1–32.

Mr. CHABOT. Our final witness this afternoon will be Professor 

Collett. You are recognized. 

TESTIMONY OF TERESA STANTON COLLETT, PROFESSOR OF 

LAW, UNIVERSITY OF ST. THOMAS SCHOOL OF LAW, MINNEAPOLIS, MN 

Ms. COLLETT. Mr. Chairman, Representative Nadler, Members of 

the Committee, thank you for the opportunity to appear. 

I am in support of CIANA for a number of reasons, but primarily 

it is because I believe that the widespread consensus represented 

by the number of States that have through their elected representatives come to the conclusion that parents should be involved in 

the decision of their minor daughters concerning the obtaining of 

an abortion is something that should be reinforced by Federal law. 

As you can see by the map that has been prepared from the 

Council for State Legislatures, the vast majority of States in this 

country have either parental notice or parental consent laws. There 

are only a tiny minority of States that have not chosen legislatively 

to enact such protection. This law furthers the will of the people 

on this issue. 

Mr. CHABOT. Professor, could you point out what the colors are 

there as far as what they represent? 

Ms. COLLETT. Certainly, Mr. Chairman. The blue States indicate 

States that have parental consent laws. The red States indicate 

States that have parental notification laws. The purple States are 

States that indicate either parental notice or parental consent. 

Now, I would actually disagree with the classification of Oklahoma 

and Connecticut, but I drew this off of the Council for State Legislatures website. The white States have not enacted laws, but you 

can see that they constitute only six States in the Union at this 

point in time. Oklahoma’s law is actually an abortion liability law, 

not a parental consent or notification law, as the Tenth Circuit has 

defined it. 

In addition to that, you will see that the majority of abortion providers and abortion advocacy groups throughout this country refer 

to the fact that a substantial minority of minors will voluntarily involve their parents in the decision to obtain abortions. When you 

look at the sources they cite on that, they actually cite a study that 

was done by Stanley K. Henshaw and Kathryn Kost. Stanley K. 

Henshaw is the demographer for the Guttmacher Institute, which 

is Planned Parenthood’s research affiliate. It is a 1992 article and 

he says that 61 percent of all minors will voluntarily involve a parent absent a parental involvement law. He indicates that this was 

based on a survey of 1,500 unmarried minors, which was a nationally representative sample. 

20

In fact, when you look at the actual article, it did not involve any 

minors from States that had parental involvement laws at the 

time, of which there were 21 States at that point in time. Therefore, none of the minors involved in the survey actually were subject to a law. In addition to that, he did not survey the parents of 

these minors, so we simply had self-reporting. So the survey itself 

is not particularly reliable. 

But the real example of experimenter bias or researcher bias of 

this particular survey is the only thing he asked these minors 

were, what were the adverse effects of this particular parental involvement? The number one adverse effect that the minors indicated for parental involvement, by 40 percent, was increase of parental stress. Now, I would suggest that, in fact, that could equally 

be indicative of good parenting as opposed to bad parenting. It also 

indicated that another adverse effect, according to 14 percent of the 

respondents, was that the minor was no longer allowed to interact 

with the individual who had impregnated her. Again, I think 

whether that is an adverse effect is one that is subject to diverse 

judgments. 

He also discloses that of those minors who indicated that there 

was individuals involved, 95 percent said that their mothers were 

involved. Ninety-nine percent indicated that an adult was involved. 

But 53 percent of those under 15 said no adult was involved, but 

where only an adult was involved and no parent was involved, a 

significant number indicated that a boyfriend was involved in deciding or arranging for the abortion. Ninety-three percent of those 

15 and under said that the boyfriend was involved. Seventy-six percent indicated that the boyfriend helped pay for the abortion. 

Clearly, a number of the young girls who obtain abortions without 

their parents’ knowledge were encouraged to do so by a boyfriend 

who could be charged with statutory rape. 

One of the substantial State interests that backs CIANA is, in 

fact, to help States protect minors from statutory rape. In addition 

to that, Mr. Chairman and Members of the Committee, the Congress has looked at the problem of teenage pregnancy and studies 

have consistently shown that adolescent pregnancies are often the 

result of impregnation by men who are at least 5 years older than 

the minor who is impregnated. One study of 46,000 pregnancies by 

school-age girls in California showed that 71 percent, or over 

33,000, were fathered by adult post-high school men whose mean 

age was 22.6 years, an average of 5 years older than the mothers. 

Even among junior high school girls, the men were six to 7 years 

their senior. 

Clearly, there is substantial State interest and there is substantial consistency among the States in the Union that parents should 

be involved. CIANA is both constitutional and is consistent with 

sound public policy. 

Thank you, Mr. Chairman. 

Mr. CHABOT. Thank you very much, Professor. 

[The prepared statement of Ms. Collett follows:]

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Mr. CHABOT. And now, the Members will have 5 minutes to ask 

questions and I yield myself 5 minutes for that purpose. 

Mrs. Carroll, I will begin with you, if I can. I first of all just want 

to say that it is my clear opinion that you did everything you could 

under the existing law to protect your daughter, so there is no way 

that you are in any way responsible for this as far as I am concerned. 

But let me ask you, do you think it is dangerous for young girls 

to be coerced into having an abortion by adults who may be trying 

to protect their own interests rather than the interests of the pregnant girl? For example, as a parent, is there information that you 

would have shared with the doctor, and did the clinic sufficiently 

ensure that your daughter would receive follow-up care? 

Mrs. CARROLL. No, they didn’t. She received one piece of paper 

that said that she needed to make an appointment in 2 weeks for 

post-care with the blanks left open. They did not schedule that. 

When I did take her to her OB, he asked if there was a paper that 

they wanted sent in to clarify that she did get post-care and she 

said, no, there was nothing that was given. 

Mr. CHABOT. Do you think it is dangerous for a young girl to——

Mrs. CARROLL. Yes. They had no idea—they didn’t know if she 

was allergic to anything, what her medical history was. They had 

no clue about anything. 

Mr. CHABOT. Okay. 

Mrs. CARROLL. She told me that they talked to her for about 5 

minutes and that was it. 

Mr. CHABOT. And you said your daughter is still going through 

difficulties psychologically with respect to this? 

Mrs. CARROLL. Yes. 

Mr. CHABOT. Thank you. Professor Myers, let me ask you, would 

you please discuss the similarities between CIANA and the ‘‘Mann 

Act’’ or other acts of Congress in which Congress has similarly utilized its Commerce Clause authority. 

Mr. MYERS. The Mann Act is a good example. That is just one 

of many instances where Congress has used its authority to regulate commerce. Clearly, transporting people across State lines has 

been interpreted as commerce among the several States and Congress has been viewed as well within its authority to achieve objectives that might undermine State laws by transporting people to a 

State for immoral purposes or other purposes that Congress objects 

to. 

Here, what the Congress’s basic objective seems to me is to try 

to reinforce the views of the home States, and in that sense, I think 

it is even clearer that it is permissible under the ‘‘Mann Act’’ line 

of cases. 

Mr. CHABOT. Thank you. Dr. Collett, let me ask you a question. 

Dr. Seigel had stated in his written testimony, I think also said 

this orally, that, quote, ‘‘under CIANA, young women would be 

forced to put themselves in dangerous situations in order to receive 

medical care,’’ unquote. But that is not really accurate, is it? 

CIANA clearly does not require parental notification in cases, for 

example, of abuse or neglect. What are your views about the points 

that Dr. Seigel made in that area? 

39

Ms. COLLETT. Well, in fact, the bill has an express exception for 

a situation where the minor is willing to sign a written statement 

that she is a victim of sexual abuse, neglect, or physical abuse, and 

where the physician will notify the authorities specified to receive 

reports of child abuse. 

In fact, in Manning v. Hunt, the Fourth Circuit specifically dealt 

with a similar requirement where judges in judicial bypass proceedings were required to report where a minor was seeking a bypass on the basis of potential abuse and the court said that the 

only people that would benefit from not having a reporting duty 

would be the potential abuser. 

It is very similar to the case out in Arizona where Planned Parenthood accepted a young girl who was being sexually assaulted by 

her foster brother. She was impregnated. They secretly gave her an 

abortion, notified no one in the household, gave her the abortion, 

sent her back into the household. She was sexually assaulted 

again. She became pregnant a second time and was sent back for 

the second abortion. Finally, it was revealed, and they were sued 

and held civilly liable for the failure to report under the Arizona 

laws. 

This has got an exemption, but it is a very sensible exemption 

that requires the physician to report. 

Mr. CHABOT. Thank you. Dr. Seigel, with the time I have remaining, you stated in your written testimony that under CIANA, minors will be forced to comply with parental notification laws and 

judicial bypass provisions in both her home State and the State 

where the abortion is to be performed, but that is not correct. 

CIANA’s first part penalizes a transporter who seeks to circumvent a State parental involvement law. It imposes no obligations on the minor. The second part of CIANA places a duty only 

on those abortion providers in States that do not have parental involvement laws, and if a minor presents the abortion provider with 

a court order she obtained from her own State court allowing her 

to bypass the parental involvement law, then the abortion provider 

does not have to give parental notice. So the bill simply doesn’t require a minor to comply with multiple judicial bypass procedures. 

Do you disagree? 

Dr. SEIGEL. I believe CIANA is detrimental to all patients. I 

think we are putting burdens on the patient, the young woman 

who needs to get adequate medical care. 

The fact of the matter is, communication is already happening, 

and I would like to just take a moment, if I may, to express my 

disappointment in the medical community. I wanted to say to Mrs. 

Carroll that I am very sorry about what I heard happen to her 

daughter. It is an example of how the medical community has let 

you down, your daughter down, and your entire family. 

I am concerned that when physicians are burdened with legalities, we will wind up spending more time learning about the legalities and the changing legalities of our laws and not spend the time 

that a physician should have spent with your daughter. 

Mr. CHABOT. My time is expired, but I would just, in response 

to that, say that it would seem that it wouldn’t be particularly difficult to have a chart that would show the States in the surrounding area, what the laws are. It would seem that is the least 

40

that one should do when you are considering something as significant as terminating the unborn child that that girl is carrying, 

so——

Dr. SEIGEL. My understanding is it is not as simple as the 

color——

Mr. CHABOT. We obviously just have to agree to disagree on that, 

and my time is expired. 

I will now recognize the gentleman from New York. 

Mr. NADLER. Thank you. Let me ask Professor Myers, in the situation, the very unfortunate situation described by Mrs. Carroll, 

forgetting CIANA, I counted about five different crimes there—harassment, stalking, interstate kidnapping, conspiracy, assault. Don’t 

you think in that situation that there were a number of crimes 

committed and that the real problem, or that a real problem—

maybe not the only one—is not the absence of this bill but the absence of prosecution and enforcement of existing law? 

Mr. MYERS. I think you are right that it sounds like there were 

many other violations. I think one of the problems with the remedies you suggest, prosecution, is they are after the fact, so that 

doesn’t help her daughter——

Mr. NADLER. Well——

Mr. MYERS.—and it doesn’t help Mrs. Carroll——

Mr. NADLER. Enforcement of this bill would also be after the fact. 

It is always after the fact. Enforcement of any law has to be after 

the fact. 

Mr. MYERS. I think you could—I would hope we could assume 

that the physicians, as Dr. Seigel said, would try to comply with 

the law, and if they made an effort to provide notice in this situation, it would have helped to protect Mrs. Carroll’s daughter. It 

seems like in that situation, if we are trying to protect the choice 

of young women, that that would be one way to further it——

Mr. NADLER. But you would agree that——

Mr. MYERS.—requiring notice. 

Mr. NADLER.—the police told Mrs. Carroll that there was nothing 

they could do in the situation. They are probably wrong. They 

should have, or the D.A. or somebody should have initiated enforcement of criminal law at that point. 

Mr. MYERS. I think it sounds like that there were violations ongoing, that there were other things that could have been done. In 

this situation, if——

Mr. NADLER. Thank you very much. 

Mr. MYERS.—they had required notice——

Mr. NADLER. I only have 5 minutes, so thank you very much. 

Dr. Seigel, you have already expressed in your opinion that the 

doctors did the wrong thing. Talk about, for a moment, and then 

I have another question for you, the real world situation, not in 

this extreme situation, but of young women who cannot confide in 

their parents, or feel they cannot confide in their parents, who are 

not being, in effect, kidnapped by somebody else, who seek the help 

of a brother or sister or grandmother or member of the clergy or 

someone to help them. Do we see those situations now? Are those 

real situations? Are they more common or less common than this 

sort of thing? 

41

Dr. SEIGEL. Well, the truth is that they are uncommon. They are 

uncommon. The vast majority of adolescents do speak to their parents, not just about abortion. When a girl comes in—we are just 

speaking about young women today. When a girl comes in and I 

speak to her and it is related to pregnancy and there is an issue 

about whether she is going to terminate, have an abortion, my responsibility as a health care provider is to encourage her telling 

her parent, and if she feels unsafe, it is my responsibility to find 

out why she is unsafe. Is she being sexually abused at home? Is 

she worried about physical abuse at home? Is she worried about 

emotional abuse at home? 

I will tell you a very quick story, since you know New York. We 

have a large immigrant population, and one of my first patients, 

an arrival from Honduras, had been in New York for about a year. 

She came in under the guise of coming in just for a school physical. 

In the course of my history taking, I realized that she hadn’t had 

a period in two or 3 months. A pregnancy test was positive and I 

gave her her options and she told me that she wanted to have an 

abortion but she could not tell her parents because she said they 

were devout Catholics and good girls just don’t do this in our country. 

I gave her some scenarios that I could tell her mother with her 

in the room or she could tell her mother with me in the room, but 

that I would protect her from physical harm. She was concerned 

that her father would beat her up. And, in fact, she did allow me 

to tell her mother with her in the room, and as soon as I told the 

mother that her daughter was pregnant, she got up to hit her, and 

luckily my reflexes were faster 15 years ago and I was able to stop 

that from happening. 

This is real world stuff, and the things that these girls are worried about occurs every day. Again, it is a minority. The vast majority of my patients do say, yes, this is important, after I explain 

to them this is a surgical procedure and if there is a problem after, 

somebody needs to know. Somebody needs to drive you to the hospital. Somebody needs to bring you home. But sometimes it is not 

the parent that is the perfect person to let in on this difficult situation. 

Mr. NADLER. Thank you. Let me ask the last question. The 

health exception in this bill, which says you don’t have to—the 

health exception is only for life-threatening conditions. Is that, 

from your knowledge of the state of the law now, the Stenberg decision and others, is that anywhere close? Or let me ask Professor 

Myers. Unfortunately, we don’t have—on our side, we were only 

permitted one-quarter of the witnesses. We don’t have a lawyer 

here, a sympathetic lawyer, but let me ask Professor Myers—not 

sympathetic to my point of view. 

How can you justify when the Stenberg case of the Supreme 

Court clearly said you have to have both a life and health exception 

to allow this sort of, these requirements in a bill in order to render 

it constitutional, this is clearly only with life-threatening. How can 

this possibly be constitutional? 

Mr. CHABOT. The gentleman’s time has expired, but you can answer the question. 

42

Mr. MYERS. It seems to me from looking at the Supreme Court 

cases is that when the Court insists on a life and health exception, 

a broader health exception, as you suggest, they are in situations 

where the law actually prevents somebody from getting an abortion. In these situations, what we are talking about are notice provisions that the Court has been much more sympathetic to and has 

upheld in virtually every case because the Court takes the view 

that a notice, unlike a veto or some other law that tries to actually 

ban abortions in certain circumstances, doesn’t really present a 

burden on the woman. At least, that is how the courts evaluate it. 

So I would say that the broader health exception isn’t necessary 

under the Supreme Court cases. 

Mr. CHABOT. The gentleman’s time has expired. 

The gentleman from Arizona, Mr. Franks, is recognized for 5 

minutes. 

Mr. FRANKS. Thank you, Mr. Chairman. 

Mrs. Carroll, notwithstanding the expertise and the erudite 

knowledge of the rest of the panel here, it seems to me that your 

testimony is one of first-hand knowledge, and it is always a very 

powerful thing when someone who has actually experienced a circumstance is able to speak to the issue. For my part, I just express 

a sincere gratitude to you for having the courage to come before 

this Committee. I know it can’t be easy to come before a Congressional Committee, and yet it seems easy to examine the motivations for being here. You know, this was your daughter. This is 

your daughter that was taken without your permission——

Mrs. CARROLL. Yes, sir. 

Mr. FRANKS.—in a sense, exploited and really abused for someone else’s purpose. It seems that oftentimes we forget that sometimes abortion is done not for a young girl, but to a young girl by 

a man for the sake of another man. 

Mrs. CARROLL. Right. 

Mr. FRANKS. I just, again, express my encouragement to you for 

being willing to come down and do this. I know it is not only protecting your own daughter, but the hope that, somehow, this will 

protect a mother in the future from having to go through what you 

went through. 

I guess my question to you is, with all of the heartache and the 

loss of your grandchild and the abuse of your child, what have been 

the long-term effects, if any, on your daughter at this point? What 

is her state of mind now? Do you think she suffers from any of 

the—that this has had a negative long-term effect on her? 

Mrs. CARROLL. Well, it happened not too long ago, but she does 

suffer. She has gone to counseling for this. I just know that she 

cries and she wishes that she could redo everything, relive that day 

over. It is just sad that it had to happen this way and this is how 

she had to, you know, this is what she had to go through. But she 

did want me to come here today and speak on her behalf, because 

she said, ‘‘Mom, just one phone call was all it would have taken 

to stop this from happening to another girl,’’ and I said, yes, just 

one phone call. And so she asked me to come here just for her sake 

and for other girls’ safety to speak and let you know what was happening. 

43

There are going to be long-term effects, and she understands 

that. But I let her know that everything will be all right eventually 

and that she can overcome any obstacle and just to be strong. God 

will get us through this. 

Mr. FRANKS. You said that maybe one phone call could have 

made the difference in her case. Do you think that that would indicate that maybe if this law had been in place at the time, that it 

would have either been a deterrent to those taking your daughter 

across State lines or would have been in her own mind? Do you 

think it could have helped——

Mrs. CARROLL. Yes, I think it could have, because when they 

came to my house one time, I asked them to please stop coming by 

and stop harassing us and they told me they weren’t harassing us, 

that they had spoken to a lawyer. So I am sure that they had help 

on how to get by the laws of our State, because I told them, I said, 

well, if you have spoken to a lawyer, then you can sign away all 

your rights and you won’t be bothered again and then you won’t 

have to bother us any more. And it is just—I know that one phone 

call would have saved her. She told me that she was the only—she 

was the youngest girl in there, she thought, and she was the only 

one crying, and nobody questioned that, really, you know. 

Mr. FRANKS. I just again reiterate my gratitude to you and just 

respect for you——

Mrs. CARROLL. Thank you. 

Mr. FRANKS.—because it was kind of difficult, I am sure, to hear 

some of the arguments that are made in opposition to something 

like this. I mean, sometimes we just have got to open our eyes and 

put all of the nonsense aside and say, what are we really talking 

about here? We are talking about parents——

Mrs. CARROLL. Right. 

Mr. FRANKS.—whose children are taken without their permission 

across the State line to have another child killed, and it is astonishing to me that somehow we are so erudite and so sophisticated 

that we miss that basic, fundamental, undeniable point. It is beggars’ comprehension. 

Mrs. CARROLL. Right. 

Mr. FRANKS. But yet you have had the courage to see above all 

that and I encourage you and wish you the best for your daughter 

and for your future. 

Mrs. CARROLL. Thank you. 

Mr. FRANKS. Thank you. 

Mr. CHABOT. The gentleman’s time has expired. 

I would note for the panel, both here and down there, that light 

over there is apparently on the blink. This light is still functioning 

over here. 

The gentleman from Virginia, Mr. Scott, who was kind enough 

to come to my district recently and we had, I thought, an excellent 

hearing there, a field hearing, and so I want to thank him again 

for making that trip and sorry that we had weather here and your 

flight got canceled and everything, but I understand you got back 

home. I am not taking your time here, by the way, in my rambling. 

[Laughter.] 

44

Even though he and I may disagree on this issue, I have a great 

amount of respect for him. Now you can disregard everything he 

says from here on. [Laughter.] 

Just kidding. Mr. Scott is recognized for 5 minutes. 

Mr. SCOTT. Thank you, Mr. Chairman. I appreciate your holding 

the hearing in Cincinnati. It shows that there are things that we 

can work on and agree on. Unfortunately, there are also things 

that we disagree on. 

I would ask Dr. Seigel, following up on that last question, I don’t 

think you got to the end of your testimony. Have medical organizations taken a position on mandatory notice and consent laws? 

Dr. SEIGEL. Yes. Actually, PRCH is in agreement with leading 

medical organizations on this issue. The AMA, for example, the 

American College of Obstetrics and Gynecology, the American College of Physicians, and the American Public Health Association all 

oppose mandatory parental involvement laws because they endanger the health of adolescents and impose undue burdens on physicians. 

Additionally, the American Academy of Pediatrics and the Society for Adolescent Medicine have opposed similar legislation entitled the Child Custody Protection Act, which is currently under 

consideration in the Senate as S. 8, because of the harm that it 

may cause adolescents. 

Mr. SCOTT. And so, on balance, they have judged that children 

would be more endangered with the passage of this bill than 

helped? 

Dr. SEIGEL. Correct. However, all——

Mr. SCOTT. Do they take the position that it is a good idea to encourage the children to seek parental involvement? 

Dr. SEIGEL. Not only do all of those organizations encourage that 

appropriate counseling for young women include them divulging 

the pregnancy to the parents, but also they have pushed us to start 

teaching it in medical schools, to our residents, to our fellows, in 

all of our programs throughout the country. This is the standard 

of care of medicine as it should be in this country right now, and 

to do anything less, in my view, is just not appropriate. 

Mr. SCOTT. Thank you. Professor Myers, you mentioned that you 

don’t need a health exception in this bill. It has no health exception. Is your——

Mr. MYERS. Well, it has a variety of exceptions that I think are 

crafted to protect——

Mr. SCOTT. Does it have a health exception? 

Mr. MYERS. It has the—there is an exception for—there is a judicial bypass in the minor’s home State——

Mr. SCOTT. Does it have a health exception? 

Mr. MYERS. It has an exception for the life situation and in the 

sexual abuse and neglect situation. 

Mr. SCOTT. It has a partial life exception. Does it have a health 

exception? Well, let me just say it has no health exception. Can you 

cite any case that supports the contention that you do not need a 

health exception in this bill? Carhart v. Stenberg would suggest 

that you need a health exception. Can you cite a case that would 

suggest that you do not need a health exception? 

45

Mr. MYERS. I think, as I mentioned earlier, I think the understanding of Stenberg was based on the Court’s view that the law 

there actually prohibited abortions in certain situations because of 

the definition. 

Mr. SCOTT. So you are citing—— Mr. MYERS. So in that situation—— Mr. SCOTT. You are citing, Stenberg, then, as the case that we 

should rely on? 

Mr. MYERS. No. What I am saying is it required a health exception because the law was an actual obstacle to a woman getting an 

abortion. 

Mr. SCOTT. Can you cite a case that we can review—can you cite 

the name of a case that we can review to lead us to the conclusion 

that you don’t need a health exception in this bill? 

Mr. MYERS. I think the——

Mr. SCOTT. The name of a case. 

Mr. MYERS. The case that I think has the best understanding of 

the Supreme Court’s case law in this area is the Fourth Circuit 

cases, Blueridge? 

Ms. COLLETT. Hodgson v. Minnesota, Representative Scott, is a 

United States Supreme Court case where there was no health exception and it involves a parental notice act. 

Mr. SCOTT. Thank you. Ms. Collett, in two States, adjoining 

States, I guess Washington and Oregon, neither of which has any 

parental involvement law, if you go from one to the other, does this 

bill require parental notification? 

Ms. COLLETT. Yes, it will. 

Mr. SCOTT. Even though neither State has that provision? 

Ms. COLLETT. That is correct. 

Mr. SCOTT. Professor Myers, if the Commonwealth of Virginia 

feels that casino gambling is immoral, under the idea and the principles in this bill, could we pass legislation prohibiting these buses 

from gathering up people and transporting them across State lines 

to go to Atlantic City, New Jersey to gamble in a casino? 

Mr. MYERS. I think it is the sort of thing, and I teach conflicts 

of law, as happens all the time, where States as long as they have 

a proper interest—— Mr. SCOTT. Is the answer yes? 

Mr. MYERS.—in protecting their residents have an interest in applying their law—— Mr. SCOTT. I am almost out of time. Do you feel that is a yes? 

Mr. MYERS. Well, I think that one is this is a Federal law, so 

whether the State of Virginia has that authority is really immaterial. I think that they do have the right to legislate——

Mr. SCOTT. Let me ask a couple of other quick questions. Under 

the bill, is it legal for the teenager to cross State lines by herself? 

That would not be a violation of this bill, is that right? 

Mr. MYERS. The law doesn’t focus on the minor. 

Mr. SCOTT. Would it be legal to transport someone to the State 

line, without crossing the State line, and then dropping the child 

off at the State line? Would that be legal under the bill? 

Mr. MYERS. It turns on transporting somebody across the State 

lines for the—— Mr. SCOTT. Would an older sister——

46

Mr. MYERS.—purpose of evading their home State’s law. 

Mr. SCOTT. Would an older sister be vulnerable under this act? 

Mr. MYERS. It applies to persons who have the proper mens rea 

who are trying to transport a minor for purposes of evading her 

home State’s law, so yes, it applies—— Mr. SCOTT. That would include an older sister? 

Mr. MYERS.—it applies to—yes, it doesn’t have an exception 

for——

Mr. SCOTT. And finally, if you catch a taxicab and in the conversation in the back make it clear that you are going from Kansas 

City, Kansas, to Kansas City, Missouri, for the purpose of getting 

an abortion and evading some parental consent laws, is the taxicab 

driver vulnerable under the bill? 

Mr. MYERS. I think it is really unrealistic to think that they 

would fall within the statutory requirement of knowingly transporting with the intent of abridging the rights of parents. So if you 

actually had a taxicab service that was set up for the purpose of 

evading the State law——

Mr. SCOTT. So if you had a taxicab driver——

Mr. MYERS.—fine, but in this situation——

Mr. SCOTT.—who listens to the conversation—— Mr. MYERS.—that you describe, I don’t think that would fall 

within the definition of this statute. 

Mr. SCOTT. If you listen to the conversation where the teenager 

says, ‘‘Please take me to the abortion clinic. I can’t get my parents’ permission here. Take me across State lines,’’ the taxicab driver 

would or would not be vulnerable? 

Mr. MYERS. I don’t think they would have the requisite intent 

under the statute. 

Mr. CHABOT. The gentleman’s time has expired, and I think that 

gentleman asked that same probing question in the last hearing 

and I think it was basically that the principal objective of the taxicab driver is to receive a fare, not to transport somebody for the 

purpose of getting an abortion, and so, therefore, probably 

wouldn’t—— Mr. NADLER. Mr. Chairman, if I may comment, with all due respect to Professor Myers, the moment that taxicab driver knows 

the purpose of the trip, if he is crossing the State line, he is doing 

it with knowledge and intent. He would clearly be vulnerable under 

this Act. 

Mr. CHABOT. I would encourage taxicab drivers not to do that. 

[Laughter.] 

But if they did, we can see if they would be prosecuted or not. 

The gentleman from Iowa, Mr. King, is recognized for 5 minutes. 

Mr. KING. Thank you, Mr. Chairman. I want to thank the witnesses for their testimony today and I regret that there was a large 

part of it that I missed. I have been able to review some of the testimony and I do know I would say, Mrs. Carroll, how difficult that 

is to come before this Committee and give this testimony. 

I am curious, with all that you have been through as a family, 

have you had any contact with the family of the father, either the 

father or his family, since this time? 

Mrs. CARROLL. No. They never contacted me to check on my 

daughter at all. She has spoken with him—the boy at school. 

47

Mr. KING. Does that continue? 

Mrs. CARROLL. Yes, at school. 

Mr. KING. Thank you. And Dr. Seigel, your testimony focused to 

some degree on the burdens imposed upon people that are seeking 

an abortion, that being a professional opinion of you as a doctor. 

I am wondering if that burden in transportation or finances or 

delay, that being a professional opinion, what you might have is a 

professional opinion with regard to any psychological damage that 

might be caused to the young lady who got the abortion and to the 

people who carry the guilt who carried her across the State line. 

Dr. SEIGEL. Well, first, I am not here giving my personal opinions. I am speaking on behalf of PRCH as well as the other organizations that I am a leader in, which is the American Academy of 

Pediatrics. So my concerns here are not just about the health concerns and health risks to the young woman who is having an abortion, but also the psychological risks, and that is one of the reasons 

I am concerned that there is inadequate language in CIANA to protect the psychological health as well as the physical health of adolescents, and that is one of the reasons we are opposed to CIANA. 

I am concerned because everyone involved in the care of this 

young woman becomes criminalized—the family who helps this adolescent, the physician who helps this adolescent, as was mentioned earlier, not just an older sibling, but a grandmother. 

Mr. KING. Doctor, from a personal and human perspective, do 

you believe that the people who organized and transported this 

woman’s daughter across the State line. circumvented the parental 

responsibility, do you think they should carry any moral guilt? 

Dr. SEIGEL. I believe, in addition, the medical community let 

Mrs. Carroll and her family down, as I—unfortunately, I don’t 

think you were here, but I did say that. I believe that we are all 

justifiably at fault. The medical community standard of care is to 

make sure that an adolescent is consenting to whatever she does 

and get an adult involved. However, I do not believe that the government can mandate good family communication. 

Mr. KING. Do you recognize that Mrs. Carroll’s daughter carries 

guilt, as well? 

Dr. SEIGEL. Absolutely, and I, as a physician, am embarrassed——

Mr. KING. And when you weigh that psychological burden that 

she will carry against the inconvenience for a young co-ed on a college campus that you allege would be brought about by this legislation, and then your testimony that college students would be negatively affected when seeking an abortion at a clinic, and you weigh 

that against, in your professional opinion, the inconvenience as 

compared to the guilt? 

Dr. SEIGEL. I wouldn’t characterize this as an inconvenience. If 

we are talking about later-term abortions, we are talking about significant medical risks. So I would not—I think it is a 

mischaracterization to call it an inconvenience. 

Mr. KING. Thank you, Dr. Seigel, and I would direct my next 

question, then, to Professor Myers. Professor Myers, I would ask if 

you could address the subject matter for this Committee and for 

the record with regard to three rights that are in our Declaration—

48

life, liberty, and the pursuit of happiness. Could you define as to 

whether they are co-equal rights or prioritized rights? 

Mr. MYERS. I think that, really, the right to life is the basic objective. If you don’t have that, you really don’t have any other—any 

right at all, so I think that that is really the fundamental right. 

This law is designed to protect that in a sense kind of indirectly 

by having parents involved in important life decisions of their 

minor children. It seems to me that it is entirely supportive of that 

core right. 

Mr. KING. I thank you, Dr. Myers, and I just conclude with this, 

that it is my opinion that they are prioritized rights, that the right 

to life is paramount over anyone’s liberty and no life should be 

taken because someone else wanted to exercise their liberty, and 

neither should someone’s pursuit of happiness infringe upon the 

liberty of anyone else. So I will argue that there are prioritized 

rights founded by our Founders and I think that is what we need 

to keep in mind in this and I fully support this bill. 

Thank you, Mr. Chairman. 

Mr. CHABOT. Thank you. The gentleman’s time has expired. 

Mr. NADLER. Mr. Chairman? 

Mr. CHABOT. Yes, the gentleman from New York? 

Mr. NADLER. I just want to point out briefly, especially for Congressman King’s benefit, who wasn’t here earlier, that in questioning earlier, it was conceded essentially by everybody that the 

conduct of the people involved with Mrs. Carroll’s daughter was not 

only unconscionable, but violated four or five different criminal 

laws in existing law. 

Mr. CHABOT. All right. I want to thank the panel for coming here 

this afternoon. I think this testimony was very helpful. We want 

to, especially, Mrs. Carroll, thank you for appearing here this afternoon and we are very sorry for the experience that you and your 

family had in this matter. So again, we want to thank everyone for 

being here. 

If there is no further business to come before the Committee, we 

are adjourned. Thank you. 

[Whereupon, at 3:49 p.m., the Subcommittee was adjourned.] 

(49)

A P P E N D I X 

MATERIAL SUBMITTED FOR THE HEARING RECORD

PREPARED STATEMENT OF THE HONORABLE STEVE CHABOT, A REPRESENTATIVE IN

CONGRESS FROM THE STATE OF OHIO, AND CHAIRMAN, SUBCOMMITTEE ON THE

CONSTITUTION

Good afternoon. I’d like to thank everyone for being here for this very important 

legislative hearing. Today, the House Constitution Subcommittee will examine H.R. 

748, the ‘‘Child Interstate Abortion Notification Act,’’ commonly known as SEEANNA (‘‘CIANA’’), which was recently introduced by my colleague, the distinguished 

gentlewoman from Florida, Congresswoman Ileana Ros-Lehtinen. I would like to 

thank Congresswoman Ros-Lehtinen for her leadership on this issue. 

CIANA’s predecessor, the Child Custody Protection Act (CCPA) also introduced by 

Congresswoman Ros-Lehtinen, received broad support, passing the House on three 

separate occasions, including the 105th, 106th, and 107th Congresses. 

This hearing is the first step in ensuring that CIANA not only passes the House 

in the 109th Congress, but is enacted into law. 

We have an expert panel with us today, and I would like to thank them for taking 

the time to share their knowledge and expertise with us. 

Obtaining an abortion is a life-altering event, as we have heard and seen on numerous occasions. The medical, physical, and emotional impact on women can be 

long lasting. 

CIANA would ensure that young girls who are seeking an abortion receive the 

care and support they need by enforcing existing state parental notification laws 

and providing for a federal notification law that protects parental rights when a 

minor crosses state lines into a state without a notification law. 

CIANA would make it a federal offense to cause the circumvention of a valid state 

parental consent or notification law by knowingly transporting a minor across a 

state line with the intent that she obtain an abortion. In addition, CIANA builds 

on the Child Custody Protection Act by also requiring that an abortion provider in 

a state without a parental involvement law notify a parent, or if necessary a legal 

guardian, before performing an abortion on a minor girl who is a resident of a different state. 

This requirement would be applicable unless the minor has already received authorization from a judge in her home state pursuant to a ‘‘judicial bypass’’ procedure, or unless she falls into one of the carefully drafted exceptions to cover cases 

of abuse or medical emergencies. 

Statistics show that approximately 80% of the public favors parental notification 

laws. Forty-four states have enacted some form of a parental involvement statute. 

Twenty-three of these states currently enforce statutes that require the consent or 

notification of at least one parent or court authorization before a young girl can obtain an abortion. 

Such laws reflect widespread agreement that the parents of a pregnant minor are 

best suited to provide counsel, guidance, and support as she decides whether to continue her pregnancy or to undergo an abortion. 

Despite widespread support for parental involvement laws and clear public policy 

considerations justifying them, substantial evidence exists that such laws are regularly evaded by individuals who transport minors to abortion providers in states 

that do not have parental notification or consent laws. 

Confused and frightened young girls are routinely assisted by adults in obtaining 

abortions and are encouraged to avoid parental involvement by crossing state lines. 

Often, these girls are guided by those who do not share the love and affection that 

most parents have for their children. Personal accounts indicate that sexual predators recognize the advantage they have over their victims and use this influence to 

50

encourage abortions in order to eliminate critical evidence of their criminal conduct, 

and, in turn, allowing the abuse to continue undetected. 

Furthermore, when parents are not involved in the abortion decisions of a child, 

the risks to the child’s health significantly increase. Parental involvement will ensure that parents have the opportunity to provide abortion providers with the minor’s complete medical history and necessary information prior to the performance 

of an abortion, information that may have life or death consequences for the minor. 

Parental involvement in the after care of a minor’s abortion procedure is also critical 

in preventing or curtailing complications such as infection, perforation, or depression, which if left untreated may be fatal. 

Public policy is clear that parents should be involved in decisions that their 

daughters make regarding abortion. CIANA will assist in enforcing existing parental involvement laws that meet the relevant constitutional criteria and will provide 

for parental involvement when minors cross state lines to have abortions in states 

without parental involvement laws. The safety of young girls and the rights of parents demand no less. 

Again, I would like to thank our witnesses for being here today.

PREPARED STATEMENT OF THE HONORABLE JERROLD NADLER, A REPRESENTATIVE IN

CONGRESS FROM THE STATE OF NEW YORK, AND RANKING MEMBER, SUB- COMMITTEE ON THE CONSTITUTION

Thank you, Mr. Chairman. 

When we last considered this legislation, I honestly did not believe that the authors could possibly come up with a bill that would be more dangerous, more destructive, of the well being and the rights of young women. 

I am humbled to admit that I suffered from a paucity of imagination that clearly 

does not afflict some on the other side of the aisle. I am truly stunned by this latest 

crazy quilt of restrictions which can have obviously has but one purpose: to impede 

the practice of medicine, to ensure that young women will have as few options as 

possible, and to teach those states, like mine, that do not believe the best way to 

promote adolescent health, and deal with the very real problems these young women 

often experience, is with draconian laws that prevent doctors and caring responsible 

adults from helping these young women who may have nowhere else to turn. 

Often, that adult is a grandparent, or a sibling, or a member of the clergy. In 

some cases, the young woman may not be able to go to her parents. Indeed, sometimes, the parents may pose a threat to the life and health of the young woman. 

That’s what happened to Spring Adams, a 13 year old from Idaho. She was shot 

to death by her father after he found out that she planned to terminate a pregnancy—one he caused by his acts of incest. 

I know that some of my colleagues might not see a problem forcing a doctor to 

ring Mr. Adams’ doorbell to tell him they are planning to perform an abortion on 

his daughter. There has been longstanding and vigorous opposition to laws, including the Freedom of Access to Clinic Entrances Act, which aim to protect doctors and 

their patients from violent fanatics. 

This bill also uses a narrow definition of medical emergency that seems to have 

been lifted from one of Alberto Gonzalez’s infamous torture memos. ‘‘The prohibition 

of subsection (a) does not apply if the abortion was necessary to save the life of the 

minor because her life was endangered by a physical disorder, physical injury, or 

physical illness, including a life endangering physical condition caused by or arising 

from the pregnancy itself.’’ That clearly falls far short of the Supreme Court’s requirement that any restriction on the right to choose must have an explicit exception to protect the life or health of the woman. There are many things far short of 

death that threaten a young woman. She deserves prompt and professional medical 

care, and the Constitution still protects her right to receive that care. 

Congress should not be tempted to play doctor. It is always bad medicine for 

women. 

We want to encourage families to work together to face difficult situations, and 

we want to provide young women facing these life altering decisions with all they 

help we can. In an ideal world, loving, supportive, and understanding families would 

join together to face these challenges. That’s what happens in the majority of cases, 

law or no law. 

But we do not live in a perfect world. Some parents are violent. Some parents 

are rapists. Some young people can turn only to their clergy, to a grandparent, a 

sibling, or some other trusted adult. We should not turn these people into criminals 

simply because they are trying to help a young woman in a dire situation. 

This bill is the wrong way to deal with a very real problem. 

51

I want to join the Chairman in welcoming our witnesses, and I look forward to 

their testimony.

PREPARED STATEMENT OF THE HONORABLE STEVE KING, A REPRESENTATIVE IN

CONGRESS FROM THE STATE OF IOWA

Thank you, Chairman Chabot, for holding this hearing today, and to our witnesses for sharing their experiences and knowledge with us. The Child Interstate 

Abortion Notification Act is necessary to uphold state parental consent and notification laws. 

A vast majority of Americans support parental involvement and notification laws, 

which protect parents’ roles when their daughters are making such an important 

life decision as whether to abort their pregnancies. Based on this support, 44 states 

have passed parental involvement statutes. Twenty-three of those states require 

that a parent either be notified of or consent to their minor daughter’s abortion. Despite all this public effort, these laws are regularly evaded by adults who transport 

children across state lines to obtain abortions in states without parental involvement laws. In many of these cases, the adult doing the transportation is a man who 

has sexually assaulted the minor, and the abortion a cover-up for his crime. 

Even the most vocal of abortion supporters recognize the psychological trauma 

abortion causes women. Coined by President Clinton, abortion advocates everywhere 

now use the tagline ‘‘safe, legal, and rare.’’ Senator Clinton even acknowledges that 

abortion is a sad and tragic choice. For teenagers, unexpected pregnancy is most 

often a panic-inducing situation. To make a decision that will so greatly impact the 

rest of their lives, girls need parental support and advice. States, by and large, have 

recognized this. They need our help to be able to realize their goal. 

Thank you, Mr. Chairman.

PREPARED STATEMENT OF THE HONORABLE ILEANA ROS-LEHTINEN, A

REPRESENTATIVE IN CONGRESS FROM THE STATE OF FLORIDA

I would like to begin by commending Chairman Chabot for his outstanding leadership, and especially for holding this important hearing. Mr. Chairman, thank you 

for considering this vital piece of legislation. 

Abortion is perhaps one of the most life-altering and life-threatening of procedures. It leaves lasting medical, emotional, and psychological consequences. 

Although Roe v. Wade legalized abortion in 1973, it did not legalize the right for 

persons other than a parent or a guardian to decide what is best for a child. Nor 

did it legalize the right for strangers to place our children in a dangerous or potentially fatal situation. 

In our society, there are many rules and regulations aimed at ensuring the safety 

of our nation’s youth through parental guidance. At my alma mater, Southwest 

High School in Miami, as in many of our schools, a child cannot be given aspirin 

to relieve a simple headache or cramp, unless the school has been given consent by 

at least one parent or legal guardian. 

Most schools, require permission to take minors on field trips and, in many 

schools, parents have the ability to decide whether or not to enroll their children 

in sexual education classes. Every one of these principles emphasize that parents 

should be involved in decisions that can seriously affect their children. The decision 

of whether or not to obtain an abortion, a life-altering, potentially fatal and serious 

medical procedure, should be no exception to these rules. 

Designed to ensure children’s safety, cosmetic ear piercing requires parental consent for fear that girls may pick up dangerous infections. Who ensures safety for 

young girls who are ill advised to disobey state laws and are taken to undergo a 

highly dangerous procedure that may tragically result in death or severe medical 

complications? 

As a mother of two teenage daughters, I realize the profound impact that a positive relationship with one’s primary caregiver has on the development of our most 

important resource, our young people. I believe that I have a right to know what 

is going on in my daughters’ lives, especially with regard to a potentially life threatening medical procedure. We must ensure that our most precious natural resource, 

our children, are protected and afforded every opportunity to succeed. 

My legislation, the Child Interstate Abortion Notification Act will incorporate all 

of the provisions previously contained in the Child Custody Protection Act (H.R. 

1755 in the 108th Congress), a bill that the House has passed in 1998, 1999, and 

52

1This statement is substantially identical to the statements I provided the Subcommittee with 

respect to H.R. 1755 in the 108th Congress, H.R. 476 in the 107th Congress, and H.R. 1218 

in the 106th Congress. 2Darby overruled Hammer v. Dagenhart, 247 U.S. 251 (1918), which held unconstitutional a 

ban on interstate shipment of goods made with child labor. The Court in Hammer found that 

the statute was in excess of the commerce power, even though it regulated only interstate transportation, because its purpose was related to production, which is a local activity. 

2002, making it a Federal offense to transport a minor across state lines to circumvent that state’s abortion parental notification laws. 

In addition, the bill will require that in a state without a parental notification requirement, abortion providers are required to notify a parent. It will protect minors 

from exploitation from the abortion industry, promote strong family ties, and will 

help foster respect for state laws. 

This historic legislation will put an end to the abortion clinics and family planning organizations that exploit young, vulnerable girls by luring them to recklessly 

disobey state laws. 

I am proud to have introduced this critical legislation less than one month ago 

with the bipartisan support of 105 original cosponsors. I am hopeful that it will pass 

again. 

About 80% of the public favors parental notification laws, and over 30 states have 

enacted such laws. Yet, these laws are often evaded by interstate transportation of 

minors, often openly encouraged in advertising by abortion providers. 

Parental consent or parental notification laws may vary from state to state, but 

they are all made with the same purpose in mind: to protect frightened and confused adolescent girls from harm. 

I thank you, Mr. Chairman, for considering this vital piece of legislation, and I 

hope that this subcommittee will support H.R. 748 for the purpose of upholding 

safety laws designed by individual states; a bill that will protect parents’ rights to 

be involved in decisions involving their minor children, will work to strengthen the 

bonds of America’s families, and most importantly will ensure that America’s youth 

have a safer, healthier, and brighter future.

PREPARED STATEMENT OF DR. JOHN C. HARRISON, PROFESSOR OF LAW,

UNIVERSITY OF VIRGINIA

The Subcommittee has asked that I give my views concerning Congress’ power to 

enact Section 2 of H.R. 748, the Child Interstate Abortion Notification Act. 1

The proposed legislation would make it a federal crime knowingly to transport 

across a state line ‘‘an individual who has not attained the age of 18 years . . . with 

the intent that such individual obtain an abortion, and thereby in fact [to abridge] 

the right of a parent under a law requiring parental involvement in a minor’s abortion decision, in force in the State where the individual resides.’’

Section 2 of H.R. 748 is a regulation of commerce among the several States. Commerce, as that term is used in the Constitution, includes travel whether or not that 

travel is for reasons of business. E.g., Caminetti v. United States, 242 U.S. 470 

(1917). To transport another person across state lines is to engage in commerce 

among the States. There is thus no need to address the scope of Congress’ power 

to regulate activity that is not, but that affects, commerce among the States, see, 

e.g., A.L.A. Schechter Poultry Corp. v. United States, 295 U.S. 495 (1935); Wickard 

v. Filburn, 317 U.S. 111 (1942); Katzenbach v. McClung, 379 U.S. 294 (1964); United 

States v. Lopez, 514 U.S. 549 (1995). 

Under the Supreme Court’s current doctrine, Congress can adopt rules concerning 

interstate commerce, such as this one, for reasons related primarily to local activity 

rather than commerce itself. United States v. Darby, 312 U.S. 100 (1941). 2Hence 

even if H.R. 748 reflected a substantive congressional policy concerning abortion and 

domestic relations it would be a valid exercise of the commerce power because it 

is a regulation of interstate commerce. 

Even under the more limited view of the commerce power that has prevailed in 

the past, this part of H.R. 748 would be within Congress’ power. This legislation, 

unlike the child labor statute at issue in Hammer v. Dagenhart, does not rest primarily on a congressional policy independent of that of the State that has primary 

jurisdiction to regulate the subject matter involved. Rather, in legislation like this 

Congress would be seeking to ensure that the laws of the State primarily concerned, 

the State in which the minor resides, are complied with. In doing so Congress would 

be dealing with a problem that arises from the federal union, not making its own 

decisions concerning local matters such as domestic relations or abortion. 

53

3The rule of the Webb-Kenyon Act currently appears in Section 2 of the Twenty-First Amendment. 

H.R. 748 in this regard resembles the Webb-Kenyon Act, Act of March 1, 1913, 

37 Stat. 699, which dealt with a problem posed by then-current dormant commerce 

clause doctrine for States with strong prohibition laws. Such States, under Leisy v. 

Hardin, 135 U.S. 100 (1890), were limited in their power to regulate liquor that was 

shipped from out of state. Under the Webb-Kenyon Act, liquor was ‘‘deprived of its 

interstate character’’ (to use the old terminology) and its introduction into a dry 

State prohibited. The Court upheld the Webb-Kenyon Act in Clark Distilling Company v. Western Maryland Railway Company and State of West Virginia, 242 U.S. 

311 (1917). 3

This statement is concerned with the Commerce Clause, not with the limitations 

on the regulation of abortion that the Court has found in the Due Process Clauses 

of the Fifth and Fourteenth Amendments as they may apply to Section 2 of H.R. 

748. That focus is appropriate, I think, because this aspect of the legislation does 

not raise any questions concerning the permissible regulation of abortion that are 

independent of the state laws that it is designed to effectuate. To the extent that 

a state rule is inconsistent with the Court’s doctrine, that rule is ineffective and this 

bill would not make it effective. Hence it is unnecessary to ask, for example, whether subsection (b)(1) of proposed section 2431 of title 18 would constitute an adequate 

exception to a rule regulating abortion. Because constitutional limits on the States’

regulatory authority are in effect incorporated into proposed Section 2431, subsection (b)(1) is in addition to any exceptions required by the Court’s doctrine. 

This testimony on legal issues associated with H.R. 748 is provided to the Subcommittee as a public service. It represents my own views and is not presented on 

behalf of any client or my employer, the University of Virginia.

54

ABORTION FORM FOR ASHLEY CARROLL, SIGNED BY HER DOCTOR, DR. KAJI AND MATERIALS RELATED TO DR. KAJI AND BRIGHAN CLINICS SUBMITTED BY CHAIRMAN STEVE

CHABOT


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