Opinion ID: 2103784
Heading Depth: 1
Heading Rank: 7

Heading: Mandatory Waiting Period

Text: In addition to the attending physician requirement and the content requirements, section -202 also provides that [t]here shall be a two-day waiting period after the physician provides the required information, excluding the day on which such information was given. On the third day following the day such information was given, the patient may return to the physician and sign a consent form. Tenn.Code Ann. § 39-15-202(d)(1) (1997). The Court strikes the down the mandatory waiting period requirement, in part, because it does not further the State's interest in maternal health. This conclusion is largely the product of the Court's inability or refusal to consider the other interests that the State may pursue. A period of reflection not only furthers the State's legitimate interest in a patient's psychological well-being, but a waiting period also furthers the State's interest in expressing a preference for childbirth over abortion. These are legitimate and substantial interests that the State may constitutionally pursue, and the majority's failure to recognize these interests is troubling. The Court also finds the mandatory waiting period unconstitutional because waiting periods require two trips to a physician which may be problematic for women who work, women who are in abusive relationships, and women who travel great distances. I disagree. It is beyond dispute that waiting period requirements are permissible forms of regulation. The idea that important decisions will be more informed and deliberate if they follow some period of reflection [is not] unreasonable, particularly where the statute directs that important information become part of the background of the decision. Casey, 505 U.S. at 884, 112 S.Ct. 2791. This Court's concern with the impact of the waiting period is not a sufficient reason to strike down this provision. In Casey , the United States Supreme Court conceded that waiting periods increased the risk that some women would be exposed to harassment from anti-abortion protesters. See id. at 886, 112 S.Ct. 2791. The Court also observed that a waiting period would be taxing on some women with limited financial resources and those who had to travel long distances. See id. at 885-86, 112 S.Ct. 2791. The Court additionally noted the problems some women would have in explaining absences to husbands, employers, or others. See id. at 886, 112 S.Ct. 2791. While the Court characterized these incidental effects of the waiting period as troublesome, it nevertheless concluded that the waiting period did not constitute an undue burden. See id. The only real distinction between section -202(d) and the Pennsylvania statute in Casey is that the Pennsylvania statute imposed a twenty-four hour waiting period while section -202(d) imposes a forty-eight hour waiting period. However, I do not find this distinction to be critical. The Casey Court upheld Pennsylvania's twenty-four hour waiting period even though it noted the district court's finding that the practical effect [would] often be a delay of much more than a day. 505 U.S. at 885-86, 112 S.Ct. 2791. With an appropriate medical emergency exception in place, any concerns with increased health risks of a two-day delay would be alleviated. Thus, I would find that section 39-15-202(d) does not constitute an undue burden.
Tennessee Code Annotated section 39-15-201(c)(2) (1997) requires that abortions performed after three months of pregnancy but before viability be completed in a hospital as defined in [section] XX-XX-XXX, licensed by the state department of health or a hospital operated by the state of Tennessee or a branch of the federal government. I would find that this statute does not act as a substantial obstacle to women seeking abortions. First, this provision does further the State's interests in protecting both the health of the mother and of the fetus. The Court, in its analysis of this provision, casually disregards any danger of complications arising during the course of an abortion and asserts instead that abortions during the period regulated by section -201(c)(2) can be safely performed in free-standing surgical facilities in addition to hospitals. While this may be true, it is also true that life-threatening complications may indeed accompany an abortion procedure. Such complications can include hemorrhaging, bacterial shock, acute renal failure, septicemia, metritis, parametritis, peritonitis, serious morbidity, and mortality. See F. Gary Cunningham, et al., Williams Obstetrics 506-07 (18th ed.1989). With this in mind, I am not prepared to conclude that the State has no legitimate interest to promote through section -201(c)(2). Hence, I find that section 39-15-201(c)(2) furthers the State's interest in maternal and fetal health within the constitutional limitations set by Casey . [22] I also find that the effect of section -201(c)(2) does not constitute an undue burden. In Casey , the Court expressed concern that statutes might prohibit significant numbers of women from obtaining abortions. See 505 U.S. at 893-94, 112 S.Ct. 2791. Such statutes, the Court concluded, were unconstitutional because they constituted substantial obstacles, thus failing the undue burden test. However, as the Court of Appeals in this case observed, section -201(c)(2) affects less than two percent of all abortions sought in Tennessee. Clearly, significant numbers of women are not precluded from obtaining abortions by section -201(c)(2). While section -201(c)(2) may increase the inconvenience and cost of obtaining an abortion for some women, this is not a sufficient reason to strike down the regulation as unconstitutional. As I noted with regard to the mandatory waiting period, abortion regulations are not rendered unconstitutional because they have such incidental effects. Given the limited number of women affected by section -201(c)(2) and the State's legitimate interests that it protects by regulating this medical procedure, I would uphold its constitutionality under the Due Process Clause of the Fourteenth Amendment and the Law of the Land Clause of the Tennessee Constitution.
In conclusion, I would hold that regulations on the right to obtain an abortion are to be reviewed under the undue burden standard adopted by the United States Supreme Court in Planned Parenthood of Southeastern Pennsylvania v. Casey . The right to obtain an abortion is protected under the state constitution, if at all, by the Law of the Land Clause in Article I, section 8; the history, language, and application of this clause show that its protections are, at most, co-extensive with those afforded by the Due Process Clause of the Fourteenth Amendment. With its opinion today, the majority has failed in its most essential duty to articulate the basis of its decision with a clear and precise rationale, and it has failed to establish an adequate foundation for its decision in legal precedent. While the law certainly must have room to grow and expand as the values and virtues of society change, this growth cannot come from the judiciary without having a firm foundation in reason, precedent, and experience. In holding that abortion regulations are reviewed under a strict scrutiny standard of review, the Court has ignored prior Tennessee law and history, and the use of this standard fails to sufficiently accommodate the important and competing interests involved in this complex issue. Even under the more lenient undue burden standard of review, however, I would find that the medical emergency exceptions are unconstitutional because they operate to prohibit obtaining an abortion when the health of a woman carrying a pre-viable fetus is threatened. But for this deficiency in the medical emergency exceptions, I would find the remainder of the challenged provisions to be constitutionally sound.