Opinion ID: 2103784
Heading Depth: 2
Heading Rank: 3

Heading: application of the undue burden standard

Text: In Casey , the United States Supreme Court rejected strict scrutiny as the standard of review for regulations of abortion. In attempting to craft a standard of review that balanced the state's interests in protecting potential life, in regulating maternal and fetal health, and in expressing a preference for childbirth over abortion against a woman's right to terminate her pregnancy, the Court adopted an undue burden standard for statutes regulating pre-viability abortions. See Casey, 505 U.S. at 870-79, 112 S.Ct. 2791. Under the undue burden standard, a statute is unconstitutional only if it has the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus. Id. at 877, 112 S.Ct. 2791. At the point of viability, the State's interest becomes far greater, and it may heavily regulate, or even completely proscribe abortion, except where the procedure is necessary to preserve a mother's life or health. See id. at 879, 112 S.Ct. 2791; see also Stenberg v. Carhart, 530 U.S. 914, ___, 120 S.Ct. 2597, 147 L.Ed.2d 743 (2000).
In Casey , the United States Supreme Court began its analysis of Pennsylvania's abortion statutes by examining the exception for abortions in medical emergencies. The Court did so because it characterized the medical emergency exception as central to the operation of the statute's other provisions. See id. at 879, 112 S.Ct. 2791. The statute defined medical emergency as a condition necessitating immediate abortion to avert [the mother's] death or for which substantial delay will create serious risk of substantial and irreversible impairment of a major bodily function. Id. Planned Parenthood argued that the exception was so narrowly defined that it foreclosed the possibility of an abortion in some circumstances in which the mother would be exposed to a threat to her health. The Court concluded that the statute was sufficiently broad to encompass all serious health risks. See id. at 880, 112 S.Ct. 2791. The Court noted, however, that if the statute did limit abortions in some circumstances in which the health of the mother would be endangered, the statute would have been unconstitutional because the essential holding of Roe forbids a State to interfere with a woman's choice to undergo an abortion procedure if continuing her pregnancy would constitute a threat to her health. Id. The Supreme Court has recently reaffirmed this holding of Casey in Stenberg v. Carhart, 530 U.S. 914, 120 S.Ct. 2597, 147 L.Ed.2d 743 (2000). In striking down a law prohibiting an abortion procedure commonly known as partial birth abortion, the Court noted that the law lacks any exception `for the preservation of the ... health of the mother.' 530 U.S. at ___, 120 S.Ct. 2597 (quoting Casey, 505 U.S. at 879, 112 S.Ct. 2791). In her concurring opinion providing the crucial fifth vote for the majority, though, Justice O'Connor stated that if the Nebraska law was not as sweeping and if it included an exception for the life and health of the mother, then the law would be constitutional in [her] view. Thus, even after Stenberg , any system of abortion regulations must provide a medical emergency exception for the life and health of the mother to pass constitutional muster. Tennessee's abortion statutes contain three separate medical emergency exceptions. Tennessee Code Annotated section 39-15-202(d)(3) (1997) suspends the forty-eight hour waiting period requirement when it would endanger the life of the pregnant woman. In addition, section 202(g) preempts the operation of the informed consent provisions as well as the waiting period when necessary to preserve the life of the pregnant woman. Neither of these provisions contains an exception when the health of the mother is threatened. Tennessee Code Annotated section 39-15-201(c)(3) (1997) does provide that a woman may procure an abortion when necessary to preserve her life or health; however, this section applies only in situations when the fetus is viable. The State argues that the medical emergency provision for the health of a woman in section -201(c)(3) may be read into the medical emergency provisions of section -202. According to the State, the General Assembly added section -201(c)(3) in response to a federal court order enjoining the abortion regulations because they did not contain a medical emergency exception for the life of the mother. The General Assembly, though, also added section -202(g) at the same time. Consequently, while the General Assembly explicitly provided for the exception to apply when the life or health of the mother carrying a viable fetus was threatened in one provision, it provided a medical emergency exception in another section added at the time that covered circumstances only when the life of a woman carrying a pre-viable fetus was threatened. Clearly, the General Assembly knew how to provide for a medical emergency exception for the health of a woman carrying a pre-viable fetus when it so desired, and the absence of the health exception in section -202 must, therefore, be presumed to be intentional. Courts may read terms into the text of a statute when such an interpretation would clearly further the intent of the legislature or when the term to be supplied was clearly omitted only by inadvertence or mistake. See In re Swanson, 2 S.W.3d 180, 186 (Tenn.1999); Knoxville Power & Light Co. v. Thompson, 152 Tenn. 223, 226, 276 S.W. 1050, 1051 (1925). Nevertheless, I cannot conclude under the circumstances that reading the word health into section -202 would further the clear intent of the legislature or that the word health was omitted in section -202 only by inadvertence or mistake. I conclude, therefore, that the plain language of Tennessee's abortion statutes does not provide a medical emergency exception to the challenged regulations when the health of a woman carrying a pre-viable fetus is threatened. Consequently, I am compelled by the United States Supreme Court's decision in Casey to also conclude that the failure to provide a medical emergency exception for the health of a woman carrying a pre-viable fetus is unconstitutional, and that this failure renders the other challenged provisions unconstitutional under the Due Process Clause of the Fourteenth Amendment and the Law of the Land Clause of the Tennessee Constitution. But for this deficiency in the medical emergency exceptions, I would find the remainder of the challenged provisions to be constitutionally sound.
The challenged informed consent provisions of section 39-15-202 can be divided into three components: (1) an attending physician requirement; (2) content requirements; and (3) a mandatory waiting period.