Document: 428 U.S. 106 96 S.Ct. 2868 49 L.Ed.2d 826 Thomas E. SINGLETON, etc., Petitioner,v.George J. L. WULFF, Jr., et al. No. 74-1393. Argued March 23, 1976. Decided July 1, Syllabus Respondents, two Missouri-licensed physicians, brought this action for injunctive relief and a declaration of the unconstitutionality Missouri statute that excludes abortions are not "medically indicated" from purposes which Medicaid benefits available to needy persons. In response petitioner's preanswer motion dismiss, each respondent averred he had provided, anticipated providing, patients, petitioner, responsible state official, acting in reliance on challenged statute, refused all applications filed connection with such abortions. A three-judge District Court dismissed relevant count complaint lack standing, having concluded no logical nexus existed between status asserted by respondents claim they sought have adjudicated. The Appeals reversed, finding alleged sufficient "injury fact" also an interest "arguably within zone interests be protected . constitutional guarantees question." That court then considered case merits found clearly violated Equal Protection Clause. Held : judgment is reversed remanded. Pp. 112-121; 121-122; 122. 508 F.2d 1211, Mr. Justice BLACKMUN delivered opinion respect Parts I, II-A, III, that: 1 1. Respondents standing maintain suit. fact," I. e., sufficiently concrete outcome their suit make it or controversy subject Court's Art. III jurisdiction. If physicians prevail remove statutory limitation reimbursable abortions, will benefit receiving payment State out pocket amount payments. P. 1112-113. 2 2. should proceeded resolve case, since who has answer other pleading addressed merits, opportunity present evidence legal arguments defense statute. 119-121. 3 BLACKMUN, joined BRENNAN, WHITE, MARSHALL, concluded, Part II-B, as prudential matter, proper proponents particular rights base Though "(o)rdinarily, one may vindicate some third party," Barrows v. Jackson, 346 249, 255, 73 1031, 1034, 97 L.Ed. 1586, here underlying justification rule absent. woman cannot safely secure abortion without physician's aid, impecunious easily being paid State. Aside herself, physician uniquely qualified, virtue his confidential, professional relationship her, litigate constitutionality State's interference with, discrimination against, decision. Moreover, there obstacles woman's assertion her own rights, desire protect privacy deter herself bringing suit, soon become at least technically moot if indigency forces forgo abortion. 113-118. 4 Michael Boicourt, Jefferson City, Mo., practitioner. 5 Frank Susman, St. Louis, respondents. 6 stice (Parts III) together (Part II-B), MARSHALL joined. 7 Like its companions,1 involves unconstitutional decision terminate pregnancy. object challenge excluding posture, however, presents issues going dispute. first whether plaintiff-appellees, perform nonmedically indicated we do. second Appeals, exercising jurisdiction because been properly determination did not. 8 * participates so-called program, under Federal Government partially underwrites qualifying plans medical assistance needy. See 42 U.S.C. § 1396 Et seq. (1970 ed. Supp. IV). Missouri's plan, set Mo.Rev.Stat. §§ 208.151-208.158 (Supp.1975), includes, 208.152, list 12 categories services eligible funding. last is: 9 "(12) Family planning defined federal rules regulations; family shall include unless medically indicated." 10 This provision litigation before us.2 11 was United States Eastern physicians. Each plaintiff avers, affidavit opposition "has anticipates providing welfare patients payments." App. 32, 36.3 plaintiffs further allege affidavits performed them defendant, official,4 208.152(12). 36. It entirely clear these applications. One affiant states "he (his) refused," Id., 32; refers "those submitted payments behalf" "payments refused." Indeed, whom would go were made. We assume, statute's several references "on behalf of" persons, see 208.151 provider himself seeks reimbursement any event, refusals defendant fund avers "deter (him) practice medicine manner considers mosexpertise (Sic ) beneficial said chill thwart ordinary customary functioning doctor-patient relationship." invalidity injunction against enforcement. number grounds stated, among face applied," unconstitutionally vague, "(d)eprives right according highest standards practice"; plaintiffs' fundamental determine bear children"; "(i)nfringes upon render patients' receive safe adequate advice treatment"; "(d) eprives classification, equal protection laws." 16, 12-13. 13 defendant's sole pre-answer dismiss. Dismissal alternative grounds: controversy; lacked "standing raised"; "cannot granted" absence "irreparable harm" plaintiffs; "personally could suffer harm"; deprivation infringement civil patients." 24-25. 14 responded memorandum described above, panel convened hear now us "forack standing." saw "logical seek adjudicated." Wulff Bd. Registration Healing Arts, 380 F.Supp. 1137, 1144 (1974). 15 Eighth Circuit reversed. 1211 reasoned Roe Wade, 410 113, 93 705, 35 147 (1973), Doe Bolton, 179, 739, 201 interpreted earlier decisions, " 'paved way assert medicine,' citing Nyberg City Virginia, 495 1342, 1344 (CA8), appeal cert. denied, 419 891, 95 169, 136 Those 'the advise abortions,' furthermore 'inextricably bound up women abortions.' 1213. Clearly, restriction affected "both professionally monetarily." 1214. result, Appeals' view, 'injury fact,' 'arguably guarantee question,' Ibid., quoting Data Processing Service Camp, 397 150, 153, 90 827, 829, 25 184 (1970). 16 Although matter "not difficulty," F.2d, 1214, next that, "urged appellants" (respondents here), proceed question case. This, rather than remand, validity profit refinement, indeed whose doubt. "obviously unconstitutional," therefore appeared "that might well decided judge." 1215. court, accordingly, chose "to final case." Ibid. Proceeding "clear violation Clause." constituted "special regulation abortion," discriminated againsboth patient "by reason patient's poverty." At 1215-1216. Section 208.152(12) declared Appeals. Injunctive felt unnecessary, assumed comply cease seeking therapeutic nontherapeutic 1213-1216. granted certiorari, limited questions identified opening paragraph opinion. 422 1041, 2655, 45 692 (1975). II 17 certain separated opinions, distinct presented. distinguished prior cases, g., U.S., 152-153, 829; Flast Cohen, 392 83, 99, n. 20, 88 1942, 1952, 20 947 (1968); 1586 (1953), these: First, plaintiff-respondents is, court's jurisdiction, and, second, whether, 18 A. needs little comment doubt respondent-physicians injury operation Their affidavits, abo, continue operations reimbursed those limitation, benefit, (and Government) parties classically adverse, exists sense. Simon Ky. Welfare Rights Org., 426 26, 37-39, 1917, 1923-1925, 48 450 (1976); Investment Co. Institute 401 617, 620-621, 91 1091, 1093-94, 28 367 (1971); 151-156, 829-31. 19 B. what doctors more difficult. adverted perceived doctor's "constitutional medicine." occasion decide exist. Assuming do, doctors, course, can them. appears, accorded assert, based partly upon, patients. must Jus tertii Was one. courts hesitate resolving controversy, even power resolve, basis persons litigation. reasons two. adjudicate unnecessarily, fact holders either do wish them, able enjoy regardless in-court litigant successful Ashwander TVA, 297 288, 345-348, 56 466, 482-83, 80 688 (1936) (Brandeis, J., concurring) (offering requirement means avoid unnecesry adjudications). Second, themselves usually best rights. depend effective advocacy, prefer construe only when most advocates like preference, extent courts' decisions doctrine Stare decisis. See, Baker Carr, 369 186, 204, 82 691, 703, 663 (1962) (standing aimed "assur(ing) adverseness sharpens presentation (the) so largely depends"); Holden Hardy, 169 366, 397, 383, 390, 780 (1898) (assertion parties' come "greater cogency" themselves). These considerations underlie general rule: "Ordinarily, party." 1034. 99 1952; McGowan Maryland, 366 420, 429, 81 1101, 1106, 393 (1961). 21 rule, applied where justifications With mind, looked primarily factual elements apply person assert. enjoyment inextricably activity wishes pursue, sure construction unnecessary sense right's unaffected Furthermore, party former fully, very nearly, proponent latter. Thus Griswold Connecticut, 381 479, 85 1678, 510 (1965), convicted giving contraception, permitted defendants, aicensed physician, married advised. pointed "confidential" nature defendants latter "likely diluted adversely affected" 481, 1680. Eisenstadt Baird, 405 438, 445-446, 92 1029, 31 349 (1972) (stressing "advocate" "impact third-party interests"); 259, 1036 (owner real estate racial covenant part she "the charge keeping repose(d) use property discriminate discontinue use"). similar Existed patients.5 188-189, S.Ct., 745-46. abortion, Would flatly control instant possible criminal prosecution. 22 element ability right. Even close, requiring nerally still apply. genuine obstacle assertion, party's loses tendency suggest truly stake, important him, becomes default proponent. Thus, NAACP Alabama, 357 449, 78 1163, 1488 (1958), held National Association Advancement Colored People, resisting order divulge names members, First Fourteenth Amendments members remain anonymous. "(t)o require (the right) claimed result nullification moment assertion." 459, 1170. 446, 1034; 1036.6 23 Application principles quickly yields result. closeness patent, Doe. aid exercise whatever dimension, necessarily stake here. constitutionally intimately involved. 153-156, 726-728. therefore, qualified 24 As obstacles. For thing, chilled publicity imminent mootness, technical sense, individual claim. Only few months, most, after maturing undergo thereto irrevocably lost, assuming, seems fair establish eligibility true insurmountable. Suit pseudonym, frequently done. longer pregnant nonetheless retain point 'capable repetition yet evading review.' 124-125, 713. And class assembled, fluid membership always included live claims. But "representative" anyway, loss terms advocacy allowing physician. reasons, conclude generally appropriate allow governmental decision, decline restrict our holding effect purely context.7 respect, affirmed. 26 On record, agree, proceeding beyond issue resolution Petitioner urges particularly inappropriate requested denied district direct find reach contention, respondents' required patently event declaratory warranted. Quite apart considerations, unacceptable appellate 27 noted, complaint's us, petitioner dismiss standing. He answer, merits. interrogatories, but stipulated facts, gave intimation defenses, any, more. dismissal "final decision" appealed from, 1291, underlay it. short, never heard does consider passed below. Hormel Helvering, 312 552, 556, 61 719, 721, 83 1037 (1941), explained "essential offer believe (and) litigants surprised introduce evidence." idea evidence, would, could, proffer evidence. assuming think justified presenting rather, allowed complaint, reinstate 29 [7,8] taken resolved time left discretion appeals, exercised facts cases. announce rule. Certainly circumstances below, doubt, Turner Memphis, 350, 805, 762 (1962), "injustice otherwise result." 557, 721.8 Suffice say Court. so, injustice likely caused avoided deciding heard. 30 Assuming, hold done so. To extent, remanded directions returned file accordingly. ordered. 32 STEVENS, concurring part. 33 (1) plaintiff-physicians financial litigation, (2) impairs They bring action. 34 Because present, I agree analysis II-B BLACKMUN's provides considering am should, sustain dtors' join POWELL, THE CHIEF JUSTICE, STEWART, REHNQUIST join, dissenting 36 holds attack (Supp.1975). erred challenge. both holdings concur opinion, four sentences II-B. 37 remand addition obtaining elective exclusion dissent holding. 38 notes, Ante, 109-110, established invoke judicial system compensate directly1 section preclude intention aboions, deprives compensation. arguments, proved, give personal over constitutionality. Warth Seldin, 490, 498-499, 2197, 2204-2205, 374 (1975); cf. 502-508, 2207-2210; supra, 41-42, 1925-1926. 39 noted Warth, careful reiterate today, 112, inquiry often inquiries necessary entertain instance party. system, actual cases controversies stand court. Kentucky Organization, 1926. Beyond question, lies less prudent clear. various forms, including presented case: defending anticipatorily attacking action, argue contravenes someone else's rights.2 40 "judicial self-governance." 509, 2210. usual wise stance policing cautious reserve. 346-348, concurring). caution given rise defend ground infringes party, ante, 114, corollary exception rest specific factors outweighing policies behind itself.3 257, 1035, (1953); Richardson, 418 166, 188-197, 94 2940, 2952-56, 41 678 (1974) (Powell, plurality acknowledges identifies "two elements" thought derived justify adjudication rights: (i) (ii) existence "relationship" patient. my view Our enlightening. covenantor breached racially restrictive selling Negroes buyers' damages covenantees. Shelley Kraemer, 334 68 836, 1161 (1948). outweighed need (these) rights" situation "in difficult impossible grievance court." 1035. rightholders threat actions breach tended insure into possession land, chance covenantor's failure sell organization resist produce asserting associational anonymity because, 116, (1972), relax permit distributor contraceptives recipients scheme operating deny 43 purports derive principle another's "some obstacle" 116. understates teaching cases: indicate proper, merely "obstacle" rightholder's practicable impossible. framing principle, gone far major precedents. 44 plurality's statement discussion virtually concedes, must, "obstacles" women's chimerical. docket regularly contains women, using pseudonyms, statutes allegedly infringe Nor incipient mootness itself quotes portion 712, shows exists. light experience share reviewing appeals petitions justifying departure simply significant. Rather descendant Barrows, NAACP, Eisenstadt, much closer taxpayers leave low-income persons' case.4 509-510, 2210; 430, 1107, B places primary element, "confidential relationship" rightholder rights.5 Focusing relationships Griswold, Planned Penthood Danforth, 52, 2831, 788, suggests flows naturally three. conclusion couched appropriateness attacks "governmental decision." 115, 118. 46 read merging purposes. support turns confidential physician-patient impact relationship. directly interdicted normal criminalizing procedures. interference, other, self-restraint proscription activity. Meyer Nebraska, 262 625, 67 1042 (1923). interfered neither nor forbidden engage procedure.6 structure payments, causes detriment. Thiaffords aver fact, abandonment salutary C 47 offered special none. persuasive wholly inappropriate, self-governance, unnecessarily nothing remuneration services. precedent prove cabin. No immediately comes today's holding, why client's customer's coverage transaction.7 Putting differently, invites perhaps legitimate parties. Before today certainly compensated services, more, deemed compelling reas departing restraint serves society system. quite recently doctrines self-restraint, "(t)hese fussiness judges. reflect conviction roving commissions assigned pass Nation's laws. Constitutional judgments necessity adjudicating Court." Broadrick Oklahoma, 413 610-611, 2915 (citation omitted). Today's threatens just "roving commissions" courts. Parenthood 788; Bellotti 132, 2857, 844. contained additional counts directed Board concerning relating minors. us. Plaintiffs sued similarly situated 15. Apparently, certified. Defendant Singleton, herein, Chief Bureau Medical Services Division Department Public Health Welfare. 16. reiterated 62, 2837. POWELL objects enough, impossible." Post, 126. Carefully analyzed, far. Negro real-estate purchaser alone stood purchase (as presumably done, amicable posture seller case), surely Alabama Could obtained injunction, suing anonymously pseudonyms. (or counterparts Doe, matter) easy alternatives, differed degree difficulty, all, force pay limit cited, explaining "directly procedures." 128. There language cited distinction, "direct" litigant's conduct provide him "direct interference" "interdiction" test appear supported precedent. Pierce Society Sisters, 268 510, 571, 69 1070 (1925), example, private schools parents children public education, though thereby "interdicted" reduced role supplementing school education. Conversely, DisAllow "criminalizing" Brown States, 411 223, 230, 1565, 1569, 208 (1973) (Fourth Amendment others); 601, 610, 2908, 2914, 830 (rights others free application same statute); 429-430, 1106-07, (1961) (store owners violating Sunday closing laws religious liberty customers). Finally, doctor afford work nothing, refusal ever necessary. nondiscriminatorily funded, denial funding complete voices concern "difficult cabin," "any transaction." 129, 129-130. predict pattern results future elects proceed, assessing decisive pre-eminent importance factors), adopting Per se rules, apparently interdiction" impossibility assertion. Still, Justice's alarm. Unless "provider services" mind enjoys "client" patient, "client's" imminently moot, definitively controlled speculate examples intended exclusive. structured made framed, arguably relies, see, 829-31, (1970), parties, Raines, 362 17, 519, 524 (1960); Dombrowski Pfister, 486-488, 1116, 1120-22, (1965); 611-618, 2915-19, (1973). Cf. 196 18, 2956, plurality, 113-144, policy adjudication. 482-483 perceives advocacy. While relevant, emphasis context requirements. sharpening long touchstone discussion. (1962); (1968). Perhaps accurate formulation consistent concerns plaintiff's remedial powers relief. 508, 2210, 343 38, 1924, (1976). uses formulation. 112-113. focus role, quality preferable area limitations power. 498, 2204; Schlesinger Reservists Stop War, 208, 225-226, 2925, 2934, 706 Congress foreclose competing interest. 500-501, 2206. retrospectively analyzes effort show 116 6. true, expressly emphasized extreme difficulty underestimates confronting would-be vendee attempted race blocked deal covenantor. denigrates members' text page quotes, approvingly, expressing rightholders' course enjoyed protection. Infra, rightly solicitude situation. argued above text, basic disagreement rests Own marked contrast previous position subordinate interests." 445, (1972). suspect inversion weakness argument interests. keep before, factor imparting confidence represented adequately grounds. 2, Supra. contends here," 118 7, cites (1925). precedential value address mention More importantly, school-parent proscribed: sent 'to period during current year,' 530, 572, practical send schools. "(t)he inevitable enforcing act destruction appellees' schools, Oregon." 534, 573. says , rules," implies advocating course. 119 7. proposed rules. Rather, grounded departs. By divining factors, alone, "quickly result," 117, appears articulated new leaves room flexibility. ease substantial abortion-clinic) dimly result" attempt distinguish involving another reassuring. Three distinguishing suggested. one, relationship, analytically empty (especially recognizes realistically, kind assembly-line type clinic). unsupported nearly half relies yielding standing: or, shows, Griswold. suggested distinction "is impaired understand how falls back contention "imminently moot," citation proves irrelevant. three "distinctions" seem insubstantial, repeat:

Category: 8