Court Opinion

ID: 9563385
Source: CourtListenerOpinion
Date Created: 2023-08-21 18:39:10.790099+00
Date Added: 2024-06-11T09:17:49.031501
License: Public Domain

BURKE, J., Concurring and Dissenting.
The problem of abortion is one which has deeply troubled our nation’s legislators and courts. It commands the most painstaking consideration of the interests of all involved—'the woman who desires an abortion, the physician who' would perform it, the hospital whose facilities would be used, and lastly and of grave importance, the rights of the embryo or fetus itself, viewed by some simply as an appendage of the mother to be removed at will, and by others as a defenseless child with its own rights to protection and life. Inevitably intertwined into the problem are differing, often widely divergent, social, religious, moral and medical attitudes. It is the solemn responsibility of the Legislature to balance and accommodate these various conflicting and competing interests, a task which it accomplished in 1967 with the passage of the Therapeutic Abortion Act. It is the task of the courts to acknowledge and respect this legislative balancing process and to uphold, if at all possible within constitutional limits, the legislative expression of that process.
The period of debate is over, our personal views, probably as divergent as those of the public generally, are set aside. We address ourselves exclusively to the particular legislation before us, and seek to determine its validity solely by reference to those established legal principles available to courts in determining challenges to legislation on grounds of unconstitutionality.
The Therapeutic Abortion Act is the product of seven years of legislative study.1 Innumerable lengthy hearings were conducted to afford the public *340ample opportunity to express its views; representatives from numerous diverse groups addressed the Legislature and made known their respective opinions, allegiances and advice. Countless drafts of proposed legislation were prepared, debated and discarded.2 This lengthy process of hearings, drafting and debate finally culminated in 1967 with the adoption of the Therapeutic Abortion Act, admittedly compromise legislation designed to accommodate as far as possible the opposing interests. The majority herein nullify the Legislature’s seven-year effort by means of a type of constitutional attack which, as I will demonstrate, is not even applicable to this case. I repeat “nullify,” for the majority have removed from the abortion procedure .the most important protective devices designed to' deny a right of abortion simply upon the demand of the mother, a concept flatly rejected by the Legislature.
It is a cardinal principle of law, and one which, I respectfully submit, the majority has failed to apply here, that a statute is presumed to be constitutional unless its unconstitutionality clearly and unmistakably appears; all intendments favor its validity and mere doubt is not a sufficient reason to declare it invalid. (In re Ricky H., 2 Cal.3d 513, 519 [86 Cal.Rptr. 76, 468 P.2d 204]; In re Dennis M., 70 Cal.2d 444, 453 [75 Cal.Rptr. 1, 450 P.2d 296].) The majority invalidate the central provisions of the Therapeutic Abortion Act on the basis of their own doubts that the act’s provisions are sufficiently certain to comply with due process requirements. However, in striking down the heart of the act, the majority have misapplied the so-called “void for vagueness” rule, have misunderstood the proper limits of that rule, and have misconstrued the evident legislative intent underlying the act’s provisions. I now discuss these separate and distinct errors in the majority’s analysis of this case.
1. Health and Safety Code sections 25951 and 25954 are not void for vagueness
a. Section 25951
The pertinent language of subdivision (c) of section 25951, which was adopted from identical language in section 230.3 of the Model Penal Code, requires a finding by the hospital’s medical committee that “[t]here is substantial risk that continuance of the pregnancy would gravely impair the physical or mental health of the mother.” Although the majority claim that they need not resolve the question, they strongly suggest (ante, pp. 327, 328, and fn. 3) that the phrase “substantial risk” is improperly *341uncertain. Further, they also conclude that the words “gravely impair” are impermissibly vague, furnishing an inadequate standard to guide those who must interpret and follow the act’s provisions. To the contrary, this court in People v. Belous, 71 Cal.2d 954 [80 Cal.Rptr. 354, 458 P.2d 194], has already acknowledged the validity of the act’s provisions in this regard: “The further criteria for determining whether an abortion is permissible is the pregnant woman’s physical and mental health. Thus, the test established is a medical one, whether the pregnant woman’s physical and mental health will be furthered by abortion or by bearing the child to term, and the assessment does not involve considerations beyond medical competence.” (Italics added; 71 Cal.2d at p. 971.)
The majority herein evidently believe, contrary to the court’s prior determination in People v. Belous, supra, 71 Cal.2d 954, that the medical staff committee of an accredited hospital will.be incompetent to determine what a “substantial” risk is. Yet this court has recently adopted a test in kidnaping cases which requires a determination which is quite similar. In People v. Daniels, 71 Cal.2d 1119 [80 Cal.Rptr. 897, 459 P.2d 225, 43 A.L.R.3d 677], a case filed one month after the Belous decision, we held that in determining whether particular movements of the robbery victim constituted the crime of kidnaping, the test is whether or not the movements “are merely incidental to the commission of the robbery and do not substantially increase the risk of harm over and above that necessarily present in the crime of robbery itself.” (71 Cal.2d at p. 1139; italics added.) As stated in a subsequent case, People v. Timmons, 4 Cal.3d 411, 415 [93 Cal.Rptr. 736, 482 P.2d 648], “The true test in each case is not mere mileage but whether the movements of the victims ‘substantially increase the risk of harm’ .... [T]he qualifier [“substantially”] is significant.” In Timmons the court recognized that the word “substantially” is a relative one, requiring the exercise of judgment, and that the substantiality of a risk of harm will vary from case to case depending upon the particular circumstances. (4 Cal.3d at p. 416, fn. 2.)
If the “substantial risk” language of the Therapeutic Abortion Act is impermissibly vague, then certainly the same language in our own redefinition of kidnaping should be held too vague to serve as a basis for the imposition of the drastic penalties which accompany that crime. Yet, as we made clear in People v. Daniels, supra, 71 Cal.2d 1119, “The law is replete with instances in which a person must, at his peril, govern his conduct by such nonmathematical standards as ‘reasonable,’ ‘prudent,’ ‘necessary and proper,’ ‘substantial,’ and the like. . . . Yet standards of this kind are not impermissibly vague, provided their meaning can be objectively ascertained by reference to common experiences of mankind.” *342(Italics added; 71 Cal.2d at pp. 1128-1129; see also People v. Victor, 62 Cal.2d 280, 298-300 [42 Cal.Rptr. 199, 398 P.2d 391].)3
If the “substantial risk” and “gravely impair” language of Health and Safety Code section 25951 were truly uncertain, and subject to widely conflicting interpretations from hospital to hospital, we would expect the statistics to disclose such a variation. Yet the majority’s own figures demonstrate that by 1970 the approval rate was relatively uniform throughout the state. (Ante at p. 331.) The variations in earlier years may be explained by a probable initial reluctance on the part of hospitals in certain areas of the state to sanction a practice which, prior to 1967, was not only a felony under the law but also ran counter to fundamental medical responsibility to protect and preserve the life of the fetus, except for the gravest of reasons (such as the preservation of the life of the mother herself).
Giving the language of Health and Safety Code section 25951 a reasonable, common sense construction, the words “substantial risk that continuance of the pregnancy would gravely impair the physical or mental health of the mother,” may be interpreted as requiring an actual (not imaginary, remote or conjectural), medically cognizable risk of serious harm over and above the risk ordinarily associated with childbirth. In the words of the majority, “It seems . . . probable . . . that the legislative intent was to require some impairment to health greater or of a different nature than that attendant upon normal pregnancy before the committee could approve an application for an abortion for reasons of risk of impaired health.” (Ante at p. 329.) Otherwise, an abortion would be permitted in every case, and the Therapeutic Abortion Act’s provisions rendered superfluous. Presumably, the determination required under section 25951 would be no different than the routine analysis which every physician, must make in deciding whether or not a particular risk justifies a contemplated operative procedure. Of necessity, the language is sufficiently broad to enable the medical staff committee to exercise an amount of discretion in each case.
*343The majority apparently believe the statutory language is too broad to serve as a useful standard; they find it “almost axiomatic” that every woman seeking an abortion is subject to some psychological risks. It is also true, however, that the performance of a successful abortion in itself may result in adverse psychological effects. Thus, that psychological risks may exist in every case does not necessarily indicate that an abortion must be approved in eveiy case. It is the committee’s responsibility under the act to determine whether, in a particular case, the usual psychological pressures constitute a substantial risk of impaired mental or physical health, or, for example, whether, under the circumstances of that case, the mother’s “physical and mental health will be furthered ... by bearing the child to term . . . .” (71 Cal.2d at p. 971.)
b. Section 25954
Thus, we approach the majority’s alternative vagueness theory, namely, that the Legislature defined “mental health” as “mental illness.” The majority in discussing a different part of the Therapeutic Abortion Act recognize that “ ‘It is a settled principle of statutory interpretation that language of a statute should not be given a literal meaning if doing so would result in absurd consequences which the Legislature did not intend. [Citations.]’ ” (Ante at p. 334.) Yet the majority overlook the evident application of that principle to the “mental health” definition in the act. The majority’s premise is that the term “mental health” in subdivision (c) of Health and Safety Code section 25951 is defined as “mental illness” in section 25954, thereby resulting in the absurd consequence that an abortion may be approved only if there is a substantial risk that continuance of the pregnancy would gravely impair the mother’s mental illness. The majority conclude “[t]he clear dictate of this provision is that the woman must already be dangerous or in need of supervision or restraint, and in danger of a further aggravation of her condition.” (Ante at p. 330.)
The majority concede, however, as they must, that “[i]t is more likely that the Legislature did not intend to require any preexisting derangement . . . .” (Ante at p. 330.) Indeed, earlier in their opinion, the majority state “[i]t thus appears that rather than defining ‘mental health’ the language [of section 25954] purports to define what is deemed to constitute impaired mental health.” (Italics added; ante at p. 326.) Quite obviously, this is precisely what the Legislature intended to do. There is nothing in the Therapeutic Abortion Act, or in prior drafts thereof, suggesting that therapeutic abortions should be available only to mentally ill mothers. The entire thrust of the act is to prevent mental and physical illness which threatens to arise from continued pregnancy. The evident purpose of *344Health and Safety Code section 25954 was, as the majority themselves acknowledge, to define more precisely the type of risk which would justify an abortion, namely, the risk that the woman might become, through continued pregnancy, dangerous to herself or others or in need of supervision or restraint.
As stated in one of the articles cited by the majority, “In one sense, this qualifying section [25954] may just restate the grounds for a mental health abortion, i.e., that there be a substantial risk of grave impairment of mental health. It may have been the legislature’s way of saying ‘and we really mean it.’ . . . [I]t is incumbent on the doctors to- recognize thát the Legislature intended to restrict abortions for mental health to serious cases.” (Leavy and Charles, supra, 15 U.C.L.A. L.Rev. 1, 8.)
I would conclude that the language of sections 25951, subdivision (c), and 25954 of the Health and Safety Code is not unconstitutionally vague since, as the court previously stated in People v. Belous, supra, 71 Cal.2d 954, the test established “is a medical one [which] . . . does not involve considerations beyond medical competence."
2. The “void for vagueness” rule is inapplicable
The majority’s sole ground for invalidating the act’s provisions regarding the requisite committee finding of substantial risk is that those provisions are impermissibly vague and uncertain, and that it would be a denial of due process to impose criminal penalties under such circumstances. Even if we assume contrary to the foregoing analysis, that the act’s “substantial risk” provision is vague and uncertain, I strongly dispute the majority’s conclusion that any such uncertainty violates due process in this case.
The majority rely upon a line of cases which hold that “ ‘[A] statute which either forbids or requires the doing of an act in terms so vague that men of common intelligence must necessarily guess at its meaning and differ as to its application, violates the first essential of due process of law.’ ’’ (Ante at p. 327.) These cases have as their premise the accepted principle that “ ‘ “No one may be required at peril of life, liberty or property to speculate as to the meaning of penal statutes. All are entitled to be informed as to what the State commands or forbids . . . (Italics added; People v. Belous, supra, 71 Cal.2d 954, 960, quoting from an earlier case.)
In People v. Belous, supra, 71 Cal.2d 954, for example, the majority invalidated as unconstitutionally vague former Penal Code section 274, which made it a crime to commit an abortion “unless the same is necessary to preserve [the woman’s] life . . . .” The court deemed the quoted *345language too uncertain to justify the imposition of criminal penalties, stating that “the physician acts at his peril if he determines that the woman is entitled to an abortion. He is subject to prosecution for a felony and to deprivation of his right to practice medicine ... if his decision is wrong.” (71 Cal.2d at p. 972.) The court in Belous distinguished the responsibility of the physician under the requirements of Penal Code section 274 from those under the Therapeutic Abortion Act which, the court noted, “reduces these pressures [upon the physician]. The act specifically authorizes an abortion by a licensed physician in an accredited hospital where the abortion is approved in advance by a committee of the medical staff of the hospital, applying medical standards. (Health & Saf. Code, § 25951.) At least in cases where there has been adherence to the procedural requirements of the statute, physicians may not be held criminally responsible, and a jury may not subsequently determine that the abortion was not authorized by statute." (Italics added; 71 Cal.2d at p. 973.)
In other words, unlike the statute attacked in People v. Belous, supra, 71 Cal.2d 954, the Therapeutic Abortion Act does not require the physician to act at his peril and speculate whether he may or may not legally perform an abortion. Instead, he may use whatever standard he, in his professional judgment, may choose in determining whether an abortion should be performed. Thereupon, as Belous points out, all the physician must do under the act is follow the procedural requirements specified in section 25951, namely, obtain advance approval from the hospital’s medical staff committee and a finding by that committee that either the requisite substantial risk exists or that the pregnancy resulted from rape or incest. So long as the committee makes the requisite finding and approves the abortion, the physician may perform it in an accredited hospital without fear of criminal prosecution.
To hold, as the majority do, that defendant Barksdale was denied due process by being compelled to guess at what the act required of him is simply bewildering to me. The only persons who are required to> interpret and apply the “substantial risk” language are those persons who comprise the medical staff committee of the hospital, and neither the act nor Penal Code section 274 imposes criminal liability for the committee’s possible error in appraising the substantiality of the risk to the mother in a particular situation.
The majority attempt to circumvent the foregoing analysis by arguing that Doctor Barksdale had standing to assert his patient’s own right to fair notice of the act’s requirements. The majority note that the woman who submits to an illegal abortion is herself guilty of a felony. (Pen. Code, *346§ 275.) Yet the vagueness theory no more applies to the woman who seeks an abortion than to the doctor who seeks to perform it: Both are unequivocally advised by the act’s provisions that they must obtain advance committee approval, accompanied by the committee’s finding of the requisite substantial risk, before an abortion may legally be performed. Thus, neither the doctor nor his patient is required to guess at the meaning of the act’s provisions at the peril of committing a felony. If they obtain the requisite committee finding and approval, they are insulated from criminal sanction; if they fail to obtain that finding and approval, they will commit a felony if they carry on with the abortion. Thus, any possible uncertainty in the minds of the members of the hospital’s medical committee regarding the act’s requirements could not affect or expand the criminal responsibility of the doctor or his patient.
I concur, of course, with the majority’s decision herein to the extent that it upholds those provisions of the act which prohibit abortions from, being performed in unaccredited hospitals or by persons who do- not hold physician’s and surgeon’s certificates. By depriving the act, however, of its carefully considered protective devices the majority adopt for this state a policy of abortion at the will of the mother, a concept expressly rejected by the Legislature. I would uphold the act in its entirety.
The order of dismissal should be reversed.
McComb, J., and Sullivan, J., concurred.
Appellant’s petition for a rehearing was denied December 29, 1972. McComb, J., Burke, J., and Sullivan, J., were of the opinion that the petition should be granted.

Leavy and Charles, California's New Therapeutic Abortion Act: An Analysis and Guide to Medical and Legal Procedure, 15 U.C.L.A L.Rev. 1.

See Sands, The Therapeutic Abortion Act: An Answer to the Opposition, 13 U.C.L.A. L.Rev. 285.

The majority (ante, pp. 327, 328, fn. 3) would distinguish Daniels on the basis that the “substantial risk” language in the Therapeutic Abortion Act defines “the line beyond which proper conduct becomes criminal,” and thus fails to give “fair notice” as to which abortions are criminal and which are not. The majority have misread the act. As I explain in part 2 hereof, the “substantial risk” criterion is solely for the guidance of the hospital’s medical committee in determining whether or not to approve an abortion. Neither the mother nor her doctor is required to guess at the meaning of the term “substantial risk” at the peril of violating the act. So long as the requisite approval is obtained from the committee, neither the mother nor her doctor may be prosecuted. Conversely, if no such advance approval is obtained, the abortion is illegal even though it may be belatedly contended that a substantial risk did exist.