# Petition — Singleton v. Wulff

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## Record

- **Collection:** Supreme Court brief
- **Document type:** Petition
- **Published:** January 1, 1976
- **Citation:** 428 U.S. 106

## Text

Supreme Court, U. S.
‘ FitED

MAY 6 1975
MICHAEL RUvAi CL
SUPREME COURT OF THE UNITED STATES
TITTTTTT TTT Tee TERM, 1975

No. 24-1393

THOMAS E. SINGLETON,
Petitioner,

vs.
GEORGE J. L. WULFF, JR., M.D.,
and

MICHAEL FREIMAN, M.D.,
Respondents.

PETITION FOR A WRIT OF CERTIORARI TO THE
UNITED STATES COURT OF APPEALS
FOR THE EIGHTH CIRCUIT

Joun C. DanrortH
Attorney General

Supreme Court Building
Jefferson City, Missouri 65101
(314) 751-3321

Counsel for Petitioner

MICHAEL L. BOICOURT
Assistant Attorney General

Of Counsel

a cD
KELLY PRESS, INC., 201 South Eighth Street, Columbia, Missouri Dial 449-4163

SN BD noc dvchdadussccecesesccesqasonsanstées

P PPPPYTOTO TT TCT TTT TTT TTT TTT TTT TT Seess

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Statutory provisions involved ..............-eseeeees

FEE REEL OE OEE HOP OOTP OT

Reasons for granting the writ ...............eceeeees

I. The Court of Appeals Erroneously Held That the

U.

Respondent-Physicians Had Standing to Assert
the Unconstitutionality of Section 208.152(12),
RSMo Supp. 1973, and, in So Doing, Rendered a
Decision in Conflict with the Opinions of the Su-
preme Court on the Matter of Standing ..........

The Court of Appeals Erroneously Determined
That It Had Jurisdiction to Examine the Merits
of This Case, Reaching the Constitutionality of a
State Statute, Because the District Court Was Giv-
en No Opportunity Itself to Examine the Consti-
tutionality of Section 208.152, nor Was the Peti-
tioner Ever Given an Opportunity to Defend the
Constitutionality of That Statute, And, to That
Extent, the Determination by the Court of Ap-
peals, on the Merits, That the Statute Was Uncon-
stitutional So Departs From the Accepted and
Usual Course of Judicial Proceedings as to Call
For an Exercise of the United States Supreme
Court’s Power of Supervision ..................

Ill. The Court of Appeals Erroneously Held Section

IV.

208.152(12), RSMo Supp. 1973, to Be Unconsti-
tutional, and, in Doing So, the Court of Appeals
Passed upon a Legal Issue Which Has Not Here-
tofore Been Determined in The United States Su-
preme Court but Which Should Finally Be Settled
Sy ee GED oS. béd00b0cc0ceduueaseactueen

The Court of Appeals Erroneously Held That the
State Must Provide Medical Payments for Non-
Therapeutic Abortions If It Provides Medical Pay-
ments for Pregnancies Carried to Term or for
Therapeutic Abortions Because the Effect of That
Holding Is to Condition the Receipt of Federal
Medicaid Funds upon State Subsidization of Non-
Therapeutic Abortions Which Result Coerces the
State into Making Payments for Non-Therapeutic
Abortions in Contradiction to the Expressed Pub-
lic Policy of the State of Missouri and Thereby
Interferes with A Power Reserved to the State by
the Tenth Amendment to the United States Con-
Aiecdebaevensevevedhensbedsedsencasedes

i RARER al ee EAD cel am see ene Ao Rl ee ee 20

Appendix 1 (Opinion and Judgment of Court of Ap-

ED bcducatectveschedacneencucdscteceedeness

Appendix 2 (Opinion and Judgment of District

DE ‘iuad0e cos 0ubuee ees webs eeeeeesedoudens

21

CITATIONS
CASES

Page

Association of Data Processing Service Organizations
v. Camp, 397 U.S. 150 (1970) ........... cece ween 7

Bandy v. U.S., 396 F.2d 929; cert. den. 393 U.S. 1004
task hditi Wass SedinShdee de oc 00 on sok 6s cececsta 13
Barlow v. Collins, 397 U.S. 159 (1970) .............4.. 8
Barrows v. Jackson, 346 U.S. 249 (1953) ............. 9

Bruska v. Missouri, 332 F.Supp. 275 (E.D.Mo. 1971);
GENE, GES UTE. BERD CEBTE) occ ccccccccccccccccss 16
Doe v. Bolton, 410 U.S. 179 (1973) ......... 2, 8, 15, 19, 20

Doe v. Scott, 321 F.Supp. 1385 (N.D.IIl. 1970), vacated
GD Ws Se EE So WeewSsceccccicsescccoccces 8

Equal Opportunity Commission v. Standard Forage
and Azel Co., Inc., 496 F.2d 1392 (5th Cir. 1974) .. 12

Eureka-Carlisle Company v. Rottman, 398 F.2d 1015

SE ED ic vvncuc cdevsceweséeeuecencesoees 12
Fitts v. U.S., 376 F.2d 516 (10th Cir. 1967) ............ 12
Flast v. Cohen, 392 U.S. 83 (1968) ................ 7, 8, 23
Gardner v. Myers, 491 F.2d 1184 (8th Cir. 1974) ....... 13
Geduldig v. Aiello, —— U.S. ——, 94 S.Ct. 2485 (1974) . 16
Giordano v. United States, 394 U.S. 310 (1969) ........ 12
Gonzalez v. Automatic Employees Credit Union, -—

U.S. ——, 42 L.Ed.2d 249 (1974) ............... 6, 11
Griswold v. Connecticut, 381 U.S. 479 (1965) .......... 9
Holiday Magic, Inc. v. Warren, 497 F.2d 687 (7th Cir.

DED Wcbacud cdGbCeNbcddb tévececddchetsessseees 11
Johnson v. Robinson, —— U.S. ——, 94 S.Ct. 1160

| | BPPPPPPPPTTTTTITOTTIITITIT rrr TTT TTT 16

CASES
Page
Klein v. Nassau County Medical Center, 347 F.Supp.

GBS CER B. Se WAGED 60 cc00senecnescadeeneeenee 9
Kahan v. Shevlin, —— U.S. ——, 94 8.Ct. 1734 (1974) . 15
N.A.A.C.P. v. Alabama, 357 U.S. 449 (1958) .......... i)
Nyberg v. The City of Virginia, 495 F.Supp. 1342 (8th

oe Peer ee 8
Ohio Municipal Judges Association v. Davis, 411 U.S.

UGE (1DTS) 2. nncccvccsccccccccesvcscccssusenss 15
Roe v. Wade, 410 U.S, 113 (1973) .......... 2, 8, 15, 19, 20
San Antonio Independent School District v. Rodriguez,

OR! BE eee 15
Tileston v. Ullman, 318 U.S. 44 (1943) ................ 9
Word v. Poelker, 495 F.2d 1349 (8th Cir. 1974) ........ 8
Wulff v. Singleton, 508 F.2d 1211 (8th Cir. 1972) ...... 15

MISCELLANEOUS
US. Comst. ant TEE ..cccvcccssscecceseceuseuaueean 12
US, Const, GUM. Boo cccccsessescuceunnseemeee 3
SS UGK. © GERD ov ccccsccceseseuseseuee sean 17
SP UGG. © BRE ccnccccccesescnuenceucueeuseee
eS Pr ee 4, 12, 13
GB UGK. © TEGO cccccncscccescesenccuseuenneee 17
> Cray & TERS CORED cc nccccccevaccssansnneee 7
a, FY PT 13

Section 208.152, RSMo Supp. 1973 . .2, 7, 8, 9, 10, 11, 12,13
Section 208.156, RSMo Supp. 1969 ................6. 7

IN THE
SUPREME COURT OF THE UNITED STATES

No.

THOMAS E. SINGLETON,
Petitioner,
vs.
GEORGE J. L. WULFF, JR., M.D.,
and

MICHAEL FREIMAN, M_.D.,
Respondents.

PETITION FOR A WRIT OF CERTIORARI TO THE
UNITED STATES COURT OF APPEALS
FOR THE EIGHTH CIRCUIT

The petitioner, Thomas E. Singleton, respectfully prays
that a writ of certiorari be issued to review the judgment
and opinion of the United States Court of Appeals for the
Eighth Circuit entered in this proceeding on December
31, 1974.

OPINION BELOW

The opinion of the Court of appeals, reported at 508
F.2d 1211 (8th Cir. 1974), appears in the Appendix hereto.
The opinion of the District Court for the Eastern District
of Missouri also appears in the Appendix hereto. That
opinion is reported at 380 F.Supp. 1137 (E.D.Mo. 1974).

The judgment of the Court of Appeals for the Eighth
Circuit was entered on December 31, 1974. A timely peti-
tion for rehearing, requested by the respondents, was denied
on January 9, 1975. On March 26, 1975, Justice Harry A.
Blackmun, Associate Justice of the Supreme Court of the
United States and Circuit Judge of the United States Court
of Appeals for the Eighth Circuit, entered an order extend-
ing the time to file petition for writ of certiorari to and in-
cluding May 8, 1975, and this petition for certiorari was
filed within that extended time period. This Court’s juris-
diction is invoked under 28 U.S.C. § 1254(1).

QUESTIONS PRESENTED

1. Whether there is a logical nexus between the status
of respondent-physicians and the claims they seek to have
adjudicated sufficient to confer standing on them to chal-
lenge the constitutionality of Section 208.152, RSMo Supp.
1973.

2. Whether the Court of Appeals acted in excess of
its jurisdiction when it proceeded to determine on the merits
the constitutionality of Section 208.152, RSMo Supp. 1973.

3. Whether the decisions of the Supreme Court in
Roe v. Wade, 410 U.S. 113, and Doe v. Bolton, 410 U.S. 179,
compel the conclusion thai a state must make Medicaid
payments to eligible welfare recipients for non-therapeutic
abortions.

4. Whether a state statute which provides medical as-
sistance payments, as a family planning service, but ex-
cludes non-therapeutic abortions as a medical expense which
the state will pay for as a family planning service, con-

3

stitutes invidious discrimination if the state does provide
medical assistance for pregnancies carried to term and for
therapeutic abortions.

5. Whether a state may be compelled, given the re-
striction on federal power embodied in the Tenth Amend-
ment to the United States Constitution, to choose between
the equally objectionable alternatives of denying all Med-
icaid payments connected with pregnancy, thereby becom-
ing ineligible to receive federal Medicaid grants, or of
paying eligible welfare recipients Medicaid for non-thera-
peutic abortions contrary to the public policy of the state.

STATUTORY PROVISIONS INVOLVED
Section 208.152(12), RSMo Supp. 1973:

‘*Benefit payments for medical assistance may be
made on behalf of those eligible needy persons who are
unable to provide for it in whole or in part, with any
payments to be made on the basis of the reasonable cost
of the care or reasonable charge for the services as de-
fined and determined by the division of welfare unless
otherwise hereinafter provided, for the following:

> > 6

(12) Family planning services as defined by fed-
eral rules and regulations; provided, however, that
such family planning services shall not include abor-
tions unless such abortions are medically indicated.’’

Title 28, U.S.C. Section 1291:

‘*The courts of appeals shall have jurisdiction of
appeals from all final decisions of the district courts
of the United Sta‘es, the United States District Court
for the District of the Canal Zone, the District Court of
Guam, and the District Court of the Virgin Islands, ex-

4

cept where a direct review may be had in the Supreme
Court... .’’

Title 28, U.S.C. Section 2281:

‘‘An interlocutory or permanent injunction re-
straining the enforcement, operation or execution of
any State statute by restraining the action of any of-
ficer of such State in the enforcement or execution of
such statute or of an order made by an administrative
board or commission acting under State statutes, shall
not be granted by any district court or judge thereof
upon the ground of the unconstitutionality of such
statute unless the application therefor is heard and
determined by a district court of three judges under
section 2284 of this title. .

STATEMENT OF THE CASE

On November 2, 1973, respondent-physicians filed a
three-count complaint against petitioner Singleton, then
designated as Chief of Bureau of Medical Services, Division
of Welfare, Missouri State Department of Public Health
and Welfare, and the Stete Board of Registration of the
Healing Arts. Only Count II pertained to petitioner Single-
ton. In Count II, respondent-physicians challenged the valid-
ity under the United States Constitution of Section
208.152(12), RSMo Supp. 1973. That statutory section ex-
cluded non-medically indicated abcrtions from the range
of medical assistance benefit payments, for family planning
services, available to eligible needy persons. The complaint
requested that the statutory section be declared in violation
of the United States Constitution and that the enforcement
thereof be permanently enjoined.

On December 12, 1973, respondent-physicians pro-

5

pounded four interrogatories to petitioner Singleton, which
were answered on January 15, 1974 (except Interrogatory
No. 4 to which objection was made).

On December 14, 1973, the petitioner Singleton’s Mo-
tion to Dismiss was mailed for filing to the Clerk of the
United States District Court for the Eastern District of
Missouri. Petitioner Singleton stated four reasons why the
complaint should be dismissed, including the following:

‘*(2) That the plaintiff doctors do not possess the
required standing to litigate the constitutional issues
raised.’’

Attached to respondent-physicians’ Memorandum in
Opposition to Appellee Singleton’s Motion to Dismiss, filed
on February 18, 1974, are affidavits from each of the re-
spondent-physicians.

The statutory three-judge court entered its Order and
Judgment supported by a Memorandum on May 31, 1974,
dismissing Count II of the Complaint on the ground that
respondents lacked standing to challenge Section
208.152(12).

Seventeen days thereafter, on June 17, 1974, respondent-
physicians filed a ‘‘ Motion for Leave of Court to Add Parties
Plaintiff’’, which was overruled on June 24, 1974.

Respondent-physicians duly filed their notice of appeal
to the United States Court of Appeals for the Eighth Cir-
cuit on June 28, 1974.

On or about July 6, 1974, petitioner Singleton filed with
the Court of Appeals his Motion to Dismiss Appeal on the
ground that under 28 U.S.C. § 1253, appeal from a final
order of a three-judge district court must be made to the
United States Supreme Court. This motion was overruled
on July 18, 1974.

6

The United States Court of Appeals for the Eighth
Circuit issued its opinion reversing the decision of the
District Court on December 31, 1974. The Court of Appeals
found it had appellate jurisdiction pursuant to the United
States Supreme Court’s decision in Gonzalez v. Automatic
Employees Credit Union, 42 L.Ed.2d 249, —— U.S. ——
(1974), that the respondent-physicians had standing to ad-
judicate the constitutionality of the state statute in ques-
tion; that the Court of Appeals had jurisaiction to reach the
merits of the constitutionality of the state statute in ques-
tion even though the petitioner had never filed an answer
in the three-judge District Court below nor had an oppor-
tunity to brief or argue the constitutionality of the state
statute under attack, and that the state statute in question
was facially unconstitutional.

' The respondent-physicians filed a motion for rehear-
ing, asking for clarification and an award of attorneys’ fees,
on January 6, 1975. The Court of Appeals denied the motion
for rehearing on January 9, 1975.

On January 31, 1975, the Court of Appeals denied pe-

_titioner’s request for stay of mandate. Mandate issued on
“February 5, 1975.

Justice Blackmun granted petitioner an extension of

time to file writ of certiorari to and including May 8, 1975,
on March 26, 1975.

REASONS FOR GRANTING THE WRIT
I

The Court of Appeals erroneously held that the respond.
ent-physicians had standing to assert the unconstitutionality
of Section 208.152(12), RSMo Supp. 1973, and, in so doing,
rendered a decision in conflict with the opinions of the
Supreme Court on the matter of standing.

The three-judge District Court was correct in its de-
termination that the posture of respondents in asserting
the unconstitutionality of the state statute in question satis-
fied neither the standing requirement of Flast v. Cohen, 392
U.S. 83, 192 (1968), that there be a logical nexus between
the status asserted Uy the complainant and the claim sought
to be adjudicated, nor the requirement of Association of
Data Processing Service Organizations Inc. v. Camp, 397
U.S. 150, 153 (1970), that the interest sought to be pro-
tected by the complaining party be within the zone of in-
terests meant to be protected or regulated by the constitu-
tional guaranty relied upon.

As emphasized by the District Court, Section 208.152
provides for the payment of medical assistance benefits ‘‘on
behalf of those eligible needy persons who are unable to
provide for it in whole or in part .. . .”’ Not only are pay-
ments made on behalf of eligible persons, but only the wel-
fare recipient is granted a right to a hearing if the wel-
fare recipient's claim for medical reimbursement is denied.
A doctor is not granted a right of appeal. See Title 45, Code
of Federal Regulations, Public Welfare, Chapter II, Section
205.10 (revised as of October 1, 1973), and Section 208.156,
RSMo 1969. Therefore, eligible needy persons are the in-
tended beneficiaries of Section 208.152; eligible needy per-
sons are the people hurt by the operation of any restriction
placed on the payment of medical assistance benefits be-

8

cause they are not provided the needed cost reimbursement;
and welfare recipients are the ones given a statutory right
to appeal adverse determinations. In determffing the exist-
ence of standing, it is entirely appropriate that the Court
consider whether the complainants asserting standing are
the intended beneficiaries of the statute in controversy.
Barlow v. Collins, 397 U.S. 159, 164-165 (1970).

Furthermore, respondent-physicians lack the kind of
direct threat of personal detriment which is necessary to
sustain their standing to challenge the constitutionality
of Section 208.152 under Flast. This fact can be demon-
strated on the basis of the very cases which the Court of
Appeals cited in pages 3 through 5 of its opinion, which is
appended hereto. For instance, in Doe v. Scott, 321 F.Supp.
1385 (N.D.IIL 1970), vacated 410 U.S. 950 (1973), Roe v.
Wade, 410 U.S. 113 (1973), and Doe v. Bolton, 410 U.S. 179
(1973), the plaintiff-physicians were subject to the provi-
sions of criminal anti-abortion statutes and, therefore, had
the requisite direct threat of personal detriment to sustain
their standing. In Nyberg v. The City of Virginia, 495
F.Supp. 1342 (8th Cir. 1974) and Word v. Poelker, 495
F.2d 1349 (8th Cir. 1974), regulations had been adopted the
effect of which was to prohibit substantially and directly
the granting of abortions, thus having a direct effect on
a woman’s right under Roe v. Wade, supra, to obtain an
abortion and having a direct effect on a physician’s right
to practice medicine by performing abortions.

In the instant case, however, respondent-physicians are
not subject to any criminal sanctions by the operation of
Section 208.152, nor does Section 208.152 operate in such
a manner as to prohibit respondent-physicians from per-
forming abortions. Section 208.152 does not in any manner
prohibit doctors from being paid for their services. The
only effect that Section 208.152 has on respondent-phy-

a

9

sicians is to create some uncertainty as to the source of
payment for abortion services rendered by them. No direct
interest exists sufficient to create a logical nexus, under
Flast, between the status asserted by respondents and the
claimed unconstitutionality of the statute. In holding that
the respondent-physicians have standing to assert the un-
constitutionality of the state statute, the Court of Appeals
contributed to an unwarranted and unjustified erosion of
the Article III restrictions on federal courts’ jurisdiction.

Likewise, the respondents cannot establish standing
on the basis that they are representing the rights of their
patients. Not having standing in their own right to chal-
lenge Section 208.152, respondents may not bring this action
on behalf of their patients to protect their patients’ funda-
mental rights. Tileston v. Ullman, 318 U.S. 44, 46 (1943).

The general rule under Tileston, that only those per-
sons having constitutional rights should be able to assert
those rights in the federal courts, can be avoided only
where the complaining parties have clear and obvious
standing on their own behalf as, for example, being sub-
ject to criminal prosecution, Griswold v. Connecticut, 381
U.S. 479, 481 (1965), or where the parties whose rights are
to be represented cannot advance those rights on their
own behalf as in Barrows v. Jackson, 346 U.S. 249, 257
(1953), and N.A.A.C.P. v. Alabama, 357 U.S. 449, 459
(1958). In the instant case, as discussed above, the respond-
ents do not have standing in their own right, are not sub-
ject to prosecution by reason of the existence of Section
208.152, and therefore cannot acquire standing under the
exception of Griswold v. Connecticut, supra. Also, the in-
digent women which Section 208.152 was intended to bene-
fit are fully able to advance their own rights. For example,
in Klein v. Nassau County Medical Center, 347 F.Supp.
496, 498 (E.D.N.Y. 1972), all plaintiffs were pregnant at

10

the time they became plaintiffs; all plaintiffs had applied
at different times for an abortion; all plaintiffs asserted
that they could not afford abortions; all plaintiffs up to
the time they filed suit had been unable to obtain an abor-
tion; and all plaintiffs alleged that they were indigent.

The failure of the Court of Appeals to interpret cor-
rectly and adhere to the standing decisions of the Supreme
Court justifies the grant of certiorari to review the judg-
ment below, and, upon review of that judgment, the Su-
preme Court should reverse the Court of Appeals and declare
that the District Court correctly held the respondent-
physicians had no standing to assert the unconstitutionality
of Section 208.152.

U

The Court of Appeals erroneously determined that it
had jurisdiction to examine the merits of this case, reaching
the constitutionality of a state statute, because the District
Court was given no opportunity itself to examine the con-
stitutionality of Section 208.152, nor was the petitioner ever
given an opportunity to defend the constitutionality of that
statute, and, to that extent, the determination by the Court
of Appeals, on the merits, that the statute was unconstitu-
tional so departs from the accepted and usual course of
judicial proceedings as to call for an exercise of the United

States Supreme Court’s power of supervision.

When the District Court dismissed Count II of the re-
spondent’s complaint for their lack of standing to assert
the unconstitutionality of Section 208.152(12), RSMo 1973
Supp., the respondents appealed that order of dismissal to
the Court of Appeals. On the record before the Court of
Appeals it was clear that the petitioner had never answered
the respondents’ complaint; that the constitutionality of the
state statute had never been placed at issue in the District
Court; that the District Court had never conducted a hear-

ll

ing or other inquiry into the constitutionality of the state
statute on its face or as applied; that the District Court had
not ruled upon the constitutionality of that state statute;
and that the petitioner had never had an opportunity to
brief or argue the constitutional merits of Section 208.152.
Nevertheless, the Court of Appeals, once it found that the
respondents had standing, proceeded to reach the merits.

In doing so, the Court of Appeals acted in excess of its juris-
diction.

In effect, the Court of Appeals took unto itself original
jurisdiction to determine the constitutionality of a state
statute which issue had not been properly before, nor de-
cided, by the District Court from which the appeal was
taken.

Exclusive original jurisdiction is conferred upon three-
judge district courts when a state statute or administrative
order is challenged, a state officer is named as a party de-
fendant, injunctive relief is sought, and it is claimed that
the state statute or administrative order is contrary to the
United States Constitution. Holiday Magic, Inc. v. Warren,
497 F.2d 687 (7th Cir. 1974) ; Title 28, U.S.C. § 2281. All of
those elements were present in Count II of the Complaint
filed by the respondents in the District Court. However, in
the instant case, the District Court never considered the
allegations containing those elements but ordered the dis-
missal of the lawsuit because the respondents had insuf-
ficient standing to sue. Although the entire three-judge
court ordered the dismissal of Count II, a single judge
could have entered an order dismissing the case for lack
of standing. Gonzalez v. Automatic Employees Credit
Union, —— U.S. ——, 42 L.Ed.2d 249 (1974). To that ex-
tent, the Court of Appeals was correct in finding that it
had jurisdiction of the respondents’ appeal from the order
dismissing Count II of respondents’ complaint. However,

12

a single-judge District Court could not have passed on
those allegations of Count IT qualifying the complaint for
a three-judge District Court pursuant to Title 28, U.S.C.
§ 2281. Therefore, the Court of Appeals did not have juris-
diction to review the substance of respondents’ Count II.

Article III of the United States Constitution grants
unto Congress the power to establish and proscribe the
jurisdiction of federal courts. Congress has provided that:

‘*The courts of appeal should have jurisdiction of
appeals from all final decisions of the district courts
of the United States, the United States District Court
for the District of the Canal Zone, the District Court of
Guam, and the District Court of the Virgin Islands, ex-
cept where a direct review may be had in the Supreme
Court.’’ Title 28, U.S.C. § 1291.

Hence, the Courts of Appeal have only appellate and no
original jurisdiction. The constitutionality of Section
208.152, RSMo Supp. 1973, was not appealed to the Court
of Appeals because the issue had never been determined by
the District Court. Therefore, the Court of Appeals acted
in excess of its jurisdiction when it reached the merits of
this case because it did not have the requisite original juris-
diction to make such a determination.

It is well recognized that a Court of Appeals should
not reach on appeal the merits of an issue on which a Dis-
trict Court has not ruled. Equal Opportunity Commission
v. Standard Forage and Azel Co., Inc., 496 F.2d 1392 (5th
Cir. 1974) ; Eureka-Carlisle Company v. Rottman, 398 F.2d
1015, 1019 (10th Cir. 1968) ; and Fitts v. U.S., 376 F.2d 516
(10th Cir. 1967). It is even more fundamental that consti-
tutional questions should not be considered for the first
time on appeal. Giordano v. United States, 394 U.S. 310,
312-313 (1969) ; Bandy v. U.S., 396 F.2d 929, 930; cert. den.

13

393 U.S. 1004 (1968); Gardner v. Myers, 491 F.2d 1184,
1190 (8th Cir. 1974).

Once the Court of Appeals determined that the re-
spondent-physicians had the requisite standing to sue, that
court should have remanded the matter to the three-judge
District Court for proceedings consistent with the Court of
Appeals’ finding. Present in Count II of the complaint
which would then be before the three-judge District Court
were all the elements necessary to invoke the jurisdiction
of such a court pursuant to Title 28, U.S.C. § 2281. The
petitioner would then have been afforded an opportunity
to file his answer defending the constitutionality of Section
208.152 on its face or as applied, and to present evidence
and legal arguments to the District Court to assist that
court in making a fully informed determination as to the
constitutionality of that state statute.’ As the matter now
stands, the Court of Appeals has abrogated the entire con-

1 For example, Section 208.152 excludes non-medically
indicated abortions as a family planning service which will
be publicly funded. Absent a District Court record the Court
of Appeals could not have known whether abortion may or
may uot have been funded under a different category. Pro-
posed federal regulations, not yet promulgated but printed
at Vol. 39, Federal Register No. 237, would exclude all
abortions from family planning services for which the fed-
eral government share is 90 percent. However, abortions
would still qualify as a physician’s service, the federal share
of which is 60 percent. The Court of Appeals had no way of
knowing the intricacies of how Section 208.152 was ap-
plied or if it absolutely prohibited medical assistance pay-
ments for abortion. Absent a defense by the petitioner and
an evidentiary hearing by the court of original jurisdiction,
the Court of Appeals had an insufficient record on which
to base a constitutional decision.

14

gressional scheme of federal court jurisdiction. Certainly,
if the District Court had made a determination concerning
the constitutionality of the state statute, appeal should
properly have been taken to the United States Supreme
Court. It is entirely illogical to assume that a Court of
Appeals could step into the case on the peripheral issue of
standing and render a decision concerning the constitu-
tionality of the state statute which decision has been re-
served by Congress solely tw a three-judge District Court
and, on appeal, to the United States Supreme Court.

Because the action of the Court of Appeals in reaching
the merits of this case constitutes such a drastic departure
from the accepted and usual course of judicial proceedings,
the United States Supreme Court should exercise its power

ms supervision and grant certiorari to review the judgment
low.

Il

The Court of Appeals erroneously held Section
208.152(12), RSMo Supp. 1973, to be unconstitutional, and,
in doing so, the Court of Appeals passed upon a legal issue
which has not heretofore been determined in the United

States Supreme Court but which should finally be settled
by this court.

There is no constitutional requirement that a state pro-
vide financial assistance for voluntary abortion as a condi-
tion of providing benefits for other medical treatment re-
lating to pregnancy.

The opinion below announces a legal proposition as
follows:

‘*. . . the statute here provides medical payments if
the pregnancy is carried to term or for therapeutic
abortion but not if a non-therapeutic abortion is per-
formed. This classification is a clear violation of the

15

Equal Protection Clause of the Fourteenth Amend-
men ?

Wulff v. Singleton, 508 F.2d 1211, 1215 (8th Cir. 1972).
Page 8 of the opinion appended hereto.

We submit that there is no support whatsoever in the
decisions of this Court for a holding that a state cannot
finance necessary medical procedures unless it also agrees
to finance procedures which are purely optional. Roe v.
Wade, 410 U.S. 113 (1973), and Doe v. Bolton, 410 U.S. 179
(1973), go no further than holding that voluntary abortion
may not be made the subject of criminal sanctions when
timely performed. It is quite another thing to say that a
state must give financial assistance to an abortion simply
because an indigent person chooses to have one.

The Equal Protection Clause prohibits only invidious
discrimination. It does not enjoin differential treatment
based on a reasonable classification in support of valid
policy.

Thus a state may provide that local schools are to be
financed substantially by local property taxes in spite of
the wide variation of the taxing resources of the several
districts. San Antonio Independent School District v. Rod-
riguez, 411 U.S. 1 (1973).

A state may permit in-term salary increases for judges
of some courts which are denied to other judges. Ohio Mu-
nicipal Judges Association v. Davis, 411 U.S. 144 (1973).

Widows may be afforded tax exemptions which are not
available to widowers. Kahn v. Shevlin, —— U.S. ——, 94
S.Ct. 1734 (1974).

A state may exclude disabilities due to normal preg-
nancy in a disability insurance program while covering
other disabilities of comparable duration including dis-

16

ability through abnormal pregnancy conditions. Geduldig
v. Aiello, —— U.S. ——, 94 S.Ct. 2485 (1974).

A state may furnish textbooks or transportation to
public school pupils without providing equivalent services
for those who attend non-public schools, in spite of the con-
stitutional permission for such aid. Bruska v. Missouri, 332
F.Supp. 275 (E.D.Mo. 1971); aff’d. 405 U.S. 1050 (1972).

The federal government is not required to provide vet-
erans’ benefits to conscientious objectors who elect alter-
nate service. Johnson v. Robinson, —— U.S. ——, 94 S.Ct.
1160 (1974), decided under the ‘‘due process’’ analogy to
the Equal Protection Clause.

In the above cases this Court has sustained differential
treatment which is incidental to the effectuation of valid
government policy. The details of the particular policy sit-
uations are not appropriate for discussion at this point. It
is sufficient to say that there are valid reasons why a state
may decide that, although voluntary abortions are per-
missible within certain time limits, the state does not choose
to give positive assistance to the abortion process. Quite
aside from the conviction that abortion is undesirable and
to be discouraged, the state has a proper interest in the al-
location of limited resources and facilities. The contrary
holding of the Court below is in conflict with the approach
of this Court in numerous cases, and an unwarranted inter-
ference with state policy. The conflict between the deci-
sion of the Court below and the decisions of this Court in
equal protection matters justify the grant of certiorari to
review the judgment below which judgment involves an
issue which has not yet been determined by this Court but
which should be.

ES ee re

17

IV

The Court of Appeals erroneously held that the state
must provide medical payments for non-therapeutic abor-
tions if it provides medical payments for pregnancies car-
ried to term or for therapeutic abortions because the ef-
fect of that holding is to condition the receipt of federal
medicaid funds upon state subsidization of non-therapeutic
abortions which result coerces the state into making pay-
ments for non-therapeutic abortions in contradiction to the
expressed public policy of the State of Missouri and thereby
interferes with a power reserved to the state by the Tenth
Amendment to the United States Constitution.

The Court of Appeals held that it was an unconstitu-
tional classification for the State of Missouri to make Med-
icaid payments for pregnancies carried to term and for
therapeutic abortions if Medicaid payments were not also
made for non-therapeutie abortions. In effect, the decision
of the Court of Appeals gave the State of Missouri one of
two equally unsatisfactory options: either the State of
Missouri must refuse to pay for all medical assistance con-
nected with pregnancies at the expense of millions of dol-
lars in federal Medicaid grants; or the State must make
Medicaid payments for non-therapeutice abortions contrary
to the public policy of Missouri.

Title 42, U.S.C. § 1396 conditions a federal grant to a
state for medical assistance programs upon the submission,
by the state, of an approved state plan for medical assist-
ance. Title 42, U.S.C. § 1396 a.(10) (A) requires the state
plan to provide for making medical assistance available to
all eligible individuals. Title 42, U.S.C. § 1396 d.(a) (5) de-
fines medical assistance as including physicians services.
The term ‘‘physicians services’’ is defined by Title 22,
U.S.C. § 1395 x.(q) as meaning ‘‘. . . professional services
performed by physicians, including surgery, consultation,

18

and home, office, and institutional calls... .’’ In amplifica-
tion of federal statutory language, Title 45, C.F.R. § 249.10,
provides:

‘*(a) State Plan Requirements.—A State plan for
medical assistance under title XIX of the Social Se-
curity Act must:

(1) Specify that at least the first five items of
medical and remedial care and services as set forth in
paragraph (b) (1) through (5) of this section will be
provided to the categorically needy.

(b) Federal Financial Participation.—Subject to
limitations in paragraph (c) of this section Federal
financial participation is available and expenditures
for medical or remedial care and services under the
State plan which meet the following definitions:

(5) Physicians’ services, whether furnished im the
office, the patient’s home, a hospital, a skilled nursing
home or elsewhere. ‘Physicians’ services’ are those
services provided, within the scope of practiec of ‘iis
profession as defined by State law, by or under the
personal supervision of an individual licensed under
State law to practice medicine or osteopathy.’’

Petitioner Singleton has been administering the Divi-
sion of Family Services of the Department of Socia! Serv-
ices, in accordance with instructions passed on by federal
administrators, on the premise that should the state plan
fail to provide for prenatal services for eligible individuals
choosing to carry a pregnancy to term, or if the state re-
fused to pay for such services contrary to its state plan,
that the State of Missouri would cease to be eligible for
federal Medicaid grants. Using the present fiscal year as a

19

basis, this would cost the State of Missouri approximately
66 million dollars a year.

The decision by the Court of Appeals in conjunction
with the provisions of Title XIX of the Social Security Act,
and the rules and regulations promulgated thereunder, con-
stitutes an unwarranted and unconstitutional intrusion by
the federal courts and Congress into the internal affairs
of the sovereign State of Missouri. The effect, m toto, of
the Court of Appeals opinion and the statutes discussed
above is to force the State of Missouri to fund publicly
non-therapeutic abortions, against the public policy of the
state as announced by its Legislature, because refusal to
do so would forfeit all federal Medicaid grants.

The coercive nature of the Court of Appeals opinion,
when combined with federal law and regulations, affirm-
atively conditioning the receipt by the State of Missouri
of 66 million dollars in Medicaid funds upon the giving of
non-therapeutic abortions, should not be tolerated in a
federal system of government with powers and rights re-
served to the states as independent political entities by
reason of the Tenth Amendment to the United States Con-
stitution.

There can be no doubt that the overall coercive effect
of the Court of Appeals opinion and the federal Social
Security Law will force the State of Missouri to abandon
a long and deeply held internal policy totally against the
concept of abortion except as necessary to save the wife or
the mother. Prior to Roe, supra, and Doe, supra, the public
policy of Missouri as expressed in statutory sections clearly
demonstrated that abortion was against the public policy
of the state. That position has not changed. Very recently,
the State of Missouri became the first state in the union
to pass a resolution requesting Congress to initiate those
actions necessary to the creation of a constitutional amend-

20

ment taking abortion out from under the protection of the
United States Constitution. Certainly, it is contrary to the
Tenth Amendment if the federal government can induce,
by the threatened termination of the entire Medicaid pro-
gram in Missouri, the State to subsidize abortions contrary
to the public policy created by the State Legislature.

The opinion by the Court of Appeals does not logically
follow the decisions of this court in Roe, supra, and Doe,
supra. It is a much different thing to say that a doctor
cannot be legally prosecuted for performing an abortion
requested by a pregnant woman than to say, as the Court
of Appeals has done, that states must subsidize the abortion
process with public funds.

The question of whether a state must publicly subsi-
dize non-therapeutic abortions for eligible Medicaid recipi-
ents is one which has not been determined by the Supreme
Court but which should be brought before this Court for
final determination.

CONCLUSION
For these reasons, a writ of certiorari should issue to
review the judgment and opinion of the Eighth Cireuit.
Respectfully submitted,

Joun C. Danrortu
Attorney General

Supreme Court Building
Jefferson City, Missouri 65101
(314) 751-3321

Counsel for Petitioner

MICHAEL L. BOICOURT
Assistant Attorney General

Of Counsel

APPENDIX 1

UNITED STATES COURT OF APPEALS
FOR THE EIGHTH CIRCUIT

No. 74-1484

GEORGE J. L. WULFF, JR., M.D. ont}
MICHAEL FREIMAN, M.D.,

A ppellants . Appeal from the
VB. United States

; District Court
THOMAS E. SINGLETON, Chief of f ¢5, the Eastern

Bureau of Medical Services, Division | pjictrict of
of Welfare, State Department of mee aby
Public Health and Welfare,
Appellee. /
OO Eeeeeee=SQ===eeeeeee
Submitted: December 13, 1974
Filed: December 31, 1974

Before MATTHES, Senior Circuit Judge, ROSS and
STEPHENSON, Circuit Judges.

STEPHENSON, Circuit Judge.

This appeal from the order of a statutory three-judge
district court dismissing plaintiffs’ cause of action for
lack of standing raises troublesome questions of jurisdic-
tion and procedure as well as a question cuncerning state
interference with the abortion decision. The three-judge
court opinion is reported as Wulff v. State Board of Regis-
tration for Healing Arts, 380 F. Supp. 1137 (E.D. Mo.
1974). We reverse.

Appellants, Missouri licensed medical doctors, brought

22

a three count complaint for declaratory and injunctive
relief against the Missouri State Board of Registration
for the Healing Arts and against Thomas E. Singleton
in his capacity as Chief of the Bureau of Medical Services.
The complaint challenged the constitutionality of state
statute regarding welfare benefits, claiming that the statu-
tory wording
is vague and uncertain, deprives plaintiffs and their
patients of the right to privacy, deprives plaintiffs
of their right to practice medicine according to the
highest standards of medical practice, deprives plain-
tiffs’ patients of the fundamental right of -a woman
to determine for herself whether to bear children,
infringes upon plaintiffs’ right to render and their
patients’ right to receive safe and adequate medical
advice and treatment, deprives plaintiffs and their
patients of the equal protection of the law and due
process of law, and constitutes state interference with
the abortion decision, all of which is in violation of
the United States Constitution.

380 F. Supp. 1137, 1139.

The three-judge court dismissed Count II of the com-
plaint for lack of standing by the medical doctors to chal-
lenge the constitutionality of the statute. See Wulff, supra
at 1144. Appeal was filed in this court.!

I. APPELLATE JURISDICTION

The portal question we have goes to the propriety of
an appeal to this court from an order entered by a district
court of three judges.”

1 The appeal concerns only Count II of the complaint. Appellants do
not challenge the district court’s ruling on Counts I and DIL

23

That inquiry has been settled for us in the instant case
by the United States Supreme Court’s recent decision in
Gonzalez v. Automatic Employees Credit Union, No. 73-858
(filed December 10, 1974), 43 Law Week 4025.

In Gonzalez appellant took his appeal directly to the
Supreme Court from a three-judge court order dismissing
the complaint for lack of standing. The court observed
that when the basis of decision by a three-judge court is
lack of standing, the case is such that ‘‘a single judge could
have declined to convene a three-judge court’’ or ‘‘the
three-judge court could have dissolved itself, leaving final
disposition of the complaint to a single judge.’’ Gonzalez
at 4028 (footnote omitted). The Court went on to say:

We hold, therefore, that when a three-judge court
denies a plaintiff injunctive relief on grounds which,
if sound, would have justified dissolution of the court
as to that plaintiff, or a refusa! to request the conven-
tion of a three-judge court ab imitio, review of the
denial is available only in the Court of Appeals.

43 Law Week 4025, 4028-29. This court has jurisdiction
in the instant case.

Il. STANDING

The district court found that there was no logical nexus
between the status of appellant-physicians and the claims
they sought to have adjudicated. Flast v. Cohen, 392 US.
83 (1968). We disagree.

This court made clear in Nyberg v. City of Virginia,
495 F.2d 1342 (1974), cert. denied, 95 S.Ct. 169:

We think that the Supreme Court in Roe v. Wade,
410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973) and
Doe v. Bolton, 410 U.S. 179. 93 S.Ct. 739, 35 L.Ed.2d
201 (1973) has clearly paved the way for physicians

24

to assert their constitutional rights to practice medi-
cine, which now includes the right to advise and per-
form abortions. * * *

Clearly the claims of medical doctors to ‘‘freely prac-
tice medicine according to the highest medical stand-
ards without arbitrary outside restraints’’ are in-
extricably bound up with the privacy rights of women
who seek abortions, YWCA v. Kugler, 342 F. Supp.
1048, 1055 (D.N.J. 1972). This is sufficient to present
a justifiable controversy and confer standing on the
physicians who bring this action. See Griswold v. Con-
necticut, 381 U.S. 479, 481, 85 S.Ct. 1678, 14 L.Ed.2d
510 (1965) ; Abele v. Markle, 452 F.2d 1121, 1125 (CA2
1971); stay granted, 409 U.S. 908, 93 S.Ct. 212, 34
L.Ed.2d 169 (1972), remanded for consideration in
light of Roe and Doe, 410 U.S. 951, 93 S.Ct. 1417, 35
L.Ed.2d 683 (1973); Doe v. Turner, 361 F.Supp. 1288,
1289 (D.Iowa 1973) (3 judge court); Freeman & Bass,
P. A. v. State of N.J. Com’n of Invest., 359 F.Supp.
1053, 1059 (D.N.J. 1973); cf. O’Shea v. Littleton, 414
U.S. 488, 94 S.Ct. 669, 38 L.Ed.2d 674 (1974). Further-
more, the practical effect of the stringent limitation on
the use of hospital facilities for performing abortions
is to arbitrarily bar the physicians from activities that
directly affect their economic interests. Abele v. Mar-
kle, supra, 452 F.2d at 1125; see also, Data Processing
Service v. Camp, 397 U.S. 150, 90 S.Ct. 827, 25 L.Ed.2d
184 (1970); Epperson v. Arkansas, 393 U.S. 97, 89
S.Ct. 266, 21 L.Ed.2d 228 (1968).

We reiterated the same thought more succinctly in Word
v. Poelker, 495 F.2d 1349, 1350 (8th Cir. 1974), where
we said:

It is now clear from the decisions in Roe v. Wade,

25

410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973) and
Doe v. Bolton, 410 U.S. 179, 93 S.Ct. 739, 35 L.Ed2d
201 (1973) that a sweeping regulation of the abortion
decision and its implementation raises clear questions
of constitutional dimension regarding a medical doc-
tor’s right to practice. Doe v. Bolton, supra at 188,
93 S.Ct. 739; Roe v. Wade, supra at 165 of 410 U.S., 93
S.Ct. 705.° °°.

See Orr v. Koefoot, 377 F. Supp. 673, 678 (D. Neb. 1974) ;
Poe v. Menghini, 339 F. Supp. 986, 990 & note 8 (D. Kan.
1972); Doe v. Scott, 321 F. Supp. 1385, 87-88 (N.D. IIl.
1970); see also Wounded Knee Legal Defense/Offense
Committee v. F.B.I., No. 73-1908 (8th Cir., filed November
7, 1974), slip opinion at 6.

The statute in question interferes with the doctor-
patient relationship as it relates to the abortion decision.
It injects unnecessarily restrictive rules upon a consti-
tutionally protected decision of doctor and patient as
surely as did the statutes in the above cited cases. The
statute interferes with the appellants’ practice of medicine
both professionally and monetarily.

We think that there is no question that (1) appellants
allege that the challenged acts have caused them ‘‘injury
in fact, economic or otherwise’’ and (2) ‘‘the interests
sought to be protected by the complainant is arguably
within the zone of interests to be protected or regulated
by the statute or constitutional guarantee in question.’’
Association of Data Processing Service Organizations, Inc.
v. Camp, 397 U.S. 150, 152-53 (1970). To hold otherwise
in light of the authority cited above would defy logic.
These medical doctors have standing to pursue this action.

26

Ill. THIS COURT’S JURISDICTION TO REACH THE
MERITS |

We are urged by appellants to reach the merits of
this case rather than remand to the three-judge court. This
question is not without its difficulty. There is little direct
authority for the propriety of our reaching the merits.
Nevertheless, we are satisfied that under the circumstances
of this case and in the interest of judicial economy and
logic we should now address the merits of this controversy.

Of course, the three-judge court has not determined
the merits. This court is not generally a court of original
jurisdiction. Even so, there is authority for the proposition
that when a case is properly before a Court of Appeals,
the court has the power ‘‘to do what plainly ought to be
done.’’ Mercury Motor Express, Inc. v. Brinke, 475 F.2d
1086, 1091 (5th Cir. 1973), citing 9 Moore’s Federal Prac-
tice § 110.25[1] (2d ed. 1972).

In reaching the merits of a case which was before the
court pursuant to an interlocutory appeal under 28 U.S.C.
§ 1292(b) this court said:

We adhere to the proposition that it would be im-
proper to consider ‘‘grave constitutional questions’’
where there exists ‘‘ reasonable likelihood’’ that further
proceedings could help clarify the issues. Borden’s
Farm Products Co. v. Baldwin, 293 U.S. 194, at 213,
55 S. Ct. 187, 79 L.Ed. 281. However, in the present
proceeding no further pleadings or evidence is neces-
sary for ‘‘refinement or clarification of the issues.”’
United States v. Petrillo, 332 U.S. 1, 67 S. Ct. 1538,
91 L.Ed. 1877; United States v. Fabro, Inc., M.D. Ga.,
206 F. Supp. 523. And we should dispose of all con-
troversies ‘‘as expeditiously as is consistent with
proper judicial administration.’’ Turner v. City of
Memphis, 369 U.S. 350, 82 S. Ct. 805, 7 L.Ed.2d 762.

- ee -

oe te eae

27

Board of Managers of Ark. Tr. Sch. for Boys v. George,
377 F.2d 228, 231 (8th Cir. 1967). In addition, Mr. Justice
Clark in writing for the Supreme Court has indicated that
effective judicial administration requires disposal of the
case on appeal rather than remanding, where the point
to be decided is clear. Levin v. Mississippi River Fuel
Corporation, 386 U.S. 162, 170 (1967), 87 S. Ct. 927, 932.

it might be argued that the above authority, though
persuasive, should not apply in the instance of an appeal
to the Court of Appeals from a statutory three-judge court.

The Supreme Court has made it clear that the three-
judge court mandate must be construed quite narrowly.
‘*Congress established the three-judge court apparatus for
one reason: to save state and federal statutes from im-
provident doom, on constitutional grounds, at the hands of
a single federal district judge.’’ Gonzalez, supra 43 Law
Week 4027.

For this court to get to the heart of the matter and
dispose of this case on the merits will not conflict with
the policy behind the statute. Indeed, we think this case
is particularly proper for disposition in this court since
‘*twhile § 2281 calls for three judges to enjoin a statute
‘upon the ground’ of its ‘unconstitutionality,’ we [the Su-
preme Court] have held that three judges are not in fact
necessary where the unconstitutionality of the statute is
obvious and patent * * *.’’ Gonzalez, supra at 4027, foot-
note 14, citing Bailey v. Patterson, 369 U.S. 31 (1962).

The statute in question is obviously unconstitutional,
and it is our view that the case might well have been de-
cided by one federal judge. See generally Roe v. Norton,
380 F. Supp. 726, 728 (D. Conn. 1974). Accordingly, we
choose to make final determination of this case.

28

IV. MERITS
The statute before the court states:

Benefit payments for medical assistance may be made
on behalf of those eligible needy persons who are un-
able to provide for it in whole or in part, with any
payments to be made on the basis of the reasonable
cost of the care or reasonable charge for the services
as defined and determined by the division of welfare
unless otherwise hereinafter provided, for the follow-
ing:

Family planning services are defined by federal rules
and regulations provided, however, that such family
planning services shall not include abortions unless
such abortions are medically indicated.

As in Word v. Poelker, supra 495 F.2d 1349, 1350,
the issue in this case concerns the facial constitutionality
of the statute viewed against the glare of the Supreme
Court’s decisions in Roe v. Wade, Doe v. Bolton, and the
precedent which has developed as a result of those cases.

We find it unnecessary to review again Roe and Doe
or what this court has said in applying those cases. Suffice
it to say that the statute here provides medical payments
if the pregnancy is carried to term or for therapeutic
abortions but not if a non-therapeutic abortion is per-
formed. This classification is a clear violation of the Equal
Protection Clause of the Fourteenth Amendment.

There is ample case authority for the holding that a
welfare payments statute which places special regulation
on abortion but not upon other medical procedures cannot
stand in light of the Supreme Court decisions. Doe v.
Rose, 499 F.2d 1112 (19th Cir. 1974) ; Doe v. Westby, F.
Supp.—, No. 745017 (W.D. S.D., filed September 24,

29

1974); Roe v. Norton, 380 F. Supp. 726 (D. Conn. 1974) ;
Doe v. Wohigemuth, 376 F. Supp. 173 (W.D. Pa. 1974) ;
Doe v. Rompton, 366 F. Supp. 189 (D. Utah 1973); Klein
v. Nassau Co. Medical Center, 347 F. Supp. 496 (E.D. N.Y.
1972); see also Doe v. Hale Hospital, 500 F.2d 144 (lst
Cir. 1974).

The control meted out by this statute does not give
proper consideration to the conflicting constitutional in-
terests involved. Word, supra at 1351. It is further invalid
since the welfare parent and her physician are discrimi-
nated against by reason of the patient’s poverty. Compare,
e.g., Klein, supra.

We declare RSMo 208.152(12) to be unconstitutional
on its face. Injunctive relief should be unnecessary. We
assume that the state will abide by the ruling of this court
and that medical assistance payments will be made on a
nondisparate basis to those eligible needy persons who
elect to carry their pregnancy to term or who receive
therapeutic abortions and also to those who elect non-
therapeutic abortions.

Reversed.

A true copy.

Attest:

CLERK, U. 8S. COURT OF APPEALS,
EIGHTH CIRCUIT.

APPENDIX 2
UNITED STATES DISTRICT COURT

E. D. Missouri, E. D.
May 31, 1974.

GEORGE J. L. WULFF, JR., M.D., and.
MICHAEL FREIMAN, M_D.,
Plaintiffs,
vs.

The STATE BOARD OF REGISTRA-
TION FOR the HEALING ARTS >No. 73 C 731(A).
and THOMAS E. SINGLETON,
Chief of Bureau of Medical Services,
Division of Welfare State Depart-
ment of Public Health and Welfare,

Defendants...

MEMORANDUM

This matter is before the Court on motion of defendant,
State Board of Registration for the Healing Arts (herein-
after referred to as State Board), to dismiss Counts I and
III of the plaintiffs’ complaint, and on motion of defendant,
Thomas E. Singleton, to dismiss Count II of plaintiffs’
complaint. Counts I and III name the State Board as de-
fendant and Count IIT names Thomas E. Singleton as de-
fendant.

Plaintiffs, George J. L. Wulff, Jr. and Michael Frei-
man, are physicians licensed by the State of Missouri, engag-
ing in the practice of obstetrics and gynecology. Defendant,
State Board, is an administrative board created by Missouri
state statutes charged with the licensing of physicians. The
State Board has the power to revoke or suspend a physi-
cian’s license for unprofessional and dishonorable conduct

32

under RSMo 334.100. Defendant, Thomas E. Singleton, is
the Chief of the Bureau of Medical Services, Division of
Welfare, State Department of Public Health and Welfare,
for the State of Missouri. In his capacity as Chief of the
Bureau of Medical Services, Singleton oversees the applica-
tions, approvals, denials and payments of claims for pay-
ment and reimbursement of medical expenses arising from
or related to the procedure of abortion for women eligible
for Missouri State Medicaid assistance.

The plaintiffs’ complaint for declaratory judgment and
injunctive relief alleges jurisdiction in this Court under 28
U.S.C. §§ 1343, 2201, 2202, 2281, 2284 and 42 U.S.C. § 1983,
and prays for the convening of a three-judge court under
28 U.S.C. § 2281, and for declaratory and injunctive relief
in all three counts of their complaint.

Plaintiffs allege that the statutory wording ‘‘but ex-
cluding abortion’’ contained in RSMo 431.061' (Count I),
‘*shall not include abortions unless such abortions are medi-
cally indicated’’ contained in RSMo 208.152 (Count I1)
and ‘‘pregnancy’’ contained in RSMo 431.061 (Count IIT)
are unconstitutional. Plaintiffs allege that the above statu-
tory wording in each count is vague and uncertain, deprives
the plaintiffs and their patients of the right to pn.acy,
deprives plaintiffs of their right to practice medicine ac-
cording to the highest standards of medical practice, de-
prives plaintiffs’ patients of the fundamental right of a
woman to determine for herself whether to bear children,
infringes upon plaintiffs’ right to render and their patients’

SLAM. BPinore, westmens of covestn conditions ond Gissasse eutiortecd,
ment of a municipal health department, or any public or private
> bak enstading chertion: '

(2) Veneral
(3) or substance abuse including those referred to in chapter
195, RSMo

33

right to receive safe and adquate medical advice and treat-
ment, deprives plaintiffs and their patients of the equal
protection of the law and due process of law, and constitutes
state interference with the abortion decision, all of which
is in violation of the United States Constitution.

The contentions relied upon by the defendant State
Board to sustain its motion to dismiss Counts I and III
may be summarized as follows:

(1) Plaintiffs failed to state a claim upon which
relief can be granted.

(2) The State Board is not a proper party de-
fendant.

(3) Plaintiffs failed to allege the existence of a
**controversy’’.

(4) Plaintiffs failed to allege enforcement by the
State Board of the challenged statute and therefore
the court should abstain from interpreting the state
statute.

(5) There is relief available to plaintiffs in state
courts and agencies.

The grounds relied upon by defendant Singleton to
sustain his motion to dismiss Count II may likewise be
summarized as follows:

(1) The declaratory relief prayed for does not
constitute a ‘‘case or controversy ripe’’ for determina-
tion by this Court.

(2) Plaintiffs lack standing to litigate the con-
stitutional questions presented.

(3) Injunctive relief cannot be granted in that the
plaintiffs are not susceptible to irreparable harm by
virtue of enforcement of the challenged statute.

34

(4) Plaintiffs have not exhausted administrative
remedies.

(5) Plaintiffs could not personally suffer harm
for which relief can be granted under 42 U.S.C. § 1983.

COUNT I

[1] RSMo 431.061 (see Footnote 1), which plaintiffs
seek to attack in Counts I and III, was enacted in 1971 by
the Missouri General Assembly as Section 1 of House Bill
73 and must be read and construed in connection with
RSMo 431.062? and 431.063, which were Sections 2 and 3
of House Bi’! 73. Mitchem v. Perry, 390 S.W.2d 600, 603
(Mo.App. 1965). When so read and construed it is apparent
that RSMo 431.061 only relates to minors’ ability to con-
tractually bind themselves to pay for medical treatment
for pregnancy, venereal disease and drug abuse. It is true
that under RSMo 431.061(1) the treatment for pregnancy

to appointmen examination, test or other medical Le
aun to te parents, legal or any person.
3 431.063. Minor’s consent , when

35

for which an unmarried minor may contractually bind her-
self excludes abortions. The effect of this exclusion is simply
to leave the law unchanged as it relates to contracts for
abortion. That is to say that a minor may not be held con-
tractually liable for the cost of receiving an abortion unless
she ratifies the debt contracted after she reaches majority.
RSMo 431.060. This does not constitute a prohibition against
giving abortions to minors.

[2] Neither the statute under attack, RSMo 431.061,
nor the two statutes enacted as part of the same bill (RSMo
431.062 and 431.063) provide any sanctions for the perform-
ance of an abortion on an unmarried minor without parental
consent. In fact, Missouri does not in light of Roe v. Wade,
410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973); Doe v.
Bolton, 410 U.S. 179, 93 S.Ct. 739, 35 L.Ed.2d 201 (1973),
and Rodgers v. Danforth, Civ. No. 18360—2 (W.D.Mo.),‘
affirmed 1973, 414 U.S. 1035, 94 S.Ct. 534, 38 L.Ed.2d 327,
at this time have sanctions for abortions performed on
adults or minors as long as the abortionist is a licensed
physician.

Plaintiffs contend in their affidavits filed in opposi-
tion to the defendants’ motions to dismiss that they fear
reprisals from the defendant State Board, in that the State
Board may discipline them under RSMo 334.100 based
upon their past performances of abortions and anticipated
future performances of abortions upon unmarried minors,
without parental consent, on a non-emergency basis. RSMo
334.100 provides, in part, that a licensee may be placed on
probation or the license suspended or revoked when a physi-

cian is found guilty of unprofessional or dishonorable con-
duct. That statute then continues, stating:

‘Without limiting the foregoing general language,

* See Appendix.

36

the following specifications shall be deemed unprofes-
sional and dishonorable conduct within the meaning
of this section:

‘*(3) Committing an unlawful abortion;’’

As pointed out above, since the decisions in Wade, Bol-
ton and Rodgers, supra, and the failure of the Missouri
Legislature to enact a statute within permissible limits of
those cases, Missouri no longer has any prohibition against
abortion, when it is performed by a physician. Therefore,
any abortion performed by a licensed physician is not
an unlawful abortion. What plaintiffs seek in reality is a
declaratory judgment by this Court that the performance
of an abortion by a licensed physician on an unmarried
minor without parental consent on a non-emergency basis
is not unprofessional and dishonorable conduct under RSMo
334.100.

In order for this Court to rule on the constitutionality
of the statutory wording ‘‘ but excluding abortion’’ in RSMo
431.061 under the Declaratory Judgment Act, 28 U.S.C.
§ 2201, as prayed for in plaintiffs’ complaint, there must
exist an ‘‘actual controversy’’ between the parties and
without such actual controversy this Court is without power
to grant declaratory relief. Maryland Casualty Co. v. Pacific
Coal & Oil Co., 312 U.S. 270, 61 S.Ct. 510, 85 L.Ed. 826
(1941). In Golden v. Zwickler, 394 U.S. 103, 108, 89 S.Ct.
956, 959, 22 L.Ed.2d 113 (1969), the Supreme Court said:

‘‘*?T)}he federal courts established pursuant to
Article III of the Constitution do not render advisory
opinions. For adjudication of constitutional issues ‘‘con-
crete legal issues, presented in actual cases, not abstrac-
tions,’’ are requisite. This is as true of declaratory
judgments as any other field.’ United Public Workers

37

of America v. Mitchell, 330 U.S. 75, 89, [67 S.Ct. 556,
564, 91 L.Ed. 754] (1947). ‘‘The difference between
an abstract question and a ‘‘controversy’’ contemplated
by the Declaratory Judgment Act is necessarily one of
degree, and it would be difficult, if it would be possible,
to fashion a precise test for determining in every case
whether there is such a controversy. Basically, the ques-
tion in each case is whether the facts alleged, under
all the circumstances, show that there is a substantial
controversy, between parties having adverse legal in-
terests, of sufficient immediacy and reality to warrant
the issuance of a declaratory judgment.’ Maryland
Casualty Co. v. Pacific Coal & Oil Co., 312 U.S. 270,
273, [61 S.Ct. 510, 512, 85 L.Ed. 826] (1941).’’

[3, 4] From the foregoing, it is clear that the ingredi-
ents necessary to sustain a complaint for declaratory judg-
ment are: (a) a substantial controversy; (b) between parties
having adverse legal interests; and (c) the controversy must
possess ‘‘immediacy and reality.’’ The plaintiffs here do
not claim that they have ever been threatened with dis-
ciplinary action by the State Board or that disciplinary
action by the State Board is even likely. The most that
can be said of the plaintiffs is that they feel uneasy or
inhibited in performing abortions on minors without pa-
rental consent. The mere possibility or even probability
that the plaintiffs may sometime in the future be adversely
affected by a disciplinary action of the State Board not
yet threatened does not create an ‘‘actual controversy”’
which is a prerequisite created by the clear language of
the Declaratory Judgment Act. Garcia v. Brownell, 236
F.2d 356 (9th Cir. 1956), cert. denied, 362 U.S. 963, 80
S.Ct. 880, 4 L.Ed.2d 878 (1960).

38

COUNT II

In Count II plaintiffs challenge the constitutionality
of the statutory wording, ‘‘shall not include abortions
unless such abortions are medically indicated,’’ contained
in RSMo 208.152(12). The pertinent portions of RSMo
208.152 are as follows:

‘*Benefit payments for medical assistance may be made
on behalf of those eligible needy persons who are unable
to provide for it in whole or in part, with any payments
to be made on the basis of the reasonable cost of the
care or reasonable charge for the services ds defined
and determined by the division of welfare unless other-
wise hereinafter provided, for the following:

‘*(12) Family planning services are defined by federal
rules and regulations provided, however, that such
family planning services shall not include abortions
unless such abortions are medically indicated.’’

[5] As established by the above statute, the medical
reimbursements for medical assistance in the area of ‘‘ medi-
cally indicated’’ abortions are made on behalf of those
eligible needy persons who are unable to provide for it in
whole or in part. Since the medical payments are made
‘‘on behalf’’ of the needy individual, there can be no argu-
ment but that the welfare recipient is the intended bene-
ficiary of this statutory section. It is the welfare recipients
and not their physicians who by Federal! Title 45, Public
Welfare Chapter II, Social Rehabilitation Services (Federal
Register, Vol. 38, No. 157, Wed., August 15, 1973) under
part 205.10(a)(5) are granted a right to a hearing if their
claims for medical reimbursement assistance are denied
and it is the welfare recipients who are afforded the right
to appeal such decisions through the administrative process

39

required by federal regulation and established under RSMo
208.156. This raises the question as to whether the plain-
tiffs have standing to litigate the constitutionality of the
statute here in question.

Plaintiffs state in their affidavits filed in opposition
to defendant Singleton’s motion to dismiss that they have
provided and anticipate providing abortions to welfare pa-
tients who are eligible for Medicaid payments for medical
assistance, and that those patients who have submitted
applications for such payments have been refused and that
they anticipate future refusals by defendant Singleton based
upon the challenged language in RSMo 208.152. Plaintiffs
further state that such refusals by defendant Singleton
deter plaintiffs from the practice of medicine in the manner
they consider to be most expert and beneficial to their pa-
tients.

Plaintiffs cite Doe v. Scott, 321 F. Supp. 1385 (N.D.
Ill. 1970); Roe v. Wade, supra, and Doe v. Bolton, supra,
as authority for their contention that they have standing
to litigate the constitutionality of RSMo 208.152. Doe v.
Scott, supra, was an action for declaratory and injunctive
relief brought to declare an Illinois criminal abortion statute
unconstitutional. The plaintiff-physicians in Scott alleged
that the existence of the [illinois criminal abortion statute
interfered with and adversely affected their ability to con-
duct their medical practices with proper regard for their
patients’ best interests. The district court in Scott, 321
F.Supp. lc. 1387-88 held:

‘*(T he physician-plaintiffs have standing to raise the
claims of their patients even if we assume that no
independent claim of theirs could withstand a motion
for judgment on the pleadings.’’

The court in Scott cited Griswold v. Connecticut, 381
U.S. 479, 481, 85 S.Ct. 1678, 14 L.Ed.2d 510 (1965), and

40

Barrows v. Jackson, 346 U.S. 249, 257, 73 S.Ct. 1031, 97
L.Ed. 1586 (1953), as supporting authority for its decision
that the plaintiff-physicians had standing to raise the
claims of their patients with respect to the constitutionality
of the Illinois abortion statute.

In Griswold v. Connecticut, supra, the appellant-physi-
cian had been convicted as an accessory for giving informa-
tion and medical advice on how to prevent conception in
violation of a Connecticut statute making it a crime for
any person to use any drug or article i: prevent conception.
In relation to the appellant-physici .a’s standing, the Su-
preme Court said, 381 U.S. 1. c. 481, 85 S.Ct. 1. ¢. 1679:

‘‘We think that appellants have standing to raise
the constitutional rights of the married people with
whom they had a professional relationship. Tileston v.
Ullman, 318 U.S. 44 [63 S.Ct. 493, 87 L.Ed. 603], is
different, for there the plaintiff seeking to represent
others asked for a declaratory judgment. In that situa-
tion we thought that the requirements of standing
should be strict, lest the standards of ‘case or contro-
versy’ in Article III of the Constitution become blurred.
Here those doubts are removed by reason of a criminal
conviction for serving married couples in violation of
an aiding-and-abetting statute. Certainly the accessory
should have standing to assert that the offense which
he is charged with assisting is not, or cannot constitu-
tionally be a crime.”’

In Barrows v. Jackson, supra, a white defendant who
was a party to a racially restrictive covenant was being
sued for damages by the covenantors because she had con-
veyed her property to Negroes. The defendant was allowed
to raise the issue that enforcement of the covenant violated
the rights of prospective Negro purchasers to equal protec-
tion of the law, although no Negro was a party to the suit.

41

The Supreme Court said, 346 U.S. 1. ¢. 255-256, 73 S.Ct. 1. ¢.
1034:

‘‘Ordinarily, one may not claim standing in this
Court to vindicate the constitutional rights of some
third party. Reference to this rule is made in varied
situations. See Joint Anti-Fascist Refugee Comm. v.
McGrath, 341 U.S. 123, 149-154 [71 S.Ct. 624, 636-639,
95 L.Ed. 817] (concurring opinion). The requirement
of standing is often used to describe the constitutional
limitation of the jurisdiction of this Court to ‘cases’ and
‘controversies’. See Coleman v. Miller, 307 U.S. 433,
464 [59 S.Ct. 972, 986, 83 L.Ed. 1385] (concurring
opinion). Apart from the jurisdictional requirement,
this Court has developed a complementary rule of self-
retraint for its own governance (not always clearly
distinguished from the constitutional limitation) which
ordinarily precludes a person from challenging the con-
stitutionality of state action by invoking the rights of
others. See Ashwander v. Tennessee Valley Authority,
297 U.S. 288, 346-348 [56 S.Ct. 466, 482-483, 80 L.Ed.
688] (concurring opinion). The common thread under-
lying both requirements is that a person cannot chal-
lenge the constitutionality of a statute unless he shows
that he himself is injured by its operation. This prin-
ciple has no application to the instant case in which
respondent has been sued for damages totaling $11,600,
and in which a judgment against respondent would
constitute a direct, pocketbook injury to her.’’

The Supreme Court went on to say in relation to its rule
on standing, |. c. 257, 73 S.Ct. 1. ¢. 1035:

‘‘This is a salutary rule, the validity of which
we reaffirm. But in the instant case, we are faced with a
unique situation in which it is the action of the state
court which might result in a denial of constitutional

42

rights and in which it would be difficult if not impos-
sible for the persons whose rights are asserted to pre-
sent their grievance before any court. Under the pecu-
liar circumstances of this case, we believe the reasons
which underlie our rule denying standing to raise an-
other’s rights, which is only a rule of practice, are out-
weighed by the need to protect the fundamental rights
which would be denied by permitting the damages
action to be maintained. Cf. Quong Ham Wah Co. v.
Industrial Acc. Comm., 184 Cal. 26, 192 P. 1021, 12
A.L.R. 1190.

Roe v. Wade, supra, and Doe v. Bolton, supra, the
other two cases relied upon by plaintiffs in the instant case
to support their contention that they have standing, are
somewhat similar in that they both attack the constitution-
ality of state criminal abortion statutes. In Roe v. Wade,
supra, the Supreme Court held that plaintiff-physician in
Wade was under indictment for violating the Texas crimi-
nal abortion statute and the Supreme Court dismissed his
complaint and remitted him to his defenses in the state
criminal proceedings against him where he could raise the
constitutionality of the statute under which he was charged.
In Doe v. Bolton, supra, the plaintiff-physicians alleged that
the Georgia criminal abortion statute chilled and deterred
them from prac icing their profession. The Supreme Court
in holding that the plaintiff-physicians had standing said,
410 U.S. 1. c. 188, 93 S.Ct. 1. ¢. 745:

‘‘(T]}he physician-appellants, who are Georgia-licensed
doctors consulted by pregnant women, also present a
justiciable controversy and do have standing despite
the fact that the record does not disclose that any one
of them has been prosecuted or threatened with prose-
cution, for violation of the State’s abortion statutes.
The physician is the one against whom these criminal

43

statutes directly operate in the event he procures an
abortion that does not meet the statutory exceptions
and conditions. The physician-appellants, therefore,
assert a sufficiently direct threat of personal detri-
ment. They should not be required to await and under-

go a criminal! prosecution as the sole means of seeking
relief.’’

In the instant case, the plaintiff-physicians have not
been convicted as accessories to a criminal offense as the
plaintiff-physician was in Griswold v. Connecticut, supra.
The plaintiff-physicians here do not present a unique situa-
tion such as was presented to the court in Barrows v. Jack-
son, supra, and they are not being sued for damages as in
Barrows, where a judgment against them would constitute
a direct pocketbook injury. Also in Barrows, the Supreme
Court felt it would be difficult if not impossible for the
Negroes whose rights were being asserted by the defendant
therein to present their grievance before any court. This
is not the situation here for in the instant case the persons
whose rights the plaintiffs are really asserting (their pa-
tients who are eligible to receive Medicaid payments) have
a statutory right to a hearing before a state agency as stated
above where they can present their grievance and if not
satisfied they can carry their grievance on to the appropriate
court. Neither are the plaintiff-physicians herein subject
to the direct operation of any criminal anti-abortion statute
as the plaintiff-physicians were in Roe v. Wade, supra,
and Doe v. Bolton, supra, and, therefore, cannot assert a
sufficiently direct threat of personal detriment as the plain-
tiff-physicians in those cases could. The only possible detri-
ment the plaintiffs in the instant case can suffer under
their contentions in Count II is the possibility that their
patients who are eligible for medical assistance under RSMo
208.152 will not be able to pay for the services the plaintiffs
have rendered to them in giving them an abortion operation.

44

Keeping in mind that it is the welfare recipient in
whose behalf medical assistance payments under RSMo
208.152 are made and that it is the welfare recipients and
not their physicians who have a right to a hearing if their
medical assistance claims are denied, and that the plaintiff-
physicians are not prohibited from performing abortions,
this Court finds that the standing requirement of Flast v.
Cohen, 392 U.S. 83, 102, 88 S.Ct. 1942, 20 L.Ed.2d 947 (1968),
that there be a logical nexus between the status asserted
by the plaintiffs and th~ claim they seek to have adjudi-
eated is not satisfied b: the litigative posture of the plain-
tiff-physicians herein, and, therefore, they lack standing
to challenge the constitutionality of the statute in question
here. This is not to say that the issue the plaintiffs bring
to this Court is not justiciable, but is only to say that these
plaintiffs are not the proper parties to request an adjudica-
tion. Flast v. Cohen, supra.

45

COUNT III
[6] Plaintiffs contend that the word ‘‘pregnancy”’ in
RSMo 431.061 is vague and ambiguous and jf it is inter-
preted, construed and applied to exlude the giving, pre-
scribing and providing of contraceptive devices to minors
without parental consent then it would be subject to all of
the constitutional defects alleged in Count I.

It is apparent from the plaintiffs’ pleadings in Count
III that the plaintiffs do not present an actual controversy
in Count III as required under the Declaratory Judgment
Act. Therefore, this Court’s reasoning in relation to Count I
and the law applied there equally applies here in Count TTI.

In view of this Court’s findings it is not necessary to
discuss the defendants’ remaining contentions.

Accordingly, for the reasons above stated, the motion
of the defendant, State Board, to dismiss Counts I and III
for lack of controversy, and the motion of defendant Single-
ton to dismiss Count IT for lack of standing, are sustained.

The Clerk of the Court will prepare and enter the proper
order dismissing the case.

APPENDIX

UNITED STATES DISTRICT COURT

FOR THE WESTERN DISTRICT OF
MISSOURI WESTERN DIVISION

Filed May 18, 1973

SAMUEL L. RODGERS, M. D.,

et al.,
Plaintiffs,
vs. | Civil Action
JOHN C. DANFORTH, Attorney No. 18980-
General of the State of
Missouri, et al.,
Defendants.

MEMORANDUM OPINION AND JUDGMENT

This complaint attacked the constitutionality of Mis-
souri criminal abortion statutes. The basic statute, Section
559.100, Missouri Revised Statutes, 1959, as amended, de-
elares the production of all miscarriages and abortions
a felony ‘‘unless the same is necessary to preserve her
(the mother’s) life or that of an unborn child,’’ with dif-
ferent penalties for the death of a ‘‘quick’’ and ‘‘unquick”’
foetus. The complaint sought both declaratory and injunc-
tive relief.

Because of the prayer for injunctive relief, a three-
judge federal court was convened under the provisions
of Title 28, U.S.C. Section 2281.

A motion to intervene was filed by ‘‘Baby Doe’’ and
an M.D. on behalf of all unborn children ‘‘who will or may
be adversely affected by the action before this court.’’

The defendant named in the origina! complaint was

48

the Attorney General of Missouri, in his official capacity,
and later, by an amended complaint, the Prosecuting At-
torney of Jackson County, Missouri, was added as a party de-
fendant, who was made the class representative of all prose-
euting attorneys in Missouri, by subsequent court order.

The Court then granted the motion of the defendants
to dismiss this action on the sole grounds of abstention,
and ordered the cause dismissed without prejudice. The
plaintiffs appealed this judgment to the Supreme Court.

While the appeal was pending, that Court decided
the cases of Roe v. Wade, 410 U.S. 113, 93 S.Cf. 705, 35
L.Ed.2d 147 (1973), and Doe v. Bolton, 410 U.S. 179, 93
S.Ct. 739, 35 L.Ed.2d 201 (1973), and remanded this case
to this Court ‘‘for further consideration in light of’’ these
two cases.

After the remand, the defendants filed an answer deny-
ing the existence of a justiciable controversy and alleging
that the attacked statutes are justified by compelling state
interests, to-wit: the protection of human life and the
protection of potential human life. The answer requested
a jury trial under either Rule 38 or 39, Federal Rules of
Civil Procedure.

The plaintiffs filed a motion for summary judgment
based on affidavits of two of the plaintiffs who are medical
doctors, and a third person who is Executive Director of
Suicide Prevention, Inc., a United Fund agency in St. Louis.

The denfendant Attorney General has filed lengthy
suggestions in opposition to the motion for summary judg-
ment, accompanied by the affidavit of an M.D. which con-
troverts affidavits filed by plaintiffs as to the ‘‘chilling
effect’’ of Missouri abortion stetutes on the practice of
their profession by doctors in Missouri.

49

The argument of the Attorney General of Missouri is
that in Roe v. Wade, supra, the Supreme Court did not
determine ‘‘whether an unborn child is human life’’; that
this is a question of fact which can only be determined by
triers of the fact after hearing evidence from expert wit-
nesses; that if human life exists from the moment of con-
ception the State has a compelling interest to protect this
life; and that summary judgment cannot be granted when
such an issue of fact exists.

This Court finds that the teachings of Roe v. Wade,
supra, completely contradict this argument. The opinion
stated that the ‘‘existence of life from the moment of con-
ception’’ is the official belief of the Catholic Church, of
many non-Catholics, and ‘‘a view strongly held .. . by
many physicians.’’

But, the opinion states, ‘‘ We need not resolve the diffi-
cult question of when life begins.’’ No statement could be
clearer. Whether life begins at conception, at quickening,
at viability, or at birth (the alternatives discussed in the
opinion), the Court held that resolution of this question
would not affect the decision.

The defendants’ prayer for trial of the factual issue
of ‘‘when life begins’’ is denied.

The lack of justiciable controversy issue raised by the
answer is fully discussed and ruled upon in the case of
Doe v. Bolton, supra. That case holds:

‘*We conclude, however, that the physician-appel-
lants, who are Georgia-licensed doctors consulted by
pregnant women, also present a justiciable controversy
and do have standing despite the fact that the record
does not disclose that any of them has been prosecuted,
or threatened with prosecution, for violation of the
State’s abortion statutes.’’

50

Four of the plaintiffs in this case are eminent Missouri-
licensed obstetricians and gynecologists, and their standing
as plaintiffs, under the teachings of Doe v. Bolton cannot
be questioned.

In Roe v. Wade the Court quoted from the Texas statute
it found unconstitutional and stated, ‘‘Similar statutes are

in existence in a majority of the States.?’’ Footnot 2 lists
‘*Mo.Rev. § 559.100 (1969).’’

There can be no question that this Missouri statute re-
ferred to in that opinion is unconstitutional under the teach-
ings of the two Supreme Court cases which we were man-
dated to consider. The other two statutes attacked are based
upon the validity of § 559.100 and must similarly be held
unconstitutional. The plaintiffs’ motion for summary judg-
ment will be granted.

In both Roe v. Wade and Doe v. Bolton the Supreme
Court affirmed the lower court’s granting of a declaratory
judgment and denial of injunctive relief, stating in both
cases that the Court would assume that the state prose-
cutorial authorities would give full recognition and credence
to the Court’s judgment as to the unconstitutionality of
the State statute.

In this case the defendant Attorney General has not
given ‘‘full recognition’ or ‘‘credence’’ to the ruling of
the Supreme Court. It does not appear that a declaratory
judgment in this case, in view of the Attorney General’s
publicly stated position, will suffice to guarantee the con-
stitutional rights of pregnant women and their consulting
doctors as decided by the Supreme Court, and, it is therefore

Ordered that the defendant Attorney General of the
State of Missouri, and the defendant class of all Prosecuting
Attorneys in the State of Missouri be, and they hereby are,
enjoined from instituting any criminal prosecutions, com-

51

plaints for warrants, or complaints for search warrants
under, or by authority of, unconstitutional Sections
542.380(3), 559.100, or 563.300, Revised Statutes of Missouri,

1969. Costs taxed to defendant Attorney General in his
official capacity.

(s)
Floyd R. Gibson, Circuit Judge

(s)
Elmo B. Hunter, District Judge

(s)
William R. Collinson, District Judge

---

Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385003_0385%3A1. Public record. Not legal advice.
