Petition for Writ of Certiorari — Voinovich v. Women's Medical Professional Corp.

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In The

SUPREME COURT OF THE UNITED STATES

October Term, 1997

GEORGE VOINOVICH, et al.,

Petitioners,

Vv.

WOMEN’S MEDICAL PROFESSIONAL

CORP., et al.,

Respondents.

ON PETITION FOR WRIT OF CERTIORARI

TO THE UNITED STATES COURT OF APPEALS

FOR THE SIXTH CIRCUIT

PETITION FOR WRIT OF CERTIORARI

BETTY D. MONTGOMERY

Attorney General

JEFFREY S. SUTTON

State Solicitor

Counsel of Record

STEPHEN P. CARNEY

Assistant Attorney General

30 E. Broad Street, 17th Floor

Columbus, Ohio 43215-3428

(614) 466-8980

Counsel for Petitioners

MATHIAS H. HECK, JR.

Prosecuting Attorney for

Montgomery County

ELISSA D. COHEN

Assistant Prosecuting

Attorney

P.O. Box 972

301 W. Third Street

Dayton, Ohio 45402

(937) 225-4979

Of Counsel:

DIANE R. RICHARDS

Bricker & Eckler LLP

100 S. Third Street

Columbus, Ohio 43215-4291

16 pr:

4

QUESTIONS PRESENTED

L.

WHETHER, IN A VAGUENESS OR SUBSTANTIVE DUE

PROCESS CHALLENGE TO STATE ABORTION

REGULATIONS, CLAIMANTS SEEKING TO

INVALIDATE THE REGULATIONS IN ALL OF THEIR

APPLICATIONS MUST ESTABLISH “NO SET OF

CIRCUMSTANCES” IN WHICH THE REGULATIONS

MAY PERMISSIBLY BE APPLIED OR MUST ESTABLISH

THAT IN A “LARGE FRACTION” OF THEIR

APPLICATIONS THE REGULATIONS WOULD BE

IMPERMISSIBLE?

WHETHER, ON ITS FACE, OHIO’S REGULATION OF

PARTIAL-BIRTH ABORTIONS PLACES AN UNDUE

BURDEN ON A WOMAN’S DUE PROCESS RIGHT TO

TERMINATE A PREGNANCY?

WHETHER, ON ITS FACE, OHIO’S REGULATION OF

POST-VIABILITY ABORTIONS IS IMPERMISSIBLY

VAGUE (BECAUSE IT REQUIRES THAT A PHYSICIAN

EXERCISE “REASONABLE” MEDICAL JUDGMENT

CONCERNING THE VIABILITY OF A FETUS OR THE

MEDICAL NECESSITY FOR AN ABORTION) OR

VIOLATES SUBSTANTIVE DUE PROCESS (BECAUSE IT

CONTAINS A MATERNAL HEALTH EXCEPTION THAT

REQUIRES THE RISK OF PHYSICAL INJURY)?

i

LIST OF PARTIES

Petitioners are George Voinovich, Governor, State of

Ohio, Betty D. Montgomery, Attorney General, State of Ohio

and Mathias H. Heck, Jr., Montgomery County Prosecuting

Attorney.

Respondents are Women’s Medical Professional Corp.

and Martin Haskell, M.D.

TABLE OF CONTENTS

Page

QUESTIONS PRESENTED .............. os

LIST OF PARTIES _... Le ea aes vy ii

TABLE OF AUTHORITIES .............. Tees

SS ee ane ery ies

i a tee oe

CONSTITUTIONAL PROVISION INVOLVED ....... 1

STATUTORY PROVISIONS INVOLVED ........... 1

STATEMENT ........ a Patti avs ee ste

I The Partial-Birth Abortion Procedure. ___. at

I. EE ee re “ore 3

A. The Restriction on Partial-Birth

EE iit rs weiss oak oo is

B. The Restriction on Post- yen

ET SS a ai | 4

Ill. Procedural History................ eg

Iv

IV. The Sixth Circuit's Decision .................. 6

A. Standard For Assessing Facial, Pre-

Implementation Challenge | urea es

B Invalidation of Ohio's Partial- Birth

TT ee eee 7

Cc. Invalidation of Ohio's Restriction on

Post-Viability Abortions. .............. 8

D. ER, Gann Sew a'e wo 9 du 68k hades

REASONS FOR GRANTING THE WRIT ........... 10

L. The Sixth Circuit's Decision Exacerbates

Several Conflicts of Authority, ....... <ccake ee

II. The Sixth Circuit's Decision Raises Important

PUR, oo wee Peed Cditieeedes: 15

Ill. The Sixth Circuit Erred In Striking The Ohio

Law.

The Court of Appeals Applied The

Wrong Standard For Assessing Facial

Challenges to an Abortion Statute... .. 18

The Court of Appeals Erred in Striking

Ohio's Partial-Birth (D&X) Abortion

ND. Ke SUE cited eed s vue ae

The Court of Appeals Erred in

Concluding that the Good-Faith and

Reasonable-Medical-Judgment

Exceptions to the Post-Viability Ban

Were Impermissibly Vague. ........... 24

Vv

The Court of Appeals Erred In

Concluding That the Ohio Post-

Viability Abortion Regulations Violate

Substantive Due Process Because

They Do Not Contain a Mental Health

Exception For the Mother ............ 26

RD ee ee ee eae 28

CASES

Ada v. Guam Society of Obstetricians

& Gynecologists,

RE OED. nob ccccccvcnsdueewes 1}

Adams Fruit Co. v. Barrett,

eee ore 18

Anderson v. Edwards,

ae eee ee 19

Barnes v. Moore,

970 F.2d 12 (Sth Cir.), cert. denied

SE PGND onc cevcccvccccccecs 11,12

Bowen v. Kendrick,

SR Soe cdg, kaka sseeees 19

Casey v. Planned Parenthood of

Southeastern Pennsylvania,

14 F.3d 848 (3d Cir. 1994)............... passim

Causeway Med. Suite v. leyoub,

109 F.3d 1096 (Sth Cir 1997) ............... 12

Chapman v. United States,

I era's s slew hue sé 13,21

Colautti v. Franklin,

I ing be dn ese 0 8 2 13,22,25

General Motors v. Tracy,

Ce 19

Jane L. v. Bangerter,

102 F.3d 1112 (10th Cir. 1996),

cert. denied, 117 §. Ct. 2453 (1997) .......... 11

Janklow v. Planned Parenthood,

Sioux Falls Clinic,

ED «a's Suee «6 cw eceaoaen 11,12

vii

Kolender v. Lawson,

ED > Sa, SG n wkd dle haat 13,22

Manning v. Hunt,

119 F.3d 254 (4th Cir. 1997) ........ 0.0... 12

Maynard v. Cartwright,

ee Fre ee 13,21

New England Accessories Trade Assn,

Inc. v. City of Nashua,

jf Fl le 14

New York v. Ferber,

Ec dla sig LUNG 4 ow wR we 19

Ohio v. Akron Ctr. For Reprod. Health,

Eo ond unig Washoe 6,10,11,19

Planned Parenthood v. Casey,

947 F.2d 682 (3rd Cir. 1991) ............. passim

Planned Parenthood v. Casey,

ER passim

Planned Parenthood Assn. Of Kansas City v. Ashcroft,

I i oo ae ie we 18

Planned Parenthood, Sioux Falls Clinic v. Miller,

63 F.3d 1452 (8th Cir. 1995),

cert. denied, 116 §. Ct. 1582(1996) .......... ll

Reno v. American Civil Liberties Union,

RR ES ee cae eo 19

Reno v. Flores,

I) SCL BS be es i ness wade 19

Richmond Boro Gun Club, Inc. v. City

Of New York,

fe EE a 14

Roemer v. Bd. Of Public Works,

ao 19

Rust v. Sullivan,

ED 6k oak is he’ awed 6,11,19

Secretary of State of Maryland v.

J.H. Munson Co.,

Se EDs woes be Webel eed sawed 21

Stoianoff v. Montana,

695 F.2d 1214 (9th Cir. 1983) ............... 14

United States v. A Single Family Residence,

803 F.2d 625 (1 Ith Cir. 1986) ............... 14

United States v. Mazurie,

EE. Gucid Use aces be vee ta 13,21

United States v. Powell,

IUD db Seek Gets cewe cosh 13,21

United States v. R.L.C.,

ED, Cc eclicaina dele Suae > ae

United States v. Reed,

114 F.3d 1067 (10th Cir. 1997) .............., 14

United States v. Salerno,

See ee ED, ni Gb dae ses weued ee) passim

Village of Hoffman Estates v. Flipside,

Hoffman Estates, Inc.,

Se ED ns coWeecdeive sede 12,13,21

Webster v. Reproductive Health Services,

SP OP el ver vcdveunss cowabe 10,19,22

STATUTORY AUTHORITIES

Se EE VUE C045 os wen ee yeeVE ewsbaced 16

la ee RAS bbe ae 16

Ariz. Rev. Stat. Ann. 13-3603.01................... 16

rr ee ati cweeseeews 16

Arkansas Code Ann. 20-16-705 .................... 17

California Health and Safety Code 123405,

ae 17

Conn. Gen. State Ann. 19a(602)(b) ................. 17

Del. Code Ann. Title 24, 1790(a)(1) & (bl) ......... 17

Fla. Stat. Ann. 390.0111(1) & (4) ©... 00 en, 17

Ga Code Ann. 16-12-141(C) ...................5.. 17

I PE Here err 16

Idaho Code Ann. 18-608(3)...............0. 0000. 17

ix

Illinois Comp. Stat. Ann., Ch. 720510/5 ............. 17

Ind. Code Ann. 16-18-2-267.5,

ES I ES ee ae 16

gn Ek Pe eee 17

Kansas Stat. Ann. 65-6-703 ......................., 17

ey I AU MUD so’. Vid dec 0 o's ce ee wel dew 17

ee U St ee cus Wace’ 17

1997 La. Acts 906, La. R.S. 14:32:9

a ik de wien 16

Maine Rev. Stat. Ann. Title22 1598 ................ 17

Mich. Comp. Laws Ann. 333.16221(1) & (m),

333.16226, 333.17016, 333.17516............ 16

Mien. Stat. Amn. 145.412(3) .......5.... ccc cece eee 17

I als Swale Saabbocee 16

ei oe. eae bbe bap 17

Mont. Code Ann. 50-20-401 ...................... 16

Mont. Code Ann. §0-20-109%(c) ...................., 17

Neb. Rev. Stat. 28-325 and 71-148 ................. 16

we 17

New York Pen. Law 125.00, 125.05, 125.45 .......... 17

De ons elbeib on 17

I ok Bee SW sbi alee wl os 17

ES ne Pe ae ae 17

R.I. Gen. Laws Ann. 11-23-5...................... 17

R.1. Gen. Laws 23-4.12-1, 23-4.12-2,

23-4.12-3, 23-4.12-4, 23-4.12-5

EE SER TEST, I i EG 16

a ee 16

S.D. Codified Laws 34-23A-27 through

es 16, 17

Tenn. Code Ann. 39-15-201(C)(3) .......0..000.... 17

Tenn. Code Ann. 39-15-209 ..................55.. 16

Dee es eve weceseebk une 16

oe oe es welb eta 17

GY od’) St chs wee 6 Ce bwle ceble cont 17

PETITION FOR A WRIT OF CERTIORARI

Ohio Governor George Voinovich, Ohio Attorney

General Betty Montgomery, and Montgomery County, Ohio,

Prosecutor, Mathias Heck, Jr., respectfully petition for a writ of

certiorari to review the judgment of the United States Court of

Appeals for the Sixth Circuit in this case.

OPINIONS BELOW

The opinion of the United States Court of Appeals for

the Sixth Circuit (Appendix (“A-”) 1) has not yet been

officially reported but soon will be. 1997 U.S. App. LEXIS

32232; 1997 FED App. 0336P. The opinion of the United

States District Court for the Southern District of Ohio, Eastern

Division (A-73) is reported. 911 F. Supp. 1051.

JURISDICTION

The opinion of the United States Court of Appeals for

the Sixth Circuit (A-1) was entered on November 18, 1997.

Jurisdiction in this Court exists under 28 U.S.C. 1254(1).

CONSTITUTIONAL PROVISION INVOLVED

The Fourteenth Amendment provides in pertinent part:

“Nor shall any State deprive any person of life, liberty, or

property without due process of law.”

STATUTORY PROVISIONS INVOLVED

See Attachment to Petition.

2

STATEMENT

1. The Partial-Birth Abortion Procedure.

Partial-birth abortions represent a recent innovation in

late-term abortion techniques. The first medical literature on

the subject did not appear until 1992, when respondent Dr.

Martin Haskell presented a paper entitled “Dilation and

Extraction for Late Second Trimester Abortion” to the National

Abortion Federation. A resident of Ohio who performs late-

term abortions there, Dr. Haskell described a new method for

performing abortions after the 20th week of gestation, and

usually between the 20th and 24th week.

The three-day procedure works in the following manner.

During the first two days, a doctor inserts laminaria into the

woman's cervix to dilate it. On the third day, after the cervix

has been dilated, the doctor uses forceps to grasp the leg of the

fetus, then pulls the fetus feet-first into the woman’s vagina.

The doctor next removes the feet, legs, torso, and shoulders of

the fetus from the vagina, so that only the upper part of the fetal

head remains in the birth canal. At that point, as the head of the

fetus remains lodged in the pregnant woman’s body, the

surgeon forces scissors into the base of the skull, places a

suction catheter into the scissor hole and evacuates the skull

contents. The suctioning of the brain is customarily what

terminates the life of the fetus. To describe this novel

procedure, Dr. Haskell coined the term “Dilation and

Extraction” or “D&X.” Dr. Haskell also explained that the

D&X procedure differs from the classic dilation and evacuation

(D&E) procedure because it does not rely upon dismemberment

to remove the fetus from the woman’s body.

The record in this case indicates that the D&X (or

partial-birth) procedure is not commonly used by abortion

practitioners. Indeed, the American Medical Association has

3

recently concluded that the partial-birth method for aborting a

fetus “‘is never the only appropriate procedure and has no

history in peer reviewed medical literature or in accepted

medical practice development.” A-59 (Boggs, J., dissenting)

(quoting AMA Board of Trustees Statement of May 19, 1997).

IL. The Ohio Statutes.

In 1995, through their representatives in the legislature,

the citizens of Ohio responded to the use of the D&X procedure

in the State and more generally to the availability of post-

viability abortions in the State. By a cumulative margin of 110-

19, the Ohio General Assembiv passed House Bill 135 (the

“Act’”), which Governor Voinovich promptly signed into law.

The legislative “intent” of the bill, according to the terms of the

enactment, was “ts prevent the unnecessary use of a specific

procedure used in performing abortions . . . based on a state

interest in preventing unnecessary cruelty to the human fetus.”

1995 H. 135, section 3. To that end, the law places limits on

the availability of partial-birth and post-viability abortions.

A. The Restriction on Partial-Birth

Abortions.

In order to “prevent[] unnecessary cruelty to the human

fetus,” 1995 H. 350, section 3, the statute restricts the use of the

D&X procedure, which involves “the termination of a human

pregnancy by purposely inserting a suction device into the skull

of a fetus to remove the brain.” R.C. 2919.15(B). While the

regulation applies to all abortions, whether the fetus is viable or

not, it does not constitute an absolute ban. Individuals violate

the restriction only when they “knowingly” perform the

procedure and only when there is no medical urgency for

performing it -- in other words, only when other procedures for

4

terminating the pregnancy would place the health of the mother

at risk. R.C. 2919.15(B) & (C); R-C. 2307.51(C).

B. The Restriction on Post-Viability

Abortions.

The legislation also limits the availability of abortions

once the fetus has become capable of living outside the

mother’s womb. Under the statute, “[nJo person shall

purposely perform” an abortion “if the unborn human is viable”

unless one of two conditions exist. R.C. 2919.17(A). The first

occurs when the abortion is performed by a physician who

determines “in good faith and in the exercise of reasonable

medical judgment” that the abortion is “necessary to prevent

the death of the pregnant woman or a serious risk of the

substantial and irreversible impairment of a major bodily

function of the pregnant woman.” /d. The second occurs when

the abortion is performed by a physician who determines “in

good faith and in the exercise of reasonable medical judgment”

that the “unborn human is not viable.” /d. In addition, any

post-viability abortions done consistently with these

requirements must also comply with several other procedural

rules. See R.C. 2929.17(B).

For purposes of the post-viability ban, a fetus of at least

24 weeks is rebuttably presumed to be viable. R.C.

2919.17(C)(1). Once a fetus has reached 22 weeks, however,

Ohio requires a physician to “perform a medical examination

of the pregnant woman” to determine whether the fetus is

viable, unless a medical emergency prevents such testing from

being done. R.C. 2919.18(A). The statute defines “medical

emergency” as a “condition that a pregnant woman’s physician

determines, in good faith and in the exercise of reasonable

medical judgment, so complicates the woman’s pregnancy as

to necessitate the immediate performance or inducement of an

abortion in order to prevent the death of the pregnant woman or

5

to avoid a serious risk of the substantial and irreversible

impairment of a major bodily function of the pregnant woman

that delay in the performance or inducement of the abortion

would create.” R.C. 2919.16(F). In turn, R.C. 2919.16(J)

defines a “serious risk of the substantial and irreversible

impairment of a major bodily function” as “any medically

diagnosed condition that so complicates the pregnancy of the

woman as to directly or indirectly cause the substantial and

irreversible impairment of a major bodily function, including,

but not limited to, the following conditions: 1) pre-eclampsia,

2) inevitable abortion; 3) prematurely ruptured membrane, 4)

diabetes; 5) multiple sclerosis.” Attempting to ensure that the

provision complied with federal law, the General Assembly

directed that this definition “be construed according to the

interpretation given to that phrase in Planned Parenthood v.

Casey, 112 §.Ct. 2791, 2822 (1992), and Planned Parenthood

v. Casey, 947 F.2d 682, 699-702 (3rd Cir. 1991).” See Section

4 of HB. 135.

The Act, in each of these réspects, was scheduled to

take effect on November 14, 1995.

Ill. Procedural History

Yet, on October 27, 1995, before the legislation had a

chance to go into operation, respondents filed this action,

seeking both declaratory and injunctive relief. Respondents are

the Women’s Medical Professional Corporation, which

operates clinics and provides abortion services in Ohio, and Dr.

Haskell who originated the D&X abortion procedure and has

used it to perform abortions between 20 and 24 weeks.

Respondents claimed that the Act was unconstitutional on its

face under two primary theories. They asserted that the partial-

birth regulation imposes undue burdens on a woman’s right to

6

terminate a pregnancy under the due process clause. And they

claimed that the Act’s post-viability regulations are

impermissible vague and also violate substantive due process.

The district court (Rice, J.) granted respondents’ request

to restrain the Act from going into effect. He then entered a

preliminary, and later a permanent, injunction prohibiting the

entire Act from becoming law. The State appealed.

IV. The Sixth Circuit’s Decision.

In a 2-1 decision (Brown, Kennedy, Boggs (dissent)),

the Sixth Circuit affirmed.

A. Standard For Assessing Facial, Pre-

Implementation Challenge.

In addressing the appropriate standard for reviewing a

facial challenge to a statute, the court forthrightly

acknowledged a cloud of uncertainty on the issue. On the one

hand, the Sixth Circuit observed, Planned Parenthood v. Casey,

505 U.S. 833 (1992), struck a spousal notification provision in

the context of a facial challenge because the record showed that

“in a large fraction of the cases in which [the provision] is

relevant, it will operate as a substantial obstacle to a woman’s

choice to undergo an abortion.” A-12 (quoting Casey, 505 U.S.

at 895). Yet in several other abortion decisions, the Sixth

Circuit observed, the Court has applied the stringent Salerno

test for assessing a facial challenge, requiring the complainant

to “establish that no set of circumstances exists under which the

Act would be valid.” A-12 (quoting United States v. Salerno,

481 U.S. 739, 745 (1987)) (citing Rust v. Sullivan, 500 U.S.

173, 183 (1991); Ohio v. Akron Ctr. For Reprod. Health, 497

U.S. 502, 514 (1990)).

7

In the end the Sixth Circuit applied the less stringent

standard, concluding that the traditional test for assessing an

across-the-board challenge to a statute does not apply.

“Although Casey does not expressly purport to overrule

Salerno,” the lower court held (A-12), “in effect it does.” The

court also applied this standard (A-18 to A-19, A-39 n.18) in

assessing respondents’ vagueness challenge.

B. Invalidation of Ohio’s Partial-Birth

(D&X) Regulation.

Applying this standard, the Sixth Circuit concluded that

Ohio’s regulation of partial-birth abortions imposes an undue

burden on a woman’s right to terminate a pregnancy. A-28-29,

32. The central flaw in the restriction, from the court’s

perspective, was definitional, namely that the statute's

description of the restricted procedure covers “the most

commonly used second trimester procedure,” the D&E

procedure. A-29. Because Ohio defines the restricted

procedure to involve “the termination of a human pregnancy by

purposely inserting a suction device into the skull of a fetus to

remove the brain,” R.C. 2919.15(A), and because “some

physicians” implement the D&E procedure by “using suction

to remove the intracranial contents” of a dismembered fetus, the

court concluded that the definition applies equally to both types

of abortion procedures. A-22, A-33. The overlap, the court

determined, places an undue burden on a woman’s right to

terminate her pregnancy because the law limits the availability

of the most common method of second trimester abortion. A-

28. Finally, the court chose not to apply its ruling exclusivly to

pre-viability abortions. Taking the view that Ohio’s regulation

of partial-birth abortions does not distinguish between pre- and

post-viability abortions, it concluded that it “essentially would

have to rewrite the Act in order to create a provision which

could stand by itself.” A-32.

Cc, Invalidation of Ohio’s Restriction on

Post-Viability Abortions.

The court next determined that the medical necessity

and medical emergency exceptions to the ban on post-viability

abortions (which require the physician to determine “in good

faith and in the exercise of reasonable medical judgment” that

the exception exists) were unconstitutionally vague because

they lacked an appropriate mens rea requirement. A-34. What

troubled the court was that other physicians could determine

“after the fact” that the performing doctor's medical judgment

was not reasonable, and therefore doctors could be held liable

even when they acted in good faith and according to their own

best medical judgment. A-35.

Lastly, the court invalidated the maternal health

exception because it concluded that it applies only to physical,

and not mental, health risks. Though agreeing that Casey “does

suggest” a maternal health exception limited to physicial health

exceptions “is constitutional,” A-42, it found Casey

distinguishable because it involved a regulation that “only

delayed abortions” while the Ohio regulation “bans post-

viability abortions.” A-44.

D. The Dissent.

Judge Coggs disagreed with the majority’s conclusion

that the entire Act offends due process. As a general matter,

rather than “interpret[ing] statutes so as to avoid difficult

constitutional questions,” he complained that “the majority’s

opinion strains to interpret Ohio’s partial-birth abortion statute

so as to make the burden imposed by Ohio’s ban on dilation-

and-extraction (“D&X”) abortions, and on most post-viability

9

abortions, appear ‘undue.’” A-53-54. He also disagreed with

his colleagues’ extension of the overbreadth doctrine from the

First Amendment into the area of vagueness and substantive

due process challenges. A-67-68.

Moving from the general to the specific, Judge Boggs

took issue with the majority's in a¥dation of the D&X

regulation. In his view, “plaintiffs 2re attempting to create

ambiguity where there is none,” as shown by their refusal at

oral argument to “be pinned down as to any set of words that

would . . . acceptably define the procedure.” A-59-60. Instead,

the dissent remarked, Ohio had authority to regulate such an

unusual procedure, particularly since the American Medical

Assocation has concluded that it “‘is never the only appropriate

procedure and has no history in peer reviewed medical

literature or in accepted medical practice development.” A-59

(quoting AMA Board of Trustees Statement of May 19, 1997).

Nor did the statute, in the dissent’s view, fail to put doctors on

“fair notice as to what is encompassed by the ban,” above all

because the D&E procedure “does not terminate the pregnancy

by purposely inserting a suction device into the fetal skull,” but

is “only a byproduct of the abortion procedure already

performed” and because “(t]he testimony at the hearing in the

district court clearly demonstrates that doctors who perform

abortions have no difficulty discerning the conduct prohibited

by the statute.” A-61. At any rate, even if there were

ambiguity in the statute, he said, the court should have invoked

the rule of lenity to resolve it. A-60 n.2.

Judge Boggs also did not think that Ohio’s restriction on

post-viability abortions was impermissibly vague. The lack of

a scienter requirement for the “medical necessity” and “medical

emergency” provisions, or for that matter any penal statute, the

dissent urged, does not render a statute unconstitutionally

vague. A-62. Even Casey recognized that the “life or health of

the mother” exception may be invoked only when necessary “in

10

appropriate medical judgment.” A-63 (quoting Casey, 505 US.

at 879). And “[iJt is difficult to see how a medical judgment

can be deemed ‘appropriate’ if it is, beyond a reasonable doubt,

not a reasonable judgment.” A-63.

On the question whether the post-viability ban must

accommodate non-physical factors, Judge Boggs believed that

the legislature’s instruction to construe the medical necessity or

emergency instructions in line with Casey revealed an earnest

(and, he thought, accurate) attempt to comply with the

Constitution. A-65. At any rate, he also concluded that the

majority’s requirement that such a law must encompass “severe

risks of mental and emotional harm” was in fact met by the

“broad” language used by the legislature concerning the

“impairment of a major bodily function.” A-65.

REASONS FOR GRANTING THE WRIT

L The Sixth Circuit’s Decision Exacerbates

Several Conflicts Of Authority.

The first reason for reviewing the Sixth Circuit's

decision is the burgeoning conflict of authority on the

appropriate standard for assessing a pre-implementation facial

challenge to an abortion regulation. The initial point of

disagreement stems from Supreme Court precedent. Not just

Salerno, but several abortion decisions as well, see Rust v.

Sullivan, 500 U.S. 173, 183 (1991), Ohio v. Akron Ctr. For

Reprod. Health, 497 U.S. 502, 514 (1990), see also Webster v.

Reproductive Health Services, 492 U.S. 490, 524 (O’Connor,

J., concurring in part and concurring in the judgment), have

applied a “no set of circumstances” test in assessing facial

challenges to a statute. By contrast, Casey appears to permit

Il

relief in such challenges so long as the claimant shows that the

statute creates an undue burden on the right to terminate a

pregnancy in a “large fraction” of the statute’s applications.

505 US. at 895.

In the aftermath of Casey, several Justices have written

separately to express their views on this precedential tension,

some agreeing with the Salerno/RustAkron Ctr.

characterization of the standard, others agreeing with the Casey

characterization of the standard. Compare Janklow v. Planned

Parenthood, Sioux Falls Clinic, 116 S. Ct. 1582, 1583 (1996)

(concluding that “Salerno’s rigid and unwise dictum has been

properly ignored in subsequent cases”) (Stevens, J., concurring

in denial of certiorari), with id at 1584-85 (Casey “did not

purport to change this well-established rule”) (quotation

omitted) (Scalia, J., joined by Rehnquist, C.J., and Thomas, J.,

dissenting from denial of certiorari), and Ada v. Guam Society

of Obstetricians & Gynecologists, 506 U.S. 1011 (1992)

(Scalia, J., joined by Rehnquist, C.J., and White, J., dissenting

from denial of certiorari).

The federal courts of appeals likewise have not been of

one mind in determining whether Casey modifies the

Salerno Rust Akron Ctr. standard. On one side of the conflict,

three courts of appeals have agreed with the Sixth Circuit's

conclusion that Casey effectively overrules Salerno. See Jane

L. v. Bangerter, 102 F.3d 1112, 1116 (10th Cir. 1996), cert.

denied, 117 §. Ct. 2453 (1997); Planned Parenthood, Sioux

Falls Clinic v. Miller, 63 F.3d 1452, 1456-58 (8th Cir. 1995),

cert. denied, 116 S. Ct. 1582 (1996), Casey v. Planned

Parenthood of Southeastern Pennsylvania, 14 F 3d 848, 863

n.21 (3d Cir. 1994) (dicta).

In contrast to these appellate courts, the Fifth Circuit

has concluded that Casey did not overrule the traditional rule

for assessing facial challenges. See Barnes v. Moore, 970 F.2d

12

12, 14 n2 (Sth Cir.) (“we do not interpret Casey as having

overruled, sub silentio, longstanding Supreme Court precedent

governing challenges to the facial constitutionality of statutes”),

cert. denied, 506 U.S. 1021 (1992); accord Causeway Med

Suite v. leyoub, 109 F.3d 1096, 1102-04 (Sth Cir. 1997) (“As

far as we can tell, the Court appears to be divided 3-3 on the

Salerno-Casey debate, and it would be ill-advised for us to

assume that the Court will abandon Salerno because three

members of the Court now desire that result”), cert. denied, 118

S. Ct. 357 (1997). Still another court of appeals, the Fourth

Circuit, appears to be leaning toward the traditional rule, but

has not yet had an opportunity so to hold. See Manning v.

Hunt, 119 F.3d 254, 268-69, n.4 (4th Cir. 1997) (“the reasoning

of the Fifth Circuit [regarding this lower-court conflict of

authority] appears to be most persuasive’).

Whether the reader is partial to one side of this debate

or the other, it is difficult to avoid the conclusion that the

question “cries out for [the Court’s] review.” Janklow v.

Planned Parenthood, Sioux Falls Clinic, 116 §. Ct. 1582, 1584

(1996) (Scalia, J., joined by Rehnquist, C.J., and Thomas, J.,

dissenting from denial of certiorari). Nor can there be any

doubt that this case squarely presents the issue, as the district

court admitted that plaintiffs had “not shown that ‘no set of

SS ee A-

1.

On top of the Salerno/Casey division of authority

presented by this case rests another split, which the Sixth

Circuit has now deepened as well. In assessing facial attacks

on allegedly vague statutes, courts have generally applied the

traditional Salerno rule, which is to say they will reject the

challenge unless the enactment is “impermissibly vague in all

of its applications.” Village of Hoffman Estates v. Flipside,

Hoffman Estates, Inc., 455 U.S. 489, 495 (1982). The Sixth

Circuit, however, took a different tack in assessing claimants’

13

vagueness challenge to the restriction on post-viability

abortions. “Since we have already held that Salerno does not

apply in the abortion context,” the court held, “it is enough that

the statute may be unconstitutionally applied to a large fraction

of women for whom the law is relevant.” A-39-40 n.18.

Right or wrong, this interpretation extends the Casey

overbreadth standard to an area of abortion regulations not even

subject to undue-burden review (post-viability regulations) and

applies the principle to a new constititutional claim

(vagueness). In addition to Hoffman Estates, this analysis

diverges from several other Supreme Court precedents. See,

e.g., Chapman v. United States, 500 U.S. 453, 467 (1991)

(“vagueness claims must be evaluated as the statute is applied

to the facts of [the] case” when “First Amendment freedoms are

not infringed by the statute”), Maynard v. Cartwright, 486 U.S.

356, 361 (1988); United States v. Powell, 423 U.S. 87, 92

(1975); United States v. Mazurie, 419 U.S. 544, 550 (1975). To

be fair, however, two precedents from this Court provide

ostensible support for this analysis. In contrast to the Hoffman

Estates Salerno rule, some cases seem to apply an overbreadth

analysis whenever there is any “constitutionally protected

conduct” at issue. See Kolender v. Lawson, 461 U.S. 352, 358-

59 n.8 (1983); Colautti, 439 U.S. at 394-401. Of course, this

approach directly conflicts with Hoffman Estates, as the Sixth

Circuit itself admitted in grappling with the question. See A-19

(“At times the Court has suggested that a statute that does not

run the risk of chilling constitutional freedoms is void on its

face only if it is impermissibly vague in all its applications, but

at other times it has suggested that a criminal statute may be

facially invalid even if it has some conceivable application”).

In addition, several circuits courts have applied a

different standard of review from the one applied by the Sixth

Circuit, some going so far as to suggest that a facial vagueness

14

claim may never be brought. See, e.g., United States v. Reed.

114 F.3d 1067, 1070 (10th Cir. 1997) (“{a] vagueness challenge

.. . Cannot be aimed at the statute on its face but must be

limited to the application of the statute to the particular conduct

charged”), Richmond Boro Gun Club, Inc. v. City of New York,

97 F.3d 681, 684 (2d Cir. 1996) (plaintiffs can only succeed

“on a facial vagueness challenge if they could show that the law

is impermissibly vague in all of its applications”) (quotation

omitted), United States v. A Single Family Residence, 803 F.2d

625, 630 (11th Cir. 1986) (a facial challenge on vagueness

grounds “is a claim that the law is invalid in toto -- and

therefore incapable of any valid application”) (internal

quotation omitted); Stoianoff v. Montana, 695 F.2d 1214, 1220

(9th Cir. 1983) (“All that we must find to sustain the facial

constitutionality of the Act is a single clear application of the

Act to the appellant”). Cf New England Accessories Trade

Assn, Inc. v. City of Nashua, 679 F.2d 1, 5 (ist Cir. 1982)

(“unless the enactment implicates constitutionally protected

conduct, we can invalidate it only if it is impermissibly vague

in all of its applications”).

The Sixth Circuit’s invalidation of the partial-birth and

post-viability abortion regulations also conflicts with this

Court’s landmark decision in Casey. See infra. While this

conflict has not yet spread to the lower courts, that fact surely

does not diminish the certworthiness of at least the first

question presented and in our view the appropriateness of

promptly reviewing all three questions.

Perhaps the most important question in the petition --

the proper constitutional standard for assessing these types of

challenges -- is the one that has most deeply divided the lower

courts and has done all the percolating that any legal issue

needs to become ripe for review. In view of the sizeable

number of partial-birth abortion regulations being challenged

throughout the country, see infra, and in view of the standard

15

of review’s impact on those claims, it would seem odd to

continue to force the lower courts to issue rulings in these cases

in the absence of much-needed guidance from the Court on this

vital point. In the last analysis, the first question presented

calls out for immediate review in light of the substantial

conflict of authority over its resolution; and the second and

third questions merit prompt review to place the standard-of-

review issue in context and resolve the tension between the

Sixth Circuit’s merits decision and Casey.

Il. The Sixth Circuit’s Decision Raises

Important Federal Questions.

Even aside from the conflicts of authority implicated by

the petition, the significance of the questions presented in and

of itself warrants review. By any relevant standard, the

constitutionality of legislation restricting partial-birth and post-

viability abortions, to say nothing of the standard for assessing

such laws, presents important, indeed exceedingly important,

federal questions. The Court has not yet considered the validity

of limitations on partial-birth abortions. Nor has it determined

whether a mental health exception is constitutionally required

when it comes to restrictions on post-viability abortions. And,

for five years now, the lower courts have remained in limbo

over the appropriate standard for reviewing these claims. Add

to this the fact that Ohioans are far from the only interested

participants in these debates, and it becomes clear that the

petition presents several certworthy federal questions.

In enacting these laws, Ohio joined a legion of other

States that have regulated one or the other of these procedures,

and sometimes both. All told, 17 States (including Ohio)

regulate partial-birth abortions. See 1997 Ala. Acts 485;

Alaska Stat. 18.16.050; Ariz. Rev. Stat. Ann. 13-3603.01; 1997

Ark. Acts 984; Ga Code Ann. 16-12-144; Ind. Code Ann. 16-

18-2-267.5, 16-34-2-1(b); 1997 La. Acts 906, La. R.S. 14:32:9

16

and 40:1299.35.3; Mich. Comp. Laws Ann. 333.16221(1) &

(m), 333.16226, 333.17016, 333.17516; Miss. Code Ann. 41-

41-73; Mont. Code Ann. 50-20-401; Neb. Rev. Stat. 28-325,

28-326(9) & 71-148; R.1. Gen. Laws 23-4.12-1, 23-4.12-2, 23-

4.12-3, 23-4.12-4, 23-4.12-5 and 23-4.12-6, S.C. Code Ann.

44-41-85; S.D. Codified Laws 34-23A-27 through 34-23A-32;

Tenn. Code Ann. 39-15-209; Utah Code Ann. 76-7.310.5.

In addition, a host of States (again including Ohio) and

the District of Columbia regulate post-viability abortions. Of

these laws, three contain maternal health exceptions that

parallel Ohio’s. See 1997 Ala. Acts 442; Ind. Stat. Ann. 16-34-

2-1(3) and 16-34-2-3; 18 Pa. C.S.A. 3211. Several of the

statutes contain maternal health exceptions, yet do not define

“health.” See Ariz. Rev. Stat. Ann. 36-2301.01(A); Ark. Code

Ann. 20-16-705; Cal. Health and Safety Code 123405, 123410,

123415, 123435; Conn. Gen. Stat. Ann. 19a-602(b); D.C. Code

22-201; Fla. Stat. Ann. 390.0111(1) & (4); Ga. Code Ann. 16-

12-141(C); Ill. Comp. Stat. Ann., Ch. 720, 510/5; lowa Code

Ann. 707.7; Ky. Rev. Stat. Ann. 311.780; La. Stat. Ann.

1299.35.4; Maine Rev. Stat. Ann. Title 22, 1598; Minn. Stat.

Ann. 145.412(3); Mo. Stat. Ann. 188.030(1); Mont. Code Ann.

50-20-109(c); Neb. Rev. Stat. 28-329; N.C. Gen. Stat. 14-45.1;

Okla. Stat. Ann. 1-732; §.D. Cod. Laws 34-23A-5; Tenn. Code

Ann. 39-15-201(C)(3); Wis Stat. Ann. 940.15; Wyo. Stat. 35-6-

102. And several of the statutes contain a “life of the mother”

exception. See Del. Code Ann., Title 24, 1790(a)(1) & (b)(1);

Idaho Code Ann. 18-608(3); Kansas Stat. Ann. 65-6-703; New

York Pen. Law 125.00, 125.05, 125.45; R.I. Gen. Laws Ann.

11-23-S.

It ought to be enough to show the substance of a

constitutional question that the decision below nullifies the

democratic efforts of an overwhelming majority of Ohioans to

express their collective concerns about partial-birth and post-

viability abortions. But here there is more. Sixteen other States

17

have enacted partial-birth abortion laws, with most of them

already under judicial attack, and all of them vulnerable under

the analysis adopted by the Sixth Circuit. Similar problems

plague the other State laws that limit post-viability abortions

and employ the Casey-approved “substantial and irreversible

impairment of a major bodily function” language to protect the

pregnant woman’s health. Moreover, the multitude of States

that have enacted post-viability laws -- including those that do

not contain explicit mental health exceptions for the mother --

need this Court’s guidance on the meaning of the required

“health” exception in the context of a ban on post-viability

abortions.

Nor has the medical community had insufficient time to

study these issues. The American Medical Association, for

example, recently took a vigorous public stand against use of

the partial-birth procedure, and in doing so advocated a federal

ban on partial-birth abortions. Its Board of Trustees issued a

statement explaining that it “is a procedure which is never the

only appropriate procedure and has no history in peer reviewed

medical literature or in accepted medical practice

development.” A-59. The position later received the

endorsement of the entire AMA House of Delegates. /d.

A final word deserves consideration. The Court has

said that the States have an interest in the potential life that

comes with all pregnancies, and a special right to safeguard that

interest once the prospects for life outside the womb move from

hope to relative certainty. At the same time, the Court has

made clear that the States must honor a woman’s right to

terminate a pregnancy pre-viability and must not shortchange

her health interests when restricting abortions after viability. A

law designed to regulate an abortion procedure that to many

seems gratuitously cruel and offensive, or one that limits the

availability of any procedure once a fetus has developed to the

point where it can become a child by the act of delivery, surely

18

advances these interests, and does so in a way that respects due

process. But whether we are right or wrong at this stage is (at

least partly) beside the point: The critical issue is that no one

can tenably dispute that these issues have irreversible

consequences for women and potential children, and those

consequences Ought to satisfy any and all calibrations of federal

importance.

Il. The Sixth Circuit Erred In Striking The

Ohio Law.

The Sixth Circuit, we believe, also erred in invalidating

the Act in its entirety. This, too, favors review.

A. The Court of Appeals Applied The

Wrong Standard For Assessing

Facial Challenges to an Abortion

Statute.

Undue burden. In assessing the appropriate standard

for reviewing an undue burden challenge to a partial-birth

abortion regulation, the Sixth Circuit overlooked the core

premise for distinguishing between facial and as-applied

challenges. Federal courts have a duty to try to save, not

destroy, State legislation. Planned Parenthood Assn. of Kansas

City v. Ashcroft, 462 U.S. 476, 493 (1983); see also Adams

Fruit Co. v. Barrett, 494 U.S. 638, 647 (1990). And a standard

of review that allows entire statutes to be nullified before the

State has had a chance to implement them and before the

presumption of constitutionality has been countered with

respect to each prospective application of the statute turns the

passive virtue of this age-old limitation on judicial review into

an active vice. Outside the context of the First Amendment

where litigants may overcome the presumption of

constitutionality of an entire statute by demonstrating

substantial problems in its application, the Court has long held

19

that a facial challenge may succeed only after the claimants

have met their burden of showing “no set of circumstances” in

which the law may be constitutionally applied. Salerno, 481

U.S. at 745.

Nor is it clear why this “traditional rule” (New York v.

Ferber, 458 U.S. 747, 767 (1982)) ought suddenly to be

interred. No studies have been done showing that the rule leads

to unfair consequences. Nor have any great hardships arisen

through the Court’s frequent application of the rule in the

abortion context, see Rust v. Sullivan, 500 U.S. 173, 183

(1991), Ohio v. Akron Ctr. For Reprod.Health, 497 U.S. 502,

$14 (1990), see also Webster v. Reproductive Health Services,

492 U.S. 490, 524 (1989) (O’Connor, J., concurring in part and

concurring in the judgment), and in other settings, see Anderson

v. Edwards, 514 U.S. 143, 155 n.6 (1995), Reno v. Flores, 507

U.S. 292, 301, 309 (1993), cf Reno v. American Civil Liberties

Union, 117 §. Ct. 2329, 2355 (1997) (O'Connor, J., concurring

in part and dissenting in part, joined by Rehnquist, C.J ). The

distinction between facial and as-applied challenges is as time

honored as it is widespread, and ultimately reflects the benefit

of the doubt that federal courts customarily give State officials,

namely that they presumably will obey, not offend, their duty

to uphold the Constitution in implementing a statute. For the

same reason, the Court has resisted invitations to invalidate

statutes based upon a “hypothetical possibility” of

unconstitutional application in the future. General Motors v.

Tracy, 117 S. Ct. 811, 830 (1997), Bowen v. Kendrick, 487 U.S.

$89, 601 (1988); Roemer v. Bd. of Public Works, 426 U.S. 736,

760-61 (1976).

Even on the facts of this case, it remains unclear what

harm the traditional rule would engender. In the court of

appeals’ view, the State’s definition of a partial-birth abortion

impermissibly covered the more traditional D&E procedure.

Taking that for granted, who suffers if the court identifies this

20

constitutional defect, then rejects the facial challenge on the

ground that the flaw does not infect the entire statute -- for

example, because the statute still may be applied to the D& X

procedure itself or to the D&E procedure in the context of post-

viability abortions? What State would not get the message?

Surely no State would start regulating pre-viability D&E

abortions after such a decision, least of all Ohio, which had no

intention of banning this customary procedure in the first place,

which would have no objection to a limiting interpretation of

the law, and whose Attorney General has never suggested that

the statute may be construed in this unusual way. What is

more, State officials who continued to apply the statute in

unconstitutional ways would soon feel the deterrent sting of

section 1988 attorney fees, not to mention civil rights actions

brought against the officials in their individual capacity and

with little likelihood of a qualified immunity shield.

Nor, for like reasons, will this approach imperil the

availability of constitutionally-permitted abortions. If anything,

these considerations will likely prompt State officials to under-

enforce, not over-enforce, laws that have been invalidated in

certain applications. But either way, wary physicians may still

bring declaratory judgment actions to determine whether the

law applies in a given setting and if so whether that application

withstands constitutional scrutiny. Or, if worst comes to worst,

they may still bring an as-applied challenge to the law if it is

unfairly used against them, at which time the rule of lenity will

govern (and limit) any ambiguous applications of the law.

That leaves the Court’s decision in Casey, which as

interpreted by the court of appeals silently abandoned not just

Salerno but a long tradition of decisions requiring claimants to

establish no set of circumstances in which the law may

21

permissibly be applied before striking the provision in its

entirety. No doubt, as the courts of appeals and several

members of this Court have recognized, there seems to be

tension between the two cases, at least at first blush.

But, in truth, Casey and Salerno are compatible. The

traditional Salerno requirement has long been met when a

statute “operates on a fundamentally mistaken premise.”

Secretary of State of Maryland v. J.H. Munson Co., 467 U.S.

947, 966 (1984). Just such a “mistaken premise” infected the

spousal-notification provision in Casey: The requirement that

a woman notify her husband before seeking an abortion rested

on the flawed assumption that “a husband’s interest in the

potential life of the [unborn] child outweighs a wife’s interest

[to choose to have an abortion].” Casey, 505 U.S. at 898.

Because the whole spousal-notification provision rested on this

mistaken premise, the statute was indeed unconstitutional in all

of its applications. The Munson principle thus reconciles Casey

and Salerno.

Vagueness. No less erroneous was the court of appeals’

extension of its Casey interpretation to facial vagueness claims.

Of course, Casey was not a vagueness case. And, in the

Court’s vagueness decisions, it has followed an essentially

unbroken tradition in concluding that such challenges cannot

succeed unless the enactment is “impermissibly vague in all of

its applications.” Village of Hoffman Estates, 455 U.S. at 495.

Unless the legislation is so vague as to “proscribe[] no

comprehensible course of conduct at all,” Powell, 423 U.S. at

92, which plainly was not the case with Ohio’s requirement that

the physician act in good faith and exercise reasonable medical

judgment in determining viability or medical necessity, the

traditional test applies. See Chapman, 500 U.S. at 467,

Maynard, 486 U.S. at 361; Powell, 423 U.S. at 92; Matzurie,

419 US. at 550.

22

True, some cases have loosely suggested that the

overbréadth rule applies when the statute implicates

“constitutional,” as distinct from First Amendment, freedoms.

See, e.g., Kolender v. Lawson, 461 U.S. 352, 358-59 (1983)

But virtually all of these cases, including Kolender itself.

involved First Amendment rights, suggesting that the term

“constitutional” was simply shorthand for First Amendment

rights. The one exception is Colautti v. Franklin, a pre-Casey

abortion decision whose broad sweep has since been questioned

by several members of the Court. See Webster, 492 U.S. 490

am of Rehnquist, C.J., joined by White, J., and Kennedy,

B. The Court of Appeals Erred in

Striking Ohio’s Partial-Birth (D&X)

Abortion Regulation.

In addition to applying the wrong standard of review,

the court of appeals committed reversible error in finding that

Ohio’s regulation of partial-birth abortions unduly burdens a

woman's right to terminate a pregnancy. The court did not

rule, as indeed it could not have ruled, that the Constitution

forbids States from restricting the availability of this unusual

procedure. Instead, the court construed Ohio’s definition of the

D&X procedure to encompass the more common (and

constitutionally legitimate) D&E procedure. But the Act

simply cannot sustain this analysis, as it contains a series of

unmistakeable inferences (if not outright directions) that the

statute bans the one procedure but not the other

First, two of the statutes created by the Act label the

proscribed procedure in no uncertain terms, one titled “Dilation

and Extraction Procedure,” 2919.15, the other titled “Civil

23

Action for Dilation and Extraction Procedure,” 2307.51. The

relevant text of the statutes proceeds to identify the D&X

procedure by name more than a dozen times, while the D&E

procedure is nowhere mentioned and nowhere banned.

Second, by its terms, Ohio’s definition of the D&X

procedure cannot plausibly cover the distinct D&E procedure.

The statute describes the D& X procedure as covering (1) “the

termination of a human pregnancy” by (2) “purposely inserting

a suction device into the skull of a fetus to remove the brain.”

Yet the late-term D&E procedure does not end a pregnancy by

using a suction device, it ends the pregnancy by dismembering

the fetus and then using a suction device to remove the

scattered remains. Nor does the D&E procedure involve a

“purpose[ful]” insertion of a suction device into the fetal skull.

It involves dismemberment of the fetus followed by anything

but purposeful suctioning of the fetal remains. The D&X

procedure, by contrast, is designed precisely to deliver most of

the body of the fetus in order to have access to the head so that

the physician may “purposely” insert a suction device into the

brain.

Third, the goal of the statute removes any doubt as to

what was proscribed: The legislators designed the D&X

regulation “to prevent the unnecessary use of a specific

procedure used in performing abortions . . . based on a state

interest in preventing unnecessary cruelty to the human fetus.”

1995 H. 350, section 3 (emphasis added). The D&X procedure

plainly is “unnecessary,” as suggested by its infrequent use, its

undistinguished pedigree, and its disapproval by the AMA. Yet

the D&E is constitutionally necessary because (as the court of

appeals itself found) it is the most common form of second

trimester abortion. And a regulation concerning “a specific

procedure” surely means just one procedure, not two, and most

assuredly the one repeatedly mentioned by name throughout the

Act. Finally, and perhaps most paradoxically, the very person

24

who challenges the overlap between the D&E and D&X

procedures, respondent Dr. Haskell, is precisely the person who

coined the term D&X in order to distinguish between the two

procedures. In using Dr. Haskell’s definition, Ohio came closer

to establishing a bill of attainder (a law that suffers from too

much specificity) than to establishing an overly-broad statute

that unduly burdens a woman’s due process rights.

But even if each of these pieces of statutory and record

evidence do not support the Ohio Attorney General’s, the Ohio

Governor's, and the relevant Ohio County Prosecutor’s

interpretat.on of the statute, which is that the law does not

restrict D&E abortions, the most one can say is that the statute

is ambiguous. Yet under those circumstances, the court’s job

is not to invalidate the law, but to adopt the narrower

interpretation of it under the rule of lenity. United States v.

RL.C., 503 U.S. 291, 305-13 (1992).

Cc. The Court of Appeals Erred in

Concluding that the Good-Faith and

Reasonable- Medical-Judgment

Exceptions to the Post-Viability Ban

Were Impermissibly Vague.

The court of appeals also erred in reviewing Ohio’s

requirement that physicians act in good faith and exercise

reasonable medical judgment in determining the viability of a

fetus and in making a finding of medical necessity before

aborting a fetus who could live outside the womb. In

court focused on the fact that they did not have a mens rea

requirement.

First, and most conspicuously, the statute does contain

a mens rea requirement. Section 2919.17 explicitly provides

that one must act “purposely” in order to break the law. This

25

fact by itself distinguishes the Ohio law from the one at issue

in Colautti v. Franklin, 439 U.S. 379 (1979), which lacked any

state-of-mind element. /d. at 381 n.1.

But, en aes Oe ee

requirement (which it does not), that alone does not a

law unconstitutionally vague. Laws frequently proscribe

unreasonable conduct, and permissibly so. “The mere fact that

a penal statute is so framed as to require a jury upon occasion

to determine a question of reasonableness is not sufficient to

make it too vague to afford a practical guide to permissible

conduct.” United States v. Ragen, 314 U.S. 513, 523 (1942).

Nor in a criminal setting is unreasonableness by itself enough

to obtain a conviction; the jury must find that the individual's

medical judgment was unreasonable “beyond a reasonable

doubt,” a daunting standard for any prosecutor to meet. Even

Casey recognized that the “life or health of the mother”

exception be invoked only when necessary “in appropriate

noted beta Casey, 505 U.S. at 879, a similar standard

of care but one that is necessary if laws of this sort are to have

any effect.

Nor does the pre-Casey decision in Colautti v. Franklin,

439 U.S. 379 (1979), support the lower court decision. Colautti

specifically reserved the question whether “under a properly

drafted statute, a finding of bad faith or some other type of

erens oeryacndan 9 gy ata a I ee ag

criminally responsible for an erroneous determination of

viability.” Jd. at 396.

Finally, it seems unfair to criticize States for using

unreasonable medical judgment as a touchstone for liability in

this area. The Court’s judgments about State regulations in this

setting after all each turn on reasonableness balancing, what

necessarily comes down to difficult distinctions between

“undue” burdens on a women’s ability to terminate a pregnancy

26

and permissible burdens on that right prompted by the State’s

interest in protecting potential life. When States follow suit in

earnestly trying to regulate in a constitutional manner in this

area, it is not because they are trying to trap the unwary. It is

because clear lines are hard to find and because the price for

complete certainty is invariably overprotection of one of these

interests and neglect for the other.

D. The Court of Appeals Erred In

Concluding That the Ohio Post-

Viability Abortion Regulations

Violate Substantive Due Process

Because They Do Not Contain a

Mental Health Exception For the

Mother.

The final error committed by the court of appeals stems

from its review of Ohio’s maternal health exception to the ban

on post-viability abortions. In holding that such exceptions

must cover the mental health of the woman in order to comply

with substantive due process, the court not only made new law

but also failed to follow several pertinent teachings of Casey.

Casey specifically upheld a maternal health exception

to an abortion regulation that was substantively identical to

Ohio’s, and indeed was the source for it. See 505 U.S. at 879-

81. By upholding the Pennsylvania formulation of the

maternal-health exception (“substantial and _ irreversible

impairment of a major bodily function”), the Court plainly was

blessing an identically-worded provision for exempting women

from other abortion regulations. In order to remove any doubt

on this score, the Ohio legislature expressly provided in the

terms of the Act that it wanted the phrase to obtain the same

construction as the Pennsylvania statute. In using the phrase

“serious risk of the substantial and irreversible impairment of

a major bodily function,” “it is the intent of the General

27

Assembly that the phrase be construed according to the

interpretation given to that phrase in Planned Parenthood v.

Casey, 112 §. Ct. 2791, 2822 (1992), and Planned Parenthood

v. Casey, 947 F.2d 682, 699-702 (3d Cir. 1991).” H. 135,

section 4, 121st Gen. Ass. (Ohio 1995). What more, in short,

could the State have done to ensure that it was acting

constitutionally in this area?

Nor does Doe v. Bolton, 410 U.S. 179 (1973), another

pre-Casey decision relied upon by the court of appeals, change

matters. Doe addressed a statute that barred abortions unless a

doctor determined “an abortion is necessary.” /d. at 183. In

doing so, it rejected a vagueness challenge to the law because

the broad wording of the statute expanded the choices of

pregnant women by authorizing an abortion for a whole host of

reasons, including emotional health. That conclusion has little

application here.

In the last analysis, the court of appeal’s mistaken

application of this Court’s precedents also supports the writ.

For the foregoing reasons, we respectfully urge the

28

CONCLUSION

Court to grant the writ.

Of Counsel:

Respectfully submitted,

BETTY D. MONTGOMERY

Attorney General of Ohio

JEFFREY S. SUTTON

State Solicitor

Counsel of Record

STEPHEN P. CARNEY

Assistant Attorney General

30 E. Broad Street, 17th Floor

Columbus, Ohio 43215-3428

(614) 466-8980

MATHIAS H. HECK, JR.

Prosecuting Attorney for

Montgomery County

ELISSA D. COHEN

Assistant Prosecuting Attorney

P.O. Box 972

301 W. Third Street

Dayton, Ohio 45402

(937) 225-4979

COUNSEL FOR PETITIONERS

DIANE R. RICHARDS

Bricker & Eckler LLP

100 S. Third Street

Columbus, Ohio 43215

ATTACHMENT -- OHIO STATUTORY PROVISIONS

2919.15 Dilation and extraction procedure

(A) As used in this section, “dilation and extraction

procedure” means the termination of a human pregnancy by

purposely inserting a suction device into the skull of a fetus to

remove the brain. “Dilation and extraction procedure” does not

include either the suction curettage procedure of abortion or the

suction aspiration procedure of abortion.

(B) No person shall knowingly perform or attempt to

perform a dilation and extraction procedure upon a pregnant

woman.

(C)(1) It is an affirmative defense to a charge under

division (B) of this section that all other available abortion

procedures would pose a greater risk to the health of a pregnant

woman than the risk posed by the dilation and extraction

procedure.

(2) Notwithstanding section 2901.05 of the Revised

Code, if a person charged with a violation of division (B) of

this section presents prima facie evidence relative to the

affirmative defense set forth in division (C)(1) of this section,

the prosecution, in addition to proving all elements of the

violation by proof beyond a reasonable doubt, has the burden

of proving by proof beyond a reasonable doubt that at least one

other available abortion procedure would not pose a greater risk

to the health of the pregnant woman than the risk posed by the

dilation and extraction procedure performed or attempted to be

performed by the person charged with the violation of division

(B) of this section.

(D) Whoever, violates division (B) of this section is

guilty of performing an unlawful abortion procedure, a felony

of the fourth degree.

(E) A pregnant woman upon whom a dilation and

extraction procedure is performed or attempted to be performed

in violation of division (B) of this section is not guilty of an

attempt to commit, complicity in the commission of, or

conspiracy in the commission of a violation of that division.

2919.16 Definitions

As used in sections 2919.16 to 2919.18 of the Revised

Code:

(A) “Fertilization” means the fusion of a human

spermatozoon with a human ovum.

(B) “Gestational age” means the age of an unborn

human as calculated from the first day of the last menstrual

period of a pregnant woman.

(C) “Health care facility’ means a hospital, clinic,

ambulatory surgical treatment center, other center, medical

school, office of a physician, infirmary, dispensary, medical

training institution, or other institution or location in or at

which medical care, treatment, or diagnosis is provided to a

person.

(D) “Hospital” has the same meanings as in section

2108.01, 3701.01 and 5122.01 of the Revised Code.

(E) “Live birth” has the same meaning as in division (A)

of section 3705.01 of the Revised Code.

(F) “Medical emergency” means a condition that a

pregnant woman’s physician determines, in good faith and in

the exercise of reasonable medical judgement, so complicates

the woman’s pregnancy as to necessitate the immediate

performance or inducement of an abortion in order to prevent

the death of the pregnant woman or to avoid a serious risk of

the substantial and irreversible impairment of a major bodily

function of the pregnant woman that delay in the performance

or inducement of the abortion would create.

(G) “Physician” has the same meaning as in section

2305.11 of the Revised Code.

(H) “Pregnant” means the human female reproductive

condition, that commences with fertilization, of having a

developing fetus.

(1) “Premature infant” means a human whose live birth

occurs prior to thirty-eight weeks of gestational age.

(J) “Serious risk of the substantial and irreversible

impairment of a major bodily function” means any medically

diagnosed condition that so complicates the pregnancy of the

woman as to directly or indirectly cause the substantial and

irreversible impairment of a major bodily function, including,

but not limited to, the following conditions:

(1) Pre-eclampsia;

(2) Inevitable abortion;

(3) Prematurely ruptured membrane,

(4) Diabetes;

(5) Multiple sclerosis.

(K) “Unborn human” means an individual organism of

the species homo sapiens from fertilization until live birth.

(L) “Viable” means the stage of development of a

human fetus at which in the determination of a physician, based

on the particular facts of a woman’s pregnancy that are known

to the physician and in light of medical technology and

information reasonably available to the physician, there is a

realistic possibility of the maintaining and nourishing of a life

outside of the womb with or without temporary artificial life-

sustaining support.

291917 Terminating a human pregnancy

after viability.

(A) No person shall purposely perform or induce or

attempt to perform or induce an abortion upon a pregnant

woman if the unborn human is viable, unless either of the

following applies:

(1) The abortion is performed or induced or attempted

to be performed or induced by a physician, and that physician

determines, in good faith and in the exercise of reasonable

medical judgment, that the abortion is necessary to prevent the

death of the pregnant woman or a serious risk of the substantial

and irreversible impairment of a major bodily function of the

pregnant woman.

(2) The abortion is performed or induced or attempted

to be performed or induced by a physician and that physician

determines, in good faith and in the exercise of reasonable

medical judgment, after making a determination relative to the

viability of the unborn human in conformity with division (a)

of section 2919.18 of the Revised Code, that the unborn human

is not viable.

(B)(1) Except as provided in division (B)(2) of this

section, no physician shall purposely perform or induce or

attempt to perform or induce an abortion upon a pregnant

woman when the unborn human is viable and when the

physician has determined, in good faith and in the exercise of

reasonable medical judgement, that the abortion is necessary to

prevent the death of the pregnant woman or a serious risk of the

substantial and irreversible impairment of a major bodily

function of the pregnant woman, unless each of the following

conditions is satisfied:

(a) The physician who performs or induces or attempts

to perform or induce the abortion certifies in writing that that

physician has determined, in gocd faith and in the exercise of

reasonable medical judgment, that the abortion is necessary to

prevent the death of the pregnant woman or a serious risk of the

substantial and irreversible impairment of a major bodily

function of the pregnant woman.

(b) The determination of the physician who performs or

induces or attempts to perform or induce the abortion that is

described in division (B)(1)(a) of this section is concurred in by

at least one other physician who certifies in writing that the

concurring physician has determined in good faith, in the

exercise of reasonable medical judgment, and following a

review of the available medical records of and any available

tests results pertaining to the pregnant woman, that the abortion

is necessary to prevent the death of the pregnant woman or a

serious risk of the substantial and irreversible impairment of a

major bodily function of the pregnant woman.

(c) The abortion is performed or induced to attempted

to be performed or induced in a health care facility that has or

has access to appropriate neonatal services for premature

infants.

(d) The physician who performs or induces or attempts

to perform or induce the abortion terminates or attempts to

terminate the pregnancy in the manner that provides the best

opportunity for the unborn human to survive, unless that

physician determines, in good faith and in the exercise of

reasonable medical judgment, that the termination of the

pregnancy in that manner poses a significantly greater risk of

the death of the pregnant woman or a serious risk of the

substantial and irreversible impairment of a major bodily

function of the pregnant woman than would other available

methods of abortion.

(e) The physician who performs or induces or attempts

to perform or induce the abortion has arranged for the

attendance in the same room in which the abortion is to be

performed or induced or attempted to be performed or induced

of at least one other physician who is to take control of, provide

immediate medical care for, and take all reasonable steps

necessary to preserve the life and health of the unborn human

immediately upon the unborn human’s complete expulsion or

extraction from the pregnant woman.

(2) Division (B)(1) of this section does not prohibit the

performance or inducement or an attempted performance or

inducement of an abortion without prior satisfaction of each of

the conditions described in divisions (B)(1)(a) to (e) of this

section if the physician who performs or induces or attempts to

perform or induce the abortion determines, in good faith and in

the exercise of reasonable medical judgment, that a medical

emergency exists that prevents compliance with one or more of

those conditions.

(C) For purposes of this section, it shall be rebuttably

presumed that an unborn child of a least twenty-four weeks of

gestational age is viable.

(D) Whoever violates this section is guilty of

terminating or attempting to terminate a human pregnancy after

viability, a felony of the fourth degree.

(E) A pregnant woman upon whom an abortion is

performed or induced or attempted to be performed or induced

in violation of division (A) or (B) of this section is not guilty of

an attempt to commit, complicity in the commission of, or

conspiracy in the commission of a violation of either of those

divisions.

2919.18 Failure to perform viability testing on

fetus.

(A)(1) Except as provided in division (A)(3) of this

section, no physician shall perform or induce or attempt to

perform or induce an abortion upon a pregnant woman after the

beginning of her twenty-second week of pregnancy unless,

prior to the performance or inducement of the abortion or the

attempt to perform or induce the abortion, the physician

determines, in good faith and in the exercise of reasonable

medical judgment, that the unborn human is not viable, and the

physician makes that determination after performing a medical

examination of the pregnant woman and after performing or

causing the performing of gestational age, weight, lung

maturity, or other tests of the unborn human that a reasonable

physician making a determination as to whether an unborn

human is or is not viable would perform or cause to be

performed.

(2) Except as provided in division (A)(3) of this section,

no physician shall perform or induce or attempt to perform or

induce an abortion upon a pregnant woman after the beginning

of her twenty-second week of pregnancy without first entering

the determination described in division (A)(1) of this section

and the associated findings of the medical examination and

tests described in that division in the medical record of the

pregnant woman.

(3) Divisions (A)(1) and (2) of this section do not

prohibit a physician from performing or inducing or attempting

to perform or induce an abortion upon a pregnant woman after

the beginning of her twenty-second week of pregnancy without

making the determination described in division (A)(1) of this

section or without making the entry described in division (A)(2)

of this section if a medical emergency exists.

(B) Whoever violates this section is guilty of failure to

perform viability testing, a misdemeanor of the fourth degree.

2307.51 Civil action for dilation and

extraction procedure.

(A) As used in this section:

(1) “Dilation and extraction procedure” has the same

meaning as in section 2919.15 of the Revised Code.

(2) “Frivolous conduct” has the same meaning as in

section 2323.51 of the Revised Code.

(B)(1) A woman upon whom a dilation and extraction

procedure is performed in violation of division (B) of section

2919.15 of the Revised Code has and may commence a civil

action for compensatory damages, punitive or exemplary

damages if authorized by section 2315.21 of the Revised Code,

and court costs and reasonable attorney’s fees against the

person who performed the dilation and extraction procedure.

(2) A woman upon whom a dilation and extraction

procedure is attempted in violation of division (B) of section

2919.15 of the Revised Code has and may commence a civil

action for compensatory damages, punitive or exemplary

damages if authorized by section 2315.21 of the Revised Code,

and court costs and reasonable attorneys [sic] fees against the

person who attempted to perform the dilation and extraction

procedure.

(C) It is an affirmative defense in a civil action

commenced pursuant to division (B)(1) or (2) of this section

that all other available abortion procedures would pose a

greater risk to the health of the woman upon whom the dilation

and extraction procedure was performed or attempted to be

performed than the risk posed by the dilation and extraction

procedure that was performed or attempted to be performed.

(D) If a judgment is rendered in favor of the defendant

in a civil action commenced pursuant to division (B)(1) or (2)

of this section and the court finds, upon the filing of a motion

under section 2323.51 of the Revised Code, that the

commencement of the civil action constitutes frivolous conduct

and that the defendant was adversely affected by the frivolous

conduct, the court shall award in accordance with section

2323.51 of the Revised Code reasonable attorney’s fees to the

defendant.

2307.52 Civil action for terminating a human

pregnancy after viability

(A) As used in this section:

(1) “Frivolous conduct” has the same meaning as in

section 2323.51 of the Revised Code.

(2) “Viable” has the same meaning as in section

2919.16 of the Revised Code.

(B)(1) A woman upon whom an abortion is purposely

performed or induced or attempted to be performed or induced

in violation of division (A) of section 2919.17 of the Revised

Code has and may commence a civil action for compensatory

damages, punitive or exemplary damages if authorized by

section 2315.21 of the Revised Code, and court costs and

reasonable attorney's fees against the person who purposely

performed or induced or attempted to perform or induce the

abortion in violation of division (A) of section 2919.17 of the

Revised Code.

(2) A woman upon whom an abortion is purposely

performed or induced or attempted to be performed or induced

in violation of division (B) of section 2919.17 of the Revised

Code has and may commence a civil action for compensatory

damages, punitive or exemplary damages if authorized by

section 2315.21 of the Revised Code, and court costs and

reasonable attorney’s fees against the person who purposely

performed or induced or attempted to perform or include the

abortion in violation of division (B) of section 2919.17 of the

Revised Code.

(C) If a judgment is rendered in favor the defendant in

a civil action commenced pursuant to division (B)(1) or (2) of

this section and the court finds, upon the filing of a motion

under section 2323.51 of the Revised Code, that the

commencement of the civil action constitutes frivolous conduct

and that the defendant was adversely affected by the frivolous

conduct, the court shall award in accordance with section

2323.51 of the Revised Code reasonable attorney’s fees to the

defendant.

2305.11 Time limitations for bringing certain

actions; extensions; effect of legal

disability.

(C) A civil action for unlawful abortion pursuant to

section 2919.12 of the Revised Code, a civil action authorized

by division (H) of section 2317.56 of the Revised Code, a civil

action pursuant to division (B)(1) or (2) of section 2307.51 of

the Revised Code for performing a dilation and extraction

procedure or attempting to perform a dilation and extraction

procedure in violation of section 2919.15 of the Revised Code,

and a civil action pursuant to division (B)(1) or (2) of section

2307.52 of the Revised Code for terminating or attempting to

terminate a human pregnancy after viability in violation of

division (A) or (B) of section 2919.17 of the Revised Code

shall be commenced within one year after the performance or

inducement of the abortion, within one year after the attempt to

perform or induce the abortion of division (A) or (B) of section

2919.17 of the Revised Code, within one year after the

performance of the dilation and extraction procedure, or, in the

case of a civil action pursuant to division (B)(2) of section

2307.51 of the Revised Code, within one year after the attempt

to perform the dilation and extraction procedure.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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