High court case may signal shift on abortionBy Joan Biskupic, USA TODAY
http://www.usatoday.com/news/washington/20..._x.htm?csp=N009Sabrina Holmquist trained as a physician in low-income neighborhoods in the Bronx, N.Y. She says she often saw pregnant teenagers in desperate health and family crises, including some girls who had been abused at home. That, Holmquist says, led her to believe that doctors sometimes should be able to perform abortions on minors without informing a parent.
But in Texas, Linda W. Flower, who practiced obstetrics for two decades, disagrees. She says that in the vast majority of cases in which a teenage girl seeks an abortion, a parent's guidance is helpful and needed. Flower says she knows of young women who have regretted having abortions.
The doctors' views reflect the dueling arguments in the first abortion case to come before the Supreme Court in five years: a New Hampshire dispute that tests whether a state may bar physicians from performing an abortion on a girl younger than 18 unless one of her parents has been notified at least 48 hours in advance — even in instances in which the girl faces a health emergency.
The case, to be heard by the court Wednesday, is the first abortion dispute before the justices since 2000, when they voted 5-4 to strike down Nebraska's ban on a procedure that critics call "partial birth" abortion because the ban lacked an exception for cases in which the woman's health was at risk. The new dispute tests whether such a health exception should be required in parental-involvement mandates, which have been passed in various forms by 43 states. (Related: Case could test Court)
The New Hampshire case arrives at the court when the judicial and political landscape surrounding the sensitive issue of abortion could be shifting, perhaps toward an era of more restrictions on the procedure. For now at least, the right to abortion established by the Supreme Court's Roe v. Wade ruling in 1973 is not the issue. But changes in the court's membership raise the possibility that a more conservative bench could begin to view restrictions on abortion more favorably.
Chief Justice John Roberts, a conservative whose precise views on abortion rights are unclear, joined the bench last month in place of the late William Rehnquist, a conservative who opposed abortion rights. And on deck for the court is conservative federal Judge Samuel Alito, who would replace the retiring Sandra Day O'Connor. She has joined with the court's four liberal members to limit state restrictions on abortion.
Alito would take part in the New Hampshire case only if the court had not decided it by the time he was confirmed by the Senate and the case had to be argued again. If he is confirmed to replace O'Connor and winds up taking a narrow view of abortion rights — as his record as a judge and government lawyer suggests — he could move the court toward allowing more restrictions on abortion.
Because of "the conservative trend in national politics ... we do stand on a precipice right now" with regard to regulation of abortion, says Susan Cohen, director of government affairs at the Alan Guttmacher Institute, which has gathered data on abortion and women's reproductive issues for four decades.
Leading Democrats such as New York Sen. Hillary Rodham Clinton and Democratic National Committee Chairman Howard Dean are reaching out to voters who oppose abortion by softening the party's rhetoric in support of abortion rights and trying to mute Republican criticism that Democrats' stance devalues life.
Clinton referred in January to the "sad, even tragic choice" of abortion, and suggested that Democrats show they are trying to diminish the number of abortions while protecting abortion rights. This month, Dean told MSNBC that he avoids using the term "pro-choice" to describe his party's stance on abortion because "it implies you're not pro-life. ... There are a lot of pro-life Democrats. We respect them, but we believe the government should ... stay out of the personal lives of families and women."
That approach seems to reflect public opinion polls that show most Americans support abortion rights but also favor restrictions. In a USA TODAY/CNN/Gallup Poll this month, 16% of those surveyed said abortion should be illegal in all circumstances. Sixty-nine percent said a girl younger than 18 should have to get a parent's consent before having an abortion, and 64% said a married woman who seeks an abortion should have to notify her husband. (Related: Poll results)
Outside opinions
New Hampshire is among 18 states that have passed laws requiring at least one parent to be notified when a minor daughter seeks an abortion. Twenty-five other states have gone a step further, requiring parental consent for an abortion to be performed in such cases. New Hampshire, Minnesota, Missouri, North Dakota and Wyoming have parental-involvement laws that do not allow exceptions for health emergencies.
Because it has landed at the court at what appears to be a pivotal time for abortion rights, the New Hampshire case —Ayotte v. Planned Parenthood - has stirred passions among medical professionals, religious groups, government leaders and others who have combined to submit 31 "friend of the court" briefs.
"Any situation where the legal system stands between a woman and her physician is inappropriate and dangerous," says Holmquist, who practices at a University of Chicago clinic and is active in Physicians for Reproductive Choice and Health, an abortion rights doctors' group that signed on to a "friend of the court" brief opposing New Hampshire's law.
She is particularly concerned about pregnant teens who are afraid to tell a parent about their situation out of fear they might be beaten or thrown out of the house. She also says that in health emergencies, there often isn't enough time to notify a parent.
Some of her concerns are echoed in a brief filed by the American College of Obstetricians and Gynecologists and other medical organizations that say the New Hampshire law "would force physicians to violate ethical and professional obligations by requiring them to delay critical treatment in a medical emergency."
Flower, who is a family practitioner in a clinic for indigent patients in the Houston area and is active in a Christian doctors' group, counters that health problems in pregnant teens often are exaggerated. She says health exceptions to abortion regulations have ended up permitting "abortion in any case, even if the mother simply isn't feeling good that day."
She adds that doctors should "help the women think beyond the crisis of an unwanted or unplanned pregnancy. Parents are the ones ... who can help (minors) look to the future."
The Supreme Court generally has been in step with public opinion on abortion rights, finding that it should be legal nationwide while allowing some state restrictions. There have been exceptions.
Although most Americans support requiring a husband to be notified if his wife seeks an abortion, the court struck down such a law in 1992 as a violation of a woman's constitutional right to end a pregnancy. The court rejected a stance that Alito had taken as a member of a U.S. appeals court.
At the time, the Supreme Court noted that it had upheld parental notification or consent requirements, which it said were "based on the quite reasonable assumption that minors will benefit from consultation with their parents and that children will often not realize that their parents have their best interests at heart."
That's why the question in the New Hampshire case is not so much the validity of a parental-notice law, but whether such a law must allow exceptions for when a girl's health is at stake. Equally significant, the dispute will test whether a new abortion restriction can be broadly challenged before it has taken effect, or only after women can claim they have been harmed by it. New Hampshire's 2003 law is not being enforced while it is being challenged.
Exceptions to the rule
The case before the high court is an appeal from New Hampshire of a ruling by a federal appeals court that rejected the state's law. The appeals court said the law was invalid without a health exception, as required by the Supreme Court's ruling that struck down Nebraska's ban on the procedure that opponents term "partial birth" abortion.
In its appeal to the Supreme Court, New Hampshire — backed by the Bush administration — says no health exception is necessary for a parental-notice law.
The brief by state Attorney General Kelly Ayotte emphasizes "the benefit of parental guidance and assistance" in making "a difficult choice." It says "a health exception is only required when there is substantial medical authority that supports the proposition that a specific regulation could pose a significant risk to women's health."
Ayotte said a teen in a medical crisis who does not want to notify a parent may go before a judge and argue that she is mature enough to decide on her own. "There is no reason to believe that a judge will not act immediately if a (girl's) health is at stake," Ayotte wrote.
But several groups that track social services, including the Center for Adolescent Health and the Law, have told the Supreme Court that girls who seek to take advantage of "judicial bypass" — which the court has required in past cases involving parental notification and consent issues — often encounter delays, uninformed court personnel and other bureaucratic hurdles.
Planned Parenthood, represented by American Civil Liberties Union lawyer Jennifer Dalven, has cited health problems that can arise when a pregnant teen cannot be treated quickly in an emergency, including damage to the liver, kidneys and other organs; fluid in the lungs; and infertility.
The American College of Obstetricians and Gynecologists says in its brief that although such problems generally affect fewer than 10% of all pregnancies, they can affect "substantial numbers" of pregnant minors.