Planned Parenthood Minnesota v. Mike Rounds
686 F.3d 889
8th Cir.2012Background
- 2005 South Dakota Act amended informed-consent for abortion, adding a suicide advisory and broader medical-risks disclosures.
- District court enjoined the Act and later proceedings addressed facial validity and undue burden/First Amendment issues.
- Planned Parenthood challenged the suicide advisory; State and Intervenors defended it as truthful, non-misleading, and relevant.
- The Eighth Circuit granted en banc review solely on the suicide advisory issue.
- Panel decisions found certain disclosures permissible while others, including the suicide advisory, were challenged; the en banc court ultimately reversed in part.
- Statutory text requires physicians to describe all known medical risks and statistically significant risks, including an increased risk of suicide ideation and suicide.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the suicide advisory violates the First Amendment or imposes undue burden | PP argues it is misleading and burdens abortion rights | State argues it is truthful, relevant, and a permissible medical risk disclosure | No; advisory upheld as truthful and relevant, not an unconstitutional burden |
| Meaning of 'increased risk' in § 34-23A-10.1(l)(e)(ii) | PP contends 'increased risk' implies causation and should be read narrowly | State reads 'increased risk' as relative risk without requiring causation | Relative risk interpretation governs; not requiring proven causation for disclosure |
| Truthfulness and relevance of the suicide advisory | PP asserts no known causal link and thus advisory is misleading | State points to peer-reviewed literature showing higher relative risk, generally known | Disclosures are truthful and relevant to patient decision under Casey/Gonzales standards |
| Effect of medical uncertainty on adequacy of disclosure | Advisory cannot be truthful if causation is not established | Uncertainty permitting informed consent exists; state may disclose associations, not require causation | Uncertainty does not render the disclosure untruthful or irrelevant; informed-consent may include associations |
Key Cases Cited
- Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833 (1992) (informed consent must inform, not hinder, decision; speech can be regulated for truthful information)
- Gonzales v. Carhart, 550 U.S. 124 (2007) (state may balance uncertainty in medical knowledge with informing patients)
- Planned Parenthood Minn., N.D., S.D. v. Rounds, 653 F.3d 662 (2011) (en banc; discussed relative risk and informed consent in SD statute)
- Rounds v. Lakey, 530 F.3d 724 (2008) (en banc (Eighth Cir.) on informed consent disclosures and undue burden/compelled speech)
- Tex. Med. Providers Performing Abortion Servs. v. Lakey, 667 F.3d 570 (2012) (physician's First Amendment rights and informational disclosures)