IFEANYI CHARLES ANTHONY OKPALOBI,doing business as Gentilly Medical Clinic for Women, Plaintiff-Appellee, and CAUSEWAY MEDICAL SUITE; BOSSIER CITY MEDICAL SUITE; HOPE MEDICAL GROUP FOR WOMEN; DELTA WOMEN'S CLINIC; WOMEN'S HEALTH CLINIC; JAMES DEGUERCE; A. JAMES WHITMORE, III, Intervenors-Appellees,
v.
MIKE FOSTER, Governor of the State of Louisiana; RICHARD P. IEYOUB, Attorney
General of Louisiana;1 STATE OF LOUISIANA, Substituted in place of Kenneth Duncan, Treasurer of the State of Louisiana, Defendants-Appellants.
No. 98-30228
UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT
September 17, 1999
[Copyrighted Material Omitted][Copyrighted Material Omitted]
Appeal from the United States District Court for the Eastern District of Louisiana
Before JOLLY, WIENER and PARKER, Circuit Judges.
WIENER and PARKER, Circuit Judges:
Mike Foster, Governor of Louisiana, Richard P. Ieyoub, Attorney General of Louisiana, and the State of Louisiana (collectively "the State") appeal the district court's order permanently enjoining "the operation and effect" of Louisiana Revised Statutes Annotated, Title 9, Section 2800.122 (West Supp. 1999)("Act 825" or "the Act"), which makes an abortion provider liable, in tort, to the woman obtaining an abortion for any damage occasioned by the abortion. The district court held the Act unconstitutional and enjoined its enforcement, finding that the Act is unconstitutionally vague and that it imposes an undue burden on a woman's right to seek a pre-viability abortion. We affirm.
I. PROCEDURAL HISTORY AND STANDARD OF REVIEW
The original complaint of Ifeanyi Charles Anthony Okpalobi ("Dr. Okpalobi") was filed in district court on July 15, 1997. Five health care clinics and two more physicians ("Intervenors") intervened on behalf of Dr. Okpalobi and filed a motion for a temporary restraining order ("TRO") and preliminary injunction to restrain the operation of Act 825.3 The State opposed the motion. After a hearing, the district court granted a TRO in an order dated August 14, 1997, one day before the Act was scheduled to take effect.
The district court held a hearing on the Plaintiffs' motion for preliminary injunction on December 10, 1997. On January 7, 1998, the district court issued an order declaring that Act 825 "has the purpose and effect of infringing and chilling the exercise of constitutionally protected rights of abortion providers and woman [sic] seeking abortions," concluding that the Plaintiffs had demonstrated a substantial likelihood of success on the merits of their Fourteenth amendment claim and granting the preliminary injunction. See Okpalobi v. Foster,
The State timely filed an appeal. We must now determine whether the district court abused its discretion when it declared that Act unconstitutional and permanently enjoined its enforcement. See Causeway Medical Suite v. Ieyoub,
The procedural posture in which this case is presented limits our review of the district court's factual findings. The only factual findings before us on review were made in the context of the district court's grant of the Plaintiffs' motion for a preliminary injunction. A preliminary injunction requires the movant, by a clear showing, to carry the burden of persuasion. See Mazurek v. Armstrong,
II. FACTS
The Plaintiffs comprise three physicians and five health care clinics that provide abortion services in Louisiana. See Okpalobi,
The evidence in the record consists of two affidavits submitted to the district court to support the Plaintiffs' motion for preliminary injunction.4 The first affidavit was executed by the administrator of Hope Medical Group for Women, a Shreveport Louisiana abortion provider. Hope's administrator asserts that Act 825 "will leave Hope no option but to cease providing abortions to our patients who need pregnancy terminations" because the Act leaves the clinic and its physicians "susceptible to significant liability."
The second affidavit was submitted by a physician who provides abortions in Baton Rouge and New Orleans, Louisiana. He also asserts that if Act 825 takes effect, he would have no choice but to discontinue his abortion practice. "The constant and real threat of large money judgments against me, when I have done no wrong, is not a risk I could reasonably bear."
III. DISCUSSION
A. The Act
This case requires us to determine the constitutionality of Act 825, which wouldhave taken effect on August 15, 1997. The Act states:
2900.12 Liability for termination of a pregnancy
A. Any person who performs an abortion is liable to the mother of the unborn child for any damage occasioned or precipitated by the abortion, which action survives for a period of three years from the date of discovery of the damage with a preemptive period of ten years from the date of the abortion.
B. For purposes of this Section:
(1) "Abortion" means the deliberate termination of an intrauterine human pregnancy after fertilization of a female ovum, by any person, including the pregnant woman herself, with an intention other than to produce a live birth or to remove a dead unborn child.
(2) "Damage" includes all special and general damages which are recoverable in an intentional tort, negligence, survival, or wrongful death action for injuries suffered or damages occasioned by the unborn child or mother.
(3) "Unborn child" means the unborn offspring of human beings from the moment of conception through pregnancy and until termination of the pregnancy.
C.(1) The signing of a consent form by the mother prior to the abortion does not negate this cause of action, but rather reduces the recovery of damages to the extent that the content of the consent form informed the mother of the risk of the type of injuries or loss for which she is seeking to recover.
(2) The laws governing medical malpractice or limitations of liability thereof provided in Title 40 of the Louisiana Revised Statutes of 1950 are not applicable to this Section.
LA. REV. STAT. ANN. 9:2800.12 (West Supp. 1999).
B. Jurisdiction
None of the parties raised or briefed on appeal any issues concerning our jurisdiction. Nevertheless, we must examine the basis for our jurisdiction sua sponte. See MCG, Inc. v. Great Western Energy Corp.,
1. Eleventh Amendment
The Eleventh Amendment prohibits the federal courts from entertaining "any suit in law or equity, commenced or prosecuted against one of the United States by Citizens of another State, or by Citizens or Subjects of any Foreign State." U.S.Const. Amend. XI. The bar imposed by the Eleventh Amendment has been extended, by judicial construction, to suits brought against states by their own citizens. See Hans v. Louisiana,
The Eleventh Amendment does not, however, bar suits seeking declaratory or injunctive relief against state officers. See Ex parte Young,
In making an officer of the state a party defendant in a suit to enjoin the enforcement of an act alleged to be unconstitutional, it is plain that such officer must have some connection with the enforcement of the act, or else it is merely making him a party as a representative of the state, and thereby attempting to make the state a party.
Id. at 157(emphasis added). Neither the Supreme Court nor the Fifth Circuit has defined the exact nature of the "connection" between a defendant state officer and the enforcement of the statute required by Ex parte Young. We therefore are called on to parse the language of and precedents for Young and examine the development of Eleventh Amendment jurisprudence from other circuits for persuasive reasoning to determine whether the Eleventh Amendment bars the present action.
Young relied on Smyth v. Ames,
To the extent that there is tension between Fitts's focus on the state officials' express enforcement power and the later articulation in Young, we are controlled by the Smyth doctrine and the unequivocal holding of Young that a state officer's connection with the enforcement of the challenged act can "[arise] out of the general law . . . so long as it exists." Id. at 157.
Some courts have interpreted Young to stand for the proposition that a Governor's general duty to enforce laws set out in the state's constitution is all the connection the Eleventh Amendment requires. In Federal Nat'l Mortgage Ass'n. v. Lefkowitz,
The Second Circuit later held that the New York Attorney General's duty to support the constitutionality of challenged state statutes, see N.Y. Exec. Law 71 (McKinney 1972), and to defend actions in which the state is "interested," see N.Y. Exec. Law 71 (McKinney 1972) was nota sufficient connection with New York's durational residency requirement for divorce actions to afford the "exigent adversity" essential to federal court jurisdiction over a constitutional challenge to that statute. See Mendez v. Heller,
Subsequently, another New York trial court attempted to sort out Young's "some connection" requirement. In Gras v. Stevens,
[These cases] have been concerned with the enforcement of programs, civil or criminal, dealing with the relations between the state and the individual - the regulation of railroad rates as in Ex parte Young itself; the forfeiture of civil rights on imprisonment, Johnson v. Rockefeller,
Id. at 1152. The district court in Gras likewise rejected the Attorney General as an appropriate defendant, noting that in spite of the fact that he was bound to support the constitutionality of the challenged New York statute and to defend actions in which the state is interested, he was not threatening to deprive the plaintiff of anything at the time the action was commenced. See id. at 1151.
An Ohio district court in Allied Artists Pictures Corp. v. Rhodes,
The Sixth Circuit approved the reasoning and affirmed the result of the district court in Allied. See Allied Artists Picture Corp. v. Rhodes,
From these cases we glean the following two part test for resolving the question of "connection" necessary for Eleventh Amendment purposes. First, we determine what powers the defendants wield to enforce the law in question. Second, we discern the nature of the law and its place on the continuum between public regulation and private action.
Act 825, on its face, does not direct the State or its officers to do anything. Rather, the Act envisions private law suits brought by abortion patients against abortion providers in state courts, leaving the judicial branch of the state government with the most direct involvement in enforcing the Act. Therefore, one argument goes, the plaintiffs' quarrel is with Louisiana courts rather than the Governor. Louisiana has chosen, however, to give its Governor and Attorney General a role in the enforcement of all of its laws. The Louisiana Constitution, Article 4, 5(A) provides:
The governor shall be the chief executive officer of the state. He shall faithfully support the constitution and laws of the state and of the United States and shall see that the laws are faithfully executed.
The Attorney General's powers and duties are set out in Article IV, 8 of the Louisiana Constitution, which provides:
As necessary for the assertion or protection of any right or interest of the state, the attorney general shall have authority (1) to institute, prosecute, or intervene in any civil action or proceeding[.]
Further, if the Attorney General neglects or declines to take an appeal from a judgment in a civil case in which the state has an interest, the Governor has the right and the duty to do so. See State ex rel. Livingston v. Graham,
Next, the Plaintiffs insist -- and we agree -- that the purpose and effect of the Act is to prevent women from obtaining legal abortions in Louisiana: The Act is a thinly-veiled attempt to regulate and interfere with a right protected by the United States constitution. We place such interference on the Allied continuum near the end closest to laws respecting the voting rights of citizens, rather than alongside procedural aspects of domestic relation law. It also falls close to the motion picture statute in Allied which, while ostensibly creating a private or civil cause of action, was found by the court to have been "designed to implement and serve the public interest of the state." Allied,
Because the connection between the Attorney General and Governor and the Act is sufficient and because the Act regulates the availability of abortions, we hold that making the Governor and the Attorney General of Louisiana defendants in this suit does not violate the Eleventh Amendment.
2. Article III, Case or Controversy requirement
In a closely related -- indeed, overlapping -- inquiry, we must determine whether there is a justiciable controversy between the Plaintiffs and the defendant state officials. Article III, 2 of the United States Constitution defines federal judicial power in terms of nine categories of "cases" and "controversies," imposing constitutional limits on federal judicial power.
One vehicle a party may use to invoke federal case or controversy jurisdiction is a suit seeking declaratory relief. See 28 U.S.C. 2201 ("any court of the United States, on the filing of an appropriate pleading, may declare the rights and other legal relations of any interested party seeking such declaration"). The purpose of the Declaratory Judgment Act is to afford added remedy to one who is uncertain of his rights and who desires early adjudication thereof without having to wait until his adversary should decide to sue and to act at his peril in the interim. See McGraw-Edison Co. v. Preformed Line Products Co.,
The Plaintiffs pleaded for declaratory relief against the Governor of Louisiana and the State of Louisiana.6 The intervenors pleaded for declaratory and injunctive relief against the Governor and the Attorney General of Louisiana. The district court declared the statute in question unconstitutional and enjoined its enforcement, without singling out any particular defendant against whom the injunction was to operate.
A suit for declaratory and injunctive relief is the classic procedural mechanism for challenges to the constitutionality of state abortion statutes. See, i.e., Roe v. Wade,
Abortion case law has developed in the context of challenges to state statutes thatimpose criminal liability on abortion patients and providers. Today we must determine whether precedent affording federal case or controversy jurisdiction over claims for declaratory and injunctive relief is applicable when the state abortion statute under attack creates a private, civil cause of action, rather than criminal liability, and whether the Governor and Attorney General of Louisiana are the appropriate defendants.
First, the civil, as opposed to criminal nature of the statute makes no difference to our jurisdiction over claims for declaratory relief. See Hopwood v. State of Texas,
We cannot rest there, however, because the question of the Ex parte Young "connection" between the defendants and the Act that we knocked down in the Eleventh Amendment skirmish has circled around and now attacks our rear flank, incarnated as a case or controversy question. Even if the Governor and the Attorney General are proper defendants, the argument goes, if the "complaint fails to allege, or the plaintiff fails to prove, that defendant state officers have ever taken or threatened to take any action with respect to a state statute then there is no 'actual controversy' within the Declaratory Judgment Act, and there is 'no case or controversy' within Article III." Shell Oil Co. v. Noel,
In 1st Westco Corp. v. School Dist. Of Philadelphia,
We are not troubled by the pre-enforcement nature of this suit. The State has not suggested that the newly enacted law will not be enforced, and we see no reason to assume otherwise. We conclude that plaintiffs have alleged an actual and well-founded fear that the law will be enforced against them. Further, the alleged danger of the statute is, in large measure, one of self-censorship; a harm that can be realized even without an actual prosecution.
Virginia American Booksellers Association v. Commonwealth,
Reversing a dismissal of a declaratory judgment action for failure to present a justiciable case or controversy, the Fourth Circuit explained: "Mobil's predicament - submit to a statute or face the likely perils of violating it - is precisely why the declaratory judgment cause of action exists." Mobil Oil Corp. v. Attorney General,
We are convinced that Article III does not require a plaintiff to plead or prove that a defendant state official has enforced or threatened to enforce a statute in order to meet the case or controversy requirement when that statute is immediately and coercively self-enforcing. The Plaintiffs' assertion that they will be forced to discontinue offering legal abortions to patients because of the untenable risks of unlimited civil liability under an unconstitutional Act, sets forth a judicable case or controversy between the plaintiffs and the Governor and Attorney General of Louisiana.7
3. Plaintiffs' standing to pursue their patients' rights
The Plaintiffs brought suit alleging that Act 825 violates their own Fourteenth Amendment rights, as well as those of their patients. The State argued in district court that the Plaintiffs lack standing to pursue their patients' rights. The district court, rejecting that position, held that, "[g]iven the relationship between the intervenors and their patients, and given the obstacles which prevent pregnant women from challenging this statute, including a desire for privacy and the imminent mootness of their claims, intervenors may assert third-party standing and raise the right of their patients." Okpalobi,
The district court addressed the issue of standing within the context of determining whether the Plaintiffs were entitled to a preliminary injunction. The district court's inquiry was thus governed by the standard applicable to ruling on a motion to dismiss for want of standing. For purposes of such a motion, "both the trial and reviewing courts must accept as true all material allegations of the complaint, and must construe the complaint in favor of the complaining party." Warth v. Seldin,
There are two distinct standing questions encompassed by the district court's order. The first, which the State did not dispute in the district court, is whether the Plaintiffs suffered an injury in fact. See Singleton v. Wulff,
The second aspect of standing, which the State did contest in the district court but not on appeal, is the Plaintiffs' standing to assert the constitutional rights of their patients who seek abortions. We must therefore determine whether, as a prudential matter,8 the Plaintiffs are proper proponents of those particular rights. See Singleton,
Second, the Singleton Court considered whether there was some genuine obstacle preventing the third party from asserting her own rights. See id. at 115-116. The Court noted two obstacles to a woman's assertion of her own rights in an abortion case. "She may be chilled from such assertion by a desire to protect the very privacy of her decision from the publicity of a court suit." Id. at 117. "A second obstacle is the imminent mootness . . . of any individual woman's claim. Only a few months, at the most, after the maturing of the decision to undergo an abortion, her right thereto will have been irrevocably lost[.]" Id.
Later, in Powers v. Ohio, a majority of the Supreme Court reiterated the framework set out by the Singleton plurality:
We have recognized the right of litigants to bring actions on behalf of third parties, provided three important criteria are satisfied: The litigant must have suffered an "injury in fact," thus giving him or her a "sufficiently concrete interest" in the outcome of the issue in dispute; the litigant must have a close relationship to the third party; and there must exist some hindrance to the third party's ability to protect his or her own interests.
Powers,
When we apply the factors dictated by the Supreme Court, we find no meaningful distinction between the Plaintiffs here and the physicians whose standing was affirmed in Singleton. They share the same patient-provider relationship. The obstacles for the absent women are identical.
The State attempts to distinguish this case from Singleton by characterizing Act 825 as a strengthening of Louisiana's informedconsent statute. See LA. REV. STAT. ANN. 40:1299.35.6 (West Supp. 1999)("Woman's Right to Know Act"). We understand the State's argument to pit a woman's interest in obtaining full disclosure of information prior to making a decision to undergo an abortion against the abusive practice of physicians who would maximize the number of abortions performed (and thereby increase revenues) by obtaining consent for an abortion from a patient who would decline the procedure were she fully informed.
This argument is reminiscent of the State of Illinois's argument that was rejected by the Seventh Circuit in Charles v. Carey, that "to permit doctors to raise the rights of their patients in this circumstance permits . . . the wolves to guard the flock of sheep." Charles v. Carey,
Yet a somewhat more difficult question remains. The Louisiana statute under attack provides the absent woman litigant with a cause of action that will be lost to her if the Plaintiffs prevail. Thus, we must ask whether the absent women's potential for recovery of a sizable money judgment under Act 825 distinguishes this case from Singleton's general rule allowing physicians to assert their abortion patients' right to choose a pre-viability abortion.
This question requires us to examine the nature of the relationship between a plaintiff and a third party that is required by Singleton and its progeny. See Singleton,
The State argues that, because Act 825 grants women a cause of action against abortion providers, including the Plaintiffs, there is not a sufficient congruence of the Plaintiffs' interests with the absent women's interests to grant the Plaintiffs' third-party standing. The State's argument falls wide of the mark. The focus of our standing inquiry is whether the third-party plaintiffs will adequately represent the absent women's constitutional rights. The State, however, does not contend that the Plaintiffs cannot serve as effective proponents of women's constitutional right to anabortion. Neither does the State assert or offer any evidence either that the Plaintiffs have somehow misframed the constitutional argument or that the absent women would construct their challenge to Act 825 differently.
To the contrary, the essence of the State's argument is that the Plaintiffs will represent the women's constitutional rights too vigorously, i.e., that the Plaintiffs will strenuously argue that Act 825 constitutes an undue burden on woman's right to obtain an abortion or is unconstitutionally vague, even though some women might prefer to retain the cause of action granted in Act 825 regardless of its effect on their constitutional rights. We will not deny standing to the Plaintiffs on the speculation that some women might not want to assert their constitutional rights. The general rule, as formulated by the Supreme Court in Singleton, is that physicians have standing to raise challenges to laws regulating abortion based on the constitutional rights of their patients because they can adequately represent the patients' interest. The State has offered no persuasive reason for deviating from that rule.
Furthermore, as we conclude that the district court's determination that Act 825 will drive a substantial portion, if not all, Louisiana abortion providers out of business, we are forced to conclude that women have no meaningful opportunity to recover under Act 825. For, if a woman cannot get an abortion in Louisiana, she cannot be damaged by an abortion provider in Louisiana; and if she cannot be damaged in Louisiana by an abortion provider, she will never have a cause of action under Act 825. We are then left with the Supreme Court's guidance in Singleton, which in the circumstances of this case, dictates that the Plaintiffs have the requisite commonality and congruence with their patients' interests to establish standing to assert their right to make abortion decisions free of undue burden by the State of Louisiana. See Powers,
4. Scope of the injunction
Federal Rule of Civil Procedure 65(d) teaches that injunctions are "binding only on the parties to the action, their officers, agents, servants, employees, and attorneys, and on those persons in active concert or participation with them who receive actual notice of the order by personal service or otherwise." The question whether the present injunction can prevent a woman, not a party to this suit, from filing an action in Louisiana State Court invoking the remedies of Act 825 was not raised in the district court or on appeal. Because potential questions about the scope of the injunction are not jurisdictional, we may not address them. See United States v. Bigler,
C. Standard of proof
The parties dispute the proper standard of proof when a plaintiff asserts a facial challenge to a statute imposing restrictions on abortion. The district court noted the apparent tension between United States v. Salerno,
On appeal, the parties point out that the Fifth Circuit jurisprudence on this question is not a model of clarity. Compare Barnes v. Moore,
D. Undue burden
Because a woman has the right to choose to have an abortion before viability, legislation restricting abortions before viability must not place an undue burden on that right. See Sojourner T,
1. Purpose
a. The Inquiry
The Casey Court provided little, if any, instruction regarding the type of inquiry lower courts should undertake to determine whether a regulation has the "purpose" of imposing an undue burden on a woman's right to seek an abortion. Other than setting forth the above-stated test, the Court added only that: "[a] statute with this purpose [placing a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability] is invalid because the means chosen by the State to further the interest in potential life must be calculated to inform the woman's free choice, not hinder it." Casey,
We are not without guidance, however, as abortion law is not the only realm of jurisprudence in which courts are required to question whether a measure has been adopted for an impermissible purpose. Such an inquiry is also mandated in both voting rights and Establishment Clause cases. In those cases, the Supreme Court has instructed that we should typically afford a government's articulation of legislative purpose significant deference. See, e.g., Bethel Sch. Dist. v. Fraser,
Relying on the Supreme Court case, Mazurek v. Armstrong,
In Jane L, the Tenth Circuit held unconstitutional a Utah law that equated viability with twenty weeks gestational age as measured from conception because, inter alia, the law had the impermissible purpose of usurping the physician's responsibility for determining fetal viability and, thus, providing a vehicle for challenging the holding of Roe v. Wade. Jane L,
The State has missed the import of these two cases -- whether they are read separately or together. Neither Mazurek nor Jane L indicates either that (1) for a court to hold that a measure has the impermissible purpose of placing an undue burden on a woman's right to an abortion, the legislature actually has to admit to such a purpose or (2) indicia of improper legislative purpose, such as statutory language, legislative history and context, and related legislation, are irrelevant to the purpose prong of the "undue burden" inquiry. In Mazurek, the Supreme Court simply rejected as insufficient evidence of improper purpose two types of evidence not relevant here and similarly discounted by the Court on other occasions -- medical data indicating that nonphysicians are capable of performing abortions safely and the involvement of certain lobbying groups in the legislative process. More importantly,in attempting to glean whether the Montana statute's purpose was improper, the Court examined the language and requirements of the challenged statute in light of existing precedent -- a traditional inquiry and one particularly useful here. Similarly, although the Tenth Circuit in Jane L obviously relied on the fact that the state admitted to an improper purpose in its appellate brief, the court also rests its conclusion that the Utah legislature adopted the measure for a forbidden purpose on the fact that the act on its face denied physicians the discretion granted them under well-established precedent.
In short, in Mazurek, the Supreme Court highlights specific types of evidence that are clearly insufficient to establish improper purpose; in Jane L, the Tenth Circuit affirms the obvious that, if the state admits to an improper purpose in adopting an abortion measure, that measure cannot pass constitutional muster under the undue burden test; and both cases reconfirm that the established methods for assaying a legislature's purpose are valid in the abortion context. It is those methods on which we rely in determining whether Act 825 has the purpose of placing a substantial burden on a woman's right to obtain an abortion.
b. Act 825
We have noted above that the State contends that the purpose of Act 825 is to encourage a physician to inform a woman of all the risks associated with having an abortion. The Act's plain language refutes such a contention. Contrary to the State's assertions, the cause of action contained in Act 825 simply does not hinge on what or how much information a physician provides to a woman prior to performing an abortion. The Act's operative language provides, without any reference to the issue of informed consent, that "[a]ny person who performs an abortion is liable to the mother of the unborn child for any damage occasioned or precipitated by the abortion . . . ." LA. REV. STAT. ANN. 9:2800.12(A). Damage is defined to include "injuries suffered or damages occasioned by the unborn child or mother." LA. REV. STAT. ANN. 9:2800.12(B)(2) (emphasis added). The Act later adds that "[t]he signing of a consent form by the mother prior to the abortion does not negate this cause of action, but rather reduces the recovery of damages to the extent that the content of the consent form informed the mother of the risk of the type of injuries or loss for which she is seeking to recover." LA. REV. STAT. ANN. 9:2800.12(C)(1) ("Reduction of Damages/Informed Consent Provision") (emphasis added).
Thus, the Act provides a cause of action (1) to women who have had an abortion (2) against the physician who performed the abortion (3) for any damage caused by the procedure to the woman or the "unborn child" -- a cause of action that (fatally, as seen below) contains no standard of care, no mens rea requirement, and no indication whatsoever regarding the steps a physician may take to avoid liability (other than to cease and desist from performing abortions). The issue of informed consent only enters the picture to reduce, not bar, damages regarding types of injuries of which the physician informed the woman prior to the abortion. Like its operative clause, the Act's "Reduction of Damages/Informed Consent" provision offers no guidance to a physician as to what he can do to satisfy Act 825's non-existent standard-of-care and state-of-mind requirements. In short, Act 825's structure and language put the lie to the State's insistence that the legislation is designed merely to enhance the information furnished to women seeking abortions.
The State's explanation of Act 825's purpose appears even more disingenuous when read in pari materia with the Louisiana Woman's Right to Know Act (the "Woman's Right to Know Act"), LA. REV. STAT. ANN. 40:1299.35.6 (West Supp. 1999), the measure that the State argues Act 825 is intended to supplement. Thatact (1) specifies in a comprehensive list the information that a physician must furnish to a woman seeking an abortion, LA. REV. STAT. ANN. 40:1299.35.6(A)(5)(a) (stating purpose of Act to "[e]nsure that every woman considering an abortion receive [sic] complete information on her alternatives and that every woman submitting to an abortion do [sic] so only after giving her voluntary and informed consent to the abortion procedure"), and (2) provides that "[a]ny physician who complies with the provisions of [the Right to Know Act] may not be held civilly liable to his patient for failure to obtain informed consent to the abortion . . . ." LA. REV. STAT. ANN. 40:1299.35.6(H). When Act 825's Reduction of Damages/Informed Consent language that grants a woman a cause of action for damage caused to her or her "unborn child" by an abortion is viewed in conjunction with the Woman's Right to Know Act, which denies a woman the ability to recover for damages for injuries of which she was informed before an abortion, it is undeniable that the provision is designed not to supplement the Woman's Right to Know Act, but to ensure that a physician cannot insulate himself from liability by advising a woman of the risks, physical or mental, associated with abortion. Like the district court, we cannot avoid the conclusion that the State's proffered legislative purpose simply is not credible.
Given the deference due to state legislation, the question of whether Act 825 fails constitutional muster exclusively because it was adopted for an improper purpose might be close. We are not, however, confronted with such a situation. To the contrary, if Act 825 were to go into effect, it undoubtedly would drive Louisiana's qualified and responsible abortion providers out of business, thereby imposing an undue burden on a woman's right to seek an abortion. Thus, we are faced with the converse situation of that confronted by the Supreme Court in Mazurek. To paraphrase the Court, there is significant evidence that the legislature intended the law to do exactly what it would do were it to go into effect.
2. Effect
The evidence shows that the Plaintiffs, who currently provide approximately 80% of all abortions in the state, will be forced to discontinue their abortion practice if Act 825 goes into effect. The district court found that the Act constitutes an undue burden because it "sets a standard no physician can meet and creates a climate in which no provider can possibly operate," thereby significantly reducing the number of abortion providers in Louisiana. Okpalobi,
E. Vagueness
1. Duty of Care
Due process prohibits laws so vague that persons "of common intelligence must necessarily guess at [their] meaning and differ as to [their] application." Smith v. Goguen,
A vague law is especially problematic, and the standard of a court's review is therefore more stringent when, as here, "the uncertainty induced by the statute threatens to inhibit the exercise of constitutionally protected rights." Colautti v. Franklin,
The Supreme Court has invalidated laws that alter the standard of care a physician owes an abortion patient on vagueness grounds because of the potential for chilling the providing of services. In Colautti v. Franklin, the Supreme Court held impermissibly vague a Pennsylvania abortion statute requiring a physician to adopt a particular standard of care whenever the physician determined that a fetus was viable or "there [was] sufficient reason to believe that the fetus may be viable." Colautti,
Here, the Plaintiffs prevailed in district court after asserting that Act 825 imposes an "invisible duty of care" on doctors. It is unclear, they argued, what, if anything, a physician could do to satisfy the Act's requirements and thereby escape liability under the Act. The district court found that the Plaintiffs had demonstrated "a substantial likelihood of success of showing that the standard of care in Act 825 is unconstitutionally vague because it fails to provide the abortion provider with fair warning of what legal standard will be applied and of what conduct will incur civil liability." See Okpalobi,
The State attempts to rebut the district court's vagueness finding by characterizing the statute as a necessary adjunct to the Woman's Right to Know Act. See LA. REV. STAT. ANN. 40:1299.35.6. Relying not on evidence in the record but on a 1996 NotreDame Law Review article,11 the State contends that such necessity arises from many forces, including, inter alia, the facts that there are fewer abortions being performed, and there is increased competition for patients among abortion providers. Further, without citation to any authority or evidence, the State contends that a reasonable patient probably would not be aware of the risks of post-abortion psychological injuries due to the suppression of this information by what the State characterizes as "paternalistic" doctors.
The Woman's Right to Know Act requires a physician to inform the woman of "the proposed abortion method and those risks (including risks to the woman's reproductive health) and alternatives to the abortion that a reasonable patient would consider material to the decision. . . . " LA. REV. STAT. ANN. 40:1299.35.6(B)(1)(a)(emphasis added). The State contends that the Woman's Right to Know Act focuses on the reasonable patient, while Act 825 imposes a "reasonable doctor" standard of care, thus augmenting, but not contradicting, the earlier statute.
This analysis is without foundation in the language of Act 825, which does not reference any standard of care, either reasonable patient or reasonable doctor. Rather, it specifically states that informed consent will not negate the cause of action, but will only reduce the recovery of damages. LA. REV. STAT. ANN. 9:2800.12(C)(1).
It is far from clear from the language of the Act that an abortion provider can escape liability under the Act by providing the woman with even the most comprehensive information concerning the risks she faces in choosing an abortion. We agree with the district court's finding that it is impossible to tell what conduct will incur liability under the act. We therefore conclude that Act 825 is unconstitutionally vague.
2. Strict liability
Under the heading "strict liability," the district court found that Act 825 "appears" to provide for automatic recovery by a woman on a showing that her unborn child was aborted. See Okpalobi,
A strict liability statute, in the context of criminal law, imposes a sanction for an unlawful act without requiring a showing of criminal intent. See United States v. Garrett,
On appeal, the State argues that the district court's interpretation of this portion of the statute is erroneous. The State asserts that there is no recovery on behalf of the fetus that is born dead or aborted since there is no survival action available to the mother. According to the State's interpretation, "[i]f the mother consents to the abortion, short of malpractice which leads to the wrongful death of the fetus before the abortion is performed, which action survives for one year only, there can be no liability for the death of the fetus." State's brief at 25. The State does not take the position, nor is there any basis for the argument, that Act 825 includes a scienter requirement.
The language of the Act belies the position taken by the State in this appeal that physicians face no liability for the death of an aborted fetus. Damage is defined in the statute to include "all special and general damages which are recoverable in an intentional tort, negligence, survival or wrongful death action for injuries suffered or damages occasioned by the unborn child or mother." LA. REV. STAT. ANN. 9:2800.12(B)(2) (emphasis added). An unborn child is an injured person for purposes of a wrongful death action in Louisiana. See Wartelle v. Women's and Children's Hosp., Inc.,
We conclude that the Act's lack of scienter requirement creates a strict liability statute. Strict liability exacerbates vagueness, making unfathomable to a physician who is attempting to conform his behavior to the dictates of the law while performing legal abortions just what he must do or not do to comply. Further, strict liability chills the inclination of physicians to provide abortions and thus inflicts an undue burden on Louisiana women's right to choose to have an abortion. See Women's Med. Prof. Corp. v. Voinovich,
F. Unborn child
The district court was troubled by the Act's provision allowing damages for "injuries suffered or damages occasioned by the unborn child or mother," LA. REV. STAT. ANN. 9:2800.12(B)(2), because Act 825 defines "unborn child" as "the unborn offspring of human beings from the moment of conception through pregnancy and until termination of pregnancy." LA. REV. STAT. ANN. 9:2800.12(B)(3). The district court held:
The classification of a fetus as an "unborn child" in the statute at issue appears to violate the Supreme Court's holdings in Roe [v. Wade,
Okpalobi,
The State argues on appeal that a post-viability fetus is an unborn child whom the State has a legitimate interest in protecting as long as it does not unduly burden awoman's choice of an abortion. Consequently, the State contends, some circumstances exist under which the statute can be applied without violation of the Constitution, citing United States v. Salerno,
IV. CONCLUSION
Based on the foregoing, we hold that Act 825 is unconstitutional in its entirety and affirm the district court's order permanently enjoining "the operation and effect" of the Act.
AFFIRMED.
Notes:
Notes
Although the record shows that the Attorney General of Louisiana was named as a party and was served with citation, he does not appear as a defendant on the docket sheet of the district court. Further, although he is named as a party in all of defendants' pleadings, in the injunction orders and on the notice of appeal, he does not appear as a party on the docket sheet in this court. He nevertheless has invoked the appellate jurisdiction of this court and is a party to this appeal.
"This section, enacted by Acts 1997, No. 825, 1, as R.S. 9:2800.11, was redesignated as R.S. 9:2800.12, pursuant to the statutory revision authority of the Louisiana State Law Institute." LA. REV. STAT. ANN. 9:2800.12, Historical and Statutory Notes.
On appeal, there is no meaningful distinction between the positions taken by Dr. Okpalobi and intervenors. We therefore refer
to them collectively as "Plaintiffs" or "Appellees."
The record also contains the deposition of a member of the Louisiana House of Representatives, concerning the legislative history of the Act. The deposition was filed on the same day that the district court issued the preliminary injunction. It is not clear whether it was available to the district court in reaching its decision.
The Allied court noted its disagreement with Gras insofar as Gras declined to find Young enforcement power in the Governor's general duty to see to the execution of state laws, but went on to agree with the Gras result. See Allied,
Plaintiffs originally named the Governor and the Treasurer of Louisiana as defendants, but later dismissed all claims against the Treasurer and substituted the State of Louisiana in his stead.
The dissent approaches this difficult question from a third angle, stating in footnote 1 that the "injunction can have no legal effect against women not part of this suit. Furthermore, Louisiana's courts are not bound by our court's determination that a particular Louisiana law is unconstitutional (aside from dealing with the specific parties who were subject to the federal court judgment)." We view the dissent's first statement as a misleading non sequitur and its second statement as erroneous. On the first point, it is immaterial that the subject injunction cannot be enforced against women who are not party to the suit because the injunction is aimed at the State of Louisiana through its responsible officials. The injunction does not prohibit a woman from filing such a suit; it does make her suit frivolous and dismissable ab initio by enjoining the State from enforcing claims based on the unconstitutional statute. As for the binding effect on Louisiana courts, the treatise cited in support of the dissent's footnote, RICHARD H. FALLON, ET AL., HART AND WECHSLER'S THE FEDERAL COURTS AND THE FEDERAL SYSTEM 209 (4th ed. 1996), does not support the dissent's assertion. In discussing a federal court's ruling on overbreadth of a state criminal statute, the treatise merely points out that if a state court later interprets the state statute less broadly than the federal court, it may avoid the problem of overbreadth identified by an earlier federal court decision. Although Louisiana Courts are free to disagree with our interpretation of their statute, neither the treatise cited, nor any other authority of which we are aware, allows state courts to ignore federal court interpretations of the U. S. Constitution, much less to enforce a state statute that has been declared unconstitutional vel non by a federal court.
In addition to constitutional standing requirements, the court has fashioned principles of judicial restraint, which have come to be know as "prudential" considerations. See Harris v. Evans,
We must not, however, conflate third party standing, which allows a plaintiff with an injury in fact to serve as a proponent of another party's constitutional rights, with procedural mechanisms that allow a litigant to actually represent an absent party's interests, which require much tighter identity of interests. See, e.g., Society of Separationists, Inc. v. Herman,
The void-for-vagueness doctrine has been employed most often to strike down laws that impose criminal sanctions. See, e.g., Colautti v. Franklin,
Thomas R. Eller, Informed Consent Civil Actions for Post-Abortion Psychological Trauma, 71 Notre Dame L. Rev. 639 (1996).
E. GRADY JOLLY, Circuit Judge, dissenting:
I respectfully dissent because of the elementary and fundamental errors that the majority has made in its reaction to a statute plainly aimed at making medical practice more difficult for abortion doctors. The statute may well constitute an unfair legislative act, but that legislative unfairness cannot be corrected by an unconstitutional judicial act. In sum, this case presents no case or controversy under Article III of the Constitution and, consequently, we have no constitutional authority to decide its merits.
The majority has affirmed an injunction that apparently enjoins no individual but instead enjoins "the operation and effect of Act 825." A court, however, does not enjoin a statute. A statute itself cannot operate to effect any result; an injunction enjoins defendants who are attempting to enforce or apply the statute.1 Yet, there are indeed named defendants in this case--the State of Louisiana and its governor. Therein lies the problem: the defendants who are sued in this case play absolutely no role in the acts complained of or in "the operation and effect of Act 825." The defendants have never sought to enforce or apply the statute; nor will they ever do so; indeed, they have no authority to do so. An injunction against the defendants is therefore meaningless.
This statute gives women who have suffered injury during an abortion procedure a cause of action against their doctors. Thus, the statute contemplates injured women as plaintiffs, suing abortion doctors as defendants. Yet, there is not a single affected woman involved in this litigation. No doctor has been sued under the statute. Consequently, no court--the only entity with governmental powers under Act 825--has ever applied the statute against any person. Instead, several abortion doctors and clinics have brought this suit2--purporting to represent the interests of women--while the State of Louisiana and its governor have been named as defendants.3 Although suing these defendantsmay present an expedient way to arrange for an opinion on the constitutionality of Act 825, the majority has disregarded the limits of our own power imposed by Article III of the Constitution and the Eleventh Amendment. This error has caused the majority to act beyond its constitutional authority and simply to issue an advisory opinion. I respectfully dissent.
* A
The standing doctrine represents "an essential and unchanging part of the case-or-controversy requirement of Article III." Lujan v. Defenders of Wildlife,
B
It is indisputable that the plaintiffs' claimed injury is not "fairly traceable" to any action of the governor. Not only does the plaintiffs' theory lack a "causal connection between the alleged injury and the conduct complained of," but the plaintiffs have not even suggested that any act of the defendants in this suit has caused, or will cause, an injury to them. The State of Louisiana and its governor have no role in the "enforcement" of the civil tort statute. Like any other tort statute, Act 825 is only triggered by a private party suing another private party. Therefore, the imminent injury complained of would be the result of unknown, injured women bringing tort suits against the plaintiff doctors and clinics. The defendants here play no role in the matter; the governor will never sue the plaintiffs under the statute nor otherwise ever apply or enforce the statute against the plaintiffs. Any injury "results from the independent action of some third party not before the court." Simon,
In response to this point, the majority points to the following provision of Louisiana's Constitution:
The governor shall be the chief executive officer of the state. He shall faithfully support the constitution and laws of the state and of the United States and shall see that the laws are faithfully executed.
La. Const. of 1974, art. IV, 5(A). The majority thus concludes that the plaintiffs' claimed injury results from the actions of the state and its governor because thegovernor is charged with the general duty faithfully to execute Louisiana's laws. Under Act 825, however, neither the governor nor any other state official has any duty to do anything. Nor does the governor have any authority to prevent a private plaintiff from invoking the statute. Consequently, an injunction against the governor (or the state for whom he acts) is utterly meaningless. Indeed, the majority's reasoning in this respect has been rejected by the Supreme Court and every circuit court to address the point.
Long ago, the Supreme Court rejected the majority's reasoning in Muskrat v. United States,
During the early part of this century, Congress sought to de-centralize land ownership within various Native American tribes. Before 1902, several tribes, including the Cherokee Nation, owned the land of their members communally. In 1902, however, Congress passed legislation that converted the ownership of the land from communal ownership to individual ownership. The legislation thus allotted a certain portion of the communally-owned land to each living member of the Cherokee Nation born before September 1, 1902. Sometime thereafter, the tribal council of the Cherokees requested that their children born after September 1, 1902, but before March 4, 1906, also receive scheduled allotments of land. Congress granted this request and passed legislation in 1906 that allowed for this expansion of the class of persons receiving property. This expansion, of course, reduced the share of those members of the class described in the 1902 act. Sensing that this situation might pose constitutional problems, Congress enacted further legislation in 1907 that gave "William Brown and Levi B. Gritts, on their own behalf and on behalf of all other Cherokee citizens" the right to sue the United States "in the court of claims to determine the validity" of the 1902 legislation. Muskrat,
The Supreme Court ordered that the suit be dismissed for lack of jurisdiction for failure to present a "Case" or "Controversy" under Article III. Muskrat,
It is true the United States is made a defendant to this action, but it has no interest adverse to the claimants. The object is not to assert a property right as against the government, or to demand compensation for alleged wrongs because of action upon its part. The whole purpose of the [1907] law is to determine the constitutional validity of this class of legislation [i.e., the 1906 act], in a suit not arising between parties concerning a property right necessarily involved in the decision in question, but in a proceeding against the government in its sovereign capacity, and concerning which the only judgment required is to settle the doubtful character of the legislation in question. Suchjudgment will not conclude private parties, when actual litigation brings to the court the question of the constitutionality of such legislation. In a legal sense the judgment could not be executed, and amounts in fact to no more than an expression of opinion upon the validity of the acts in question. Confining the jurisdiction of this court within the limitations conferred by the Constitution, which the court has hitherto been careful to observe, and whose boundaries it has refused to transcend, we think the Congress, in the act of March 1, 1907, exceeded the limitations of legislative authority, so far as it required of this court action not judicial in its nature within the meaning of the Constitution.
Muskrat,
The principle emanating from Muskrat--that parties lack constitutional standing to sue governmental entities solely to challenge the constitutionality of legislation--does not apply, however, when the plaintiffs sue a governmental official charged with specific duties in the enforcement of the challenged legislation. This point was made clear when, the year after Muskrat, the Supreme Court decided another suit involving the Cherokee Nation land. Levi B. Gritts, one of the named plaintiffs in Muskrat, was the captioned plaintiff in Gritts v. Fisher,
The lesson of Muskrat and Gritts is that Article III does not permit federal courts to entertain suits against sovereign governments for the simple purpose of challenging the constitutionality of legislation of that sovereign.6 Instead, if a party seeks to enjoin enforcement of particular legislation, he must sue a government official charged with specific duties of enforcement relating to the legislation, that is to say, the official with whom a controversy has been or will be created. In any different situation, the federal courts would decide the constitutionality of legislative acts without the benefit of a defense from an interested party.7
This precedent, which so clearly rejects the majority's reasoning, has never been questioned by the Supreme Court in its opinions since Muskrat and Gritts. Neither has any federal appellate court questioned it. In fact, each of the several circuit courts that has addressed the issue has specifically concluded that plaintiffs cannot sue state officials in an attempt to test the constitutionality of state statutes when those state officials play no role in enforcement of the relevant statutes. See 1st Westco Corp. v. School Dist. of Philadelphia,
II
Article III's standing requirement is not the only constitutional bar to this case against Louisiana and its governor. Over one hundred years ago, the Supreme Court ruled that the Eleventh Amendment prohibits federal court jurisdiction when citizens challenge the constitutionality of a civil statute by suing state officials whose only duty to enforce the statute in question is their generic duty to enforce the laws of the state:
There is a wide difference between a suit against individuals, holding official positions under a state, to prevent them, under the sanction of an unconstitutional statute, from committing by some positive act a wrong or trespass, and a suit against officers of a state merely to test the constitutionality of a state statute, in the enforcement of which those officers will act only by formal judicial proceedings in the courts of the state. In the present case, as we have said, neither of the state officers named held any special relation to the particular statute allegedto be unconstitutional. They were not expressly directed to see to its enforcement. If, because they were law officers of the state, a case could be made for the purpose of testing the constitutionality of the statute, by an injunction suit brought against them, then the constitutionality of every act passed by the legislature could be tested by a suit against the governor and the attorney general, based upon the theory that the former, as the executive of the state, was, in a general sense, charged with the execution of all its laws, and the latter, as attorney general, might represent the state in litigation involving the enforcement of its statutes. That would be a very convenient way for obtaining a speedy judicial determination of questions of constitutional law which may be raised by individuals, but it is a mode which cannot be applied to the states of the Union consistently with the fundamental principle that they cannot, without their assent, be brought into any court at the suit of private persons.
Fitts v. McGhee,
V
With all due respect, it seems indisputable to me that the majority has disregarded the clear restrictions upon our judicial power under Article III and the Eleventh Amendment. The majority's view on our authority to decide the merits of this case is not supported by either Supreme Court precedent or our own precedent.
I therefore respectfully dissent.
Notes:
Although the district court opinion suggests that the judgment operates universally against all who would claim its benefits, an injunction operates only to enjoin those persons involved in the lawsuit. See Fed. R. Civ. P. 65(d). The injunction can have no legal effect against women not part of this suit. Furthermore, Louisiana's courts are not bound by our court's determination that a particular Louisiana law is unconstitutional (aside from dealing with the specific parties who were subject to the federal court judgment). Because "state courts and lower federal courts stand in a coordinate rather than a hierarchical relationship," Louisiana courts may choose to view the majority's opinion as persuasive precedent, or they may not. See generally, RICHARD H. FALLON, ET AL., HART AND WECHSLER'S THE FEDERAL COURTS AND THE FEDERAL SYSTEM 209 (4th ed. 1996).
The abortion clinics and Dr. Whitmore are intervenors, but for simplicity I refer to them, along with Dr. Okpalobi (the initial plaintiff), collectively as the "plaintiffs" throughout this dissent.
Although both the State of Louisiana and Governor Foster (in his official capacity) have been named as defendants, there is in effect only one defendant in this case. The state acts only through its officials, and the only official named was the governor. Thus, when I only refer to the defendant governor, that reference includes the State of Louisiana.
At the beginning of this lawsuit, both Governor Foster and Treasurer Duncan were named, in their official capacities, as defendants. Dr. Okpalobi, the original plaintiff, named the treasurer as a defendant because Dr. Okpalobi pressed a Takings Clause claim. The treasurer was, apparently, named as a defendant in an attempt to secure an injunction ordering the treasurer to pay money out of the state treasury. Dr. Okpalobi later amended his complaint to substitute the State of Louisiana for Treasurer Duncan. The plaintiffs have never explained any threatened, or even conceivable, action that either the governor or the state itself might take to "enforce" Act 825.
The legislation is described in Muskrat,
Specifically, the plaintiffs argued that the 1906 Act "arbitrarily takes from the [plaintiffs] and others similarly situated property which is theirs and gives it to others, and therefore is violative of due process of law." Gritts,
No sovereign immunity issue existed in Muskrat and Gritts because Congress had waived the United States' sovereign immunity by passing the l907 Act that specified the United States as a defendant in suits challenging the legislation. See Muskrat,
As the majority notes, the defendants in this case waived their right to a trial on the merits. This should be a clue that the named defendants are not the proper parties for a challenge to Act 825. It is rare indeed that a party, who continues to contest the merits of the case, will agree to waive the right to a trial. Surely a party who has a genuine stake in the availability of a cause of action under Act 825--that is, a woman injured during an abortion procedure--would have taken on a more spirited defense of Act 825 and demanded that the plaintiffs prove their factual allegations at trial. It is also worth noting that the defendants also attempted to waive oral argument before our court. These repeated waivers of rights by the defendants should raise some suspicion that there may not be an Article III case or controversy presented in this case.
