The only question before us on this appeal is the constitutionality of G.S. 35-36 through G.S. 35-50, inclusive.
The respondent attacks these statutes on the grounds that they are violative of the Due Process Clause of the Fourteenth Amendment to the United States Constitution and the Law of the Land Clause of Article I, Section 19, of the Nprth Carolina Constitution, both from procedural and substantive standpoints,
*98
that they deny the respondent equal protection of the law, are unconstitutionally vague and arbitrary, and provide for cruel and unusual punishment. The term “law of the land” as used in Article I, Section 19, of the Constitution of North Carolina, is synonymous with “due process of law” as used in the Fourteenth Amendment to the Federal Constitution.
Surplus Store, Inc. v. Hunter,
The right of a state to sterilize retarded or insane persons was first upheld by the United States Supreme Court in
Buck v. Bell,
Most of these statutes have been declared constitutional. The grounds for declaring some of the statutes unconstitutional were 'ack of notice and a hearing,
In re Hendrickson,
Our research does not disclose any case which holds that a state does not have the right to sterilize an insane or a retarded person if notice and hearing are provided, if it is applied equally to all persons, and if it is not prescribed as a punishment for a crime.
Respondent contends, however, that not all the requirements of procedural due process have been met in this case. A
*99
former sterilization statute was held unconstitutional by this Court on procedural grounds, specifically that notice and a hearing were not provided.
See Brewer v. Valk,
G.S. 35-45 provides:
“The person alleged to be subject to the provisions of this séction shall have the right to counsel at all stages of the proceedings provided for herein. This person and all others served with the notification provided for in G.S. 35-41 shall be fully informed of .the person’s entitlement to counsel at the time of this service of notice. This information shall be given in language and in a manner calculated to insure, insofar as such is possible in view of the individual’s capability to comprehend it, that the recipient understands the entitlement. Every person subject to be sterilized under this Article after the filing of the petition shall have counsel at every stage of the proceedings. If there is a conflict between the election of the person concerned and that of the other persons being served with notice, determination of the question of representation by counsel shall be made by the court having jurisdiction of the case. The person concerned may, in any instance, be represented by counsel retained by him. In cases of claimed indigency, a request for counsel shall be processed in the manner provided for in Subchapter IX, Chapter 7A, General Statutes of North Carolina.”
*100
Despite the above specified safeguards, respondent still asserts that two important procedural rights have been omitted : (1) a provision that the State will provide the funds, necessary to obtain a medical expert on behalf of the respondent and (2) the right of cross-examination. It is true that this statute does not require the State to pay a medical expert on behalf of the respondent. However, G.S. 7A-454 allows the court in its discretion to approve a fee for the services of an expert witness who testifies for an indigent person. We know of no constitutional mandate that requires more.
See generally
“Right of Indigent Defendant in Criminal Case to Aid of State by Appointment of Investigator or Expert,” Annot.,
“ . . . [D]efendant contends that the right to have medical experts appointed by the court, at the state’s expense, to examine him and assist his defense, is an integral and essential part of his constitutionally-guaranteed right to counsel. He has cited us no authority to support that position, and our own independent investigation has disclosed none. That he has the right to counsel . . . is not in doubt. . . . We know of nothing, however, either by constitution or by statute, requiring the state at its own expense to make available to the defendant, in addition to counsel, the full paraphernalia of defense. . . . We have no doubt that those who make the law could appropriately provide impecunious defendants with such assistance as was sought here, were it deemed practicable and in the public interest to do so. They have not done so. They were under no constitutional compulsion to do so. . . . ”
*101 The right of cross-examination is specifically provided by G.S. 35r43: “In the event a hearing is requested, the district attorney . . . shall present the evidence for the petitioner. The respondent shall be entitled to examine the petitioner’s witnesses and shall be entitled to present evidence in his own behalf.” (Emphasis added.) In order to assure this right, the only requirement- is that the respondent, his guardian, attorney or other interested party object in writing to the sterilization. Since respondent'^s represented at every stage of the proceeding, we do not think this requirement is unduly burdensome.
We h'old that the provisions of this statute far exceed the minimum requirements of procedural due process.
Buck v. Bell, supra; Hagins v. Redevelopment Comm.,
Respondent further contends that the statutes in question Í deny him substantive due process. “Due process” has a dual significance, as it pertains to procedure and substantive lawr As to procedure, it means notice and an opportunity to be heard and to defend in- an orderly proceeding adapted to the nature of the case before a competent and impartial tribunal having jurisdiction of the cause.
State v. Smith,
The traditional substantive due process test has been that a statute must have a rational relation to a valid state objective. In a growing series of decisions, the United States Supreme
*102
Court has recognized a right of privacy emanating from the Fourteenth Amendment’s concept of personal liberty or encompassed within the penumbra of the Bill of Rights that includes the abortion decision,
Roe v. Wade,
“ . . . The Court’s decisions recognizing a right of privacy also acknowledge that some state regulation in areas protected by that right is appropriate. As noted above, a State may properly assert important interests in safeguarding health, in maintaining medical standards, and in protecting potential life. ...
“We, therefore, conclude that the right of personal privacy ... is not unqualified and must be considered against important state interests in regulation.
N: * *
“Where certain ‘fundamental rights’ are involved, the Court has held that regulation limiting these rights may be justified only by a ‘compelling state interest,’ [citations omitted], and that legislative enactments must-* be narrowly drawn to express only the legitimate state interests at stake. [Citations omitted.]”
The right to procreate is not absolute but is vulnerable to a certain degree of state regulation. Roe v. Wade, supra; Buck v. Bell, supra. The two state interests recognized as paramount to the individual’s freedom of choice in Roe v. Wade, supra, at least after the first trimester of pregnancy, were the state’s concern with the health of the mother and the potential life of the child. The welfare of the parent and the future life and health of the unborn child are also the chief concerns of the *103 State of North Carolina in authorizing sterilizaiton of individuals under certain circumstances.
The interest of the unborn child is sufficient to warrant sterilization of a retarded individual. “The state’s concern for the welfare of its citizenry extends to future generations and when there is overwhelming' evidence . . . that a potential parent will be unable to provide a proper environment for a child because of his own mental illness or mental retardation, the state has sufficient interest to order sterilization.”
Cook v. State,
“It can hardly be disputed-that the right of a woman to bear and the right of a man to beget children is a natural and constitutional right, nor can it be successfully disputed that no citizen has any rights that are superior to the common welfare. Acting for the public good, the state, in the exercise of its police power, may impose reasonable restrictions upon the natural and constitutional rights of its citizens. Measured by its injurious effect upon society, the state may limit a class of citizens in its right to bear or beget children with an inherited tendency to mental deficiency, including feeblemindedness, idiocy, or imbecility. It is the function of the Legislature, and its duty as well, to enact appropriate legislation to protect the public and preserve the race from the known effects of the procreation of mentally deficient children by the mentally deficient. ...” In re Cavitt,182 Neb. 712 ,157 N.W. 2d 171 (1968).
The United States Supreme Court has also held that the welfare of all citizens should take precedence over the rights of individuals to procreate. In
Buck v. Bell, supra,
the Court said: “ ... It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes.
Jacobson v. Massachusetts,
Furthermore, the sterilization of a mentally ill or retarded individual at certain times may be in the best interest of that *104 individual. The mentally ill or retarded individual may not be capable of determining- his inability to cope with children. In addition, he may be capable of functioning in society and caring for his own needs but may be unable to handle the additional responsibility of children. This individual also may not be able to practice other forms of birth control and therefore sterilization is the only available remedy. Sterilization itself does not prevent the normal sex drive of the person, it only prevents procreation. Therefore, the State may only be providing for the welfare of the individual when this individual is unable to do so for himself.
We hold that the sterilization of mentally ill or retarded persons under the safeguards as set out in G.S. 35-36 through G.S. 35-50, inclusive, is a valid and reasonable exercise of the police power,
see Buck v. Bell, supra; Brewer v. Valk, supra,
and that these state interests rise to the level of a compelling state interest.
See Village of Belle Terre v. Boraas,
The equal protection clauses of the United States and North Carolina Constitutions impose upon lawmaking bodies the requirement that any legislative classification “be based on differences that are reasonably related to the purposes of the Act in which it is found.”
Morey v. Doud,
The object of G.S. 35-36 through G.S. 35-50, inclusive, is to prevent the procreation of children by a mentally ill or retarded individual who because of physical, mental or nervous disease *105 or deficiency which is not likely to materially improve, would probably be unable to care for a child or children or who would likely, unless sterilized, procreate a child or children who probably would have serious physical, mental or nervous diseases or deficiencies. Considering this object, the classification under these statutes is reasonable.
Sterilization laws in several states have been declared unconstitutional because they affect only a certain class of mentally ill or retarded persons.
Skinner v. Oklahoma, supra; Haynes v. Lapeer, Circuit Judge, supra; In re Thompson, supra; Smith v. Board of Examiners of Feebleminded, supra.
These cases declared laws unconstitutional when the law provided for a group of the feebleminded to be sterilized, such as those institutionalized, and for another group of feebleminded, such as those not institutionalized, not to be sterilized. G.S. 35-36 and G.S. 35-37 provide for the sterilization of all mentally ill or retarded persons inside or outside an institution who meet the requirements of these statutes. We have found no case that holds that sterilization of all mentally ill or retarded persons denies equal protection. Many cases have held otherwise.
Buck v. Bell, supra; Smith v. Command,
“But, it is said, however it might be if this reasoning were applied generally, it fails when it is confined to the small number who are in the institutions named and is not applied to the multitudes outside. It is the usual last resort of constitutional arguments to point out shortcomings of this sort. But the answer is that the law does all that is needed when it does all that it can, indicates a policy, applies it to all within the lines, and seeks to bring within the lines all similarly situated so far and so fast as its means allow. Of course so far as the operations enable those who otherwise must be kept confined to be returned to the world, and thus open the asylum to others, the equality aimed at will be more nearly reached.”
Since the North Carolina law applies to all those named in the statute (G.S. 35-43), these statutes, G.S. 35-36 through G.S. 35-50, inclusive, do not violate the equal protection clauses of the United States Constitution or the Constitution of North Carolina.
Respondent next asserts that this legislation provides no adequate judicial standard to guide the court in reaching a *106 decision whether to authorize the sterilization of an individual. Respondent points to the indefiniteness of the terms found in G.S. 35-43:
"... If the judge of the district court, shall find from the evidence that the person alleged to be subject to this section is subject to it and that because of a physical, mental, or nervous disease or deficiency which is not likely to materially improve, the person would probably be unable to care for a child or children; or, because the person would be likely, unless sterilized, to procreate a child or children which probably would have serious physical, mental, or nervous diseases or deficiencies, he shall enter an order and judgment authorizing the physician or surgeon named in the petition to perform the operation.” (Emphasis added.)
Defendant contends that these indefinite terms render the statute unconstitutionally vague and arbitrary; that there exists no standard at all, except the subjective determination of an individual judge.
It is true that a statute must be held void if it is so loosely and obscurely drawn as to be incapable of enforcement.
State v. Morrison,
“However, as was said in State v. Partlow, supra [91 N.C. 550 ,49 A.R. 652 (1884)]. ‘It is plainly the duty of the court to so construe a statute, ambiguous in its meaning, as to give effect to the legislative intent, if this be practicable.’ It is also well established that this Court will not adjudge an act of the General Assembly unconstitutional unless it is clearly so. Kornegay v. Goldsboro,180 N.C. 441 ,105 S.E. 187 . Where a statute is susceptible of two interpretations, one of which will render it constitutional and the other will render it unconstitutional, the former will be adopted. City of Randleman v. Hinshaw,267 N.C. 136 ,147 S.E. 2d 902 ; Finance Co. v. Leonard,263 N.C. 167 ,139 S.E. 2d 356 ; Nesbitt v. Gill,227 N.C. 174 ,41 S.E. 2d 646 . If possible, the language of a statute will be interpreted so as to avoid an absurd consequence. Young v. Whitehall Co.,229 N.C. 360 ,49 S.E. 2d 797 ; State v. Scales,172 N.C. 915 ,90 S.E. 439 . A statute is never to be construed so as to require an impossibility if that result *107 can be avoided by another fair and reasonable construction of its terms. Comrs. v. Prudden,180 N.C. 496 ,105 S.E. 7 . ‘A statute or amendment formally passed is presumed and if permissible should be construed so as to have some meaning.’ Mitchell v. R. R.,183 N.C. 162 ,110 S.E. 859 . See also State v. Humphries,210 N.C. 406 ,186 S.E. 473 . ...”
See also State v. Miller,
“ . . . [I]mpossible standards of statutory clarity are not required by the constitution. When the language of a statute . . . prescribes boundaries sufficiently distinct for judges and juries to interpret and administer it uniformly, constitutional requirements are fully met. United States v. Petrillo,332 U.S. 1 , 91 L.ed. 1877,67 S.Ct. 1538 .” In re Burns,275 N.C. 517 , 531,169 S.E. 2d 879 , 888 (1969).
Several recent United States Supreme Court opinions have spoken to this issue of unconstitutional vagueness or lack of any judicial standard. In
Parker v. Levy,
In the light of the foregoing principles, we believe that G.S. 35-36 through G.S. 35-50 meet this constitutional standard. The definitions of “mental disease,” “mental illness” and “mental defective” are found in G.S. 35-1.1, the same chapter as the sterilization procedure, and are capable of being understood and complied with by the triers of fact with the help of experts in the field. It is conceded that the words “likely” and “probably” necessarily contain germs of uncertainty. However, it is the duty of the court to construe a statute, ambiguous in its meaning, so as to give effect to the legislative intent.
Hobbs v. Moore County, supra.
Here, it is clear that the General Assembly intended to provide the mentally ill and defective with sufficient safeguards to prevent misuse of this potentially dangerous procedure. The statute does not specify the burden of proof that the petitioner must meet before the order authorizing the sterilization can be entered. In keeping with the intent of the General Assembly, clearly expressed throughout the article, that the rights of the individual must be fully protected, we hold that the evidence must be clear, strong and convincing before such an order may be entered.
See McCorkle v. Beatty,
The respondent’s next contention that sterilization amounts to cruel and unusual punishment is without basis in law in this case. The cruel and unusual punishment clause of the Constitution refers to those persons convicted of a crime. Since this is r.not a criminal proceeding, there is no basis for the cruel and unusual argument. The two cases cited in the
amicus curiae
brief,
Davis v. Berry, supra,
and
Mickle v. Henrichs,
This unfortunate respondent and his mother both consented to the performance of a vasectomy. While we do not attach much importance to the respondent’s consent due to his mental condition, his mother unquestionably is in a position to know what is best for the future of her child. Under the provisions of G.S. 35-36 through G.S. 35-50, inclusive, the rights of respondent and the State will be fully protected at hearing.
We hold, therefore, that the trial court erred in declaring these statutes unconstitutional. The judgment so entered is reversed.
Reversed.
