## Facts

- Melissa Anspach, an unemancipated 16-year-old, went to a city-operated health center after recent sexual intercourse, initially seeking a pregnancy test.
- After being told pregnancy tests were not available that day, she returned to request “the morning after pill.”
- By providing her date of birth, Melissa disclosed she was 16 and met with a social worker who told her the center could provide emergency contraception (EC) and asked if she wanted it; Melissa said yes.
- A nurse provided a two-dose EC regimen, explained how to take it and warned of possible side effects; Melissa took the first dose at the center and the second at home.
- After the second dose, Melissa experienced severe abdominal pain and vomiting and was treated at a hospital; her parents then learned she had received EC.
- Melissa and her parents alleged the center did not ask about parental knowledge, encourage parental involvement, or notify the parents before providing EC.
- The family alleged EC conflicted with their religious beliefs and interfered with the parents’ authority over their child’s medical decisions.

## Issues

1. Whether providing EC to a minor without parental notification or encouragement of parental consultation violated the parents’ Fourteenth Amendment liberty interest in directing the upbringing and care of their child.
2. Whether the clinic’s counseling and provision of EC violated the minor’s substantive due process right to bodily integrity by coercion, compulsion, deliberate indifference, or conscience-shocking conduct.
3. Whether providing EC contrary to the family’s religious beliefs imposed a substantial burden on their First Amendment free exercise rights.

## Decision

- The Third Circuit affirmed dismissal under Rule 12(b)(6) of all federal § 1983 constitutional claims.
- The court held the parents’ substantive due process claim failed because the clinic did not coerce the minor, displace parental decision-making by compulsion, or constitutionally have to notify or involve parents.
- The court held the minor’s bodily-integrity claim failed because the pleadings alleged voluntary acceptance of EC and did not allege coercion, deception about the medication’s nature, or conduct that shocks the conscience.
- The court held the free exercise claims failed because the clinic’s conduct was neutral and generally applicable and did not compel the family to violate religious beliefs; any burden was incidental.
- After dismissing the federal claims, the district court properly remanded remaining state-law claims to state court.

## Legal Principles

- Parental liberty interests, while fundamental in some contexts, do not create a general federal constitutional right to be notified of or to veto a minor’s voluntary access to contraceptive services from a public provider absent coercive state interference.
- Substantive due process bodily-integrity claims generally require coercion/compulsion or conduct so egregious that it “shocks the conscience”; negligence (even serious) is not enough.
- Government action that is neutral and generally applicable and that does not compel religiously prohibited conduct does not violate the Free Exercise Clause merely because it incidentally conflicts with religiously motivated parental preferences.
- Section 1983 does not constitutionalize ordinary disputes over medical counseling or alleged failures to provide additional information or to encourage parental consultation.

## Conclusion

The Third Circuit held that a municipal health center’s provision of emergency contraception to a 16-year-old who sought it voluntarily, without parental notice or required parental consultation, did not state federal constitutional claims for deprivation of parental rights, bodily integrity, or free exercise, and affirmed dismissal of the § 1983 claims.


Anspach ex rel. Anspach v. City of Phila., Dep’t of Pub. Health, 503 F.3d 256 (3d Cir. 2007)