Facts
- A pregnant Georgia woman using the pseudonym “Mary Doe” sought an abortion but was denied because she did not satisfy Georgia’s statutory grounds.
- Georgia law allowed abortion only if a physician, in “best clinical judgment,” found one of three conditions: threat to the woman’s life or health, likely serious fetal defect, or pregnancy from rape.
- The law also imposed procedural conditions: performance only in a hospital accredited by a specified hospital accreditor, approval by a hospital abortion committee, and written concurrence by two additional licensed physicians.
- The law restricted lawful abortions to Georgia residents.
- Plaintiffs included Doe, Georgia-licensed physicians, and other health and religious professionals; defendants included the Georgia Attorney General and other state officials.
- A three-judge federal district court invalidated the statute’s substantive limitation to the three grounds but upheld the procedural conditions; plaintiffs appealed directly to the Supreme Court.
Issues
- Whether the case was justiciable and whether Doe and physician plaintiffs had standing despite the time-limited nature of pregnancy.
- Whether the “best clinical judgment” standard was unconstitutionally vague.
- Whether the law’s procedural requirements (accredited-hospital requirement, committee approval, and two-physician concurrence) violated the Fourteenth Amendment.
- Whether the residency restriction violated the Privileges and Immunities Clause.
Decision
- The Supreme Court held Doe’s claim was not moot and that Doe had standing because pregnancy is capable of repetition yet evading review.
- The Court held physician plaintiffs had standing due to threatened criminal sanctions and interference with medical practice.
- The Court upheld the “best clinical judgment” language against a vagueness challenge.
- The Court invalidated the accredited-hospital requirement, hospital committee approval requirement, and two-physician concurrence requirement as unconstitutional under the Fourteenth Amendment.
- The Court invalidated the residency requirement under the Privileges and Immunities Clause.
- The judgment was affirmed in part and reversed in part.
Legal Principles
- Pregnancy-related challenges may remain justiciable under the “capable of repetition, yet evading review” exception to mootness.
- Physicians may have standing to challenge abortion regulations that threaten prosecution and chill medical judgment.
- A statutory standard tied to a physician’s “best clinical judgment” may be sufficiently definite to satisfy due process vagueness limits.
- States may not impose abortion-specific procedural hurdles—such as mandatory accredited-hospital performance, special committee permission, or multiple-physician concurrence—when they unduly burden the abortion decision and intrude on the physician–patient relationship without adequate justification.
- A state may not restrict access to lawful abortion services to its own residents; such discrimination against nonresidents violates the Privileges and Immunities Clause.
Conclusion
The Court substantially struck down Georgia’s abortion statute by invalidating its hospital accreditation, committee-approval, multi-physician concurrence, and residency requirements, while sustaining the statute’s “best clinical judgment” standard and confirming standing for the pregnant plaintiff and physicians to challenge the law.