Will there be a constitutional right to abortion after the reconsideration of Roe v. Wade?
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The plaintiffs were family planning (FP) services and physicians who sought a preliminary injunction against enforcement of regulations promulgated by the Secretary of Health and Human Services of the US. The regulations prohibited counseling and referral for abortion services by FP services that receive funds under Title X of the Public Health Services Act. The Court held that the regulations exceeded the Secretary's authority, since nothing in Title X or legislative history relating to its enactment indicated that Congress intended to prohibit FP services from offering information with respect to abortions. The Court also ruled that the regulations violated a woman's Fifth Amendment liberty interest in choosing to have an abortion, her First Amendment right to receive necessary information to exercise her liberty interest, and a physician's First Amendment right to disseminate necessary information to patients. The Court granted the request for a preliminary injunction. On 15 June 1988, the same court granted the plaintiffs' request for a permanent injunction against enforcement of the regulations. On 3 March 1988, the US District Court, D. Massachusetts, also enjoined enforcement of the regulations (Commonwealth of Massachusetts vs. Bowen [679 F.Supp. 137]). On 30 June 1988, however, the US District Court, S.D. New York, rejected a challenge to the regulations, ruling that the Secretary did not exceed his authority and that the regulations were not unconstitutional (State of New York vs. Bowen [690 F.Supp. 1261]).
The Supreme Administrative Court upheld the decision of a lower court that the refusal of the state of Baden-Wurttemberg to allow physicians to perform abortions in private clinics was lawful. It ruled that the state was not required to recognize a private clinic as an "institution" for the performance of abortions under Article 3, Paragraph 1, of the Fifth Amendment of the Criminal Code (provisions on abortion). It also concluded that such a refusal did not violate the right to exercise one's profession contained in the Constitution.
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On May 23, 1991, the US Supreme Court upheld federal regulations that prohibit federally funded family planning programs from counseling about or referring for abortion. As a result, government benefits may now entail substantial costs. The regulations changed the nature of government-assisted family planning from comprehensive care and counseling to limited services and government-prescribed information. The reasoning in Rust v Sullivan allows government to limit freedom of speech in federally funded programs. The decision may have been influenced by antiabortion sentiment, but it does not affect the legality of abortion. Instead, it sets a precedent for government control of whether and how health care can be discussed wherever government pays some of the bills.
Because child endangerment laws and their judicial interpretation are different in each state, healthcare providers should familiarize themselves with the law in their particular jurisdiction. In situations in which parents refuse on religious grounds to consent to medical treatment for their children, health care providers should consult local counsel as to the legal options available.
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