2. Chapter 17
Procreation And
Ethical Dilemmas
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3. Abortion
Premature termination of pregnancy. It can be
classified as spontaneous or induced. It may
occur as an incidental result of a medical
procedure or it may be an elective decision on
the part of the patient.
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4. U.S. Supreme Court Decisions
Right to Abortion
• 1973: Roe v. Wade
– First Trimester
–abortion decision between woman & physician.
– Second Trimester
–state may reasonably regulate abortion
procedure.
– Third Trimester
–state may prohibit all abortions except those
deemed necessary to protect maternal life or
health.
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5. Abortion Review:
Committee to Restrictive
• 1973: Doe v. Bolton
• Requirements struck down
– residency
– performance of abortion by Joint Commission
approved hospital
– approval of abortion by a medical staff committee
– consultations
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6. Funding - I
• Not Required for Elective Abortions
– 1977: In Beal v. Doe
– The Court ruled that it is not inconsistent with the
Medicaid portion of the Social Security Act to
refuse to fund unnecessary (although perhaps
desirable) medical services.
– Maher v. Roe
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7. Funding - II
• Not Required for Therapeutic Abortions
– 1980: Harris v. McRae
– Different states not compelled to fund
Medicaid recipients' medically necessary
abortions for which federal reimbursement
is unavailable, but may choose to do so.
– Supreme Court voted 6 to 3 states may
refuse to spend public funds to provide non-
therapeutic abortions for women.

8. Funding Bans:
Unconstitutional in California
1981: Committee to Defend Reproductive Rights v.
Meyers
• If the state cannot directly prohibit a woman's right to
obtain an abortion, may the state by discriminatory
financing indirectly nullify that constitutional right?
Can the state tell an indigent person that the state will
provide him with welfare benefits only upon the
condition that he join a designated political party or
subscribe to a particular newspaper that is favored by
the government? Can the state tell a poor woman that
it will pay for her needed medical care b but only if
she gives up her constitutional right to choose
whether or not to have a child? 8

9. Funding Discrimination: Prohibited
in Arizona
The Arizona Supreme Court in Simat Corp. v. Arizona
Health Care Cost Containment Sys., found that the
state's constitution does not permit the state & the
Arizona HealthCare Cost Containment System to
refuse to fund medically necessary abortion
procedures for pregnant women suffering from
serious illness while, at the same time, funding such
procedures for victims of rape or incest or when the
abortion was necessary to save the woman's life.
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10. States May Protect Viable Fetus
• 1979: Colauti v. Franklin
• The Supreme Court in Colautti v. Franklin
voted 6 to 3 that states may seek to protect a
fetus that a physician has determined could
survive outside the womb. Determination of
whether a particular fetus is viable & must
be, a matter for judgment of the physician.
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11. Parental Consent
Statute Unconstitutional: Missouri
• 1976: Danford v. Planned Parenthood
• Unconstitutional to require parental consent
under age 18
• Statute failed to provide any definitive
guidelines
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12. Parental Consent Statute Ruled
Unconstitutional: Massachusetts
• 1979: Bellotti v. Baird
• Parental consent requirement struck down.
• MA statute too restrictive.
– statute as written & construed, no minor, no matter
how mature & capable of informed decision
making, could receive an abortion without the
consent of either both parents or a superior court
judge.
– making minor's abortion subject in every instance
to an absolute third-party veto.
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13. Notifying Parent for Immature Minor
Constitutional: Utah
• 1981: H.L. Matheson
• Statute requiring physician to notify parents of
minor, when possible, upheld.
• Parental notice does not violate constitutional
rights of immature, dependent minor.
• State may not, however, legislate a blanket un-
reviewable power of parents to veto their
daughter’s abortion.
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14. Consent Not Required for Emancipated
Minors
• 1987: In re Anonymous
• Consent Not Required for Emancipated Minor.
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15. Parental Notification Not Required
• 2000: Planned Parenthood v. Owen
• Colorado Parental Notification Act, Colo. Rev. Stat. §
§ 12-37.5-101, et seq. (1998), which required
physician to notify parents of a minor prior to
performing an abortion upon her, violates minor's
rights protected by the U.S. Constitution.
• The act generally prohibited physicians from
performing abortions on an unemancipated minor
until at least 48 hours after written notice has been
delivered to minor's parent, guardian, or foster parent.
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16. Minor’s Decision to
Abort Found Sufficient
• 2006: In re Doe
• Minor sufficiently mature
– Precluded notification of parents
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17. Justices Send Abortion Case Back to
Lower Court
• 2006: Ayotte v. Planned Parenthood of New England
• the Supreme Court referred this case back to the
appeals court
– court was requested to find a way to include an
exception to the law for a medical emergency
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18. Minor’s Decision to Abort
Not Sufficient
• 2008: In re petition of Doe
• Juvenile sought judicial waiver of statutory
requirement that physician notify her parents
or guardian prior to terminating her pregnancy
• Juvenile failed to prove evidence of sufficient
majority
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19. State Interest Not Compelling
• 1975: Poe v. Gerstein
• Husbands interest in the baby was held to be
insufficient to force his wife to face the mental
and physical risk of pregnancy and childbirth.
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20. Spousal Consent Unconstitutional
• 1975: Doe v. Zimmerman
• Pennsylvania Abortion Control Act requiring written
consent of the husband unconstitutional.
• Provisions impermissibly permitted husband to
withhold his consent either because of his interest in
potential life of the fetus or for capricious reasons.
• Although father's interest in the fetus was
legitimate, it did not outweigh the mother's
constitutionally protected right to an abortion.
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21. Father of Unborn Fetus
Could Not Stop Abortion
• 1988: Doe v. Smith
• Natural father not entitled to prevent abortion
• Father demonstrated substantial instability
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22. Spousal Consent Undue Burden
• 1992: Planned Parenthood v. Casey
• Spousal consent undo burden on the woman
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23. Restricting Right to
Abortion Affirmed
• 1992: Planned Parenthood v. Casey
• Court reaffirmed
– right of women to have an abortion.
– state’s power to restrict abortions after fetal
viability.
– principle that state has legitimate interests in
protecting woman & life of fetus.
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24. Restricting Right to
Abortion Affirmed
Undue burden to require spousal notification
Not undue burden to require:
– a woman be informed of nature of abortion procedure
& risks involved.
–a woman be offered information on the fetus & on
alternatives to abortion.
–a woman to give her informed consent before abortion
procedure
–parental consent be given for a minor seeking an
abortion, providing for a judicial bypass option if the
minor does not wish or cannot obtain parental consent.
–there be a 24-hour waiting period before any abortion
can be performed.
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25. Abortion Counseling - I
• Physician Counseling of Patient Upheld
– 1983: City of Akron v. Akron Center
– States cannot mandate what information
physicians provide abortion patients
– states cannot require abortions for women more
than three months pregnant be performed in a
hospital
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26. Abortion Counseling - II
• Prohibition of Abortion Counseling Not
unconstitutional
– 1991: Rust Sullivan
• Federal regulations that prohibit abortion
counseling & referral by family planning
clinics that receive funds under Title X held
constitutional.
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27. 24-Hour Waiting Period Not
Burdensome
• 1992: Planned Parenthood of Southwestern
Pennsylvania v. Casey
– Law allows for exceptions to this requirement in
the event of a medical emergency.
• 1993: Utah’s Women’s Clinic, Inc. v. Leavitt
– law allows an exception for a medical emergency
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28. Incompetent Persons
• 1987: In re Doe
• Profoundly retarded woman became pregnant during
her residence in a group home as a result of a sexual
attack by an unknown person. The record supported a
finding that if the woman had been able to do so, she
would have requested the abortion. The court
properly chose welfare agencies & the woman's
guardian ad litem as the surrogate decision
makers, rather than the woman's mother.
• The mother apparently had little contact with her
daughter over the years.
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29. Viability Test Required
• 1989: Webster v. Reproductive
• Statute upheld providing that no public
facilities or employees should be used to
perform abortions.
• Physicians should conduct viability tests
before performing abortion.
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30. Partial-Birth Abortion - I
• Plan Constitutionally Vague
• 1998: Women's Medical Professional Corp. v.
Voinovich
• Statute banning any use of the D&X procedure was
unconstitutionally vague.
• Likely a properly drafted statute will eventually be
judged constitutionally sound.
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31. Partial-Birth Abortion - II
• Partial-Birth Abortion:
Ban Act Unconstitutional
• Little Rock Family Planning Services v.
Jegley, 1999
• Arkansas act unconstitutional because it was
unconstitutionally vague, imposed an undue burden
on women seeking abortions, and it did not
adequately protect the health and lives of pregnant
women.
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32. Partial Birth Abortion - III
• Partial-Birth Abortion Statute Vague
– 2000: Planned Parenthood of Cent. N.J. v. Farmer
• partial-birth abortion statute was void for
vagueness.
• created undue burden on woman's right to
abortion.
• Partial-Birth Abortion: Ban Unconstitutional
– Stenberg v. Carhart
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33. Partial Birth Abortion - IV
• 2003: Partial Birth Abortion Act: 1st federal
restrictions
– President Bush signs federal restrictions banning
late term abortions.
• 2005: Bush administration asked the Supreme Court
– to review an appellate court's decision holding the
Partial Birth Abortion Act of 2003
unconstitutional.
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34. Partial Birth Abortion - V
• 2006: National Abortion Fed’n v. Gonzages
– found to be unconstitutional
– it imposed and undo burden on a woman’s right to
choose previability abortion
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35. Physicians Feeling the Heat
• Picketing Physicians: Privacy Issue
• Antiabortion Demonstration
• Obstructing Access to Abortion Clinics
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36. Continuing Controversy - I
• Employee Refusal to Participate in Abortions
– Pharmacists
• Physicians feeling the heat
• Use of force against demonstrators
– picketing physicians’ residencies
– trespass, obstructing access to abortion clinics
• State abortion statutes
• Abortion and Conflicting Beliefs
– morality of abortion
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37. Sterilization
• Elective Sterilization
– Blood Vessel Mistakenly Cut
– Negligent Sterilization Pregnancy
• Regulation of Sterilization for Convenience
• Therapeutic Sterilization
• Involuntary/Eugenic Sterilization
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38. Artificial Insemination
• Artificial insemination is the injection of
seminal fluid into a woman to induce
pregnancy
• Consent
• Confidentiality
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39. Surrogacy
• A method of reproduction whereby woman agrees to
give birth to a child she will not raise the handover to
a contract party
– who was often unable to give birth herself
• Surrogacy raises many ethical and legal issues
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40. Wrongful Birth, Life, & Conception
• Wrongful Birth
• Wrongful Life
• Wrongful Conception
• Prevention of such Lawsuits
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41. REVIEW QUESTIONS
1. Discuss the legal and ethical issues involved in Roe v.
Wade.
2. Do you agree that individual states should be able to
place reasonable restrictions or waiting periods?
Who should determine what is reasonable?
3. Should a married woman be allowed to abort without
her husband's consent?
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42. REVIEW QUESTIONS, cont.
4. Give two arguments for and two arguments against
partial-birth abortions.
5. Explain why you think Roe v. Wade is an example of
legislating morality.
6. Do you agree that eugenic sterilization should be
allowed? Why or why not?
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43. REVIEW QUESTIONS, cont.
7. Describe surrogacy and the legal and ethical issues
that can arise.
8. Describe the distinctions among wrongful
birth, wrongful life, and wrongful conception. Why is
there such a diversity and opinions from the different
states?
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