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И еще про аборты
Точка зрения, которую и я разделяю.
The End of Roe v Wade and New Legal Frontiers on the Constitutional Right to Abortion
I. Glenn Cohen, JD1; Melissa Murray, JD2; Lawrence O. Gostin, JD3 JAMA. Published online July 8, 2022.
On June 24, 2002, the US Supreme Court ended the constitutional right to abortion in Dobbs v Jackson Women’s Health Organization.1 The Court’s majority decision authored by Justice Samuel Alito was substantially the same as a draft opinion leaked a month earlier.2 The regulation of abortion will now be decided by the states. In this Viewpoint, we explain the Dobbs ruling and what it means for physicians, public health, and society.
The Dobbs Ruling
The Supreme Court majority opinion upheld Mississippi’s ban on abortion at 15 weeks’ gestational age, but went further to explicitly overrule Roe v Wade (1973), which recognized the right of a patient, in consultation with their physician, to choose an abortion, and also to overrule Planned Parenthood v Casey (1992), which affirmed Roe’s core holding. Justice Alito reasoned that “Roe was egregiously wrong from the start,” insisting the Court’s reasoning “was exceptionally weak, and the decision has had damaging consequences.”1
The majority’s concerns with Roe and Casey coalesced around 3 principal objections: (1) “The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision,” including the Fourteenth Amendment; (2) the right to abortion is not “‘deeply rooted in this Nation’s history and tradition’ and ‘implicit in the concept of ordered liberty’”; and (3) the “permissibility of abortion, and the limitations, upon it, are to be resolved like most important questions in our democracy: by citizens trying to persuade one another and then voting.”1 The majority resolved “to heed the Constitution and return the issue of abortion to the people’s elected representatives.”1
In dissent, the 3 liberal justices (Breyer, Sotomayor, and Kagan) lamented the majority’s casual disregard for stare decisis, the principle that courts should follow settled precedents and the rule of law. Chief Justice Roberts’ concurring opinion argued the Court did not need to overrule Roe and Casey, decisions the Court often reexamined and sustained, and that doing so seriously undermined the Court’s institutional legitimacy. He would have simply ruled that Mississippi’s 15-week ban was constitutionally permissible. Justice Kavanaugh’s concurring opinion insisted the Court had returned to a position of “judicial neutrality,” “restoring the people’s authority to resolve the issue of abortion through democratic self-government.”1
The most immediate effects of the Dobbs ruling will be the closing of abortion clinics in approximately half the states. Some states had “trigger laws” that took effect immediately after the reversal of Roe v Wade. Other states had “zombie” laws banning abortions that were enacted before Roe but never repealed. This rapidly diminishing landscape for abortion access will not change the reality that many individuals will still seek to end their pregnancies, and 2 avenues raise serious legal questions—medication abortion and travel to states that permit abortions.
Medication Abortions: FDA Preemption
Currently, more than half of all abortions are managed through a 2-drug regimen of mifepristone followed by misoprostol within 70 days (10 weeks) of gestation, and it is likely more women will rely on medication abortions.2 In 2000, the Food and Drug Administration (FDA) approved mifepristone (Mifeprex) with an accompanying Risk Evaluation and Mitigation Strategy (REMS), a safety program to ensure the drug’s benefits outweigh its risks. Reproductive rights groups have urged FDA to liberalize the REMS parameters to ensure broader access.3 Many states have already restricted access to mifepristone; for example, Mississippi requires the drug be taken only in the presence of a physician, making telemedicine prescriptions difficult.3,4 Abortion laws after Dobbs likely will conflict even more directly with FDA’s approval of mifepristone.
The Food, Drug, and Cosmetic Act empowered FDA to ensure drugs and devices are safe and effective for their intended use. Under the Constitution’s Supremacy Clause, when state and federal law clash, federal law supersedes. That is, federal law “preempts” conflicting state laws. Attorney General Merrick Garland recently announced that “states may not ban mifepristone based on disagreement with the FDA’s expert judgment.”5 FDA preemption is based on the agency having power to set a national uniform standard for approved medications across the country. It is likely that litigation will result over whether state attempts to restrict medical abortion are preempted by FDA’s approval of mifepristone. The issue may ultimately come before the Supreme Court. It is difficult to predict how the Justices would decide since the Court has reached divergent conclusions in prior cases concerning FDA preemption of state tort law.4
Restricting Travel to States That Permit Abortions
Pregnant individuals who wish to seek abortion services but live in states that ban or restrict abortions may travel to other states that permit abortions. For many this will be a major hardship, including those who cannot afford to travel for long distances or cannot take time off from work or child care, persons with disabilities, and those subject to partner abuse.6 Could a state restrict or eliminate the right to travel to another state for abortion or make it a crime for a state’s residents to achieve an abortion in another state? No state has yet adopted an explicit ban on travel, but at least 1 state has proposed doing so.4
In his separate concurrence, Justice Kavanaugh considered the issue directly: “May a State bar a resident of that State from traveling to another State to obtain an abortion? In my view, the answer is no based on the constitutional right to interstate travel.”1 Attorney General Garland agreed: The Constitution “restricts states’ authority to ban reproductive services provided outside their borders.…Under bedrock constitutional principles, women who reside in states that have banned access to comprehensive reproductive care must remain free to seek that care in states where it is legal.”5 Garland also stated that physicians have a First Amendment right “to inform and counsel each other about the reproductive care that is available in other states.”5 Under some state laws that proscribe “aiding or abetting” an abortion, physicians could risk legal sanctions for informing patients about abortion availability in other states. Although the constitutional right to travel has been widely recognized, like the right to abortion, it is nowhere explicit in the Constitution’s text, and the 3 dissenting justices highlighted the right to travel as a vexing issue the Court will likely face.
Constitutional Rights at Risk
The Court’s opinion potentially places at risk other rights, including Griswold v Connecticut (right to contraception), Lawrence v Texas (right to engage in same-sex sex), and Obergefell v Hodges (right to same-sex marriage). Justice Alito’s majority opinion stated, “To ensure that our decision is not misunderstood or mischaracterized, we emphasize that our decision concerns the constitutional right to abortion and no other right.”1 Justice Kavanaugh agreed: “Overruling Roe does not mean the overruling of those precedents, and does not threaten or cast doubt on those precedents.”1 These assurances rang hollow in light of Justice Clarence Thomas’ concurrence, urging fellow justices to “reconsider all of this Court’s substantive due process precedents,” including Griswold, Lawrence, and Obergefell, which like Roe and Casey were “demonstrably erroneous.” He insisted the Court has “a duty to ‘correct the error’ established in those precedents.”1
Contraception
Griswold v Connecticut in 1965 established a constitutional right of married couples to buy and use contraceptives without government restriction.7 Yet many abortion restrictions state that “personhood” or being an “unborn child” begins at fertilization, which raises concerns about access to certain contraception methods, including intrauterine devices and Plan B (levonorgestrel), an emergency contraception taken up to 72 hours after unprotected sex. In Burwell v Hobby Lobby (2003), Justice Alito said that some FDA-approved contraceptives “may have the effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus.”8 Oklahoma’s recent abortion ban recognized the rights of “a human fetus or embryo in any stage of gestation from fertilization until birth,” but explicitly excluded “contraception or emergency contraception.”9 Other states may not be as permissive of all contraceptive devices.
Assisted Reproductive Technologies
Physicians and clinics that provide assisted reproductive technology (ART) services, such as vitro fertilization (IVF), could similarly be subject to criminal penalties. Approximately 2% of all infants born in the US every year are conceived using ART.10 In the US many embryos created as part of IVF are ultimately destroyed for medical or other reasons.10 The Dobbs opinion includes numerous references to “the unborn human being,” “potential life,” and “the life of the unborn,” which many state antiabortion statutes declare begins at the point of fertilization. That same logic may encompass prohibiting the destruction of embryos.10 As the dissenting justices warn, “law often has a way of evolving without regard to original intentions—a way of actually following where logic leads... Rights can expand in that way.”1
Conclusions
In a single day the Court has not only undone 50 years of constitutional protections for abortion, but has thrown into doubt whether the Constitution protects a wide range of medical and familial decisions.
The End of Roe v Wade and New Legal Frontiers on the Constitutional Right to Abortion
I. Glenn Cohen, JD1; Melissa Murray, JD2; Lawrence O. Gostin, JD3 JAMA. Published online July 8, 2022.
On June 24, 2002, the US Supreme Court ended the constitutional right to abortion in Dobbs v Jackson Women’s Health Organization.1 The Court’s majority decision authored by Justice Samuel Alito was substantially the same as a draft opinion leaked a month earlier.2 The regulation of abortion will now be decided by the states. In this Viewpoint, we explain the Dobbs ruling and what it means for physicians, public health, and society.
The Dobbs Ruling
The Supreme Court majority opinion upheld Mississippi’s ban on abortion at 15 weeks’ gestational age, but went further to explicitly overrule Roe v Wade (1973), which recognized the right of a patient, in consultation with their physician, to choose an abortion, and also to overrule Planned Parenthood v Casey (1992), which affirmed Roe’s core holding. Justice Alito reasoned that “Roe was egregiously wrong from the start,” insisting the Court’s reasoning “was exceptionally weak, and the decision has had damaging consequences.”1
The majority’s concerns with Roe and Casey coalesced around 3 principal objections: (1) “The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision,” including the Fourteenth Amendment; (2) the right to abortion is not “‘deeply rooted in this Nation’s history and tradition’ and ‘implicit in the concept of ordered liberty’”; and (3) the “permissibility of abortion, and the limitations, upon it, are to be resolved like most important questions in our democracy: by citizens trying to persuade one another and then voting.”1 The majority resolved “to heed the Constitution and return the issue of abortion to the people’s elected representatives.”1
In dissent, the 3 liberal justices (Breyer, Sotomayor, and Kagan) lamented the majority’s casual disregard for stare decisis, the principle that courts should follow settled precedents and the rule of law. Chief Justice Roberts’ concurring opinion argued the Court did not need to overrule Roe and Casey, decisions the Court often reexamined and sustained, and that doing so seriously undermined the Court’s institutional legitimacy. He would have simply ruled that Mississippi’s 15-week ban was constitutionally permissible. Justice Kavanaugh’s concurring opinion insisted the Court had returned to a position of “judicial neutrality,” “restoring the people’s authority to resolve the issue of abortion through democratic self-government.”1
The most immediate effects of the Dobbs ruling will be the closing of abortion clinics in approximately half the states. Some states had “trigger laws” that took effect immediately after the reversal of Roe v Wade. Other states had “zombie” laws banning abortions that were enacted before Roe but never repealed. This rapidly diminishing landscape for abortion access will not change the reality that many individuals will still seek to end their pregnancies, and 2 avenues raise serious legal questions—medication abortion and travel to states that permit abortions.
Medication Abortions: FDA Preemption
Currently, more than half of all abortions are managed through a 2-drug regimen of mifepristone followed by misoprostol within 70 days (10 weeks) of gestation, and it is likely more women will rely on medication abortions.2 In 2000, the Food and Drug Administration (FDA) approved mifepristone (Mifeprex) with an accompanying Risk Evaluation and Mitigation Strategy (REMS), a safety program to ensure the drug’s benefits outweigh its risks. Reproductive rights groups have urged FDA to liberalize the REMS parameters to ensure broader access.3 Many states have already restricted access to mifepristone; for example, Mississippi requires the drug be taken only in the presence of a physician, making telemedicine prescriptions difficult.3,4 Abortion laws after Dobbs likely will conflict even more directly with FDA’s approval of mifepristone.
The Food, Drug, and Cosmetic Act empowered FDA to ensure drugs and devices are safe and effective for their intended use. Under the Constitution’s Supremacy Clause, when state and federal law clash, federal law supersedes. That is, federal law “preempts” conflicting state laws. Attorney General Merrick Garland recently announced that “states may not ban mifepristone based on disagreement with the FDA’s expert judgment.”5 FDA preemption is based on the agency having power to set a national uniform standard for approved medications across the country. It is likely that litigation will result over whether state attempts to restrict medical abortion are preempted by FDA’s approval of mifepristone. The issue may ultimately come before the Supreme Court. It is difficult to predict how the Justices would decide since the Court has reached divergent conclusions in prior cases concerning FDA preemption of state tort law.4
Restricting Travel to States That Permit Abortions
Pregnant individuals who wish to seek abortion services but live in states that ban or restrict abortions may travel to other states that permit abortions. For many this will be a major hardship, including those who cannot afford to travel for long distances or cannot take time off from work or child care, persons with disabilities, and those subject to partner abuse.6 Could a state restrict or eliminate the right to travel to another state for abortion or make it a crime for a state’s residents to achieve an abortion in another state? No state has yet adopted an explicit ban on travel, but at least 1 state has proposed doing so.4
In his separate concurrence, Justice Kavanaugh considered the issue directly: “May a State bar a resident of that State from traveling to another State to obtain an abortion? In my view, the answer is no based on the constitutional right to interstate travel.”1 Attorney General Garland agreed: The Constitution “restricts states’ authority to ban reproductive services provided outside their borders.…Under bedrock constitutional principles, women who reside in states that have banned access to comprehensive reproductive care must remain free to seek that care in states where it is legal.”5 Garland also stated that physicians have a First Amendment right “to inform and counsel each other about the reproductive care that is available in other states.”5 Under some state laws that proscribe “aiding or abetting” an abortion, physicians could risk legal sanctions for informing patients about abortion availability in other states. Although the constitutional right to travel has been widely recognized, like the right to abortion, it is nowhere explicit in the Constitution’s text, and the 3 dissenting justices highlighted the right to travel as a vexing issue the Court will likely face.
Constitutional Rights at Risk
The Court’s opinion potentially places at risk other rights, including Griswold v Connecticut (right to contraception), Lawrence v Texas (right to engage in same-sex sex), and Obergefell v Hodges (right to same-sex marriage). Justice Alito’s majority opinion stated, “To ensure that our decision is not misunderstood or mischaracterized, we emphasize that our decision concerns the constitutional right to abortion and no other right.”1 Justice Kavanaugh agreed: “Overruling Roe does not mean the overruling of those precedents, and does not threaten or cast doubt on those precedents.”1 These assurances rang hollow in light of Justice Clarence Thomas’ concurrence, urging fellow justices to “reconsider all of this Court’s substantive due process precedents,” including Griswold, Lawrence, and Obergefell, which like Roe and Casey were “demonstrably erroneous.” He insisted the Court has “a duty to ‘correct the error’ established in those precedents.”1
Contraception
Griswold v Connecticut in 1965 established a constitutional right of married couples to buy and use contraceptives without government restriction.7 Yet many abortion restrictions state that “personhood” or being an “unborn child” begins at fertilization, which raises concerns about access to certain contraception methods, including intrauterine devices and Plan B (levonorgestrel), an emergency contraception taken up to 72 hours after unprotected sex. In Burwell v Hobby Lobby (2003), Justice Alito said that some FDA-approved contraceptives “may have the effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus.”8 Oklahoma’s recent abortion ban recognized the rights of “a human fetus or embryo in any stage of gestation from fertilization until birth,” but explicitly excluded “contraception or emergency contraception.”9 Other states may not be as permissive of all contraceptive devices.
Assisted Reproductive Technologies
Physicians and clinics that provide assisted reproductive technology (ART) services, such as vitro fertilization (IVF), could similarly be subject to criminal penalties. Approximately 2% of all infants born in the US every year are conceived using ART.10 In the US many embryos created as part of IVF are ultimately destroyed for medical or other reasons.10 The Dobbs opinion includes numerous references to “the unborn human being,” “potential life,” and “the life of the unborn,” which many state antiabortion statutes declare begins at the point of fertilization. That same logic may encompass prohibiting the destruction of embryos.10 As the dissenting justices warn, “law often has a way of evolving without regard to original intentions—a way of actually following where logic leads... Rights can expand in that way.”1
Conclusions
In a single day the Court has not only undone 50 years of constitutional protections for abortion, but has thrown into doubt whether the Constitution protects a wide range of medical and familial decisions.
no subject
Мир движется в тьму, и это, мне кажется, результат открытия коммуникаций. Мы внезапно узнали, что это за человечество вообще вокруг нас.
no subject
большее количество прав и свобод "для всех" мешает накапливать средства и ограничивает власть, потому у упределенного слоя всегда будет потребность на то чтобы права и свободы других были ограничены, и чем больше тем лучше.
так что это не изза открытия коммуникаций, наверное, а нечто вроде "качания маятника"- без добавочной силы он будет тянуть назад,а добавки в нужном направлении не получилось (пока что).
no subject
Да, по-моему, даже не то, что выросло новое, а вдруг, после двух легализаций, марихуаны и однополых браков, все расслабились, и оказались готовы отступать - в том числе, и те, кто еще 10 лет назад неутомимо боролся. Потом они стали бороться за... бог знает что. Как-то все стало очень сложно.
Я вообще-то ожидал, что поколение внуков бумеров будет свободолюбивым, как хиппи. Как бумеры. А тут вот оно что. Поди-ка угадай. Остается валить на фесбук.
no subject
no subject
ну и есть уменя мысль- что хиппи как раз боролись "за свободы", следующие поколения уже имели эти свободы и им не надо было бороться. и даже не понимали, что нужно за это бороться или вообще хотя бы прикладывать усилия, чтобы поддерживать.
no subject
Да, убедительно. Для них это как бы данное. Для них это "было всегда".
no subject
Посмотрите на секретарш, например. У них сложная и напряженная работа, а платят им мало. Традиционно на них работают женщины с детьми, и почему-то нет никаких воплей о том, будто женщины не могут сосредоточится на сложных заданиях, держа в голове все ступени и быстро, без истерики, находить решения для неожиданных препятствий.
Это теперь люди стали жить лучше, и не хотят рожать, пока у них нет надежды на будущую приличную жизнь. Контрацептивы позволяют. Так что по последним будет следующий удар, а так же по тем, кто смеет жить без детей у всех на виду, показывая "дурной пример" - гомосексуалистам. Создают большое количество людей в отчаянном положении, на благо экономики, которую нежно любят супербогатые. Плата политикам, видимо, оправдывается сторицей. Причем обеим сторонам.
Заявление о "потенциальной" жизни замалчивает огромный, многолетний и целеустремленный труд родителей, направленной на ежедневную заботу и воспитание человека. Как известно, если до пяти лет "потенциальный" человек жил с животными, он даже говорить путем будет не способен. А эти якобы "за нерожденного человека" уверяют, будто из него запросто может выйти гениальный скрипач или доктор. Как будто гении вырастают на деревьях, как листья. Да и тем полив нужен.
no subject
по каждому пункту.
но как мы видим, мракобесие в стране набирает обороты.
причем, при нынечшнем положении вещей, "много людей" стране (почти любой)и не нужно. тк много механизации роботизации и тд. важны как раз направления регуляции, чтоб не было чересчур много.
вместо этого- щемят самых уязвимых. ведь женщины на аборты идут не от хорошей жизни, а вынужденно, и в самом аборте для женщины- нет ничего привлекательного, это не наркотики. а общество (в лице придруковатых судй и им подобных затурканных религией) криминализирует пострадавших и врачей.
это не о потенциальной жизни, разумеется, это о власти и гноблении.
no subject
Но его сейчас активно подпитывают власть имеющие.
no subject