essay on abortion pdf

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• Rom J Morphol Embryol
• v.61(1); Jan-Mar 2020

A research on abortion: ethics, legislation and socio-medical outcomes. Case study: Romania

Andreea mihaela niţă.

1 Faculty of Social Sciences, University of Craiova, Romania

Cristina Ilie Goga

This article presents a research study on abortion from a theoretical and empirical point of view. The theoretical part is based on the method of social documents analysis, and presents a complex perspective on abortion, highlighting items of medical, ethical, moral, religious, social, economic and legal elements. The empirical part presents the results of a sociological survey, based on the opinion survey method through the application of the enquiry technique, conducted in Romania, on a sample of 1260 women. The purpose of the survey is to identify Romanians perception on the decision to voluntary interrupt pregnancy, and to determine the core reasons in carrying out an abortion.

The analysis of abortion by means of medical and social documents

Abortion means a pregnancy interruption “before the fetus is viable” [ 1 ] or “before the fetus is able to live independently in the extrauterine environment, usually before the 20 th week of pregnancy” [ 2 ]. “Clinical miscarriage is both a common and distressing complication of early pregnancy with many etiological factors like genetic factors, immune factors, infection factors but also psychological factors” [ 3 ]. Induced abortion is a practice found in all countries, but the decision to interrupt the pregnancy involves a multitude of aspects of medical, ethical, moral, religious, social, economic, and legal order.

In a more simplistic manner, Winston Nagan has classified opinions which have as central element “abortion”, in two major categories: the opinion that the priority element is represented by fetus and his entitlement to life and the second opinion, which focuses around women’s rights [ 4 ].

From the medical point of view, since ancient times there have been four moments, generally accepted, which determine the embryo’s life: ( i ) conception; ( ii ) period of formation; ( iii ) detection moment of fetal movement; ( iv ) time of birth [ 5 ]. Contemporary medicine found the following moments in the evolution of intrauterine fetal: “ 1 . At 18 days of pregnancy, the fetal heartbeat can be perceived and it starts running the circulatory system; 2 . At 5 weeks, they become more clear: the nose, cheeks and fingers of the fetus; 3 . At 6 weeks, they start to function: the nervous system, stomach, kidneys and liver of the fetus, and its skeleton is clearly distinguished; 4 . At 7 weeks (50 days), brain waves are felt. The fetus has all the internal and external organs definitively outlined. 5 . At 10 weeks (70 days), the unborn child has all the features clearly defined as a child after birth (9 months); 6 . At 12 weeks (92 days, 3 months), the fetus has all organs definitely shaped, managing to move, lacking only the breath” [ 6 ]. Even if most of the laws that allow abortion consider the period up to 12 weeks acceptable for such an intervention, according to the above-mentioned steps, there can be defined different moments, which can represent the beginning of life. Nowadays, “abortion is one of the most common gynecological experiences and perhaps the majority of women will undergo an abortion in their lifetimes” [ 7 ]. “Safe abortions carry few health risks, but « every year, close to 20 million women risk their lives and health by undergoing unsafe abortions » and 25% will face a complication with permanent consequences” [ 8 , 9 ].

From the ethical point of view, most of the times, the interruption of pregnancy is on the border between woman’s right over her own body and the child’s (fetus) entitlement to life. Judith Jarvis Thomson supported the supremacy of woman’s right over her own body as a premise of freedom, arguing that we cannot force a person to bear in her womb and give birth to an unwanted child, if for different circumstances, she does not want to do this [ 10 ]. To support his position, the author uses an imaginary experiment, that of a violinist to which we are connected for nine months, in order to save his life. However, Thomson debates the problem of the differentiation between the fetus and the human being, by carrying out a debate on the timing which makes this difference (period of conception, 10 weeks of pregnancy, etc.) and highlighting that for people who support abortion, the fetus is not an alive human being [ 10 ].

Carol Gilligan noted that women undergo a true “moral dilemma”, a “moral conflict” with regards to voluntary interruption of pregnancy, such a decision often takes into account the human relationships, the possibility of not hurting the others, the responsibility towards others [ 11 ]. Gilligan applied qualitative interviews to a number of 29 women from different social classes, which were put in a position to decide whether or not to commit abortion. The interview focused on the woman’s choice, on alternative options, on individuals and existing conflicts. The conclusion was that the central moral issue was the conflict between the self (the pregnant woman) and others who may be hurt as a result of the potential pregnancy [ 12 ].

From the religious point of view, abortion is unacceptable for all religions and a small number of abortions can be seen in deeply religious societies and families. Christianity considers the beginning of human life from conception, and abortion is considered to be a form of homicide [ 13 ]. For Christians, “at the same time, abortion is giving up their faith”, riot and murder, which means that by an abortion we attack Jesus Christ himself and God [ 14 ]. Islam does not approve abortion, relying on the sacral life belief as specified in Chapter 6, Verse 151 of the Koran: “Do not kill a soul which Allah has made sacred (inviolable)” [ 15 ]. Buddhism considers abortion as a negative act, but nevertheless supports for medical reasons [ 16 ]. Judaism disapproves abortion, Tanah considering it to be a mortal sin. Hinduism considers abortion as a crime and also the greatest sin [ 17 ].

From the socio-economic point of view, the decision to carry out an abortion is many times determined by the relations within the social, family or financial frame. Moreover, studies have been conducted, which have linked the legalization of abortions and the decrease of the crime rate: “legalized abortion may lead to reduced crime either through reductions in cohort sizes or through lower per capita offending rates for affected cohorts” [ 18 ].

Legal regulation on abortion establishes conditions of the abortion in every state. In Europe and America, only in the XVIIth century abortion was incriminated and was considered an insignificant misdemeanor or a felony, depending on when was happening. Due to the large number of illegal abortions and deaths, two centuries later, many states have changed legislation within the meaning of legalizing voluntary interruption of pregnancy [ 6 ]. In contemporary society, international organizations like the United Nations or the European Union consider sexual and reproductive rights as fundamental rights [ 19 , 20 ], and promotes the acceptance of abortion as part of those rights. However, not all states have developed permissive legislation in the field of voluntary interruption of pregnancy.

Currently, at national level were established four categories of legislation on pregnancy interruption area:

( i )  Prohibitive legislations , ones that do not allow abortion, most often outlining exceptions in abortion in cases where the pregnant woman’s life is endangered. In some countries, there is a prohibition of abortion in all circumstances, however, resorting to an abortion in the case of an imminent threat to the mother’s life. Same regulation is also found in some countries where abortion is allowed in cases like rape, incest, fetal problems, etc. In this category are 66 states, with 25.5% of world population [ 21 ].

( ii )  Restrictive legislation that allow abortion in cases of health preservation . Loosely, the term “health” should be interpreted according to the World Health Organization (WHO) definition as: “health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” [ 22 ]. This type of legislation is adopted in 59 states populated by 13.8% of the world population [ 21 ].

( iii )  Legislation allowing abortion on a socio-economic motivation . This category includes items such as the woman’s age or ability to care for a child, fetal problems, cases of rape or incest, etc. In this category are 13 countries, where we have 21.3% of the world population [ 21 ].

( iv )  Legislation which do not impose restrictions on abortion . In the case of this legislation, abortion is permitted for any reason up to 12 weeks of pregnancy, with some exceptions (Romania – 14 weeks, Slovenia – 10 weeks, Sweden – 18 weeks), the interruption of pregnancy after this period has some restrictions. This type of legislation is adopted in 61 countries with 39.5% of the world population [21].

The Centre for Reproductive Rights has carried out from 1998 a map of the world’s states, based on the legislation typology of each country (Figure ​ (Figure1 1 ).

The analysis of states according to the legislation regarding abortion. Source: Centre for Reproductive Rights. The World’s Abortion Laws, 2018 [ 23 ]

An unplanned pregnancy, socio-economic context or various medical problems [ 24 ], lead many times to the decision of interrupting pregnancy, regardless the legislative restrictions. In the study “Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008” issued in 2011 by the WHO , it was determined that within the states with restrictive legislation on abortion, we may also encounter a large number of illegal abortions. The illegal abortions may also be resulting in an increased risk of woman’s health and life considering that most of the times inappropriate techniques are being used, the hygienic conditions are precarious and the medical treatments are incorrectly administered [ 25 ]. Although abortions done according to medical guidelines carry very low risk of complications, 1–3 unsafe abortions contribute substantially to maternal morbidity and death worldwide [ 26 ].

WHO has estimated for the year 2008, the fact that worldwide women between the ages of 15 and 44 years carried out 21.6 million “unsafe” abortions, which involved a high degree of risk and were distributed as follows: 0.4 million in the developed regions and a number of 21.2 million in the states in course of development [ 25 ].

Case study: Romania

Legal perspective on abortion

In Romania, abortion was brought under regulation by the first Criminal Code of the United Principalities, from 1864.

The Criminal Code from 1864, provided the abortion infringement in Article 246, on which was regulated as follows: “Any person, who, using means such as food, drinks, pills or any other means, which will consciously help a pregnant woman to commit abortion, will be punished to a minimum reclusion (three years).

The woman who by herself shall use the means of abortion, or would accept to use means of abortion which were shown or given to her for this purpose, will be punished with imprisonment from six months to two years, if the result would be an abortion. In a situation where abortion was carried out on an illegitimate baby by his mother, the punishment will be imprisonment from six months to one year.

Doctors, surgeons, health officers, pharmacists (apothecary) and midwives who will indicate, will give or will facilitate these means, shall be punished with reclusion of at least four years, if the abortion took place. If abortion will cause the death of the mother, the punishment will be much austere of four years” (Art. 246) [ 27 ].

The Criminal Code from 1864, reissued in 1912, amended in part the Article 246 for the purposes of eliminating the abortion of an illegitimate baby case. Furthermore, it was no longer specified the minimum of four years of reclusion, in case of abortion carried out with the help of the medical staff, leaving the punishment to the discretion of the Court (Art. 246) [ 28 ].

The Criminal Code from 1936 regulated abortion in the Articles 482–485. Abortion was defined as an interruption of the normal course of pregnancy, being punished as follows:

“ 1 . When the crime is committed without the consent of the pregnant woman, the punishment was reformatory imprisonment from 2 to 5 years. If it caused the pregnant woman any health injury or a serious infirmity, the punishment was reformatory imprisonment from 3 to 6 years, and if it has caused her death, reformatory imprisonment from 7 to 10 years;

2 . When the crime was committed by the unmarried pregnant woman by herself, or when she agreed that someone else should provoke the abortion, the punishment is reformatory imprisonment from 3 to 6 months, and if the woman is married, the punishment is reformatory imprisonment from 6 months to one year. Same penalty applies also to the person who commits the crime with the woman’s consent. If abortion was committed for the purpose of obtaining a benefit, the punishment increases with another 2 years of reformatory imprisonment.

If it caused the pregnant woman any health injuries or a severe disablement, the punishment will be reformatory imprisonment from one to 3 years, and if it has caused her death, the punishment is reformatory imprisonment from 3 to 5 years” (Art. 482) [ 29 ].

The criminal legislation from 1936 specifies that it is not considered as an abortion the interruption from the normal course of pregnancy, if it was carried out by a doctor “when woman’s life was in imminent danger or when the pregnancy aggravates a woman’s disease, putting her life in danger, which could not be removed by other means and it is obvious that the intervention wasn’t performed with another purpose than that of saving the woman’s life” and “when one of the parents has reached a permanent alienation and it is certain that the child will bear serious mental flaws” (Art. 484, Par. 1 and Par. 2) [ 29 ].

In the event of an imminent danger, the doctor was obliged to notify prosecutor’s office in writing, within 48 hours after the intervention, on the performance of the abortion. “In the other cases, the doctor was able to intervene only with the authorization of the prosecutor’s office, given on the basis of a medical certificate from hospital or a notice given as a result of a consultation between the doctor who will intervene and at least a professor doctor in the disease which caused the intervention. General’s Office Prosecutor, in all cases provided by this Article, shall be obliged to maintain the confidentiality of all communications or authorizations, up to the intercession of any possible complaints” (Art. 484) [ 29 ].

The legislation of 1936 provided a reformatory injunction from one to three years for the abortions committed by doctors, sanitary agents, pharmacists, apothecary or midwives (Art. 485) [ 29 ].

Abortion on demand has been legalized for the first time in Romania in the year 1957 by the Decree No. 463, under the condition that it had to be carried out in a hospital and to be carried out in the first quarter of the pregnancy [ 30 ]. In the year 1966, demographic policy of Romania has dramatically changed by introducing the Decree No. 770 from September 29 th , which prohibited abortion. Thus, the voluntary interruption of pregnancy became a crime, with certain exceptions, namely: endangering the mother’s life, physical or mental serious disability; serious or heritable illness, mother’s age over 45 years, if the pregnancy was a result of rape or incest or if the woman gave birth to at least four children who were still in her care (Art. 2) [ 31 ].

In the Criminal Code from 1968, the abortion crime was governed by Articles 185–188.

The Article 185, “the illegal induced abortion”, stipulated that “the interruption of pregnancy by any means, outside the conditions permitted by law, with the consent of the pregnant woman will be punished with imprisonment from one to 3 years”. The act referred to above, without the prior consent from the pregnant woman, was punished with prison from two to five years. If the abortion carried out with the consent of the pregnant woman caused any serious body injury, the punishment was imprisonment from two to five years, and when it caused the death of the woman, the prison sentence was from five to 10 years. When abortion was carried out without the prior consent of the woman, if it caused her a serious physical injury, the punishment was imprisonment from three to six years, and if it caused the woman’s death, the punishment was imprisonment from seven to 12 years (Art. 185) [ 32 ].

“When abortion was carried out in order to obtain a material benefit, the maximum punishment was increased by two years, and if the abortion was made by a doctor, in addition to the prison punishment could also be applied the prohibition to no longer practice the profession of doctor”.

Article 186, “abortion caused by the woman”, stipulated that “the interruption of the pregnancy course, committed by the pregnant woman, was punished with imprisonment from 6 months to 2 years”, quoting the fact that by the same punishment was also sanctioned “the pregnant woman’s act to consent in interrupting the pregnancy course made out by another person” (Art. 186) [ 26 ].

The Regulations of the Criminal Code in 1968, also provided the crime of “ownership of tools or materials that can cause abortion”, the conditions of this holding being met when these types of instruments were held outside the hospital’s specialized institutions, the infringement shall be punished with imprisonment from three months to one year (Art. 187) [ 32 ].

Furthermore, the doctors who performed an abortion in the event of extreme urgency, without prior legal authorization and if they did not announce the competent authority within the legal deadline, they were punished by imprisonment from one month to three months (Art. 188) [ 32 ].

In the year 1985, it has been issued the Decree No. 411 of December 26 th , by which the conditions imposed by the Decree No. 770 of 1966 have been hardened, meaning that it has increased the number of children, that a woman could have in order to request an abortion, from four to five children [ 33 ].

The Articles 185–188 of the Criminal Code and the Decree No. 770/1966 on the interruption of the pregnancy course have been abrogated by Decree-Law No. 1 from December 26 th , 1989, which was published in the Official Gazette No. 4 of December 27 th , 1989 (Par. 8 and Par. 12) [ 34 ].

The Criminal Code from 1968, reissued in 1997, maintained Article 185 about “the illegal induced abortion”, but drastically modified. Thus, in this case of the Criminal Code, we identify abortion as “the interruption of pregnancy course, by any means, committed in any of the following circumstances: ( a ) outside medical institutions or authorized medical practices for this purpose; ( b ) by a person who does not have the capacity of specialized doctor; ( c ) if age pregnancy has exceeded 14 weeks”, the punishment laid down was the imprisonment from 6 months to 3 years” (Art. 185, Par. 1) [ 35 ]. For the abortion committed without the prior consent of the pregnant woman, the punishment consisted in strict prison conditions from two to seven years and with the prohibition of certain rights (Art. 185, Par. 2) [ 35 ].

For the situation of causing serious physical injury to the pregnant woman, the punishment was strict prison from three to 10 years and the removal of certain rights, and if it had as a result the death of the pregnant woman, the punishment was strict prison from five to 15 years and the prohibition of certain rights (Art. 185, Par. 3) [ 35 ].

The attempt was punished for the crimes specified in the various cases of abortion.

Consideration should also be given in the Criminal Code reissued in 1997 for not punishing the interruption of the pregnancy course carried out by the doctor, if this interruption “was necessary to save the life, health or the physical integrity of the pregnant woman from a grave and imminent danger and that it could not be removed otherwise; in the case of a over fourteen weeks pregnancy, when the interruption of the pregnancy course should take place from therapeutic reasons” and even in a situation of a woman’s lack of consent, when it has not been given the opportunity to express her will, and abortion “was imposed by therapeutic reasons” (Art. 185, Par. 4) [ 35 ].

Criminal Code from 2004 covers abortion in Article 190, defined in the same way as in the prior Criminal Code, with the difference that it affects the limits of the punishment. So, in the event of pregnancy interruption, in accordance with the conditions specified in Paragraph 1, “the penalty provided was prison time from 6 months to one year or days-fine” (Art. 190, Par. 1) [ 36 ].

Nowadays, in Romania, abortion is governed by the criminal law of 2009, which entered into force in 2014, by the section called “aggression against an unborn child”. It should be specified that current criminal law does not punish the woman responsible for carrying out abortion, but only the person who is involved in carrying out the abortion. There is no punishment for the pregnant woman who injures her fetus during pregnancy.

In Article 201, we can find the details on the pregnancy interruption infringement. Thus, the pregnancy interruption can be performed in one of the following circumstances: “outside of medical institutions or medical practices authorized for this purpose; by a person who does not have the capacity of specialist doctor in Obstetrics and Gynecology and the right of free medical practice in this specialty; if gestational age has exceeded 14 weeks”, the punishment is the imprisonment for six months to three years, or fine and the prohibition to exercise certain rights (Art. 201, Par. 1) [ 37 ].

Article 201, Paragraph 2 specifies that “the interruption of the pregnancy committed under any circumstances, without the prior consent of the pregnant woman, can be punished with imprisonment from 2 to 7 years and with the prohibition to exercise some rights” (Art. 201, Par. 1) [ 37 ].

If by facts referred to above (Art. 201, Par. 1 and Par. 2) [ 37 ] “it has caused the pregnant woman’s physical injury, the punishment is the imprisonment from 3 to 10 years and the prohibition to exercise some rights, and if it has had as a result the pregnant woman’s death, the punishment is the imprisonment from 6 to 12 years and the prohibition to exercise some rights” (Art. 201, Par. 3) [ 37 ]. When the facts have been committed by a doctor, “in addition to the imprisonment punishment, it will also be applied the prohibition to exercise the profession of doctor (Art. 201, Par. 4) [ 37 ].

Criminal legislation specifies that “the interruption of pregnancy does not constitute an infringement with the purpose of a treatment carried out by a specialist doctor in Obstetrics and Gynecology, until the pregnancy age of twenty-four weeks is reached, or the subsequent pregnancy interruption, for the purpose of treatment, is in the interests of the mother or the fetus” (Art. 201, Par. 6) [ 37 ]. However, it can all be found in the phrases “therapeutic purposes” and “the interest of the mother and of the unborn child”, which predisposes the text of law to an interpretation, finally the doctors are the only ones in the position to decide what should be done in such cases, assuming direct responsibility [ 38 ].

Article 202 of the Criminal Code defines the crime of harming an unborn child, pointing out the punishments for the various types of injuries that can occur during pregnancy or in the childbirth period and which can be caused by the mother or by the persons who assist the birth, with the specification that the mother who harms her fetus during pregnancy is not punished and does not constitute an infringement if the injury has been committed during pregnancy or during childbirth period if the facts have been “committed by a doctor or by an authorized person to assist the birth or to follow the pregnancy, if they have been committed in the course of the medical act, complying with the specific provisions of his profession and have been made in the interest of the pregnant woman or fetus, as a result of the exercise of an inherent risk in the medical act” (Art. 202, Par. 6) [ 37 ].

The fact situation in Romania

During the period 1948–1955, called “the small baby boom” [ 39 ], Romania registered an average fertility rate of 3.23 children for a woman. Between 1955 and 1962, the fertility rate has been less than three children for a woman, and in 1962, fertility has reached an average of two children for a woman. This phenomenon occurred because of the Decree No. 463/1957 on liberalization of abortion. After the liberalization from 1957, the abortion rate has increased from 220 abortions per 100 born-alive children in the year 1960, to 400 abortions per 100 born-alive children, in the year 1965 [ 40 ].

The application of provisions of Decrees No. 770 of 1966 and No. 411 of 1985 has led to an increase of the birth rate in the first three years (an average of 3.7 children in 1967, and 3.6 children in 1968), followed by a regression until 1989, when it was recorded an average of 2.2 children, but also a maternal death rate caused by illegal abortions, raising up to 85 deaths of 100 000 births in the year of 1965, and 170 deaths in 1983. It was estimated that more than 80% of maternal deaths between 1980–1989 was caused by legal constraints [ 30 ].

After the Romanian Revolution in December 1989 and after the communism fall, with the abrogation of Articles 185–188 of the Criminal Code and of the Decree No. 770/1966, by the Decree of Law No. 1 of December 26 th , 1989, abortion has become legal in Romania and so, in the following years, it has reached the highest rate of abortion in Europe. Subsequently, the number of abortion has dropped gradually, with increasing use of birth control [ 41 ].

Statistical data issued by the Ministry of Health and by the National Institute of Statistics (INS) in Romania show corresponding figures to a legally carried out abortion. The abortion number is much higher, if it would take into account the number of illegal abortion, especially those carried out before 1989, and those carried out in private clinics, after the year 1990. Summing the declared abortions in the period 1958–2014, it is to be noted the number of them, 22 037 747 exceeds the current Romanian population. A detailed statistical research of abortion rate, in terms of years we have exposed in Table ​ Table1 1 .

The number of abortions declared in Romania in the period 1958–2016

Source: Pro Vita Association (Bucharest, Romania), National Institute of Statistics (INS – Romania), EUROSTAT [ 42 , 43 , 44 ]

Data issued by the United Nations International Children’s Emergency Fund (UNICEF) in June 2016, for the period 1989–2014, in matters of reproductive behavior, indicates a fertility rate for Romania with a continuous decrease, in proportion to the decrease of the number of births, but also a lower number of abortion rate reported to 100 deliveries (Table ​ (Table2 2 ).

Reproductive behavior in Romania in 1989–2014

Source: United Nations International Children’s Emergency Fund (UNICEF), Transformative Monitoring for Enhanced Equity (TransMonEE) Data. Country profiles: Romania, 1989–2015 [ 45 ].

By analyzing data issued for the period 1990–2015 by the International Organization of Health , UNICEF , United Nations Fund for Population Activity (UNFPA), The World Bank and the United Nations Population Division, it is noticed that maternal mortality rate has currently dropped as compared with 1990 (Table ​ (Table3 3 ).

Maternal mortality estimation in Romania in 1990–2015

Source: World Health Organization (WHO), Global Health Observatory Data. Maternal mortality country profiles: Romania, 2015 [ 46 ].

Opinion survey: women’s opinion on abortion

Argument for choosing the research theme

Although the problematic on abortion in Romania has been extensively investigated and debated, it has not been carried out in an ample sociological study, covering Romanian women’s perception on abortion. We have assumed making a study at national level, in order to identify the opinion on abortion, on the motivation to carry out an abortion, and to identify the correlation between religious convictions and the attitude toward abortion.

Examining the literature field of study

In the conceptual register of the research, we have highlighted items, such as the specialized literature, legislation, statistical documents.

Formulation of hypotheses and objectives

The first hypothesis was that Romanian women accept abortion, having an open attitude towards this act. Thus, the first objective of the research was to identify Romanian women’s attitude towards abortion.

The second hypothesis, from which we started, was that high religious beliefs generate a lower tolerance towards abortion. Thus, the second objective of our research has been to identify the correlation between the religious beliefs and the attitude towards abortion.

The third hypothesis of the survey was that, the main motivation in carrying out an abortion is the fact that a woman does not want a baby, and the main motivation for keeping the pregnancy is that the person wants a baby. In this context, the third objective of the research was to identify main motivation in carrying out an abortion and in maintaining a pregnancy.

Another hypothesis was that modern Romanian legislation on the abortion is considered fair. Based on this hypothesis, we have assumed the fourth objective, which is to identify the degree of satisfaction towards the current regulatory provisions governing the abortion.

Research methodology

The research method is that of a sociological survey by the application of the questionnaire technique. We used the sampling by age and residence looking at representative numbers of population from more developed as well as underdeveloped areas.

Determination of the sample to be studied

Because abortion is a typical women’s experience, we have chosen to make the quantitative research only among women. We have constructed the sample by selecting a number of 1260 women between the ages of 15 and 44 years (the most frequently encountered age among women who give birth to a child). We also used the quota sampling techniques, taking into account the following variables: age group and the residence (urban/rural), so that the persons included in the sample could retain characteristic of the general population.

By the sample of 1260 women, we have made a percentage of investigation of 0.03% of the total population.

The Questionnaires number applied was distributed as follows (Table ​ (Table4 4 ).

The sampling rates based on the age, and the region of residence

Source: Sample built, based on the population data issued by the National Institute of Statistics (INS – Romania) based on population census conducted in 2011 [ 47 ].

Data collection

Data collection was carried out by questionnaires administered by 32 field operators between May 1 st –May 31 st , 2018.

The analysis of the research results

In the next section, we will present the main results of the quantitative research carried out at national level.

Almost three-quarters of women included in the sample agree with carrying out an abortion in certain circumstances (70%) and only 24% have chosen to support the answer “ No, never ”. In modern contemporary society, abortion is the first solution of women for which a pregnancy is not desired. Even if advanced medical techniques are a lot safer, an abortion still carries a health risk. However, 6% of respondents agree with carrying out abortion regardless of circumstances (Table ​ (Table5 5 ).

Opinion on the possibility of carrying out an abortion

Although abortions carried out after 14 weeks are illegal, except for medical reasons, more than half of the surveyed women stated they would agree with abortion in certain circumstances. At the opposite pole, 31% have mentioned they would never agree on abortions after 14 weeks. Five percent were totally accepting the idea of abortion made to a pregnancy that has exceeded 14 weeks (Table ​ (Table6 6 ).

Opinion on the possibility of carrying out an abortion after the period of 14 weeks of pregnancy

For 53% of respondents, abortion is considered a crime as well as the right of a women. On the other hand, 28% of the women considered abortion as a crime and 16% associate abortion with a woman’s right (Table ​ (Table7 7 ).

Opinion on abortion: at the border between crime and a woman’s right

Opinions on what women abort at the time of the voluntary pregnancy interruption are split in two: 59% consider that it depends on the time of the abortion, and more specifically on the pregnancy development stage, 24% consider that regardless of the period in which it is carried out, women abort a child, and 14% have opted a fetus (Table ​ (Table8 8 ).

Abortion of a child vs. abortion of a fetus

Among respondents who consider that women abort a child or a fetus related to the time of abortion, 37.5% have considered that the difference between a baby and a fetus appears after 14 weeks of pregnancy (the period legally accepted for abortion). Thirty-three percent of them have mentioned that the distinction should be performed at the first few heartbeats; 18.1% think it is about when the child has all the features definitively outlined and can move by himself; 2.8% consider that the difference appears when the first encephalopathy traces are being felt and the child has formed all internal and external organs. A percentage of 1.7% of respondents consider that this difference occurs at the beginning of the central nervous system, and 1.4% when the unborn child has all the features that we can clearly see to a newborn child (Table ​ (Table9 9 ).

The opinion on the moment that makes the difference between a fetus and a child

We noticed that highly religious people make a clear association between abortion and crime. They also consider that at the time of pregnancy interruption it is aborted a child and not a fetus. However, unexpectedly, we noticed that 27% of the women, who declare themselves to be very religious, have also stated that they see abortion as a crime but also as a woman’s right. Thirty-one percent of the women, who also claimed profound religious beliefs, consider that abortion may be associated with the abortion of a child but also of a fetus, this depending on the time of abortion (Tables ​ (Tables10 10 and ​ and11 11 ).

The correlation between the level of religious beliefs and the perspective on abortion seen as a crime or a right

The correlation between the level of religious beliefs and the perspective on abortion procedure conducted on a fetus or a child

More than half of the respondents have opted for the main reason for abortion the appearance of medical problems to the child. Baby’s health represents the main concern of future mothers, and of each parent, and the birth of a child with serious health issues, is a factor which frightens any future parent, being many times, at least theoretically, one good reason for opting for abortion. At the opposite side, 12% of respondents would not choose abortion under any circumstances. Other reasons for which women would opt for an abortion are: if the woman would have a medical problem (22%) or would not want the child (10%) (Table ​ (Table12 12 ).

Potential reasons for carrying out an abortion

Most of the women want to give birth to a child, 56% of the respondents, representing also the reason that would determine them to keep the child. Morality (26%), faith (10%) or legal restrictions (4%), are the three other reasons for which women would not interrupt a pregnancy. Only 2% of the respondents have mentioned other reasons such as health or age.

A percentage of 23% of the surveyed people said that they have done an abortion so far, and 77% did not opted for a surgical intervention either because there was no need, or because they have kept the pregnancy (Table ​ (Table13 13 ).

Rate of abortion among women in the sample

Most respondents, 87% specified that they have carried out an abortion during the first 14 weeks – legally accepted limit for abortion: 43.6% have made abortion in the first four weeks, 39.1% between weeks 4–8, and 4.3% between weeks 8–14. It should be noted that 8.7% could not appreciate the pregnancy period in which they carried out abortion, by opting to answer with the option “ I don’t know ”, and a percentage of 4.3% refused to answer to this question.

Performing an abortion is based on many reasons, but the fact that the women have not wanted a child is the main reason mentioned by 47.8% of people surveyed, who have done minimum an abortion so far. Among the reasons for the interruption of pregnancy, it is also included: women with medical problems (13.3%), not the right time to be a mother (10.7%), age motivation (8.7%), due to medical problems of the child (4.3%), the lack of money (4.3%), family pressure (4.3%), partner/spouse did not wanted. A percentage of 3.3% of women had different reasons for abortion, as follows: age difference too large between children, career, marital status, etc. Asked later whether they regretted the abortion, a rate of 69.6% of women who said they had at least one abortion regret it (34.8% opted for “ Yes ”, and 34.8% said “ Yes, partially ”). 26.1% of surveyed women do not regret the choice to interrupted the pregnancy, and 4.3% chose to not answer this question. We noted that, for women who have already experienced abortion, the causes were more diverse than the grounds on which the previous question was asked: “What are the reasons that determined you to have an abortion?” (Table ​ (Table14 14 ).

The reasons that led the women in the sample to have an abortion

The majority of the respondents (37.5%) considered that “nervous depression” is the main consequence of abortion, followed by “insomnia and nightmares” (24.6%), “disorders in alimentation” and “affective disorders” (each for 7.7% of respondents), “deterioration of interpersonal relationships” and “the feeling of guilt”(for 6.3% of the respondents), “sexual disorders” and “panic attacks” (for 6.3% of the respondents) (Table ​ (Table15 15 ).

Opinion on the consequences of abortion

Over half of the respondents believe that abortion should be legal in certain circumstances, as currently provided by law, 39% say it should be always legal, and only 6% opted for the illegal option (Table ​ (Table16 16 ).

Opinion on the legal regulation of abortion

Although the current legislation does not punish pregnant women who interrupt pregnancy or intentionally injured their fetus, survey results indicate that 61% of women surveyed believe that the national law should punish the woman and only 28% agree with the current legislation (Table ​ (Table17 17 ).

Opinion on the possibility of punishing the woman who interrupts the course of pregnancy or injures the fetus

For the majority of the respondents (40.6%), the penalty provided by the current legislation, the imprisonment between six months and three years or a fine and deprivation of certain rights for the illegal abortion is considered fair, for a percentage of 39.6% the punishment is too small for 9.5% of the respondents is too high. Imprisonment between two and seven years and deprivation of certain rights for an abortion performed without the consent of the pregnant woman is considered too small for 65% of interviewees. Fourteen percent of them think it is fair and only 19% of respondents consider that Romanian legislation is too severe with people who commit such an act considering the punishment as too much. The imprisonment from three to 10 years and deprivation of certain rights for the facts described above, if an injury was caused to the woman, is considered to be too small for more than half of those included in the survey, 64% and almost 22% for nearly a quarter of them. Only 9% of the respondents mentioned that this legislative measure is too severe for such actions (Table ​ (Table18 18 ).

Opinion on the regulation of abortion of the Romanian Criminal Code (Art. 201)

Conclusions

After analyzing the results of the sociological research regarding abortion undertaken at national level, we see that 76% of the Romanian women accept abortion, indicating that the majority accepts only certain circumstances (a certain period after conception, for medical reasons, etc.). A percentage of 64% of the respondents indicated that they accept the idea of abortion after 14 weeks of pregnancy (for solid reasons or regardless the reason). This study shows that over 50% of Romanian women see abortion as a right of women but also a woman’s crime and believe that in the moment of interruption of a pregnancy, a fetus is aborted. Mostly, the association of abortion with crime and with the idea that a child is aborted is frequently found within very religious people. The main motivation for Romanian women in taking the decision not to perform an abortion is that they would want the child, and the main reason to perform an abortion is the child’s medical problems. However, it is noted that, in real situations, in which women have already done at least one abortion, most women resort to abortion because they did not want the child towards the hypothetical situation in which women felt that the main reason of abortion is a medical problem. Regarding the satisfaction with the current national legislation of the abortion, the situation is rather surprising. A significant percentage (61%) of respondents felt as necessary to punish the woman who performs an illegal abortion, although the legislation does not provide a punishment. On the other hand, satisfaction level to the penalties provided by law for various violations of the legal conditions for conducting abortion is low, on average only 25.5% of respondents are being satisfied with these, the majority (average 56.2%) considering the penalties as unsatisfactory. Understood as a social phenomenon, intensified by human vulnerabilities, of which the most obvious is accepting the comfort [ 48 ], abortion today is no longer, in Romanian society, from a legal or religious perspective, a problem. Perceptions on the legislative sanction, moral and religious will perpetual vary depending on beliefs, environment, education, etc. The only and the biggest social problem of Romania is truly represented by the steadily falling birth rate.

Conflict of interests

The authors declare that they have no conflict of interests.

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5.1: Arguments Against Abortion

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• Nathan Nobis & Kristina Grob
• Morehouse College & University of South Carolina Sumter via Open Philosophy Press

We will begin with arguments for the conclusion that abortion is generally wrong , perhaps nearly always wrong . These can be seen as reasons to believe fetuses have the “right to life” or are otherwise seriously wrong to kill.

5.1.1 Fetuses are human

First, there is the claim that fetuses are “human” and so abortion is wrong. People sometimes debate whether fetuses are human , but fetuses found in (human) women clearly are biologically human : they aren’t cats or dogs. And so we have this argument, with a clearly true first premise:

Fetuses are biologically human.

All things that are biologically human are wrong to kill.

Therefore, fetuses are wrong to kill.

The second premise, however, is false, as easy counterexamples show. Consider some random living biologically human cells or tissues in a petri dish. It wouldn’t be wrong at all to wash those cells or tissues down the drain, killing them; scratching yourself or shaving might kill some biologically human skin cells, but that’s not wrong; a tumor might be biologically human, but not wrong to kill. So just because something is biologically human, that does not at all mean it’s wrong to kill that thing. We saw this same point about what’s merely biologically alive.

This suggests a deficiency in some common understandings of the important idea of “human rights.” “Human rights” are sometimes described as rights someone has just because they are human or simply in virtue of being human .

But the human cells in the petri dish above don’t have “human rights” and a human heart wouldn’t have “human rights” either. Many examples would make it clear that merely being biologically human doesn’t give something human rights. And many human rights advocates do not think that abortion is wrong, despite recognizing that (human) fetuses are biologically human.

The problem about what is often said about human rights is that people often do not think about what makes human beings have rights or why we have them, when we have them. The common explanation, that we have (human) rights just because we are (biologically) human , is incorrect, as the above discussion makes clear. This misunderstanding of the basis or foundation of human rights is problematic because it leads to a widespread, misplaced fixation on whether fetuses are merely biologically “human” and the mistaken thought that if they are, they have “human rights.” To address this problem, we need to identify better, more fundamental, explanations why we have rights, or why killing us is generally wrong, and see how those explanations might apply to fetuses, as we are doing here.

It might be that when people appeal to the importance and value of being “human,” the concern isn’t our biology itself, but the psychological characteristics that many human beings have: consciousness, awareness, feelings and so on. We will discuss this different meaning of “human” below. This meaning of “human” might be better expressed as conscious being , or “person,” or human person. This might be what people have in mind when they argue that fetuses aren’t even “human.”

Human rights are vitally important, and we would do better if we spoke in terms of “conscious-being rights” or “person-rights,” not “human rights.” This more accurate and informed understanding and terminology would help address human rights issues in general, and help us better think through ethical questions about biologically human embryos and fetuses.

5.1.2 Fetuses are human beings

Some respond to the arguments above—against the significance of being merely biologically human—by observing that fetuses aren’t just mere human cells, but are organized in ways that make them beings or organisms . (A kidney is part of a “being,” but the “being” is the whole organism.) That suggests this argument:

Fetuses are human beings or organisms .

All human beings or organisms are wrong to kill.

Therefore, fetuses are wrong to kill, so abortion is wrong.

The first premise is true: fetuses are dependent beings, but dependent beings are still beings.

The second premise, however, is the challenge, in terms of providing good reasons to accept it. Clearly many human beings or organisms are wrong to kill, or wrong to kill unless there’s a good reason that would justify that killing, e.g., self-defense. (This is often described by philosophers as us being prima facie wrong to kill, in contrast to absolutely or necessarily wrong to kill.) Why is this though? What makes us wrong to kill? And do these answers suggest that all human beings or organisms are wrong to kill?

Above it was argued that we are wrong to kill because we are conscious and feeling: we are aware of the world, have feelings and our perspectives can go better or worse for us —we can be harmed— and that’s what makes killing us wrong. It may also sometimes be not wrong to let us die, and perhaps even kill us, if we come to completely and permanently lacking consciousness, say from major brain damage or a coma, since we can’t be harmed by death anymore: we might even be described as dead in the sense of being “brain dead.” 10

So, on this explanation, human beings are wrong to kill, when they are wrong to kill, not because they are human beings (a circular explanation), but because we have psychological, mental or emotional characteristics like these. This explains why we have rights in a simple, common-sense way: it also simply explains why rocks, microorganisms and plants don’t have rights. The challenge then is explaining why fetuses that have never been conscious or had any feeling or awareness would be wrong to kill. How then can the second premise above, general to all human organisms, be supported, especially when applied to early fetuses?

One common attempt is to argue that early fetuses are wrong to kill because there is continuous development from fetuses to us, and since we are wrong to kill now , fetuses are also wrong to kill, since we’ve been the “same being” all along. 11 But this can’t be good reasoning, since we have many physical, cognitive, emotional and moral characteristics now that we lacked as fetuses (and as children). So even if we are the “same being” over time, even if we were once early fetuses, that doesn’t show that fetuses have the moral rights that babies, children and adults have: we, our bodies and our rights sometimes change.

A second attempt proposes that rights are essential to human organisms: they have them whenever they exist. This perspective sees having rights, or the characteristics that make someone have rights, as essential to living human organisms. The claim is that “having rights” is an essential property of human beings or organisms, and so whenever there’s a living human organism, there’s someone with rights, even if that organism totally lacks consciousness, like an early fetus. (In contrast, the proposal we advocate for about what makes us have rights understands rights as “accidental” to our bodies but “essential” to our minds or awareness, since our bodies haven’t always “contained” a conscious being, so to speak.)

Such a view supports the premise above; maybe it just is that premise above. But why believe that rights are essential to human organisms? Some argue this is because of what “kind” of beings we are, which is often presumed to be “rational beings.” The reasoning seems to be this: first, that rights come from being a rational being: this is part of our “nature.” Second, that all human organisms, including fetuses, are the “kind” of being that is a “rational being,” so every being of the “kind” rational being has rights. 12

In response, this explanation might seem question-begging: it might amount to just asserting that all human beings have rights. This explanation is, at least, abstract. It seems to involve some categorization and a claim that everyone who is in a certain category has some of the same moral characteristics that others in that category have, but because of a characteristic (actual rationality) that only these others have: so, these others profoundly define what everyone else is . If this makes sense, why not also categorize us all as not rational beings , if we are the same kind of beings as fetuses that are actually not rational?

This explanation might seem to involve thinking that rights somehow “trickle down” from later rationality to our embryonic origins, and so what we have later we also have earlier , because we are the same being or the same “kind” of being. But this idea is, in general, doubtful: we are now responsible beings, in part because we are rational beings, but fetuses aren’t responsible for anything. And we are now able to engage in moral reasoning since we are rational beings, but fetuses don’t have the “rights” that uniquely depend on moral reasoning abilities. So that an individual is a member of some general group or kind doesn’t tell us much about their rights: that depends on the actual details about that individual, beyond their being members of a group or kind.

To make this more concrete, return to the permanently comatose individuals mentioned above: are we the same kind of beings, of the same “essence,” as these human beings? If so, then it seems that some human beings can be not wrong to let die or kill, when they have lost consciousness. Therefore, perhaps some other human beings, like early fetuses, are also not wrong to kill before they have gained consciousness . And if we are not the same “kind” of beings, or have different essences, then perhaps we also aren’t the same kind of beings as fetuses either.

Similar questions arise concerning anencephalic babies, tragically born without most of their brains: are they the same “kind” of beings as “regular” babies or us? If so, then—since such babies are arguably morally permissible to let die, even when they could be kept alive, since being alive does them no good—then being of our “kind” doesn’t mean the individual has the same rights as us, since letting us die would be wrong. But if such babies are a different “kind” of beings than us, then pre-conscious fetuses might be of a relevantly different kind also.

So, in general, this proposal that early fetuses essentially have rights is suspect, if we evaluate the reasons given in its support. Even if fetuses and us are the same “kind” of beings (which perhaps we are not!) that doesn’t immediately tell us what rights fetuses would have, if any. And we might even reasonably think that, despite our being the same kind of beings as fetuses (e.g., the same kind of biology), we are also importantly different kinds of beings (e.g., one kind with a mental life and another kind which has never had it). This photograph of a 6-week old fetus might help bring out the ambiguity in what kinds of beings we all are:

In sum, the abstract view that all human organisms have rights essentially needs to be plausibly explained and defended. We need to understand how it really works. We need to be shown why it’s a better explanation, all things considered, than a consciousness and feelings-based theory of rights that simply explains why we, and babies, have rights, why racism, sexism and other forms of clearly wrongful discrimination are wrong, and , importantly, how we might lose rights in irreversible coma cases (if people always retained the right to life in these circumstances, presumably, it would be wrong to let anyone die), and more.

5.1.3 Fetuses are persons

Finally, we get to what some see as the core issue here, namely whether fetuses are persons , and an argument like this:

Fetuses are persons, perhaps from conception.

Persons have the right to life and are wrong to kill.

So, abortion is wrong, as it involves killing persons.

The second premise seems very plausible, but there are some important complications about it that will be discussed later. So let’s focus on the idea of personhood and whether any fetuses are persons. What is it to be a person ? One answer that everyone can agree on is that persons are beings with rights and value . That’s a fine answer, but it takes us back to the initial question: OK, who or what has the rights and value of persons? What makes someone or something a person?

Answers here are often merely asserted , but these answers need to be tested: definitions can be judged in terms of whether they fit how a word is used. We might begin by thinking about what makes us persons. Consider this:

We are persons now. Either we will always be persons or we will cease being persons. If we will cease to be persons, what can end our personhood? If we will always be persons, how could that be?

Both options yield insight into personhood. Many people think that their personhood ends at death or if they were to go into a permanent coma: their body is (biologically) alive but the person is gone: that is why other people are sad. And if we continue to exist after the death of our bodies, as some religions maintain, what continues to exist? The person , perhaps even without a body, some think! Both responses suggest that personhood is defined by a rough and vague set of psychological or mental, rational and emotional characteristics: consciousness, knowledge, memories, and ways of communicating, all psychologically unified by a unique personality.

A second activity supports this understanding:

Make a list of things that are definitely not persons . Make a list of individuals who definitely are persons . Make a list of imaginary or fictional personified beings which, if existed, would be persons: these beings that fit or display the concept of person, even if they don’t exist. What explains the patterns of the lists?

Rocks, carrots, cups and dead gnats are clearly not persons. We are persons. Science fiction gives us ideas of personified beings: to give something the traits of a person is to indicate what the traits of persons are, so personified beings give insights into what it is to be a person. Even though the non-human characters from, say, Star Wars don’t exist, they fit the concept of person: we could befriend them, work with them, and so on, and we could only do that with persons. A common idea of God is that of an immaterial person who has exceptional power, knowledge, and goodness: you couldn’t pray to a rock and hope that rock would respond: you could only pray to a person. Are conscious and feeling animals, like chimpanzees, dolphins, cats, dogs, chickens, pigs, and cows more relevantly like us, as persons, or are they more like rocks and cabbages, non-persons? Conscious and feeling animals seem to be closer to persons than not. 13 So, this classificatory and explanatory activity further supports a psychological understanding of personhood: persons are, at root, conscious, aware and feeling beings.

Concerning abortion, early fetuses would not be persons on this account: they are not yet conscious or aware since their brains and nervous systems are either non-existent or insufficiently developed. Consciousness emerges in fetuses much later in pregnancy, likely after the first trimester or a bit beyond. This is after when most abortions occur. Most abortions, then, do not involve killing a person , since the fetus has not developed the characteristics for personhood. We will briefly discuss later abortions, that potentially affect fetuses who are persons or close to it, below.

It is perhaps worthwhile to notice though that if someone believed that fetuses are persons and thought this makes abortion wrong, it’s unclear how they could coherently believe that a pregnancy resulting from rape or incest could permissibly be ended by an abortion. Some who oppose abortion argue that, since you are a person, it would be wrong to kill you now even if you were conceived because of a rape, and so it’s wrong to kill any fetus who is a person, even if they exist because of a rape: whether someone is a person or not doesn’t depend on their origins: it would make no sense to think that, for two otherwise identical fetuses, one is a person but the other isn’t, because that one was conceived by rape. Therefore, those who accept a “personhood argument” against abortion, yet think that abortions in cases of rape are acceptable, seem to have an inconsistent view.

5.1.4 Fetuses are potential persons

If fetuses aren’t persons, they are at least potential persons, meaning they could and would become persons. This is true. This, however, doesn’t mean that they currently have the rights of persons because, in general, potential things of a kind don’t have the rights of actual things of that kind : potential doctors, lawyers, judges, presidents, voters, veterans, adults, parents, spouses, graduates, moral reasoners and more don’t have the rights of actual individuals of those kinds.

Some respond that potential gives the right to at least try to become something. But that trying sometimes involves the cooperation of others: if your friend is a potential medical student, but only if you tutor her for many hours a day, are you obligated to tutor her? If my child is a potential NASCAR champion, am I obligated to buy her a race car to practice? ‘No’ to both and so it is unclear that a pregnant woman would be obligated to provide what’s necessary to bring about a fetus’s potential. (More on that below, concerning the what obligations the right to life imposes on others, in terms of obligations to assist other people.)

5.1.5 Abortion prevents fetuses from experiencing their valuable futures

The argument against abortion that is likely most-discussed by philosophers comes from philosopher Don Marquis. 14 He argues that it is wrong to kill us, typical adults and children, because it deprives us from experiencing our (expected to be) valuable futures, which is a great loss to us . He argues that since fetuses also have valuable futures (“futures like ours” he calls them), they are also wrong to kill. His argument has much to recommend it, but there are reasons to doubt it as well.

First, fetuses don’t seem to have futures like our futures , since—as they are pre-conscious—they are entirely psychologically disconnected from any future experiences: there is no (even broken) chain of experiences from the fetus to that future person’s experiences. Babies are, at least, aware of the current moment, which leads to the next moment; children and adults think about and plan for their futures, but fetuses cannot do these things, being completely unconscious and without a mind.

Second, this fact might even mean that the early fetus doesn’t literally have a future: if your future couldn’t include you being a merely physical, non-conscious object (e.g., you couldn’t be a corpse: if there’s a corpse, you are gone), then non-conscious physical objects, like a fetus, couldn’t literally be a future person. 15 If this is correct, early fetuses don’t even have futures, much less futures like ours. Something would have a future, like ours, only when there is someone there to be psychologically connected to that future: that someone arrives later in pregnancy, after when most abortions occur.

A third objection is more abstract and depends on the “metaphysics” of objects. It begins with the observation that there are single objects with parts with space between them . Indeed almost every object is like this, if you could look close enough: it’s not just single dinette sets, since there is literally some space between the parts of most physical objects. From this, it follows that there seem to be single objects such as an-egg-and-the-sperm-that-would-fertilize-it . And these would also seem to have a future of value, given how Marquis describes this concept. (It should be made clear that sperm and eggs alone do not have futures of value, and Marquis does not claim they do: this is not the objection here). The problem is that contraception, even by abstinence , prevents that thing’s future of value from materializing, and so seems to be wrong when we use Marquis’s reasoning. Since contraception is not wrong, but his general premise suggests that it is , it seems that preventing something from experiencing its valuable future isn’t always wrong and so Marquis’s argument appears to be unsound. 16

In sum, these are some of the most influential arguments against abortion. Our discussion was brief, but these arguments do not appear to be successful: they do not show that abortion is wrong, much less make it clear and obvious that abortion is wrong.

Legalized Abortion and the Public Health: Report of a Study (1975)

Chapter: summary and conclusions.

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

SUMMARY AND CONCLUSIONS The legal status of abortion in the United States became a heightened national issue with the January 1973 rulings by the Supreme Court that severely limited states' rights to control the procedure. The Court's decisions on the historic cases of Roe v. Wade and Doe v. Bolton precluded any state interference with the doctor-patient decision on abortion during the first trimester (three months) of pregnancy. During the second trimester, a state could intervene only to the extent of insisting on safe medical practices "reasonably related to maternal health." And for approximately the final trimester of a pregnancy—what the Court called "the state subsequent to viability" of a fetus—a state could forbid abortion unless medical judgment found it necessary "for the preservation of the life or health of the mother." The rulings crystallized opposition to abortion, led to the intro- duction of national and state legislation to curtail or prohibit it, and generated political pressures for a national debate on the issue. Against this background of concerns about abortion, the Institute of Medicine in 1974 called together a committee to review the existing evidence on the relationship between legalized abortion and the health of the public. The study group was asked to examine the medical risks to women who obtained legal abortions, and to document changes in the risks as legal abortion became more available. Although there have been other publications on particular relationships between abortion and health, the Institute's study is an attempt to enlist scholars, researchers, health practitioners, and concerned lay persons in a more comprehensive analysis of the available medical information on the subject. Ethical issues of abortion are not discussed in this analysis, nor are questions concerning the fetus in abortion. The study group recog- nizes that this approach implies an ethical position with which some may disagree. The emphasis of the study is on the health effects of abortion, not on the alternatives to abortion.

Abortion legislation and practices are important factors in the relationship between abortion and health status. In order to examine legislation and court decisions that have affected the availability of legal abortion in the U.S., the study group classified the laws and practices into three categories: restrictive conditions, under which abortion is prohibited or permitted only to save the pregnant woman's life; moderately restrictive conditions, under which abortion is per- mitted with approval by several physicians, in a wider range of circumstances to preserve the woman's physical or mental health, prevent the birth of a child with severe genetic or congenital defects, or terminate a pregnancy caused by rape or incest; and non-restrictive conditions, under which abortion essentially is available according to the terms of the Supreme Court ruling. Before 1967, all abortion laws in the United States could be classified as restrictive. Easing of restrictions began in 1967 with Colorado, and soon thereafter 12 other states also adopted moderately restrictive legislation to expand the conditions under which therapeutic abortion could be obtained. In 1970, four states (Alaska, Hawaii, New York, and Washington) removed nearly all legal controls on abortion. Non-restrictive conditions have theoretically existed throughout all fifty states since January 22, 1973, the date of the Supreme Court decision. There is evidence that substantial numbers of illegal abortions were obtained in the U.S. when restrictive laws were in force. Although some of the illegal abortions were performed covertly by physicians in medical settings, many were conducted in unsanitary surroundings by unskilled operators or were self-induced. In this report, "illegal abortion" generally refers to those performed by a non-physician or the woman herself. The medical risks associated with the last two types of illegal abortions are patently greater than with the first. A recent analysis of data from the first year of New York's non- restrictive abortion legislation indicates that approximately 70 percent of the abortions obtained legally in New York City would otherwise have been obtained illegally. Replacement of legal for illegal abortions also is reflected in the substantial decline in the number of reported complications and deaths due to other-than-legal abortions since non- restrictive practices began to be implemented in the United States. The number of all known abortion-related deaths declined from 128 in 1970 to 47 in 1973; those deaths specifically attributed to other-than-legal abortions (i.e., both illegal and spontaneous) dropped from 111 to 25 during the same period, with much of that decline attributed to a reduced incidence of illegal abortions. Increased use of effective con- traception may also have played a role in the decline of abortion-related deaths. Methods most frequently used in the United States to induce abortion during the first trimester of pregnancy are suction (vacuum aspiration) or dilatation and curettage (D&C). Abortions in the second trimester are usually performed by replacing part of the amniotic fluid that surrounds

the fetus with a concentrated salt solution (saline abortion), which usually induces labor 24 to 48 hours later. Other second trimester methods are hysterotomy, a surgical entry into the uterus; hysterectomy, which is the removal of the uterus; and, recently, the injection into the uterine cavity of a prostaglandin, a substance that causes muscular contractions that expel the fetus. Statistics on legal abortion are collected for the U.S. government by the Center for Disease Control. CDC's most recent nationwide data are for 1973, the year of the Supreme Court decision. Some of those figures are: — The 615,800 legal abortions reported in 1973 were an increase of approximately 29,000 over the number reported in 1972. These probably are underestimates of the actual number of abortions performed because some states have not yet developed adequate abortion reporting systems. — The abortion ratio (number of abortions per 1,000 live births) increased from 180 in 1972 to 195 in 1973. — More than four out of five abortions were performed in the first trimester, most often by suction or D&C. — Approximately 25 percent of the reported 1973 abortions were obtained outside the woman's home state. In 1972, before the Supreme Court decision, 44 percent of the reported abortions had been obtained outside the home state of the patient, primarily in New York and the District of Columbia. — Approximately one-third of the women obtaining abortions were less than 20 years old, another third were between 20 and 25, and the remaining third over 25 years of age. — In all states where data were available, about 25 percent of the women obtaining abortions were married. — White women obtained 68 percent of all reported abortions, but non-white women had abortion ratios about one-third greater than white women. In 1972, non-white women had abortion rates (abortions per 1,000 women of reproductive age) about twice those of whites in three states from which data were available to analyze. A national survey of hospitals, clinics, and physicians conducted in 1974 by The Alan Guttmacher Institute furnished data on the number of abortions performed in the U.S. during 1973, itemized by state and type of provider. A total of 745,400 abortions were reported in the survey, a figure higher than the 615,800 abortions reported in 1973 to CDC. The Guttmacher Institute obtains its data from providers of health services, while CDC gets most of its data from state health departments.

Risks of medical complications associated with legal abortions are difficult to evaluate because of problems of definition and subjective physician judgment. Available information from 66 centers is provided by the Joint Program for the Study of Abortion, undertaken by The Population Council in 1970-1971. The JPSA study surveyed almost 73,000 legal abortions. It used a restricted definition of major complications, which included unintended major surgery, one or more blood transfusions, three or more days of fever, and several other categories involving prolonged illness or permanent impairment. Although this study also collected data on minor complica- tions, such as one day of fever post-operatively, the data on major com- plications are probably more significant. The major complication rates published by the JPSA study and summarized below relate to women who had abortions in local facilities and from whom follow-up information was obtained. — Complications in women not obtaining concurrent sterilization and with no pre-existing medical problems (e.g., diabetes, heart disease, or gynecological problems) occurred 0.6 times per 100 abortions in the first trimester and 2.1 per 100 in the second trimester. — Complications in women not obtaining concurrent sterilization, but having pre-existing problems, occurred 2.0 times per 100 in the first trimester and 6.7 in the second. — Complications in women obtaining concurrent sterilization and not having pre-existing problems occurred 7.2 times per 100 in the first trimester and 8.0 in the second. — Women with both concurrent sterilization and pre-existing problems experienced complications approximately 17 times per 100 abortions regardless of trimester. The relatively high complication rates associated with sterilization in the JPSA study would probably be lower today because new sterilization techniques require minimal surgery and carry lower rates of complications. The frequency of medical complications due to illegal abortions cannot be calculated precisely, but the trend in these complications can be estimated from the number of hospital admissions due to septic and incomplete abortion—two adverse consequences of the illegal procedure.

The number of such admissions in New York City's municipal hospitals declined from 6,524 in 1969 to 3,253 in 1973; most restrictions on legal abortion in New York City were lifted in July of 1970. In Los Angeles, the number of reported hospital admissions for septic abortions declined from 559 in 1969 to 119 in 1971. Other factors, such as an increased use of effective contraception and a decreasing rate of unwanted pregnancies may have contributed to these declines, but it is probable that the introduction of less restrictive abortion legislation was a major factor. There has not been enough experience with legal abortion in the U.S. for conclusions to be drawn about long-term complications, particularly for women obtaining repeated legal abortions. Some studies from abroad suggest that long-term complications may include prematurity, miscarriage, or ectopic pregnancies in future pregnancies, or infertility. But research findings from countries having long experience with legal abortion are inconsistent among studies and the relevance of these data to the U.S. is not known; methods of abortion, medical services, and socio-economic characteristics vary from one country to another. Risks of maternal death associated with legal abortion are low—1.7 deaths per 100,000 first trimester procedures in 1972 and 1973—and less than the risks associated with illegal abortion, full-term pregnancy, and most surgical procedures. The 1973 mortality rate for a full-term pregnancy was 14 deaths per 100,000 live vaginal deliveries; the 1969 rate for cesarean sections was 111 deaths per 100,000 deliveries. For second trimester abortions, the combined 1972-73 mortality ratio was 12.2 deaths per 100,000 abortions. (For comparison, the surgical removal of the tonsils and adenoids had a mortality risk of five deaths per 100,000 operations in 1969). When the mortality risk of legal abortion is examined by length of gestation it becomes apparent that the mortality risks increase not only from the first to the second trimester, but also by each week of ges- tation. For example, during 1972-73, the mortality ratio for legal abortions performed at eight weeks or less was 0.5, and for those performed between nine and 10 weeks was 1.7 deaths per 100,000 legal abortions. At 11 to 12 weeks the mortality ratio increased to 4.2 deaths, and by 16 to 20 weeks, the ratio was more than 17 deaths per 100,000 abortions. Hysterotomy and hysterectomy, methods performed infrequently in both trimesters, had a combined mortality ratio of 61.3 deaths per 100,000 procedures. Some data on the mortality associated with illegal abortion are avail- lable from the National Center for Health Statistics (NCHS) and from CDC. In 1961 there were 320 abortion-related deaths reported in the U.S., most of them presumed by the medical profession to be from illegal abortion. By 1973, total reported deaths had declined to 47, of which 16 were specifi- cally attributed to illegal abortions. There has been a steady decline in the mortality rates (number of deaths per 100,000 women aged 15-44) associated with other-than-legal abortion for both white and non-white women, but in 1973 the mortality rate for non-white women (0.29) was almost ten times greater than that reported for white women (0.03).

Psychological effects of legal abortion are difficult to evaluate for reasons that include lack of information on pre-abortion psychological status, ambiguous terminology, and the absence of standardized measurements. The cumulative evidence in recent years indicates that although it may be a stressful experience, abortion is not associated with any detectable increase in the incidence of mental illness. The depression or guilt feelings reported by some women following abortion are generally described as mild and temporary. This experience, however, does not necessarily apply to women with a previous history of psychiatric illness; for them, abortion may be followed by continued or aggravated mental illness. The JPSA survey led to an estimate of the incidence of post-abortion psychosis ranging from 0.2 to 0.4 per 1,000 legal abortions. This is lower than the post-partum psychosis rate of one to two per 1,000 deliveries in the United States. Psychological factors also bear on whether a woman obtains a first or second-trimester abortion. Two studies in particular suggest that women who delay abortion into the later period may have more feelings of ambiva- lence, denial of the pregnancy, or objection on religious grounds, than those obtaining abortions in the first trimester. It is also apparent, however, that some second-trimester abortions result from procedural delays, difficulties in obtaining a pregnancy test, locating appropriate counseling, or arranging and financing the procedure. Diagnosis of severe defects of a fetus well before birth has greatly advanced in the past decade. Developments in the techniques of amniocen- tesis and cell culture have enabled a number of genetic defects and other congenital disorders to be detected in the second trimester of pregnancy. Prenatal diagnosis and the opportunity to terminate an affected pregnancy by a legal abortion may help many women who would have refrained from becoming pregnant or might have given birth to an abnormal child, to bear children unaffected by the disease they fear. Abortion, with or with- out prenatal diagnosis, also can be used in instances where there is reasonable risk that the fetus may be affected by birth defects from non-genetic causes, such as those caused by exposure of the woman to rubella virus infection or x-rays, or by her ingestion of drugs known to damage the fetus. Almost 60 inherited metabolic disorders, such as Tay-Sachs disease, potentially can be diagnosed before birth. More than 20 of these diseases already have been diagnosed with reasonaable accuracy by means of amniocentesis and other procedures. The techniques also can be used to identify a fetus with abnormal chromosomes, as in Down's syndrome (mongolism), and to discriminate between male and female fetuses, which in such diseases as hemophilia would allow determination of whether the fetus was at risk of being affected or simply at risk of being a hereditary carrier of the disorder.

In North America, amniocentesis was performed in more than 6,000 second-trimester pregnancies between 1967 and 1974. The diagnostic accuracy was close to 100 percent and complication rates were about two percent. Less than 10 percent of the diagnoses disclosed an affected fetus, meaning that the great majority of parents at risk averted an unnecessary abortion and were able to carry an unaffected child to term. There are many limitations to the use of prenatal diagnosis, especially for mass screening purposes. Amniocentesis is a fairly expensive procedure, and relatively few medical personnel are qualified to administer it and carry out the necessary diagnostic tests. Only a small number of genetic disorders can now be identified by means of amniocentesis and many couples still have no way to determine whether or not they are to be the parents of a child with genetic defects. Nevertheless, the avail- ability of a legal abortion expands the options available to a woman who faces a known risk of having an affected child. Abortion as a substitute for contraception is one possibility raised by the adoption of non-restrictive abortion laws. Limited data do not allow definitive conclusions, but they suggest that the introduction of non-restrictive abortion laws in the U.S. has not lead to any documented decline in demand for contraceptive services. Among women who sought abortion and who had previously not used contraception or had used it poorly, there is some evidence that they may have begun to practice contraception because contraceptives were made available to them at the time of their abortion. The health aspects of this issue bear on the higher mortality and mor- bidity associated with abortion as compared with contraceptive use, and on the possibility that if women rely on abortion rather than contraception they may have repeated abortions, for which the risk of long-term compli- cations is not known. The incidence of repeated legal abortions is little known because legal abortion has only been widely available in the U.S. for a few years. Data from New York City indicate that during the first two years of non-restrictive laws 2.45 percent of the abortions obtained by residents were repeat procedures. If those two years are divided into six-month periods, repeated legal abortions as a percent of the total rose from 0.01 percent in the first period to 6.02 percent in the last. Part of this increase is attributable to a statistical fact: the longer non-restrictive laws are in effect, the greater the number of women eligible to have repeated legal abortions. Perhaps, too, the reporting system has improved. In any case, some low incidence of repeated abortions is to be expected because none of the current contraceptive methods is completely failureproof, nor are they likely to be used with maximum care on all occasions.

8 A recent study has suggested that one additional factor contributing to the incidence of repeated abortions is that abortion facilities may not routinely provide contraceptive services at the time of the procedure. This is of concern because of recent evidence that ovulation usually oc- curs within five weeks and perhaps as early as 10 days after an abortion. The conclusions of the study group: — Many women will seek to terminate an unwanted pregnancy by abortion whether it is legal or not. Although the mortality and morbidity . associated with illegal abortion cannot be fully measured, they are clearly greater than the risks associated with legal abortion. Evidence suggests that legislation and practices that permit women to obtain abortions in proper medical surroundings will lead to fewer deaths and a lower rate of medical complications than restrictive legislation and practices. —• The substantial differences between the mortality and morbidity associated with legal abortion in the first and second trimesters suggest that laws, medical practices, and educational programs should enable and encourage women who have chosen abortion to obtain it in the first three months of pregnancy. — More research is needed on the consequences of abortion on health status. Of highest priority are investigations of long-term medical complications, particularly after multiple abortions the effects of abortion and denied abortion on the mental health and social welfare of individuals and families the factors of motivation, behavior, and access associated with contraceptive use and the choice of abortion.

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Abortion - List of Free Essay Examples And Topic Ideas

Abortion is a highly contentious issue with significant moral, legal, and social implications. Essays on abortion could explore the various aspects of the debate including the ethical dimensions, the legal frameworks governing abortion, and the social attitudes surrounding it. They might delve into historical changes in public opinion, the different arguments presented by pro-life and pro-choice advocates, and the impact of legal rulings on the accessibility and safety of abortion services. Discussions could also explore the intersection of abortion with issues like gender equality, religious freedom, and medical ethics. We have collected a large number of free essay examples about Abortion you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Issue of Sex-Selective Abortion

Sex-selective abortion is the practice of ending a pregnancy due to the predicted gender of the baby. It has been occurring for centeriues in many countries many people believe that males are more valuable than females. This practice has been happening in many Asian countries but even in the US many Asians still hold strong to those beliefs. Due to these beleifs there is a huge shift in sex ratio in Asian countries. People are using the technology to determine […]

Abortion and Women’s Rights

In spite of women's activist desires, the matter of conceptive decision in the United States was not settled in 1973 by the important Supreme Court choice on account of Roe v. Wade. From the beginning there was animal-like restriction by the Catholic Church. Anyway, in the course of at least the last 20 years, the too early or soon birth discussion has changed into a definitely spellbound, meaningful debate between two differentiating societal talks that are moored to the problems […]

Women’s Rights in the United States in the 1970s

In the 1940’s-1960’s, there was a blurred distinction between clinical and sexual exams within the medical field (Wendy Kline, She’s Beautiful When She’s Angry). For example, many male doctors would provide pelvic exams as a means to teach women sex instruction, and were taught to assert their power over their patients. This led to women instituting new training programs for proper examinations, creating a more gentle and greatly-respected method of examining women and their bodies. There was also an increase […]

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Abortion: a Woman’s Choice

Women have long been criticized in every aspect of their lives. They have even little to no choice about how to live their lives. Much like, abortion, which is the termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus. It has been one of the most sensitive topics, society sees it as a murderous act. On, January 22, 1973, the Supreme Court ruled on making the availability of abortion […]

Abortion: the most Debated Topic

There is no question that abortion is one of the most debated topics of the last 50 years. Women all over the United States tend to feel passionately over one side or the other, either pro-choice or anti-abortion. Not one to shy away from controversial subjects, I chose this topic to shed light on both sides of the ethical and moral decision of this important issue surrounding a termination of pregnancy. There is no question the gravity of this decision, […]

Women’s Rights to Choose

Every person in the United States is granted inalienable rights, whether it be to practice their own religion or vote, which should include autonomy over their own bodies.  A woman should have the right to choose what she does with her own body, and in 1973 that became a possibility for American women.  In 1973 Roe v. Wade made it possible for women to legally choose to terminate unwanted pregnancies within their first two trimesters.  The government finally took into […]

Don Marquis’s View on Abortion

Don Marquis begins his argument of abortion being immoral by mentioning the pro-choice premise, which was that the statement of a fetus is never a person being too narrow. It's too narrow because if the fetus is never a person, then what would be the difference of a 9-month-old fetus and a newborn baby? That would just mean that infanticide isn't considered murder because a 9-month-old fetus and newborn weren't ever considered to be a person. Marquis further mentions that […]

Effects of Abortion on Young Women

Abortion is defined as the deliberate termination of a human pregnancy. It is a controversial conversation that most people avoid having.  Abortion is different than most issues in politics, because it directly impacts women, rather than men. Young women being targeted over the last forty-five years, has changed the way the public views abortion and what it does to women. A rise in physical complications, mental health problems, and the modern wave of feminism are the effects of legalized abortion […]

The Murder of Innocence

Abortion is a new generation's way of shrugging off accountability of their action at the cost of human life agreeing to the first revision to the structure that says we have the proper way to give of discourse. Me personally for one beyond any doubt that most of us would agree to the reality that ready to say and do what we need and select. For it is our choice to control of speech our conclusions. In connection, moms at […]

The History of Abortion

The history of abortion' is more complex than most people realize. There has been a lot of debate in the past few years about abortion being murder/not murder. Abortion has become illegal in most states. There are several women who believe in "pro-choice" which means they want to have a choice taking care of the baby. I, personally, believe abortion is murder. You are killing a fetus that is going to be born within months and they don't have a […]

Abortion: Go or no Go

Premature birth ends a pregnancy by killing an actual existence yet the mother isn't accused of homicide. Is this right? Shockingly, this has happened roughly twenty million times in the previous twenty years. Tragically, in South Africa, an unborn human has been slaughtered lawfully because of the nation's insufficient laws! The enemy of a honest unprotected human is a killer, accordingly, the individual merits the discipline proportional to a killer by law. Premature birth on interest just gives a mother […]

Abotion: Right or Wrong

When does a person learn right from wrong?  Is someone that knows right from wrong, different from someone who does not? These questions bring up the topic of the difference between a "Human" and a "Person". A human would be of human genetics and have a certain build. On the other hand, a human can also not be a person at certain points in the stage of life. If you can distinguish right from wrong, and are able to make […]

Let’s Talk about my Abortion Article

Why is something that requires two people, almost always considered the woman's problem? Every answer to this question is different, more aggressive in some cases, but it narrows down to basic human rights. Now you may be asking "What the hell is she talking about?" and I can assure you, we will get to that. I'd like for you to first put yourself in a situation: You're given a puppy, yet you're allergic to dogs and absolutely do not have […]

Debates on Abortion Theme

Abortion has proved to be a highly controversial topic in religion, politics, and even ethics. Its debate has caused division between factions with some supporting and others opposing its practice. This issue has also landed in the realm of philosophy where several ethicists have tried to explain why they think the method should either be supported or opposed. This essay looks at the works of Judith Thomson and Don Marquis as a representation of both sides of arguments (advocates and […]

Abortion on Teens should be Abolished

Am sure we have all heard of the girl meets boy story, where the girl falls in love with the boy despite receiving plenty of warnings and criticism from any person who has ever mattered in the girl's life. Everything is merry and life is good for the girl until one day she realizes she has missed her period and rushes to her man's home telling herself that everything will be okay. Reality checks in, hard, when the boy declines […]

The Mother and Abortion

For Gwendolyn Brooks, writing poetry that would be considered out of the ordinary and frowned upon was a common theme for her. Her widespread knowledge on subjects like race, ethnicity, gender, and even abortion placed this African American poet apart from many others. Like many poets, Brooks based many of her works on her own life experiences. Although it's unclear whether or not Brooks had an abortion herself, she creates hints and provokes strong feelings towards the issue, revealing the […]

An Issue of Women’s Reproductive Rights

We hold these truths to be self-evident: that men and women are created equal (Elizabeth Cady Stanton). In America this has been the basis of what our nation stands for. It is stated that every citizen has the right to equality that shall not be stripped away, in many cases that is not true. Whether man or women you should possess the same rights, but more often than not the women's rights are taken away. There are many instances in […]

What is Abortion

Every year, approximately 40-50 million abortions are conducted. That's about 125,000 little human beings being vacuumed, sucked out, and dissolved, everyday. That's 1 baby being aborted every 26 seconds. As of 58% of Americans think abortion should be legal.. Only 37% thinks it should be illegal in all, Or most cases. Abortion should be eliminated because it is murder, gives women mental health issues, and can cause high risks in the mother's future baby's health. There are two different types […]

The Complex Debate: Exploring Abortion Laws and their Implications

There has been a disputed discussion in history among religious, political, ethical, moral and practical grounds when it comes to the case about abortion. Abortion law forbids, allows, limits and governs the availability of abortion. Abortion laws alter to a high degree by country. For example, three countries in Latin America and two others in Europe ban the act of abortion altogether. In other countries like the United Kingdom contains the abortion act of 1967 that clarifies and prescribes abortion […]

My Beliefs on Abortion

Society today condones the killing of a life, they call it abortion, but I will try to show you why this is wrong.  Life begins at conception.  The Bible provides proof that God knew us before we were even formed.  This provides truth that what is inside a woman's body is a human life. I believe that when you decide to have an abortion, you are deciding to kill an innocent baby.  Whether you're doing it because the baby may […]

Research on Abortion Issues

The raging battle for women's rights can be found in almost every avenue of American culture. Whether it be in the workplace, in the government, in churches, or within families, females are fighting for their freedom to control their own lives. They want to work in whichever field they desire, to love whomever they want, and to make decisions for themselves. One of the biggest cases in the quarrel for feminism is the legalization of abortion. Women argue that it […]

Reasons the Constitution of Texas should be Rewritten

The constitution of Texas was written in 1876 but this constitution is not successful in this modern time. Rules and set of protocols which are written in this constitution are not valid for urban Texas these rules need to be amended. From the time of the adoption of this constitution, a total number of 653 amendments were proposed and out of these 653 a total of 474 amendments were approved by the voters and 179 were rejected. Some ?urrent political […]

Get Rid of Abortion or Not?

The world includes a huge variety of people who share different beliefs and morals, however, the Bible states that no one should judge others. One is supposed to respect another for whom they are as a person. The people in this world are beginning to divide because of the debate concerning if abortion is right, or if it is wrong. People identifying themselves to be pro-choice are in support of abortion because they believe a woman should be allowed to […]

Abortion Issues in Modern World

Premature birth alludes to the end of a pregnancy by evacuating or removing the baby or fetus from the uterus before it is prepared for birth. There are two noteworthy types of premature birth: unconstrained, which is regularly alluded to as an unsuccessful labor or the intentional fetus removal, which is frequently instigated fetus removal. The term fetus removal is normally used to allude to the prompted premature birth, and this is the premature birth, which has been loaded up […]

My Understanding of Abortion

Life has a beginning and an end and every individual knows this, as much as they may not want to know or understand it. An abortion, however, brings a thought to many people within our modern society: Is a baby alive before it is born? There are many ways to look at this but scientist have found out that there is an age of viability, where a baby is considered alive after a certain period of a woman's pregnancy. Before […]

Potential Factors that Influence Abortion

When it comes to women and unplanned pregnancies, there are alternatives other than abortions that a woman can use who and go for who isn't interested in having a child. Adoptions could be one of those alternatives; however, some women can't bear the thought of actually carrying a child. Therefore, they turn to their only option which is the abortion. For women, there are several reasons that may lead to them wanting to have an abortion. According to Stacey (2018), […]

The Status of Women’s Sexual and Reproductive Rights

The consequences of sexual behaviour between women and men have driven a desire and determination of women to control their fertility, yet in an environment in which anti-choice legislators and organizations do not protect women's reproductive rights, there is an ongoing dispute on who decides the fate of such rights. The status of women's sexual and reproductive rights remains controversial and while there have been many attempts to gain such basic human right, the fight for reproductive freedoms remains intense. […]

Abortion and Fathers Rights

In this section I will be focusing on the fathers' situation before and after conception, and bring out arguments how he could effectively avoid becoming a parent in any way (biological, bearer of financial costs, emotional). The father after conception has no alternatives left, unlike the mother has. She is in a position that can terminate the pregnancy by opting for an abortion, or she can carry out (or at least try to) the pregnancy until the end. The father […]

Abstinence only Vs. Abortion Rates

If an individual decides to have premarital sex and becomes pregnant it is likely that they will be shamed by someone no matter what decision they make.  If they decide to keep the baby they will be shamed.  If they decided to put the baby up for adoption they will be shamed.  If they decide to get an abortion they will be shamed.  Although the United States of America was founded on the ideas of freedom of religion and the […]

Why Abortion should be Illegal

Abortion is an issue in today’s society, people that agree or disagree about taking an innocent life away. Even though women now have the legal right to decide what to do with their bodies and to decide whether to end a baby’s life, there are options other than abortions. Each and every life is valuable, and babies should be able to experience a future ahead of them. Abortions should be illegal. Making abortion illegal could allow children to live a […]

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Frequently Asked Questions

Why abortion is legal.

Due to the outcome of a Supreme Court hearing, abortion is completely legal. In 1973, the Supreme Court's ruling on Roe vs Wade provided people legal access to abortion across the entire country. While legal, some doctors will not perform abortions.

How Abortion Affects Economy?

Women who have access to legal abortion will have the ability to continue their education and careers. Women denied an abortion because of gestational limits are more than 80% more likely to experience bankruptcy or face eviction.

Where Abortion is Illegal?

Abortion is legal in the entire country of the US, but some states have restrictions based on gestational status, fetal fatal conditions, and even rape. Other countries around the world have different laws and some have completely outlawed abortion, including Honduras, the Dominican Republic, and El Salvador.

Will Abortion Affect Health?

Women who have an abortion by a medical professional are at no risk for future pregnancies and there are no risks to overall health. Abortions do not increase any risk of breast cancer or have any effect on fertility.

Is Abortion Morally Justifiable?

This will depend on the person and their beliefs. Many women find abortion to be moral and a choice they are allowed to make in regards to their own bodies. Some religions have a strict stance on abortion and deem it immoral, regardless of the reason.

How To Write an Essay About Abortion

Introduction to the topic of abortion.

Abortion is a deeply complex and often controversial topic, encompassing a range of ethical, legal, and social issues. In your essay's introduction, it is important to define abortion and the various viewpoints and ethical considerations surrounding it. This introduction should establish the scope of your essay, whether you are focusing on the moral arguments, the legal aspects, the impact on individuals and society, or a combination of these. Your introduction should set a respectful and scholarly tone, acknowledging the sensitivity of the topic and the diverse opinions held by different groups.

Developing a Balanced Argument

The body of your essay should be dedicated to presenting a balanced and well-reasoned argument. Whether your essay is persuasive, analytical, or exploratory in nature, each paragraph should focus on a specific aspect of the abortion debate. This could include the ethical implications of abortion, the legal history and current laws regarding abortion in different regions, the psychological and physical effects on individuals, or the societal impacts. It's crucial to back up your points with evidence, such as statistical data, legal texts, ethical theories, medical research, and sociological studies. Addressing counterarguments is also important to show that you have considered multiple viewpoints and to strengthen your own argument.

Exploring Ethical and Societal Implications

An essay on abortion should also delve into the ethical dilemmas and societal implications surrounding the topic. This might involve discussing the moral philosophies related to the right to life, bodily autonomy, and the definition of personhood. The societal perspective might include the impact of abortion laws on different socio-economic groups, public health considerations, and the role of education and family planning. This section of your essay should challenge readers to think critically about their own values and the role of societal norms and laws in shaping the abortion debate.

Concluding the Discussion

In your conclusion, bring together all the threads of your argument, emphasizing the complexity of the abortion debate. This is your final opportunity to reinforce your main points and leave a lasting impression on your readers. Reflect on the broader implications of the debate and the ongoing challenges in finding a consensus in such a polarized issue. You might also offer recommendations for future policy, research, or public discourse. Remember, a strong conclusion doesn't just restate what has been said; it provides closure and offers new insights, prompting readers to continue thinking about the topic long after they have finished reading your essay.

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IN THE SUPREME COURT OF THE STATE OF ARIZONA PLANNED PARENTHOOD ARIZONA, INC., SUCCESSOR-IN-INTEREST TO PLANNED PARENTHOOD CENTER OF TUCSON, INC.; LAURA CONOVER, PIMA COUNTY ATTORNEY, Appellants, V. KRISTIN K. MAYES, ATTORNEY GENERAL OF THE STATE OF ARIZONA, Appellee, and ERIC HAZELRIGG, M.D., AS GUARDIAN AD LITEM OF UNBORN CHILD OF PLAINTIFF JANE ROE AND ALL OTHER UNBORN INFANTS SIMILARLY SITUATED; DENNIS MCGRANE, YAVAPAI COUNTY ATTORNEY, Intervenors. COUNSEL: No. CV-23-0005-PR Filed April 9, 2024 Appeal from the Superior Court in Pima County The Honorable Kellie L. Johnson, Judge No. C127867 AFFIRMED Opinion of the Court of Appeals, Division Two 254 Ariz. 401 (App. 2022) VACATED D. Andrew Gaona (argued), Austin C. Yost, Coppersmith Brockelman PLC, Phoenix; and Diana O. Salgado, Planned Parenthood Federation of America, Washington, DC, Attorneys for Planned Parenthood Arizona Inc. Laura Conover, Pima County Attorney, Samuel E. Brown (argued), Jonathan Pinkney, Pima County Attorney's Office, Tucson; and Aadika

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court Singh, Joshua Rosenthal, Cristian Torres, Public Rights Project, Oakland, CA, Attorneys for Laura Conover Kristin K. Mayes, Arizona Attorney General, Joshua D. Bendor (argued), Solicitor General, Alexander W. Samuels, Assistant Solicitor General, Luci D. Davis, Assistant Attorney General, Phoenix, Attorneys for Kristin K. Mayes Kevin H. Theriot, Jacob P. Warner (argued), Alliance Defending Freedom, Scottsdale; John J. Bursch, Alliance Defending Freedom, Washington, DC; and Denise M. Harle, Alliance Defending Freedom, Lawrenceville, GA, Attorneys for Eric Hazelrigg and Dennis McGrane Joshua W. Carden, Carden Livesay, Ltd, Mesa, Attorney for Amicus Curiae American College of Pediatricians Kevin L. Beckwith, Law Offices of Kevin L. Beckwith P.C., Phoenix; Olivia F. Summers, American Center for Law and Justice, Washington, DC, Attorneys for Amici Curiae Charlotte Lozier Institute et al. Roberta S. Livesay, Carden Livesay, Ltd, Mesa, Attorney for Amicus Curiae American Association of Pro-Life Obstetricians and Gynecologists Parker C. Fox, Phoenix and Tim Griffin, Arkansas Attorney General, Nicholas J. Bronni, Arkansas Solicitor General, Dylan L. Jacobs, Deputy Solicitor General, Hannah L. Templin, Assistant Solicitor General, Little Rock, AR, Attorneys for Amicus Curiae State of Arkansas and 16 Other States Kory Langhofer, Thomas Basile, Statecraft PLLC, Phoenix, Attorneys for Amici Curiae Speaker of the Arizona House of Representatives Ben Toma and President of the Arizona Senate Warren Petersen Andrew S. Lishko, May, Potenza, Baran & Gillespie, P.C., Phoenix, Attorneys for Amicus Curiae Jill Norgaard Steven H. Aden, Americans United for Life, Washington, DC; and Samuel D. Green, Reason for Life, Palmdale, CA, Attorneys for Amicus Curiae Center for Arizona Policy

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court Timothy D. Ducar, Law Offices of Timothy D. Ducar, PLC, Scottsdale; and Mathew D. Staver, Liberty Counsel, Orlando, FL, Attorneys for Amici Curiae Arizona Life Coalition, Frederick Douglass Foundation, and the National Hispanic Christian Leadership Conference Doug Newborn, Doug Newborn Law Firm, PLLC, Tucson, Attorney for Amicus Curiae Christian Medical and Dental Associations Abigail J. Mills, Schmitt Schneck Even & Williams, P.C., Phoenix, Attorneys for Amicus Curiae The Prolife Center at the University of St. Thomas (MN) David J. Euchner, Lauren K. Beall, Arizona Attorneys for Criminal Justice, Tucson, Attorneys for Amicus Curiae Arizona Attorneys for Criminal Justice Susan C. Salmon, Joy E. Herr-Cardillo, The University of Arizona, James E. Rogers College of Law, Tucson, Attorneys for Amicus Curiae the Family & Juvenile Law Association, University of Arizona, James E. Rogers College of Law Alexis E. Danneman, Jean-Jacques Cabou, Perkins Coie LLP, Phoenix, Attorneys for Amicus Curiae National Council of Jewish Women of Arizona Adriane Hofmeyr, Hofmeyr Law PLLC, Tucson; and Orlando Economos, Benjamin Seel, Democracy Forward Foundation, Washington, DC, Attorneys for Amici Curiae Law Professors Sambo (Bo) Dul, Neta Borshansky, Noah T. Gabrielsen, Office of Governor Katie Hobbs, Phoenix, Attorneys for Amicus Curiae Governor Katie Hobbs Bruce Samuels, Lauren A. Crawford, Hannah Dolski, Anita Ramalho Rocha, Papetti Samuels Weiss McKirgan LLP, Scottsdale, Attorneys for Amici Curiae League of Women Voters of Arizona and Arizona Business Owners Timothy J. Berg, Emily Ward, Fennemore Craig, P.C., Phoenix, Attorneys for Amicus Curiae Joel John

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court Christopher D. Thomas, Karen Scherner Aldama, Kristine J. Beaudoin, Perkins Coie LLP, Phoenix; and Nicole Saharsky, Mayer Brown LLP, Washington, DC, Attorneys for Amici Curiae American College of Obstetricians and Gynecologists, American Medical Association, Arizona Medical Association and Society for Maternal-Fetal Medicine J. Stanley Martineau, Martineau Law, PLLC, Mesa, Attorneys for Amici Curiae Mario Villegas and Estate of Baby Villegas JUSTICE LOPEZ authored the Opinion of the Court, in which JUSTICES BOLICK, BEENE, and KING joined. VICE CHIEF JUSTICE TIMMER authored a dissenting opinion in which CHIEF JUSTICE BRUTINEL joined.¹ JUSTICE LOPEZ, Opinion of the Court: ¶1 We consider whether the Arizona Legislature repealed or otherwise restricted A.R.S. § 13-3603 by enacting the abortion statutes in Title 36,² namely A.R.S. § 36-2322, the statute proscribing physicians from performing elective abortions after fifteen weeks' gestation. This case involves statutory interpretation - it does not rest on the justices' morals or public policy views regarding abortion; nor does it rest on § 13-3603's constitutionality, which is not before us. ¶2 We conclude that § 36-2322 does not create a right to, or otherwise provide independent statutory authority for, an abortion that repeals or restricts § 13-3603, but rather is predicated entirely on the 1 Justice William G. Montgomery has recused himself from this case. 2 References to “Title 36″ pertain strictly to the abortion statutes codified in title 36, chapters 20 and 23, §§ 36-2151 through -2164, and §§ 36-2301 through -2326. 4

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court existence of a federal constitutional right to an abortion since disclaimed by Dobbs v. Jackson Women's Health Organization, 597 U.S. 215, 292 (2022). Absent the federal constitutional abortion right, and because § 36-2322 does not independently authorize abortion, there is no provision in federal or state law prohibiting § 13-3603's operation. Accordingly, § 13-3603 is now enforceable. ¶3 When this litigation was initiated in 1971, the plaintiffs asserted a number of state and federal constitutional challenges to § 13-3603, in addition to those presented in Roe v. Wade, 410 U.S. 113 (1973), which was overruled by Dobbs. We remand the case to the trial court for consideration of those additional constitutional challenges if the plaintiffs wish to pursue them, and we temporarily extend the existing stay against enforcement of § 13-3603 so that the trial court may determine how to proceed. BACKGROUND ¶4 In 1864, the First Legislative Assembly published a code of laws governing the territory of Arizona. See Howell Code (1864). The Howell Code established Arizona's first criminal code, which included constraints on abortion. In 1901, the Twenty-First Legislative Assembly enacted a penal code reiterating the abortion law, dividing criminality between people who facilitate abortions and women who solicit assistance to procure an abortion. See Revised Statutes of Arizona, Penal Code §§ 234, 244 (1901). This language was adopted in whole in 1913, after Arizona statehood. See Revised Statutes of Arizona, Penal Code § 273 (1913). In 1928, the Arizona Legislature codified abortion criminality in A.R.S. §§ 13-211 to -213. ¶5 In 1971, Planned Parenthood Center of Tucson, Inc. sued the Attorney General challenging the constitutionality of Arizona's abortion statutes under both the state and federal constitutions. See Planned Parenthood Ctr. of Tucson, Inc. v. Marks, 17 Ariz. App. 308, 311-13 (1972) (reversing the trial court's order of dismissal and remanding to proceed to a resolution of the case on its merits). On remand from Marks, the trial court ruled Arizona's abortion statutes unconstitutional. See Nelson v. Planned Parenthood Ctr. of Tucson, Inc., 19 Ariz. App. 142, 143 (1973). On appeal, the court of appeals reversed the trial court's ruling, upholding the 5

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court constitutionality of the abortion statutes. Id. at 150. In 1973, after Nelson upheld § 13-211's constitutionality, the United States Supreme Court recognized a federal constitutional right to an abortion in Roe. This new right established by Roe was inconsistent with § 13-211, so the Arizona Court of Appeals revisited the issue in Marks, this time holding the statute unconstitutional because of Roe and enjoining enforcement of § 13-211. Nelson, 19 Ariz. App. at 152. ¶6 Despite Nelson, the Arizona Legislature did not repeal § 13-211. To the contrary, four years after Roe and Nelson, the legislature recodified § 13-211 as § 13-3603, maintaining the operative language of the statute.3 1977 Ariz. Sess. Laws ch. 142, § 99 (1st Reg. Sess.). ¶7 The abortion law's recodification was not the only legislative change made to the abortion statutory scheme. Between 1973 and 2022, and conforming to the federal abortion right established in Roe, the Arizona Legislature codified dozens of abortion statutes in Title 36. See, e.g., 1973 Ariz. Sess. Laws ch. 155, § 1 (1st Reg. Sess.); 2022 Ariz. Sess. Laws ch. 105, § 1 (2d Reg. Sess.). To the extent permitted by Roe and its progeny, all of these statutes restricted abortions, including adding many procedural requirements for physicians performing abortions. ¶8 In June 2022, the Supreme Court overturned Roe, thereby eliminating the federal constitutional right to abortion and returning “the authority to regulate abortion... to the people and their elected representatives." Dobbs, 597 U.S. at 292. ³ Section 13-3603 provides: A person who provides, supplies or administers to a pregnant woman, or procures such woman to take any medicine, drugs or substance, or uses or employs any instrument or other means whatever, with intent thereby to procure the miscarriage of such woman, unless it is necessary to save her life, shall be punished by imprisonment in the state prison for not less than two years nor more than five years. 6

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court ¶9 After Dobbs, then-Attorney General Mark Brnovich moved for relief under Arizona Rule of Civil Procedure 60(b)(5)-(6), seeking to set aside the permanent injunction against § 13-3603 imposed in 1973. Planned Parenthood Arizona, Inc. (“Planned Parenthood") opposed the motion, conceding that the original foundation for the injunction - Roe—was no longer applicable, but asserting that the injunction must be modified to harmonize § 13-3603 with Title 36, including § 36-2322. Planned Parenthood Ariz., Inc. v. Brnovich, 254 Ariz. 401, 403 ¶ 5 (App. 2022). ¶10 The trial court granted the Rule 60 motion, noting that simply "modifying the injunction to harmonize laws not in existence when the Complaint was filed, on grounds for relief not set forth in the Complaint, is procedurally improper." The court further reasoned that "the requested modified injunction which would carve out an exception for physicians, is not consistent with the plain language of A.R.S. § 13-3603 which contains no such exception." Because the legal grounds for the 1973 injunction were overturned by Dobbs, the trial court "vacate[d] the judgment in its entirety" to allow full enforcement of § 13-3603. Planned Parenthood appealed and filed an emergency motion to stay the trial court's order pending appeal. The trial court denied the request; however, the court of appeals subsequently granted the stay. ¶11 The court of appeals reversed the trial court's order, concluding, in part, that “[l]icensed physicians who perform abortions in compliance with Title 36 are not subject to prosecution under § 13-3603." Id. at 408 ¶ 26. The court of appeals held that the trial court improperly limited review regarding the 1973 injunction, as a proper review would necessitate a consideration of the full statutory scheme, including Title 36. Id. at 404-05 ¶¶7, 9-10. Accordingly, the court of appeals considered whether § 13-3603 conflicted with Title 36, ultimately finding no "conflict between § 13-3603 and Title 36 that must result in the repeal of either." Id. at 405 ¶ 13. Instead, the court of appeals held that the statutes should be harmonized "to conclude the abortion regulations in Title 36 govern," so "physicians who perform abortions in compliance with Title 36 are not subject to prosecution under § 13-3603.” Id. ¶¶ 10, 13. ¶12 Dr. Eric Hazelrigg (“Hazelrigg”) sought timely review of the court of appeals' opinion. We granted review to consider the statutory construction of Arizona's abortion laws post-Dobbs, an issue of statewide

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court importance. We have jurisdiction under article 6, section 5(3) of the Arizona Constitution. DISCUSSION I. ¶13 We review a question of statutory construction de novo. BSI Holdings, LLC v. Ariz. Dep't of Transp., 244 Ariz. 17, 19 ¶ 9 (2018). ¶14 We pause to emphasize the unusual nature of the statutory interpretation in which we must engage. Interpreting and harmonizing multiple statutes concerning the same subject matter is a familiar task. See, e.g., State v. Santillanes, 541 P.3d 1150, 1155 ¶ 16 (Ariz. 2024); Mussi v. Hobbs, 255 Ariz. 395, 401 ¶ 30 (2023); State v. Patel, 251 Ariz. 131, 137 ¶ 24 (2021). Here, we consider a statute that was never repealed-in fact, it was recodified even after it was enjoined — followed by the enactment of a series of statutes regulating the same subject matter in the wake of Roe, the Supreme Court decision striking down the original statute. Hence, the question presented is different from those arising in the ordinary statutory interpretation context: whether the later statutes "repeal or otherwise limit" the earlier statute. Neither party could identify precedent squarely resolving such an unusual circumstance. Thus, we examine the later-adopted Title 36 statutes to determine whether they repealed or limited § 13-3603, or instead merely restricted abortions to the extent possible so long as Roe prevented enforcement of § 13-3603. A. 15 We begin by setting out the rules of statutory construction that guide our analysis. We interpret statutes “in view of the entire text, considering the context and related statutes on the same subject." Nicaise v. Sundaram, 245 Ariz. 566, 568 ¶ 11 (2019). Clear and unequivocal language determines a statute's meaning, reading each word, phrase, clause, and sentence in such a way to ensure no part of the statute is void or trivial. See Janson ex rel. Janson v. Christensen, 167 Ariz. 470, 471 (1991). Under this plain meaning analysis, “[w]e look first to the language of the provision, for if the [statutory] language is clear, judicial construction is neither required nor proper." Perini Land & Dev. Co. v. Pima County, 170 Ariz. 380, 383 (1992); see 8

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court also SolarCity Corp. v. Ariz. Dep't of Revenue, 243 Ariz. 477, 480 ¶ 8 (2018). This analytical approach is premised on foundational trust in legislative competency, and this Court "presume[s] that the legislature knows the existing laws when it enacts or modifies a statute." State v. Garza Rodriguez, 164 Ariz. 107, 111 (1990). ¶16 Statutory terms must be given effect "in accordance with their commonly accepted meanings, ‘unless the legislature has offered its own definition of the words or it appears from the context that a special meaning was intended."" State v. Reynolds, 170 Ariz. 233, 234 (1992) (internal citation omitted) (quoting Mid Kan. Fed. Sav. & Loan Ass'n of Wichita v. Dynamic Dev. Corp., 167 Ariz. 122, 128 (1991)). In determining "commonly accepted meanings," "we may refer to established and widely used dictionaries.” Id.; Special Fund Div. v. Indus. Comm'n, 232 Ariz. 110, 113 ¶ 12 (App. 2013). We also may consider a statement of legislative intent, including a construction provision, in discerning the meaning of a statute. See S. Ariz. Home Builders Ass'n v. Town of Marana, 254 Ariz. 281, 286 ¶ 31 (2023) (noting that we determine the meaning of a statute "according to the plain meaning of the words in their broader statutory context, unless the legislature directs us to do otherwise"); Aros v. Beneficial Ariz., Inc., 194 Ariz. 62, 66 (1999). Therefore, we read a statute in the context of the law that grants it authority. Cf. S. Ariz. Home Builders Ass'n, 254 Ariz. at 286 ¶ 31. ¶17 If the statutory language is ambiguous-if "it can be reasonably read in two ways"-we may use alternative methods of statutory construction, including examining the rule's historical background, its spirit and purpose, and the effects and consequences of competing interpretations. State v. Salazar-Mercado, 234 Ariz. 590, 592 ¶ 5 (2014); State v. Aguilar, 209 Ariz. 40, 47 ¶ 23 (2004). “A statute is not ambiguous merely because the parties disagree about its meaning,” it is ambiguous if the “meaning is not evident after examining the statute's text as a whole or considering statutes relating to the same subject or general purpose." Glazer v. State, 244 Ariz. 612, 614 ¶ 12 (2018). B. ¶18 We first address Planned Parenthood's claim that Title 36 creates a right to an abortion or otherwise independently authorizes elective abortion up to fifteen weeks' gestation. Although Planned 9

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court Parenthood conceded at oral argument that Title 36 does not create a right to abortion, it maintained its argument that § 36-2322 codifies permissive authorization to perform abortions such that it repeals or restricts § 13-3603. Planned Parenthood and Hazelrigg's Title 36 arguments center almost entirely on § 36-2322. ¶19 Section 36-2322 provides, in relevant part: A. Except in a medical emergency, a physician may not perform, induce or attempt to perform or induce an abortion unless the physician or the referring physician has first made a determination of the probable gestational age of the unborn human being and documented that gestational age in the maternal patient's chart and, if required, in a report required to be filed with the department . . . . B. Except in a medical emergency, a physician may not intentionally or knowingly perform, induce or attempt to perform or induce an abortion if the probable gestational age of the unborn human being has been determined to be greater than fifteen weeks. 120 that." Planned Parenthood argues that, in order to statutorily restrict the availability of abortion, specifically through § 36-2322's use of the terms "except” and “unless,” Title 36 must implicitly and necessarily authorize the procedure because "unless" is a conjunction meaning "except on the condition that” or “without the accompanying circumstances or condition See Unless, Merriam-Webster Dictionary, https://www.merriam-webster.com/dictionary/unless (last visited Mar. 20, 2024). Accordingly, Planned Parenthood embraces the court of appeals' holding that § 36-2322 “prohibits abortions except those it allows-that is, it permits a licensed physician to perform abortions in emergency situations and elective abortions if the physician has determined the fetus's gestational age is fifteen weeks or less and otherwise has complied with Title 36." Brnovich, 254 Ariz. at 406 ¶ 19 n.8.4 4 Planned Parenthood further contends that § 36-2322 should be read to exempt “medical emergency” situations from the gestational age 10

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court ¶21 Planned Parenthood is correct that if it were a standalone statute, by its plain terms, § 36-2322's proscription on elective abortion after fifteen weeks' gestation logically implies that abortion is otherwise permissible. But its interpretation that the purpose and effect of "except" and “unless” is to statutorily authorize certain abortions is not the only reasonable one. Reasonable minds could differ about whether “except” and "unless" independently statutorily authorize conduct not proscribed or, alternatively, merely qualify the circumstances under which a physician may be penalized under § 36-2322 (in other words, that a physician may not be penalized under § 36-2322 when the “except” and “unless” provisions apply).5 This textual ambiguity—one interpretation which concludes that § 36-2322 independently authorizes conduct not proscribed, thus repealing § 13-3603, and the other which posits that § 36-2322 simply qualifies the circumstances under which a physician may be penalized, thus leaving § 13-3603 undisturbed - generates two possible conclusions about § 36-2322's effect on § 13-3603. ¶22 Section 36-2322's text in isolation, therefore, does not resolve the fundamental issue before us: whether the statute creates independent statutory authority for abortion intended to repeal or restrict § 13-3603 or merely acknowledges the existence of a contemporaneous federal constitutional right to abortion under Roe at the time of its passage. Notably, § 36-2322's text does not address its effect on § 13-3603. Given the competing plausible textual readings of § 36-2322, which create ambiguity concerning the statute's effect on § 13-3603, any interpretation of the statute that ignores or minimizes the impact of Dobbs' disavowal of a federal constitutional abortion right runs headlong into the construction provision of Senate Bill 1164 ("S.B. 1164")-the genesis of § 36-2322 and part of what requirement and to criminalize abortions after fifteen weeks. This interpretation is reasonable, but we do not address it further because it has no bearing on whether the statute creates an independent statutory authorization for physicians to perform elective abortions before fifteen weeks' gestation that overrides § 13-3603, which is the issue before us. 5 Penalties for violating § 36-2322 include a criminal class 6 felony conviction and medical license suspension or revocation. See A.R.S. §§ 36-2324(A), -2325(A).

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court the legislature enacted. We must interpret the statute in its proper context. This requires us to reconcile the legislature's construction provision, which specifically preserves § 13-3603, and the text of § 36-2322, which is silent on, and ambiguous as to, its effect on § 13-3603. See Stambaugh v. Killian, 242 Ariz. 508, 509 ¶ 7 (2017); S. Ariz. Home Builders Ass'n, 254 Ariz. at 286 ¶ 31. C. 123 To determine if Title 36 creates a right to abortion, or otherwise provides independent statutory authority to perform the procedure, as Planned Parenthood contends, we must consider S.B. 1164’s construction provision. 124 The legislature included a two-part construction provision in S.B. 1164, expressing its unequivocal intent that, in restricting elective abortion to fifteen weeks' gestation, it did not create, recognize, or expand a right to an abortion, nor did it repeal § 13-3603's proscription on elective abortion: This act does not: 1. Create or recognize a right abortion or alter generally accepted medical standards. The Legislature does not intend this act to make lawful an abortion that is currently unlawful. 2. Repeal, by implication or otherwise, section 13-3603, Arizona Revised Statutes, or any other applicable state law regulating or restricting abortion. See 2022 Ariz. Sess. Laws ch. 105, § 2 (2d Reg. Sess.). The construction provision is part of the bill that legislators have before them and approve, and has the same force of law as codified law. See The Arizona Legislative Bill Drafting Manual 2021-2022 at 7. 125 We must consider the legislature's construction provision in S.B. 1164 when discerning the act's meaning because it is part of the bill the legislature approved. See, e.g., State ex rel. Ariz. Dep't of Revenue v. Tunkey, 254 Ariz. 432, 438 27 (2023) (Bolick, J., concurring) ("If the legislature agrees on findings, purposes, or definitions, it becomes our duty to 12

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court ascertain statutory meaning through those prisms."); cf. S. Ariz. Home Builders Ass'n, 254 Ariz. at 286 ¶ 31; see also Kevin M. Stack, The Enacted Purposes Canon, 105 Iowa L. Rev. 283, 304–05 (2019); Antonin Scalia & Bryan Garner, Reading Law: The Interpretation of Legal Texts 232 (2012) (“Legal drafters have the power. to limit the implications of their terms . . . .”). 126 Before we consider S.B. 1164's construction provision, we first address Planned Parenthood's contention that § 36-2322 does not create a right to abortion, but rather “allows" the procedure and, thus, provides independent statutory authorization for it. We reject this distinction. As Hazelrigg notes, because S.B. 1164 does not define “right,” we may rely on dictionary definitions. See Special Fund Div., 232 Ariz. at 113 ¶ 12. A "right" is a "privilege . . . secured . . . by law." Right, Black's Law Dictionary (11th ed. 2019). Here, we disagree that a statute that expressly disclaims creation of a right may be read to simultaneously create an independent statutory authorization akin to a right. Both describe a privilege secured by law. 127 Planned Parenthood argues that S.B. 1164's construction provision against repeal of § 13-3603 “or any other applicable state law regulating or restricting abortion" clarifies the legislature’s intent to give every Title 36 provision effect, and any repeal of § 36-2322 would contravene this express legislative provision because the statute is part of Title 36. In other words, the legislature's construction provision was designed to foreclose a reading of S.B. 1164 that would result in its own demise. ¶28 This interpretation does not withstand scrutiny. First, it is inconsistent with the plain meaning and manifest purpose of the construction provision—to clarify that § 36-2322's enactment does not "create or recognize a right to abortion,” repeal the statutory ban on elective abortion, or repeal "any other applicable state law regulating or restricting abortion." See 2022 Ariz. Sess. Laws. ch. 105, § 2 (2d Reg. Sess.) (emphasis added). Neither the construction provision's text, nor its context, suggest that the legislature intended to create an independent statutory authority for abortion that would repeal § 13-3603. To do so would contravene its express preservation of § 13-3603's ban on elective abortion, which the legislature neither repealed nor amended in any manner, and any other applicable law that regulated or restricted abortion. Second, any suggestion that the legislature crafted the construction provision to clarify its intent not 13

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court to repeal § 36-2322 by virtue of its own passage is absurd. See 4QTKIDZ, LLC v. HNT Holdings, LLC, 253 Ariz. 382, 385 ¶ 5 (2022) (noting that the plain, clear and unambiguous text of a statute controls unless it results in an absurdity). The construction provision must be read as reflecting the legislature's intent not to repeal other laws akin to § 13-3603, not § 36-2322 itself. ¶29 A cursory review of the construction provision that the legislature "did not intend [S.B. 1164] to make lawful an abortion that is currently unlawful" seemingly engenders confusion, but its context and logic instead yield clarity. This provision can reasonably bear only one meaning: the legislature did not intend the act to codify an independent statutory right to an elective abortion before fifteen weeks' gestation or otherwise repeal any other abortion laws more restrictive than S.B. 1164. Any other reading is implausible because, at the time of its passage, S.B. 1164 merely sought to restrict a federal constitutional right to abortion that the legislature was powerless to abolish. Under no scenario could the legislature's restriction of a broader abortion right be construed to "make lawful an abortion that is currently unlawful" unless the act was misinterpreted to (1) override § 13-3603, the only provision in Arizona or federal law at the time that made an elective abortion before fifteen weeks' gestation "currently unlawful" or (2) otherwise repeal more restrictive abortion statutes. Thus, the provision must mean that the legislature "d[id] not intend [S.B. 1164] to make lawful an abortion that is currently unlawful [under § 13-3603 or any other statute more restrictive than S.B. 1164]." This is the only interpretation that is internally consistent with, and does not defeat, the remainder of S.B. 1164's construction provision. And it helps that the legislature identified precisely which statute it meant to preserve: § 13-3603. 6 S.B. 1164's ban on elective abortion after fifteen weeks' gestation was the most temporally restrictive abortion statute. This construction provision conceivably may also apply to other non-temporal statutory abortion restriction statutes. See, e.g., A.R.S. § 36-2152(A) (requiring parental consent or judicial authorization for abortions on minors); A.R.S. § 13-3603.02(A)(1) (prohibiting physicians from performing an abortion when a physician knows the purpose is based on genetic abnormality or race or gender). 14

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court 130 Hazelrigg argues, and we agree, that the court of appeals misconstrued the legislature's express intent embodied in S.B. 1164 by holding that the statutory scheme demonstrates that the legislature enacted S.B. 1164 with the design "to restrict-but not to eliminate - elective abortions." Brnovich, 254 Ariz. at 406 ¶ 16. That was the statute's effect, but the court of appeals divines a legislative purpose in a vacuum. At the time of S.B. 1164's passage when Roe was still in effect, the legislature was devoid of authority to ban elective abortions without running afoul of the Supremacy Clause. Indeed, the legislature's previous attempt to restrict elective abortion after twenty weeks' gestation was enjoined. See Isaacson v. Horne, 716 F.3d 1213, 1231 (9th Cir. 2013). It is no surprise that the legislature merely intended "to restrict-but not to eliminate-elective abortions." It could do no more. Further, at that time, abortion up to fifteen weeks' gestation was already legal in Arizona, so there was no reason for the legislature to codify in statute a right that already existed under federal constitutional law. 131 In context, S.B. 1164 was not a legislative attempt to preserve a right to abortion in Arizona; instead, it was a significant legislative restriction on elective abortion. It is a strained interpretation, indeed, that transforms S.B. 1164—a legislative limitation of elective abortion and an express preservation of a statutory ban on all elective abortions-into an independent statutory authority for elective abortion that overrides § 13-3603 and survives Roe's demise. See, e.g., Roberts v. State, 253 Ariz. 259, 267 ¶25 (2022) (noting that the "historical sequence" of statutory enactments and judicial decisions may inform statutory interpretation). We do not interpret the act to negate its own purpose. See King v. Burwell, 576 U.S. 473, 493 (2015). D. 132 The court of appeals and Planned Parenthood's interpretation of S.B. 1164 is particularly dubious in light of Arizona's additional statutory provision that our laws "shall be interpreted and construed to acknowledge, on behalf of an unborn child at every stage of development, all rights, privileges and immunities available to other persons, citizens and residents of this state, subject only to the Constitution of the United States and decisional interpretations thereof by the United States Supreme Court." 15

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court A.R.S. § 1-219(A).7 This statute further illustrates that access to abortion in Arizona is, and remains, confined to a federal constitutional right beyond the reach of Arizona's legislature. Section 1-219(A), left untouched by § 36-2322, establishes the public policy of the state, provides additional interpretive guidance, and belies the notion that the legislature intended to create independent statutory authority for elective abortion. ¶33 Moreover, S.B. 1164's construction provision mirrors provisions in numerous other bills codified in Title 36, demonstrating the consistency, gravity, and clarity of the legislature's intent not to independently grant a right or authorize access to abortion. See, e.g., 2009 Ariz. Sess. Laws ch. 172, § 6 (1st Reg. Sess.); 2010 Ariz. Sess. Laws ch. 111, § 1 (2d Reg. Sess.); 2011 Ariz. Sess. Laws ch. 9, § 4 (1st Reg. Sess.); 2011 Ariz. Sess. Laws ch. 10, § 8 (1st Reg. Sess.); 2012 Ariz. Sess. Laws ch. 250, § 11 (2d Reg. Sess.); 2021 Ariz. Sess. Laws ch. 286, § 17 (1st Reg. Sess.). E. 134 Planned Parenthood argues that the legislature's failure to include an express statutory trigger provision repealing § 36-2322 upon Roe's reversal evinces the legislature's implicit intent to create an independent statutory authority for elective abortion up to fifteen weeks' gestation that effectively repeals § 13-3603. Planned Parenthood emphasizes the import of the legislature's omission because S.B. 1164 otherwise mirrors "Mississippi's 15-week law,” which included an express statutory trigger. See Miss. Code Ann. § 41-41-191(8) (2018). We are unpersuaded. 135 Planned Parenthood and the dissent make much of the fact that Mississippi's statutes, which largely parallel Arizona's statutes at issue here, contain a "trigger provision" that specifies applicability of certain abortion provisions only in the event that Roe is overturned, whereas 7 Section 1-219(A) is preliminarily enjoined in federal court from enforcement “as applied to abortion care that is otherwise permissible under Arizona law." Isaacson v. Brnovich, 610 F. Supp. 3d 1243, 1257 (D. Ariz. 2022). Thus, the injunction has no bearing on this Court's authority to consider § 1-219(A) in interpreting the statutes before us or to determine whether abortion is permissible under Arizona law. 16

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court Arizona's do not. Under the divergent circumstances of the two state laws, the difference is of no consequence. ¶36 In 2007, Mississippi enacted Mississippi Code Annotated § 41-41-45(2), which provides in relevant part: "No abortion shall be performed or induced in the State of Mississippi, except in the case where necessary for the preservation of the mother's life or where the pregnancy was caused by rape." It was this law that included the express trigger provision, which provided that it would take effect ten days following a determination by the state attorney general that Roe was overturned and the statute would be constitutional. 2007 Miss. Laws ch. 441, § 6. Including an express trigger provision made sense given that Roe was in effect when Mississippi Code Annotated § 41-41-45 was enacted. 137 Of course, § 13-3603, the Arizona near-analog to § 41-41-45, does not have a trigger provision, for a simple and obvious reason: it was first enacted 109 years before Roe. Its subsequent recodifications, even after Roe, make clear the legislature's determination to keep it on the books. A trigger provision would serve utterly no purpose. And even the dissent acknowledges that § 13-3603 has never been repealed and, following Dobbs, should be given effect. Infra ¶¶ 65, 88–91. 38 Mississippi subsequently enacted, among other laws restricting abortion, a fifteen-week gestational limit on abortions in 2018. Miss. Code Ann. § 41-41-191. This statute, like the similar § 36-2322(B), does not contain an express trigger provision. Rather, it contains a subsection entitled "Construction," which provides in relevant part: "Nothing in this section shall be construed as creating or recognizing a right to abortion or as altering generally accepted medical standards. It is not the intention of this section to make lawful an abortion that is otherwise unlawful," and "[a]n abortion that complies with this section, but violates any other law is unlawful." Miss. Code Ann. § 41-41-191(8). ¶39 The bulk of this language is virtually identical to the construction provision in Arizona law—except that the Arizona language explicitly identifies one statute in particular that it does not “[r]epeal by implication or otherwise": § 13-3603. Mississippi's fifteen-week provision that “[a]n abortion that complies with [it], but violates any other law is unlawful" — which is absent from § 36-2322(B)'s construction provision - is 17

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court not dispositive, as the dissent contends. Infra ¶96. Just as the Mississippi fifteen-week law implicitly yields to the enforceability of § 41-41-45, Arizona's fifteen-week law-§ 36-2322(B) — conforms its application to § 13-3603's enforceability. To the extent the dissent suggests such language and construction serve as a trigger provision in the Mississippi statute, infra ¶¶94-95, it would obviously play the same role in the Arizona statute — indeed, even more so, by identifying a particular statute that is left intact. ¶40 Regardless, the absence of an express trigger provision is not dispositive here. We typically do not infer legislative intent from silence. Cf. Sw. Paint & Varnish Co. v. Ariz. Dep't of Env't Quality, 194 Ariz. 22, 25 ¶ 21 (1999) (noting that legislative acquiescence by silence is “limited to instances in which the legislature has considered and declined to reject the relevant judicial interpretation”). Second, in light of Title 36's genesis as the statutory mechanism to restrict and regulate abortion in response to Roe, Dobbs' elimination of a federal constitutional right to abortion removed the sole authority for elective abortion in Arizona necessitating many Title 36 regulations, including § 36-2322. Third, although the legislature did not include the express trigger provision that appears in Mississippi's law, it was not silent on the issue. Despite the dissent's requirement of an express trigger provision, infra ¶¶ 93–96, we conclude that the legislature made its intent known. The legislature's unwavering and unqualified affirmative maintenance of a statutory ban on elective abortion since 1864 (albeit enjoined since 1973), S.B. 1164's construction provision that the legislature did not intend to repeal § 13-3603 in passing § 36-2322, and § 1-219(A)'s public policy pronouncement that the rights of the "unborn child" were limited only by the federal Constitution and the Supreme Court's interpretation of it, effectively constitute a discernible comprehensive trigger provision in the event of Roe's demise. F. ¶41 Planned Parenthood urges that we divine legislative intent from statements of “numerous public officials,” namely the former Governor, the Maricopa County Attorney, and the former Attorney General, concerning the meaning of § 36-2322. This reed is too thin to bear the interpretive weight Planned Parenthood places upon it. "We believe the best policy is not to consider nonlegislators' statements to determine the 8

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court legislature's intent concerning the specific application of a proposed statute, unless the circumstances provide sufficient guarantees that the statements reflect legislators' views." Hayes v. Cont'l Ins. Co., 178 Ariz. 264, 270 (1994). Here, we do not find these expressed opinions particularly illuminating or relevant as to legislative intent or the meaning of § 36-2322. As Hazelrigg notes, legislative and non-legislative statements support both parties’ interpretations. At most, conflicting statements made by public officials illustrate the novelty of the interpretative task presented to us by the legislature. G. ¶42 Planned Parenthood contends that, like the court of appeals, we must harmonize §§ 13-3603 and 36-2322 to give effect to each. See, e.g., UNUM Life Ins. Co. of Am. v. Craig, 200 Ariz. 327, 329 ¶ 11 (2001) ("When two statutes appear to conflict, we will attempt to harmonize their language to give effect to each.”). We disagree. Our conclusion that the legislature did not intend to create a privilege secured by law to obtain or perform an abortion obviates the need to harmonize §§ 13-3603 and 36-2322. Harmonization between these laws may be accomplished only by repealing § 13-3603 in contravention of the legislature's express intent and engaging in untenable statutory interpretation such as excising physicians from the plain meaning of "person" in § 13-3603, defined as “a human being” in A.R.S § 13-105(30). And indeed, despite purporting to harmonize the statutes, the dissent's treatment of § 13-3603 all but nullifies it. We decline to do so. See Schatz v. Allen Matkins Leck Gamble & Mallory LLP, 198 P.3d 1109, 1120 (Cal. 2009) ("Courts ‘will infer the repeal of a statute only when... a subsequent act of the legislature clearly is intended to occupy the entire field covered by a prior enactment."" (alteration in original) (citation omitted)). 143 Roe's recognition of a right to an abortion was not absolute, and many states—including Arizona-legislatively restricted the time, place, and manner in which an abortion could be performed. Title 36 and the corresponding construction provisions were passed under Roe's authority, and thus, must be interpreted through the mutating lens of the Supreme Court's abortion jurisprudence. See Aguilar, 209 Ariz. at 47 ¶ 23. Through this lens it becomes clear that Title 36 is merely Arizona's statutory mechanism for restricting and regulating Roe's abortion right. And, as

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court Planned Parenthood concedes, Arizona has never independently created a statutory right to abortion. We will not “amend a statute judicially [nor] read implausible meaning into express statutory language” given the absence of an abortion right in Arizona jurisprudence. Kyle v. Daniels, 198 Ariz. 304, 306 ¶ 7 (2000). Therefore, because the federal constitutional right to abortion that overrode § 13-3603 no longer exists, the statute is now enforceable, prospectively prohibiting abortion unless necessary to save a woman's life. See § 13-3603. II. ¶44 We next consider the viability of the remaining portions of Title 36 in light of Planned Parenthood's contention that simultaneous enforcement of § 13-3603 and Title 36 implicates physicians' due process right to notice of potential criminal and regulatory liability for abortion-related conduct. A. 145 We first clarify the effect of our Opinion on Title 36. Any portion of Title 36 solely applicable to elective abortion under the defunct federal constitutional right arguably may no longer be operative simply for want of purpose; what does not exist cannot be regulated. We refrain, however, from crafting an advisory opinion as to the operability of any Title 36 provision not squarely before us. The enforceability of Title 36 provisions must be revisited by the legislature or adjudicated by the courts as controversies arise. 146 Section 36-2322, however, is before us. We hold that it remains enforceable even though it was enacted solely to curtail the federal abortion right by criminalizing physicians' performance of abortion after fifteen weeks' gestation and adding other regulatory requirements concerning abortions performed due to “a medical emergency." §§ 36-2322(C)(1)-(7), -2324(A). Although we conclude that the legislature enacted § 36-2322 to curtail elective abortion in lieu of enforcement of § 13-3603 that was then-enjoined under Roe, we do not attempt to-nor have we been requested to-divine the legislature's intent in passing § 36-2322's additional substantive criminal and regulatory provisions that exceed the scope of § 13-3603's ban on elective abortion. If, in light of 20

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court § 13-3603's enforceability, a decision is to be made to rescind any provision in § 36-2322, it is the legislature's prerogative. 147 Various other Title 36 provisions, in addition to § 36-2322, regulating abortion-related conduct and entailing criminal and regulatory sanctions remain relevant when § 13-3603's elective abortion ban is enforceable. For example, Title 36's abortion licensing requirements, A.R.S. § 36-449.02, reporting requirements, A.R.S. §§ 36-2161 to -2164, and emergency consent requirements, A.R.S. § 36-2153(C), may apply to abortions necessary to save a woman's life. Moreover, other statutory provisions such as A.R.S. § 36-2302, which proscribes, subject to statutory exceptions, “use of a human fetus or embryo... [resulting from an abortion] for animal or human research," remain relevant because they may implicate all abortion-related activity. ¶48 B. Planned Parenthood contends that § 13-3603 and Title 36's abortion-related criminal and regulatory provisions cannot coexist without implicating due process because the overlapping laws do not adequately apprise physicians of the contours of their criminal liability. We note that Planned Parenthood's primary due process concern centers on the co-existence of criminal provisions in §§ 13-3603 and 36-2322, but its due process argument extends to § 13-3603's potential overlap with other Title 36 criminal provisions. 149 United States v. Batchelder, 442 U.S. 114 (1979), a unanimous Supreme Court decision by Justice Thurgood Marshall, deals with precisely this question. In Batchelder, the Court rejected a claim that two federal criminal statutes could not coexist because Congress intended to enact two independent gun control statutes, each enforceable on its own terms. 442 U.S. at 123–24 ("This Court has long recognized that when an act violates more than one criminal statute,” the decisions of "[w]hether to prosecute and what charge[s] to file . . . generally rest in the prosecutor's discretion.”). The Court determined that one statute cannot be interpreted as implicitly repealing another statute merely because a defendant's conduct might violate both statutes. Id. at 122. The Court reasoned that, "it is 'not enough to show that the two statutes produce differing results when applied to the same factual situation.”” Id. (quoting Radzanower v. Touche Ross & Co., 426 21

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court U.S. 148, 155 (1976)). “Rather, the legislative intent to repeal must be manifest in the 'positive repugnancy between the provisions.”” Id. (quoting United States v. Borden Co., 308 U.S. 188, 199 (1939)). 150 Our jurisprudence accords with Batchelder. We have consistently upheld the principle that the legislature may proscribe the same conduct through multiple laws and our criminal statutes are replete with examples of multiple laws applying to the same conduct. See, e.g., A.R.S. § 13-116 (“An act or omission which is made punishable in different ways by different sections of the laws may be punished under both . . . .”); State v. Jones, 235 Ariz. 501, 504 ¶ 13 (2014) (“The same conduct may result in different offenses . . . .”); Anderjeski v. City Court of Mesa, 135 Ariz. 549, 550 (1983) (“Although arising out of one act, the statutes describe two separate and distinct offenses."); State v. Culver, 103 Ariz. 505, 507–08 (1968) (holding criminal statutes merely prohibiting the same conduct did not conflict where there was no positive repugnancy between the two laws); State v. O'Brien, 123 Ariz. 578, 583-84 (App. 1979) ("A specific statute does not supplant an earlier general statute unless all provisions are covered; that is, where the specific statute is narrower, the general one is not repealed. Where a single act violates more than one statute and there is no evidence of legislative intent to repeal one of them, the government has the option of prosecuting under either." (internal citations omitted)); State v. Lopez, 174 Ariz. 131, 143 (1992) ("When conduct can be prosecuted under two or more statutes, the prosecutor has the discretion to determine which statute to apply."). "So long as overlapping criminal provisions clearly define the conduct prohibited and the punishment authorized, the notice requirements of the Due Process Clause are satisfied.” Batchelder, 442 U.S. at 123. ¶51 Here, § 13-3603 prohibits "a person" from performing any abortion “unless it is necessary to save [a woman's] life" and punishes a violation of the statute “by imprisonment in the state prison for not less than two years nor more than five years." Section 36-2322(B), “[e]xcept in a medical emergency," proscribes a physician from performing an abortion after fifteen weeks' gestation and deems a violation of the statute a class 6 felony under § 36-2324. Thus, as in Batchelder, these statutes create overlapping criminal liability, but they also on their face "clearly define the conduct prohibited and the punishment authorized." 442 U.S. at 123. The 22

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court fact there is overlap between the two statutes does not violate due process notice requirements. Id. ¶52 In addition to overlapping criminal statutes, Planned Parenthood argues that § 13-3603's criminal provision and Title 36's regulatory scheme present physicians performing abortions with an unnavigable array of criminal and regulatory requirements. We disagree. Multi-title statutory regulation of conduct, particularly business and professional activity, is hardly unique to abortion. For example, employers confronting marijuana impairment at work are tasked with consulting both Title 23, Chapter 2, Article 14—the Drug Testing of Employees Act-and Title 36, Chapter 28.1–the Arizona Medical Marijuana Act. And, as Hazelrigg notes, doctors, lawyers, securities brokers, and commodities traders, among other professions, are also permissibly subject to overlapping criminal, civil, and regulatory laws. As long as these legal requirements clearly define prohibited conduct and the sanction, they do not implicate due process notice requirements. See Batchelder, 442 U.S. at 123. We do not conclude that a physician's regulatory compliance burden in this arena is constitutionally distinguishable from any other regulated professional's legal obligations. 153 In light of this Opinion, physicians are now on notice that all abortions, except those necessary to save a woman's life, are illegal, see § 13-3603, and that additional criminal and regulatory sanctions may apply to abortions performed after fifteen weeks' gestation, see §§ 36-2322, -2324, -2325. Physicians are tasked with otherwise comporting their conduct with Title 36's requirements. See § 13-116; see also Lopez, 174 Ariz. at 143. The application of § 13-3603 and Title 36 to physicians' conduct does not facially implicate constitutional due process concerns.8 Our holding, of course, does not foreclose a physician from raising an as-applied due process 8 Pima County Attorney's Office argues that § 13-3603's "necessary to save [a pregnant woman's] life" exception to the ban on abortion "would violate due process because it does not provide physicians clarity on how they should conform their conduct to the law in life- and health-threatening situations." We decline to address this argument here because it is beyond the scope of the issue before us, a factual record was not developed in the trial court, and neither the trial court nor the court of appeals ruled on this issue. See Hawkins v. Allstate Ins. Co., 152 Ariz. 490, 503 (1987). 23

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court challenge on facts, and with a developed factual record, that are not before us. III. 154 The dissent contends that the majority “errs by finding § 36-2322(B) ambiguous and then using the construction [provision] to interpret the statute in a way unsupported by its plain textual meaning,” infra ¶ 73, and also misplaces our focus “on whether § 36-2322(B) grants an affirmative right to an abortion akin to Roe's recognition of a constitutional right," infra ¶ 76. We address these points in turn. 155 We begin with the dissent's assertion that § 36-2322(B) is unambiguous, which forecloses any consideration of Arizona's abortion statutory history or the legislature's clear statements of the statute's intended effect on § 13-3603. Infra ¶ 73. The dissent misconstrues the nature of the ambiguity. There is no dispute that § 36-2322(B) unambiguously criminalizes physicians' performance of elective abortion after fifteen weeks' gestation. But the statute is silent and otherwise ambiguous as to its intended effect on § 13-3603- the sole issue before us. See Part I, B¶¶21-22. Invocation of a menagerie of rules of statutory construction, infra ¶ 80, with which we agree and follow when applicable, does not change the fact that § 36-2322(B) is ambiguous most importantly not for what it says, but for what it does not say. See, e.g., State v. Sweet, 143 Ariz. 266, 269-70 (1985) (“The problem in interpreting the statute at issue is not that certain words or groups of words have more than one meaning, but it is the failure to include necessary words which causes confusion as to the scope of the statute."). Because the statute's text does not reveal its effect on § 13-3603, it is ambiguous. Id. And because it is ambiguous, we may consider the construction provision in determining § 36-2322(B)'s effect on § 13-3603. See Sakrison v. Pierce, 66 Ariz. 162, 172 (1947) (noting that the policy section of an act "would be controlling" in interpreting "an operative portion of the statute that was ambiguous or of doubtful meaning or application"). ¶56 Given § 36-2322(B)'s ambiguity concerning its effect on § 13-3603, we turn to the dissent's curious claim that we misplace our focus 'on whether § 36-2322(B) grants an affirmative right to an abortion akin to Roe's recognition of a constitutional right." Infra ¶ 76. The dissent subtly, 24

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court but critically, misconstrues our reasoning. To clarify, the issue before us is not whether, in the abstract, abortion not expressly proscribed by statute is legally permissible; it is whether § 36-2322(B)'s proscription on elective abortion after fifteen weeks' gestation created statutory authorization for abortion before fifteen weeks' gestation that repeals or limits § 13-3603's total ban on elective abortions. Viewed through this lens, the dissent's unremarkable claim that "[p]roscribing conduct does not require the legislature to grant people an affirmative right to engage in conduct falling outside the proscription," infra ¶76, the corollary observation that “the legislature does not affirmatively grant a right by decriminalizing conduct," infra ¶78 (emphasis omitted), and an illustration of these principles involving driving under the speed limit, infra ¶ 77, have no import. Here, our focus on whether § 36-2322(B) — in context rather than in a legal and historical vacuum-grants an affirmative right or statutory authorization or otherwise effectively repeals § 13-3603 is the question before us. 157 The dissent relies on United States v. Vuitch, 402 U.S. 62 (1971), a pre-Roe case, for the proposition that physicians may perform “abortions that are not expressly outlawed." Infra ¶71. Vuitch is distinguishable; it does not elucidate the issue before us. In Vuitch, the Supreme Court, in upholding the District of Columbia's abortion ban, noted that abortions performed pursuant to the statutory exception for abortions necessary to preserve a mother's life or health were "legal." 402 U.S. at 69-71. The Court's recognition that an act is legal if performed pursuant to an express statutory exception to a proscribed act is unsurprising, but it has no relevance here. As noted, the issue in this case is not whether an abortion not expressly proscribed by law may be performed lawfully, it is whether § 36-2322(B)'s proscription on elective abortion after fifteen weeks' gestation created statutory authorization to perform other abortions in violation of an existing statute, thus repealing or limiting § 13-3603. Vuitch simply did not address the effect of a law on a pre-existing statute. 158 The dissent, employing the general/specific canon, contends that § 36-2322(B) merely operates as an exception to § 13-3603 and "does not repeal any aspect of § 13-3603" because it “negates § 13-3603 only in its application to the situation that § 36-2322(B) covers." Infra ¶¶ 87-89. Not so. "Repeal" means to “abrogat[e] . . . an existing law." Repeal, Black's Law Dictionary (11th ed. 2019). As the dissent acknowledges, "a physician who performs an abortion in compliance with § 36-2322(B) nevertheless violates 25

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court § 13-3603." Infra ¶ 85. The dissent's interpretation renders lawful what is a crime under § 13-3603. Thus, under the dissent's approach, § 36-2322(B) effectively repeals and supplants § 13-3603. The dissent's reasoning is tenable only to the extent that it discounts statutory history, the legislature's public policy pronouncement in § 1-219(A), and the construction provision that the legislature did not intend § 36-2322(B) to “repeal, by implication or otherwise, section 13-3603." Although the dissent asserts that we elevate the construction provision over the statute's text in discerning the legislature's intent concerning § 36-2322(B)'s ambiguous effect on § 13-3603, infra ¶ 79, we decline to apply the general/specific canon to ignore the legislature's plain statement in the approved bill that it did not intend for § 36-2322(B) to repeal § 13-3603, precisely the result obtained under the dissent's statutory harmonization analysis. 159 The dissent notes that the legislature's statement of intent concerning § 36-2322(B) described its objective “to restrict the practice of nontherapeutic or elective abortion to the period up to fifteen weeks of gestation," but that, in the dissent's view, “[n]othing suggests an intent to make abortions permitted under § 36-2322(B) unlawful upon Roe's demise.” Infra ¶ 105. The legislature's statement of intent and construction provision are not logically inconsistent. The intent statement expressed what the legislature intended § 36-2322(B) to do-restrict elective abortion after fifteen weeks' gestation through penalties specified in Title 36—and the construction provision expressed what the legislature did not intend the law to do-repeal § 13-3603, “by implication or otherwise." ¶60 Finally, the dissent invokes the adage that the legislature does not ordinarily “hide elephants in mouseholes," which means that the legislature "does not alter the fundamental details of a regulatory scheme in vague terms or ancillary provisions,” Whitman v. Am. Trucking Ass'ns, 531 U.S. 457, 468 (2001). Infra ¶ 66. The dissent asserts that Whitman supports its contention that the Arizona Legislature could not have intended that, if Roe was overruled, the state would enforce § 13-3603, which was enjoined solely due to Roe's recognition of a federal constitutional right to abortion. Infra ¶ 66. But here, the elephant is not hidden in a mousehole; rather, the elephant is standing in the room, albeit perhaps in a corner, despite the dissent's refusal to acknowledge it. 26

PLANNED PARENTHOOD V. KRISTIN MAYES/HAZELRIGG Opinion of the Court ¶61 We do not, as the dissent implies, rest our conclusion solely on the construction provision. In interpreting § 36-2322(B)'s ambiguity on its effect on § 13-3603, we consider Title 36's genesis as the statutory mechanism to restrict and regulate abortion in response to Roe, the legislature's unwavering and unqualified affirmative maintenance of a statutory ban on elective abortion since 1864 (albeit enjoined since 1973), § 1-219(A)'s pronouncement of the state's public policy essentially to restrict abortion to the extent permitted by "the Constitution of the United States and decisional interpretations thereof by the United States Supreme Court" and, finally, S.B. 1164's construction provision that clearly states that the legislature did not intend to repeal § 13-3603 by passing § 36-2322(B). See Part I, E ¶ 40. It is the dissent's interpretation-deliberately blind to Arizona's relevant statutory history, public policy pronouncement, and the legislature's explicit construction provision contradicting the dissent's conclusion that is strained. The only elephant hiding in a mousehole is the dissent's contention that the legislature's curtailment of access to elective abortion in § 36-2322 and its accompanying express preservation of a statutory ban on all elective abortions was intended to create an independent statutory authority for elective abortion that vitiates § 13-3603 and survives Roe's demise. See Part I, C¶ 31. IV. ¶62 Hazelrigg requests attorney fees and costs under the private attorney general doctrine. Under the private attorney general doctrine, we may award attorney fees "to a party who has vindicated a right that: (1) benefits a large number of people; (2) requires private enforcement; and (3) is of societal importance." Cave Creek Unified Sch. Dist. v. Ducey, 233 Ariz. 1, 8 ¶ 26 (2013) (quoting Arnold v. Ariz. Dep't of Health Servs., 160 Ariz. 593, 609 (1989)). Despite Hazelrigg's intervenor status, private enforcement was not required to resolve this case. In fact, then-Attorney General Brnovich initiated the trial court litigation, and Yavapai County Attorney Dennis McGrane sought to intervene. Therefore, because this case did not require private enforcement, we decline to award attorney fees and costs under the private attorney general doctrine. 27

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG Opinion of the Court CONCLUSION 163 The abortion issue implicates morality and public policy concerns, and invariably inspires spirited debate and engenders passionate disagreements among citizens. A policy matter of this gravity must ultimately be resolved by our citizens through the legislature or the initiative process. Today, we decline to make this weighty policy decision because such judgments are reserved for our citizens. Instead, we merely follow our limited constitutional role and duty to interpret the law as written. See Ariz. Const. art 3; Ariz. Sch. Bds. Ass'n v. State, 252 Ariz. 219, 229 ¶ 45 (2022) (“We respect the role of the legislature in the discharge of its constitutional duties . . . and we heed our constitution's fundamental premise that the division of powers necessarily impels judicial restraint, particularly in the realm of lawmaking.”). For the reasons discussed, the legislature has demonstrated its consistent design to restrict elective abortion to the degree permitted by the Supremacy Clause and an unwavering intent since 1864 to proscribe elective abortions absent a federal constitutional right-precisely what it intended and accomplished in § 36-2322. To date, our legislature has never affirmatively created a right to, or independently authorized, elective abortion. We defer, as we are constitutionally obligated to do, to the legislature's judgment, which is accountable to, and thus reflects, the mutable will of our citizens. ¶64 We affirm the trial court's judgment vacating the injunction of § 13-3603, vacate the court of appeals' opinion and stay of enforcement of § 13-3603, and remand to the trial court for potential consideration of the remaining constitutional challenges to § 13-3603 alleged in Planned Parenthood's complaint for declaratory relief. Although we lift the stay on enforcement of § 13-3603, we do so with two caveats. First, § 13-3603 may be enforced prospectively only. Second, we stay enforcement of § 13-3603 for fourteen calendar days from the filing date of this Opinion to permit the parties, on remand, to determine whether to pursue remaining issues raised in the trial court and, if so, to request further stay relief at the trial court's discretion. 28

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting TIMMER, VCJ., joined by BRUTINEL, CJ., dissenting: ¶65 Whether women have a federal constitutional right to terminate a pregnancy before fetal viability has been a hotly debated and extraordinarily divisive issue in Arizona and, indeed, in our entire country. Yet, after the Supreme Court ended the debate in June 2022 by issuing Dobbs v. Jackson Women's Health Organization, 597 U.S. 215, 231–32 (2022), to overrule Roe v. Wade, 410 U.S. 113 (1973), the Arizona Legislature stood pat. During its 2023 session, the legislature did not (1) repeal A.R.S. § 36-2322(B), which exempts physicians from prosecution if they perform abortions when a fetus has a gestational age less than fifteen weeks or if the pregnant woman would otherwise suffer substantial and irreversible health consequences; (2) repeal or curtail other abortion-regulating statutes in Title 36; or (3) clarify the impact of A.R.S. § 13-3603, the near-total abortion ban that lay dormant since Roe issued in 1973, on multiple modern-era statutes. Instead, the legislature purposely chose to leave all these statutes fully intact and simultaneously operational. ¶66 Nevertheless, relying on a statutory construction note tucked within a session law predating Dobbs, the majority interprets § 36-2322(B) as providing that if Roe was overruled, the state would turn back the clock to 1973 by enforcing the near-total abortion ban against physicians, even if they comply with § 36-2322(B) by performing elective abortions before the fifteen-week gestation point or performing abortions when necessary to prevent serious impairment to the pregnant woman's health. I strongly disagree. As the adage goes, the legislature does not ordinarily "hide elephants in mouseholes." See Whitman v. Am. Trucking Ass'ns, 531 U.S. 457, 468 (2001); Estate of Braden ex rel. Gabaldon v. State, 228 Ariz. 323, 330 ¶30 (2011) (Bales, J., dissenting). And the legislature neither did so nor could do so here with a session law note existing wholly apart from statutory text. Sections 13-3603 and 36-2322(B) can and should be interpreted harmoniously to permit their joint enforcement until the legislature or the people, through the initiative process, say otherwise. This means physicians should be permitted to lawfully perform abortions before the fifteen-week gestation point or when necessary to preserve the pregnant woman's health. (Notably, both laws would remain subject to challenge 29

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting under Arizona's constitution. That challenge is not at issue here.) Respectfully, I dissent. A. Both A.R.S. § 13-3603 And A.R.S. § 36-2322(B) Are Clear And Unambiguous, Making Judicial Interpretation Unnecessary And Inappropriate. Section 13-3603, the near-total abortion ban enjoined as unconstitutional by the court of appeals in 1973 after Roe, has remained essentially unchanged since 1865: ¶67 A person who provides, supplies or administers to a pregnant woman, or procures such woman to take any medicine, drugs or substance, or uses or employs any instrument or other means whatever, with intent thereby to procure the miscarriage of such woman, unless it is necessary to save her life, shall be punished by imprisonment in the state prison for not less than two years nor more than five years. (Emphasis added); see also Howell Code, ch. 10, § 45 (1865). Section 13-3603 is unambiguous, and no one suggests otherwise. Any person who performs an abortion or assists in one must be imprisoned for at least two years and not more than five years. The statute uses the above-italicized conditional clause to identify the only exception to the total ban: when “it is necessary to save [the pregnant woman's] life." Otherwise, the prohibition applies regardless of the pregnancy's duration, whether it resulted from rape or incest, and even if a physician concludes that continuing the pregnancy would substantially and irreversibly impair the woman's health. 168 Since 2000, A.R.S. § 36-2301.01(A)(1) has prohibited physicians from "knowingly perform[ing] an abortion of a viable fetus" unless "necessary to preserve the life or health of the [pregnant] woman.” See 2000 Ariz. Sess. Laws ch. 365, § 2 (2d Reg. Sess.). In 2022, the legislature enacted § 36-2322(B) to further restrict when a physician may perform an abortion. See 2022 Ariz. Sess. Laws ch. 105, § 1 (2d Reg. Sess.) (leaving § 36-2301.01(A) in place and operational). At that time, the Supreme Court was still considering Dobbs, which concerned the constitutionality of 30

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting Mississippi's "Gestational Age Act" (an act containing a statute nearly identical to § 36-2322). Section 36-2322(B) went into effect three months after the opinion in Dobbs issued and provides as follows: "Except in a medical emergency, a physician may not intentionally or knowingly perform, induce or attempt to perform or induce an abortion if the probable gestational age of the unborn human being has been determined to be greater than fifteen weeks."⁹ (Emphasis added.) A physician who violates § 36-2322(B) is guilty of a class 6 felony, which is punishable by up to two years' imprisonment, and the state will suspend or revoke the physician's license to practice medicine. See A.R.S. §§ 36-2324(A), -2325(A); 13-702(D). ¶69 I disagree with the majority that § 36-2322(B) is ambiguous. See supra ¶¶21-22. That statute has only one reasonable meaning, and we should apply it. See Glazer v. State, 237 Ariz. 160, 163 ¶ 12 (2015). We start with the statute's text "because it is the most reliable indicator of a statute's meaning." State v. Holle, 240 Ariz. 300, 302 ¶ 11 (2016). If the legislature's intent is "readily discernable from the face of the statute," we do not resort to other methods of statutory interpretation, like examining a statute’s context, history, or purpose. See id.; Franklin v. CSAA Gen. Ins. Co., 255 Ariz. 409, 411 ¶ 8 (2023). Nor do we attempt to divine and give effect to the legislature's unexpressed intent or look to session laws to manufacture ambiguity where none exists. See Holle, 240 Ariz. at 302 ¶ 11. 170 Like § 13-3603, the territorial-era abortion ban, § 36-2322(B) uses conditional words to precisely identify conduct that is lawful and therefore permissible. Specifically, a physician commits a crime only "if" the physician performs an abortion when the fetus has a gestational age A "medical emergency" occurs when a physician makes a “good faith clinical judgment" that the pregnant woman suffers a medical condition that “necessitate[s] the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irreversible impairment of a major bodily function." A.R.S. § 36-2321(7). "Major bodily function[s]" include "functions of the immune system, normal cell growth, and digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine and reproductive functions." § 36-2321 (6). 31

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting greater than fifteen weeks "[e]xcept in a medical emergency." § 36-2322(B) (emphasis added). By default, all other physician-performed abortions are permissible and lawful under the provision, assuming the physician complies with other statutes not before us. 10 See A.R.S. § 13-103(A) (“No conduct or omission constitutes an offense... unless it is an offense . . . under this title or under another statute or ordinance.”). The statute has no other reasonable interpretation. ¶71 United States v. Vuitch, 402 U.S. 62 (1971), supports this plain-meaning interpretation. There, the Supreme Court addressed the District of Columbia's indictment of a physician under the district's abortion ban. Id. at 63-64. Similar to Arizona's territorial-era abortion ban, the District of Columbia's ban prohibited abortions on threat of a multi-year prison term "unless the same were done as necessary for the preservation of the mother's life or health.” See id. at 68 (quoting D.C. Code § 22-201 (1901)). The issue was whether the statute was unconstitutionally vague. See id. at 63–64. The Court upheld the statute, reasoning in part that the ban's exception constituted an element of the crime the government must prove rather than an affirmative defense. See id. at 71. In doing so, the Court characterized abortions falling within the life-or-health exception as "legal," and elaborated as follows: The statute does not outlaw all abortions, but only those which are not performed under the direction of a competent, 10 Even when a physician complies with § 36-2322(B), the physician nevertheless commits a crime if he performs an abortion on a minor without receiving parental consent or judicial authorization. See A.R.S. § 36-2152(A). The physician also commits a crime by performing an abortion while knowing the woman is seeking to avoid having a baby with a genetic abnormality or of a particular race or gender. See A.R.S. § 13-3603.02(A)(1). The federal district court preliminarily enjoined § 13-3603.02(A)(1) as it concerns genetic abnormalities because the provision is likely unconstitutionally vague and imposed an undue burden on a woman's - now abrogated — federal constitutional right to terminate a pre-viability pregnancy. See Isaacson v. Brnovich, 563 F. Supp. 3d 1024, 1047 (D. Ariz. 2021). 32

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting licensed physician, and those not necessary to preserve the mother's life or health . . . . When Congress passed the District of Columbia abortion law in 1901 and amended it in 1953, it expressly authorized physicians to perform such abortions as are necessary to preserve the mother's "life or health.” See id. at 69-70. Like the District of Columbia's ban, § 36-2322(B) clearly permits physicians to lawfully perform abortions that are not expressly outlawed. ¶72 The majority agrees that this is the logical, plain reading of § 36-2322. See supra ¶ 21. Nevertheless, because the statute does not explain how it operates alongside § 13-3603, the majority finds that § 36-2322(B)'s conditional language can also be reasonably interpreted as “merely acknowledg[ing] the existence of a contemporaneous federal constitutional right to abortion under Roe," which forced the legislature to “qualify the circumstances under which a physician may be penalized." See supra ¶¶21-22, 55. Finding the statute therefore ambiguous, the majority then examines secondary principles—including, most prominently, the construction note in the session law that enacted § 36-2322 and other statutes. See supra ¶¶ 23–31. ¶73 In my view, the majority errs by finding § 36-2322(B) ambiguous and then using the construction note to interpret the statute in a way unsupported by its plain textual meaning. First, nothing in the statutory text even hints that § 36-2322(B)'s identification of legal, and therefore permissible, abortions depends on Roe's continuing enforceability. And no language suggests that any aspect of § 36-2322(B) would become inoperative if the Supreme Court overruled Roe. ¶74 Second, § 36-2322's failure to explain its effect on § 13-3603 does not cloud the plain meaning of § 36-2322(B)'s enacted text. The authorities cited by the majority do not support that a statute's silence about its impact on the operation of a different statute creates an ambiguity in textual meaning. See S. Ariz. Home Builders Ass'n v. Town of Marana, 254 Ariz. 281, 286 ¶ 31 (2023); Stambaugh v. Killian, 242 Ariz. 508, 509 ¶ 7 (2017); State v. Sweet, 143 Ariz. 266, 269-70 (1985). Notably, the majority does not 33

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting identify any unclear language in § 36-2322(B) resulting from its silence concerning § 13-3603. There simply is no "textual ambiguity," as the majority claims. See supra ¶21. Section 36-2322(B) has a single, plain meaning that is not made ambiguous by § 13-3603's existence or by the existence of other statutes outlawing abortions in defined circumstances. See Part I, D¶ 99. The conflict between the statutes only comes into play in deciding whether one repeals the other or whether they can be harmonized. See Part I, C-D ¶¶85-91. It does not transform § 36-2322(B)'s plain language into ambiguous text that needs further interpretation. 175 Third, § 36-2322(B)'s conditional language cannot logically reflect a forced accommodation to Roe, as the majority concludes, because Roe would not have tolerated the after-fifteen-week ban. Roe held that women have a due process right to terminate a pregnancy before the fetus becomes viable and to obtain that abortion without the government's undue interference. See Roe, 410 U.S. at 164; see also Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833, 846, 873, 876–77 (1992) (reaffirming Roe's central holding but replacing its rigid trimester framework with an "undue burden" test to determine whether abortion regulations are permissible). Viability at the time Roe was decided was around twenty-eight weeks, and in 2022 was suggested to be twenty-three or twenty-four weeks. See Dobbs, 597 U.S. at 276. Also, the Supreme Court stressed after Roe that determining precisely when viability is reached must be left to the attending physician in each case, and neither a legislature nor a court could establish viability in terms of gestational weeks or other factors. See Colautti v. Franklin, 439 U.S. 379, 388–89 (1979), abrogated by Dobbs, 597 U.S. 215. For that reason- -as the legislature undoubtedly knew when it enacted § 36-2322(B) — the Ninth Circuit Court of Appeals invalidated A.R.S. § 36-2159, which banned elective abortions after twenty weeks.¹¹ See Isaacson v. Horne, 716 F.3d 1213, 1225-26 (9th Cir. 2013). But for Dobbs, the more-restrictive after-fifteen-week ban would undoubtedly have met the same fate. In short, Roe did not force the legislature to allow abortions up to the fifteen-week gestation point. - 11 Nevertheless, as with § 13-3603, the legislature has never repealed § 36-2159. 34

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting 176 Fourth, the majority's focus on whether § 36-2322(B) grants an affirmative right to an abortion akin to Roe's recognition of a constitutional right is misplaced. See supra ¶ 22 ("Section 36-2322's text in isolation, therefore, does not resolve the fundamental issue before us: whether the statute creates independent statutory authority for abortion intended to repeal or restrict § 13-3603 . . . .”); ¶ 23 (“To determine if Title 36 creates a right to abortion, or otherwise provides independent statutory authority to perform the procedure... we must consider S.B. 1164's construction provision."); ¶ 42 (concluding "the legislature did not intend to create a privilege secured by law to obtain or perform an abortion” by enacting § 36-2322(B)). Section 36-2322(B) proscribes abortions performed by physicians under particular circumstances. As previously explained, see Part I, A ¶¶ 70–71, § 36-2322(B) provides that all other abortions performed by physicians are necessarily lawful and permitted under the criminal law because they are not proscribed. See § 13-103(A). Proscribing conduct does not require the legislature to grant people an affirmative right to engage in conduct falling outside the proscription, and the majority does not cite any authority suggesting otherwise. Notably, two years before Roe and without considering whether women had a right to a pre-viability abortion, the Supreme Court in Vuitch interpreted the District of Columbia's abortion ban as providing that abortions falling within the life-or-health exception are permitted and lawful. Likewise, at a time when women lacked a federal constitutional or statutory right to an abortion, the legislature enacted what is now § 13-3603, which permits women to obtain abortions to save their lives. Doing so did not grant women a statutory right to an abortion under those circumstances. ¶77 An example raised at oral argument illustrates the point. I can legally drive thirty-five miles per hour when the speed limit is forty-five miles per hour. But the law establishing the speed limit does not grant me an affirmative right to drive thirty-five miles per hour; I simply will not be ticketed for doing so. Likewise, under § 36-2322(B), women do not need an affirmative right to terminate a pregnancy for a physician to perform an abortion either before the fifteen-week gestation point or to prevent the pregnant woman from suffering serious health conditions; the physician simply will not be prosecuted for doing so. 35

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting 178 Too, the legislature does not affirmatively grant a right by decriminalizing conduct. For example, in 2021, the legislature repealed A.R.S. § 13-3604, which had provided that a woman who has an abortion that is not necessary to save her life shall be imprisoned from one to five years. See 2021 Ariz. Sess. Laws ch. 286, § 3 (1st Reg. Sess.). And when enacting § 36-2322, the legislature provided that the “pregnant woman on whom an abortion is performed, induced or attempted in violation of § 36-2322 may not be prosecuted for conspiracy” to violate the statute. § 36-2324(B). By affirmatively declining to hold women criminally responsible for seeking or obtaining an abortion, the legislature did not grant women a right to seek an abortion; it simply decided the state would not prosecute women for doing so. The majority misses the mark by asking and then answering whether § 36-2322(B) grants a limited right to abortion. ¶79 Fifth, the majority incorrectly elevates the construction note in § 36-2322(B)'s session law to equal its text. Instead of using the note as a tool in interpreting any ambiguous language in the statutory text, the majority incorrectly uses the note to create an ambiguity in the text. See supra ¶ 22 ("[A]ny interpretation of the statute that ignores or minimizes the impact of Dobbs' disavowal of a federal constitutional abortion right runs headlong into the construction provision of Senate Bill 1164 ... the genesis of § 36-2322 and part of what the legislature enacted."); id. ("We must interpret the statute in its proper context" which "requires us to reconcile the legislature's construction provision, which specifically preserves § 13-3603, and the text of § 36-2322 . . . ."); ¶ 24 ("The construction provision is part of the bill that legislators [had] before them and approve[d], and has the same force of law as codified law.”); ¶ 25 (stating the Court must consider the construction note to discern § 36-2322(B)'s meaning "because [the construction note] is part of the bill the legislature approved”). ¶80 The "construction" note, which-despite its title-expresses only legislative intent and provides absolutely no insight on what the legislature meant by any language in the statute, is emphatically not part of the statutory text. See 2022 Ariz. Sess. Laws ch. 105, § 2 (2d Reg. Sess.). We have repeatedly stressed that declarations of legislative intent in an enactment are "devoid of operative effect." See Redgrave v. Ducey, 251 Ariz. 451, 457 ¶ 22 (2021) (concluding that if statutory text conflicts with a

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting statement of purpose or intent, "the text must prevail"); Cronin v. Sheldon, 195 Ariz. 531, 538 ¶30 (1999) ("The preamble [stating legislative purpose and intent] is devoid of operative effect."); Sakrison v. Pierce, 66 Ariz. 162, 172 (1947) (stating that the policy section of an act would be controlling only "if we were called upon to interpret an operative portion of the statute that was ambiguous or of doubtful meaning" and emphasizing that "the policy of the law is not controlling and can be considered only where the statute is ambiguous” (quoting 59 C.J.S., Statutes, § 602 for the latter quote)). The majority ignores this principle. ¶81 We have also consistently emphasized that if a statute has a plain textual meaning, we simply apply it rather than construe it by examining secondary sources. See, e.g., Mussi v. Hobbs, 255 Ariz. 395, 402 ¶34 (2023) ("It is a basic principle that courts will not read into a statute something which is not within the manifest intention of the legislature as indicated by the statute itself." (emphasis added) (quoting Town of Scottsdale v. State ex. rel. Pickrell, 98 Ariz. 382, 386 (1965))); S. Ariz. Home Builders Ass'n, 254 Ariz. at 286 ¶ 31 ("Statutory interpretation requires us to determine the meaning of the words the legislature chose to use."); City of Mesa v. Killingsworth, 96 Ariz. 290, 294 (1964) (“Where the statute is unambiguous, the courts will only apply the language used and not interpret, for the statute speaks for itself."). We hold the legislature to its enacted statutory text, and the majority therefore errs by using the construction note to vary § 36-2322(B)'s plain language. See Roberts v. State, 253 Ariz. 259, 266 ¶ 20 (2022) (quoting City of Phoenix v. Donofrio, 99 Ariz. 130, 133 (1965)) (stating "courts will not read into a statute something which is not within the manifest intention of the legislature as gathered from the statute itself” (emphasis added)); In re McLauchlan, 252 Ariz. 324, 326 ¶15 (2022) (“Legislative history is not a substitute for clear legislative language . . .”); Antonin Scalia & Bryan A. Garner, Reading Law: The Interpretation of Legal Texts 56-58 (2012) (noting the supremacy of statutory text and explaining that statutory purpose "sheds light only on deciding which of various textually permissible meanings should be adopted"). ¶82 For all these reasons, it is simply implausible to interpret § 36-2322(B)'s conditional language as merely acknowledging Roe's restriction on the state's ability to prohibit pre-viability abortions. The 37

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting statute says what it means and means what it says: The state will prosecute physicians for performing abortions after the fetus reaches fifteen weeks in age unless a medical emergency requires the procedure. The state will not prosecute physicians for performing abortions before the fetus reaches fifteen weeks in age. These abortions are lawful. There is no room for misunderstanding. ¶83 My colleagues accuse me of "deliberately blind[ing]” myself to legislative history and the legislature's construction note in interpreting § 36-2322(D). See supra ¶ 61. Not so. With eyes wide open, I fulfill the legislature's intent by giving plain meaning to the language actually enacted. I decline to engage in the guesswork needed to engraft onto § 36-2322(B)'s straightforward language a meaning the legislature may or may not have intended had it anticipated the Supreme Court would overrule Roe. ¶84 But what effect does a reinvigorated § 13-3603 have on § 36-2322(B)? The majority does not address whether the statutes can be harmonized, as the court of appeals held. See Planned Parenthood Ariz., Inc. v. Brnovich, 254 Ariz. 401, 405 ¶ 13 (App. 2022). Because it concludes that § 36-2322(B) does not create a legal privilege to obtain or perform an abortion, the majority finds no conflict and thus “[no] need to harmonize” the two statutes. See supra ¶ 42. I disagree, so I turn to that issue. B. Sections 13-3603 And 36-2322(B) Conflict. 185 The conflict between §§ 13-3603 and 36-2322(B) is readily apparent. On the one hand, § 13-3603 criminalizes performing any abortions, unless necessary to save the pregnant woman's life. On the other hand, § 36-2322(B) criminalizes physician-performed abortions only when the physician performs an abortion after the fetus is fifteen weeks of age and a medical emergency does not necessitate the procedure. Consequently, a physician who performs an abortion in compliance with § 36-2322(B) nevertheless violates § 13-3603, unless the abortion was necessary to save the pregnant woman's life. In that situation, the statutes operate inconsistently and therefore conflict. See State v. Jones, 235 Ariz. 501, 503 ¶ 8 (2014); see also Cave Creek Unified Sch. Dist. v. Ducey, 233 Ariz. 1, 7 38

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting ¶ 24 (2013) (holding that a conflict exists when statutes cannot be read "to give each effect and meaning”). C. Section 36-2322(B) Operates As An Exception To § 13-3603. 186 We have repeatedly stated that courts have a duty to harmonize statutes to rectify conflicts, as far as possible, and avoid construing one statute as impliedly repealing another. See, e.g., State v. Rice, 110 Ariz. 210, 213 (1973); State Land Dep't. v. Tucson Rock & Sand Co., 107 Ariz. 74, 77 (1971); Ard v. State, 102 Ariz. 221, 224 (1967). Reconciling any contradictions "giv[es] force and meaning to all statutes involved." UNUM Life Ins. Co. of Am. v. Craig, 200 Ariz. 327, 333 ¶ 28 (2001). ¶87 The conflict between the statutes here is reconciled by applying the general/specific canon. That canon is not used to discern the meaning of statutory language but instead directs the operation of conflicting provisions. See Guard./Conserv. of Denton, 190 Ariz. 152, 157 (1997). It provides that "[w]hen 'two conflicting statutes cannot operate contemporaneously, the more recent, specific statute governs over an older, more general statute.”” Jones, 235 Ariz. at 503 ¶ 8 (quoting UNUM Life Ins. Co., 200 Ariz. at 333 ¶ 29); see also State v. Santillanes, 541 P.3d 1150, 1155–56 ¶ 20 (Ariz. 2024) (recognizing the canon); Scalia & Garner 183 (“If there is a conflict between a general provision and a specific provision, the specific provision prevails.”). ¶88 As the more specific and recent statute, § 36-2322(B) applies in circumstances governed by it. See Jones, 235 Ariz. at 503 ¶¶ 8, 11; Guard./Conserv. of Denton, 190 Ariz. at 157; Lemons v. Superior Court, 141 Ariz. 502, 505 (1984). Because § 13-3603 is the more general statute, outlawing almost all abortions, § 36-2322(B) operates as an exception to § 13-3603's near-total ban. See State v. Cassius, 110 Ariz. 485, 487 (1974) ("Where a statute first expresses a general intent, and later an inconsistent particular intent, such particular intent will be taken as an exception to the general intent, and both will stand."). ¶89 To be clear, § 36-2322(B) does not repeal any aspect of § 13-3603. See Scalia & Garner 184 ("Note that the general/specific canon 39

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting does not mean that the existence of a contradictory specific provision voids the general provision. Only its application to cases covered by the specific provision is suspended; it continues to govern all other cases.”). Instead, § 36-2322(B) negates § 13-3603 “only in its application to the situation that [§ 36-2322(B)] covers.' Id. at 185. Contrary to the majority's characterization, see supra ¶ 42, applying § 36-2322(B) as an exception to § 13-3603 does not "repeal" any part of the latter statute. See Cassius, 110 Ariz. at 487 (finding that a later criminal statute operates as an exception to a conflicting general statute, neither statute is repealed, and “each is given full effect"). 11 190 So, if a physician performs an abortion at the thirteen-week gestation point as permitted by § 36-2322(B), the state cannot prosecute the physician under § 13-3603. Section 36-2322(B) operates as an exception, just like § 13-3603's exception for abortions performed to save the pregnant woman's life. But if the physician performs an abortion at the sixteen-week gestation point and without a medical emergency in violation of § 36-2322(B), the state may prosecute the physician under either § 13-3603 or § 36-2322(B). See United States v. Batchelder, 442 U.S. 114, 123–24 (1979) ("[W]hen an act violates more than one criminal statute, the Government may prosecute[] under either so long as it does not discriminate against any class of defendants."); State v. Romero, 130 Ariz. 142, 147 (1981) (concluding "[t]here is no question that the Legislature could proscribe the conduct covered by [two different statutes]” so long as the state did not use an "unjustifiable selection standard"). No exception to prosecution would exist under either statute. And, of course, the state may prosecute any non-physician, including other medical professionals, for performing an abortion in violation of § 13-3603. 191 Resolving the conflict in this way recognizes that each statute is given full effect as parts of a single statutory scheme governing abortions. See Fleming v. State Dep't of Pub. Safety, 237 Ariz. 414, 417 ¶ 12 (2015) ("[W]hen statutes relate to the same subject matter, we construe them together as though they constitute one law . . . ."). It does not matter that the provisions are in different statutory chapters or that § 13-3603 lay largely dormant for decades until reinvigorated by Dobbs. See State ex rel. 40

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting Larson v. Farley, 106 Ariz. 119, 122 (1970). Related statutes "must be construed as one system governed by one spirit and policy.” Id. ¶92 The majority's position neutralizes most of Title 36, which regulates and restricts abortions and abortion clinics, and impliedly repeals the part of § 36-2322(B) permitting physicians to lawfully perform abortions before the fetus is fifteen weeks old or in a medical emergency. But viewing § 36-2322(B) as an exception to § 13-3603, as I do, avoids impliedly repealing any statute and results in a single, cohesive legislative scheme. See Fleming, 237 Ariz. at 417. D. Neither The Construction Note Nor Any Other Law Triggers § 36-2322(B)'s Nullification Upon Roe's Demise and § 13-3603's reanimation. 193 The only way to conclude that § 36-2322(B) is not given full effect as an exception to § 13-3603 is if the legislature had enacted a "trigger clause" abrogating § 36-2322(B) upon Roe's demise. Indisputably, the legislature did not expressly do so. Nevertheless, the majority finds "a discernible comprehensive trigger provision" by considering the legislature's continuing recognition of § 13-3603, the session law's construction note, and A.R.S. § 1-219(A), which states that laws should be interpreted as acknowledging that a fetus has the same rights as all persons. See supra ¶ 40. My colleagues then conclude Dobbs pulled this trigger by "remov[ing] the sole authority for elective abortion in Arizona," thereby abrogating § 36-2322(B). See supra¶¶40, 43. ¶94 Before addressing the majority's reasoning, it is useful to consider what constitutes a trigger clause. Mississippi's abortion scheme provides an example. In 2007, the Mississippi Legislature enacted a law banning all abortions "except in the case where necessary for the preservation of the mother's life or where the pregnancy was caused by rape." Miss. Code Ann. § 41-41-45(2). Roe, of course, would have abrogated that ban. Consequently, the Mississippi Legislature made the law effective ten days after the Mississippi Attorney General publishes a determination that the Supreme Court has overruled Roe and the ban would probably be upheld by that Court as constitutional. See 2007 Miss. Laws ch. 441, §§ 4, 6. 41

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting Those circumstances would automatically "trigger" the almost total ban on abortion. 195 Mississippi's fifteen-week gestation statute, in turn, has a provision in its text triggering the statute's own demise upon § 41-41-45(2)'´s effective date. Mississippi Code § 41-41-191(8) provides that “[a]n abortion that complies with this section, but violates any other state law, is unlawful." Thus, if Mississippi's near-total abortion ban became effective as certified by the Mississippi Attorney General, abortions previously permitted by § 41-41-191 would become "unlawful" without further legislative action. The Mississippi Legislature explicitly directed what would occur if the Supreme Court overruled Roe as certified by the Mississippi Attorney General: the state's near-total ban would go into effect and abortions complying with the fifteen-week gestation statute would nevertheless become unlawful as violating the new near-total ban. ¶96 Neither § 36-2322(B) nor any other Arizona law has trigger language like § 41-41-191(8)'s clause. The majority characterizes the session law construction note as “virtually identical" to Mississippi's § 41-41-191(8) and asserts either both must have a trigger clause or neither do. See supra ¶ 39. But the majority refuses to recognize and give weight to the crucial, operative language that explicitly triggers § 41-41-191's demise upon its conflict with another statute. See id. Critically, unlike Mississippi's legislature, our legislature opted not to provide that an abortion that complies with § 36-2322(B) “but violates any other state law,” including § 13-3603, makes the abortion "unlawful." And in my view, the construction note, together with § 13-3603's continued existence and § 1-219(A)'s interpretation directive acknowledging fetal rights, cannot be dressed up as a comparable trigger clause. 197 The legislature included § 36-2322(B) within a new article entitled "Gestational Limit on Abortion." See 2022 Ariz. Sess. Laws ch. 105 (2d Reg. Sess.). Nothing in the statutory text even arguably constitutes a trigger clause. The construction note contained within the session law provides: 42

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting This act does not: 1. Create or recognize a right to abortion or alter generally accepted medical standards. The Legislature does not intend this act to make lawful an abortion that is currently unlawful. 2. Repeal, by implication or otherwise, section 13-3603, Arizona Revised Statutes, or any other applicable state law regulating or restricting abortion. See 2022 Ariz. Sess. Laws ch. 105, § 2 (2d Reg. Sess.). Nothing in this note conditions § 36-2322(B)'s effectiveness on whether or not the Supreme Court overrules Roe. And it certainly would have been easy to include that condition in a sentence or two if the legislature had intended that result. See Scalia & Garner at 181-82 (highlighting "[t]he familiar 'easy-to-say-so-if-that-is-what-was-meant' rule of statutory interpretation” (quoting Commissioner v. Beck's Estate, 129 F.2d 243, 245 (2d Cir. 1942))). Undoubtedly, the legislature knew how to use trigger clauses because it has explicitly inserted them into other abortion-related session laws. See, e.g., 1999 Ariz. Sess. Laws ch. 311, §§ 12, 13 (1st Reg. Sess.) (calling for the conditional repeal and the conditional enactment of statutory provisions triggered by a court finding that the statutory definition of "abortion clinics” is unconstitutional). And the Arizona Legislature in 2022 followed a drafting manual explaining how to word such provisions. See Ariz. Legis. Bill Drafting Manual § 4.4 at 30-32 (2021-2022) (explaining conditional enactments and repeals and providing sample language not found in § 36-2322 or the construction note); see also A.R.S. § 41-1304(A) (charging a council of legislators with providing bill-drafting services to improve the quality of legislation). ¶98 The majority reaches the opposite conclusion, but I do not find its reasoning persuasive. First, the construction note's statement that the act including § 36-2322(B) does not "[c]reate or recognize" women's right to abortion does not mean revived § 13-3603 serves to make unlawful all abortions that comply with § 36-2322(B). As previously explained, the legislature does not have to affirmatively grant women a right to an abortion to criminalize or not criminalize performing abortions 43

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting in some situations. See Part I, A ¶¶ 76–78. Thus, the legislature did not affirmatively grant the right by permitting anyone to perform a lawful abortion if necessary to save a pregnant woman's life, see § 13-3603, or by permitting physicians to perform lawful abortions before the fifteen-week gestation point or in a medical emergency, see § 36-2322(B). 199 Second, the note's statement that “[t]he Legislature does not intend this act to make lawful an abortion that is currently unlawful” did not trigger § 36-2322(B)'s abrogation upon Roe's demise. The majority concludes that the only "currently unlawful” abortions are ones proscribed by § 13-3603 because only that provision is more restrictive than § 36-2322(B). See supra 29. Thus, because nearly all abortions under § 13-3603 are unlawful, the majority reasons that abortions performed before the fifteen-week gestation point or in a medical emergency per § 36-2322(B) became "unlawful" when the injunction was lifted on § 13-3603. See supra ¶ 29. 100 The majority's factual premise is incorrect because the legislature included all abortion laws within the “currently unlawful” clause and not just those more restrictive than § 36-2322(B). See 2022 Ariz. Sess. Laws ch. 105, § 2 (2d Reg. Sess.) (“The Legislature does not intend this act to make lawful an abortion that is currently unlawful."). Many statutes other than § 13-3603 criminalize abortions. And unlike § 13-3603, those statutes operated without restriction when the legislature enacted § 36-2322(B), making abortions performed in violation of those provisions "currently unlawful." See A.R.S. § 13-3603.01 (proscribing partial-birth abortions unless necessary to save the life of the pregnant woman); § 36-2152(A) (prohibiting physicians from performing abortions on minors without parental consent or judicial authorization); § 36-2301.01 (prohibiting a physician from "knowingly perform[ing] an abortion of a viable fetus" except in a medical emergency); §13-3603.02(A)(1) (proscribing abortions committed when a physician knows the woman is seeking to avoid having a baby with a genetic abnormality or of a particular race or gender). ¶101 Notably, at the time the legislature enacted § 36-2322(B), abortions up to the fifteen-week gestation point and those performed in a 44

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting medical emergency were not "currently unlawful" under § 13-3603 because that statute had been enjoined for more than fifty years. It would be downright bizarre for the legislature to have enacted § 36-2322(B) while simultaneously intending to make “unlawful” abortions complying with that statute. ¶102 For all these reasons, it is implausible to conclude the legislature planted within the construction note a bombshell of reverting to a near-total ban on abortion—including those to preserve a woman's health-by using the term “currently unlawful" as referring to abortions made unlawful by a long-enjoined § 13-3603 rather than currently operative statutes making certain abortions unlawful. See Whitman, 531 U.S. at 468; Estate of Braden ex rel. Gabaldon, 228 Ariz. at 330 ¶ 30 (Bales, J., dissenting). If the legislature intended otherwise, it could have easily said so. ¶103 Third, the note's statement that the act including § 36-2322(B) does not repeal § 13-3603 or other provisions "regulating or restricting abortions" does not mean that abortions permitted under § 36-2322(B) become unlawful if Roe is overruled and § 13-3603 is no longer enjoined. As previously explained, § 13-3603 does not have to be repealed for § 36-2322(B) to operate. See Part I, C ¶¶ 86-92. Both statutes can remain fully intact and operate as one cohesive act. And by explicitly keeping other statutes "regulating or restricting abortions" intact, the legislature signaled its intention to maintain a single, cohesive system in which all statutes remain fully operational. Under the majority's view, maintaining other statutes "restricting abortions” would be impossible because § 13-3603's near-total ban would engulf those provisions without exception. ¶104 Fourth, § 1-219(A) provides no authority for concluding that abortions permitted under § 36-2322(B) would become unlawful under § 13-3603 if Roe was overruled. Section 1-219(A) is an interpretation provision and is not substantive. Because no language in the construction note can be interpreted as a trigger clause, § 1-219(A) adds nothing and does not support the majority's position. 1105 In sum, unlike Mississippi's legislature, our legislature did not include a trigger clause in the act containing § 36-2322(B). Any 45

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting lingering doubt is further removed by considering the legislature's express statement of intent. In it, the legislature makes several findings of fact concerning gestation and the state's legitimate interests in protecting potential new life and the health of a pregnant woman. See 2022 Ariz. Sess. Laws ch. 105, § 3(A) (2d Reg. Sess.). It then affirmatively states what it intends to accomplish: “This Legislature intends through this act and any rules and policies adopted hereunder, to restrict the practice of nontherapeutic or elective abortion to the period up to fifteen weeks of gestation." See 2022 Ariz. Sess. Laws ch. 105, § 3(B) (2d Reg. Sess.). Nothing suggests an intent to make abortions permitted under § 36-2322(B) unlawful upon Roe's demise. CONCLUSION 106 All agree the legislature enacted § 36-2322(B) in hopes the Supreme Court in Dobbs would uphold Mississippi's similar Gestational Age Act. See Governor's Approval Message, 2022 Ariz. Sess. Laws ch. 105 (2d Reg. Sess.) ("This very issue is pending before the United States Supreme Court now in Dobbs v. Jackson Women's Health Organization.”). But the legislature perhaps got more than it expected when Dobbs overruled Roe. Some, most, or even all legislators in 2022 would have included a trigger clause repealing § 36-2322(B) and other Title 36 laws if they foresaw that Roe would be overruled and the injunction on § 13-3603 lifted. But the legislature did not state that intent in any statute or session law, and we should not speculate about what it would have done. Justice Antonin Scalia and Bryan Garner, considered by many to be leading scholars in statutory interpretation, call doing otherwise as following, "[t]he false notion that when a situation is not quite covered by a statute, the court should reconstruct what the legislature would have done had it confronted the issue." Scalia & Garner at 349. They caution that “judicial predictions of how the legislature would have decided issues it did not in fact decide are bound to be little more than wild guesses.” Id. at 350 (quoting Frank H. Easterbrook, Statutes' Domains, 50 U. Chi. L. Rev. 533, 547–48 (1983)). ¶107 What the legislature did express in plain language was a statutory scheme that includes both § 13-3603 and § 36-2322(B). I would therefore apply the latter statute as an exception to the former, leaving both 46

PLANNED PARENTHOOD v. KRISTIN MAYES/HAZELRIGG VICE CHIEF JUSTICE TIMMER, joined by CHIEF JUSTICE BRUTINEL, Dissenting fully intact and operative. This would mean physicians could perform abortions up to the fifteen-week gestation point or to preserve the pregnant woman's health without incurring harsh criminal penalties. If the legislature or the people desire a different result, either could enact a new law. ¶108 The majority's opinion today will undoubtedly be derided by many as result-oriented or a reflection of individual justices' ideology. My dissenting opinion will probably spark similar criticism. That is the cross borne by all judges in controversial social-issue cases like this one. But nothing is further from the truth. In upholding our oaths to follow the laws of this state, we simply disagree - vehemently — about what those laws mean. And in my view, the majority mistakenly returns us to the territorial-era abortion statute last operative in 1973. I would leave it to the people and the legislature to determine Arizona's course in the wake of Roe's demise. With great respect for my colleagues, I dissent. 47