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UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
_____________________
No. 91-1953
_____________________
HELEN B. BARNES, M.D., ET AL.,
Plaintiffs-Appellees,
versus
MIKE MOORE, Attorney General of the State of
Mississippi and his employees, agents and successors,
Defendants-Appellants.
_________________________________________________________________
Appeal from the United States District Court for the
Southern District of Mississippi
_________________________________________________________________
(August 17, 1992)
Before REYNALDO G. GARZA, DAVIS, and BARKSDALE, Circuit Judges.
PER CURIAM:
On August 5, following oral argument earlier that day in this
appeal from the district court's preliminarily enjoining
enforcement of the Mississippi Informed Consent to Abortion Act, we
vacated the injunction, stating that we would file an opinion, to
include further disposition of this appeal. Pursuant to Planned
Parenthood of Southeastern Pennsylvania v. Casey, 60 U.S.L.W. 4795
(U.S. June 29, 1992), we hold that the Act is facially
constitutional. Accordingly, this case is REMANDED to the district
court for entry of an order of dismissal.
I.

In March 1991, the Mississippi Legislature enacted the
Informed Consent to Abortion Act, Miss. Code Ann. §§ 41-41-31, et
seq., effective that July. That May, the plaintiffs (abortion
clinics and physicians who perform abortions or provide abortion
referral services) filed suit, asserting that the Act is
unconstitutional on its face, and seeking, inter alia, immediate
injunctive relief. Although the Act was to become effective on
July 1, the Mississippi Attorney General agreed to suspend
enforcement until September 1. After two days of evidentiary
hearings on plaintiffs' motion for a preliminary injunction, the
district court, on August 30, two days before the Act was to become
effective, granted the injunction, "suspending the effective date
and enforcement" of the Act. It so ruled because of controlling
Supreme Court precedent.
While this appeal from that injunction was pending, the
Supreme Court rendered its decision in Casey on the facial
challenge to the Pennsylvania Abortion Control Act, upholding the
informed consent, 24-hour waiting period, parental consent, and
reporting and recordkeeping provisions, but striking down the
spousal notification provision. The judgment was announced in a
joint opinion by Justices O'Connor, Kennedy, and Souter. The
parties to this appeal then filed supplemental briefs on the effect
of Casey.
II.
The Mississippi Act's informed consent and 24-hour waiting
period provisions are substantially identical to similar provisions
- 2 -

of the Pennsylvania Act at issue in Casey; but, unlike the
Pennsylvania Act, Mississippi's does not contain spousal
notification (struck down in Casey), parental consent, and
reporting and recordkeeping provisions. Accordingly, as plaintiffs
essentially conceded at oral argument, they cannot now meet the
well-established four-part test for obtaining a preliminary
injunction, including showing a substantial likelihood of success
on the merits.1 Therefore, we vacated the preliminary injunction.
In any event, plaintiffs have raised a host of challenges to the
Mississippi Act, in an attempt to distinguish it from the Act
upheld in Casey, resulting in our either remanding for further
proceedings or holding against the facial challenge and remanding
for entry of an order of dismissal.
Because the plaintiffs are challenging the facial validity of
the Mississippi Act, they must "establish that no set of
circumstances exists under which the Act would be valid." United
States v. Salerno, 481 U.S. 739, 745 (1987); Casey, 60 U.S.L.W. at
1
The four prerequisites [for the extraordinary
relief of preliminary injunction] are as follows:
(1) a substantial likelihood that plaintiff will
prevail on the merits, (2) a substantial threat
that plaintiff will suffer irreparable injury if
the injunction is not granted, (3) that the
threatened injury to plaintiff outweighs the
threatened harm the injunction may do to defendant,
and (4) that granting the preliminary injunction
will not disserve the public interest.
Canal Authority v. Callaway, 489 F.2d 567, 572 (5th Cir. 1974).
- 3 -

4834 (Rehnquist, C.J., dissenting in part).2 In light of Casey's
holding substantially identical provisions of the Pennsylvania Act
facially constitutional, the plaintiffs cannot satisfy this "heavy
burden". Salerno, 481 U.S. at 745.
A.
Section 41-41-33 of the Mississippi Act requires the physician
to inform the patient of medical risks of abortion "including, when
medically accurate, the risks of infection, hemorrhage, danger to
subsequent pregnancies and infertility"; the probable gestational
age of the fetus; and the "medical risks associated with carrying
her child to term". That section further requires that the patient
be informed, by a physician or physician's agent, "[t]hat medical
assistance benefits may be available for prenatal care, childbirth
and neonatal care"; "[t]hat the father is liable to assist in the
support of her child"; that there are available private and public
services for pregnancy prevention counseling; and that she has a
right to review printed materials provided by the State which
describe the stages of fetal development and list agencies that
offer alternatives to abortion. Those printed materials are to be
"objective, nonjudgmental, and designed to convey only accurate
information", § 41-41-35; and the Act expressly permits the
2The Casey joint opinion may have applied a somewhat different
standard in striking down the spousal notification provision of the
Pennsylvania Act, not in issue here. 60 U.S.L.W. at 4812; see also
id. at 4834 & n.2 (Rehnquist, C.J., dissenting in part).
Nevertheless, we do not interpret Casey as having overruled, sub
silentio, longstanding Supreme Court precedent governing challenges
to the facial constitutionality of statutes.
- 4 -

physician or agent to comment, or refrain from comment, on them.
§ 41-41-33(b)(iv).
The Mississippi Act requires a 24-hour waiting period between
the disclosure of information and performance of an abortion,
except for a "medical emergency". § 41-41-33. And, a physician
convicted of "purposefully, knowingly or recklessly" performing an
abortion in violation of the Act is guilty of a misdemeanor,
punishable by fine or imprisonment for up to six months. § 41-41-
39.
B.
1.
As stated, plaintiffs' post-Casey facial challenge primarily
keys on specific differences between the Mississippi and
Pennsylvania Acts. For example, the Pennsylvania Act contains an
exception to the penalty for violating the informed consent
requirements if the physician "can demonstrate, by a preponderance
of the evidence, that he or she reasonably believed that furnishing
the information would have resulted in a severely adverse effect on
the physical or mental health of the patient". 18 Pa. Cons. Stat.
Ann. § 3205 (Supp. 1992). This exception is not found in the
Mississippi Act. As another example, the Acts differ in some
respects in defining "abortion" and "medical emergency".3 We do
3The Mississippi Act defines "abortion" as
the use or prescription of any instrument,
medicine, drug or any other substance or device to
terminate the pregnancy of a woman known to be
pregnant with an intention other than to increase
the probability of a live birth, to preserve the
- 5 -

not find merit in any of the facial challenges, including to the
definition of a "medical emergency".
In defining that term, the Mississippi Act uses the phrase
"grave peril of immediate and irreversible loss of major bodily
function", § 41-41-31(b); Pennsylvania, "serious risk of
life or health of the child after live birth or to
remove a dead fetus.
Miss. Code Ann. § 41-41-31(a) (Supp. 1991). The Pennsylvania Act
defines it as follows:
The use of any means to terminate the clinically
diagnosable pregnancy of a woman with knowledge
that the termination by those means will, with
reasonable likelihood, cause the death of the
unborn child except that, for the purposes of this
chapter, abortion shall not mean the use of an
intrauterine device or birth control pill to
inhibit or prevent ovulation, fertilization or the
implantation of a fertilized ovum within the
uterus.
18 Pa. Cons. Stat. Ann. § 3203 (1983).
The Mississippi Act defines "medical emergency" as
that condition which, on the basis of the
physician's best clinical judgment, so complicates
a pregnancy as to necessitate an immediate abortion
to avert the death of the mother or for which a
twenty-four-hour delay will create grave peril of
immediate and irreversible loss of major bodily
function.
Miss. Code Ann. § 41-41-31(b) (Supp. 1991). The Pennsylvania Act
defines it as follows:
That condition which, on the basis of the
physician's good faith clinical judgment, so
complicates the medical condition of a pregnant
woman as to necessitate 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 major bodily function.
18 Pa. Cons. Stat. Ann. § 3203 (Supp. 1992).
- 6 -

substantial and irreversible impairment of major bodily function",
§ 3203. Nevertheless, the Mississippi Act allows physicians to
rely on their "best clinical judgment", § 41-41-31(b); and they are
subject to criminal penalties only if they "purposefully,
knowingly, or recklessly" violate the Act, § 41-41-39. We
conclude, as the Third Circuit did in Casey, that the Mississippi
Legislature's intent in drafting that provision was to assure that
compliance with the Act would not pose a significant threat to the
life or health of women seeking abortions. See Casey, 60 U.S.L.W.
at 4808.
2.
Plaintiffs contend, however, that this case should be remanded
for further evidentiary proceedings, so that they can attempt to
prove that, on its face, the Mississippi Act poses an "undue
burden" on women seeking abortions in Mississippi, even though the
Supreme Court has held that substantially identical requirements do
not constitute an undue burden on women seeking abortions in
Pennsylvania.4 They correctly note that the authors of the Casey
4The Casey joint opinion defined an "undue burden" as follows:
A finding of an undue burden is a shorthand for the
conclusion that a state regulation has the purpose
or effect of placing a substantial obstacle in the
path of a woman seeking an abortion of a nonviable
fetus. A statute with this purpose is invalid
because the means chosen by the State to further
the interest in potential life must be calculated
to inform the woman's free choice, not hinder it.
And a statute which, while furthering the interest
in potential life or some other valid state
interest, has the effect of placing a substantial
obstacle in the path of a woman's choice cannot be
considered a permissible means of serving its
- 7 -

joint opinion made repeated references to the evidence in the
record and the findings of fact by the district court in
Pennsylvania. See, e.g., 60 U.S.L.W. at 4809-10. However, in
clarifying what they meant by an "undue burden", the authors of the
joint opinion stated that they were "set[ting] forth a standard of
general application". Id. at 4807. Applying that standard, we
conclude that the differences between the Mississippi and
Pennsylvania Acts are not sufficient to render the former
unconstitutional on its face.5 Further evidentiary proceedings
would not affect that conclusion.
III.
We earlier VACATED the preliminary injunction. For the
foregoing reasons, we REMAND this case to the district court for
entry of an order of dismissal.
legitimate ends.
60 U.S.L.W. at 4807.
5In their post-Casey supplemental brief, plaintiffs reduce
their argument to the aphorism "Mississippi ain't Pennsylvania",
stating, "The record in this case proves what all know empirically:
Mississippi ain't Pennsylvania." This speaks volumes about the
invalidity of their challenge to the Mississippi Act on its face;
in fact, no more really need be said.
- 8 -

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