Anspach v. City of Philadelphia, Department of Public Health

OPINION

Melissa Anspach and her parents brought this action against the city of Philadelphia (the “City”) and certain of its employees and agents, including the City’s Health Department and the Commissioner of Public Health. Melissa is a 16-year-old unemancipated minor. They allege that agents of the City violated Melissa’s constitutionally protected right to bodily integrity and parental guidance, as well as her parents’ constitutional right to familial privacy and their parental liberty, by providing Melissa with emergency contraception without notifying her parents, or encouraging her to consult with them. 1 Both Melissa and her parents also allege a viola *259 tion of their First Amendment right of religious freedom, and several causes of action under state law.

The District Court dismissed the federal constitutional claims pursuant to Fed. R.Civ.P. 12(b)(6), and remanded the remaining state claims to state court. 2 This appeal followed.

For the reasons that follow, we will affirm the District Court’s dismissal.

I. FACTUAL AND PROCEDURAL HISTORY

A.

On January 26, 2004, Melissa Anspach visited a health center operated by the City’s Department of Public Health (the “Center”). Melissa had recently engaged in sexual intercourse and feared she may be pregnant. Upon arriving at the Center, she requested a pregnancy test, but a receptionist informed her that pregnancy tests were not being administered that day. Melissa then left the Center but returned a short time later after a friend prompted her to “ask for the morning after pill.” Upon her return, Melissa was directed to the pediatric ward where she provided her name and date of birth, thereby disclosing that she was sixteen years of age.

Plaintiffs allege that Melissa then spoke with defendant Maria Fedorova, a social worker, for approximately ten minutes. They discussed sexually transmitted diseases, birth control, and emergency contraception. During the conversation, Fe-dorova confirmed that the Center could provide pills “that would prevent [Melissa] from getting pregnant,” and Melissa requested the pills.

• Defendant Mary Gilmore, a registered nurse, next took Melissa’s temperature and blood pressure, and gave her four tablets of “Nordette.” 3 Gilmore told Melissa to take four pills right away and then four more in twelve hours. 4 Before Melis *260 sa took the pills, Gilmore consulted with Fedorova’ “to find out how Melissa should take the pills.” She also asked Dr. Jiten-dra Shah if she wanted to examine Melissa. After determining that the doctor did not want to examine Melissa, Gilmore returned to Melissa, who asked if the pills would make her sick. Gilmore consulted with the doctor once again, and the doctor advised Gilmore to tell Melissa to drink ginger ale. Melissa' then took the four Nordette pills in the nurse’s presence, and went home.

Melissa took the second dose of pills at home at approximately 4:00 A.M. as she had been instructed. After taking the second dose, she experienced severe stomach pains and began vomiting. Melissa’s father came to her room and found her lying on the floor. Upon learning that Melissa had taken emergency contraception, Mr. Anspach called their family physician and the poison control center, and then took Melissa to the emergency room of a nearby hospital. Melissa was treated there and released the same day, but subsequently returned because of sub-conjunctive hemorrhaging in her eye that was apparently caused by excessive vomiting.

B.

Plaintiffs thereafter filed a complaint in the Court of Common Pleas in Philadelphia County. They asserted claims under 42 U.S.C. § 1988, as well as various claims arising under state law. The suit was subsequently removed to federal court where the Defendants filed a motion to dismiss pursuant to Rule 12(b)(6).

The parents’ § 1983 claims are premised on their contention that Defendants violated their constitutional rights of parental guidance by providing Melissa with medication without parental consent. Melissa alleges that the same conduct violated her constitutional right to bodily integrity and parental guidance under the Fourteenth Amendment. Each of the Plaintiffs claims violations of his or her right to the free exercise of religion under the First Amendment. 5

The District Court dismissed all of Plaintiffs’ claims under § 1983 and remanded the remaining state law claims to state court. This appeal of the dismissal of the federal constitutional claims followed.

II. STANDARD OF REVIEW

We have jurisdiction pursuant to 28 U.S.C. § 1291. Our review of the order granting the motion to dismiss is plenary. Morse v. Lower Merion Sch. Dist., 132 F.3d 902, 906 (3d Cir.1997). When reviewing a Rule 12(b)(6) dismissal, we accept as true all well-pled factual allegations in the complaint, id., and view the allegations of the complaint in the light most favorable to the plaintiff. Pinker v. Roche Holdings, Ltd., 292 F.3d 361, 374 n. 7 (3d Cir.2002). In a § 1983 action, “the plaintiffs are entitled to relief if their complaint sufficiently alleges deprivation of any right secured by the Constitution.” Langford v. City of Atlantic City, 235 F.3d 845, 847 (3d Cir.2000).

Although we view the allegations in the complaint in the light most favorable to the plaintiff, we need not credit “bald assertions” or “legal conclusions.” In re Burlington Coat Factory Sec. Litig., 114 F.3d 1410, 1429-30 (3d Cir.1997). “[L]egal conclusions masquerading as factual conclusions will not suffice to prevent a motion to dismiss.” Morse, 132 F.3d at 906 n. 8 (quoting Fernandez-Montes v. Allied Pi *261 lots Assoc., 987 F.2d 278, 284 (5th Cir.1993)).

III. DISCUSSION

To state a cause of action under § 1983, Plaintiffs must allege the deprivation of a constitutional right under color of state law. 42 U.S.C. § 1983; Gomez v. Toledo, 446 U.S. 635, 640, 100 S.Ct. 1920, 64 L.Ed.2d 572 (1980); see also Mark v. Borough of Hatboro, 51 F.3d 1137, 1141 (3d Cir.1995), cert. denied, 516 U.S. 858, 116 S.Ct. 165, 133 L.Ed.2d 107 (1995). The Anspachs contend in Count I of their Complaint that Defendants’ conduct deprived them of their fundamental right to direct Melissa’s rearing and education. In Count II, Melissa alleges that Defendants deprived her of her right to parental guidance and advice in matters relating to medical care. Both counts arise out of the liberty interests guaranteed by the Due Process Clause of the Fourteenth Amendment. Plaintiffs also allege that Defendants violated their First Amendment right to free exercise of religion by providing Melissa with medication that could abort a pregnancy in violation of their religious-objections to abortion.

A. Substantive Due Process

The Supreme Court has long recognized that the right of parents to care for and guide their children is a protected fundamental liberty interest. See, e.g., Meyer v. Nebraska, 262 U.S. 390, 43 S.Ct. 625, 67 L.Ed. 1042 (1923); Pierce, v. Society of Sisters, 268 U.S. 510, 45 S.Ct. 571, 69 L.Ed. 1070 (1925); Prince v. Massachusetts, 321 U.S. 158, 64 S.Ct. 438,88 L.Ed. 645 (1944); Wisconsin v. Yoder, 406 U.S. 205, 92 S.Ct. 1526, 32 L.Ed.2d 15 (1972); Parham v. J. R, 442 U.S. 584, 99 S.Ct. 2493, 61 L.Ed.2d 101 (1979); Troxel v. Granville, 530 U.S. 57, 120 S.Ct. 2054, 147 L.Ed.2d 49 (2000). That constitutional protection is “deeply rooted in this Nation’s history and tradition.” Moore v. City of East Cleveland, Ohio, 431 U.S. 494, 503, 97 S.Ct. 1932, 52 L.Ed.2d 531 (1977) (citing Yoder, 406 U.S. 205).

Nevertheless, the parental liberty interest is not absolute. It is well-established that “[m]inors, as well .as adults, are protected by the Constitution and possess constitutional rights.” Planned Parenthood of Central Missouri v. Danforth, 428 U.S. 52, 74, 96 S.Ct. 2831, 49 L.Ed.2d 788 (1976) (overruled in part by Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833, 112 S.Ct. 2791, 120 L.Ed.2d 674 (1992)). Accordingly, parental interests must be balanced with the child’s right to privacy, which is also protected under the Due Process Clause.

This delicate balance is only implicated, however, if the constitutional rights of both the parent and child are involved. “In a typical § 1983 action, a court must initially determine whether the plaintiff has even alleged the deprivation of a right that either federal law or the Constitution protects.” Gru enke v. Seip, 225 F.3d 290, 298 (3d Cir.2000) (citing Baker v. McCollan, 443 U.S. 137, 140, 99 S.Ct. 2689, 61 L.Ed.2d 433 (1979) (“The first inquiry in any § 1983 suit ... is whether the plaintiff has been deprived of a right secured by the Constitution and laws.”) (quotation omitted)). As we shall explain, the allegations here do not establish the constitutional violation required to maintain an action under § 1983. Thus, we need not decide which way that balance would otherwise tip.

1. Interference with Parental Rights

Melissa’s parents allege a substantive due process violation based on state interference with family relations. They argue that the Center’s policies were aimed at preventing parents from learning of their minor daughter’s possible pregnancies. In support of their contention, *262 the Anspachs point to the fact that personnel at the Center knew Melissa’s age, failed to ask Melissa if her parents knew of her predicament, and failed to encourage Melissa to consult with her parents before deciding whether to take emergency contraception. The Complaint alleges that these facts demonstrate that Defendants “engaged in a course of conduct that was intended to influence Melissa to refrain from discussing with her parents her possible pregnancy and what course of action was appropriate.” App. at 23a.

The Due Process Clause of the Fourteenth Amendment provides that “[n]o State shall ... deprive any person of life, liberty, or property, without due process of law.” U.S. Const. Amend. XIV. To state a due process claim under § 1983, the Anspachs must identify a “recognized ‘liberty or property’ interest within the purview of the Fourteenth Amendment, and [show] that [they were] intentionally or recklessly deprived of that interest, even temporarily, under color of state law.” Griffith v. Johnston, 899 F.2d 1427, 1435 (5th Cir.1990) (citations omitted), cert. denied, 498 U.S. 1040, 111 S.Ct. 712, 112 L.Ed.2d 701 (1991). However, we must remain mindful that “section 1983 imposes liability for violations of rights protected by the Constitution, not for violations of duties of care arising out of tort law.” Baker v. McCollan, 443 U.S. 137, 146, 99 S.Ct. 2689, 61 L.Ed.2d 433 (1979); see also DeShaney v. Winnebago County Dept. of Soc. Servs., 489 U.S. 189, 202, 109 S.Ct. 998, 103 L.Ed.2d 249 (1989) (“[T]he Due Process Clause of the Fourteenth Amendment ... does not transform every tort committed by a state actor into a constitutional violation.”).

As we noted earlier, the Due Process Clause of the Fourteenth Amendment “protects the fundamental right of parents to make decisions concerning the care, custody, and control of their children.” Troxel, 530 U.S. at 66, 120 S.Ct. 2054. However, “the right is neither absolute nor unqualified.” C.N. v. Ridgewood Bd. of Educ., 430 F.3d 159, 182 (3d Cir.2005). The type of “interference” that the An-spachs assert would impose a constitutional obligation on state actors to contact parents of a minor or to encourage minors to contact their parents. Either requirement would undermine the minor’s right to privacy and exceed the scope of the familial liberty interest protected under the Constitution.

Courts have recognized the parental liberty interest only where the behavior of the state actor compelled interference in the parent-child relationship. These cases involve coercion that is absent from the allegations in Plaintiffs’ Complaint. This point is perhaps best illustrated by Doe v. Irwin, 615 F.2d 1162 (6th Cir.1980), a case very similar to the one before us here.

In Doe, a class of parents of minor children sued a publicly funded family planning center. They claimed that the distribution of contraceptives to minors without notice to the parents violated the parents’ constitutional rights. The Family Planning Center in Doe served both adults and minors. “Neither the Center nor any of its services related to minors [were] advertised, and minors [were] not sought out or encouraged to attend the Center....” Id. at 1163. Minors were, however, “permitted to come to the Center either with or without parental consent.” Id. The Family Planning Center’s services included prescription of contraceptives that were distributed to minors “both with and without parental knowledge or consent.” Id.

The Family Planning Center’s programs featured weekly “rap sessions” for minors. They were educational and dealt with methods of birth control, as well as the responsibilities that accompany being sexually active and the “desirability of com- *263 munieating with parents and others involved with a decision to engage in sexual activities.” Id. Minors were not served by the Family Planning Center unless they had first attended at least one weekly rap session. These sessions were intended to give “factual information about birth control and human reproduction.” Id. at 1164. Minors who attended a rap session had to register and make an appointment at the Family Planning Center. The first visit to the Family Planning Center included a physical examination. If no medical problems were detected, female minors were usually given a three-month supply of birth control pills. Id. According to the testimony of the administrator of the Family Planning Center, the Center’s personnel did not advocate that unmarried teenagers become sexually active, but the personnel tried “to deal with individuals ...” in a “non-judgmental” way. Id. at 1164 (quotation omitted).

The district court in Doe found that the distribution of contraceptives to minors without notice to parents violated the parents’ constitutional rights. The court entered a permanent injunction and ordered the Family Planning Center to “cease and desist from distributing contraceptives and contraceptive devices to minor, unemanci-pated children in the absence of notice to the parents ... and a reasonable opportunity for the parents of such children to consult with their children as to the decision of the child whether or not to obtain contraceptives or contraceptive devices.” Id. at 1165 (quotation omitted).

The Court of Appeals for the Sixth Circuit reversed. It relied on a line of Supreme Court cases involving the right of privacy, the authority of the state to regulate the conduct of children, and the scope of a minor’s right of privacy and concluded that “[a]s with adults, the minor’s right of privacy includes the right to obtain contraceptives.” Id. at 1166 (citing Carey v.

Population Services Int'l, 431 U.S. 678, 692-93, 97 S.Ct. 2010, 52 L.Ed.2d 675 (1977)). Citing Bellotti v. Baird, 443 U.S. 622, 99 S.Ct. 3035, 61 L.Ed.2d 797 (1979) (Bellotti II), the court explained that “[t]he Supreme Court has not squarely decided whether a state may impose a requirement of parental notice, as opposed to parental consent, as a condition of a minor’s receiving an abortion.” Doe, 615 F.2d at 1167. The court observed that the “one fundamental difference” between the case before it and cases where the state had interfered with the rights of parents or the rights of children was that “[i]n each of the Supreme Court cases the state was either requiring or prohibiting some activity.” Id. at 1168. The court then explained its observation as follows:

In Meyer v. Nebraska, [262 U.S. 390 (1923) ] the state forbade the teaching of foreign languages to pupils who had not passed the eighth grade. The Court held the statute not reasonably related to any end within the competency of the state and violative of parents’ Fourteenth Amendment right to liberty. In Pierce v. Society of Sisters, [268 U.S. 510 (1925) ] the statute required all children between the ages of 8 and 16 to attend public schools. The Court found that the law' unreasonably interfered with the liberty interest of parents to direct the upbringing and education of their children, including the right to send them to accredited private schools. Again in Wisconsin v. Yoder, [406 U.S. 205 (1972)] the law in question made school attendance compulsory. The Court held that Amish parents’ First Amendment rights to the free exercise of their religion were infringed by the attendance requirement. In Prince v. Massachusetts, [321 U.S. 158 (1944) ] child labor laws were construed to prohibit street sales of religious tracts by children. In that case the Court upheld *264 the conviction of a parent who contended that these laws unreasonably interfered with her right of free exercise of religion and her parental rights. In so holding, the Court determined that a state’s authority is not nullified merely because the parent grounds his claim to control the child’s course of conduct on religion or conscience.

Id. at 1168. Viewed against this legal backdrop, it is clear that Plaintiffs cannot maintain a due process violation when the conduct complained of was devoid of any form of constraint or compulsion.

Plaintiffs compare the absence of protocols in place at the Center here with the rap sessions in Doe in an attempt to minimize Doe’s relevance to our analysis of their claims. See Appellants’ Br. at 24-25. They emphasize the following aspects of the Family Planning Center’s protocol in Doe: intra-uterine devices were not dispensed to minors without parental consent, the program encouraged minors to discuss “their sexual interests with their parents,” and “[t]he decision on whether a particular individual will receive contraceptives is made in every case by a physician.” Id. at 25. Although it is clear that the services provided by the Center here are not alleged to include those considerations, we do not think the difference sufficient to alter our analysis or the relevance of Doe.

Significantly, no one prevented Melissa from calling her parents before she took the pills she had requested. Plaintiffs attempt to argue that the circumstances surrounding Melissa’s visit were tantamount to state coercion and that such coercion was sufficient to establish a due process violation. Plaintiffs cite Lee v. Weisman, 505 U.S. 577, 112 S.Ct. 2649, 120 L.Ed.2d 467 (1992), to support their argument that “these were adult employees of the City of Philadelphia telling a 16-year-[old] minor how and what to do. Coercion is plainly inherent in this relationship.” Appellants’ Br. at 20. We disagree.

In Lee, the Supreme Court held that reciting a nondenominational prayer during a high school graduation violated the First Amendment. The Court reasoned that circumstances endemic to a high school graduation coerced those attending to join in the prayer whether or not doing so violated their personal religious beliefs. The Court explained:

What to most believers may seem nothing more than a reasonable request that the nonbeliever respect their religious practices, in a school context may appear to the nonbeliever or dissenter to be an attempt to employ the machinery of the State to enforce a religious orthodoxy. ...

The undeniable fact is that the school district’s supervision and control of a high school graduation ceremony places public pressure, as well as peer pressure, on attending students to stand as a group or, at least, maintain respectful silence during the Invocation and Benediction. This pressure, though subtle and indirect, can be as real as any overt compulsion.... [F]or the dissenter of high school age, who has a reasonable perception that she is being forced by the State to pray in a manner her conscience will not allow, the injury is ... real.

505 U.S. at 592-93, 112 S.Ct. 2649. The Court also stressed that attendance at the ceremony was not truly voluntary. “[T]o say a teenage student has a real choice not to attend her high school graduation is formalistic in the extreme.” Id. at 595, 112 S.Ct. 2649.

The circumstances here are very different. The Anspachs’ allegation of coercion is merely that Nurse Gilmore “told Melissa to swallow the pills before leaving the center.” Appellants’ Br. at 19. However,

*265 Melissa was only given the pills because she asked for them. Arguing that coercion is established because a nurse said “take these,” while handing Melissa a glass of water and the pills she had requested, ignores what really happened. Moreover, Plaintiffs’ insistence that the atmosphere at the Center was sufficiently coercive to implicate the Due Process Clause is belied by the allegations in their Complaint. The Complaint states that, when she entered the Center for the second time, Melissa, requested the morning after pill and was thereafter advised by Fedorova that the Center could provide pills that would prevent Melissa from becoming pregnant. App. at 16-17a. Melissa responded that she would take the pills. Id. “Nurse Gilmore then gave four of the pills to Melissa and instructed Melissa to take these pills with water, which Melissa did in Nurse Gilmore’s presence.” App. at 18a. Simply being told when and how to take a pill that Melissa herself requested is -not tantamount to coercion.

In Arnold v. Bd. of Educ. of Escambia, County, Ala., 880 F.2d 305, 308-09 (11th Cir.1989), the Court of Appeals for the Eleventh Circuit found a constitutional violation where plaintiffs alleged that school officials had engaged in overt acts to procure an abortion for a student without contacting her parents. 6 The school guidance counselor had discovered that “Jane Doe” was pregnant. She then summoned Jane to her office for counseling, and, at the expense of the school, procured a pregnancy test that was positive. The counsel-, or and the vice principal of the school then persuaded Jane Doe and John Doe (who had admitted paternity) to obtain an abortion. Id. at 309. Because the youngsters could not afford to pay for an abortion themselves, school officials paid them to perform menial tasks so they could raise the money for the procedure. School officials even paid an individual to drive the minors to a medical facility where the abortion was performed. Id. at 308-09. The court held that these actions- amounted to .coercion of a minor to obtain an abortion or to refrain from discussing the matter with her parents in violation of the latter’s parental rights. Id. at 313.

The defendants in Arnold were public school officials in a position of authority over- the Doe plaintiffs and the minors there were required by law to attend school where they were subject to the authority of the ' defendants. The complaint in Arnold alleged that the school officials not only pressured -the children to refrain from discussing the pregnancy and abortion with their parents, but also imposed their own will on the decision of the children regarding whether to abort the pregnancy 'in various ways, including by providing them with the money for the procedure and hiring a driver to take them to the appointment. Id. at 309. There are no similar acts that could arguably be seen as coercion alleged here.

Nor can the Anspachs find support in our decision in Gruenke v. Seip, 225 F.3d 290, 309 (3d Cir.2000). There, we recognized the parental liberty interest of a mother whose daughter was forced by her high school swim team coach to take a pregnancy test after he became suspicious that she was pregnant. Id. at 296-97. Acting on a hunch, the coach discussed his suspicions with other school personnel, including a guidance counselor, and asked other team members about their suspicions. Although spreading this rumor widely, he did not contact the minor’s parents. He finally insisted that the swimmer in question take a pregnancy test. Id. at 295-96. 'Thereafter, the student and her *266 mother sued the coach under § 1983 alleging, inter alia, violation of the mother’s constitutional right to manage her daughter’s upbringing as well as the daughter’s right to privacy. Id. at 297.

In determining whether the plaintiffs had alleged a constitutional violation in Gruenke, we recognized both the parental interest in directing the care of their children and the fact that, “for some portions of the day, children are in the compulsory custody of state-operated school systems. In that setting the state’s power is custodial and tutelary, permitting a degree of supervision and control that could not be exercised over free adults.” Id. at 304 (citation and quotations omitted). During this custodial time, in order to maintain order and the proper educational atmosphere, at times, those authorities “may impose standards of conduct that differ from those approved of by some parents.” Id. Where these standards collide, a court will require the State to demonstrate a compelling interest that outweighs the parental liberty interest in raising and nurturing their child. Id. at 305.

We recognized in Gruenke that “[sjchool-sponsored counseling and psychological testing that pry into private family activities can overstep the boundaries of school authority and impermissibly usurp the fundamental rights of parents to bring up their children....” Id. at 307. However, that recognition does not extend to circumstances where there is no manipulative, coercive, or restraining conduct by the State.

The coach’s conduct at issue in Gruenke is qualitatively different from Defendants’ conduct here. Significantly, he took action in tandem with his authority as the minor’s swim coach. Without the minor’s invitation, indeed, against her express wishes, the coach had very personal conversations with her in an attempt to have her admit to being pregnant, and he asked other coaches to do the same. Id. at 296. When she wouldn’t admit to being pregnant, he paid for a pregnancy test and told her, through other members on the team, that unless she took the pregnancy test, he would take her off the relay team. Id. In addition, knowing that the minor’s possible pregnancy was a topic of gossip among other team members as well as their parents, he would occasionally tell others that it was possible that she was pregnant, while att