Vatican Releases Declaration on Human Dignity

 On April 8, the Vatican's Dicastery for the Doctrine of the Faith published a Declaration on Human Dignity, “Dignitas Infinita" (full text).  An introduction to the Declaration by the Prefect of the Dicastery says in part:

The five-year course of the text’s preparation helps us to understand that the document before us reflects the gravity and centrality of the theme of dignity in Christian thought. The text required a considerable process of maturation to arrive at the final version that we have published today.

In its initial three sections, the Declaration recalls fundamental principles and theoretical premises, with the goal of offering important clarifications that can help avoid frequent confusion that surrounds the use of the term “dignity.” The fourth section presents some current and problematic situations in which the immense and inalienable dignity due to every human being is not sufficiently recognized. The Church sees the condemnation of these grave and current violations of human dignity as a necessary measure, for she sustains the deep conviction that we cannot separate faith from the defense of human dignity, evangelization from the promotion of a dignified life, and spirituality from a commitment to the dignity of every human being.

The items described at length in the fourth section as "grave violations of human dignity" are the drama of poverty, war, travail of migrants, human trafficking, sexual abuse, violence against women, abortion, surrogacy, euthanasia and assisted suicide, marginalization of people with disabilities, gender theory, sex change and digital violence. The document's discussion of gender identity has perhaps created the most controversy. The Document says in part:

It needs to be emphasized that ‘biological sex and the socio-cultural role of sex (gender) can be distinguished but not separated.’” Therefore, all attempts to obscure reference to the ineliminable sexual difference between man and woman are to be rejected: “We cannot separate the masculine and the feminine from God’s work of creation, which is prior to all our decisions and experiences, and where biological elements exist which are impossible to ignore.” Only by acknowledging and accepting this difference in reciprocity can each person fully discover themselves, their dignity, and their identity....

It follows that any sex-change intervention, as a rule, risks threatening the unique dignity the person has received from the moment of conception. This is not to exclude the possibility that a person with genital abnormalities that are already evident at birth or that develop later may choose to receive the assistance of healthcare professionals to resolve these abnormalities. However, in this case, such a medical procedure would not constitute a sex change in the sense intended here.

Asked at a Press Gaggle (full text) about President Biden's reaction to the Declaration, the White House Press Secretary said that it was not the President's role "to litigate internal church policy," but that the President has been clear that it is important to have protections for the transgender community and the broader LGBTQ+ community. 

Vox reports at greater length on the Vatican document.

Arizona Supreme Court Says 160-Year-Old Abortion Ban Is Enforceable

In Planned Parenthood Arizona, Inc. v. Mayes, (AZ Sup. Ct., April 9, 2024), the Arizona Supreme Court held that A.R.S. §13-3603 that outlaws all abortions except when necessary to save the mother's life-- originally enacted in 1865-- again became operative when Roe v. Wade was overruled. In a 4-2 decision, the majority concluded that A.R.S. §36-2322, Arizona's 15-week abortion law enacted in 2022, did not prevent the effectiveness of the 1864 law. Senate Bill 1164 which enacted the 15-week law contained the following provision on "Construction" of the law:

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.

Today's majority opinion said in part:

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 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.

The majority added 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. 

Vice Chief Justice Timmer dissented, joined by Chief Justice Brutinel, saying in part:

  ... [R]elying 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.”... 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.

Arizona Republic reports on the decision.

Texas' Claim Against HHS Over Pharmacy Guidance Dismissed As Moot

In State of Texas v. U.S. Department of Health & Human Services, (WD TX, April 5, 2024), a Texas federal district court dismissed as moot a challenge to an HHS Guidance Document for pharmacies. Initially, HHS issued Guidance reminding retail pharmacies of their non-discrimination obligations. The state of Texas and a pharmacy sued contending that the Guidance required Texas pharmacies to dispense abortion-inducing drugs in violation of Texas law and in violation of religious beliefs of plaintiff pharmacy. HHS denied this and moved for dismissal of the complaint. The court disagreed. The court now describes that decision by saying in part:

So based on the suspicion that Defendants were “smurfing” the administration’s policy goal contrary to the Supreme Court’s holding in Dobbs, the Court shot down Defendants’ motion. [See prior posting.]

Three months after the court refused to dismiss the suit, HHS issued a revised Guidance which explicitly provided that the Guidance does not require pharmacies to fill prescriptions for the purpose of abortions. The court went on:

[D]espite the textual changes, which appear crafted specifically to capitulate to Plaintiffs’ claims, Plaintiffs remain unpersuaded....

Plainly put, Plaintiffs’ concern is that anyone—pregnant or not—can walk into a pharmacy with a prescription for methotrexate, which the pharmacy must fill under every circumstance because the prescription was lawfully prescribed for a non-abortion purpose like rheumatoid arthritis. It’s not an unreasonable concern....

From the Court’s perspective, it’s hard to account for the Revised Guidance’s plain text, Defendants’ reasons for issuing the Revised Guidance, and Defendants’ in-person statements, but then still conclude that Plaintiffs will be forced to dispense drugs for abortion purposes. Indeed, it seems the only way the Court could even “reasonably expect” that Plaintiffs’ alleged injury would occur at this point would be for the Court to disregard all of Defendants’ actions as deceptive litigation posturing.  

To be sure, that argument appeals to the Court’s healthy distrust for the fourth branch of government. But there is no evidence that Defendants have tried to enforce these “obligations” against Mayo or any pharmacy in Texas in the almost two years since the  Pharmacy Guidance was issued. ...

Plaintiffs have received everything they asked for; they should take the win. As a result, the issues are now moot and the Court lacks jurisdiction.

ADF issued a press release reacting to the decision.

Florida Supreme Court Clears Abortion Rights Proposal for November Ballot

 In Advisory Opinion to the Attorney General re: Limiting Government Interference with Abortion, (FL Sup. Ct., April 1, 2024), the Florida Supreme Court, in a 4-3 decision, rejected challenges to placing a proposed abortion rights constitutional amendment on the November ballot. The proposed amendment provides:

Limiting government interference with abortion.—Except as provided in Article X, Section 22, no law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider.

The court said in part:

We decline to adopt a standard that would effectively vest us with the power to bar an amendment from the ballot because of a supposed ambiguity in the text of the amendment.  We decline to encroach on the prerogative to amend their constitution that the people have reserved to themselves.

Chief Justice Muniz filed a concurring opinion, joined by Justices Canaday and Couriel concur, saying in part:

... [Q]uestions of justice are appropriately at the heart of the voters’ assessment of a proposed amendment like the one under review.  With its reference to the existence of “inalienable rights” in all persons, our constitution’s Declaration of Rights assumes a pre-constitutional, objective moral reality that demands our respect—indeed, a moral order that government exists to protect.  The proposed amendment would constitutionalize restrictions on the people’s authority to use law to protect an entire class of human beings from private harm.  It would cast into doubt the people’s authority even to enact protections that are prudent, compassionate, and mindful of the complexities involved.  Under our system of government, it is up to the voters—not this Court—to decide whether such a rule is consistent with the deepest commitments of our political community.

Justice Grosshans filed a dissenting opinion in which Justic Sasso concurs. Justice Francis filed a dissenting opinion. Justice Sasso filed a dissenting opinion in which Justices Grosshans and Francis concur, saying in part:

I agree with the majority that, at a very high level, the voters will understand that this amendment creates a broad right to abortion in Florida.  However, our precedent has consistently required that the summary explain more than the amendment’s general aim.  Indeed, we have said that ballot summaries must explain the “material legal effect,” so that the electorate is advised of the “true meaning, and ramifications, of an amendment” and is thereby “adequately informed.” 

The summary here does none of this.

In a separate decision yesterday, the Florida Supreme Court held that the state Constitution's Privacy Clause does not protect abortion rights. (See prior posting.) Orlando Sentinel reports on the two decisions.

Florida Supreme Court Overrules Cases Holding State Constitution Protects Abortion

In Planned Parenthood of Southwest and Central Florida v. State of Florida, (FL Sup. Ct., April 1, 2024), the Florida Supreme Court in a 6-1 decision receded from (i.e. overruled) its prior decisions that held the Privacy Clause of the Florida Constitution protects the right to abortion. Focusing on the original public meaning of the Privacy Clause that was adopted by Florida voters in 1980, the Court said in part:

The Privacy Clause of the Florida Constitution does not mention abortion or include a word or phrase that clearly incorporates it.  Era-appropriate dictionary definitions and contextual clues suggest that abortion does not naturally fit within the rights at issue.  Reliable historical sources, like the technical meaning of the terms contained in the provision, the origin of the amendment, and the framing of the public debate, similarly do not support a conclusion that abortion should be read into the provision’s text.  Roe is also relevant to our analysis of the public meaning of the Privacy Clause.  But speculation as to Roe’s effect on voter understanding does not overcome the combined force of the substantial evidence we have examined above.  Thus, we cannot conclude that in 1980 a voter would have assumed the text encompassed a polarizing definition of privacy that included broad protections for abortion.

The Court thus rejected Planned Parenthood's suit seeking a temporary injunction against enforcement of Florida's 15-week abortion ban. As the dissent points out, however, the decision also has the effect of triggering in 30 days the effectiveness of the state's 6-week Heartbeat Protection Act. That Act, by its terms, was to take effect if the state Supreme Court held that the state Constitution's right to privacy does not protect abortion, if it allowed the 15-week ban to remain in effect or if the Court receded from any of its prior cases protecting abortion.

Justice Sasso filed a concurring opinion focusing on the issue of standing. Justice Labarga filed a dissenting opinion, saying in part:

The majority concludes that the public understanding of the right of privacy did not encompass the right to an abortion. However, the dominance of Roe in the public discourse makes it inconceivable that in 1980, Florida voters did not associate abortion with the right of privacy.

In a second case decided yesterday, the Florida Supreme Court cleared a proposed constitutional amendment protecting pre-viability abortion rights for placement on the November ballot. (See posting on decision.)  Orlando Sentinel reports on the two decisions.

Supreme Court Hears Oral ArgumentsToday On Abortion Pill Restrictions

 The U.S. Supreme Court is hearing oral arguments today in two related cases-- FDA v. Alliance for Hippocratic Medicine and Danco Laboratories, LLC v. Alliance for Hippocratic Medicine.  At issue is the FDA's actions in 2016 and 2021 regarding the administration and distribution of the abortion pill mifepristone. (See prior posting.) Links to briefs and pleadings in the cases can be found on the SCOTUSblog case pages (Danco, Alliance).  Live audio broadcast of the arguments beginning at 10:00 AM EDT can be accessed here. SCOTUS blog has further background on the issues being argued today. This posting will be updated to link to the transcript and recording of the arguments when they become available later today.

UPDATE: Here is a link to the transcript and audio of this morning's oral arguments. NBC News reports on the oral arguments.

Montana Supreme Court Says AG Wrongly Rejected Language of Reproductive Rights Initiative

In Montanans Securing Reproductive Rights v. Knudson,(MT Sup. Ct., March 18, 2024), the Montana Supreme Court held that the state Attorney General was incorrect in in concluding that a proposed reproductive rights ballot initiative violates the separate vote requirement of the Montana Constitution. It also held that the Attorney General lacked authority to append a fiscal statement to the initiative. The court ordered the Attorney General to prepare a ballot statement for the initiative and forward it to the Secretary of State. 

Justice McKinnon filed a concurring opinion. Justice Rice filed a dissenting opinion, saying in part:

I believe it is clear that the provisions of CI-14 are not readily understood, have effects that are concealed, and would result in voter confusion this review is designed to prevent.

(See prior related posting.) Montana Free Press reports on the decision. [Thanks to Thomas Rutledge for the lead.]

Catholic Bishops Mobilize Special Prayer Efforts for Supreme Court's Decision on Abortion Pill Availability

On March 26, the U.S. Supreme Court will hear oral arguments in Food and Drug Administration v. Alliance for Hippocratic Medicine and a companion case Danco Laboratories, LLC v. Alliance for Hippocratic Medicine. (SCOTUSblog case page.) At issue are challenges to the Food and Drug Administration's relaxation of restrictions on the administration and use of the abortion drug mifepristone. (See prior posting.) On March 14, the U.S. Conference of Catholic Bishops issued a letter (full text) calling for the recitation of a special prayer beginning the day before oral arguments and daily until the date in June when the case is decided.  The letter reads in part:

The USCCB Committee on Pro-Life Activities is inviting Catholics to join a focused effort of prayer for the end of abortion and the protection of women and preborn children, beginning on March 25, the eve of the oral arguments, and the anniversary of St. John Paul II’s landmark, pro-life encyclical, The Gospel of Life (Evangelium vitae). In particular, we will invoke the intercession of St. Joseph, Defender of Life....

The Tablet and Catholic World Report both report on the Bishops' Nationwide Invitation to Prayer.

France Adds Abortion Rights to Its Constitution

 As reported by AP, France's Parliament yesterday gave final approval to a Constitutional amendment that guarantees abortion rights:

The measure was approved in a 780-72 vote in the Palace of Versailles. Abortion enjoys wide support in France across most of the political spectrum, and has been legal since 1975....

Both houses of France’s parliament, the National Assembly and Senate, had separately adopted a bill to amend Article 34 of the French Constitution, but the amendment needed final confirmation by a three-fifths majority in the special joint session. The measure specifies that “the law determines the conditions by which is exercised the freedom of women to have recourse to an abortion, which is guaranteed.”...

The government argued in its introduction to the bill that the right to abortion is threatened in the United States, where the Supreme Court in 2022 overturned a 50-year-old ruling that used to guarantee it....

State Constitutional Challenge to Abortion Restrictions Filed in Wisconsin Supreme Court

Last year in Kaul v. Urmanski, (WI Cir. Ct., Dec. 5, 2023), a Wisconsin state trial court held that Wisconsin Statute §940.04 which prohibits destroying the life of an unborn child applies only to feticide, and not to consensual abortions. That case is now on appeal to the Wisconsin Supreme Court. Yesterday, Planned Parenthood filed a petition with the Wisconsin Supreme Court asking it to take original jurisdiction over a state constitutional challenge to §940.04. It contends that the Court should decide the constitutional question before it engages in the statutory interpretation issue presented in the Kaul case. The petition (full text) in Planned Parenthood of Wisconsin v. Linton, (WI Sup.Ct., filed 2/22/2024), contends that Wisconsin Statute §940.04, if interpreted to ban abortions in all cases except to save the life of the mother, violates Art. I, Sec. 1 of the Wisconsin Constitution. The Petition asserts that the abortion ban (enacted in the mid 19th century) violates the right to bodily integrity, autonomy and self-determination; the physician's and the patient's right to equal protection, and the physician's right to practice his or her profession. Courthouse News Service reports on Planned Parenthood's petition.

Satanic Temple Loses Challenge to Idaho Abortion Bans

In The Satanic Temple v. Labrador, (D ID, Jan. 31, 2024), an Idaho federal district court dismissed several challenges to Idaho's statutes criminalizing abortion filed by The Satanic Temple which has created its own Abortion Ritual.  The court describes plaintiff's claims:

The Satanic Temple (“TST”) filed the instant case arguing Defendants actions have: (1) effected a regulatory taking of the economic value of a pregnant woman’s womb in violation of the Fifth Amendment; (2) effectively made pregnant women into slaves in violation of the Thirteenth Amendment; (3) given unconstitutional preferences to rape victims in violation of the Fourteenth Amendment; and (4) violated Idaho’s religious freedom statutes.

After finding that TST lacks standing to bring the suit, the court goes on to also reject TST's first three claims on the merits and concludes that TST, which asked to file an amended complaint to substitute a free exercise claim for its claim under Idaho's Exercise of Religious Freedom Act, should do this by fining a new lawsuit rather than an amended complaint.

Idaho Attorney General Labrador issued a press release announcing the decision which he titled "Attorney General Labrador Defeats Satan." LifeNews reporting on the decision said that lawyers for TST plan an appeal to the 9th Circuit.

Pennsylvania Supreme Court Casts Doubt on Abortion Exclusion From State Medicaid Coverage

In Allegheny Reproductive Health Center v. Pennsylvania Department of Human Services, (PA Sup. Ct., Jan. 29, 2024) [Majority Opinion], the Pennsylvania Supreme Court remanded to the trial court for strict scrutiny review a challenge to the constitutionality of Pennsylvania's ban on the use of state Medicaid funds for abortion services (except in the case of rape, incest or threat to the life of the mother). Six of the Court's 7 Justices participated in the case.  Justice Donohue's opinion (joined by Justice Wecht) sets out the conclusions of a majority of the Justices in a 219-page opinion. The majority overruled its 1985 decision in Fischer v. Department of Public Welfare that had upheld the ban.  The majority concluded that that pregnancy-related distinctions may violate the state Constitution's Equal Rights Amendment (Art. I, Sec. 28), saying in part:

... [T]he Fischer Court ignored that reproductive functions, by definition, have historically been the primary basis for the distinction between men and women, i.e., physical characteristics that make one a member of the sex. The text of Section 28 does not support the exception created by Fischer that equality of rights can be denied or abridged based on a physical characteristic that makes a person a member of the male or female sex....

 ... [W]e overrule Fischer’s interpretation of the Equal Rights Amendment. We further conclude that when a statute is challenged as violative of Section 28, a sex-based distinction is presumptively unconstitutional, and it is the government’s burden to rebut the presumption with evidence of a compelling state interest in creating the classification and that no less intrusive methods are available to support the expressed policy.

The majority also overruled Fischer's holding that the state Constitution's equal protection provision (Art. I, Sec. 26) does not prevent the state from conferring a benefit unequally.  The majority said in part:

... [A] court, presented with a challenge to a legislative classification that touches on the exercise of a civil right on the basis that it violates Article I, Section 26, must determine whether the classification operates neutrally with regard to the exercise of that right. If it does not, the court shall then conduct a commensurate means-end review.

Writing only for himself and Justice Wecht, Justice Donohue also contended that that the state Constitution substantively protects a woman's right to make reproductive decisions, including abortion.

Justice Wecht also filed a 71-page concurring opinion discussing additional issues. Chief Justice Todd filed a 17-page opinion dissenting in part, concluding that the Fischer decision is binding precedent. Justice Dougherty filed a brief opinion concurring in part, agreeing with the majority's overruling of Fischer. Justice Mundy filed a 24-page opinion dissenting in part, concluding that the funding ban should be upheld on the basis of the Fischer case and strongly criticizing the majority's holding that Art. I, Section 26 requires funding neutrality.

Philadelphia Inquirer reports on the decision.

Arkansas AG Certifies Abortion Amendment Proposal; Signature Collection May Begin

After rejecting two prior proposals as being unclear or misleading (1 , 2 ) on Tuesday, Arkansas Attorney General Tim Griffin certified the popular name and ballot title for a proposed constitutional amendment that, if adopted by voters, will liberalize abortion rules in Arkansas.  The ballot proposal describes the changes as follows in part:

... [T]his amendment changes Arkansas law by amending the Arkansas Constitution to provide that the government of the State of Arkansas, its officers, or its political subdivisions shall not prohibit, penalize, delay, or restrict abortion services (1) in cases of rape, (2) in cases of incest, (3) in the event of a fatal fetal anomaly, or (4) when, in a physician’s good-faith medical judgment, abortion services are needed to protect a pregnant female’s life or to protect a pregnant female from a physical disorder, physical illness, or physical injury; to provide that the government of the State of Arkansas, its officers, or its political subdivisions shall not prohibit, penalize, delay, or restrict abortion services within 18 weeks of fertilization....

As reported by the Arkansas Democrat Gazette, the Attorney General's approval allows proponents to begin to collect 90,704 signatures needed to get the proposal on the November 2024 ballot.

White House Fact Sheet Focuses on Administration's Protection of Access to Reproductive Health Care

On Monday, which was the 51st anniversary of the Supreme Court's decision in Roe v. Wade, the White House issued a Fact Sheet (full text) announcing new actions to protect access to reproductive health care. According to the Whtie House, these include:

The Departments of the Treasury, Labor, and Health and Human Services (HHS) are issuing new guidance to clarify standards and support expanded coverage of a broader range of FDA-approved contraceptives at no cost under the Affordable Care Act....

The Secretary of HHS is issuing a letter to private health insurers, state Medicaid and Children’s Health Insurance Programs, and Medicare plans about their obligations to cover contraception for those they serve....

... The Administration is committed to helping ensure all patients, including women who are experiencing pregnancy loss and other pregnancy-related emergencies, have access to emergency medical care required under the Emergency Medical Treatment and Labor Act (EMTALA). The Administration has long taken the position that the required emergency care can, in some circumstances, include abortion care. The Department of Justice (DOJ) is defending that interpretation of the law before the Supreme Court, which is expected to rule by June. 

To increase awareness of EMTALA and improve the procedures for ensuring that patients facing all types of medical emergencies receive the care to which they are entitled, HHS is announcing today a comprehensive plan to educate all patients about their rights and to help ensure hospitals meet their obligations under federal law....

The Fact Sheet went on to outline at length steps the Administration has taken to protect access to abortion, including medication abortion, and to contraception. The Fact Sheet comes as the White House is convening the fourth meeting of its Task Force on Reproductive Health Care.

Montana AG Says Abortion Rights Initiative Cannot Go on Ballot

In a Memorandum dated January 16, Montana's Attorney General has ruled that proponents of an abortion rights amendment to the Montana Constitution may not begin to collect signatures to get the proposal on the ballot because the proposal is legally insufficient. (Full text of AG's ruling.) Montana's Supreme Court in Armstrong v. State (1999) has previously held that the state Constitution's privacy provisions protect the right to pre-viability abortion. The proposed Amendment as summarized by the Secretary of State would explicitly protect that right, would assure the right to abortion even post-viability when necessary to protect the pregnant person's life or health, and would prohibit the state from taking adverse action against patients, healthcare providers or anyone assisting someone in obtaining reproductive care. The Attorney General's Memorandum concludes that the proposed Amendment "logrolls multiple distinct political choices into a single initiative," in violation of the separate-vote provision of the state Constitution. Montana Free Press reporting on the Attorney General's action, says that Amendment proponents plan to challenge the Attorney General's action in court. [Thanks to Thomas Rutledge for the lead.]

Sign Ordinance Restricting Anti-Abortion Protester Does Not Violate 1st Amendment

In Roswell v. Mayor and City Council of Baltimore, (D MD, Jan.19, 2024), a Maryland federal district court dismissed a suit by an anti-abortion sidewalk counselor who communicates with women entering and exiting a Planned Parenthood Clinic. A city ordinance prevented plaintiff from using A-frame signs in front of the clinic to communicate his religious convictions about abortions as well as information about alternatives to abortion. A permit to erect such signs can be obtained only by the owner of the property or an agent of the owner. Finding that the city ordinance did not violate plaintiff's free speech rights, the court said in part:

Plaintiff asks this Court to find that zoning ordinances cannot distinguish between the owners and tenants of adjacent properties utilizing A-frame signs for non-residential uses and those with no such property interest without running afoul of First Amendment principles. Fatal to Roswell’s position is the simple fact that the regulations do not “target speech based on its communicative content.” ...

The court also rejected plaintiff's free exercise of religion challenge, saying in part: 

Here, the challenged ordinances are unconcerned with religious exercise. They neither prohibit nor compel religious conduct. And even if the ordinances did burden religious exercise, a law that “incidentally burden[s] religion” does not violate the Free Exercise Clause if it is “neutral and generally applicable.”

HHS Adopts Rules Implementing Conscience Protections in Federal Law

The Department of Health and Human Services has made available a 100-page Release (full text) titled Safeguarding the Rights of Conscience as Protected by Federal Statutes that will be published in the Federal Register on January 11. The Release adopts the final version of amendments to rules initially adopted in 2011 and amended in 2019. though the 2019 version never took effect because of litigation. (See prior posting.) The new Rules seek to implement conscience protections in various statutes that bar recipients of federal funds from requiring health care personnel and organizations to participate in conduct that violates their religious or moral beliefs.  The new Rules provide in part:

OCR considers the posting of a notice consistent with this part as a best practice towards achieving compliance with and educating the public about the Federal health care conscience protection statutes, and encourages all entities subject to the Federal health care conscience protection statutes to post the model notice provided in Appendix A to this part. OCR will consider posting a notice as a factor in any investigation or compliance review under this rule.

(See prior related posting.) 

In a Release (full text) criticizing the new Rule, Alliance Defending Freedom said in part:

In its rule, HHS suggests it will continue its misguided use of the Emergency Medical Treatment and Labor Act to require doctors to perform abortions even though that federal law has no abortion requirement, and conscience laws provide no exception allowing forced performance of abortion.

In a Release (full text) commending the Biden Administration for the Rule change, the ACLU said in part:

The Biden administration announced it would partially repeal a dangerous and unnecessary Trump-era rule, which numerous courts had declared unlawful, that would have allowed health care institutions and providers to deny patients treatment and information based on personal religious or moral beliefs.

Court Limits Discussion of Religion in Trial for Blocking Abortion Clinic Entrance

In United States v. Gallagher, (MD TN, Jan. 5, 2024), a Tennessee federal district court ruled on the extent to which defendants can refer to their religious activities or beliefs and to the First Amendment in their upcoming criminal trial for violation of the Free Access to Clinic Entrances Act. Defendants are charged criminally with barricading the entrance to a Mt. Juliet, Tennessee abortion clinic in a so-called "rescue" operation. The court said in part:

It does not appear to be disputed that these defendants’ actions were motivated, at least in part, by their religious objections to the intentional termination of pregnancies. The Government argues, however, that evidence of those motivations would be “totally extraneous” to the “nature of the” charged offenses and should, therefore, be excluded.... The Government’s argument, however, is in significant tension with the FACE Act itself, which affirmatively places the defendants’ states of mind at issue by criminalizing only “intentional” acts taken “because [the victim] is or has been, or in order to intimidate such person or any other person or any class of persons from, obtaining or providing reproductive health services.” 18 U.S.C. § 248(a)(1). The defendants’ subjective motivations are, therefore, an unavoidable aspect of this case, and it is not clear to the court that those motivations can be accurately represented without at least some incidental reference to the details of their beliefs—which happen, in this instance, to be based in religion....

The court has already ruled that, as a matter of well-settled law, religious motivations are not a defense to a violation of either the FACE Act or the conspiracy statute.... The court, however, will not go so far as to wholly forbid the discussion of the defendants’ religious beliefs for the limited purpose of establishing or refuting intent or purpose.... 

... The defendants cannot turn an ounce of relevance into a gallon of irrelevant political messaging. The court, however, will not bar discussion of the defendants’ views altogether.

... When the defendants prayed or discussed their religious views, those specific actions were protected by the First Amendment. But if, in the next breath, they turned to discussing a plan to unlawfully obstruct the entrance of a clinic, then that conspiracy was just as illegal as it would have been if it had been the sole topic of conversation. Similarly, if they engaged in activities that would, in isolation, be protected by the First Amendment, but they did so while also violating the FACE Act through physical obstruction or intimidation, then the non-criminal components of their actions are no shield against prosecution for the criminal ones. Any argument to the contrary would be improper and will be barred.

The court also ruled that defendants may not present evidence or arguments at trial on various other matters including jury nullification, selective prosecution, potential sentences and good character. (See prior related posting.)

Supreme Court Grants Review of EMTALA's Impact on State Abortion Restrictions

Yesterday, the U.S. Supreme Court agreed to review an Idaho federal district court decision (see prior posting) that preliminarily enjoined the state of Idaho from enforcing its nearly total abortion ban to the extent it conflicts with the federal Emergency Medical Treatment and Labor Act. The Supreme Court Order (full text) comes in the companion cases of Moyle v. United States, (Docket No. 23-726) and Idaho v. United States, (Docket No. 23-727) (certiorari granted, 1/5/2024). In September 2023, a 3-judge panel of the U.S. 9th Circuit Court of Appeals stayed the district court's injunction pending appeal. (See prior posting.)  However, the full 9th Circuit in an en banc Order vacated the panel's opinion that stayed the injunction and granted en banc review. In yesterday's Order, the Supreme Court allowed plaintiffs to bypass review by the 9th Circuit and present the case to the Supreme Court.  The Supreme Court also again stayed the district court's preliminary injunction that limited enforcement of Idaho's abortion ban. It granted review on the Question Presented in Idaho's Application:

Whether EMTALA preempts state laws that protect human life and prohibit abortions, like Idaho's Defense of Life Act.

The Court set arguments for the April 2024 argument session. Here is the SCOTUSblog case page that will link to pleadings in the Supreme Court.

AP reports on the Supreme Court's decision. Yesterday President Biden issued a Statement (full text) criticizing the Supreme Court's action, saying in part:

Today’s Supreme Court order allows Idaho’s extreme abortion ban to go back into effect and denies women critical emergency abortion care required by federal law. The overturning of Roe v. Wade has enabled Republican elected officials to pursue dangerous abortion bans like this one that continue to jeopardize women’s health, force them to travel out of state for care, and make it harder for doctors to provide care, including in an emergency. These bans are also forcing doctors to leave Idaho and other states because of laws that interfere with their ability to care for their patients. This should never happen in America.

5th Circuit: EMTALA Does Not Require Emergency Abortions

In State of Texas v. Becerra, (5th Cir., Jan. 2, 2024), the U.S. 5th Circuit Court of Appeals affirmed an injunction issued by a Texas federal district court barring enforcement of a Guidance document on emergency abortion care issued by the Department of Health and Human Services. (See prior posting.) The Department of Health and Human Services' Guidance to hospitals (and accompanying Letter) stated that the federal Emergency Medical Treatment & Labor Act (EMTALA) requires hospital emergency rooms to perform certain abortions, even when they violate Texas law, when an abortion is the stabilizing treatment necessary to resolve an emergency medical condition. The 5th Circuit said in part:

While EMTALA directs physicians to stabilize patients once an emergency medical condition has been diagnosed, ..., the practice of medicine is to be governed by the states. HHS' argument that "any" type of treatment should be provided is outside EMTALA's purview....

 ... EMTALA requires hospitals to stabilize both the pregnant woman and her unborn child....

... EMTALA leaves the balancing of stabilization to doctors, who must comply with state law.... We agree with the district court that EMTALA does not provide an unqualified right for the pregnant mother to abort her child especially when EMTALA imposes equal stabilization obligations....

Texas Tribune reports on the decision.