Amicus Curiae Brief — Thomas E. Dobbs, State Health Officer of the Mississippi Department of Health, et al., Petitioners v. Jackson Women's Health Organization, et al.

Supreme Court briefJul 20, 2020

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No. 19-1392

In the Supreme Court of the United States

THOMAS E. DOBBS, STATE HEALTH OFFICER OF THE

MISSISSIPPI DEPARTMENT OF HEALTH, ET AL., PETITIONERS

v.

JACKSON WOMEN’S HEALTH ORGANIZATION, ET AL.

ON PETITION FOR A WRIT OF CERTIORARI

TO THE UNITED STATES COURT OF APPEALS

FOR THE FIFTH CIRCUIT

BRIEF FOR THE STATES OF TEXAS, ALABAMA,

ALASKA, ARIZONA, ARKANSAS, GEORGIA, IDAHO,

INDIANA, KANSAS, KENTUCKY, LOUISIANA,

MISSOURI, NEBRASKA, OHIO, OKLAHOMA, SOUTH

CAROLINA, TENNESSEE, AND WEST VIRGINIA AS

AMICI CURIAE IN SUPPORT OF PETITIONERS

KEN PAXTON

Attorney General of Texas

JEFFREY C. MATEER

First Assistant Attorney

General

RYAN L. BANGERT

Deputy First Assistant

Attorney General

KYLE D. HAWKINS

Solicitor General

Counsel of Record

HEATHER GEBELIN HACKER

BETH KLUSMANN

Assistant Solicitors General

OFFICE OF THE

ATTORNEY GENERAL

P.O. Box 12548 (MC 059)

Austin, Texas 78711-2548

Kyle.Hawkins@oag.texas.gov

(512) 936-1700

QU E S TIO N P RE SE N TE D

Whether an abortion law is necessarily unconstitutional, regardless of the State’s interest or the actual

burden on women, when it theoretically could prevent a

small number of women from obtaining a previability

abortion.

(I)

TA BLE O F C O NTE N TS

Page

Question presented .......................................................... I

Table of authorities ....................................................... IV

Interest of amici curiae ................................................... 1

Summary of argument..................................................... 2

Argument.......................................................................... 4

I. The Fifth Circuit erroneously failed to apply the

undue-burden test. ............................................... 4

A. States may enact laws that impact the ability

to obtain a previability abortion. ................... 5

1. Regulations of previability abortion are

subject to the undue-burden test............. 5

2. Applying the undue-burden test would

have made a difference in this case. ........ 7

B. Casey’s viability framework does not

preclude consideration of other important

state interests. ................................................ 9

C. Abortion providers are attempting to avoid

scrutiny by claiming laws are “bans.” ......... 12

II. Medical and scientific advances require

reconsideration of the viability framework. ..... 14

A. Changed circumstances require the Court to

reevaluate its viability precedent. ............... 14

B. New medical and scientific developments

undermine the viability framework............. 16

C. If the viability line is absolute, only this

Court can move it.......................................... 18

III. The Court should condemn the district court’s

rhetoric. ............................................................... 19

Conclusion ...................................................................... 21

(III)

IV

TA BLE O F AU T HO R I TIE S

Page(s)

Cases:

Abbott v. Perez,

138 S. Ct. 2305 (2018) ............................................... 2, 19

In re Abbott,

954 F.3d 772 (5th Cir. 2020) ........................................ 13

In re Abbott,

956 F.3d 696 (5th Cir. 2020) ........................................ 20

Adams & Boyle, PC v. Slatery,

956 F.3d 913 (6th Cir. 2020) ........................................ 13

Atkins v. Virginia,

536 U.S. 304 (2002) ....................................................... 17

Bernard v. Individual Members of Ind. Med.

Licensing Bd.,

392 F. Supp. 3d 935 (S.D. Ind. 2019) .......................... 20

Box v. Planned Parenthood of Ind. & Ky., Inc.,

139 S. Ct. 1780 (2019) ................................. 10, 11, 13, 18

Box v. Planned Parenthood of Ind. & Ky., Inc.,

No. 18-1019, 2020 WL 3578669 (U.S. July 2, 2020) ..... 3

Box v. Planned Parenthood of Ind. & Ky., Inc.,

No. 19-816, 2020 WL 3578672 (U.S. July 2, 2020) ....... 3

Bryant v. Woodall,

363 F. Supp. 3d 611 (M.D.N.C. 2019) ....................... 5, 7

City of Akron v. Akron Ctr. for Reprod.

Health, Inc.,

462 U.S. 416 (1983) ................................................. 15, 17

Doe v. Bolton,

410 U.S. 179 (1973) ....................................................... 11

In re Gee,

941 F.3d 153 (5th Cir. 2019) ........................................ 20

V

Cases—Continued:

Page(s)

Gonzales v. Carhart,

550 U.S. 124 (2007) ............................. 8, 9, 11, 16, 17, 18

Grutter v. Bollinger,

539 U.S. 306 (2003) ....................................................... 12

Isaacson v. Horne,

716 F.3d 1213 (9th Cir. 2013) .................................... 5, 7

Jackson Women’s Health Org. v. Currier,

349 F. Supp. 3d 536 (S.D. Miss. 2018) ............ 1, 2, 8, 19

Jackson Women’s Health Org. v. Dobbs,

945 F.3d 265 (5th Cir. 2019) ........................ 1, 5, 6, 9, 19

June Med. Servs. LLC v. Russo,

Nos. 18-1323, 18-1460, 2020 WL 3492640

(U.S. June 29, 2020)............................................. passim

Little Rock Family Planning Servs. v.

Rutledge,

397 F. Supp. 3d 1213 (E.D. Ark. 2019) ......................... 7

Marks v. United States,

430 U.S. 188 (1977) ......................................................... 2

McCorvey v. Hill,

385 F.3d 846 (5th Cir. 2004) ................................... 14-15

MKB Mgmt. Corp. v. Stenehjem,

795 F.3d 768 (8th Cir. 2015) ........................................ 15

Planned Parenthood of Ind. & Ky., Inc. v.

Comm’r of Ind. State Dep’t of Health,

888 F.3d 300 (7th Cir. 2018) .................................. 13, 15

Planned Parenthood of Ind. & Ky., Inc. v.

Comm’r of Ind. State Dep’t of Health,

917 F.3d 532 (7th Cir. 2018) ........................................ 10

Planned Parenthood of Se. Pa. v. Casey,

505 U.S. 833 (1992) .............................................. passim

VI

Cases—Continued:

Page(s)

Preterm-Cleveland v. Himes,

294 F. Supp. 3d 746 (S.D. Ohio 2018) ......................... 13

Preterm-Cleveland v. Himes,

944 F.3d 630 (6th Cir. 2019) ........................................ 13

Reed v. Town of Gilbert,

576 U.S. 155 (2015) ................................................... 7, 12

Roe v. Wade,

410 U.S. 113 (1973) ................................... 6, 8, 10, 11, 14

In re Rutledge,

956 F.3d 1018 (8th Cir. 2020) ................................. 12-13

SisterSong Women of Color Reprod. Justice

Collective v. Kemp,

1:19-CV-02973-SCJ, 2020 WL 3958227

(N.D. Ga. July 13, 2020) ................................................. 7

Stenberg v. Carhart,

530 U.S. 914 (2000) ....................................................... 17

Tex. Med. Providers Performing Abortion

Servs. v. Lakey,

No. A-11-CA-486-SS, 2012 WL 373132

(W.D. Tex. Feb. 6, 2012) .............................................. 20

Webster v. Reprod. Health Servs.,

492 U.S. 490 (1989) ................................................. 11, 18

Statutes:

Partial-Birth Abortion Ban Act of 2003,

Pub. L. No. 108-105, 117 Stat. 1201 (2003) ................ 16

Ala. Code § 26-23B-5(a) ..................................................... 17

Ariz. Rev. Stat. § 36-2159(B) ............................................. 17

VII

Statutes—Continued:

Page(s)

Ark. Code:

§ 20-16-1405(a)(1) ......................................................... 17

§ 20-16-2002................................................................... 16

Ga. Code § 16-12-141(b) ..................................................... 17

Idaho Code:

§ 18-503 .......................................................................... 16

§ 18-505 .......................................................................... 17

Ind. Code § 16-34-2-1(a)(3) ................................................ 17

Iowa Code § 146B.2(2)(a)................................................... 17

Kan. Stat.:

§ 65-6723(f) .................................................................... 17

§ 65-6724(a) ................................................................... 17

Ky. Rev. Stat. § 311.782(1) ................................................ 17

La. Stat. § 40:1061.1(E) ..................................................... 17

Miss. Code:

§ 41-41-137..................................................................... 17

§ 41-41-191(2) .................................................................. 8

Mo. Rev. Stat. § 188.058(1) ................................................ 17

N.C. Gen. Stat. § 14-45.1(a) ............................................... 17

N.D. Cent. Code § 14-02.1-05.3(3) .................................... 17

Neb. Rev. Stat.:

§ 28-3,104 .................................................................. 16-17

§ 28-3,106 ....................................................................... 17

Ohio Rev. Code § 2919.201(A) ........................................... 17

Okla. Stat. tit. 63, § 1-745.5(A) .......................................... 17

S.C. Code § 44-41-450(A) ................................................... 17

S.D. Codified Laws § 34-23A-70 ....................................... 17

Tex. Health & Safety Code § 171.044 .............................. 17

Utah Code § 76-7-302.5 ...................................................... 17

VIII

Statutes—Continued:

Page(s)

W. Va. Code:

§ 16-2M-2 ....................................................................... 17

§ 16-2M-4(a) .................................................................. 17

Other Authorities:

A. Pawlowski, ‘Miracle baby’: Born at 21

Weeks, She May Be the Most Premature

Surviving Infant (Nov. 2017),

https://www.today.com/health/born-21weeks-she-may-be-most-prematuresurviving-baby-t118610 ............................................... 15

Compl., Whole Woman’s Health Alliance v.

Hill, No. 1:18-CV-1904 (S.D. Ind. June 21,

2018) ............................................................................... 18

Compl., Whole Woman’s Health Alliance v.

Paxton, No. 1:18-CV-00500 (W.D. Tex.

June 14, 2018) .......................................................... 18-19

Fox Television, Extreme Preemie, ‘About the

Size of a Hand,’ Goes Home in Georgia

(July 2020), https://fox6now.com/2020/

07/01/extreme-preemie-comes-home-forfirst-time/ ...................................................................... 15

Mem. of Law in Support of Plfs.’ Emergency

Mot. for TRO & Prelim. Injunctive Relief,

Robinson v. Marshall, No. 2:19-cv-00365MHT-JTA, (M.D. Ala. Mar. 30, 2020) ........................ 13

Mem. of Law Supporting Ex Parte TRO or

Prelim. Inj., Little Rock Family Planning

Servs. v. Rutledge, No. 4:19-CV-00449-KGB

(E.D. Ark. Apr. 13, 2020) ............................................. 13

IX

Other Authorities—Continued:

Page(s)

Mot. for & Br. in Support of TRO and/or

Prelim. Inj., Preterm-Cleveland, Inc. v.

Yost, No. 1:19-cv-00360 (S.D. Ohio Mar. 30,

2020) ............................................................................... 13

Mot. for TRO and/or Prelim. Inj., Planned

Parenthood Ctr. for Choice v. Abbott, No.

1:20-cv-00323-LY (W.D. Tex. Mar. 25, 2020)............. 13

Order, Jackson Women’s Health Org. v. Dobbs,

No. 3:18-CV-00171-CWR-FKB (S.D. Miss.

Aug. 15, 2018) .................................................................. 8

Stuart W.G. Derbyshire & John C. Bockmann,

Reconsidering Fetal Pain, 46 J. of Med.

Ethics, no. 1 (2019) ....................................................... 16

INTE RE ST O F A MIC I C U RI AE

Amici curiae are the States of Texas, Alabama,

Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana,

Kansas, Kentucky, Louisiana, Missouri, Nebraska, Ohio,

Oklahoma, South Carolina, Tennessee, and West Virginia. 1

This case implicates Amici States’ interests in several

ways. First, Amici States regulate previability abortion,

and many have laws that prohibit abortions after 20 or

22 weeks LMP. See infra p. 17 n.8. The district court’s

opinion below casts doubt on the lawfulness of any restriction on the right to abortion prior to 23 weeks LMP.

Jackson Women’s Health Org. v. Currier, 349 F. Supp.

3d 536, 539-40 (S.D. Miss. 2018). And in affirming the district court’s judgment, the Fifth Circuit applied a test

that would invalidate automatically any law that might

prevent some previability abortions, without regard to

the State’s interest and the law’s burden. See Jackson

Women’s Health Org. v. Dobbs, 945 F.3d 265, 273 (5th

Cir. 2019). The Fifth Circuit’s test is incorrect, as this

Court recently confirmed in June Medical Services LLC

v. Russo, Nos. 18-1323, 18-1460, 2020 WL 3492640 (U.S.

June 29, 2020), and if left intact, it calls into question

Amici States’ ability to enforce their laws.

Second, the decisions below curtail Amici States’ ability to put on evidence of new medical and scientific discoveries regarding fetal development and fetal pain. By

treating viability as the only relevant consideration, the

decisions below depart from this Court’s precedents in a

No counsel for any party authored this brief, in whole or in

part. No person or entity other than amici contributed monetarily

to its preparation or submission. On July 6, 2020, counsel of record

for all parties received notice of amici’s intention to file this brief.

1

(1)

2

way that would effectively prevent Amici States from relying on advances in medicine and science to better craft

optimal public policy. The decisions below were wrong to

disregard the States’ obvious interest in legislating according to the latest scientific knowledge.

Finally, the decisions below wrongly impugn the motives of Mississippi and any other State that values unborn life. The district court tarnished Mississippi’s abortion regulation as the product of decades-old racism and

sexism. Jackson Women’s, 349 F. Supp. 3d at 540 n.22,

543 n.40. States should be able to defend their laws before a fair forum that presumes good faith, see, e.g., Abbott v. Perez, 138 S. Ct. 2305, 2324 (2018), not one quick

to condemn state legislators, without any evidence, as

bigots. This Court should denounce the district court’s

baseless aspersions.

SU M MA RY O F AR GU ME NT

I. By adopting a novel constitutional test that asks

only whether some unknown number of women might be

prevented from obtaining a previability abortion, the

Fifth Circuit’s decision conflicts with both Casey and

June Medical, which require courts to assess whether an

abortion law is reasonably related to a legitimate state

interest, and whether the law presents a substantial

obstacle to abortion access. June Med., 2020 WL

3492640, at *23 (Roberts, C.J., concurring in the judgment) (citing Planned Parenthood of Se. Pa. v. Casey,

505 U.S. 833, 878 (1992) (plurality op.)). 2 The Fifth

As the narrowest ground for the Court’s decision to reverse in

June Medical, Chief Justice Roberts’ opinion is controlling. Marks

v. United States, 430 U.S. 188, 193 (1977). Unless otherwise indicated, all citations to June Medical are to the Chief Justice’s controlling opinion.

2

3

Circuit refused to follow Casey and instead applied a

novel test that renders irrelevant both the impact of a

law and whether the State has an interest in the

excruciating pain an unborn child experiences as it is

torn limb from limb during an abortion. The Fifth

Circuit’s test treats the right to previability abortion as

absolute such that no state interest could ever justify any

limitation of abortion previability. But no other

constitutional right enjoys such absolute unquestioning

protection, which perhaps is why Roe and Casey do not

elevate the abortion right above all others.

Since the decision below rests on plainly incorrect

reasoning, this Court should at a minimum grant, vacate,

and remand so that the Fifth Circuit can apply the

undue-burden test as reaffirmed in June Medical. See,

e.g., Box v. Planned Parenthood of Ind. & Ky., Inc., No.

18-1019, 2020 WL 3578669 (U.S. July 2, 2020); Box v.

Planned Parenthood of Ind. & Ky., Inc., No. 19-816, 2020

WL 3578672 (U.S. July 2, 2020). But the better course is

to set this case for plenary review. It is time for this

Court to clarify that all abortion laws, no matter whether

they “ban,” “prohibit,” or “regulate” previability

abortion, are subject to the undue-burden test.

II. The decisions below prevent States from offering

scientific evidence that undermines the factual assumptions the Court relied on in Roe and Casey. Yet Roe and

Casey themselves plainly contemplate that state legislatures may fine-tune regulations in response to evolving

medical information. That is the case here: In the 47

years since Roe, innumerable advances in science and

medicine inform our understanding of fetal development

and the capacity to experience pain.

Unless otherwise indicated, all citations to Casey are to the plurality opinion.

4

Yet the district court declared all scientific developments irrelevant and the viability line absolute. Not only

is that wrong under this Court’s precedents, but it would

strip state legislatures of the ability to legislate effectively in light of evolving knowledge. This Court, in turn,

will become the Nation’s sole “ex officio medical board”

charged with refereeing the impact of medical advances

on the regulation of abortion. The better course is to do

what the district court would not: allow States to present

scientific evidence to satisfy their end of the undue-burden standard without handcuffing them to an erroneous

test that treats viability as the only relevant consideration.

III. Finally, the Court should condemn the district

court’s commentary that accused the Mississippi

Legislature of racism and sexism. District courts are

charged with making factfindings that are relied on by

appellate courts. District courts cannot proceed from the

assumption that abortion regulations are inherently

illegitimate. Nor should they disparage the good faith of

lawmakers who value unborn life.

ARGU ME N T

I. The Fifth Circuit Erroneously Failed to Apply

the Undue-Burden Test.

This Court recently reaffirmed that Casey’s undueburden test governs challenges to state abortion regulations. The test is universal: States are free to enact abortion regulations reasonably related to their legitimate interests as long as their laws do not pose an undue burden. June Med., 2020 WL 3492640, at *23. Yet the Fifth

Circuit below refused to apply the undue-burden test to

Mississippi’s 15-week law. The Fifth Circuit joined other

courts in holding that the undue-burden inquiry does not

apply when a law might “ban” some previability

5

abortions. Jackson Women’s, 945 F.3d at 273; see also,

e.g., Isaacson v. Horne, 716 F.3d 1213, 1222-25 (9th Cir.

2013); Bryant v. Woodall, 363 F. Supp. 3d 611, 627-28

(M.D.N.C. 2019), appeal docketed, No. 19-1685 (4th Cir.

June 26, 2019).

That reasoning is inconsistent with June Medical and

Casey. This Court has never sanctioned a “ban” test that

ignores all evidence other than the viability of the unborn

child. To be sure, Roe and Casey generally endorse the

State’s broad authority to regulate abortion post-viability. But it does not follow from that rule that a State can

impose no restrictions on abortion before viability. The

Court should not allow lower courts’ confusion to persist

any longer.

A. States may enact laws that impact the ability

to obtain a previability abortion.

The Fifth Circuit should have applied the undue-burden test. Under that test, an abortion regulation must be

upheld if it (1) is reasonably related to a legitimate state

interest, and (2) poses no substantial obstacle to abortion. June Med., 2020 WL 3492640, at *23; Casey, 505

U.S. at 878. That test applies regardless of the impact of

the regulation.

1. Regulations of previability abortion are

subject to the undue-burden test.

The Fifth Circuit concluded that, because Mississippi’s 15-week law was a “ban” on previability abortion,

“the undue-burden balancing test has no place in this

case.” Jackson Women’s, 945 F.3d at 273. The panel purported to ground its opinion in Roe and Casey, id. at 271,

273, but those cases did not create a separate test for

“bans” that ignores all evidence other than viability. Instead, the language cited describes the scope of the right

6

to elective abortion and permits States to regulate within

it.

After recognizing a right to elective abortion in Roe,

the Court chose to set the limit of that right at viability.

Roe v. Wade, 410 U.S. 113, 163-64 (1973). After viability,

there is no right to elective abortion. Id. Casey reiterated

the scope of that right when it reaffirmed “the central

holding of Roe,” that “a State may not prohibit any

woman from making the ultimate decision to terminate

her pregnancy before viability.” 505 U.S. at 879. But the

Court permitted States to place limitations on that right,

as long as those limitations do not amount to an undue

burden. Id. at 878.

The Fifth Circuit misunderstood this language from

Casey as automatically invalidating any law that might

“prohibit” a subset of women from obtaining a previability abortion—here, those seeking an abortion between

15- and 16-weeks’ gestation. Jackson Women’s, 945 F.3d

at 273. But that is not how Casey applied its own holding.

Casey subjected every law at issue to the undue-burden

test, even though some of the laws may have “banned” or

“prohibited” a subset of women from obtaining a previability abortion: women on the cusp of viability (24-hour

waiting period), women whose spouses might interfere

(spousal-notice provision), and minors without parental

consent or judicial bypass. Casey, 505 U.S. at 885-87, 895,

899-900. Most recently in June Medical, the plurality applied the undue-burden test despite concluding that

“thousands of Louisiana women” would have “no practical means of obtaining a safe, legal abortion.” 2020 WL

3492640, at *19 (plurality op.).

Thus, Roe and Casey, while generally defining the

right to elective abortion, do not forbid States from enacting laws that might prohibit some previability

7

abortions. No constitutional right is absolute, and abortion is no exception. Previability abortion—just like free

speech, see Reed v. Town of Gilbert, 576 U.S. 155, 163-64

(2015)—may be regulated so long as the regulation

passes the applicable constitutional test.

Taking the Court’s “may not prohibit” language literally would require courts to enjoin any state law that

stands between a woman and a previability abortion,

whether it be a health-and-safety standard that would

shut down a filthy clinic or a prohibition on governmentfunded abortions. The Court has never endorsed this

view. Yet many courts have misread the Court’s precedent to automatically invalidate laws that might prevent

some women from obtaining previability abortions.

Isaacson, 716 F.3d at 1222-25; SisterSong Women of

Color Reprod. Justice Collective v. Kemp, 1:19-CV02973-SCJ, 2020 WL 3958227, at *10-*11 (N.D. Ga. July

13, 2020); Little Rock Family Planning Servs. v.

Rutledge, 397 F. Supp. 3d 1213, 1266-68 (E.D. Ark. 2019),

appeal docketed, No. 19-2690 (8th Cir. Aug. 9, 2019); Bryant, 363 F. Supp. 3d at 627-28. Given that the right to

elective abortion derives only from this Court’s precedent, this Court is the only body that can correct this error, and it should grant the petition to do so.

2. Applying the undue-burden test would

have made a difference in this case.

a. By refusing to apply the undue-burden test here,

the lower courts prevented Mississippi from adequately

defending its law. As June Medical reaffirmed, the first

step in the undue-burden test is the “threshold requirement” that the State have a “legitimate purpose and that

the law be reasonably related to that goal.” 2020 WL

3492640, at *25 (cleaned up).

8

The Mississippi Legislature made multiple findings

supporting its 15-week gestational limit including fetal

development, integrity of the medical profession, and

maternal health. Miss. Code § 41-41-191(2). Mississippi

also sought to present evidence to the district court of an

interest in preventing fetal pain, given the scientific evidence that a 15-week-old fetus has developed the brain

structures necessary to feel pain. Pet. App. 75a-100a.

These interests are legitimate, see Gonzales v. Carhart,

550 U.S. 124, 157-60 (2007); Roe, 410 U.S. at 163; and the

15-week law is reasonably related to them.

Yet the district court refused to let Mississippi defend its law with evidence of fetal pain. Order, Jackson

Women’s Health Org. v. Dobbs, No. 3:18-CV-00171CWR-FKB (S.D. Miss. Aug. 15, 2018) (excluding fetalpain testimony). The district court then went one step

further, opining that the Mississippi Legislature was

“gaslighting” and that its true purpose was malicious—

to control women and minorities. Jackson Women’s, 349

F. Supp. 3d at 540 n.22.

Mississippi was entitled to defend its law with evidence supporting its interests, especially when those interests are disputed. Such evidence is relevant to the undue-burden test’s “threshold requirement” of a legitimate purpose. June Med., 2020 WL 3492640, at *25. Yet

the district court and Fifth Circuit gave Mississippi no

opportunity to defend its interests.

b. The Fifth Circuit also improperly relieved the

plaintiffs of their burden to prove the second element of

the undue-burden test: the law places a “substantial obstacle in the path of a woman seeking an abortion of a

nonviable fetus.” Id. (quoting Casey, 505 U.S. at 877).

Currently, Mississippi has one abortion clinic, and it

performs abortions only up to 16-weeks’ gestation.

9

Jackson Women’s, 945 F.3d at 273. The record shows

that, in 2017, 90 women obtained abortions between 15

and 16 weeks. Id. at 273 n.31. The plaintiffs introduced

no evidence to explain why these women could not schedule their abortions one week earlier. There is, therefore,

no summary-judgment evidence that Mississippi’s law

would pose a substantial obstacle to any woman’s ability

to obtain a previability abortion, much less a large fraction or significant number of women. 3 See June Med.,

2020 WL 3492640, at *25 (noting Casey’s spousal-notice

requirement impacted a “significant number” of women).

Instead, the law still gives Mississippi women a reasonable opportunity—nearly four months—to make their

choice.

The lower courts’ failure to apply the undue-burden

test warrants reversal. The Court should either grant,

vacate, and remand in light of June Medical’s affirmation of the undue-burden test, or grant and reverse after

holding that the undue-burden test applies in these circumstances.

B. Casey’s viability framework does not preclude

consideration of other important state

interests.

Even if Mississippi’s law would prevent some previability abortions, the analysis does not stop there. The

Fifth Circuit erred in assuming that the viability of the

unborn child is the only state interest that can justify

limiting abortion rights. Jackson Women’s, 945 F.3d at

274 (holding that “the Supreme Court’s viability framework has already balanced the State’s asserted interests

And if there were a true obstacle to access for any actual

woman, the proper means of adjudication is an as-applied challenge,

not wholesale facial invalidation. Gonzales, 550 U.S. at 167.

3

10

and found them wanting”). But as described above, the

Court’s “viability framework” was just that—a framework. The Court did not purport to rule on all possible

interests that would justify a limitation on abortion. See

Box v. Planned Parenthood of Ind. & Ky., Inc., 139 S.

Ct. 1780, 1792 (2019) (Thomas, J., concurring) (noting

that Casey did not address eugenic abortions, but only

five provisions of Pennsylvania law); Planned

Parenthood of Ind. & Ky., Inc. v. Comm’r of Ind. State

Dep’t of Health, 917 F.3d 532, 536 (7th Cir. 2018) (Easterbrook, J., dissenting from denial of rehearing en banc)

(“Judicial opinions are not statutes; they resolve only the

situations presented for decision.”).

When setting the limit of the right to elective abortion at viability, Roe weighed only the bare interest in

unborn life—the belief that unborn life has value and

should not be aborted—against a complete prohibition

on elective abortions. 410 U.S. at 163-64. When reconsidering Roe, Casey again balanced only the States’ interest

in potential life against the woman’s interests in terminating her pregnancy. 505 U.S. at 870-71. Neither case

claimed to have considered all possible state interests

that might warrant limitations on abortion.

Thus, even if Mississippi’s law arguably prevented

some previability abortions, that is not the end of the

analysis. State interests other than the viability of the

unborn child are sufficiently important to justify limiting

the right to previability abortion, as some Justices have

previously indicated.

Fetal pain is one such compelling interest. Justice

Blackmun, the author of Roe, found it “obvious” that “the

State’s interest in the protection of an embryo . . . increases progressively and dramatically as the organism’s

capacity to feel pain, to experience pleasure, to survive,

11

and to react to its surroundings increases day by day.”

Webster v. Reprod. Health Servs., 492 U.S. 490, 552

(1989) (Blackmun, J., joined by Brennen and Marshall,

JJ., concurring in part) (cleaned up); see also id. at 569

(Stevens, J., concurring in part) (stating that the interest

in protecting a “developed fetus” from “physical pain or

mental anguish” is “valid”). Thus, multiple Justices that

joined Roe agree that fetal pain and development are important considerations in measuring the State’s interests. If so, then States can enact measures to prevent developed unborn children from suffering the pain of being

dismembered during an abortion.

The Court has recognized other state interests that

justify regulation of previability abortion: preventing the

coarsening of society to the humanity of newborns, Gonzales, 550 U.S. at 157; the integrity and ethics of the medical profession, id.; protection of minors, Casey, 505 U.S.

at 899-900; and maternal health, Roe, 410 U.S. at 154.

Justice Thomas has also identified a “compelling interest

in preventing abortion from becoming a tool of modernday eugenics,” and indicated that there could be “other

compelling interests in adopting . . . other abortion-related laws.” Box, 139 S. Ct. at 1783 & n.2 (Thomas, J.,

concurring).

Reading Roe and Casey to conclude, as the Fifth Circuit did, that no state interest other than viability can

justify preventing a previability abortion, makes that

right absolute. But Roe was clear that it is not: A woman

does not have a right to terminate her pregnancy “at

whatever time, in whatever way, and for whatever reason

she alone chooses.” 410 U.S. at 153-54; see also Doe v.

Bolton, 410 U.S. 179, 189 (1973) (stating that “a pregnant

woman does not have an absolute constitutional right to

an abortion on her demand”).

12

Treating the right to previability abortion—a right

found only in the precedent of the Court, not the text of

the Constitution—as absolute would endow it with

greater protection than enumerated constitutional rights

that may be limited when the State’s interest is strong

enough. See, e.g., Reed, 576 U.S. at 163-64 (free speech);

Grutter v. Bollinger, 539 U.S. 306, 326 (2003) (equal protection). And June Medical affirms that the substantialobstacle analysis is similar to the analysis used in other

types of claims that consider the State’s interest. See

2020 WL 3492640, at *24 (citing religious-freedom and

free-speech cases). Abortion should not be an exception

to the normal rules.

The Fifth Circuit’s assumption that there is no state

interest strong enough to justify a limitation on previability abortion was incorrect. The Court should grant the

petition, require the plaintiffs to prove an undue burden,

and allow Mississippi the full opportunity to defend its

law.

C. Abortion providers are attempting to avoid

scrutiny by claiming laws are “bans.”

If the Fifth Circuit’s judgment stands, and all laws

that might prohibit some previability abortions are unconstitutional, then abortion providers will claim that

abortion laws are effectively “bans” in order to cut off

debate, prevent the State from introducing evidence of

its interests, and avoid their obligation to prove an undue

burden.

This concern is not theoretical. The COVID-19 pandemic caused multiple States to temporarily postpone

elective medical procedures, including abortion, in order

to preserve personal protective equipment, ensure sufficient hospital capacity, and maintain social distancing.

See, e.g., In re Rutledge, 956 F.3d 1018, 1023 (8th Cir.

13

2020); Adams & Boyle, PC v. Slatery, 956 F.3d 913, 921

(6th Cir. 2020); In re Abbott, 954 F.3d 772, 787 (5th Cir.

2020). These temporary limits were challenged by abortion providers who cited Jackson Women’s for the proposition that the postponements were “bans” on previability abortion, and that evidence of the pandemic was irrelevant. 4

Abortion providers have also relied on this misunderstanding to obtain injunctions of anti-discrimination laws

that seek to prevent racist, sexist, and ableist abortions.

Planned Parenthood of Ind. & Ky., Inc. v. Comm’r of

Ind. State Dep’t of Health, 888 F.3d 300, 305-07 (7th Cir.

2018), cert. granted in part, judgment rev’d in part sub

nom. Box, 139 S. Ct. 1780; Preterm-Cleveland v. Himes,

294 F. Supp. 3d 746, 754 (S.D. Ohio 2018), en banc review

granted, 944 F.3d 630 (6th Cir. 2019). But the constitutionality of such laws is an open question. Box, 139 S. Ct.

at 1792 (Thomas, J., concurring).

The Court has never countenanced a constitutional

test for abortion that fails to account for the State’s interest. Indeed, Casey’s undue-burden standard was

adopted because the Court had not adequately considered the State’s interest in previous cases. 505 U.S. at

873. Abortion providers should not be permitted to escape their burden by claiming the law might “ban” an

Mem. of Law in Support of Plfs.’ Emergency Mot. for TRO &

Prelim. Injunctive Relief at 19-22, Robinson v. Marshall, No. 2:19cv-00365-MHT-JTA, (M.D. Ala. Mar. 30, 2020); Mem. of Law Supporting Ex Parte TRO or Prelim. Inj. at 24-26, Little Rock Family

Planning Servs. v. Rutledge, No. 4:19-CV-00449-KGB (E.D. Ark.

Apr. 13, 2020); Mot. for & Br. in Support of TRO and/or Prelim. Inj.

at 15-18, Preterm-Cleveland, Inc. v. Yost, No. 1:19-cv-00360 (S.D.

Ohio Mar. 30, 2020); Mot. for TRO and/or Prelim. Inj. at 17-20,

Planned Parenthood Ctr. for Choice v. Abbott, No. 1:20-cv-00323LY (W.D. Tex. Mar. 25, 2020).

4

14

abortion. The Fifth Circuit erred in refusing to apply the

undue-burden test.

II. Medical and Scientific Advances Require

Reconsideration of the Viability Framework.

When creating the right to abortion in Roe, the Court

explained that allowing States to prohibit abortions after

viability was “logical” and “biological.” 410 U.S. at 163.

But the understanding of biology did not stop in 1973. As

more is learned about fetal development and pain, and as

new “brutal” techniques for abortion emerge, what is

“logical” and “biological” changes as well. Thus, even if

the Court believes, as did the Fifth Circuit, that its holdings create a strict “viability line” that is dispositive here,

it is time to reevaluate that line, and States are entitled

to present evidence to support that argument.

The difficult questions of fetal development, pain, and

abortion techniques belong with the people’s elected officials, who can handle evolving science more nimbly, and

who are accountable to the electorate if they strike the

wrong balance. But if this Court has adopted a bright viability line, only this Court can weigh that new evidence

against “the woman’s liberty interest in defining her

‘own concept of existence, of meaning, of the universe,

and of the mystery of human life.’” June Med., 2020 WL

3492640, at *23.

A. Changed circumstances require the Court to

reevaluate its viability precedent.

Much has changed since Roe. “[N]eonatal and medical science . . . now graphically portrays, as science was

unable to do [at the time of Roe], how a baby develops

sensitivity to external stimuli and to pain much earlier

than was then believed.” McCorvey v. Hill, 385 F.3d 846,

852 (5th Cir. 2004) (Jones, J., concurring) (footnote

15

omitted). In 1973, viability meant 28 weeks’ gestation. By

1992, the gestation line was 23 or 24 weeks. Casey, 505

U.S. at 860. Babies born at only 21 weeks have now survived. 5 Multiple Justices have observed that the “Roe

framework . . . is clearly on a collision course with itself,”

due in part to the moving viability line. City of Akron v.

Akron Ctr. for Reprod. Health, Inc., 462 U.S. 416, 458

(1983) (O’Connor, J., dissenting). Several years later, the

Court in Casey concluded that its precedents had “undervalue[d] the State’s interest in potential life” and gave

States greater ability to protect it. 505 U.S. at 873.

Circuit-court judges have also noted that changed

circumstances call for reevaluation of the viability framework. The Eighth Circuit has criticized that framework

for limiting States’ ability to consider evidence of developments in obstetrics, viability, and maternal health.

MKB Mgmt. Corp. v. Stenehjem, 795 F.3d 768, 773-75

(8th Cir. 2015). In the Fifth Circuit, Judge Jones has

noted that “if courts were to delve into the facts underlying Roe’s balancing scheme with present-day

knowledge, they might conclude that the woman’s

‘choice’ is far more risky and less beneficial, and the

child’s sentience far more advanced, than the Roe Court

knew.” McCorvey, 385 F.3d at 852 (Jones, J., concurring); see also Planned Parenthood of Ind. & Ky., Inc.,

888 F.3d at 311-14 (Manion J., dissenting in part) (calling

for a reevaluation of Roe and Casey).

Fox Television, Extreme Preemie, ‘About the Size of a Hand,’

Goes Home in Georgia (July 2020), https://fox6now.com/2020/

07/01/extreme-preemie-comes-home-for-first-time/; A. Pawlowski,

'Miracle baby': Born at 21 Weeks, She May Be the Most Premature

Surviving Infant (Nov. 2017), https://www.today.com/health/born21-weeks-she-may-be-most-premature-surviving-baby-t118610.

5

16

B. New medical and scientific developments

undermine the viability framework.

1. States’ interests in protecting unborn life exist

“from the inception of the pregnancy.” Gonzales, 550

U.S. at 158. Those interests, which exist prior to viability,

have been strengthened by new evidence of the fetus’s

development and her capacity to feel pain. 6 Dr. Condic’s

unrebutted declaration traces much of this developing

evidence. Pet. App. 75a-100a. And recently, two researchers who have “very different views on the morality

of abortion” reviewed the relevant literature and concluded that “neuroscience cannot definitively rule out fetal pain before 24 weeks.” Stuart W.G. Derbyshire &

John C. Bockmann, Reconsidering Fetal Pain, 46 J. of

Med. Ethics, no. 1 (2019). 7

When enacting the Partial-Birth Abortion Ban Act of

2003, Congress cited the “medical fact” that “unborn infants at this stage can feel pain when subjected to painful

stimuli and that their perception of this pain is even more

intense than that of newborn infants and older children

when subjected to the same stimuli.” Pub. L. No. 108105, § 2(14)(M), 117 Stat. 1201 (2003) (noting that “during a partial-birth abortion procedure, the child will fully

experience the pain associated with piercing his or her

skull and sucking out his or her brain”).

State legislatures have increasingly sought to give effect to this new evidence by enacting previability limitations on abortion. See, e.g., Ark. Code § 20-16-2002 (findings on fetal development and fetal pain); Idaho Code

§ 18-503 (findings on fetal pain); Neb. Rev. Stat. § 28Amici States agree with Mississippi’s discussion of the impact

of abortion on maternal health but focus their analysis here on the

impact of abortion on the unborn child.

7

Available at https://jme.bmj.com/content/46/1/3.

6

17

3,104 (findings on fetal pain). In total, at least twenty-two

States have determined that abortion should be prohibited at some point prior to the district court’s determination of viability in this case. 8 Cf. Atkins v. Virginia, 536

U.S. 304, 315-16 (2002) (finding a “national consensus” of

only eighteen States sufficient to prohibit the execution

of individuals with intellectual disabilities). The evidence

is mounting, and the States are noticing. The viability

framework should be reconsidered.

2. Relevant advances have not been limited to fetal

pain and development. Abortion providers have also discovered new, brutal ways to abort unborn children since

Roe. The dilation and evacuation (D&E) procedure currently used after 15-weeks’ gestation was not used for

second trimester abortions at the time of Roe. City of Akron, 462 U.S. at 436 & n.23.; see also Stenberg v. Carhart,

530 U.S. 914, 924 (2000). A D&E abortion involves ripping a fetus apart with forceps and removing it piece-bypiece from the womb, Gonzales, 550 U.S. at 135-36, a procedure some on the Court have characterized as “brutal”

and “gruesome,” id. at 181-82 (Ginsburg, J. dissenting).

The Court has never contemplated whether the State

can limit abortions involving the dismemberment of a living, pain-capable unborn child. The closest the Court has

come was in upholding the partial-birth abortion ban in

Ala. Code § 26-23B-5(a); Ariz. Rev. Stat. § 36-2159(B); Ark.

Code § 20-16-1405(a)(1); Ga. Code § 16-12-141(b); Idaho Code § 18505; Ind. Code § 16-34-2-1(a)(3); Iowa Code § 146B.2(2)(a); Kan.

Stat. §§ 65-6723(f) & 6724(a); Ky. Rev. Stat. § 311.782(1); La. Stat.

§ 40:1061.1(E); Miss. Code § 41-41-137; Mo. Rev. Stat. § 188.058(1);

Neb. Rev. Stat. § 28-3,106; N.C. Gen. Stat. § 14-45.1(a); N.D. Cent.

Code § 14-02.1-05.3(3); Ohio Rev. Code § 2919.201(A); Okla. Stat.

tit. 63, § 1-745.5(A); S.C. Code § 44-41-450(A); S.D. Codified Laws

§ 34-23A-70; Tex. Health & Safety Code § 171.044; Utah Code § 767-302.5; W. Va. Code §§ 16-2M-2 & 4(a).

8

18

Gonzales, and the Court had little difficulty identifying

numerous state interests justifying prohibition of that

brutal and inhumane procedure. Id. at 156-60; see also

Casey, 505 U.S. at 882 (noting that “most women considering an abortion would deem the impact on the fetus relevant, if not dispositive, to the decision”). But under the

circuit courts’ interpretation of this Court’s precedent,

States cannot act on these new developments.

C. If the viability line is absolute, only this Court

can move it.

State legislatures are best positioned to evaluate and

weigh this new evidence, as they can hold hearings each

session and react quickly to scientific developments. But

as it stands now, they must wait years for a legal issue

surrounding abortion to sufficiently “percolat[e]” and

make its way to this Court. Box, 139 S. Ct. at 1784

(Thomas, J., concurring). And even then, if lower courts

follow the logic of the Fifth Circuit, States will be unable

to submit evidence of these advances in support of their

interests. Not only will this Court be required to act as

“the country’s ex officio medical board,” Gonzales, 550

U.S. at 164 (quoting Webster, 492 U.S. at 518-19 (plurality op.)), it will be forced to do so on records devoid of the

relevant evidence.

The practical results of the Court’s viability jurisprudence have been one-sided. Abortion providers routinely

sue to try and take advantage of new medical technology,

such as telemedicine and medication abortion, to expand

the right to abortion. See, e.g., Compl. at 20-25 (¶¶ 90121), Whole Woman’s Health Alliance v. Hill, No. 1:18CV-1904 (S.D. Ind. June 21, 2018) (challenging “Laws

That Deny Abortion Patients the Benefits of Scientific

Progress”) (emphasis omitted); Compl. at 18-23 (¶¶ 83110), Whole Woman’s Health Alliance v. Paxton, No.

19

1:18-CV-00500 (W.D. Tex. June 14, 2018) (same). But

States cannot do the same to limit previability abortion

without this Court’s approval.

Weighing the evidence of fetal development, fetal

pain, women’s health, society’s values, and women’s liberty may require the members of the Court to “act as

legislators, not judges,” June Med., 2020 WL 3492640, at

*23, but it is a task the Court has removed from the

States and taken for itself. The States’ only recourse is

to seek relief from the Court.

III. The Court Should Condemn the District Court’s

Rhetoric.

After declaring evidence of Mississippi’s interests in

its 15-week law to be irrelevant, the district court performed its own non-record research and opined that the

law reflected Mississippi’s general oppression of women,

racial minorities, and homosexuals. Jackson Women’s,

349 F. Supp. 3d at 540 n.22, 543 n.40. The court asserted

that Mississippi had a “history of disregarding the constitutional rights of its citizens” and concluded that Mississippi’s interest in women’s health was “pure gaslighting.” Id. The court concluded that the law represented

the “old Mississippi” that was “bent on controlling

women and minorities.” Id. at 540 n.22.

As did Judge Ho in concurrence, Jackson Women’s,

945 F.3d at 282-86 (Ho, J. concurring in the judgment),

this Court should condemn the district court’s rhetoric.

A district court is required to presume good faith, not the

opposite. Abbott, 138 S. Ct. at 2324. The district court

turned that rule on its head and reached into Mississippi’s past to ascribe aspersions on today’s legislators

for doing their jobs.

The district court’s behavior is part of a broader and

troubling trend. In the last year, the Fifth Circuit has

20

had to admonish (1) a Texas district court for “adopt[ing]

all 30 of [plaintiff abortion clinics’] proposed findings

without citing or discussing a single declaration submitted by [the State],” In re Abbott, 956 F.3d 696, 718-19

(5th Cir. 2020), and (2) a Louisiana district court for its

conclusion that it was “‘untenable’ to make [abortion]

Plaintiffs establish standing because doing so would

make it harder for them to succeed on the merits,” In re

Gee, 941 F.3d 153, 159 (5th Cir. 2019) (per curiam). Other

district courts around the country have suggested that

reasonable, commonsense abortion regulations are the

products of invidious paternalism. See, e.g., Bernard v.

Individual Members of Ind. Med. Licensing Bd., 392 F.

Supp. 3d 935, 958-59 (S.D. Ind. 2019) (live-dismemberment ban); Tex. Med. Providers Performing Abortion

Servs. v. Lakey, No. A-11-CA-486-SS, 2012 WL 373132,

at *2 (W.D. Tex. Feb. 6, 2012) (informed-consent provision).

This is far from harmless error; June Medical

treated the district court’s factfinding as all but dispositive. 2020 WL 3492640, at *6-*7 (plurality op.). If appellate courts are to rely on district-court findings, district

courts cannot be allowed to treat abortion regulations as

per se the product of intolerable animus. Whatever else

it does, the Court should make clear that the district

court’s bias will not be tolerated.

21

C O NC LU SIO N

The petition for a writ of certiorari should be granted.

Respectfully submitted.

KEN PAXTON

Attorney General of Texas

JEFFREY C. MATEER

First Assistant Attorney

General

RYAN L. BANGERT

Deputy First Assistant

Attorney General

KYLE D. HAWKINS

Solicitor General

Counsel of Record

HEATHER GEBELIN HACKER

BETH KLUSMANN

Assistant Solicitors General

OFFICE OF THE

ATTORNEY GENERAL

P.O. Box 12548 (MC 059)

Austin, Texas 78711-2548

Kyle.Hawkins@oag.texas.gov

(512) 936-1700

JULY 2020

Additional counsel on next page

22

Counsel for Additional Amici States:

STEVE MARSHALL

Attorney General

of Alabama

JEFF LANDRY

Attorney General

of Louisiana

KEVIN G. CLARKSON

Attorney General

of Alaska

ERIC SCHMITT

Attorney General

of Missouri

MARK BRNOVICH

Attorney General

of Arizona

DOUGLAS J. PETERSON

Attorney General

of Nebraska

LESLIE RUTLEDGE

Attorney General

of Arkansas

DAVE YOST

Attorney General

of Ohio

CHRISTOPHER M. CARR

Attorney General

of Georgia

MIKE HUNTER

Attorney General

of Oklahoma

LAWRENCE G. WASDEN

Attorney General

of Idaho

ALAN WILSON

Attorney General

of South Carolina

CURTIS T. HILL, JR.

Attorney General

of Indiana

HERBERT H. SLATERY III

Attorney General

of Tennessee

DEREK SCHMIDT

Attorney General

of Kansas

PATRICK MORRISEY

Attorney General

of West Virginia

DANIEL CAMERON

Attorney General

of Kentucky

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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