Amicus Curiae Brief — Mike Moyle, Speaker of the Idaho House of Representatives, et al., Petitioners v. United States

Supreme Court briefMar 28, 2024

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No. 23-726 and 23-727

_________________________________________________

In The Supreme Court of the United States

_________________________________________________

MIKE MOYLE, SPEAKER OF THE IDAHO HOUSE OF

REPRESENTATIVES, ET AL.

UNITED STATES OF AMERICA

_________________________________________________

STATE OF IDAHO

UNITED STATES OF AMERICA

_________________________________________________

On Writs of Certiorari to the United States

Court of Appeals for the Ninth Circuit

_________________________________________________

BRIEF OF AMICI CURIAE AMNESTY INTERNATIONAL,

GLOBAL JUSTICE CENTER, HUMAN RIGHTS WATCH, AND

THE IPAS IMPACT NETWORK

IN SUPPORT OF RESPONDENT

_________________________________________________

ELISE KEPPLER

GLOBAL JUSTICE CENTER

11 Hanover Square, 6th Floor

New York, NY 10005

BETHANY VAN KAMPEN SARAVIA

IPAS IMPACT NETWORK

4711 Hope Valley Rd 4F-720

Durham NC 27707-5651

MACARENA SÁEZ

AISLING REIDY

HUMAN RIGHTS WATCH

350 5th Ave., 34th Floor

New York, NY 10118

CHRISTINA G. HIOUREAS

Counsel of Record

FOLEY HOAG LLP

1301 Avenue of the Americas

New York, NY 10019

chioureas@foleyhoag.com

(212) 812-0307

MANDIVAVARIRA MUDARIKWA

AMNESTY INTERNATIONAL,

INTERNATIONAL SECRETARIAT

Peter Beneson House

1 Easton St.

London, UK WC1X 0DW

TABLE OF CONTENTS

TABLE OF AUTHORITIES.................................... ii

INTEREST OF AMICI CURIAE ............................. 1

SUMMARY OF ARGUMENT .................................. 3

ARGUMENT .............................................................. 4

A. Idaho’s near-total abortion ban

jeopardizes the life, health and well-being

of pregnant people, and restricts their

access to essential reproductive

healthcare .................................................4

B. Idaho’s near-total abortion ban violates

international law.................................... 16

CONCLUSION .........................................................35

TABLE OF AUTHORITIES

Cases

Adkins et al. v. State of Idaho,

Case no. CV01-23-14744 (4th Dist. Idaho 2023)... 6

Avero Belgium Ins. v. American Airlines, Inc., 423

F.3d 73, 79 n.8 (2d Cir. 2005) .............................. 18

Flores v. Southern Peru Copper Corp.,

414 F.3d 233 (2d Cir. 2003) ................................. 18

Medellin v. Texas,

552 U.S. 491, 506 (2008) ...................................... 19

Siderman de Blake v. Republic of Argentina,

965 F.2d 699, 716 (9th Cir. 1992) ........................ 31

United States v. Duarte-Acero,

208 F.3d 1282, 1287 (11th Cir. 2000) .................. 19

Statutes

Idaho Code §18-622(2)(a)(i) ......................................... 5

La. R.S. 40:1061(F) ...................................................... 9

42 U.S.C. § 1395dd ...................................................... 9

42 U.S.C. § 1395dd(e)(1)............................................ 10

iii

Treaties

Convention on the Elimination of All Forms of

Discrimination Against Women (adopted Dec. 18,

1979, entered into force Sept. 3, 1981), 1249

U.N.T.S 13 ............................................................ 22

Convention on the Rights of Persons with Disabilities

(adopted Mar. 30, 2007, entered into force May 3,

2008), 2515 U.N.T.S 3 .......................................... 22

Convention on the Rights of the Child (adopted Nov.

20, 1989, entered into force Sept. 2, 1990), 1577

U.N.T.S 3 .............................................................. 22

International Convention on the Elimination of All

Forms of Racial Discrimination (adopted Dec. 21,

1965, entered into force Jan. 4, 1969), 660

U.N.T.S. 195 ......................................................... 22

International Covenant on Civil and Political Rights

(adopted Dec, 16, 1966, entered into force Mar.

23, 1976), 999 U.N.T.S. 171 ................................. 18

International Covenant on Economic, Social and

Cultural Rights (adopted Dec. 16, 1966, entered

into force Jan. 3, 1976), 993 U.N.T.S. 3 .............. 22

United Nations Convention Against Torture and

Other Cruel, Inhuman or Degrading Treatment or

Punishment (adopted Dec. 10, 1984, entered into

force June 26, 1987), 1465 U.N.T.S. 85 ............... 18

Vienna Convention on the Law of Treaties (adopted

May 23, 1969, entered into force Jan. 27, 1980),

1155 U.N.T.S. 331 ................................................ 18

Other Authorities

A. Njoku et al., Listen to the Whispers before They

Become Screams: Addressing Black Maternal

Morbidity and Morality in the United States 11

Healthcare 3 (2023), https://www.mdpi.com/22279032/11/3/438 ....................................................... 16

A. Redinger & H. Nguyen, Incomplete Abortions,

National Library of Medicine (June 27, 2022),

https://www.ncbi.nlm.nih.gov/books/

NBK559071 ............................................................ 9

American College of Obstetricians and Gynecologists,

Understanding and Navigating Medical

Emergency Exceptions in Abortion Bans and

Restrictions (Aug. 14, 2022),

https://www.acog.org/news/newsarticles/2022/08/understanding-medicalemergency-exceptions-in-abortion-bansrestrictions ............................................................. 6

Amnesty International, Poland: A Year On, Abortion

Ruling Harms Women (Oct. 19, 2021),

https://www.amnesty.org/en/latest/news/2021/10/p

oland-a-year-on-abortion-ruling-harms-women ... 8

ANSIRH, The Harms of Denying a Woman a Wanted

Abortion: Findings from the Turnaway Study,

https://www.ansirh.org/sites/default/files/publicati

ons/files/the_harms_of_denying_a_woman_a_wan

ted_abortion_4-16-2020.pdf ................................. 11

ANSIRH, Turnaway Study: Long-Term Study Shows

That Restriction Abortion Harms Women,

https://www.ansirh.org/sites/default/files/publicati

ons/files/turnaway_study_brief_web.pdf ............. 13

B. Frederiksen et. al., A National Survey of OBGYNs’

Experiences After Dobbs, Kaiser Fam. Found,

(June 21, 2023), https://www.kff.org/reportsection/a-national-survey-of-obgyns-experiencesafter-dobbs-report/https://www.kff.org/reportsection/a-national-survey-of-obgyns-experiencesafter-dobbs-report ................................................ 16

Brief of Amici Curiae Economists in Support of

Respondents, Dobbs v. Jackson Women’s Health

Org. 597 U.S. 215 (2022)...................................... 14

Committee Against Torture, Concluding

Observations on the Second Periodic Report of

Ireland, U.N. Doc. CAT/C/IRL/CO/2 (Aug. 31,

2017) ..................................................................... 32

Committee Against Torture, Concluding

Observations on the Seventh Periodic Rep. of

Ecuador, U.N. Doc. CAT/C/ECU/CO/7 (Jan. 11,

2017) ..................................................................... 32

Committee Against Torture, Concluding

Observations on the Seventh Periodic Report of

Poland, U.N. Doc. CAT/C/POL/CO/7 (Aug. 29,

2019) ..................................................................... 33

Committee Against Torture, Concluding

Observations on the Third Periodic Report of the

Philippines, U.N. Doc. CAT/C/PHL/CO/3 (June 2,

2016) ..................................................................... 33

Committee on Economic, Social and Cultural Rights,

General Comment 22 on the right to sexual and

reproductive health, U.N. Doc. E/C.12/GC/22 (May

2, 2016) ................................................................. 23

Committee on the Elimination of All Forms of

Discrimination against Women, General

Recommendation 24 (Article 12: Women and

Health), UN Doc. A/54/38/Rev.1 (1999) ............... 29

Committee on the Elimination of All Forms of

Discrimination against Women, General

Recommendation 35 on gender-based violence

against women, updating general

recommendation 19, U.N. Doc. CEDAW/C/GC/35

(July 26, 2017) ...................................................... 34

Committee on the Elimination of All Forms of

Discrimination against Women, Report of the

Inquiry concerning the United Kingdom of Great

Britain and Northern Ireland under Article 8 of

the Optional Protocol to the Convention on the

Elimination of All Forms of Discrimination

against Women, UN Doc. CEDAW/C/OP.8/GBR/1

(Mar. 6, 2018) ....................................................... 29

Committee on the Elimination of All Forms of

Discrimination against Women, Summary of the

Inquiry concerning the Philippines under Article 8

of the Optional Protocol to the Convention on the

Elimination of All Forms of Discrimination

against Women, UN Doc. CEDAW/C/OP.8/PHL/1

(Apr. 22, 2015) ...................................................... 29

Committee on the Elimination of All Forms of

Discrimination against Women, Views of the

Committee under Article 7(3) of the Optional

Protocol, Concerning Commc’n No. 17/2008, U.N.

Doc. CEDAW/C/49/D/17/2008 (Sept. 27, 2011)

(Alyne da Silva Pimentel Teixeira v Brazil) ........ 29

vii

Committee on the Elimination of All Forms of

Discrimination against Women, Views of the

Committee under Article 7(3) of the Optional

Protocol, Concerning Commc’n No. 22/2009, U.N.

Doc. U.N. Doc. CEDAW/C/50/D/222009 (Nov. 4,

2011) (L.C. v Peru) ............................................... 24

Committee on the Elimination of Racial

Discrimination, Concluding Observations on the

Combined Tenth to Twelfth Reports of the United

States of America, U.N. Doc. CERD/C/USA/CO/1012 (Sept. 21, 2022)................................................ 24

Committee on the Rights of Persons with Disabilities

and Committee on the Elimination of All Forms of

Discrimination against Women, Guaranteeing

sexual and reproductive health and rights for all

women, in particular women with disabilities

(Aug. 29, 2018), https://www.ohchr.org/en/treatybodies/crpd/statements-declarations-andobservations ......................................................... 24

Committee on the Rights of the Child, General

Comment No. 4: Adolescent Health and

Development in the Context of the Convention on

the Rights of the Child, U.N. Doc. CRC/GC/2003/4

(July 1, 2003) ........................................................ 25

Committee on the Rights of the Child, General

comment No. 15 (2013) on the right of the child to

the enjoyment of the highest attainable standard

of health, U.N. Doc. CRC/C/GC/15 (Apr. 17, 2013)

.............................................................................. 23

viii

E. Howell, “Reducing Disparities in Severe Maternal

Morbidity and Mortality,” 61 CLIN OBSTET

GYNECOL 2 (2018) ................................................... 4

F. Sellers & F. Nirappil, Confusion post-Roe spurs

delays, denials for some lifesaving pregnancy care,

The Washington Post (July 16, 2022),

https://www.washingtonpost.com/health/2022/07/

16/abortion-miscarriage-ectopic-pregnancycare ..................................................................... 6, 8

Global Justice Center et al., Submission to the

Human Rights Committee (2023)

https://www.globaljusticecenter.net/wpcontent/uploads/2023/10/Final-ICCPR-Report.pdf

.............................................................................. 12

Human Rights Committee, Concluding Observations:

Cameroon, U.N. Doc. CCPR/C/CMR/CO/4 (Aug. 4,

2010) ..................................................................... 19

Human Rights Committee, Concluding Observations:

Chile, U.N. Doc. CCPR/C/CHL/CO/6 (Aug. 13,

2014) ..................................................................... 20

Human Rights Committee, Concluding Observations:

Costa Rica, U.N. Doc. CCPR/C/CRI/CO/6 (Apr. 21,

2016) ..................................................................... 20

Human Rights Committee, Concluding Observations:

Dominican Republic, UN Doc.

CCPR/C/DOM/CO/5 (Apr. 19, 2012) .................... 20

Human Rights Committee, Concluding Observations:

Guatemala, U.N. Doc. CCPR/C/GTM/CO/3 (Apr.

19, 2012) ............................................................... 20

Human Rights Committee, Concluding Observations:

Jamaica, U.N Doc. CCPR/C/JAM/CO/3 (Nov. 17,

2011) ..................................................................... 20

Human Rights Committee, Concluding Observations:

Malawi, U.N. Doc. CCPR/C/MWI/CO/1/Add.1

(Aug. 19, 2014) ..................................................... 20

Human Rights Committee, Concluding Observations:

Mali, UN Doc. CCPR/CO/77/MLI (Apr. 16, 2003)

.............................................................................. 20

Human Rights Committee, Concluding Observations:

Malta, U.N. Doc. CCPR/C/MLT/CO/2 (Nov. 21,

2014) ..................................................................... 20

Human Rights Committee, Concluding Observations:

Paraguay, U.N. Doc. CCPR/C/PRY/CO/3 (Apr. 29,

2013) ..................................................................... 20

Human Rights Committee, Concluding Observations:

Peru, U.N. Doc. CCPR/C/PER/CO/5 (Apr. 29,

2013) ..................................................................... 20

Human Rights Committee, Concluding Observations:

Sierra Leone, U.N. Doc. CCPR/C/SLE/CO/1 (Apr.

17, 2014) ............................................................... 20

Human Rights Committee, Concluding Observations:

Sri Lanka, U.N. Doc. CCPR/C/LKA/CO/5 (Nov.

21, 2014) ............................................................... 20

Human Rights Committee, General Comment 28

(Article 3: the Equality of Rights Between Men

and Women), U.N. Doc. CCPR/C/21/Rev.1/Add.10

(Mar. 29, 2000) ..................................................... 27

Human Rights Committee, General Comment 36

(Article 6: Right to Life), UN Doc. CCPR/C/GC/36

(Sept. 3, 2019) ...................................................... 21

Human Rights Committee, Views Adopted by the

Committee Under Article 5(4) of the Optional

Protocol, Concerning Commc’n No. 1153/2003,

U.N. Doc. CCPR/C/85/D/1153/2003 (Nov. 22,

2005) (K.L. v. Peru) .............................................. 25

Human Rights Committee, Views Adopted by the

Committee Under Article 5(4) of the Optional

Protocol, Concerning Commc’n No. 1608/2007,

U.N. Doc. CCPR/C/101/D/1608/2007 (Apr. 28,

2011) (LMR v. Argentina) .................................... 31

Human Rights Committee, Views Adopted by the

Committee Under Article 5(4) of the Optional

Protocol, Concerning Commc’n No. 2324/2013,

U.N. Doc. CCPR/C/116/D/2324/2013 (Nov. 17,

2017) (Mellet v. Ireland)....................................... 27

Human Rights Committee, Views Adopted by the

Committee Under Article 5(4) of the Optional

Protocol, Concerning Commc’n No. 2425/2014,

U.N. Doc. CCPR/C/119/D/2425/2014 (June 12,

2017) (Whelan v. Ireland) .................................... 27

Human Rights Watch, A State of Isolation: Access to

Abortion for Women in Ireland (Jan. 28, 2010),

https://www.hrw.org/report/2010/01/28/stateisolation/access-abortion-women-ireland .............. 8

Human Rights Watch, It’s Your Decision, It’s Your

Life’: The Total Criminalization of Abortion in the

Dominican Republic (Nov. 19, 2018),

https://www.hrw.org/report/2018/11/19/its-yourdecision-its-your-life/total-criminalizationabortion-dominican-republic ................................. 7

Human Rights Watch, Regression on Abortion Harms

Women in Poland (Jan. 26, 2022),

https://www.hrw.org/news/2022/01/26/regressionabortion-harms-women-poland8 ........................... 7

J. Lang, What Happens to Women Who Are Denied

Abortions?, New York Times Magazine (June 12,

2013),

https://www.nytimes.com/2013/06/16/magazine/st

udy-women-denied-abortions.html?_r=0; ..... 11, 13

ANSIRH, Turnaway Study: Long-Term Study Shows

That Restriction Abortion Harms Women,

https://www.ansirh.org/sites/default/files/publicati

ons/files/turnaway_study_brief_web.pdf ............. 13

J. Mendez et al., Denial of abortion services and the

prohibition of torture and cruel, inhuman and

degrading treatment (Oct. 25, 2016),

https://www.ohchr.org/Documents/Issues/Women/

WG/AmicusBrazil.pdf .......................................... 33

J. Tolentino, We’re Not Going Back to the Time Before

Roe. We’re Going Somewhere Worse, The New

Yorker (June 24, 2022),

https://www.newyorker.com/magazine/2022/07/04/

we-are-not-going-back-to-the-time-before-roe-weare-going-somewhere-worse/amp ........................ 35

xii

K. Backes Kozhimannil et. al., Abortion Access as a

Racial Justice Issue, NEW ENG J. MED. (2022),

https://pubmed.ncbi.nlm.nih.gov/36069823/ ....... 16

K. Bennhold & M. Pronczuk, Poland Shows the Risks

for Women When Abortion is Banned, The New

York Times (June 12, 2022),

https://www.nytimes.com/2022/06/12/world/europ

e/poland-abortion-ban.html ................................... 7

K. Holland & P. Cullen, Woman ‘denied a

termination’ dies in hospital, The Irish Times

(Nov. 14, 2012),

https://www.irishtimes.com/news/woman-denieda-termination-dies-in-hospital-1.551412 .............. 8

L. Gallup and R. Sun, Number of Idaho abortion

patients traveling to Washington up 56% after Roe

overturned, Oregon Public Broadcasting (July 11,

2023),

https://www.opb.org/article/2023/07/10/idahoabortion-patients-traveling-to-washingtonincreases-56-percent-after-roe-overturned/ ........ 14

L. Hill et al., Health Coverage by Race and Ethnicity,

2010-2022, Kaiser Fam. Found (Jan. 11, 2024),

https://www.kff.org/racial-equity-and-healthpolicy/issue-brief/health-coverage-by-race-andethnicity/............................................................... 16

L. Ross, What is Reproductive Justice?,

REPRODUCTIVE JUSTICE BRIEFING BOOK: A PRIMER

ON REPRODUCTIVE JUSTICE AND SOCIAL CHANGE

(2007) .................................................................... 14

xiii

M.A. Biggs et al., Women’s Mental Health and Wellbeing 5 Years After Receiving or Being Denied an

Abortion: A Prospective, Longitudinal Cohort

Study, 74 JAMA PSYCHIATRY 2 (2017) .................. 24

M. Murray, Race-ing Roe: Reproductive Justice,

Racial Justice, and the Battle for Roe v. Wade,

134 HARV. L. REV. 2025 (2021) ............................ 14

Physicians for Human Rights, Criminalized Care:

How Louisiana’s Abortion Bans Endanger

Patients and Clinicians (Mar. 19, 2024),

https://phr.org/our-work/resources/louisianaabortion-bans/ ........................................................ 9

Prison Policy Initiative, Idaho profile,

https://www.prisonpolicy.org/profiles/ID.html.... 13

Promsex, World Health Organization implementation

story: Closing the gaps between law and attitudes:

advocation for legal and dignified abortion in

Peru (Sept. 27, 2023),

https://www.who.int/publications/m/item/advocati

ng-for-legal-and-dignified-abortion-in-peru ........ 26

R. Kaye and S. Samaniego, Idaho’s murky abortion

law is driving doctors out of the state, CNN (May

13, 2023),

https://www.cnn.com/2023/05/13/us/idahoabortion-doctors-drain/index.html/ ..................... 11

R. Klitzman, Opinion: Roe’s reversal doesn’t just hurt

women – it harms us all, CNN (June 25, 2022),

https://www.cnn.com/2022/06/25/opinions/medical

-ethics-post-roe-world-klitzman/index.html ....... 35

xiv

Senate Committee on the Judiciary, Testimony of

Khiara M. Bridges, A Post-Roe America: The

Legal Consequences of the Dobbs Decision (July

12, 2022)

https://www.judiciary.senate.gov/imo/media/doc/T

estimony%20-%20Bridges%20-%202022-07121.pdf .................................................................. 15

Sens. Elizabeth Warren et al., Post-Roe Abortion

Bans Threaten Women’s Lives: Health Care

Providers Speak Out on the Devastating Harm

Posed by Abortion Bans and Restrictions (Oct.

2022),

https://www.warren.senate.gov/imo/media/doc/Ab

ortion%20Care%20Oversight%20Report1.pdf ...... 5

T. Weinberg, Missouri doctors fear vague emergency

exception to abortion ban puts patients at risk,

Missouri Independent (July 2, 2022),

https://missouriindependent.com/2022/07/02/miss

ouri-doctors-fear-vague-emergency-exception-toabortion-ban-puts-patients-at-risk........................ 5

UN Human Rights Council, Report of the Special

Rapporteur on Extreme Poverty and Human

Rights on His Mission to the United States of

America (May 4, 2018), U.N. Doc.

A/HRC/38/33/Add.1 .............................................. 12

UN Office of the High Comm’r for Human Rights,

Information Series on Sexual and Reproductive

Health: Abortion (2020),

https://www.ohchr.org/Documents/Issues/Women/

WRGS/SexualHealth/INFO_Abortion_WEB.pdf

.............................................................................. 15

UN Working Group on the issue of discrimination

against women in law and in practice, Report of

the Working Group, UN Doc. A/HRC/32/44 (Apr.

8, 2016) ................................................................. 30

UN Working Group on the issue of discrimination

against women in law and in practice, Women’s

Autonomy, Equality and Reproductive Health in

International Human Rights: Between

Recognition, Backlash and Regressive Trends at 1

(Oct. 2017),

https://www.ohchr.org/sites/default/files/Documen

ts/Issues/Women/WG/WomensAutonomyEquality

ReproductiveHealth.pdf ................................ 26, 29

Z. Abrams, “Abortion bans cause outsized harm for

people of color,” 54 MONITOR ON PSYCH. 4 (2023),

https://www.apa.org/monitor/2023/06/abortionbans-harm-people-of-color ................................... 14

INTEREST OF AMICI CURIAE1

Global Justice Center is a non-partisan, non-profit

organization dedicated to promoting the enforcement

of international law in a progressive, nondiscriminatory manner. Global Justice Center works

for peace, justice, and security by enforcing

international laws that protect human rights and

promote gender equality. The organization seeks to

promote gender equality by focusing on and

advocating for change in two primary areas: fighting

for sexual and reproductive rights and demanding

justice for sexual and gender-based violence.

Human Rights Watch is a non-profit, non-partisan

organization that investigates and reports on

violations of fundamental human rights in over 100

countries to secure the respect of these rights for all

persons. It is the largest international human rights

organization based in the United States. By exposing

and calling attention to human rights abuses

committed by state and non-state actors, Human

Rights Watch seeks to bring international public

opinion to bear upon offending actors to end abusive

practices.

Amnesty International is a non-governmental, nonprofit organization representing the largest

Pursuant to Supreme Court Rule 37(6), amici state that no

counsel for any party authored this brief in whole or in part, and

that no entity or person other than amici and their counsel made

any monetary contribution toward the preparation and

submission of this brief. The parties have filed blanket consents

to the filing of amicus briefs in support of either or no party.

grassroots human rights movement in the world with

more than ten million members and supporters. Its

mission is to advocate for global compliance with

international human rights law, the development of

human rights norms, and the effective enjoyment of

human rights by all persons. It engages in advocacy,

litigation, and education to prevent and end human

rights violations and to seek accountability. Amnesty

International has researched, documented, and

campaigned on the human rights impact and rights

violations due to restrictive abortion laws.

The Ipas Impact Network works globally to

advance reproductive justice. Ipas believe that all

people have the right to make fundamental decisions

about their own bodies and health. It works with

partners across Africa, Asia and the Americas to

ensure that reproductive health services, including

abortion and contraception, are available and

accessible to all.

Together, amici share a commitment to ensuring that

the United States complies with its obligations under

international human rights law.

SUMMARY OF ARGUMENT

Idaho’s near-total abortion ban restricts access

to necessary emergency reproductive healthcare,

exacerbating preventable maternal mortality and

morbidity and otherwise negatively impacting people

capable of pregnancy in Idaho. The law’s narrow

exception for life-saving care will not prevent or

mitigate these harms in practice, and will leave

patients in Idaho without access to emergency

reproductive healthcare.

The United States has ratified several human

rights treaties—including the International Covenant

on Civil and Political Rights (ICCPR), the

International Convention on the Elimination of All

Forms of Racial Discrimination (ICERD), and the

Convention Against Torture (CAT)—which require it

to guarantee access to safe and legal abortion services,

in particular in emergencies or acute medical crises

governed by the Emergency Medical Treatment and

Active Labor Act (EMTALA). In accordance with the

United States’ obligations under these treaties, the

federal government—and therefore each state—is

required to respect, protect and fulfil individuals’

international human rights to life; health; privacy;

non-discrimination; and to be free from torture, cruel,

inhuman and degrading treatment. These rights are

directly jeopardized by Idaho’s draconian abortion

law.

ARGUMENT

Idaho’s

near-total

abortion

ban

jeopardizes the life, health and well-being

of pregnant people,2 and restricts their

access

essential

reproductive

healthcare

Idaho’s near-total abortion ban places pregnant

people at significant risk of preventable maternal

mortality and morbidity, and is likely to cause other

grave harms. Evidence from other U.S. states and

foreign countries with similar abortion restrictions

demonstrates the devastating toll of denying access to

emergency reproductive healthcare. The effects will

be felt most acutely by marginalized groups that

already face barriers to reproductive health and

disproportionate rates of preventable maternal

mortality and morbidity.3

2 Amici refer to pregnant people or pregnant individuals in this

brief, recognizing that while the majority of personal experiences

with abortion relate to cisgender women and girls (that is,

women and girls whose sense of personal identity and gender

corresponds with the sex they are assigned at birth), intersex

people, transgender men and boys, and people with other gender

identities may have the reproductive capacity to become

pregnant and may need and have abortions. Where statistics or

quotes refer specifically to women or girls, this language has

been retained for accuracy, but is not meant to exclude other

pregnant individuals.

3 E. Howell, “Reducing Disparities in Severe Maternal Morbidity

and Mortality,” 61 CLIN OBSTET GYNECOL 2 (2018) (noting

disproportionate rates of maternal mortality and morbidity for

Black, American Indian/Alaska Native, and certain Hispanic

populations).

1. Near-total abortion bans jeopardize the lives,

health and wellbeing of pregnant individuals

seeking care in emergency circumstances

protected by EMTALA

Idaho’s near-total abortion ban will exacerbate

preventable maternal mortality and morbidity by

restricting access to life-saving and health-preserving

care.

Although Idaho’s near-total abortion ban

contains an exception to save a pregnant woman’s

life,4 in practice, the right to life-saving treatment is

undermined by the threat of criminal punishment and

the uncertainty, complexity, and speed associated

with urgent medical decisions. This results in

healthcare providers and institutions delaying or

denying abortion care and other necessary

reproductive healthcare.5

4 Idaho Code §18-622(2)(a)(i) (2020) (providing that an abortion

shall not be a felony if a physician “determined, in his good faith

medical judgment and based on the facts known to the physician

at the time, that the abortion was necessary to prevent the death

of the pregnant woman”).

See Sens. Elizabeth Warren et al., Post-Roe Abortion Bans

Threaten Women’s Lives: Health Care Providers Speak Out on

the Devastating Harm Posed by Abortion Bans and Restrictions

(Oct.

2022),

https://www.warren.senate.gov/imo/media/doc/Abortion%20Car

e%20Oversight%20Report1.pdf. See also T. Weinberg, Missouri

doctors fear vague emergency exception to abortion ban puts

patients at risk, Missouri Independent (July 2, 2022),

https://missouriindependent.com/2022/07/02/missouri-doctorsfear-vague-emergency-exception-to-abortion-ban-puts-patientsat-risk/.

As the American College of Obstetricians and

Gynecologists (ACOG) recognizes, “it is critical for

clinicians to be able to use and rely upon their

expertise and medical judgment to determine the

treatments indicated for each clinical situation and

level of care.”6 It may not become clear until too late

that an abortion was necessary “to prevent the death

of the pregnant women,” because as ACOG explains,

“[n]o single patient’s condition progresses at the same

pace,” and “[a] patient may experience a combination

of medical conditions or symptoms that, together,

become life-threatening.”7 Physicians may therefore

realize too late that the life of the patient was at stake,

or may believe that an abortion is necessary to save

the life of the pregnant person, but nevertheless

decline to provide the treatment given the risk of

felony charges on the basis of that judgment.

The risks to the health of pregnant individuals

in Idaho in emergency situations have already been

documented, with women reporting “suffer[ing]

unimaginable tragedy and health risks due to Idaho’s

abortion bans.”8 In one case, a physician described

having to send a pregnant patient home while she was

miscarrying because, without absolute certainty

regarding the pregnancy outcome, the physician

American College of Obstetricians and Gynecologists,

Understanding and Navigating Medical Emergency Exceptions

in Abortion Bans and Restrictions (Aug. 14, 2022),

https://www.acog.org/news/newsarticles/2022/08/understanding-medical-emergency-exceptionsin-abortion-bans-restrictions.

7 Id.

Adkins et al. v. State of Idaho, Case no. CV01-23-14744,

Complaint (4th Dist. Idaho 2023), ¶ 10.

feared that Idaho’s near-total abortion ban prevented

them from providing immediate care to manage the

miscarriage.9

Evidence from other jurisdictions with

restrictive abortion laws like Idaho’s demonstrates

that purported exceptions to “save the life of the

mother” or for “medical emergencies only” are

ineffective and dangerous. For example, in the

Dominican Republic, where abortion is criminalized,

“[m]edical providers said that criminal penalties for

abortion made it difficult for them to exercise their

best judgment and provide the best standard of care

when their pregnant patients faced serious health

risks.”10 Similarly, in Poland, where abortion is

almost completely outlawed, pregnant persons with

cancer have been prevented from obtaining an

abortion or accessing chemotherapy due to the

potential harm to the fetus, placing more importance

on the fetus than the pregnant person.11 Finally, in

9 Id. At 67–68.

10 Human Rights Watch, ‘It’s Your Decision, It’s Your Life’: The

Total Criminalization of Abortion in the Dominican Republic

(Nov. 19, 2018), https://www.hrw.org/report/2018/11/19/its-yourdecision-its-your-life/total-criminalization-abortion-dominicanrepublic.

11 See K. Bennhold & M. Pronczuk, Poland Shows the Risks for

Women When Abortion is Banned, The New York Times (June

12,

2022),

https://www.nytimes.com/2022/06/12/world/europe/polandabortion-ban.html. See also Human Rights Watch, Regression on

Abortion Harms Women in Poland (Jan. 26, 2022),

https://www.hrw.org/news/2022/01/26/regression-abortionharms-women-poland; Amnesty International, Poland: A Year

On, Abortion Ruling Harms Women (Oct. 19, 2021),

Ireland, where until 2018 abortion was criminalized

under a law similar to Idaho’s, doctors were in

practice constrained from providing life-saving

abortions. For example, in 2012 in Ireland, a patient

died in a hospital after being repeatedly refused an

abortion to save her life because a fetal heartbeat

could be detected.12

Examples of these challenges in U.S.

jurisdictions with strict abortion regimes also abound.

In 2022, hospital staff in Wisconsin would not remove

fetal tissue from a patient with an incomplete

miscarriage for fear that it would violate that state’s

abortion ban.13 While the patient ultimately survived,

it was only after she was left to bleed at home for

weeks. Delayed miscarriage care—now common in

states with strict abortion laws—can have fatal

consequences, including through organ failure,

hemorrhaging, and sepsis.14

https://www.amnesty.org/en/latest/news/2021/10/poland-a-yearon-abortion-ruling-harms-women/.

12 See K. Holland & P. Cullen, Woman ‘denied a termination’ dies

hospital,

The

Irish

Times

(Nov.

14,

2012),

https://www.irishtimes.com/news/woman-denied-a-terminationdies-in-hospital-1.551412. See also Human Rights Watch, A

State of Isolation: Access to Abortion for Women in Ireland (Jan.

28,

2010),

https://www.hrw.org/report/2010/01/28/stateisolation/access-abortion-women-ireland.

F. Sellers & F. Nirappil, Confusion post-Roe spurs delays,

denials for some lifesaving pregnancy care, The Washington Post

(July

16,

2022),

https://www.washingtonpost.com/health/2022/07/16/abortionmiscarriage-ectopic-pregnancy-care.

14 See generally A. Redinger & H. Nguyen, Incomplete Abortions,

National

Library

Medicine

(June

27,

2022),

Healthcare providers in Louisiana, a state with

an abortion law comparable to Idaho’s,15 have

confirmed the chilling effect of criminalizing abortion,

stating that they have “increased the use of medical

procedures and treatments that do not meet the

standard of care—heightening risk to patients—and

which could have been avoided if they had been able

to provide abortion care.”16

These avoidable medical emergencies can be

prevented by EMTALA, which guarantees access to

stabilizing emergency medical care, including

abortions, for patients seeking care in the emergency

departments of hospitals that receive Medicare

funds.17 EMTALA recognizes the complexity of

medical

decision-making

during

reproductive

emergencies and provides doctors with appropriate

latitude to make the best possible decisions for their

patients.

https://www.ncbi.nlm.nih.gov/books/NBK559071/

(describing

“complications that can arise after the management of

incomplete abortion including death, uterine rupture, uterine

perforation, subsequent hysterectomy, multisystem organ

failure, pelvic infection, cervical damage, vomiting, diarrhea,

infertility, and/or psychological effects. Patients can present with

different forms of shock, including hemorrhagic, septic, and

cervical.”).

15 La. R.S. 40:1061(F) (2015), in fact providing a wider scope of

exceptions than Idaho’s law.

Physicians for Human Rights, Criminalized Care: How

Louisiana’s Abortion Bans Endanger Patients and Clinicians at

(Mar.

19,

2024),

https://phr.org/wpcontent/uploads/2024/03/PHR-Report-Criminalized-CareMarch-2024.pdf.

17 42 U.S.C. § 1395dd.

Conversely, Idaho’s near-total abortion ban

provides an extremely narrow exception to the

criminal law prohibiting abortion services. This

restrictive law forces doctors to make complex medical

decisions in the shadow of potential incarceration.

EMTALA’s protections are not, by contrast, limited to

life-threatening conditions. Rather, the law applies to

any condition “manifesting itself by acute symptoms

of sufficient severity (including severe pain) such that

the absence of immediate medical attention could

reasonably be expected to result in … (i) placing the

health of the individual (or, with respect to a pregnant

woman, [or] the health of the woman …) in serious

jeopardy, (ii) serious impairment to bodily functions,

or (iii) serious dysfunction of any bodily organ or

part.”18 This nuanced approach, reflecting the

complex reality of medical decision-making and the

importance of emergency treatment, is absent in

Idaho’s near-total abortion ban.

2. Idaho’s near-total abortion ban harms the lives,

health and well-being of pregnant people

Restricting access to reproductive healthcare

harms the physical and mental health and wellbeing

of pregnant people, with lasting effects. Indeed, being

denied access to reproductive healthcare can lead to a

broad range of long-lasting harms, including higher

rates of eclampsia, postpartum hemorrhage, chronic

headaches or migraines, and gestational hypertension

compared to those who had an abortion.19 A 2013 U.S.

18 Id., § 1395dd(e)(1) (emphasis added).

19 ANSIRH, The Harms of Denying a Woman a Wanted Abortion:

Findings

from

the

Turnaway

Study,

https://www.ansirh.org/sites/default/files/publications/files/the_

study that compared similarly-situated pregnant

women seeking abortions found that those who were

denied abortions were more likely to suffer

hypertension and chronic pelvic pain, to fall below the

poverty line, and to become unemployed.20

In the mere two years it has been in place,

Idaho’s near-total abortion ban has had devastating

consequences. Reproductive healthcare providers are

leaving the state, driven away by the risk of facing

felony charges for their work.21 The law is turning

Idaho into a reproductive healthcare desert.

For pregnant people left to seek treatment from

Idaho’s remaining reproductive healthcare providers,

accessing necessary medical services is increasingly

difficult. One abortion provider in Idaho reported

treating a patient who had been forced to visit three

hospitals and travel hundreds of miles because she

was repeatedly denied care, resulting in an invasive

surgery, blood transfusion, and multi-day hospital

stay.22 Pregnant people across the United States

harms_of_denying_a_woman_a_wanted_abortion_4-162020.pdf.

Id.; J. Lang, What Happens to Women Who are Denied

Abortions, New York Times Magazine (June 12, 2013),

https://www.nytimes.com/2013/06/16/magazine/study-womendenied-abortions.html?_r=0.

21 R. Kaye & S. Samaniego, Idaho’s murky abortion law is driving

doctors out of the state, CNN (May 13, 2023),

https://www.cnn.com/2023/05/13/us/idaho-abortion-doctorsdrain/index.html/.

22 Global Justice Center et al., Submission to the Human Rights

Committee at 17 (2023), https://www.globaljusticecenter.net/wpcontent/uploads/2023/10/Final-ICCPR-Report.pdf.

living under similar near-total abortion bans have

faced serious complications after being denied

abortions, including fertility loss and sepsis, as well as

psychological and emotional harms.23

The risk to women’s mental health from lack of

access to abortion care has been well documented. The

Turnaway Study, for instance, found that individuals

who were denied abortions reported more symptoms

of anxiety and stress, lower self-esteem, and lower life

satisfaction than those who received abortions.24

There are also economic consequences to

abortion restrictions. As the UN Special Rapporteur

on extreme poverty and human rights has stated, the

“lack of access to abortion services traps many women

in cycles of poverty.”25 Pregnant people denied care are

at increased risk of poverty, physical health

impairments, and intimate partner violence.26

23 Id. at 16.

24 M.A. Biggs et al., Women’s Mental Health and Well-being 5

Years After Receiving or Being Denied an Abortion: A

Prospective, Longitudinal Cohort Study, 74 JAMA PSYCHIATRY 2

(2017).

25 UN Human Rights Council, Report of the Special Rapporteur

on Extreme Poverty and Human Rights on His Mission to the

United States of America (May 4, 2018), U.N. Doc.

A/HRC/38/33/Add.1, ¶ 56.

26 J. Lang, What Happens to Women Who Are Denied Abortions?

New

York

Times

Magazine

(June

12,

2013),

https://www.nytimes.com/2013/06/16/magazine/study-womendenied-abortions.html?_r=0; ANSIRH, Turnaway Study: LongTerm Study Shows That Restriction Abortion Harms Women,

https://www.ansirh.org/sites/default/files/publications/files/turn

away_study_brief_web.pdf.

3. The harms of abortion restrictions

disproportionately on marginalized groups

fall

Idaho’s near-total abortion ban will not affect

all residents equally. Abortion restrictions have a

disproportionate impact on low-income and other

marginalized populations, such as racial and ethnic

minorities and rural residents. In a state that

incarcerates Black residents at a rate 5.2 times higher

than white residents,27 the communities that are

already surveilled and arrested at higher rates are

more vulnerable to criminal charges under the neartotal abortion ban. Some of these individuals and

groups already lack access to maternal and prenatal

care, and suffer the highest rates of preventable

maternal mortality and morbidity across the country.

Restrictions on reproductive healthcare like

Idaho’s near-total abortion ban affect Black,

indigenous, and other people of color (BIPOC) at

higher rates. “In 2019, the abortion rate was 23.8 per

1,000 Black women, 11.7 per 1,000 Hispanic women,

13 per 1,000 Asian American, Native American, and

other women—and just 6.6 per 1,000 white women,

according to data reported to the Centers for Disease

Control and Prevention (CDC).”28

Prison

Policy

Initiative,

Idaho

https://www.prisonpolicy.org/profiles/ID.html.

profile,

28 Z. Abrams, “Abortion bans cause outsized harm for people of

color,”

MONITOR

PSYCH.

(2023),

https://www.apa.org/monitor/2023/06/abortion-bans-harmpeople-of-color (citing K. Kortsmitt et al., “Abortion Surveillance

- United States 2019,” 70 CTRS FOR DISEASE CONTROL AND

PREVENTION: SURVEILLANCE SUMMARIES 9 (2021).

These discrepancies are exacerbated by

structural

inequalities

and

intersecting

discriminations on the basis of race, gender, and

class.29 As patients with greater resources travel

outside Idaho’s borders to access necessary

reproductive care,30 low-income BIPOC individuals

burdened by the costs and other challenges of

interstate travel31 will be left without access to

essential healthcare.

The UN Working Group on Discrimination

Against Women and Girls has highlighted the

economic inequality associated with abortion

restrictions, which turn “safe termination of

pregnancy” into “a privilege of the rich, while women

with limited resources have little choice but to resort

29 See

L. Ross, What is Reproductive Justice?, REPRODUCTIVE

JUSTICE BRIEFING BOOK: A PRIMER ON REPRODUCTIVE JUSTICE

AND SOCIAL CHANGE at 4 (2007); See also, M. Murray, Race-ing

Roe: Reproductive Justice, Racial Justice, and the Battle for Roe

v. Wade, 134 HARV. L. REV. 2025, at 2093 (2021).

30 L. Gallup and R. Sun, Number of Idaho abortion patients

traveling to Washington up 56% after Roe overturned, Oregon

Public

Broadcasting

(July

11,

2023),

https://www.opb.org/article/2023/07/10/idaho-abortion-patientstraveling-to-washington-increases-56-percent-after-roeoverturned/.

“For instance, an increase in travel distance from 0 to 100

miles increases births [that is, reduced abortions] for . . . Black

women by 3.3% versus by 2.1% for white women.” Brief of Amici

Curiae Economists in Support of Respondents at 21, Dobbs v.

Jackson Women’s Health Org. 597 U.S. 215 (2022) (citing C.

Myers, Cooling off or Burdened? The Effects of Mandatory

Waiting Periods on Abortions and Births at n. 76 (IZA Inst. Of

Lab. Econ., Discussion Paper Series No. 14434, 2021)).

to unsafe providers and practices.”32 And even as

misoprostol and mifepristone make self-managed

abortion safer, restrictive laws are constraining access

to this medication, while legal experts worry that selfmanaged abortion could itself ultimately be

criminalized under laws like Idaho’s near-total

abortion ban.33

These effects are part of a broader pattern in

the United States. One study shows that 70% of

obstetricians/gynecologists say racial and ethnic

inequities in maternal health have already worsened

since the decision in Dobbs v. Jackson Women's

Health Organization,34 which permitted laws such as

32 UN Office of the High Comm’r for Human Rights (OHCHR),

Information Series on Sexual and Reproductive Health: Abortion

(2020),

https://www.ohchr.org/Documents/Issues/Women/WRGS/Sexual

Health/INFO_Abortion_WEB.pdf (emphasis added).

33 Senate Committee on the Judiciary, Testimony of Khiara M.

Bridges, A Post-Roe America: The Legal Consequences of the

Dobbs

Decision,

(July

12,

2022),

https://www.judiciary.senate.gov/imo/media/doc/Testimony%20%20Bridges%20-%202022-07-121.pdf.

B. Frederiksen et. al., A National Survey of OBGYNs’

Experiences After Dobbs, Kaiser Fam. Found (June 21, 2023),

https://www.kff.org/report-section/a-national-survey-of-obgynsexperiences-after-dobbs-report/; “Recent estimates suggest that

a nationwide abortion ban would increase maternal mortality by

21% overall and by 33% among Black Americans.” K. Backes

Kozhimannil et. al., Abortion Access as a Racial Justice Issue,

387

NEW

ENG.

MED.

(2022),

https://pubmed.ncbi.nlm.nih.gov/36069823/

(citing

Stevenson, The pregnancy-related mortality impact of a total

abortion ban in the United States: A Research Note On Increased

Deaths Due To Remaining Pregnant 58 DEMOGRAPHY 6 (2021)).

Idaho’s to proliferate. In contrast, EMTALA protects

access to care for the most marginalized groups.35

Idaho’s restrictive law will primarily endanger

those with limited resources who already face barriers

to accessing essential healthcare36—the very same

groups that EMTALA is designed to protect.

EMTALA’s emergency protections are especially

crucial for pregnant BIPOC, for whom pregnancy is

already more dangerous, and particularly for Black

women, who are facing a maternal mortality and

morbidity crisis.37

Idaho’s near-total abortion ban violates

international law

By ratifying various treaties and through the

application of customary international law, the

United States is bound by international law. Its

obligations include the requirement to protect and

provide access to safe and legal abortion and other

reproductive healthcare. Access to safe and legal

abortion is protected by multiple complementary

rights recognized under international law, including:

(1) the right to life; (2) the right to health; (3) the right

to privacy; (4) the right to non-discrimination; and (5)

35 L. Hill et al., Health Coverage by Race and Ethnicity, 2010-

2022,

Kaiser

Fam.

Found

(Jan.

11,

2024),

https://www.kff.org/racial-equity-and-health-policy/issuebrief/health-coverage-by-race-and-ethnicity/ (noting BIPOC

populations are disproportionately likely to be uninsured).

36 See infra n. 3.

37 A. Njoku et al., Listen to the Whispers before They Become

Screams: Addressing Black Maternal Morbidity and Mortality in

the

United

States,

HEALTHCARE

(2023),

https://www.mdpi.com/2227-9032/11/3/438.

the right to be free from torture and other cruel,

inhuman, or degrading treatment or punishment.

Idaho’s near-total abortion ban violates these human

rights, putting the United States in breach of its

international legal obligations.

1. The United States is obligated to respect,

protect, and fulfill the rights articulated in the

treaties it has ratified

The United States has ratified several

foundational human rights instruments, including

the ICCPR, ICERD, and the CAT. It has also signed—

but not yet ratified—several other related

instruments, including the Convention on the

Elimination of All Forms of Discrimination Against

Women (CEDAW), the International Covenant on

Economic, Social and Cultural Rights (ICESCR), the

International Convention on the Rights of the Child

(CRC) and the International Convention on the Rights

of Persons with Disabilities (CRPD).

Where the United States has ratified a treaty,

it is bound to follow the terms stated therein.38

Countries that have ratified a treaty are “legally

obligated to uphold the principles embodied in that

treaty”39 and, in the case of certain treatiesdiscussed

infra, must implement those obligations through their

national law.40 Similarly, although the United States

38 Flores v. Southern Peru Copper Corp., 414 F.3d 233, 256 (2d

Cir. 2003) (citing Haver v. Yaker, 76 U.S. 32, 35 (1869)).

39 Id.

40 International Covenant on Civil and Political Rights (adopted

Dec. 16, 1966, entered into force Mar. 23, 1976), 999 U.N.T.S. 171

(ICCPR). art. 2; United Nations Convention Against Torture and

is not formally bound by treaties it has signed but not

ratified, it must, as a signatory, refrain from taking

actions that “defeat the object and purpose of the

treaty.”41

2. Idahoans’ rights are jeopardized by Idaho’s neartotal abortion ban

a. The right to life

Article 6 of the ICCPR, which the United States

has ratified and is bound by, provides that “[e]very

human being has the inherent right to life. This right

shall be protected by law. No one shall be arbitrarily

deprived of his life.”

That abortion bans violate Article 6 should be

abundantly evident. The plain language—the starting

point of any interpretation42—is clear: a law that only

permits abortion care in narrow circumstances and

that renders life-saving abortion care virtually

inaccessible violates the right to life, particularly

Other Cruel, Inhuman or Degrading Treatment or Punishment

(adopted Dec. 10, 1984, entered into force June 26, 1987), 1465

U.N.T.S. 85, art. 4.

41 Vienna Convention on the Law of Treaties (adopted May 23,

1969, entered into force Jan. 27, 1980), 1155 U.N.T.S. 331

(VCLT), art. 18(a). Although the United States is not a party to

the VCLT, the treaty’s provisions are considered customary

international law. Avero Belgium Ins. v. American Airlines, Inc.,

423 F.3d 73, 79 n.8 (2d Cir. 2005).

42 VCLT, art. 31(1); Medellin v. Texas, 552 U.S. 491, 506 (2008)

(“The interpretation of a treaty, like the interpretation of a

statute, begins with its text.”).

where medical decisions have to be made in uncertain,

complex, and fast-evolving circumstances.

Even if the plain text of the Idaho law was in

any way ambiguous, authoritative international

guidance both contemplates and prohibits such

abortion bans. The UN Human Rights Committee

(HRC)43 has recognized the centrality of sexual and

reproductive healthcare to women’s right to life and

health, and explicitly noted the link between reducing

maternal mortality and morbidity and ensuring that

women have access to reproductive health services,

including safe abortion.44 The HRC has thus urged

43 The HRC is “the body charged under the ICCPR with

monitoring its implementation.” United States v. Duarte-Acero,

208 F.3d 1282, 1287 (11th Cir. 2000). Among its other

responsibilities, the HRC makes recommendations in individual

cases, “stud[ies] . . . reports submitted by” participating

countries, and issues “general comments” that provide guidance

on the treaty. ICCPR, art. 40.

Human Rights Committee, Concluding Observations:

Cameroon, U.N. Doc. CCPR/C/CMR/CO/4 (Aug. 4, 2010), ¶ 13

(urging the State to “step up its efforts to reduce maternal

mortality, including by ensuring that women have access to

reproductive health services.”). See also Human Rights

Committee, Concluding Observations: Chile, U.N. Doc.

CCPR/C/CHL/CO/6 (Aug. 13, 2014), ¶ 15; Human Rights

Committee, Concluding Observations: Costa Rica, U.N. Doc.

CCPR/C/CRI/CO/6 (Apr. 21, 2016), ¶ 17; Human Rights

Committee, Concluding Observations: Malawi, U.N. Doc.

CCPR/C/MWI/CO/1/Add.1 (Aug. 19, 2014), ¶ 9; Human Rights

Committee, Concluding Observations: Sierra Leone, U.N. Doc.

CCPR/C/SLE/CO/1 (Apr. 17, 2014), ¶ 14; Human Rights

Committee, Concluding Observations: Malta, U.N. Doc.

CCPR/C/MLT/CO/2 (Nov. 21, 2014), ¶ 13; Human Rights

Committee, Concluding Observations: Sri Lanka, U.N. Doc.

CCPR/C/LKA/CO/5 (Nov. 21, 2014), ¶ 10; Human Rights

States to ensure access to reproductive health

services, in particular abortion care, for all women

and adolescents.45

In its General Comment 36 on the right to life,

the HRC has confirmed that, while states can regulate

abortion, “those measures must not result in violation

of the right to life of a pregnant woman or girl, or her

other rights under the Covenant.”46 More specifically,

States “should not introduce new barriers” to abortion

and “should remove existing barriers to effective

access by women and girls to safe and legal

abortion.”47

To carry out these two goals, the HRC has

called on States to ensure that “restrictions on the

ability of women or girls to seek abortion [do] not . . .

jeopardize their lives, subject them to physical or

mental pain or suffering . . ., discriminate against

Committee, Concluding Observations: Paraguay, U.N. Doc.

CCPR/C/PRY/CO/3 (Apr. 29, 2013), ¶ 13; Human Rights

Committee, Concluding Observations: Peru, U.N. Doc.

CCPR/C/PER/CO/5 (Apr. 29, 2013), ¶ 14; Human Rights

Committee, Concluding Observations: Guatemala, U.N. Doc.

CCPR/C/GTM/CO/3 (Apr. 19, 2012), ¶ 20; Human Rights

Committee, Concluding Observations: Jamaica, U.N Doc.

CCPR/C/JAM/CO/3 (Nov. 17, 2011), ¶ 14; Human Rights

Committee, Concluding Observations: Dominican Republic, UN

Doc. CCPR/C/DOM/CO/5 (Apr. 19, 2012), ¶ 15. See also Human

Rights Committee, Concluding Observations: Mali, UN Doc.

CCPR/CO/77/MLI (Apr. 16, 2003), ¶ 14 (on emergency obstetrics

care).

45 Id.

46 Human Rights Committee, General Comment 36 (Article 6:

Right to Life), UN Doc. CCPR/C/GC/36 (Sept. 3, 2019), ¶ 8.

47 Id.

them or arbitrarily interfere with their privacy.”48

States “must provide safe, legal and effective access to

abortion . . . where carrying a pregnancy to term

would cause the pregnant woman or girl substantial

pain or suffering, most notably[, inter alia,] where the

pregnancy … is not viable.”49

Idaho’s near-total abortion ban directly

jeopardizes the life and well-being of pregnant people,

violating their right to life under the ICCPR. As in

other jurisdictions, the law’s narrow carve-out

permitting abortion services only to save a patient’s

life will not prevent an increase in maternal mortality

and morbidity. In the shadow of Idaho’s law, pregnant

Idahoans facing acute medical crises have not

received adequate medical care. One patient was sent

home while miscarrying due to physicians’ fear that

providing services might place them in violation of the

law.50 Pregnant Idahoans are now facing a

reproductive health desert, with reproductive

healthcare providers seeking to avoid criminal

liability by fleeing the state or simply declining to

provide care.

Idaho’s restrictive abortion law violates the

rights of pregnant people under Article 6 of the

ICCPR, including because it places the lives of

pregnant people at risk, despite its narrow exception.

The restrictive law as written is contrary to the HRC’s

clear guidance that countries should refrain from

restricting abortion in a manner that threatens a

48 Id.

49 Id.

50 Supra n. 9.

patient’s life, subjects them to physical or mental pain

or suffering, or discriminates against them.

b. The right to health

Idaho’s near-total abortion ban endangers the

physical and mental health of persons seeking

abortions and people in need of emergency

reproductive healthcare. The restrictive law violates

Idahoans’ human rights and contravenes the United

States’ obligation to respect the right to health,51 in

particular the obligation to not act in a manner that

defeats the object and purpose of the treaties it has

signed.

The right to health is protected under Article

12 of the ICESCR, which the United States has

51 See International Convention on the Elimination of All Forms

of Racial Discrimination (adopted Dec. 21, 1965, entered into

force Jan. 4, 1969), 660 U.N.T.S. 195 at 212 (ICERD), art. 5(e)(iv);

International Covenant on Economic, Social and Cultural Rights

(adopted Dec. 16, 1966, entered into force Jan. 3, 1976), 993

U.N.T.S. 3 (ICESCR), art. 12; Convention on the Elimination of

All Forms of Discrimination Against Women (adopted Dec. 18,

1979, entered into force Sept. 3, 1981), 1249 U.N.T.S 13

(CEDAW), arts. 11(1)(f), 12, 14(2)(b); Convention on the Rights

of Persons with Disabilities (adopted Mar. 30, 2007, entered into

force May 3, 2008), 2515 U.N.T.S 3 (CRPD), art. 25; Convention

on the Rights of the Child (adopted Nov. 20, 1989, entered into

force Sept. 2, 1990), 1577 U.N.T.S 3 (CRC), art. 24. See also

Committee on Economic, Social and Cultural Rights, General

Comment No. 22 (2016) on the right to sexual and reproductive

health, U.N. Doc. E/C.12/GC/22 (May 2, 2016), ¶¶ 10-11, 13-14,

45, 49; Committee on the Rights of the Child, General comment

No. 15 (2013) on the right of the child to the enjoyment of the

highest attainable standard of health, U.N. Doc. CRC/C/GC/15

(Apr. 17, 2013), ¶ 56.

signed. As the Committee on Economic, Social, and

Cultural Rights, which monitors implementation and

provides guidance on treaty interpretation under the

ICESCR, has confirmed, “[t]he freedoms [protected

under the right to health] include the right to make

free and responsible decisions and choices, free of

violence, coercion and discrimination, regarding

matters concerning one’s body and sexual and

reproductive health[, and entitle all people to] full

enjoyment of the right to sexual and reproductive

health.”52 Idaho’s near-total abortion ban, which is

designed entirely to constrain “full enjoyment of the

right to sexual and reproductive health,” violates the

right to health of pregnant Idahoans.

Restrictions on abortion also violate the right to

non-discrimination in healthcare under the ICERD,

which the United States has ratified. Under this

treaty, State parties must prohibit and eliminate

“racial discrimination in all its forms and to guarantee

the right of everyone, without distinction as to race,

colour, or national or ethnic origin, to equality before

the law,” and this obligation encompasses “[t]he right

to public health, medical care, social security and

social services.”53 As discussed infra, Idaho’s neartotal abortion ban deepens racial inequality with

respect to enjoyment of the right to public health and

medical care.

The right to health is further protected under

CEDAW, the CRC, and the CRPD, which the United

52 Committee on Economic, Social and Cultural Rights, General

Comment 22 on the right to sexual and reproductive health, U.N.

Doc. E/C.12/GC/22 (May 2, 2016), ¶ 5.

53 CERD, art. 5(e)(iv).

States has signed. The CEDAW Committee, the

Committee on the Rights of the Child, and the

Committee on the Rights of Persons with Disabilities

have unanimously and unambiguously recognized

that access to abortion, and the ability to make free

decisions regarding abortion, are indispensable to the

fulfillment of the right to health and prevention of

discrimination.54 Through its sweeping restrictions,

the Idaho law restricts the ability of pregnant people

to make free decisions regarding their reproductive

health and rights—in many cases leading to serious

and irreparable health consequences—in violation of

the rights protected under CEDAW, the CRC, and the

CRPD.

c. The right to privacy

Human rights treaty bodies have consistently

found that denying access to abortion or imposing

Committee on the Rights of Persons with Disabilities and

Committee on the Elimination of All Forms of Discrimination

against Women (CEDAW Committee), Guaranteeing sexual and

reproductive health and rights for all women, in particular

women

with

disabilities

(Aug.

29,

2018),

https://www.ohchr.org/en/treaty-bodies/crpd/statementsdeclarations-and-observations; CEDAW Committee, Views of the

Committee under Article 7(3) of the Optional Protocol,

Concerning Commc’n No. 22/2009, U.N. Doc. U.N. Doc.

CEDAW/C/50/D/222009 (Nov. 4, 2011) (L.C. v Peru), ¶ 8.15;

Committee on the Elimination of Racial Discrimination,

Concluding Observations on the Combined Tenth to Twelfth

Reports of the United States of America, U.N. Doc.

CERD/C/USA/CO/10-12 (Sept. 21, 2022), ¶¶ 35-36; Committee on

the Rights of the Child, General Comment No. 4: Adolescent

Health and Development in the Context of the Convention on the

Rights of the Child, U.N. Doc. CRC/GC/2003/4 (July 1, 2003), ¶

31.

barriers to such access undermines women’s

reproductive autonomy and violates their right to

privacy.55

Article 17 of the ICCPR provides that “[n]o one

shall be subjected to arbitrary or unlawful

interference with his privacy, family, home or

correspondence, nor to unlawful attacks on his honour

and reputation.” The HRC has concluded that

restrictions on abortion infringe upon this right of

privacy—including in cases where abortion is

prohibited except in narrow circumstances such as

under the Idaho law.

In 2005, for example, the HRC considered the

case of K.L., a woman who sought an abortion in

Peru.56 Medical officials declined to perform the

abortion, citing article 119 of Peru’s criminal code,

which—akin to Idaho’s law—“permitted [therapeutic

abortion]57 only when termination of the pregnancy

was the only way of saving the life of the pregnant

woman or avoiding serious and permanent damage to

55 See, e.g., Human Rights Committee, Views Adopted by the

Committee Under Article 5(4) of the Optional Protocol,

Concerning

Commc’n

No.

1153/2003,

U.N.

Doc.

CCPR/C/85/D/1153/2003 (Nov. 22, 2005) (K.L. v. Peru), ¶ 6.4.

56 Id.

Abortions to protect a pregnant person’s life or health are

referred to as therapeutic abortions in Peru. Promsex, World

Health Organization implementation story: Closing the gaps

between law and attitudes: advocation for legal and dignified

abortion

Peru

(Sept.

27,

2023),

https://www.who.int/publications/m/item/advocating-for-legaland-dignified-abortion-in-peru.

her health.”58 The HRC determined that “the refusal

to act in accordance with the [woman’s] decision to

terminate her pregnancy was not justified.”59 The

Committee agreed with the woman’s claim that

Peruvian officials “interfered arbitrarily in her

private life,” and found that their actions violated

article 17 of the ICCPR.60 Similar human rights

violations will occur under Idaho’s law.

Further, Idaho’s near-total abortion ban and

others like it in the United States have decimated

reproductive autonomy—the power to control all

aspects of one’s reproductive health—which is “at the

very core of [individuals’] fundamental right[s] to

equality and privacy.”61

d. The right to non-discrimination

Treaties ratified by the United States expressly

prohibit discrimination and require it to take

measures to eradicate all forms of discrimination

against individuals, including in the context of

medical care. Under Idaho’s near-total abortion ban,

pregnant people are denied the right to nondiscrimination.

58 K.L. v. Peru, ¶ 2.3.

59 Id., ¶ 6.4.

60 Id.

UN Working Group on the issue of discrimination against

women in law and in practice, Women’s Autonomy, Equality and

Reproductive Health in International Human Rights: Between

Recognition, Backlash and Regressive Trends at 1 (Oct. 2017),

https://www.ohchr.org/sites/default/files/Documents/Issues/Wo

men/WG/WomensAutonomyEqualityReproductiveHealth.pdf.

The ICCPR sets forth a general right to be free

from discrimination of any kind, including on the

grounds of race, sex, or other status.62 The HRC has

issued

authoritative

guidance

noting

that

interference with pregnant individuals’ access to

reproductive health care violates their right to nondiscrimination.63 In considering individual cases

under its optional protocol, the HRC found that

denials of abortion constituted a violation of the right

to be free from discrimination under Article 26 of the

ICCPR.64 The HRC further confirmed that the right to

non-discrimination on the basis of sex and gender

“obligates States to ensure that State regulations,

including with respect to access to health services,

accommodate the fundamental biological differences

between men and women in reproduction and do not

directly or indirectly discriminate on the basis of

sex.”65

The right to non-discrimination is also

protected under the CERD. The CERD Committee has

62 ICCPR, art. 26.

63 Human Rights Committee, General Comment 28 (Article 3: the

Equality of Rights Between Men and Women), U.N. Doc.

CCPR/C/21/Rev.1/Add.10 (Mar. 29, 2000), ¶ 20.

64 Human Rights Committee, Views Adopted by the Committee

Under Article 5(4) of the Optional Protocol, Concerning Commc’n

No. 2425/2014, U.N. Doc. CCPR/C/119/D/2425/2014 (June 12,

2017) (Whelan v. Ireland), ¶ 7.12; Human Rights Committee,

Views Adopted by the Committee Under Article 5(4) of the

Optional Protocol, Concerning Commc’n No. 2324/2013, U.N.

Doc. CCPR/C/116/D/2324/2013 (Nov. 17, 2017) (Mellet v.

Ireland), ¶ 7.11.

Mellet v. Ireland, ¶ 7 (Cleveland, S., concurring). See also

Whelan v. Ireland (Cleveland, S., concurring).

noted its particular concern that “systemic racism,

along with intersecting factors such as gender, race,

ethnicity and migration status, have a profound

impact on access by women and girls to the full range

of sexual and reproductive health services … without

discrimination,” particularly in light of “the limited

availability of culturally sensitive and respectful

maternal health care.”66

The right to non-discrimination on the basis of

sex and gender is further enshrined in CEDAW. As

confirmed by the CEDAW Committee, “[i]t is

discriminatory for a State party to refuse to provide

legally for the performance of certain reproductive

health services for women,”67 and criminalization of

abortion “does grave harm to women’s health and

human rights by stigmatizing a safe and needed

medical procedure.”68

The CEDAW Committee reaffirmed this

position in the cases of L.C. v Peru and Alyne da Silva

Committee on the Elimination of Racial Discrimination,

Concluding Observations on the Combined Tenth to Twelfth

Reports of the United States of America, U.N. Doc.

CERD/C/USA/CO/10-12 (Sept. 21, 2022), ¶ 35.

67 CEDAW Committee, General Recommendation 24 (Article 12:

Women and Health), UN Doc. A/54/38/Rev.1 (1999), chap. 1, ¶

11.

UN Working Group on the issue of discrimination against

women in law and in practice, Women’s autonomy, equality and

reproductive health in international human rights: Between

recognition, backlash and regressive trends at 5 (Oct. 2017),

www.ohchr.org/Documents/Issues/Women/WG/WomensAutono

myEqualityReproductiveHealth.pdf.

Pimentel v Brazil,69 as well as in its inquiries on the

Philippines70 and on Northern Ireland,71 all of which

confirm that the provision of healthcare may not

discriminate on the grounds of sex/gender and must

guarantee gender equality. The UN Working Group

on Discrimination Against Women and Girls has also

noted that countries violate women’s rights when they

“neglect[] women’s health needs, fail[] to make

gender-sensitive health interventions, depriv[e]

women of autonomous decision-making capacity and

criminaliz[e] or deny[] them access to health services

that only women require.”72

Idaho’s near-total abortion ban is incompatible

with the rights of women to non-discrimination, given

that

reproductive

healthcare

restrictions

disproportionately impact women and those assigned

the female sex at birth. Healthcare providers have

reported delaying or denying care on the basis of

Committee, Views of the Committee under Article

7(3) of the Optional Protocol, Concerning Commc’n No. 17/2008,

U.N. Doc. CEDAW/C/49/D/17/2008 (Sept. 27, 2011) (Alyne da

Silva Pimentel Teixeira v Brazil).

69 CEDAW

70 CEDAW Committee, Summary of the Inquiry concerning the

Philippines under Article 8 of the Optional Protocol to the

Convention on the Elimination of All Forms of Discrimination

against Women, UN Doc. CEDAW/C/OP.8/PHL/1 (Apr. 22, 2015).

CEDAW Committee, Report of the Inquiry concerning the

United Kingdom of Great Britain and Northern Ireland under

Article 8 of the Optional Protocol to the Convention on the

Elimination of All Forms of Discrimination against Women, UN

Doc. CEDAW/C/OP.8/GBR/1 (Mar. 6, 2018).

UN Working Group on the issue of discrimination against

women in law and in practice, Report of the Working Group, UN

Doc. A/HRC/32/44 (Apr. 8, 2016), ¶ 14.

Idaho’s law and similar laws in other states, putting

women at risk of potentially deadly conditions such as

sepsis or hemorrhage.73 By depriving only those

Idahoans with the capacity to become pregnant of

access to the emergency medical services provided for

under EMTALA, Idaho’s policy targets one group of

people, denying group members’ basic human rights

and jeopardizing their lives and health. Idaho’s law is

patently incompatible with the right to nondiscrimination, as it is entirely conceived to limit the

availability of emergency reproductive care for

women. It further undermines the right to nondiscrimination by exacerbating racial inequalities in

access to health care. By contrast, EMTALA’s

provisions on reproductive health were designed to

protect women from discriminatory abortion bans

that are incompatible with the rights of women and

all pregnant people to non-discrimination.

e. The right to be free from torture and other

cruel, inhuman, or degrading treatment or

punishment

The prohibition against torture is recognized

within multiple treaties to which the United States is

party. Article 7 of the ICCPR states that “[n]o one

shall be subjected to torture or to cruel, inhuman or

degrading treatment or punishment.” Article 16 of the

CAT specifies that every Party “shall undertake to

prevent in any territory under its jurisdiction . . . acts

of cruel, inhuman or degrading treatment or

punishment.” Moreover, the prohibition against

Supra n. 9, 12, 13 (documenting cases in which healthcare

providers have denied care), 14 (describing conditions such as

sepsis and hemorrhage that can result from delayed access to

abortion).

torture is one of the most firmly rooted principles of

international human rights law and has, as a

threshold matter, become a well-accepted norm of

customary international law.74 This prohibition, as

noted by the HRC, “relates not only to acts that cause

physical pain but also to acts that cause mental

suffering.”75

The HRC, in a case in which a woman with a

non-viable pregnancy was forced to leave Ireland to

access abortion, held that “[b]y virtue of the existing

legislative framework, the State party subjected the

author to conditions of intense physical and mental

suffering,” and that the facts “amounted to cruel,

inhuman or degrading treatment in violation of article

7 of the Covenant.”76 As a remedy, the HRC instructed

that Ireland “should amend its law on the voluntary

termination of pregnancy … to ensure compliance

with the Covenant, ensuring effective, timely and

74 See Siderman de Blake v. Republic of Argentina, 965 F.2d 699,

716 (9th Cir. 1992) (“There is no doubt that the prohibition

against official torture is a norm of customary international

law.”).

75 Human Rights Committee, Views Adopted by the Committee

Under Article 5(4) of the Optional Protocol, Concerning Commc’n

No. 1608/2007, U.N. Doc. CCPR/C/101/D/1608/2007 (Apr. 28,

2011) (LMR v. Argentina), ¶ 9.2. See also Human Rights

Committee, General comment 36 (Article 6: Right to Life), U.N.

Doc. CCPR/C/GC/36 (Sept. 3, 2019), ¶ 8 (“States parties must

provide safe, legal and effective access to abortion where the life

and health of the pregnant woman or girl is at risk, or where

carrying a pregnancy to term would cause the pregnant woman

or girl substantial pain or suffering, most notably where the

pregnancy is the result of rape or incest or where the pregnancy

is not viable.”) (emphasis added).

76 Mellet v. Ireland, ¶¶ 7.4, 7.6.

accessible procedures for pregnancy termination in

Ireland,” and “take measures to ensure that healthcare providers are in a position to supply full

information on safe abortion services without fearing

they will be subjected to criminal sanctions.”77

The Committee Against Torture (CAT

Committee), the body charged with monitoring

implementation of the CAT, has expressed concern at

the severe physical and mental anguish experienced

by pregnant individuals as a result of abortion

restrictions.78 The CAT Committee has acknowledged

that denial of abortion can result in “physical and

mental suffering so severe in pain and intensity as to

amount to torture.”79

The CAT Committee has affirmed that narrow

exceptions only to save the life of the pregnant person,

but not permitting abortions to preserve their health

(as is the case with the Idaho statute), are not

sufficient to satisfy the requirement that State parties

refrain from adopting policies amounting to torture

and other cruel, inhuman, or degrading treatment or

punishment.80

77 Id., ¶ 9.

78 See Committee Against Torture (CAT Committee), Concluding

Observations on the Second Periodic Report of Ireland, U.N. Doc.

CAT/C/IRL/CO/2 (Aug. 31, 2017), ¶ 31; CAT Committee,

Concluding Observations on the Seventh Periodic Rep. of

Ecuador, U.N. Doc. CAT/C/ECU/CO/7 (Jan. 11, 2017), ¶ 45.

79 See CAT Committee, Concluding Observations on the Seventh

Periodic Report of Poland, U.N. Doc. CAT/C/POL/CO/7 (Aug. 29,

2019), ¶ 33(d).

CAT Committee, Concluding Observations on the Third

Periodic Report of the Philippines, U.N. Doc. CAT/C/PHL/CO/3

Denial of abortion, particularly when a

pregnancy is causing severe pain or suffering, can also

meet the threshold of cruel, inhuman or degrading

treatment.81 The CEDAW Committee has found that

“criminalization of abortion, denial or delay of safe

abortion and/or post-abortion care, [and] forced

continuation of pregnancy ... are forms of genderbased violence that ... may amount to torture or cruel,

inhuman or degrading treatment.”82

Idaho’s law and the anguish that it subjects

pregnant people to are incompatible with the United

States’ obligation to uphold the right to be free from

torture and other cruel, inhuman or degrading

treatment or punishment.

Pregnant people in Idaho are being abandoned

to suffer medical emergencies alone, and they and

their healthcare providers must navigate their

(June 2, 2016), ¶ 40(b) (urging the state to “[r]eview its

legislation in order to allow for legal exceptions to the prohibition

of abortions in specific circumstances such as when the

pregnancy endangers the life or health of the woman…”)

(emphasis added).

81 J. Mendez et al., Denial of abortion services and the prohibition

of torture and cruel, inhuman and degrading treatment (Oct. 25,

2016),

https://www.ohchr.org/Documents/Issues/Women/WG/AmicusBr

azil.pdf; K.L. v. Peru, ¶ 6.3 (The Committee found that forcing

an adolescent to carry her pregnancy to term, despite

confirmation of a severe fetal impairment caused severe mental

anguish, violated ICCPR art. 7).

82 CEDAW Committee, General Recommendation 35 on gender-

based

violence

against

women,

updating

general

recommendation 19, U.N. Doc. CEDAW/C/GC/35 (July 26, 2017),

¶ 18.

medical decision-making in the shadow of

criminalization.83 As discussed supra, physicians in

Idaho have reported having to deny emergency care to

pregnant patients and send them home without

essential care during miscarriages.84 Through its

cruel denial of access to reproductive healthcare,

Idaho’s draconian law is producing an alarming level

of suffering, and violating human rights that are

protected under international law.

The stories emerging from pregnant people in

Idaho illustrate the mental anguish and trauma

associated with the denial of basic emergency care.

Not only are pregnant Idahoans left alone to navigate

health emergencies, they are prevented from even

seeking guidance from their religious and health

advisers through an expansive interpretation of the

prohibition on “aiding and abetting” abortions.85

Idaho’s near-total abortion ban subjects pregnant

people to additional anxiety and stress as they

attempt to navigate strict controls on their

83 Supra n. 10.

84 Supra n. 9.

85 R. Klitzman, Opinion: Roe’s reversal doesn’t just hurt women

–

harms

all,

CNN

(June

25,

2022),

https://www.cnn.com/2022/06/25/opinions/medical-ethics-postroe-world-klitzman/index.html; See also J. Tolentino, We’re Not

Going Back to the Time Before Roe. We’re Going Somewhere

Worse,

The

New

Yorker

(June

24,

2022),

https://www.newyorker.com/magazine/2022/07/04/we-are-notgoing-back-to-the-time-before-roe-we-are-going-somewhereworse/amp.

reproductive freedom, and produces traumatic health

outcomes that create lasting emotional anguish.86

*****

Restrictive abortion laws increase preventable

maternal mortality and morbidity and harm pregnant

people. Idaho’s near-total abortion ban makes

pregnancy more dangerous and restricts access to

necessary emergency reproductive healthcare. The

evidence from jurisdictions with similar legislation

makes clear that the devastating effects of this law

will take a disproportionate toll among already

marginalized populations.

Idaho’s draconian abortion law gravely violates

pregnant Idahoan’s human rights. International

human rights law protects the right to access

emergency healthcare services, including safe and

legal abortions, a right which is similarly guaranteed

under EMTALA. By contrast, Idaho’s near-total

abortion ban law violates the rights to life; health;

non-discrimination; privacy; and to be free from

torture, cruel, inhuman and degrading treatment. To

prevent further violations of pregnant Idahoans’

human rights, EMTALA’s protections must be

guaranteed.

CONCLUSION

For the foregoing reasons, the order of the

district court should be affirmed.

86 Supra n. 24.

Respectfully submitted.

ELISE KEPPLER

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AISLING REIDY

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CHRISTINA G. HIOUREAS

Counsel of Record

FOLEY HOAG LLP

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MANDIVAVARIRA MUDARIKWA

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March 28, 2024

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