Case: 23-10362 Document: 543-1 Page: 14 Date Filed: 08/16/2023
A. Associational Standing
1. Factual Predicate
The Medical Organizations and Doctors chiefly rely on associational standing. That is, the organizations contend that they have standing because their members are likely to sustain injuries as a result of FDA’s actions. See Hunt v. Wash. State Apple Adv. Comm’n, 432 U.S. 333, 343 (1977). We conclude that the Medical Organizations and Doctors have made a “clear showing” that their members face injury with sufficient likelihood to support entering a preliminary injunction. Barber, 860 F.3d at 352.
The standing theory forwarded here rests on several basic premises, which are recited as follows. Mifepristone causes adverse effects for a certain percentage of the women who take it. Those adverse events are traceable to FDA because it approved the drug. And hundreds of the Medical Organizations’ members are OB/Gyns or emergency-room doctors who treat women who experience severe adverse effects.
The Doctors are allegedly injured when they treat mifepristone patients. They offer four reasons why that is so. First, when a doctor treats a woman suffering from a mifepristone complication, he or she will often be required to perform or complete an abortion. And even if not, the doctor must participate in the medical treatment that facilitates an abortion. The Doctors allege that being made to provide this treatment conflicts with their sincerely held moral beliefs and violates their rights of conscience.
Second, treating mifepristone patients imposes mental and emotional strain above what is ordinarily experienced in an emergency-room setting. Third, providing emergency treatment forces the Doctors to divert time and resources away from their ordinary patients, hampering their normal practice. And fourth, the Doctors allege that mifepristone patients involve more risk of complication than the average patient, and so expose the Doctors to
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