Supreme Court Delivers 9-0 Decision Lawsuit Alliance for Hippocratic Medicine v. FDA
The issue in front of the Court was the recently relaxed FDA regulation allowing wide accessibility of two abortion pills but was remanded back to a lower court on procedural standing requirements.
The Alliance for Hippocratic Medicine brought a lawsuit against the FDA in the Fifth Circuit of Appeals Court challenging the new FDA regulation allowing access to over-the-counter abortion pill medications to the pubic at large. The Alliance for Hippocratic Medicine challenged four actions to the new FDA regulation: the 2000 Approval, 2016 Amendments, 2019 Generic Approval, and 2021 Non-Enforcement Decision.
The Circuit Court three judge panel ruled, the Medical Organizations and Doctors have made a substantial showing that the 2016 Amendments and the 2021 Non-Enforcement Decision violate the APA. Accordingly, those actions will be stayed pending final judgment. But to repeat, all of this relief is subject to the Supreme Court’s prior order, which stays the district court’s order until the disposition of any petition for certiorari.
The lawsuit was then appealed to the Supreme Court and oral arguments were heard on March 26, 2024, arguing on the merits of the case. Today the 9 - 0 decision was remanding back to the lower court on standing. The issue at heart is whether the plaintiffs meet the threshold requirements in the “Doctrine of Standing.”
Supreme Court Justice Kavanaugh issued the 9 - 0 opinion.
Plaintiffs are pro-life, oppose elective abortion, and have sincere legal, moral, ideological, and policy objections to mifepristone being prescribed and used by others. Because plaintiffs do not prescribe or use mifepristone, plaintiffs are unregulated parties who seek to challenge FDA’s regulation of others. Plaintiffs advance several complicated causation theories to connect FDA’s actions to the plaintiffs’ alleged injuries in fact. Therefore, the Supreme Court decision ruled the Alliance for Hippocratic did not have standing and remanding back to a lower court for further review.
The Doctrine of Standing as an Essential Element of the Separation of Powers, For a plaintiff to get in the federal courthouse door and obtain a judicial determination of what the governing law is, the plaintiff cannot be a mere bystander, but instead must have a “personal stake” in the dispute. “limiting who can sue, the standing requirement implements “the Framers’ concept of the proper—and properly limited—role of the courts in a democratic society.”’
The Court finds to establish standing,
“a plaintiff must demonstrate (i) that she has suffered or likely will suffer an injury in fact, (ii) that the injury likely was caused or will be caused by the defendant, and (iii) that the injury likely would be redressed by the requested judicial relief.”
The second and third standing requirement finds “a defendant’s action causes an injury, enjoining the action or awarding damages for the action will typically redress that injury. So the two key questions in most standing disputes are injury in fact and causation.”
“In sum, to sue in federal court, a plaintiff must show that he or she has suffered or likely will suffer an injury in fact. Second is causation. The plaintiff must also establish that the plaintiff ’s injury likely was caused or likely will because by the defendant’s conduct.
Because the plaintiffs doctors and medical associations do not prescribe, manufacture, sell, or advertise mifepristone or sponsor a competing drug, the plaintiffs suffer no direct monetary injuries from FDA’s actions relaxing regulation of mifepristone. “Because the plaintiffs do not prescribe, manufacture, sell, or advertise mifepristone or sponsor a competing drug, the plaintiffs suffer no direct monetary injuries from FDA’s actions relaxing regulation of mifepristone.”
Essentially, the ruling is based on Article III of the Constitution and whether the plaintiffs had standing since the doctors and medical plaintiffs in the lawsuit are not forced through regulation to prescribe mifepristone to their patients, the standing threshold requirements have not been established by the plaintiffs.
“The doctors ever since FDA approved mifepristone in 2000. The plaintiffs have not identified any instances where a doctor was required, notwithstanding conscience objections, to perform an abortion or to provide other abortion-related treatment that violated the doctor’s conscience. Nor is there any evidence in the record here of hospitals overriding or failing to accommodate doctors’ conscience objections.”
Supreme Court Justice Clarence Thomas went on to explain possible remedy under associated standing merits of the lawsuit “Our doctrine permits an association to have standing based purely upon a member’s injury, not its own. If a single member of an association has suffered an injury, our doctrine permits that association to seek relief for its entire membership— even if the association has tens of millions of other, non-injured members.
The Alliance’s attempted use of our associational-standing doctrine illustrates how far we have strayed from the traditional rule that plaintiffs must assert only their own injuries. Thus, the allegedly injured parties—the doctors—are two degrees removed from the party before us pursuing those injuries.”
“Despite its continued reliance on associational standing, the Court has yet to explain how the doctrine comports with Article III. When once asked to “reconsider and reject the principles of associational standing” in favor of the class- action mechanism, the Court justified the doctrine solely by reference to its “special features, advantageous both to the individuals represented and to the judicial system as a whole.”
No party challenges our associational standing doctrine today. In an appropriate case, however, the Court should address whether associational standing can be squared with Article III’s requirement that courts respect the bounds of their judicial power.
A University of Chicago Law abstract asserts “Associational standing was first recognized as an offshoot of third-party standing to allow an organization to assert its members’ rights concerning their relationship with, or involvement in, the organization itself. The Court has since extended associational standing to allow a group to pursue any of its members’ claims within the group’s substantive purview, including those completely unrelated to the member’s affiliation with the group. The Court has likewise allowed zero-member groups to invoke associational standing, despite their lack of members, to litigate non-members’ claims, and even enabled groups to pursue their members’ damages claims in certain circumstances.”
“Associational standing allows plaintiff groups to circumvent Rule 23 by allowing them to effectively craft their own classes without judicial approval. The doctrine also violates Rule 17(a)’s real party-in-interest requirement, triggers disputes over potential asymmetric claim preclusion, and offers a backdoor method for courts to inappropriately issue nationwide defendant-oriented injunctions.”
Cornell Law School outlines numerous other political organizations who were successful on lawsuits injuries to associations of individuals who use the environment affording them standing.
In Davis v. FEC (See Davis v. FEC, 554 U.S. 724, 734 (2008) ( “[T]he injury required for standing need not be actualized. A party facing prospective injury has standing to sue where the threatened injury is real, immediate, and direct.” ).
Hence, Supreme Court Justice Clarence Thomas suggests the lawsuit may have associational standing remanding the lawsuit back to a lower Circuit Court as did the Supreme Court 9 - 0 for further proceedings.
Even after almost 250 years of jurisprudence in America, basic constitutional structural arguments are still being adjudicated. This case still has potential legal ground on associational standing.
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