Thomas More Society's Amici Curae to Support Defunding Planned Parenthood in Indiana

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    IN THE

    UNITED STATES DISTRICT COURT

    SOUTHERN DISTRICT OF INDIANA

    INDIANAPOLIS, INDIANA

    PLANNED PARENTHOOD OF INDIANA, )

    INC., et al. )

    ) Case No. 1:11-CV-0630 TWP-DKL

    Plaintiffs, )

    ) Hon. Tanya Walton Pratt

    vs. ) United States District Court

    ) Judge Presiding

    COMMISSIONER OF THE INDIANA )

    STATE DEPARTMENT OF HEALTH, et al., )

    )

    Defendants. )

    MEMORANDUM OF LAW ON BEHALF OF MEMBERS OF THE

    INDIANA GENERAL ASSEMBLY, ASAMICI CURIAE, IN OPPOSITION TO

    PLAINTIFFS MOTION FOR A PRELIMINARY INJUNCTION

    Introduction

    Plaintiffs, Planned Parenthood of Indiana, Inc., Dr. Michael King, M.D., Carla

    Cleary, C.N.M., Letitia Clemons, and Dejiona Jackson, by her guardian and next friend

    Jackie Grubbs, seek a preliminary injunction against enforcement of certain provisions of

    House Enrolled Act 1210. Specifically, plaintiffs ask this Court to enjoin the provisions

    of the law that defund entities that perform abortions or maintain or operate facilities

    where abortions are performed, Indiana Code 5-22-17-5.5, and that require a pregnant

    woman seeking an abortion to be informed that human physical life begins when a

    human ovum is fertilized by a human sperm, Indiana Code 16-34-2-1.1(a)(1)(E), and

    that objective scientific information shows that a fetus can feel pain at or before (20)

    weeks of postfertilization age. Indiana Code 16-34-2-1.1(a)(1)(G).

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    The Preliminary Injunction Standard

    In order to be entitled to a preliminary injunction under controlling Seventh Circuit

    precedent, plaintiffs have the burden of establishing the following five factors:

    (1) that they have no adequate remedy at law;

    (2) that they will suffer irreparable harm if the preliminary injunction

    is not issued pending the resolution of the substantive action;

    (3) that the irreparable harm they will suffer if the preliminary

    injunction is not granted outweighs the irreparable harm the defendants will

    suffer if the injunction is granted;

    (4) that they have a reasonable likelihood of prevailing on the merits

    at trial; and

    (5) that the injunction will not hurt the public interest.

    Manbourne,Inc. v. Conrad, 796 F.2d 884, 887 (7th Cir. 1986).

    In this memorandum, amici curiae, members of the Indiana General Assembly (the

    names of the amici are attached to this memorandum) address the fourth requirement for

    issuance of a preliminary injunction, i.e., whether there is a reasonable likelihood of

    plaintiffs prevailing on the merits at trial with respect to their challenge to Indiana Code

    5-22-17-5.5 and 16-34-2-1.1(a)(1)(E). With respect to plaintiffs challenge to 16-34-

    2-1.1(a)(1)(G) and all other matters not discussed herein (e.g., whether plaintiffs have

    established the other factors necessary to warrant preliminary injunctive relief and

    whether the funding restrictions conflict with or are preempted by federal law), amici

    generally adopt defendants memorandum of law.

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    I.

    FORBIDDING ENTITIES THAT PERFORM ABORTIONS OR MAINTAIN OR

    OPERATE ANY FACILITY WHERE ABORTIONS ARE PERFORMED FROM

    QUALIFYING FOR THE RECEIPT OF STATE FUNDS OR FEDERAL FUNDS

    ADMINISTERED BY THE STATE OF INDIANA DOES NOT IMPOSE AN

    UNCONSTITUTIONAL CONDITION ON THE ASSERTED RIGHT

    OF PHYSICIANS TO PERFORM ABORTIONS.

    (Response to Plaintiffs Memorandum of Law, Part One: Count One:

    Defunding Provisions, Part IV, pp. 22-26)

    Indiana House Enrolled Act 1210 adds a new section to the Indiana Code, 5-22-

    17-5.5, which provides as follows:

    (a) This section does not apply to hospitals licensed under IC 16-21-

    2 or ambulatory surgical centers licensed under IC 16-21-2.

    (b) An agency of the state may not:

    (1) enter into a contract with; or

    (2) make a grant to:

    any entity that performs abortions or maintains or operates a facility

    where abortions are performed that involves the expenditure of state funds

    or federal funds administered by the state.

    (c) Any appropriation by the state:

    (1) in a budget bill;

    (2) under IC 5-19-13.5; or

    (3) in any other law of the state,

    to pay for a contract with or grant made to any entity that performs

    abortions or maintains or operates a facility where abortions are performed

    is canceled, and the money appropriated is not available for payment of any

    contract with or grant made to the entity that performs abortions or

    maintains or operates a facility where abortions are performed.

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    988 (7th Cir. 1984). [I]f the government could deny a benefit to a person because of his

    constitutionally protected speech or associations, his exercise of those freedoms would in

    effect be penalized and inhibited. This would allow the government to produce a result

    which [it] could not command directly. Perry, 408 U.S. at 597 (citation and internal

    quotation marks omitted). [F]unding classifications that interfere with the exercise of

    constitutional rights must be necessary to promote a compellinggovernmental purpose.

    Dempsey, 167 F.3d at 461 (quoting Thompson, 394 U.S. at 634) (emphasis inDempsey).

    Plaintiffs unconstitutional condition argument necessarily presupposes that

    physicians (and other health care professionals) have a constitutional right to perform

    abortions. But as plaintiffs themselves admit (Memorandum at 23), the Supreme Court1

    has never expressly held that abortion providers have such a right. See Singleton v. Wulff,

    428 U.S. 106, 113 (1976) (plurality) (declining to decide whether a physician has a

    constitutional right[] to practice medicine). [T]he practice of medicine, including the2

    performance of abortions, is subject to reasonable licensing and regulation by the State.

    That distinguishes this case from the unconstitutional condition argument raised in1

    Rust v. Sullivan, 500 U.S. 173, 192-200 (1991), which was based on the First Amendment free

    speech rights of Title X grantees, and a similar argument advanced inPlanned Parenthood of

    Central & Northern Arizona v. Arizona, 718 F.2d 938, 942-46 (9th Cir. 1983), both cited by

    plaintiffs (Memorandum at 25-26 & n. 12). Section 5-22-17-5.5 does not implicate the free

    speech rights of abortion providers and plaintiffs do not contend otherwise.

    The plurality in Singleton concluded that it generally is appropriate to allow a physician2

    to assert the rights of women patients as against governmental interference with the abortion

    decision . . . . 428 U.S. at 118. Conferring third-party standing on physicians to represent the

    constitutional rights of their patients, however, is analytically distinct from whether the

    physicians themselves have a constitutional right to perform abortions.

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    Planned Parenthood v. Casey, 505 U.S. 833, 884 (1992) (plurality).

    Even assuming, however, that physicians (or other health care professionals) have

    a constitutional right to perform abortions, that right is not independent of the pregnant

    womans rights, but is derived from and dependent upon her right to obtain an abortion.

    See Casey, 505 U.S. at 884 ([w]hatever constitutional status the doctor-patient relation

    may have as a general matter, in the present context it is derivative of the womans

    position). See also Harris v. McRae, 448 U.S. 297, 318 n. 21 (1980) (the constitutional

    entitlement of a physician who administers medical care to an indigent woman is no

    broader than that of his patient);Dempsey, 167 F.3d at 464 ([a]ny constitutional right of

    clinics to provide abortion services . . . is derived directly from womens constitutional

    right to choose abortion) (citing Casey). Plaintiffs, however, have neither alleged nor

    proved that 5-22-17-5.5 burdens or otherwise interferes with the constitutional right of

    pregnant women to obtain abortions. Because prohibiting recipients of state funds or

    federal funds administered by the State from performing abortions would have at most

    an extremely attenuated effect upon the availability of abortion services,Dempsey, 167

    F.3d at 465, the asserted right of abortion providers toperform abortions, which is

    derivative of the womans right to obtain an abortion, is not violated either.

    None of the authorities cited by plaintiffs supports their unconstitutional

    condition argument. The difference between restrictions placed upon abortionproviders

    and those placed upon abortion patients distinguishes the statute at issue here from the

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    hypothetical one discussed in Harris v. McRae, 448 U.S. at 317 n. 19 ([a] substantial

    constitutional question would arise if Congress had attempted to withhold all Medicaid

    benefits from an otherwise eligible candidate simply because the candidate exercised her

    constitutionally protected freedom to terminate her pregnancy by abortion). In Planned3

    Parenthood of Central & Northern Arizona v. Arizona , the Ninth Circuit assumed that

    Planned Parenthood had a constitutional right to engage in abortion, 718 F.2d at 944,

    without engaging in any analysis of the issue and without recognizing that any such right,

    if it exists, is derivative of the pregnant womans right to obtain an abortion. InDempsey,

    the Eighth Circuit held that to interpret state law to prohibit abortion providers from

    receiving state family planning funds without allowing them to establish affiliates that

    would be eligible for such funds would cross the line established inRust v. Sullivan ,

    F.C.C. v. League of Women Voters, 468 U.S. 364, 400 (1984), and Regan v. Taxation

    With Representation, 461 U.S. 540 (1983). 167 F.3d at 463. All three cases, however,4

    involved constitutionally protected free speech, including abortion advocacy (Rust),

    It is also distinct from the hypothetical raised in Webster v. Reproductive Health3

    Services, 492 U.S. 490 (1989). In rejecting a challenge to a state law that prohibited abortions

    from being performed in publicly owned and operated facilities, the Court expressed the view

    that [t]his case might . . . be different if the State barred doctors who performed abortions in

    private facilities from the use of public facilities for any purpose. Id. at 510 n. 8. Section 5-22-

    17-5.5, of course, does no such thing. Moreover, nothing in 5-22-17-5.5 disqualifies from state

    and federal programs any entity that employs or contracts with a physician who, outside the

    scope of his employment or contract, performs abortions, so long as the entity itselfdoes not

    perform abortions or maintain or operate a facility where abortions are performed.

    Amici, it should be emphasized, do notargue that 5-22-17-5.5 does not permit the4

    creation of affiliates that would qualify for state and federal funds administered by the State of

    Indiana, but only that such affiliation is not necessary in order to uphold the statute.

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    editorializing (League of Women Voters) and lobbying (Regan), which 5-22-17-5.5 does

    not restrict. To the extent thatDempsey suggests that abortion providers have a constitutional

    right to perform abortions, it cited no authority in support of that proposition.

    Finally, plaintiffs cite the federal district courts decision inPlanned Parenthood

    of Central Texas v. Sanchez, 280 F. Supp.2d 590, 608 (W.D. Tex. 2003), which held,

    inter alia, that abortion providers have some constitutionally-protected right, derived

    from their patients rights, to perform the services that are necessary to enable women to

    exercise their own constitutional rights. Because the appropriation rider at issue in

    Sanchezwithholds funding from the Plaintiffs because they engage in a constitutionally

    protected activity, it creates an unconstitutional condition. Id. On appeal, however, the

    district courts judgment was remanded with directions. Planned Parenthood of Houston

    and Southeast Texas v. Sanchez, 403 F.3d 324 (5th Cir. 2005). The court of appeals

    determined that the appropriation rider did not foreclose the creation of affiliates which,

    depending upon how they were structured, could largely obviate the preemption issue that

    had been raised and decided adversely to the State in the lower court. Id. at 335-43. 5

    Planned Parenthood of Houston and Southeast Texas v. Sanchez, 403 F.3d 324 (5th Cir.

    2005). Although the Fifth Circuit did not expressly address the merits of the district

    courts unconstitutional condition analysis in remanding the case for further

    The Fifth Circuits opinionholding that the availability of an affiliation option was5

    critical to any decision upholding the rider against a preemption challengewas limited to Title

    X, 403 F.3d at 338 n. 68, which, as plaintiffs concede (Memorandum at 7), is not at issue here.

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    proceedings (in which all issues on the merits were resolved), in a later appeal from the

    denial of attorney fees the court of appeals noted that [b]y remanding the entire case to

    the district court with instructions to dissolve the injunction, . . . we implicitly rejected

    that claim as well. Planned Parenthood of Houston and Southeast Texas v. Sanchez,

    480 F.3d 734, 742 (5th Cir. 2007). In view of this clarification, plaintiffs reliance on the

    district courts judgment and reasoning in Sanchez(Memorandum at 26) is misplaced.

    The Fifth Circuits opinion in Sanchezsupports the constitutionality of 5-22-17-5.5.

    In sum, plaintiffs have failed to demonstrate that abortion providers have a

    constitutional right to perform abortions, much less that such a right is independent of the

    constitutional rights of pregnant women to obtain abortions. Assuming that there is a

    right toperform abortions, it necessarily derives from the rights of women to obtain

    abortions. Accordingly, if requiring abortion providers to choose between performing

    abortions or receiving the non-abortion related funding, Complaint at 11, 53, would

    have no effect on the availability of abortion services (and plaintiffs do not contend

    otherwise), then it cannot be said that 5-22-17-5.5 imposes an unconstitutional

    condition on abortion providers, whose rights, to the extent they exist, are subordinate to

    those of their patients. Because plaintiffs have not shown that they have a reasonable

    likelihood of success at trial with respect to their unconstitutional condition argument,

    their motion for a preliminary injunction enjoining enforcement of 5-22-17-5.5 should

    be denied.

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    II.

    REQUIRING A PHYSICIAN OR OTHER HEALTH CARE PROFESSIONAL

    TO INFORM A PREGNANT WOMAN SEEKING AN ABORTION THAT

    HUMAN PHYSICAL LIFE BEGINS WITH FERTILIZATION DOES NOT

    VIOLATE THE FIRST AMENDMENT FREE SPEECH RIGHTS OF

    PHYSICIANS OR OTHER HEATH CARE PROFESSIONALS.

    (Response to Plaintiffs Memorandum of Law, Part Two: Count Two:

    Compelled Speech Provisions, Part III, pp. 30-33)

    Under Indianas informed consent statute, as amended by House Enrolled Act

    1210, consent to an abortion is voluntary and informed only if, at least eighteen hours

    before the abortion is performed and in the presence of the pregnant woman, the attending

    physician, the referring physician or other authorized and qualified person (physician

    assistant, advanced practice nurse or midwife) has informed the pregnant woman orally

    and in writing, inter alia, that human physical life begins when a human ovum is

    fertilized by a human sperm. IND.CODE 16-34-2-1.1(a)(1)(E). Plaintiffs complain that

    this requirement violates the First Amendment free speech rights of physicians and other

    health care professionals because it compels them to express an ideological view with

    which they do not agree. Complaint at 13-15. 66-73, 76; Memorandum at 30-33; King

    Decl. 12-13; Cleary Decl. 9. Amici respond that 16-34-2-1.1(a)(1)(E) merely

    requires physicians or other authorized and qualified health care professionals to provide

    their pregnant women patients with scientifically and medically accurate information that

    could be relevant to their decision whether to have an abortion. Such a requirement does

    not violate the free speech rights of physicians and other health care professionals.

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    In Planned Parenthood v. Casey, 505 U.S. 833 (1992), the Supreme Court held

    that a requirement that a doctor give a woman certain information as part of obtaining

    her consent to an abortion implicates a physicians First Amendment right not to speak,

    id. at 884, citing Wooley v. Maynard, 430 U.S. 705 (1977), but only as part of the

    practice of medicine, subject to reasonable licensing and regulation by the State. Casey,

    505 U.S. at 884. The Court found no violation of the physicians right not to speak where

    physicians merely were required to give truthful, nonmisleading information relevant to

    the pregnant womans decision to have an abortion.Id. at 882.

    The Supreme Court has determined that relevant information (in the abortion

    context) is notlimited to the medical risks of the procedure, but includes information

    regarding the nature of the procedure, the probable gestational age of the fetus, a

    description of the fetus and the consequences to the fetus, Casey, 505 U.S. at 881-82,6

    as well as information concerning the way in which the fetus will be killed, Gonzales

    v. Carhart, 550 U.S. 124, 159 (2007), all of which may legitimately and constitutionally

    influence the womans decision whether or not to undergo an abortion. Casey, 505 U.S.

    at 882-83; Gonzales, 550 U.S. at 159-60. Apropos of the issue before this Court, the

    The materials that had to be made available to the pregnant woman in Casey included a6

    description of the probable anatomical and physiological characteristics of the unborn child at

    two-week gestational increments, and any relevant information on the possibility of the unbornchilds survival, and a description of the methods of abortion procedures commonly employed,

    the medical risks commonly associated with each such procedure, the possible detrimental

    psychological effects of abortion and the medical risks commonly associated with each such

    procedure and the medical risks commonly associated with carrying a child to term. 505 U.S. at

    908-09 (Appendix to Joint Opinion).

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    Eighth Circuit has explained, Casey and Gonzales establish that, while the State cannot

    compel an individual to speak the States ideological message, it can use its regulatory

    authority to require a physician to provide truthful, non-misleading information relevant

    to a patients decision to have an abortion, even if that information might also encourage

    the patient to choose childbirth over abortion. Planned Parenthood Minnesota,North

    Dakota, South Dakota v. Rounds, 530 F.3d 724, 734-35 (8th Cir. 2008) (en banc). That is

    precisely what 16-34-2-1.1(a)(1)(E) requires.

    The three words used in 16-34-2-1.1(a)(1)(E) are human, physical and

    life. Human, according to a standard medical dictionary, means a member of the

    genusHomo and particularly of the speciesH[omo]sapiens. MOSBYS DICTIONARY OF

    MEDICINE,NURSING &HEALTH PROFESSIONS 903 (7th ed. 2006). Physical, another

    medical dictionary explains, means [r]elating to the body, as distinguished from the

    mind. STEDMANS MEDICAL DICTIONARY FOR THE HEALTH PROFESSIONS & NURSING

    1207 (Illustrated Sixth Edition 2008). See also DORLANDS ILLUSTRATED MEDICAL

    DICTIONARY 1464 (31st ed. 2007) (pertaining to the body). Finally, life is defined as

    the quality or condition proper to living beings: the state of existence characterized by

    such functions as metabolism, growth, reproduction, adaptation and response to stimuli.

    STEDMANS MEDICAL DICTIONARY at 894. Thus, when 16-34-2-1.1(a)(1)(E) requires a

    pregnant woman to be informed that human physical life begins when a human ovum is

    fertilized by a human sperm she is simply being informed that, in physical (i.e.,

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    biological) terms, human life begins with fertilization. Contrary to plaintiffs strained and

    artificial reading, Memorandum at 32, nothing in 16-34-2-1.1(a)(1)(E) sets forth an

    unverifiable moral, religious [or] philosophical viewpoint as to when human life

    begins. As the leading English language dictionary used by the Supreme Court states,

    physical means of or relating to the body, of or relating to natural or material things

    as opposed to things mental, moral,spiritual, or imaginary. WEBSTERS THIRDNEW

    INTERNATIONAL DICTIONARY 1706 (2002) (emphasis added).

    Section 16-34-2-1.1(a)(1)(E) states that the physical life of every human begins

    with fertilization, an unexceptionable and incontrovertible statement of fact. That human

    life, in physical (i.e., biological) terms, begins with the fertilization of a human ovum by a

    human sperm is supported by a wealth of scientific and medical evidence, including many

    standard embryology and physiology texts. See, e.g., Keith L. Moore and T.V.N.

    Persaud, THE DEVELOPING HUMAN,CLINICALLY ORIENTED EMBRYOLOGY, 2 (8th ed.

    2008) ([h]uman development is a continuous process that begins when an oocyte (ovum)

    from a female is fertilized by a sperm (spermatazoon) from a male), id. at 15 ([h]uman

    development begins at fertilization when a male gamete or sperm unites with a female

    gamete or oocyte to form a single cell, a zygote. This highly specialized, totipotent cell

    marks the beginning of each of us as a unique individual) (emphasis and bold in

    original); Gary A. Thibodeau and Kevin T. Patton, ANTHONYS TEXTBOOK OF ANATOMY

    AND PHYSIOLOGY 1168 (18th ed. 2007) ([t]he fertilized ovum . . . is genetically

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    complete; it represents the first cell of a genetically new individual); M.J.T. Fitzgerald

    and M. Fitzgerald, HUMAN EMBRYOLOGY 1 (1994) ([t]he prenatal period of life

    commences at the moment of fertilization, and terminates at birth); Ronan ORahilly and

    Fabiola Muller, HUMAN EMBRYOLOGY &TERATOLOGY 8 (3d ed. 1996) ([a]lthough life

    is a continuous process, fertilization . . . is a critical landmark because, under ordinary

    circumstances, a new, genetically distinct human organism is formed when the

    chromosomes of the male and female pronuclei blend in the oocyte); Frank J. Dye,

    HUMAN LIFE BEFORE BIRTH 53 (2000) ([t]wo cells on the verge of death are the

    participants in fertilization, one of the most thought-provoking events in biology. If these

    two cells undergo fertilization, a new individual may result) (bold in original); Wm.

    Larsen,HUMAN EMBRYOLOGY 1 (3d ed. 2001) (we begin our description of the

    developing human with the formation and differentiation of the male and female sex cells

    orgametes, which will unite at fertilization to initiate the embryonic development of a

    new individual) (bold in original); Richard E. Jones and Kristin H. Lopez, HUMAN

    REPRODUCTIVE BIOLOGY 23 (3d ed. 2006) ([t]he process offertilization, orconception,

    involves fusion of the nucleus of a male gamete (sperm) and a female gamete (ovum) to

    form a new individual) (emphasis in original); Bruce M. Carlson, HUMAN EMBRYOLOGY

    &DEVELOPMENTAL BIOLOGY 3, 24, 32-40 (3d ed. 2004) (same). Given the scientific and

    medical consensus that the physical life of every human begins with fertilization, it is not

    surprising that neither of the plaintiffs experts on this issue cites a single scientific or

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    medical source to the contrary in his declaration. See Orentlicher Decl., 14-24; Silver

    Decl. 11-25.

    Both legislatures and courts have recognized the scientific and medical reality that

    human physical (i.e., biological) life begins with fertilization. After reviewing many

    authorities and hearing testimony from world-renowned geneticists, biologists and

    physicians, the Subcommittee on Separation of Powers of the Senate Judiciary Committee

    stated: [C]ontemporary scientific evidence points to a clear conclusion: the life of a

    human being begins at conception, the time when the process of fertilization is complete.

    Report of the Subcommittee on Separation of Powers, Senate Judiciary Committee, on S.

    158, the Human Life Bill, 97th Congress, 1st Sess, at 7 (1991). Physicians, biologists,

    and other scientists agree that conception marks the beginning of the life of a human

    beingof a being that is alive and a member of the human species. Id. More recently, a

    special task force created by the South Dakota Legislature found that the new

    recombinant DNA technologies indisputably prove that the unborn child is a whole

    human being from the moment of fertilization . . . . Report of the South Dakota Task

    Force to Study Abortion 31 (December 2005).

    Only three years ago, the Eighth Circuit Court of Appeals considered the

    constitutionality of a South Dakota informed consent statute that requires a physician to

    advise a woman seeking an abortion that the procedure will terminate the life of a whole,

    separate, unique, living human being. S.D.CODIFIED LAWS 34-23A-10.1(1)(b) (Supp.

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    2010). Human being, in turn, is defined as an individual living member of the species

    of Homo sapiens, including the unborn human being during the entire embryonic and

    fetal ages from fertilization to full gestation. Id. 34-23A-1(4). The court of appeals

    held that, taking into account the definition of human being set forth in 34-23A-1(4),

    the disclosure required by 34-23A-10.1(1)(b) is neither untruthful [n]or misleading. .

    Rounds, 530 F.3d at 737. Rather, the statute merely requires the physician to disclose

    truthful and non-misleading information as part of obtaining informed consent to a

    procedure. Id. And that is all 16-34-2-1.1(a)(1)(E) requires.7

    Many courts have recognized that, in physical (i.e., biological) terms, human life begins7

    with conception (understood as fertilization). See, e.g., Bonbrest v. Kotz, 65 F.Supp 138, 140

    (D. D.C. 1946) ([f]rom the viewpoint of the civil law and the law of property, a child en ventre

    sa mere is not only regarded as human being, but as such from the moment of conception which

    it is in fact); Corkey v. Edwards, 322 F.Supp. 1248, 1252 (W.D.N.C. 1971) ([b]iologically, a

    living organism belonging to the species homo sapiens is created out of this organization

    [referring to fertilization]), vacated and remanded for further consideration in light of Roe v.

    Wade, 410 U.S. 950 (1973); Steinberg v. Brown, 321 F.Supp. 741, 746 (N.D. 1970) (a new life

    comes into being with the union of human egg and sperm cells); Wolfe v. Isbell, 280 So.2d 758,761 (Ala. 1973) (from the moment of conception, the fetus or embryo is not a part of the

    mother, but rather has a separate existence within the body of the mother); Scott v. McPheeters,

    92 P.2d 678, 681 (Cal. App. 1939) (it is an established and recognized fact by science and by

    everyone of understanding that an unborn child is a human being separate and distinct from its

    mother); Smith v. Brennan, 157 A.2d 497, 502 (N.J. 1960) ([m]edical authorities have long

    recognized that a child is in existence from the moment of conception, and not merely a part of

    its mothers body); State v. Ausplund, 167 P. 1019, 1022-23 (Or. 1917) ([w]hen a virile

    spermatozoon unites with a fertile ovum in the uterus, conception is accomplished [and] a new

    life has begun);Amadio v. Levin, 501 A.2d 1085, 1087 (Pa. 1985) (a child en ventre sa mere is

    a separate individual from the moment of conception); Sylvia v. Gobeille, 220 A.2d 222, 223-24

    (R.I. 1966) (noting the medical fact that a fetus becomes a living human being from the momentof conception);Leal v. C.C. Pitts Sand & Gravel,Inc. 413 S.W.2d 825, 828 (Tex. Civ. App.

    1967) (Cadena, J., dissenting) (medical science . . . consider[s] that life begins at conception),

    revd, 419 S.W.2d 820, 822 (Tex. 1967) (citing with approval Justice Cadenas dissent). See

    also Wm. L. Prosser, HANDBOOK OF THE LAW OF TORTS 31, 189 (1941) (medical authority

    has recognized long since that the child is in existence from the moment of conception).

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    None of the authorities cited by plaintiffs (Memorandum at 30-31) precludes the

    State from requiring a pregnant woman seeking an abortion to be informed that human

    physical life begins with fertilization. InRoe v. Wade, 410 U.S. 113, 159 (1973), the

    Court declined to resolve the difficult question of when life begins, in the absence of a

    consensus of opinion in the disciplines of medicine, philosophy, and theology . . . .

    The absence of an interdisciplinary consensus, however, has little or no bearing on the

    scientific and medical consensus, set forth above, that the physical (i.e., the biological)

    life of every human begins with fertilization.8

    In City of Akron v. Akron Center for Reproductive Health, Inc., 462 U.S. 416

    (1983), overruled in part on other grounds,Planned Parenthood v. Casey, 505 U.S. 833,

    881-87 (1992), the Supreme Court struck down a provision in a municipal ordinance

    requiring physicians to inform a pregnant woman seeking an abortion that the unborn

    child is a human being from the moment of conception. AKRON CODIFIED ORDINANCES,

    ch. 1870, 1870.06(B)(3). That requirement, the Court explained, is inconsistent with

    [our] holding inRoe v. Wade that a State may not adopt one theory of when life begins to

    justify its regulation of abortions. 462 U.S. at 444. The Courts decision in City of

    Akron is not controlling for two reasons: First, unlike the ordinance struck down in City

    of Akron, 16-34-2-1.1(a)(1)(E) refers tophysical(i.e., biological) life, not whether the

    Neither of the two medical sources cited inRoe, 410 U.S. at 160 nn. 59-60, addressed8

    when human life, in biological terms, begins. See DORLANDS ILLUSTRATED MEDICAL

    DICTIONARY 1689 (24th ed. 1965) (defining viable and viability); L. Hellman & J. Pritchard,

    WILLIAMS OBSTETRICS 493 (14th ed. 1971) (same).

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    unborn human child is a human being in some undefined philosophical or moral sense.

    Second, the scope of the dictum in City of Akron was narrowed considerably in Webster v.

    Reproductive Health Services, 492 U.S. 490 (1989).

    In Webster, the Court considered the constitutionality of language in the preamble

    to a Missouri abortion law in which the legislature found, inter alia, that [t]he life of

    each human being beings at conception. MO.REV.STAT. 1.205.1(1) (1986). In

    invalidating the preamble, the court of appeals relied upon the language quoted above

    from City of Akron. Reproductive Health Services v. Webster, 851 F.2d 1071, 1075-76

    (8th Cir. 1988). The Supreme Court reversed.

    The Court explained that the court of appeals had misconceived the meaning of

    the Akron dictum, which was only that a State could not justify an abortion regulation

    otherwise invalid underRoe v. Wade on the ground that it embodied the States view

    about when life begins. Webster, 492 U.S. at 506. In light ofWebster, it is apparent that

    the dictum in City of Akron means only that an otherwise unconstitutional abortion

    regulation, e.g,, a prohibition of abortion, cannot be justified by adoption of a theory as to

    when human life begins. City of Akronplaces no limitation on a States ability to declare

    (or to require a physician or other health professional to inform a pregnant woman

    seeking an abortion) that the physical life of every human begins with fertilization.

    Plaintiffs next citePlanned Parenthood v. Casey. In Casey, the Supreme Court

    repeatedly refers, when speaking of an embryo or fetus, to the States interest in potential

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    life, scrupulously avoiding describing it as an existing human life. Plaintiffs

    Memorandum at 30 (citing Casey, 505 U.S. at 875-76). Plaintiffs, however, overlook

    more than a dozen references in the Joint Opinion to the life of the fetus, prenatal

    life, the States interest in fetal life, the life of the unborn, the States interest in

    [fetal] life, life, fetal life and the life of the child, where the word life, in

    referring to the unborn child, is notqualified with or limited by the adjective potential.

    Casey, 505 U.S. at 846, 853, 860, 869, 870, 872, 873, 877, 881, 883, 885, 898. Similarly,

    in Gonzales v. Carhart, also cited by plaintiffs (Memorandum at 30), the Supreme Court

    frequently referred to fetal life, the life of the fetus that may become a child, the life

    of the unborn, the life within the woman, infant life and life without using the

    word potential. Carhart, 550 U.S. at 134, 145, 146, 157, 158, 159, 160, 163.

    In Casey, the Supreme Court did not use the word human to describe the life of

    the unborn child. In Carhart, however, the Court stated that the federal Partial-Birth9

    Abortion Ban Act expresses respect for the dignity ofhuman life, 550 U.S. at 157

    (emphasis added), and that Casey itself confirms the States interest in promoting respect

    for human life at all stages in the pregnancy. Id. at 163 (emphasis added).10

    If it is not human life, what kind of life is it? As the New York Court of Appeals9

    observed almost forty years ago, It is human, if only because it may not be characterized as not

    human, and it is unquestionably alive. Byrn v. New York City Health & Hospitals Corp., 286

    N.E.2d 887, 888 (N.Y. 1972), appeal dismissed, 410 U.S. 949 (1973).

    On at least ten occasions in Carhart, the Court referred to acts during an abortion that10

    kill the fetus. 550 U.S. at 139, 140, 148, 151, 153, 154, 157, 159, 164. Except as a metaphor

    (and the Court was not speaking in metaphors), one cannot kill what is not alive.

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    In Acuna v. Turkish, 930 A.2d 416, 427 (N.J. 2007), the last case cited by plaintiffs

    (Memorandum at 30-31), the New Jersey Supreme Court expressly did notreach the

    constitutional arguments raised by defendants and amici who claim[ed] that it is both an

    undue burden on a womans right of self-determination and a violation of a physicians

    First Amendment free speech right to compel a physician to advise a pregnant woman that

    an embryo is an existing human being and that an abortion is tantamount to killing a

    child. The court did not resolve those arguments, explaining that we cannot find that

    New Jerseys common law imposes a legal duty on a physician to give the instructions

    sought by plaintiff. Id. (emphasis added). Nothing in the New Jersey Supreme Courts

    decision inAcuna v. Turkish addressed whether astatutory requirement that a pregnant

    woman be told, before undergoing an abortion, that human physical life begins with

    fertilization would be constitutional.

    Plaintiffs complain that, [c]oming from a physician, the statement that human

    physical life begins at conception, presented as fact, carries significant weight for a

    woman seeking an abortion, even if she did not previously share that belief.

    Memorandum at 32. But, for the reasons set forth above, the statement, properly

    understood, is scientifically and medically accurate. It is a statement offact, not belief.

    Moreover, nothing in 16-34-2-1.1(a)(1)(E) requires the physician (or other authorized

    and qualified health care professional) to state that he or she agrees with the statement or

    to present the statement as his or her own. Furthermore, whether, as plaintiffs suggest

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    (Memorandum at 32), [a] reasonable person seeking an abortion is likely to be aware of

    the moral significance the statement carries has no bearing on its constitutionality.11

    Finally, plaintiffs argue that the statement that human physical life begins when a

    human ovum is fertilized by a human sperm is not at all relevant to the womans decision

    to have an abortion. Memorandum at 33. But that argument cannot be squared with

    Caseys analysis of informed consent in the abortion context. [I]nformed choice need

    not be defined in such narrow terms that all considerations of the effect on the fetus are

    made irrelevant. 505 U.S. at 883. Indeed, most women considering an abortion would

    deem the impact on the fetus relevant, if not dispositive, to the decision. Id. at 882.

    Requiring the pregnant woman to be informed that human physical life begins with

    fertilization may help her to understand and appreciate the full consequences of her

    decision, including the consequences to the fetus.Id. Where, as here, the information

    the State requires to be made available to the woman is truthful and non-misleading, the

    requirement is constitutional. Id. Because plaintiffs have not shown that they have a

    reasonable likelihood of success with respect to their challenge to 16-34-2-1.1(a)(1)(E),

    their motion for a preliminary injunction enjoining enforcement of 16-34-2-1.1(a)(1)(E)

    should be denied.

    Although 16-34-2-1.1(a)(1)(E) presents a descriptive statement of fact, not a11

    normative statement of opinion, the Court has recognized that [e]ven in the earliest stages of

    pregnancy, the State may enact rules and regulations designed to encourage [the pregnant

    woman] to know that there are philosophic and social arguments of great weight that can be

    brought to bear in favor of continuing the pregnancy to full term . . . . Casey, 505 U.S. at 872.

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    List ofAmici Curiae

    Senate

    Sen. David Long 16 Districtth

    PresidentPro Tem

    Sen. Edward Ed Charbonneau 5 Districtth

    Sen. Brandt Hershman 7 Districtth

    Sen. Carlin Yoder 12 Districtth

    Sen. Dennis Kruse 14 Districtth

    Sen. James Jim Banks 17 Districtth

    Sen. Travis Holdman 19 Districtth

    Sen. James Jim Buck 21 Districtst

    Sen. Constance Connie Lawson 24 Districtth

    Sen. Doug Eckerty 26 Districtth

    Sen. Michael Mike Delph 29 Districtth

    Sen. Scott Schneider 30 Districtth

    Sen. James Jim Merritt, Jr. 31 Districtst

    Sen. Patricia Pat Miller 32 Districtnd

    Sen. Richard Michael Mike Young 35 Districtth

    Sen. Richard Bray 37 Districtth

    Sen. Greg Walker 41 Districtst

    Sen. Jean Leising 42 Districtnd

    Sen. Johnny Nugent 43 Districtrd

    Sen. Brent Steele 44 Districtth

    Sen. James Jim Smith, Jr. 45 Districtth

    Sen. James Jim Tomes 49 Districtth

    House of Representatives

    Rep. Brian Bosma 88 Districtth

    Speaker

    Rep. Donald Don Lehe 15 Districtth

    Rep. Douglas Doug Gutwein 16 Districtth

    Rep. Timothy Tim Wesco 21 Districtst

    Rep. Rebecca Kubacki 22 Districtnd

    Rep. William Bill Friend 23 Districtrd

    Rep. Richard Rich McClain 24 Districtth

    Rep. Jeffrey Jeff Thompson 28 Districtth

    Rep. Kevin Mahan 31 Districtst

    (list continued on next page)

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    House of Representatives

    (continued from previous page)

    Rep. Paul Eric Turner 32 Districtnd

    Rep. Billy Joe Bill Davis 33 Districtrd

    Rep. Heath VanNatter 38 Districtth

    Rep. Gregory Steurwald 40 Districtth

    Rep. James Jim Baird 44 Districtth

    Rep. Bruce Borders 45 Districtth

    Rep. Robert Bob Heaton 46 Districtth

    Rep. Timothy Tim Neese 48 Districtth

    Rep. Wesley Wes Culver 49 Districtth

    Rep. Daniel Dan Leonard 50 Districtth

    Rep. Richard Dick Dodge 51 Districtst

    Rep. David Yarde 52 Districtnd

    Rep. Robert Bob Cherry 53 Districtrd

    Rep. Thomas Tom Knollman 55 Districtth

    Rep. Charles Woody Burton 58 Districtth

    Rep. Milo Smith 59 Districtth

    Rep. Matthew Matt Ubelhor 62 Districtnd

    Rep. Mark Messmer 63 Districtrd

    Rep. Eric Koch 65 Districtth

    Rep. Randall Randy Frye 67th District

    Rep. Judson Jud McMillin 68 Districtth

    Rep. David Dave Cheatham 69 Districtth

    Rep. Rhonda Rhoads 70 Districtth

    Rep. Edward Ed Clere 72 Districtnd

    Rep. Steven Steve Davisson 73 Districtrd

    Rep. Susan Sue Ellspermann 74 Districtth

    Rep. Ronald Ron Bacon 75 Districtth

    Rep. Matthew Matt Lehmen 79 Districtth

    Rep. Cynthia Cindy Noe 87 Districtth

    Rep. Michael Mike Speedy 90 Districtth

    Rep. Robert Bob Behning 91 Districtst

    Rep. David Dave Frizzell 93 Districtrd