Page:Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration (5th Cir. Apr. 12, 2023).pdf/17

 emergency room “with heavy vaginal bleeding and unstable vital signs as a result of taking chemical abortion drugs.” PI App. 195. When the woman arrived in the emergency room, the baby in her womb was not dead; the doctors were “able to detect a fetal heartbeat.” PI App. 195. But due to the mother’s unstable condition, the doctors “had no choice but to perform an emergency D&C.” PI App. 196. The doctor testified that her colleague “felt as though she was forced to participate in something that she did not want to be a part of—completing the abortion.” PI App. 196.

And not only have these doctors suffered injuries in the past, but it’s also inevitable that at least one doctor in one of these associations will face a harm in the future. Cf. City of Los Angeles v. Lyons, 461 U.S. 95 (1983). Here, the plaintiff-doctors have “‘set forth’ by affidavit or other evidence ‘specific facts’” that they are certain to see more patients. Clapper, 568 U.S. at 411 (quoting Lujan v. Defs. of Wildlife, 504 U.S. 555, 561 (1992)). That’s because FDA has removed almost all of mifepristone’s REMS and thus enabled women to (1) get the drug without ever talking to a physician, (2) take the drug without ever having a physical exam to ensure gestational age and/or an ectopic pregnancy, and (3) attempt to complete the chemical abortion regimen at home; FDA has also (4) directed the hundreds of thousands of women who have complications to seek “emergency care” from the plaintiffs and plaintiffs’ hospitals. Several doctors testified that they have seen an increasing number of women coming to the emergency room with complications from chemical abortions due to FDA’s virtual elimination of controls on the dispensing and administration of the drugs. PI App. 194, 205, 215, 866. And given how many women these doctors have seen in emergency departments in the past, these doctors quite reasonably know with statistical certainty—again, a statistic estimated on Mifeprex’s own “Patient Agreement Form”—that women will continue needing plaintiffs’ “emergency care.” See PI App. 205, 215, 868. The crisis is “concededly