Page:Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration (5th Cir. Aug. 16, 2023).pdf/29

 We next address the Doctors’ argument that they will suffer an independent injury by way of the “enormous stress and pressure” that is involved with treating women suffering complications from taking mifepristone. Dr. Wozniak Declaration ¶ 17. They maintain that FDA’s actions cause women to present at the emergency room with complications that involve a unique level of trauma and distress, due to the high amount of emotional and physical strain often associated with the experience. Dr. Delgado Declaration ¶ 14; Dickerson Declaration ¶ 14; Dr. Skop Declaration ¶ 33.

It is true that the Supreme Court has interpreted Article III to recognize injuries that “significantly affect[]” a plaintiff’s “quality of life.” Sierra Club v. Morton, 405 U.S. 727, 734–35 (1972). And several of our sister circuits acknowledge standing that is predicated on “emotional or psychological harm.” ''Maddox v. Bank of N.Y. Mellon Tr. Co., 19 F.4th 58, 65 (2d Cir. 2021) (quoting TransUnion, 141 S. Ct. at 2211 n.7); see also Clemens v. ExecuPharm Inc.'', 48 F.4th 146, 155 (3d Cir. 2022) (same). However, the mental and emotional stress shown here is best understood as additional to the Doctors’ conscience injuries, not independent from them. The threat of being forced to violate a sincerely held moral belief is cognizable at least in part because the event would involve acute emotional and psychological harm. Maddox, 19 F.4th at 65; Clemens, 48 F.4th at 155. The emotional and mental strain of which the Doctors testify is of the same nature, albeit of an arguably lesser magnitude. In this way, the “enormous stress and pressure” that the Medical Organizations and Doctors cite augment the Doctors’ conscience injuries, but does not provide a separate basis for Article III standing.

Danco argues that the Medical Organizations and Doctors’ standing