In RE STATE OF TEXAS ATTORNEY GENERAL OF TEXAS KEN PAXTON, IN HIS OFFICIAL CAPACITY AS ATTORNEY GENERAL OF TEXAS TEXAS MEDICAL BOARD AND STEPHEN BRINT CARLTON, IN HIS OFFICIAL CAPACITY AS EXECUTIVE DIRECTOR OF THE TEXAS MEDICAL BOARD v. the State of Texas, 682 S.W.3d 890

Kate Cox, ~20 weeks pregnant with a fetus diagnosed with trisomy 18; Dr. Damla Karsan believes an abortion may be medically necessary.
Dr. Karsan sued and sought a court pre-authorization to perform the abortion; her verified pleading asserted a "good faith belief" but did not allege that, in her "reasonable medical judgment," Cox had a life‑threatening condition as defined by the statute.
The trial court issued a temporary restraining order (TRO) declaring the abortion would fall within the statute's medical‑necessity exception and enjoined enforcement of various Texas abortion provisions against respondents.
The State sought mandamus relief from the Texas Supreme Court, arguing the trial court lacked authority to make the medical‑judgment determination and to enjoin enforcement by officials without enforcement power.
The Texas Supreme Court conditionally granted relief, directing the trial court to vacate the TRO, explaining that physicians — not judges — must apply the statute’s objective "reasonable medical judgment" standard; the Court did not bar physicians from acting in true emergencies.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether a court can preauthorize an abortion under the statute from pleadings alone	Court may preliminarily declare exception applies to prevent harm	Only a physician can exercise the statutorily required medical judgment; court should not decide medical merits	Trial court erred; judges may not substitute for physicians' reasonable medical judgment; TRO vacated
Whether a "good faith belief" pleading satisfies the statute's "reasonable medical judgment" requirement	Good‑faith belief suffices to invoke exception	Statute requires an objective standard: reasonable medical judgment by a reasonably prudent physician	Pleading failed to allege that objective standard; lower subjective standard is insufficient
Whether the trial court had authority to enjoin the Attorney General and restrain enforcement of the cited statutes	Plaintiffs sought relief against state enforcement to allow procedure	State: AG lacks authority to enforce some provisions; court cannot enjoin actions beyond its jurisdiction	Court noted TRO restrained enforcement powers the AG does not have and refrained from resolving full jurisdictional challenges but concluded relief was not warranted on pleadings
Whether mandamus relief is appropriate to vacate the TRO	TRO necessary to prevent alleged irreparable harm	Mandamus appropriate because TRO effectively decided merits and exceeded court's power	Texas Supreme Court conditionally granted mandamus directing vacatur of the TRO

In re Newton, 146 S.W.3d 648 (Tex. 2004) (mandamus appropriate where TRO effectively decides merits)
Tex. Dep’t of Parks & Wildlife v. Miranda, 133 S.W.3d 217 (Tex. 2004) (trial court must rule on plea to jurisdiction at earliest opportunity)
In re Abbott, 601 S.W.3d 802 (Tex. 2020) (limits on trial court authority when jurisdiction is lacking)
State v. Stephens, 663 S.W.3d 45 (Tex. Crim. App. 2021) (attorney general's enforcement authority limited in certain contexts)
Whole Woman’s Health v. Jackson, 642 S.W.3d 569 (Tex. 2022) (limitations on who may be enjoined regarding abortion enforcement)
Abbott v. Anti-Defamation League Austin, Sw., & Texoma Regions, 610 S.W.3d 911 (Tex. 2020) (standards for preliminary injunctive relief)
BP Am. Prod. Co. v. Laddex, Ltd., 513 S.W.3d 476 (Tex. 2017) (sequencing of jurisdictional and merits analysis for injunctive relief)