State 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. Amanda Zurawski Lauren Miller Lauren Hall Anna Zargarian Ashley Brandt Kylie Beaton Jessica Bernardo Samantha Casiano Austin Dennard, D.O. Taylor Edwards Kiersten Hogan Lauren Van Vleet Elizabeth Weller Damla Karsan, M.D., on Behalf of Herself and Her Patients And Judy Levison, M.D., M.P.H., on Behalf of Herself and Her Patients, 690 S.W.3d 644

After Dobbs, Texas law generally prohibits abortion but allows exceptions for life-saving abortions when a physician, using "reasonable medical judgment," determines a pregnant woman faces a life-threatening condition, placing her at risk of death or serious physical impairment.
Plaintiffs (women denied or delayed legal abortions and their physicians) sued the State, arguing Texas’s abortion laws are unclear and violate the Texas Constitution by chilling physician decisions in medical emergencies.
The trial court temporarily enjoined enforcement of certain Texas abortion statutes, expanding circumstances where abortion must be allowed, adopting a "good faith" standard for physicians.
The State defendants appealed directly to the Texas Supreme Court, arguing the injunction was improper, plaintiffs lacked standing, and the laws’ constitutionality was not appropriately challenged.
The case specifically focused on the Human Life Protection Act, its exceptions for life-saving abortions, and whether the trial court’s injunction was consistent with statutory and constitutional standards.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Standing	Plaintiffs face threat of enforcement, chilling doctors' conduct.	No specific threat/enforcement; named officials lack authority over criminal law.	Dr. Karsan has standing as to AG's civil enforcement threat.
Sovereign Immunity	Declaratory Judgments Act waives immunity for constitutional challenge.	No waiver for interpretive suits or hypothetical claims.	Act waives immunity for constitutional validity challenges.
Statutory Construction: "Life-Saving"	Texas law is unclear/confusing; should allow abortion for unsafe pregnancies and severe fetal anomalies under "good faith."	Law is clear; "reasonable medical judgment" and objective criteria govern; broader judicial rewrite improper.	Law allows abortion for life-threatening physical conditions, based on reasonable medical judgment.
Constitutional Claims (Due Course & Equal Protection)	Law violates Texas Due Course and Equal Protection clauses by endangering women's health and discriminating based on sex.	Constitution does not guarantee abortion rights beyond statute; state interest in unborn life; statute is rational.	Statute does not violate Due Course or Equal Protection clauses.

In re State, 682 S.W.3d 890 (Tex. 2023) (clarified difference between "reasonable medical judgment" and "good faith belief" in abortion law exceptions)
Heckman v. Williamson County, 369 S.W.3d 137 (Tex. 2012) (standing doctrine in Texas state courts)
Abbott v. Mexican Am. Legis. Caucus, 647 S.W.3d 681 (Tex. 2022) (must name specific state official with enforcement power in constitutional challenge)
Bell v. Low Income Women of Texas, 95 S.W.3d 253 (Tex. 2002) (abortion regulation and equal protection analysis under Texas Constitution)
Harris v. McRae, 448 U.S. 297 (1980) (upheld Hyde Amendment limits on abortion funding against equal protection challenge under federal law)