have to address the claims that we won below on our bottle i'd like to spend the first half of my argument explaining why the regulatory scheme differential treatment of abortion and all comparable medical procedures violates the equal protection c traditional practices in which abortions are performed yet leaving all other physician practices unregulated regardless of the procedures performed in them the number or type of surgeries performed second this regulatory scheme addresses generally applicable healthy limbs they have no particular application to abortion over other surgical procedures and which are unrelated to the state's interest in potential life third the undisputed evidence in the record demonstrates that abortion reproductive choice in a way that is discovered by much to our society and by the state it is very clear that abortion patients and abortion providers are particularly are and politically unpopular group in this country under connection to generalized health concerns that are addressed by the regulatory scheme are so grodd and so widely applicable in comparison with the group targeted that the connection cannot possibly be seen rational it's not that is the test of the cloister purely economic regulation that's not the test that applies whereas here you have a politically unpopular group exercising a constitutional right but one of the fundamental rights trying to be equal protection under the roman rational basis review you get something more than that burden only on a politically unpopular group so here you have to take that under take that more searching level of review which requires some real estate between the classification that's being imposed the breadth of the law to tell you the rest of the in response to a lot of highly publicized articles about p c b pollution problems but i think most people can see the p c bees are probably less dangerous than a whole cast of other chemicals and i think the argument could be made just as i was  rational because if you really you're picking out a polluter you're picking out a chemical that doesn't warrant it but it was a legislative response to a highly publicized incident what's different about this well that you're there into one step at a time  appropriate for economic legislation this is not the proper setting for the one step at a time approach because you have a politically unpopular group you're exercising a constitutional right in that kind of setting the legislature must do more than simply place all the burden s of the law on that politically unpopular group it needs to have a real rational connection between the classification that it has drawn and the object the brecht of the legislation and the problem being solved or being addressed the problem being addr addresses strategical safety generally in anything from practice so if it's going to take that kind of law it has to be rational in choosing who apply to and it is not rational to predict people one surgery out of all the surgery performed in the entire state abortions would increase in cost and how many people would be dissuaded from getting an abortion at that price or anything like that at this point your honor the record indicates that the price that the cost of abortions will be increased by tens of thousand dollars taking a number out of the us for the cost five hundred dollars and if we were to it would go up ten percent to five hundred fifty dollars wouldn't you have some obligation to show through economic evidence or something that if the price goes up ten percent that a significant had done the calculations they could be calculated on the basis of what we have been given by experts we have i'd like to reserve the rest of my time for a bottle  at a phoenix abortion clinic passed common sense regulations modeled on treatment protocols from planned parenthood and designed to ensure that women seeking after sties their right to an abortion do not risk death or serious injury the absence of planned parenthood in this case is taken if again but what is more significant is the character of the regulations to which the point and object and this is an example clinics must maintain clean smoke free environment free environments instruments must be sterilized patient medical histories must be taken before surgery properly trained personnel should monitor patient recovery well there are a lot of other birds and i was to impose white wine it doesn't make any sense to impose those kind of burdens only on abortion providers make any sense to differentiate between those somewhat procedures performed at surgery centers that are not affiliated with hospitals and clinics your honor as the supreme court has repeatedly recognized abortion is a unique act and that the social and psychological implications of abortion make it different from other medical procedures you cannot simply focus in on the medical aspects of abortion is not what the regulations  the regulation you're talking about in fact i'm saying you know i'm sorry you know the regulation extends to ensure that minimum health and safety regulations are in place in arizona abortion clinics but by saying was noted before in the discussion of the equal protection argument the statements take steps to regulate one procedure over another and it was in this case that the situation and circumstances that led to  the legislature to act and it's important to note in the case that the legislature did in fact rely on standards from abortion providers themselves in an attempt to make sure that abortion is s in arizona there was no targeting and there's no evidence in this case that was targeting or animists towards abortion providers there was simply a desire to make sure that there are no more men hearings so it is appropriate function for the legislature to determine what types of medical procedures should be regulated and that's what they did in this case and their response was completely rational to the situation that occurred in the late one nine hundred ninety s in arizona now you know you  provider's fourth amendment rights and that allowing government employees with a duty to maintain patient confidentiality allowing these employees to access patient identifying information violated the informational written really i didn't think addressed the question of me on the electron constitutional delegation of licensing you responded to the due process argument and i understand your argument what is your response as to the i'm probably unconstitutional delegation argument self leaving aside the due process questions and your honor there was no improper unconstitutional delegation in this case in fact if you look at what the regulation requires which is admitting privileges for one physician a facility during the time that the patient is there there is no delegation of authority because the department of health services maintains the right to license abortion clinics and hospitals as they always have maintained the decision as to few they grant admitting privileges to right but you can't have one without the other under this legislation so in fact the hospitals have a veto power over just this particular type of procedure right now you're on any do you know that in the state of the self i mean hospitals credential for a lot of a lot of different criteria that are different from licensure for example part of the requirements generally are that you has a certain amount of procedures done at the hospital for you can't get them you can't read up at the hospital much you perform  if you use the hospital privileges but in this unique area generally speaking these client providers are going to be using hospital privileges so effectively it seems to me in most cases you're going to you're  so the state has delegated to insurance companies who couldn't could not do abortions your honor my argument would be much the same and the fact is the plaintiffs bear the burden of showing that this is the district court was incorrect in finding that solutions fourth amendment rights were violated and i would like to point the court to the case of new york first as berger and that case is controlling here and it's important to note that both in berger quint cases upon which this court ruled argent chemical both courts found that on the basis of one single comprehensive set of regulations that in a business was closely regulated and a warrant was not required to conduct compliance inspections and that's exactly what we're trusting here compliance inspections and i would also note that there are fifteen different types of medical facilities in arizona that are currently subject required a display of a license just as they do here when they impose civil and criminal penalties for violating a set of regulations just as we do here and the court also noted that other states regulate  using similar to pieces of legislation and in this case the record demonstrates that at least four other states have regulated abortion clinics to marling south carolina texas tennessee and mississippi berger's that out and three part analysis which the district court failed to properly apply for determining when and industry is or is not closely regulated the first and them element is that the and in this case it is needed for the state to ensure quality patient care and to ensure that abortion clinics are complying with the regulations and thirdly that there is a constitutionally adequate substitute warrant and the burger court went into great detail describing when this would occur it noted that if the business owner knows that there will be periodic inspections in clearly the plaintiffs in this case know that they're going to be given that your honor supreme court's analysis in berger is equally applicable here and the fourth amendment is not violated and the second issue would like to address briefly is information privacy and i would point to this course decision in the wall versus planned parenthood which was upholding the arizona parental consent statute and in that case the court found that activists by state employees without disclosure did not violate patient information privacy rights and that's exactly what we have here we have access to records with no disclosure we can still trust has an affirmative duty to protect patient confidentiality  medical records are important both to ensure quality patient care and to ensure a quality review of their services and that is exactly what you just attempting to do to ensure both quality care and to reform our view of the services to ensure that the clinics are complying with the provisions of the regulatory act that clearly are only intended to protect patient health and safety and that's what's required of any other medical procedure are in fact there are fifteen other types of medical facilities including urgent care centers outpatient surgical centers that have this same sort of an inspection routine in quite so this is not in any way singling out abortion for special treatment thank you thank you search warrant which searches by entry into the industry here there is no possible friction by which plaintiffs can be said to have consented to searches of their offices without a warrant by entering into the practice of medicine it's a profession with a history of independence from  dangerous it's not closely linked to criminal activity and the matters that are regulated by the scheme do not require sudden immediate inspection to be detected you know they're trying to see if these people are compliance with the scheme they're looking at who's on the staff what are their enough to show original need and second inspection scheme does not provide a constitutionally adequate substitute for a warrant in terms of limits on time place and spoke and limits on the discretion of the inspector survey inspections may be conducted whenever an inspector desired to conduct one and investigate retore inspections are triggered any time a violation is alleged even by a third party even anonymously and regardless of the credibility so long as the person alleges there is a violation that ex can compile health data the information under this scheme is not that it is abortion patients complete actual medical records including identifying information medical history ultrasound charts so the record keeping and interest they offer to inadequate just to the cations to make sure the facilities are properly recording contact information of patients and to allow the state to track records through quality assurance and peer review activities as well as to track patterns among certain types of industries can ever be considered closely regulated you know the example was given to auto manufacturers that only industrial types of a business is regulated instead the court in burger set out a three part t applied to any industry that is being considered closely regulated in this case the state would argue that when you go into abortion thank you very healthy in your very life are potentially implicated by going into the abortion clinic so that certainly makes it equally if not more important than some sort of industrial industry cited by the by the plaintiffs and moving onto the information privacy argument  that the state has not narrowly tailored its access to the records in order to balance the state's need for access with the patient's right to privacy and that is simply incorrect the regulation does properly balance acc with patient confidentiality it does not allow access that any time that an inspector chooses to access those records records may only be accessed during specified inspections life insurance section licensure inspections and a complaint investigation when a complaint that reasonably alleges a violation of the regulatory act has been made this is not broad sweeping authority to look at patient records the act indicates what needs to be in the record and what is important to be in the record both to ensure patient privacy and to allow distress to do its job to ensure the patient's quality met pair bonding to the patient's name and address and well one obvious reason would be to ensure compliance with the act because the act requires that those things be in the patient record but the testimony was also elicited in this case from the head of the inspection unit d h s that they use patient names times to track records to track certain patients to look for trends in health care and that would be equally important with a rating of twenty accurately that was an id number that they're going on like why do you need the name i requirements are well established tracking morbidity mortality rates for quality assurance as well established there are there are there are procedures from the joint commission and others of th