Document ID: ./input/supremecourt_opinions/opinions/23pdf/23-235_n7ip.pdf
Page Number: 23.0

Cite as:  602 U. S. ____ (2024) 

19 

Opinion of the Court 

government  safety  regulations.  Nor  will  this  Court  now 
create such a novel standing doctrine out of whole cloth.

Consider  some  examples.  EPA  rolls  back  emissions 
standards for power plants—does a doctor have standing to
sue  because  she  may  need  to  spend  more  time  treating 
asthma  patients?    A  local  school  district  starts  a  middle 
school football league—does a pediatrician have standing to
challenge  its  constitutionality  because  she  might  need  to 
spend  more  time  treating  concussions?    A  federal  agency 
increases a speed limit from 65 to 80 miles per hour—does
an emergency room doctor have standing to sue because he
may  have  to  treat  more  car  accident  victims?    The 
government  repeals  certain  restrictions  on  guns—does  a 
surgeon  have  standing  to  sue  because  he  might  have  to 
operate on more gunshot victims? 

The answer is no:  The chain of causation is simply too 
attenuated.  Allowing doctors or other healthcare providers
to  challenge  general  safety  regulations  as  unlawfully  lax 
would  be  an  unprecedented  and  limitless  approach  and 
would  allow  doctors  to  sue  in  federal  court  to  challenge
almost any policy affecting public health.4 

And in the FDA drug-approval context, virtually all drugs
come  with  complications,  risks,  and  side  effects.    Some 
drugs  increase  the  risk  of  heart  attack,  some  may  cause 
cancer,  some  may  cause  birth  defects,  and  some  heighten
the  possibility  of  stroke.    Approval  of  a  new  drug  may 
therefore yield more visits to doctors to treat complications
or side effects.  So the plaintiffs’ loose approach to causation 
would  also  essentially  allow  any  doctor  or  healthcare
provider  to  challenge  any  FDA  decision  approving  a  new 
drug.  But  doctors  have  never  had  standing  to  challenge 
FDA’s drug approvals simply on the theory that use of the 
—————— 

4 A  safety  law  regulating  hospitals  or  the  doctors’  medical  practices
obviously  would  present  a  different  issue—either  such  a  law  would 
directly  regulate  doctors,  or  the  causal  link  at  least  would  be 
substantially less attenuated.