Document ID: ./input/supremecourt_opinions/opinions/23pdf/23-726_6jgm.pdf
Page Number: 42.0

Cite as:  603 U. S. ____ (2024) 

19 

ALITO, J., dissenting 

any latitude, it said, “ ‘operates for the benefit, not the dis-
advantage, of the pregnant woman.’ ”  Id., at 445–446, 522 
P. 3d,  at  1203–1204.    Even  so,  Idaho’s  law  is  focused  on 
“death,” and a doctor must be able to say in “good faith” that
he  or  she  was  acting  to  preserve  the  woman’s  life,  not
simply her health.  Idaho Code Ann. §18–622(2)(a)(i). 

These different considerations—health versus life—may 
lead to different outcomes.  For instance, consider the situ-
ation of a woman who experiences a condition that was dis-
cussed in the briefs and at argument: preterm prelabor rup-
ture  of  membranes  (PPROM),  which  occurs  when  a
woman’s amniotic sac breaks before the 37th week of preg-
nancy.  1 App. 295.  The Members of this Court are not phy-
sicians and should therefore be wary about expressing con-
clusions  about  medical  issues.    But  guidance  provided  by
prominent  medical  institutions  is  sufficient  to  show  how 
Idaho  law  and  EMTALA,  as  interpreted  by  the  Govern-
ment, may conflict in such cases.

If  a  woman  experiences  PPROM  between  the  34th  and 
37th week of pregnancy and does not go into labor, her phy-
sician  is  likely  to  recommend  that  labor  be  induced.18    In  
that situation, it does not appear that the risk of conflict is 
high.

On  the  other  hand,  when  PPROM  occurs  earlier  than 
If 
that,  the  chances  of  conflict  are  greatly  increased. 
PPROM occurs before the 34th week and the woman’s preg-
nancy continues, she may experience conditions such as an
infection of the amniotic fluid, inflammation of the uterine 
lining, hemorrhage, or sepsis.19  However, life-threatening 

—————— 

18 See, e.g., 1 App. 306; Mount Sinai, Premature Rupture of Membranes,
https://www.mountsinai.org/health-library/special-topic/premature-
rupture-of-membranes#:~:text=Sometimes%20the%20membranes% 
20break%20before,rupture%20of%20membranes%20 (June 21, 2024). 

19 One study found that 14% of women with PPROM before the point 
of viability developed one or more of these complications, and approxi-
mately 1% to 5% developed life-threatening sepsis.  1 App. 298.  A review