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How to Write an Argumentative Essay | Examples & Tips

Published on July 24, 2020 by Jack Caulfield . Revised on July 23, 2023.

An argumentative essay expresses an extended argument for a particular thesis statement . The author takes a clearly defined stance on their subject and builds up an evidence-based case for it.

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Table of contents

When do you write an argumentative essay, approaches to argumentative essays, introducing your argument, the body: developing your argument, concluding your argument, other interesting articles, frequently asked questions about argumentative essays.

You might be assigned an argumentative essay as a writing exercise in high school or in a composition class. The prompt will often ask you to argue for one of two positions, and may include terms like “argue” or “argument.” It will frequently take the form of a question.

The prompt may also be more open-ended in terms of the possible arguments you could make.

Argumentative writing at college level

At university, the vast majority of essays or papers you write will involve some form of argumentation. For example, both rhetorical analysis and literary analysis essays involve making arguments about texts.

In this context, you won’t necessarily be told to write an argumentative essay—but making an evidence-based argument is an essential goal of most academic writing, and this should be your default approach unless you’re told otherwise.

Examples of argumentative essay prompts

At a university level, all the prompts below imply an argumentative essay as the appropriate response.

Your research should lead you to develop a specific position on the topic. The essay then argues for that position and aims to convince the reader by presenting your evidence, evaluation and analysis.

• Don’t just list all the effects you can think of.
• Do develop a focused argument about the overall effect and why it matters, backed up by evidence from sources.
• Don’t just provide a selection of data on the measures’ effectiveness.
• Do build up your own argument about which kinds of measures have been most or least effective, and why.
• Don’t just analyze a random selection of doppelgänger characters.
• Do form an argument about specific texts, comparing and contrasting how they express their thematic concerns through doppelgänger characters.

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An argumentative essay should be objective in its approach; your arguments should rely on logic and evidence, not on exaggeration or appeals to emotion.

There are many possible approaches to argumentative essays, but there are two common models that can help you start outlining your arguments: The Toulmin model and the Rogerian model.

Toulmin arguments

The Toulmin model consists of four steps, which may be repeated as many times as necessary for the argument:

• Make a claim
• Provide the grounds (evidence) for the claim
• Explain the warrant (how the grounds support the claim)
• Discuss possible rebuttals to the claim, identifying the limits of the argument and showing that you have considered alternative perspectives

The Toulmin model is a common approach in academic essays. You don’t have to use these specific terms (grounds, warrants, rebuttals), but establishing a clear connection between your claims and the evidence supporting them is crucial in an argumentative essay.

Say you’re making an argument about the effectiveness of workplace anti-discrimination measures. You might:

• Claim that unconscious bias training does not have the desired results, and resources would be better spent on other approaches
• Cite data to support your claim
• Explain how the data indicates that the method is ineffective
• Anticipate objections to your claim based on other data, indicating whether these objections are valid, and if not, why not.

Rogerian arguments

The Rogerian model also consists of four steps you might repeat throughout your essay:

• Discuss what the opposing position gets right and why people might hold this position
• Highlight the problems with this position
• Present your own position , showing how it addresses these problems
• Suggest a possible compromise —what elements of your position would proponents of the opposing position benefit from adopting?

This model builds up a clear picture of both sides of an argument and seeks a compromise. It is particularly useful when people tend to disagree strongly on the issue discussed, allowing you to approach opposing arguments in good faith.

Say you want to argue that the internet has had a positive impact on education. You might:

• Acknowledge that students rely too much on websites like Wikipedia
• Argue that teachers view Wikipedia as more unreliable than it really is
• Suggest that Wikipedia’s system of citations can actually teach students about referencing
• Suggest critical engagement with Wikipedia as a possible assignment for teachers who are skeptical of its usefulness.

You don’t necessarily have to pick one of these models—you may even use elements of both in different parts of your essay—but it’s worth considering them if you struggle to structure your arguments.

Regardless of which approach you take, your essay should always be structured using an introduction , a body , and a conclusion .

Like other academic essays, an argumentative essay begins with an introduction . The introduction serves to capture the reader’s interest, provide background information, present your thesis statement , and (in longer essays) to summarize the structure of the body.

Hover over different parts of the example below to see how a typical introduction works.

The spread of the internet has had a world-changing effect, not least on the world of education. The use of the internet in academic contexts is on the rise, and its role in learning is hotly debated. For many teachers who did not grow up with this technology, its effects seem alarming and potentially harmful. This concern, while understandable, is misguided. The negatives of internet use are outweighed by its critical benefits for students and educators—as a uniquely comprehensive and accessible information source; a means of exposure to and engagement with different perspectives; and a highly flexible learning environment.

The body of an argumentative essay is where you develop your arguments in detail. Here you’ll present evidence, analysis, and reasoning to convince the reader that your thesis statement is true.

In the standard five-paragraph format for short essays, the body takes up three of your five paragraphs. In longer essays, it will be more paragraphs, and might be divided into sections with headings.

Each paragraph covers its own topic, introduced with a topic sentence . Each of these topics must contribute to your overall argument; don’t include irrelevant information.

This example paragraph takes a Rogerian approach: It first acknowledges the merits of the opposing position and then highlights problems with that position.

Hover over different parts of the example to see how a body paragraph is constructed.

A common frustration for teachers is students’ use of Wikipedia as a source in their writing. Its prevalence among students is not exaggerated; a survey found that the vast majority of the students surveyed used Wikipedia (Head & Eisenberg, 2010). An article in The Guardian stresses a common objection to its use: “a reliance on Wikipedia can discourage students from engaging with genuine academic writing” (Coomer, 2013). Teachers are clearly not mistaken in viewing Wikipedia usage as ubiquitous among their students; but the claim that it discourages engagement with academic sources requires further investigation. This point is treated as self-evident by many teachers, but Wikipedia itself explicitly encourages students to look into other sources. Its articles often provide references to academic publications and include warning notes where citations are missing; the site’s own guidelines for research make clear that it should be used as a starting point, emphasizing that users should always “read the references and check whether they really do support what the article says” (“Wikipedia:Researching with Wikipedia,” 2020). Indeed, for many students, Wikipedia is their first encounter with the concepts of citation and referencing. The use of Wikipedia therefore has a positive side that merits deeper consideration than it often receives.

An argumentative essay ends with a conclusion that summarizes and reflects on the arguments made in the body.

No new arguments or evidence appear here, but in longer essays you may discuss the strengths and weaknesses of your argument and suggest topics for future research. In all conclusions, you should stress the relevance and importance of your argument.

Hover over the following example to see the typical elements of a conclusion.

The internet has had a major positive impact on the world of education; occasional pitfalls aside, its value is evident in numerous applications. The future of teaching lies in the possibilities the internet opens up for communication, research, and interactivity. As the popularity of distance learning shows, students value the flexibility and accessibility offered by digital education, and educators should fully embrace these advantages. The internet’s dangers, real and imaginary, have been documented exhaustively by skeptics, but the internet is here to stay; it is time to focus seriously on its potential for good.

If you want to know more about AI tools , college essays , or fallacies make sure to check out some of our other articles with explanations and examples or go directly to our tools!

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An argumentative essay tends to be a longer essay involving independent research, and aims to make an original argument about a topic. Its thesis statement makes a contentious claim that must be supported in an objective, evidence-based way.

An expository essay also aims to be objective, but it doesn’t have to make an original argument. Rather, it aims to explain something (e.g., a process or idea) in a clear, concise way. Expository essays are often shorter assignments and rely less on research.

At college level, you must properly cite your sources in all essays , research papers , and other academic texts (except exams and in-class exercises).

Add a citation whenever you quote , paraphrase , or summarize information or ideas from a source. You should also give full source details in a bibliography or reference list at the end of your text.

The exact format of your citations depends on which citation style you are instructed to use. The most common styles are APA , MLA , and Chicago .

The majority of the essays written at university are some sort of argumentative essay . Unless otherwise specified, you can assume that the goal of any essay you’re asked to write is argumentative: To convince the reader of your position using evidence and reasoning.

In composition classes you might be given assignments that specifically test your ability to write an argumentative essay. Look out for prompts including instructions like “argue,” “assess,” or “discuss” to see if this is the goal.

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Argumentative Essay – Outline, Form, and Examples

What is an argumentative essay.

An argumentative essay requires the writer to investigate a specific topic by collecting and evaluating evidence to establish a position on the subject matter.

When preparing to compose a good argumentative essay, utilize the following steps:

Step 1: Select a topic.

Step 2: Identify a position.

Step 3: Locate appropriate resources.

Step 4: Identify evidence supporting the position. ( NOTE: If there is little evidence in support of the claim, consider re-examining the main argument.)

When gathering evidence, use credible sources . To determine the credibility of the source, consider authority, currency, accuracy, and objectivity:

Who is the author ? Are they an expert in the field? Has a reputable publisher published the work?

How current is the information in the source? Does the currency of the source matter? Does the age of the source impact the content? Is there newer information that disproves the source’s information?

Can other sources verify the accuracy of the information? Does the information contradict that found in other commonly accepted sources?

Is there any evidence of bias, or is the source objective ? Is the research sponsored by an organization that may skew the information?

The following are typically recognized as providing appropriate, credible research material:

Peer-reviewed journals/research papers

Government agencies

Professional organizations

Library databases

Reference books

Writers should avoid using the following sources:

Social media posts

Out-of-date materials

Step 5: Utilize the research to determine a thesis statement that identifies the topic, position, and support(s).

Step 6: Use the evidence to construct an outline, detailing the main supports and relevant evidence.

Argumentative essay outline

After gathering all of the necessary research, the next step in composing an argumentative essay focuses on organizing the information through the use of an outline:

Introduction

Attention Grabber/Hook

Background Information: Include any background information pertinent to the topic that the reader needs to know to understand the argument.

Thesis: State the position in connection to the main topic and identify the supports that will help prove the argument.

Topic sentence

Identify evidence in support of the claim in the topic sentence

Explain how the evidence supports the argument

Evidence 3 (Continue as needed)

Support 2 (Continue as needed)

Restate thesis

Review main supports

Concluding statement

Invite the audience to take a specific action.

Identify the overall importance of the topic and position.

How to write an argumentative essay

Regardless of the writer’s topic or point of view, an argumentative essay should include an introductory paragraph, body paragraphs, a conclusion, and works cited.

Background information

Body Paragraphs

Analysis of evidence

Rephrased thesis

Review of main ideas

Call to action

Works Cited

Argumentative essay introduction

The introduction sets the tone for the entire paper and introduces the argument. In general, the first paragraph(s) should attract the reader’s attention, provide relevant context, and conclude with a thesis statement.

To attract the reader's attention , start with an introductory device. There are several attention-grabbing techniques, the most common of which consist of the following:

The writer can emphasize the topic’s importance by explaining the current interest in the topic or indicating that the subject is influential.

Pertinent statistics give the paper an air of authority.

There are many reasons for a stimulating statement to surprise a reader. Sometimes it is joyful; sometimes it is shocking; sometimes it is surprising because of who said it.

An interesting incident or anecdote can act as a teaser to lure the reader into the remainder of the essay. Be sure that the device is appropriate for the subject and focus of what follows.

Provide the reader with relevant context and background information necessary to understand the topic.

Conclude with a thesis statement that identifies the overall purpose of the essay (topic and position). Writers can also include their support directly in the thesis, which outlines the structure of the essay for the reader.

Avoid the following when writing the introduction to argumentative writing:

Starting with dictionary definitions is too overdone and unappealing.

Do not make an announcement of the topic like “In this paper I will…” or “The purpose of this essay is to….”

Evidence supporting or developing the thesis should be in the body paragraphs, not the introduction.

Beginning the essay with general or absolute statements such as “throughout history...” or “as human beings we always...” or similar statements suggest the writer knows all of history or that all people behave or think in the same way.

Argumentative essay thesis

The thesis statement is the single, specific claim the writer sets out to prove and is typically positioned as the last sentence of the introduction . It is the controlling idea of the entire argument that identifies the topic, position, and reasoning.

When constructing a thesis for an argumentative paper, make sure it contains a side of the argument, not simply a topic. An argumentative thesis identifies the writer’s position on a given topic. If a position cannot be taken, then it is not argumentative thesis:

Topic: Capital punishment is practiced in many states.

Thesis: Capital punishment should be illegal.

While not always required, the thesis statement can include the supports the writer will use to prove the main claim. Therefore, a thesis statement can be structured as follows:

TOPIC + POSITION (+ SUPPORTS)

No Supports: College athletes (TOPIC) should be financially compensated (POSITION).

Supports: College athletes (TOPIC) should be financially compensated (POSITION) because they sacrifice their minds and bodies (SUPPORT 1), cannot hold

Argumentative essay body paragraphs

Body paragraphs can be of varying lengths, but they must present a coherent argument unified under a single topic. They are rarely ever longer than one page, double-spaced; usually they are much shorter.

Lengthy paragraphs indicate a lack of structure. Identify the main ideas of a lengthy paragraph to determine if they make more sense as separate topics in separate paragraphs.

Shorter paragraphs usually indicate a lack of substance; there is not enough evidence or analysis to prove the argument. Develop the ideas more or integrate the information into another paragraph.

The structure of an argumentative paragraph should include a topic sentence, evidence, and a transition.

The topic sentence is the thesis of the paragraph that identifies the arguable point in support of the main argument. The reader should know exactly what the writer is trying to prove within the paragraph by reading the first sentence.

The supporting evidence and analysis provide information to support the claim. There should be a balance between the evidence (facts, quotations, summary of events/plot, etc.) and analysis (interpretation of evidence). If the paragraph is evidence-heavy, there is not much of an argument; if it is analysis-heavy, there is not enough evidence in support of the claim.

The transition can be at the beginning or the end of a paragraph. However, it is much easier to combine the transition with the concluding observation to help the paragraphs flow into one another. Transitions in academic writing should tell the reader where you were, where you are going, and relate to the thesis.

Some essays may benefit from the inclusion of rebuttals to potential counterarguments of the writer’s position.

Argumentative essay conclusion

The conclusion should make readers glad they read the paper. It can suggest broader implications that will not only interest readers but also enrich their understanding in some way. There are three aspects to follow when constructing the conclusion: rephrase the thesis, synthesize information, and call the reader to action.

Rephrased the thesis in the first sentence of the conclusion. It must be in different words; do not simply write it verbatim.

Synthesize the argument by showing how the paper's main points support the argument.

Propose a course of action or a solution to an issue. This can redirect the reader's thought process to apply the ideas to their life or to see the broader implications of the topic.

Avoid the following when constructing the conclusion:

Beginning with an unnecessary, overused phrase such as "in conclusion," "in summary," or "in closing;" although these phrases can work in speeches, they come across as trite in writing

Introducing a new idea or subtopic in the conclusion

Making sentimental, emotional appeals that are out of character with the rest of the paper

Including evidence (quotations, statistics, etc.) that should be in the body of the paper

Argumentative essay examples

Examples of argumentative essays vary depending upon the type:

Academic essays differ based upon the topic and position. These essays follow a more traditional structure and are typically assigned in high school or college. Examples of academic argumentative essay topics include the following:

Advantages or disadvantages of social media

Animal testing

Art education

Benefit or detriment of homework

Capital punishment

Class warfare

Immigration

School uniforms

Universal healthcare

Violence in video games

Argumentative literary essays are typically more informal and do not follow the same structure as an academic essay. The following are popular examples of argumentative literary essays:

“Letter from Birmingham Jail” by Martin Luther King, Jr.

“Death of the Moth” by Virginia Woolf

“Shooting an Elephant” by George Orwell

“Thoughts for the Times on War and Death” by Sigmund Freud

“Does the Truth Matter? Science, Pseudoscience, and Civilization” by Carl Sagan

“Self-Reliance” by Ralph Waldo Emerson

Choose Your Test

Sat / act prep online guides and tips, how to write an a+ argumentative essay.

Miscellaneous

You'll no doubt have to write a number of argumentative essays in both high school and college, but what, exactly, is an argumentative essay and how do you write the best one possible? Let's take a look.

A great argumentative essay always combines the same basic elements: approaching an argument from a rational perspective, researching sources, supporting your claims using facts rather than opinion, and articulating your reasoning into the most cogent and reasoned points. Argumentative essays are great building blocks for all sorts of research and rhetoric, so your teachers will expect you to master the technique before long.

But if this sounds daunting, never fear! We'll show how an argumentative essay differs from other kinds of papers, how to research and write them, how to pick an argumentative essay topic, and where to find example essays. So let's get started.

What Is an Argumentative Essay? How Is it Different from Other Kinds of Essays?

There are two basic requirements for any and all essays: to state a claim (a thesis statement) and to support that claim with evidence.

Though every essay is founded on these two ideas, there are several different types of essays, differentiated by the style of the writing, how the writer presents the thesis, and the types of evidence used to support the thesis statement.

Essays can be roughly divided into four different types:

#1: Argumentative #2: Persuasive #3: Expository #4: Analytical

So let's look at each type and what the differences are between them before we focus the rest of our time to argumentative essays.

Argumentative Essay

Argumentative essays are what this article is all about, so let's talk about them first.

An argumentative essay attempts to convince a reader to agree with a particular argument (the writer's thesis statement). The writer takes a firm stand one way or another on a topic and then uses hard evidence to support that stance.

An argumentative essay seeks to prove to the reader that one argument —the writer's argument— is the factually and logically correct one. This means that an argumentative essay must use only evidence-based support to back up a claim , rather than emotional or philosophical reasoning (which is often allowed in other types of essays). Thus, an argumentative essay has a burden of substantiated proof and sources , whereas some other types of essays (namely persuasive essays) do not.

You can write an argumentative essay on any topic, so long as there's room for argument. Generally, you can use the same topics for both a persuasive essay or an argumentative one, so long as you support the argumentative essay with hard evidence.

Example topics of an argumentative essay:

• "Should farmers be allowed to shoot wolves if those wolves injure or kill farm animals?"
• "Should the drinking age be lowered in the United States?"
• "Are alternatives to democracy effective and/or feasible to implement?"

The next three types of essays are not argumentative essays, but you may have written them in school. We're going to cover them so you know what not to do for your argumentative essay.

Persuasive Essay

Persuasive essays are similar to argumentative essays, so it can be easy to get them confused. But knowing what makes an argumentative essay different than a persuasive essay can often mean the difference between an excellent grade and an average one.

Persuasive essays seek to persuade a reader to agree with the point of view of the writer, whether that point of view is based on factual evidence or not. The writer has much more flexibility in the evidence they can use, with the ability to use moral, cultural, or opinion-based reasoning as well as factual reasoning to persuade the reader to agree the writer's side of a given issue.

Instead of being forced to use "pure" reason as one would in an argumentative essay, the writer of a persuasive essay can manipulate or appeal to the reader's emotions. So long as the writer attempts to steer the readers into agreeing with the thesis statement, the writer doesn't necessarily need hard evidence in favor of the argument.

Often, you can use the same topics for both a persuasive essay or an argumentative one—the difference is all in the approach and the evidence you present.

Example topics of a persuasive essay:

• "Should children be responsible for their parents' debts?"
• "Should cheating on a test be automatic grounds for expulsion?"
• "How much should sports leagues be held accountable for player injuries and the long-term consequences of those injuries?"

Expository Essay

An expository essay is typically a short essay in which the writer explains an idea, issue, or theme , or discusses the history of a person, place, or idea.

This is typically a fact-forward essay with little argument or opinion one way or the other.

Example topics of an expository essay:

• "The History of the Philadelphia Liberty Bell"
• "The Reasons I Always Wanted to be a Doctor"
• "The Meaning Behind the Colloquialism ‘People in Glass Houses Shouldn't Throw Stones'"

Analytical Essay

An analytical essay seeks to delve into the deeper meaning of a text or work of art, or unpack a complicated idea . These kinds of essays closely interpret a source and look into its meaning by analyzing it at both a macro and micro level.

This type of analysis can be augmented by historical context or other expert or widely-regarded opinions on the subject, but is mainly supported directly through the original source (the piece or art or text being analyzed) .

Example topics of an analytical essay:

• "Victory Gin in Place of Water: The Symbolism Behind Gin as the Only Potable Substance in George Orwell's 1984"
• "Amarna Period Art: The Meaning Behind the Shift from Rigid to Fluid Poses"
• "Adultery During WWII, as Told Through a Series of Letters to and from Soldiers"

There are many different types of essay and, over time, you'll be able to master them all.

A Typical Argumentative Essay Assignment

The average argumentative essay is between three to five pages, and will require at least three or four separate sources with which to back your claims . As for the essay topic , you'll most often be asked to write an argumentative essay in an English class on a "general" topic of your choice, ranging the gamut from science, to history, to literature.

But while the topics of an argumentative essay can span several different fields, the structure of an argumentative essay is always the same: you must support a claim—a claim that can reasonably have multiple sides—using multiple sources and using a standard essay format (which we'll talk about later on).

This is why many argumentative essay topics begin with the word "should," as in:

• "Should all students be required to learn chemistry in high school?"
• "Should children be required to learn a second language?"
• "Should schools or governments be allowed to ban books?"

These topics all have at least two sides of the argument: Yes or no. And you must support the side you choose with evidence as to why your side is the correct one.

But there are also plenty of other ways to frame an argumentative essay as well:

• "Does using social media do more to benefit or harm people?"
• "Does the legal status of artwork or its creators—graffiti and vandalism, pirated media, a creator who's in jail—have an impact on the art itself?"
• "Is or should anyone ever be ‘above the law?'"

Though these are worded differently than the first three, you're still essentially forced to pick between two sides of an issue: yes or no, for or against, benefit or detriment. Though your argument might not fall entirely into one side of the divide or another—for instance, you could claim that social media has positively impacted some aspects of modern life while being a detriment to others—your essay should still support one side of the argument above all. Your final stance would be that overall , social media is beneficial or overall , social media is harmful.

If your argument is one that is mostly text-based or backed by a single source (e.g., "How does Salinger show that Holden Caulfield is an unreliable narrator?" or "Does Gatsby personify the American Dream?"), then it's an analytical essay, rather than an argumentative essay. An argumentative essay will always be focused on more general topics so that you can use multiple sources to back up your claims.

Good Argumentative Essay Topics

So you know the basic idea behind an argumentative essay, but what topic should you write about?

Again, almost always, you'll be asked to write an argumentative essay on a free topic of your choice, or you'll be asked to select between a few given topics . If you're given complete free reign of topics, then it'll be up to you to find an essay topic that no only appeals to you, but that you can turn into an A+ argumentative essay.

What makes a "good" argumentative essay topic depends on both the subject matter and your personal interest —it can be hard to give your best effort on something that bores you to tears! But it can also be near impossible to write an argumentative essay on a topic that has no room for debate.

As we said earlier, a good argumentative essay topic will be one that has the potential to reasonably go in at least two directions—for or against, yes or no, and why . For example, it's pretty hard to write an argumentative essay on whether or not people should be allowed to murder one another—not a whole lot of debate there for most people!—but writing an essay for or against the death penalty has a lot more wiggle room for evidence and argument.

A good topic is also one that can be substantiated through hard evidence and relevant sources . So be sure to pick a topic that other people have studied (or at least studied elements of) so that you can use their data in your argument. For example, if you're arguing that it should be mandatory for all middle school children to play a sport, you might have to apply smaller scientific data points to the larger picture you're trying to justify. There are probably several studies you could cite on the benefits of physical activity and the positive effect structure and teamwork has on young minds, but there's probably no study you could use where a group of scientists put all middle-schoolers in one jurisdiction into a mandatory sports program (since that's probably never happened). So long as your evidence is relevant to your point and you can extrapolate from it to form a larger whole, you can use it as a part of your resource material.

And if you need ideas on where to get started, or just want to see sample argumentative essay topics, then check out these links for hundreds of potential argumentative essay topics.

101 Persuasive (or Argumentative) Essay and Speech Topics

301 Prompts for Argumentative Writing

Top 50 Ideas for Argumentative/Persuasive Essay Writing

[Note: some of these say "persuasive essay topics," but just remember that the same topic can often be used for both a persuasive essay and an argumentative essay; the difference is in your writing style and the evidence you use to support your claims.]

KO! Find that one argumentative essay topic you can absolutely conquer.

Argumentative Essay Format

Argumentative Essays are composed of four main elements:

• A position (your argument)
• Your reasons
• Supporting evidence for those reasons (from reliable sources)
• Counterargument(s) (possible opposing arguments and reasons why those arguments are incorrect)

If you're familiar with essay writing in general, then you're also probably familiar with the five paragraph essay structure . This structure is a simple tool to show how one outlines an essay and breaks it down into its component parts, although it can be expanded into as many paragraphs as you want beyond the core five.

The standard argumentative essay is often 3-5 pages, which will usually mean a lot more than five paragraphs, but your overall structure will look the same as a much shorter essay.

An argumentative essay at its simplest structure will look like:

Paragraph 1: Intro

• Set up the story/problem/issue
• Thesis/claim

Paragraph 2: Support

• Reason #1 claim is correct
• Supporting evidence with sources

Paragraph 3: Support

• Reason #2 claim is correct

Paragraph 4: Counterargument

• Explanation of argument for the other side
• Refutation of opposing argument with supporting evidence

Paragraph 5: Conclusion

• Re-state claim
• Sum up reasons and support of claim from the essay to prove claim is correct

Now let's unpack each of these paragraph types to see how they work (with examples!), what goes into them, and why.

Paragraph 1—Set Up and Claim

Your first task is to introduce the reader to the topic at hand so they'll be prepared for your claim. Give a little background information, set the scene, and give the reader some stakes so that they care about the issue you're going to discuss.

Next, you absolutely must have a position on an argument and make that position clear to the readers. It's not an argumentative essay unless you're arguing for a specific claim, and this claim will be your thesis statement.

Your thesis CANNOT be a mere statement of fact (e.g., "Washington DC is the capital of the United States"). Your thesis must instead be an opinion which can be backed up with evidence and has the potential to be argued against (e.g., "New York should be the capital of the United States").

Paragraphs 2 and 3—Your Evidence

These are your body paragraphs in which you give the reasons why your argument is the best one and back up this reasoning with concrete evidence .

The argument supporting the thesis of an argumentative essay should be one that can be supported by facts and evidence, rather than personal opinion or cultural or religious mores.

For example, if you're arguing that New York should be the new capital of the US, you would have to back up that fact by discussing the factual contrasts between New York and DC in terms of location, population, revenue, and laws. You would then have to talk about the precedents for what makes for a good capital city and why New York fits the bill more than DC does.

Your argument can't simply be that a lot of people think New York is the best city ever and that you agree.

In addition to using concrete evidence, you always want to keep the tone of your essay passionate, but impersonal . Even though you're writing your argument from a single opinion, don't use first person language—"I think," "I feel," "I believe,"—to present your claims. Doing so is repetitive, since by writing the essay you're already telling the audience what you feel, and using first person language weakens your writing voice.

For example,

"I think that Washington DC is no longer suited to be the capital city of the United States."

"Washington DC is no longer suited to be the capital city of the United States."

The second statement sounds far stronger and more analytical.

Paragraph 4—Argument for the Other Side and Refutation

Even without a counter argument, you can make a pretty persuasive claim, but a counterargument will round out your essay into one that is much more persuasive and substantial.

By anticipating an argument against your claim and taking the initiative to counter it, you're allowing yourself to get ahead of the game. This way, you show that you've given great thought to all sides of the issue before choosing your position, and you demonstrate in multiple ways how yours is the more reasoned and supported side.

Paragraph 5—Conclusion

This paragraph is where you re-state your argument and summarize why it's the best claim.

Briefly touch on your supporting evidence and voila! A finished argumentative essay.

Your essay should have just as awesome a skeleton as this plesiosaur does. (In other words: a ridiculously awesome skeleton)

Argumentative Essay Example: 5-Paragraph Style

It always helps to have an example to learn from. I've written a full 5-paragraph argumentative essay here. Look at how I state my thesis in paragraph 1, give supporting evidence in paragraphs 2 and 3, address a counterargument in paragraph 4, and conclude in paragraph 5.

Topic: Is it possible to maintain conflicting loyalties?

Paragraph 1

It is almost impossible to go through life without encountering a situation where your loyalties to different people or causes come into conflict with each other. Maybe you have a loving relationship with your sister, but she disagrees with your decision to join the army, or you find yourself torn between your cultural beliefs and your scientific ones. These conflicting loyalties can often be maintained for a time, but as examples from both history and psychological theory illustrate, sooner or later, people have to make a choice between competing loyalties, as no one can maintain a conflicting loyalty or belief system forever.

The first two sentences set the scene and give some hypothetical examples and stakes for the reader to care about.

The third sentence finishes off the intro with the thesis statement, making very clear how the author stands on the issue ("people have to make a choice between competing loyalties, as no one can maintain a conflicting loyalty or belief system forever." )

Paragraphs 2 and 3

Psychological theory states that human beings are not equipped to maintain conflicting loyalties indefinitely and that attempting to do so leads to a state called "cognitive dissonance." Cognitive dissonance theory is the psychological idea that people undergo tremendous mental stress or anxiety when holding contradictory beliefs, values, or loyalties (Festinger, 1957). Even if human beings initially hold a conflicting loyalty, they will do their best to find a mental equilibrium by making a choice between those loyalties—stay stalwart to a belief system or change their beliefs. One of the earliest formal examples of cognitive dissonance theory comes from Leon Festinger's When Prophesy Fails . Members of an apocalyptic cult are told that the end of the world will occur on a specific date and that they alone will be spared the Earth's destruction. When that day comes and goes with no apocalypse, the cult members face a cognitive dissonance between what they see and what they've been led to believe (Festinger, 1956). Some choose to believe that the cult's beliefs are still correct, but that the Earth was simply spared from destruction by mercy, while others choose to believe that they were lied to and that the cult was fraudulent all along. Both beliefs cannot be correct at the same time, and so the cult members are forced to make their choice.

But even when conflicting loyalties can lead to potentially physical, rather than just mental, consequences, people will always make a choice to fall on one side or other of a dividing line. Take, for instance, Nicolaus Copernicus, a man born and raised in Catholic Poland (and educated in Catholic Italy). Though the Catholic church dictated specific scientific teachings, Copernicus' loyalty to his own observations and scientific evidence won out over his loyalty to his country's government and belief system. When he published his heliocentric model of the solar system--in opposition to the geocentric model that had been widely accepted for hundreds of years (Hannam, 2011)-- Copernicus was making a choice between his loyalties. In an attempt t o maintain his fealty both to the established system and to what he believed, h e sat on his findings for a number of years (Fantoli, 1994). But, ultimately, Copernicus made the choice to side with his beliefs and observations above all and published his work for the world to see (even though, in doing so, he risked both his reputation and personal freedoms).

These two paragraphs provide the reasons why the author supports the main argument and uses substantiated sources to back those reasons.

The paragraph on cognitive dissonance theory gives both broad supporting evidence and more narrow, detailed supporting evidence to show why the thesis statement is correct not just anecdotally but also scientifically and psychologically. First, we see why people in general have a difficult time accepting conflicting loyalties and desires and then how this applies to individuals through the example of the cult members from the Dr. Festinger's research.

The next paragraph continues to use more detailed examples from history to provide further evidence of why the thesis that people cannot indefinitely maintain conflicting loyalties is true.

Paragraph 4

Some will claim that it is possible to maintain conflicting beliefs or loyalties permanently, but this is often more a matter of people deluding themselves and still making a choice for one side or the other, rather than truly maintaining loyalty to both sides equally. For example, Lancelot du Lac typifies a person who claims to maintain a balanced loyalty between to two parties, but his attempt to do so fails (as all attempts to permanently maintain conflicting loyalties must). Lancelot tells himself and others that he is equally devoted to both King Arthur and his court and to being Queen Guinevere's knight (Malory, 2008). But he can neither be in two places at once to protect both the king and queen, nor can he help but let his romantic feelings for the queen to interfere with his duties to the king and the kingdom. Ultimately, he and Queen Guinevere give into their feelings for one another and Lancelot—though he denies it—chooses his loyalty to her over his loyalty to Arthur. This decision plunges the kingdom into a civil war, ages Lancelot prematurely, and ultimately leads to Camelot's ruin (Raabe, 1987). Though Lancelot claimed to have been loyal to both the king and the queen, this loyalty was ultimately in conflict, and he could not maintain it.

Here we have the acknowledgement of a potential counter-argument and the evidence as to why it isn't true.

The argument is that some people (or literary characters) have asserted that they give equal weight to their conflicting loyalties. The refutation is that, though some may claim to be able to maintain conflicting loyalties, they're either lying to others or deceiving themselves. The paragraph shows why this is true by providing an example of this in action.

Paragraph 5

Whether it be through literature or history, time and time again, people demonstrate the challenges of trying to manage conflicting loyalties and the inevitable consequences of doing so. Though belief systems are malleable and will often change over time, it is not possible to maintain two mutually exclusive loyalties or beliefs at once. In the end, people always make a choice, and loyalty for one party or one side of an issue will always trump loyalty to the other.

The concluding paragraph summarizes the essay, touches on the evidence presented, and re-states the thesis statement.

How to Write an Argumentative Essay: 8 Steps

Writing the best argumentative essay is all about the preparation, so let's talk steps:

#1: Preliminary Research

If you have the option to pick your own argumentative essay topic (which you most likely will), then choose one or two topics you find the most intriguing or that you have a vested interest in and do some preliminary research on both sides of the debate.

Do an open internet search just to see what the general chatter is on the topic and what the research trends are.

Did your preliminary reading influence you to pick a side or change your side? Without diving into all the scholarly articles at length, do you believe there's enough evidence to support your claim? Have there been scientific studies? Experiments? Does a noted scholar in the field agree with you? If not, you may need to pick another topic or side of the argument to support.

#2: Pick Your Side and Form Your Thesis

Now's the time to pick the side of the argument you feel you can support the best and summarize your main point into your thesis statement.

Your thesis will be the basis of your entire essay, so make sure you know which side you're on, that you've stated it clearly, and that you stick by your argument throughout the entire essay .

#3: Heavy-Duty Research Time

You've taken a gander at what the internet at large has to say on your argument, but now's the time to actually read those sources and take notes.

Check scholarly journals online at Google Scholar , the Directory of Open Access Journals , or JStor . You can also search individual university or school libraries and websites to see what kinds of academic articles you can access for free. Keep track of your important quotes and page numbers and put them somewhere that's easy to find later.

And don't forget to check your school or local libraries as well!

#4: Outline

Follow the five-paragraph outline structure from the previous section.

Fill in your topic, your reasons, and your supporting evidence into each of the categories.

Before you begin to flesh out the essay, take a look at what you've got. Is your thesis statement in the first paragraph? Is it clear? Is your argument logical? Does your supporting evidence support your reasoning?

By outlining your essay, you streamline your process and take care of any logic gaps before you dive headfirst into the writing. This will save you a lot of grief later on if you need to change your sources or your structure, so don't get too trigger-happy and skip this step.

Now that you've laid out exactly what you'll need for your essay and where, it's time to fill in all the gaps by writing it out.

Take it one step at a time and expand your ideas into complete sentences and substantiated claims. It may feel daunting to turn an outline into a complete draft, but just remember that you've already laid out all the groundwork; now you're just filling in the gaps.

If you have the time before deadline, give yourself a day or two (or even just an hour!) away from your essay . Looking it over with fresh eyes will allow you to see errors, both minor and major, that you likely would have missed had you tried to edit when it was still raw.

Take a first pass over the entire essay and try your best to ignore any minor spelling or grammar mistakes—you're just looking at the big picture right now. Does it make sense as a whole? Did the essay succeed in making an argument and backing that argument up logically? (Do you feel persuaded?)

If not, go back and make notes so that you can fix it for your final draft.

Once you've made your revisions to the overall structure, mark all your small errors and grammar problems so you can fix them in the next draft.

#7: Final Draft

Use the notes you made on the rough draft and go in and hack and smooth away until you're satisfied with the final result.

A checklist for your final draft:

• Formatting is correct according to your teacher's standards
• No errors in spelling, grammar, and punctuation
• Essay is the right length and size for the assignment
• The argument is present, consistent, and concise
• Each reason is supported by relevant evidence
• The essay makes sense overall

#8: Celebrate!

Once you've brought that final draft to a perfect polish and turned in your assignment, you're done! Go you!

Be prepared and ♪ you'll never go hungry again ♪, *cough*, or struggle with your argumentative essay-writing again. (Walt Disney Studios)

Good Examples of Argumentative Essays Online

Theory is all well and good, but examples are key. Just to get you started on what a fully-fleshed out argumentative essay looks like, let's see some examples in action.

Check out these two argumentative essay examples on the use of landmines and freons (and note the excellent use of concrete sources to back up their arguments!).

The Use of Landmines

A Shattered Sky

The Take-Aways: Keys to Writing an Argumentative Essay

At first, writing an argumentative essay may seem like a monstrous hurdle to overcome, but with the proper preparation and understanding, you'll be able to knock yours out of the park.

Remember the differences between a persuasive essay and an argumentative one, make sure your thesis is clear, and double-check that your supporting evidence is both relevant to your point and well-sourced . Pick your topic, do your research, make your outline, and fill in the gaps. Before you know it, you'll have yourself an A+ argumentative essay there, my friend.

What's Next?

Now you know the ins and outs of an argumentative essay, but how comfortable are you writing in other styles? Learn more about the four writing styles and when it makes sense to use each .

Understand how to make an argument, but still having trouble organizing your thoughts? Check out our guide to three popular essay formats and choose which one is right for you.

Ready to make your case, but not sure what to write about? We've created a list of 50 potential argumentative essay topics to spark your imagination.

Courtney scored in the 99th percentile on the SAT in high school and went on to graduate from Stanford University with a degree in Cultural and Social Anthropology. She is passionate about bringing education and the tools to succeed to students from all backgrounds and walks of life, as she believes open education is one of the great societal equalizers. She has years of tutoring experience and writes creative works in her free time.

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• Writing Tips

How to Write an Argumentative Essay

4-minute read

• 30th April 2022

An argumentative essay is a structured, compelling piece of writing where an author clearly defines their stance on a specific topic. This is a very popular style of writing assigned to students at schools, colleges, and universities. Learn the steps to researching, structuring, and writing an effective argumentative essay below.

Requirements of an Argumentative Essay

To effectively achieve its purpose, an argumentative essay must contain:

●  A concise thesis statement that introduces readers to the central argument of the essay

●  A clear, logical, argument that engages readers

●  Ample research and evidence that supports your argument

Approaches to Use in Your Argumentative Essay

1.   classical.

●  Clearly present the central argument.

●  Outline your opinion.

●  Provide enough evidence to support your theory.

2.   Toulmin

●  State your claim.

●  Supply the evidence for your stance.

●  Explain how these findings support the argument.

●  Include and discuss any limitations of your belief.

3.   Rogerian

●  Explain the opposing stance of your argument.

●  Discuss the problems with adopting this viewpoint.

●  Offer your position on the matter.

●  Provide reasons for why yours is the more beneficial stance.

●  Include a potential compromise for the topic at hand.

Tips for Writing a Well-Written Argumentative Essay

●  Introduce your topic in a bold, direct, and engaging manner to captivate your readers and encourage them to keep reading.

●  Provide sufficient evidence to justify your argument and convince readers to adopt this point of view.

●  Consider, include, and fairly present all sides of the topic.

●  Structure your argument in a clear, logical manner that helps your readers to understand your thought process.

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●  Discuss any counterarguments that might be posed.

●  Use persuasive writing that’s appropriate for your target audience and motivates them to agree with you.

Steps to Write an Argumentative Essay

Follow these basic steps to write a powerful and meaningful argumentative essay :

Step 1: Choose a topic that you’re passionate about

If you’ve already been given a topic to write about, pick a stance that resonates deeply with you. This will shine through in your writing, make the research process easier, and positively influence the outcome of your argument.

Step 2: Conduct ample research to prove the validity of your argument

To write an emotive argumentative essay , finding enough research to support your theory is a must. You’ll need solid evidence to convince readers to agree with your take on the matter. You’ll also need to logically organize the research so that it naturally convinces readers of your viewpoint and leaves no room for questioning.

Step 3: Follow a simple, easy-to-follow structure and compile your essay

A good structure to ensure a well-written and effective argumentative essay includes:

Introduction

●  Introduce your topic.

●  Offer background information on the claim.

●  Discuss the evidence you’ll present to support your argument.

●  State your thesis statement, a one-to-two sentence summary of your claim.

●  This is the section where you’ll develop and expand on your argument.

●  It should be split into three or four coherent paragraphs, with each one presenting its own idea.

●  Start each paragraph with a topic sentence that indicates why readers should adopt your belief or stance.

●  Include your research, statistics, citations, and other supporting evidence.

●  Discuss opposing viewpoints and why they’re invalid.

●  This part typically consists of one paragraph.

●  Summarize your research and the findings that were presented.

●  Emphasize your initial thesis statement.

●  Persuade readers to agree with your stance.

We certainly hope that you feel inspired to use these tips when writing your next argumentative essay . And, if you’re currently elbow-deep in writing one, consider submitting a free sample to us once it’s completed. Our expert team of editors can help ensure that it’s concise, error-free, and effective!

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8 Effective Strategies to Write Argumentative Essays

In a bustling university town, there lived a student named Alex. Popular for creativity and wit, one challenge seemed insurmountable for Alex– the dreaded argumentative essay!

One gloomy afternoon, as the rain tapped against the window pane, Alex sat at his cluttered desk, staring at a blank document on the computer screen. The assignment loomed large: a 350-600-word argumentative essay on a topic of their choice . With a sigh, he decided to seek help of mentor, Professor Mitchell, who was known for his passion for writing.

Entering Professor Mitchell’s office was like stepping into a treasure of knowledge. Bookshelves lined every wall, faint aroma of old manuscripts in the air and sticky notes over the wall. Alex took a deep breath and knocked on his door.

“Ah, Alex,” Professor Mitchell greeted with a warm smile. “What brings you here today?”

Alex confessed his struggles with the argumentative essay. After hearing his concerns, Professor Mitchell said, “Ah, the argumentative essay! Don’t worry, Let’s take a look at it together.” As he guided Alex to the corner shelf, Alex asked,

Table of Contents

“What is an Argumentative Essay?”

The professor replied, “An argumentative essay is a type of academic writing that presents a clear argument or a firm position on a contentious issue. Unlike other forms of essays, such as descriptive or narrative essays, these essays require you to take a stance, present evidence, and convince your audience of the validity of your viewpoint with supporting evidence. A well-crafted argumentative essay relies on concrete facts and supporting evidence rather than merely expressing the author’s personal opinions . Furthermore, these essays demand comprehensive research on the chosen topic and typically follows a structured format consisting of three primary sections: an introductory paragraph, three body paragraphs, and a concluding paragraph.”

He continued, “Argumentative essays are written in a wide range of subject areas, reflecting their applicability across disciplines. They are written in different subject areas like literature and philosophy, history, science and technology, political science, psychology, economics and so on.

Alex asked,

“When is an Argumentative Essay Written?”

The professor answered, “Argumentative essays are often assigned in academic settings, but they can also be written for various other purposes, such as editorials, opinion pieces, or blog posts. Some situations to write argumentative essays include:

1. Academic assignments

In school or college, teachers may assign argumentative essays as part of coursework. It help students to develop critical thinking and persuasive writing skills .

2. Debates and discussions

Argumentative essays can serve as the basis for debates or discussions in academic or competitive settings. Moreover, they provide a structured way to present and defend your viewpoint.

3. Opinion pieces

Newspapers, magazines, and online publications often feature opinion pieces that present an argument on a current issue or topic to influence public opinion.

4. Policy proposals

In government and policy-related fields, argumentative essays are used to propose and defend specific policy changes or solutions to societal problems.

5. Persuasive speeches

Before delivering a persuasive speech, it’s common to prepare an argumentative essay as a foundation for your presentation.

Regardless of the context, an argumentative essay should present a clear thesis statement , provide evidence and reasoning to support your position, address counterarguments, and conclude with a compelling summary of your main points. The goal is to persuade readers or listeners to accept your viewpoint or at least consider it seriously.”

Handing over a book, the professor continued, “Take a look on the elements or structure of an argumentative essay.”

Elements of an Argumentative Essay

An argumentative essay comprises five essential components:

Claim in argumentative writing is the central argument or viewpoint that the writer aims to establish and defend throughout the essay. A claim must assert your position on an issue and must be arguable. It can guide the entire argument.

2. Evidence

Evidence must consist of factual information, data, examples, or expert opinions that support the claim. Also, it lends credibility by strengthening the writer’s position.

3. Counterarguments

Presenting a counterclaim demonstrates fairness and awareness of alternative perspectives.

4. Rebuttal

After presenting the counterclaim, the writer refutes it by offering counterarguments or providing evidence that weakens the opposing viewpoint. It shows that the writer has considered multiple perspectives and is prepared to defend their position.

The format of an argumentative essay typically follows the structure to ensure clarity and effectiveness in presenting an argument.

How to Write An Argumentative Essay

Here’s a step-by-step guide on how to write an argumentative essay:

1. Introduction

• Begin with a compelling sentence or question to grab the reader’s attention.
• Provide context for the issue, including relevant facts, statistics, or historical background.
• Provide a concise thesis statement to present your position on the topic.

2. Body Paragraphs (usually three or more)

• Start each paragraph with a clear and focused topic sentence that relates to your thesis statement.
• Furthermore, provide evidence and explain the facts, statistics, examples, expert opinions, and quotations from credible sources that supports your thesis.
• Use transition sentences to smoothly move from one point to the next.

3. Counterargument and Rebuttal

• Acknowledge opposing viewpoints or potential objections to your argument.
• Also, address these counterarguments with evidence and explain why they do not weaken your position.

4. Conclusion

• Restate your thesis statement and summarize the key points you’ve made in the body of the essay.
• Leave the reader with a final thought, call to action, or broader implication related to the topic.

5. Citations and References

• Properly cite all the sources you use in your essay using a consistent citation style.
• Also, include a bibliography or works cited at the end of your essay.

6. Formatting and Style

• Follow any specific formatting guidelines provided by your instructor or institution.
• Use a professional and academic tone in your writing and edit your essay to avoid content, spelling and grammar mistakes .

Remember that the specific requirements for formatting an argumentative essay may vary depending on your instructor’s guidelines or the citation style you’re using (e.g., APA, MLA, Chicago). Always check the assignment instructions or style guide for any additional requirements or variations in formatting.

Did you understand what Prof. Mitchell explained Alex? Check it now!

Fill the Details to Check Your Score

Prof. Mitchell continued, “An argumentative essay can adopt various approaches when dealing with opposing perspectives. It may offer a balanced presentation of both sides, providing equal weight to each, or it may advocate more strongly for one side while still acknowledging the existence of opposing views.” As Alex listened carefully to the Professor’s thoughts, his eyes fell on a page with examples of argumentative essay.

Example of an Argumentative Essay

Alex picked the book and read the example. It helped him to understand the concept. Furthermore, he could now connect better to the elements and steps of the essay which Prof. Mitchell had mentioned earlier. Aren’t you keen to know how an argumentative essay should be like? Here is an example of a well-crafted argumentative essay , which was read by Alex. After Alex finished reading the example, the professor turned the page and continued, “Check this page to know the importance of writing an argumentative essay in developing skills of an individual.”

Importance of an Argumentative Essay

After understanding the benefits, Alex was convinced by the ability of the argumentative essays in advocating one’s beliefs and favor the author’s position. Alex asked,

“How are argumentative essays different from the other types?”

Prof. Mitchell answered, “Argumentative essays differ from other types of essays primarily in their purpose, structure, and approach in presenting information. Unlike expository essays, argumentative essays persuade the reader to adopt a particular point of view or take a specific action on a controversial issue. Furthermore, they differ from descriptive essays by not focusing vividly on describing a topic. Also, they are less engaging through storytelling as compared to the narrative essays.

Alex said, “Given the direct and persuasive nature of argumentative essays, can you suggest some strategies to write an effective argumentative essay?

Turning the pages of the book, Prof. Mitchell replied, “Sure! You can check this infographic to get some tips for writing an argumentative essay.”

Effective Strategies to Write an Argumentative Essay

As days turned into weeks, Alex diligently worked on his essay. He researched, gathered evidence, and refined his thesis. It was a long and challenging journey, filled with countless drafts and revisions.

Finally, the day arrived when Alex submitted their essay. As he clicked the “Submit” button, a sense of accomplishment washed over him. He realized that the argumentative essay, while challenging, had improved his critical thinking and transformed him into a more confident writer. Furthermore, Alex received feedback from his professor, a mix of praise and constructive criticism. It was a humbling experience, a reminder that every journey has its obstacles and opportunities for growth.

Frequently Asked Questions

An argumentative essay can be written as follows- 1. Choose a Topic 2. Research and Collect Evidences 3. Develop a Clear Thesis Statement 4. Outline Your Essay- Introduction, Body Paragraphs and Conclusion 5. Revise and Edit 6. Format and Cite Sources 7. Final Review

One must choose a clear, concise and specific statement as a claim. It must be debatable and establish your position. Avoid using ambiguous or unclear while making a claim. To strengthen your claim, address potential counterarguments or opposing viewpoints. Additionally, use persuasive language and rhetoric to make your claim more compelling

Starting an argument essay effectively is crucial to engage your readers and establish the context for your argument. Here’s how you can start an argument essay are: 1. Begin With an Engaging Hook 2. Provide Background Information 3. Present Your Thesis Statement 4. Briefly Outline Your Main 5. Establish Your Credibility

The key features of an argumentative essay are: 1. Clear and Specific Thesis Statement 2. Credible Evidence 3. Counterarguments 4. Structured Body Paragraph 5. Logical Flow 6. Use of Persuasive Techniques 7. Formal Language

An argumentative essay typically consists of the following main parts or sections: 1. Introduction 2. Body Paragraphs 3. Counterargument and Rebuttal 4. Conclusion 5. References (if applicable)

The main purpose of an argumentative essay is to persuade the reader to accept or agree with a particular viewpoint or position on a controversial or debatable topic. In other words, the primary goal of an argumentative essay is to convince the audience that the author's argument or thesis statement is valid, logical, and well-supported by evidence and reasoning.

Great article! The topic is simplified well! Keep up the good work

Excellent article! provides comprehensive and practical guidance for crafting compelling arguments. The emphasis on thorough research and clear thesis statements is particularly valuable. To further enhance your strategies, consider recommending the use of a counterargument paragraph. Addressing and refuting opposing viewpoints can strengthen your position and show a well-rounded understanding of the topic. Additionally, engaging with a community like ATReads, a writers’ social media, can provide valuable feedback and support from fellow writers. Thanks for sharing these insightful tips!

wow incredible ! keep up the good work

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Is Science Always Right?

Of course not! Science can’t be always right by definition because scientific knowledge isn’t something cut in stone. It can be changed and redefined. Scientists can be mistaken in certain issues and then admit their mistakes. The funniest example of that is medieval scientists believing that insects have eight feet because Aristotle, the great Ancient Greek scholar, wrote that, and his authority was unquestionable for almost two thousand years. No one even thought of doubting his conclusion and rechecking how many feet a grasshopper or a fly really had. Scientists of the 18 th century – and I mean real and respected scientists, not charlatans – believed that there was an invisible fluid called caloric, and it was that substance that conducted heat. French academics claimed in the same 18 th century that stones can’t fall from the sky. That is, they denied that meteorites fall on Earth sometimes.

This is precisely how science works: scientists keep doubting and testing seemingly established facts, looking for new ways to explain them, which allow us to describe our observations more accurately. That is why, if science is wrong about any issue, it won’t continue to be wrong indefinitely. Scientists will correct their mistakes and replace an inaccurate theory with a more accurate one; they will reduce a law that is now considered universal to a particular case of an even more universal law.

Here is another point worth stressing: science cannot (and doesn’t try to) explain everything there is. There are phenomena that fall out of scope of science, e.g., love between people, the perception of beauty and the emotions that we have when we are looking on pictures, listening to music, or reading poetry.

In fact, there are some scholars who attempt to explore those phenomena and to explain all human feelings and thoughts away by physics or chemistry. Physics and chemistry can only look into what happens in our body when we feel something. Feelings can’t be reduced to physics and chemistry. It’s like trying to explain how a poet writes a poem: “Well, he gets a sheet of paper and a pencil. The pencil scratches the paper, small particles of graphite leave their traces on the paper, that’s how…” Can this method explain why the poet decided to write Those Parts Of Thee That The World’s Eye Doth View , rather than So Oft Have I Invoked Thee For My Muse or Oh Shadow on the Grass ?

Naturally, science doesn’t look into the issues of faith. Science doesn’t say anything about angels, heaven and hell, or miracles – if it’s real science, that is, not a religious doctrine pretending to be science. There have been quite a few such fakes. Besides, there are people who are convinced that there isn’t anything except the things that science can explore. In other words, there is neither love nor beauty nor God. In fact, this opinion is by no means scientific. It is a philosophical doctrine called scientism (derived from the word ‘science’), which isn’t related to real science, such as physics, mathematics, biology, chemistry and so forth.

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Bloomberg published a copy of an opinion that appeared briefly on the Supreme Court’s website and seemed to concern an Idaho abortion case.

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(Bench Opinion) Cite as: 603 U. S. (2024)1 Per Curiam 2 Moyle v. 1.0 5/23/2024 12:00 PM NOTICE: This opinion is subject to formal revision before publication in the United States Reports. Readers are requested to notify the Reporter of Decisions, Supreme Court of the United States, Washington, D. C. 20543, [email protected], of any typographical or other formal errors. SUPREME COURT OF THE UNITED STATES Nos. 23-726 and 23-727 Mike Moyle, Speaker of the Idaho House of Representatives, et al., PETITIONERS 23-726v. United States Idaho, PETITIONER 23-727v. UNITED STATES on writs of certiorari to the united states court of appeals for the ninth circuit [June 26, 2024] Per Curiam. The writs of certiorari before judgment are dismissed as improvidently granted, and the stays entered by the Court on January 5, 2024, are vacated. It is so ordered. 6Moyle v. United States Kagan, J., concurring Cite as: 603 U. S. (2024)1 Kagan, J., concurring Cite as: 603 U. S. (2024)5 Kagan, J., concurring SUPREME COURT OF THE UNITED STATES

Nos. 23-726 and 23-727 Mike Moyle, Speaker of the Idaho House of Representatives, et al., PETITIONERS 23-726v. United States Idaho, PETITIONER 23-727v. UNITED STATES on writs of certiorari to the united states court of appeals for the ninth circuit [June 26, 2024] Justice Kagan, with whom Justice Sotomayor joins, and with whom Justice Jackson joins as to Part II, concurring. An Idaho law prohibits abortions unless necessary to prevent a pregnant woman's death; the law makes no exception for abortions necessary to prevent grave harms to the woman's health, like the loss of her fertility. Before the law could take effect, the Federal Government sued the State under the Emergency Medical Treatment and Labor Act (EMTALA). That law requires a Medicare-funded hospital to provide essential care to patients experiencing medical emergencies. The Government's suit contended that EMTALA preempts the Idaho abortion law in a narrow class of cases: when the state law bars a hospital from performing an abortion needed to prevent serious health harms. The District Court, believing the Government was likely to prevail in its suit, entered a preliminary injunction. During the year that the injunction was in place, women in Idaho were able to obtain abortions in medical emergencies. Idaho meanwhile sought to get the injunction lifted. When the en banc Court of Appeals for the Ninth Circuit declined to stay the injunction, Idaho filed an emergency application here. This Court stayed the injunction and granted the State's petition for certiorari before judgment. With that stay in effect, Idaho could enforce its abortion ban even when terminating a pregnancy was necessary to prevent grave harm to the woman. The on-the-ground impact was immediate. To ensure appropriate medical care, the State's largest provider of emergency services had to airlift pregnant women out of Idaho roughly every other week, compared to once in all of the prior year (when the injunction was in effect). See Tr. of Oral Arg. 66, 113. I concur in the Court's decision today to vacate its stay and dismiss the writ of certiorari before judgment as improvidently granted. I do so because Idaho's arguments about EMTALA do not justify, and have never justified, either emergency relief or our early consideration of this dispute. With this Court's writ of certiorari dismissed, the lower courts can proceed with this litigation in the regular course. And with this Court's stay dissolved, the District Court's preliminary injunction will again take effect. That will prevent Idaho from enforcing its abortion ban when the termination of a pregnancy is needed to prevent serious harms to a woman's health. I EMTALA requires hospitals to provide abortions that Idaho's law prohibits. When that is so, Idaho's law is preempted. The Court's ruling today follows from those premises.

Federal law and Idaho law are in conflict about the treatment of pregnant women facing health emergencies. EMTALA requires a Medicare-funded hospital to offer an abortion when needed to stabilize a medical condition that seriously threatens a pregnant woman's life or health. See 42 U. S. C. §1395dd. Idaho allows abortions only when "necessary to prevent" a pregnant woman's “death." Idaho Code Ann. §18-622(2)(a)(i) (Supp. 2023). By their terms, the two laws differ. What falls in the gap between them are cases in which continuing a pregnancy does not put a woman's life in danger, but still places her at risk of grave health consequences, including loss of fertility. In that situation, federal law requires a hospital to offer an abortion, whereas Idaho law prohibits that emergency care. And the record shows that, as a matter of medical reality, such cases exist. For example, when a woman comes to an emergency room with PPROM, the serious risk she faces may not be of death but of damage to her uterus, preventing her from having children in the future. See 2 App. 594; see also id., at 615-616 (similar for pre-eclampsia). Idaho has never suggested that its law would allow an abortion in those circumstances. See Tr. of Oral Arg. 23 (stating that although the threat of death need not be “imminen[t]," only that threat can justify an abortion); see also id., at 25-28, 33-34. That is why hospitals in Idaho have had to airlift medically fragile women to other States to receive abortions needed to prevent serious harms to their health. See id., at 66, 103– 104, 113–115. Those transfers measure the difference between the life-threatening conditions Idaho will allow hospitals to treat and the health-threatening conditions it will not, despite EMTALA's command. Given that conflict, I agree with the Court's decision today to step back from its early intervention in this dispute. In the first stage of this suit, the District Court considered both sides' medical evidence and entered a preliminary injunction against Idaho's law on the ground of preemption. See 623 F. Supp. 3d 1096, 1103-1105, 1110, 1117 (2022). After the Idaho Supreme Court construed the law, the District Court revisited its findings, and reaffirmed its entry of the injunction. See 2023 WL 3284977, *1, *5 (May 4, 2023). In line with standard practice, that decision now can go to the Court of Appeals, and the District Court can afterward consider further evidence and arguments for the purpose of final judgment. Idaho is not entitled to anything more. It mainly argues that EMTALA never requires a hospital to “offer medical treatments that violate state law," even when they are needed to prevent substantial health harms. Tr. of Oral Arg. 4. In my view, that understanding of EMTALA is not “likely to succeed on the merits,” and so cannot support a stay of the injunction. Nken v. Holder, 556 U. S. 418, 434 (2009). Neither does the State's argument provide any basis for this Court to short-circuit the proceedings below. Today's ruling thus puts the case back where it belongs, and with the preliminary injunction in place. II Justice Alito's dissenting opinion requires a brief response. His primary argument is that although EMTALA generally obligates hospitals to provide emergency medical care, it never demands that they offer an abortion- no matter how much that procedure is needed to prevent grave physical harm, or even death. See post, at 4–15. That view has no basis in the statute. EMTALA unambiguously requires that a Medicare-funded hospital provide whatever medical treatment is necessary to stabilize a health emergency—and an abortion, in rare situations, is such a treatment. The statutory obligation kicks in when an individual arrives at a hospital with an “emergency medical condition,” which is one involving serious jeopardy to health. §1395dd(e)(1)(A). The hospital must then “stabilize" the condition. §1395dd(b)(1)(A). That means offering the medical treatment necessary to ensure that “no material deterioration of the condition” is likely to occur. §1395dd(e)(3)(A). The statute does not list particular treatments—for example, defibrillation, blood transfusion, or mechanical ventilation. What it instead requires is the treatment that is medically appropriate to stabilize the patient. And when a pregnancy goes terribly wrong, that treatment may be an abortion. Termination of the pregnancy (which is often of a non-viable fetus) may be the only way to prevent a woman's death or serious injury, including kidney failure or loss of fertility. See 623 F. Supp. 3d, at 1101, 1103–1105. I do not understand Justice Alito to dispute that medical fact. And from that fact, a statutory obligation arises. It does not matter that EMTALA "does not mention abortion." Post, at 12; see post, at 5. Neither, as just noted, does EMTALA mention any other treatment. The statute simply requires the hospital to offer the treatment necessary to prevent the emergency condition from spiraling downward. And on rare occasions that means providing an abortion.

The statute's references to protecting an “unborn child” do not lead to a different result. Contrary to Justice Alito's view, none alters EMTALA's command when a pregnancy threatens the woman's life or health. Three of the four provisions Justice Alito cites concern the treatment of women in labor (including all those with healthy pregnancies). Those provisions ensure that a hospital, in considering the transfer of a woman to another facility, takes account of risks to not only the woman but also her “unborn child.” §1395dd(c)(1)(A)(ii), (2)(A), (e)(1)(B) (ii). The provisions have no application to women who are not in labor, but instead are experiencing a different pregnancy-related condition. The fourth provision (included within the definition of “emergency medical condition") specifies that a hospital must treat a condition that “plac[es] the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy." §1395dd(e)(1) (A)(i). The parenthetical there, added in an amendment to EMTALA, ensures that a woman with no health risks of her own can demand emergency-room treatment if her fetus is in peril. It does not displace the hospital's duty to a woman whose life or health is in jeopardy, and who needs an abortion to stabilize her condition. Then, the statute requires offering that treatment to the woman. Because the Idaho law conflicts with that requirement-prevents hospitals from doing what EMTALA commands the Court is right to dissolve its stay of the District Court's injunction. Doing so will again give Idaho women access to all the needed medical treatments that EMTALA guarantees. The amendment's history confirms that understanding. As originally enacted, EMTALA did not obligate hospitals to provide medical care when a woman's fetus, but not the woman herself, was in peril. See Tr. of Oral Arg. 105 (Solicitor General describing “well-publicized cases" where women's “own health and life were not in danger, but the fetus was in grave distress and hospitals weren't treating them”). To fix that problem, very large bipartisan majorities in both the House and the Senate elected to broaden the provision, entitling a woman to demand care for her unborn child as well as herself. See 103 Stat. 2248; 135 Cong. Rec. 31431 (1989); id., at 31127; id., at 24605; id., at 23393. The amendment would likely have sparked far more opposition if it somehow tacitly withdrew EMTALA's requirement that hospitals treat women who need an abortion to prevent death or serious harm. 8Moyle v. United States Barrett, J., concurring Cite as: 603 U. S. (2024)1 Barrett, J., concurring Cite as: 603 U. S. (2024)7 Barrett, J., concurring SUPREME COURT OF THE UNITED STATES Nos. 23-726 and 23-727 Mike Moyle, Speaker of the Idaho House of Representatives, et al., PETITIONERS 23-726v. United States Idaho, PETITIONER

23-727v. UNITED STATES on writs of certiorari to the united states court of appeals for the ninth circuit [June 26, 2024] Justice Barrett, with whom The Chief Justice and Justice Kavanaugh join, concurring. We granted certiorari before judgment in these cases to decide whether the Emergency Medical Treatment and Labor Act (EMTALA) preempts a provision of Idaho law that prohibits abortions except when necessary to save the life of the mother. 601 U. S. (2024). Because the shape of these cases has substantially shifted since we granted certiorari, I concur in the Court's judgment dismissing the writ as improvidently granted. I In 2022, the Department of Health and Human Services issued guidance to “remind hospitals of their existing obligation to comply with EMTALA." Centers for Medicare & Medicaid Services, Reinforcement of EMTALA Obligations Specific to Patients Who Are Pregnant or Are Experiencing Pregnancy Loss, Note, p. 1 (July 11, 2022) (rev. Aug. 25, 2022) (italics deleted). The guidance tells physicians that if they believe that “abortion is the stabilizing treatment necessary to resolve" a pregnant woman's emergency medical condition, they "must provide that treatment.” Id., at 1 (italics and emphasis deleted). Any contrary state law, the guidance continues, is "preempted." Ibid. (italics and emphasis deleted). Idaho's Defense of Life Act criminalizes the performance of most abortions. Idaho Code Ann. §18–622 (Supp. 2023). As originally enacted, the Act allowed accused physicians to raise an affirmative defense that "the abortion was necessary to prevent the death of the pregnant woman." §18-622(2)(a)(i). Soon before the Act was set to take effect, the United States sued Idaho, seeking to enjoin Idaho's law "to the extent it conflicts with EMTALA." 1 App. 5. EMTALA, the United States argued, requires physicians to perform abortions under certain circumstances that Idaho's Act would forbid. After holding an evidentiary hearing, the District Court identified a conflict and granted a preliminary injunction. 623 F. Supp. 3d 1096 (Idaho 2022). The court based its conclusion on three key assumptions: (1) The Act prohibits the termination of ectopic pregnancies; (2) the pregnant woman's death must be objectively “imminent" or "certain” before a physician can perform an abortion; and (3) the “necessary to prevent death" exception is only an affirmative defense. Id., at 1109–1114. The Government's witnesses, whose testimony the court credited, made similar assumptions. Id., at 1104-1105. They claimed that the Act might prohibit abortions as treatment for conditions including severe heart failure, pre-eclampsia, preterm premature rupture of the membranes (PPROM), sepsis, and placental abruption, because a physician could not know, "with certainty," that an abortion is necessary to save the mother's life in those circumstances. See, e.g., 1 App. 30–38. They also assumed that the Act only permitted abortions where death was “imminent.” See, e.g., 2 id., at 608. After the District Court ruled, the Idaho Supreme Court construed the Act. That court explained that the Act "does not require objective certainty, or a particular level of immediacy, before the abortion can be 'necessary' to save the woman's life.” Planned Parenthood Great Nw. v. State, 171 Idaho 374, 445, 522 P. 3d 1132, 1203 (2023). And "treating an ectopic pregnancy, by removing the fetus,” the court concluded, does not count as an " "abortion" " under the Act. Ibid. Without holding a new evidentiary hearing, the District Court denied Idaho's motion for reconsideration. 2023 WL 3284977 (May 4, 2023). The Idaho Legislature later amended the definition of “abortion" to exclude "[t]he removal of a dead unborn child” and “[t]he removal of an ectopic or molar pregnancy.” §18–604(1)(b), (c). It also changed the "life of the mother” affirmative defense into an exception from the prohibition on criminal abortions. §18-622(2).

The Ninth Circuit initially stayed the District Court's injunction, 83 F. 4th 1130 (2023), but the en banc court vacated the panel's stay, declined to stay the injunction, and scheduled oral argument on the merits, 82 F. 4th 1296 (2023). We granted Idaho's and the Legislature's applications to stay the District Court's injunction pending appeal, treated the applications as petitions for a writ of certiorari before judgment, and granted the petitions. 601 U. S. (2024). II Before the Ninth Circuit had the opportunity to review the District Court's preliminary injunction, this Court stayed the injunction and granted certiorari before judgment. Both decisions were premised on the belief that Idaho would suffer irreparable harm under the injunction and that these cases were ready for the Court's immediate determination. Since then, briefing and oral argument have "shed more light on this case than in the nature of things was afforded at the time" the Court considered petitioners' emergency applications. Belcher v. Stengel, 429 U. S. 118, 119 (1976) (per curiam) (dismissed as improvidently granted). I am now convinced that these cases are no longer appropriate for early resolution. The parties dispute whether EMTALA requires hospitals to provide abortions—or any other treatment forbidden by state law as necessary stabilizing care. They also disagree about whether EMTALA, as a statute enacted under Congress's spending power and that operates on private parties, can preempt state law (an issue aired for the first time in this Court). In my judgment, it would be imprudent to answer these important questions now. Since this suit began in the District Court, Idaho law has significantly changed-twice. And since we granted certiorari, the parties' litigating positions have rendered the scope of the dispute unclear, at best. In its stay application, Idaho argued that the Government's interpretation of EMTALA would render Idaho's Act virtually unenforceable. As Idaho understood it, the Government's theory would allow physicians to perform abortions whenever necessary to avoid “ “serious jeopardy" " to the mother's mental health. Stay Reply Brief in No. 23A470, p. 6. On that broad reading, Idaho projected that emergency rooms would function as "federal abortion enclaves governed not by state law, but by physician judgment, as enforced by the United States's mandate to perform abortions on demand." Ibid. (citation omitted). Idaho also warned that the Government's interpretation would "threate[n] religious healthcare providers" by forcing doctors and hospitals to perform abortions regardless of conscience objections. Id., at 15. Both of these points were relevant to the Court's assessment of the irreparable harm that Idaho would suffer from the preliminary injunction, Nken v. Holder, 556 U. S. 418, 434 (2009), as well as the need for “immediate determination in this Court," Supreme Court Rule 11. At the merits stage, however, the United States disclaimed these interpretations of EMTALA. First, it emphatically disavowed the notion that an abortion is ever required as stabilizing treatment for mental health conditions. Brief for United States 26, n. 5; Tr. of Oral Arg. 76–78. That is an important concession: If restricted to conditions posing serious jeopardy to a woman's physical health, the Government's reading of EMTALA does not gut Idaho's Act. Second, the United States clarified that federal conscience protections, for both hospitals and individual physicians, apply in the EMTALA context. Tr. of Oral Arg. 87-89. That is another critical point: It alleviates Idaho's concern that the Government's interpretation of EMTALA would strip healthcare providers of conscience protections. Narrowing happened from the other direction too. The United States identified PPROM, placental abruption, pre-eclampsia, and eclampsia as conditions for which EMTALA requires an emergency abortion to be available. (The same conditions that the Government's witnesses identified before Idaho's law changed.) But in this Court, petitioners represent that the Act permits physicians to treat each of these conditions with emergency abortions, even if the threat to the woman's life is not imminent. Reply Brief in No. 23-726, pp. 21-22; Reply Brief in No. 23-727, pp. 8–9; Tr. of Oral Arg. 23. The same is true for the conditions identified by the Government's witnesses (severe heart failure and sepsis). Reply Brief in No. 23–727, pp. 8–9. A grant of certiorari before judgment presumes that further proceedings below are unnecessary to the Court's resolution of the question presented. That was a miscalculation in these cases, because the parties' positions are still evolving. The United States has clarified that EMTALA's reach is far more modest than it appeared when we granted certiorari and a stay. Idaho law has materially changed since the District Court entered the preliminary

injunction, and, based on the parties' arguments before us, it seems that the framing of these cases has not had sufficient opportunity to catch up. Cf. The Monrosa v. Carbon Black Export, Inc., 359 U. S. 180, 184 (1959) ("Examination of a case on the merits, on oral argument, may bring into 'proper focus' a consideration which, though present in the record at the time of granting the writ, only later indicates that the grant was improvident"). On top of that, petitioners have raised a difficult and consequential argument, which they did not discuss in their stay applications, about whether Congress, in reliance on the Spending Clause, can obligate recipients of federal funds to violate state criminal law. Brief for Petitioners in No. 23–726, pp. 48–51; Reply Brief in No. 23-727, pp. 3–4; see also Brief for Prolife Center at the University of St. Thomas as Amicus Curiae. The District Court did not address this issue below nor did the Ninth Circuit, which we bypassed. We should not jump ahead of the lower courts, particularly on an issue of such importance. Cutter v. Wilkinson, 544 U. S. 709, 718, n. 7 (2005) (“[W]e are a court of review, not of first view"); New York v. Uplinger, 467 U. S. 246, 251 (1984) (Stevens, J., concurring) (dismissing as improvidently granted where "constitutional questions" would otherwise be considered "premature[ly]"). The lower courts should address the Spending Clause issue in the first instance. For these reasons, a “deviation from normal appellate practice" in these cases has proved to be unwise. Supreme Court Rule 11. I therefore agree that we should dismiss the writ of certiorari as improvidently granted and permit proceedings to run their course in the courts below. 66 Having dismissed the writ, I also agree that we should vacate the stay. As the party seeking emergency relief from this Court, Idaho bore the burden of showing that it would be “ “irreparably injured'" if the preliminary injunction remained in effect. Nken, 556 U. S., at 434. The Court's grant of a stay reflected, among other things, its determination that Idaho had satisfied that burden. Now, based on the parties' representations, it appears that the injunction will not stop Idaho from enforcing its law in the vast majority of circumstances. To be sure, the text of the two laws differs: Idaho's Act allows abortion only when “necessary to prevent the death of the pregnant woman,” Idaho Code Ann. §18–622(2)(a)(i), while EMTALA requires stabilizing care to prevent "serious jeopardy" to the woman's health, 42 U. S. C. §1395dd(e)(1)(A)(i). But Idaho represents that its exception is broader than the United States fears, and the United States represents that EMTALA's requirement is narrower than Idaho fears. That matters in assessing Idaho's irreparable harm for purposes of the stay. The dramatic narrowing of the dispute especially the Government's position on abortions to address mental health and conscience exemptions for healthcare providers has undercut the conclusion that Idaho would suffer irreparable harm under the preliminary injunction. Contrary to Idaho's concerns at the stay stage, the Government's interpretation of EMTALA does not purport to transform emergency rooms into "federal abortion enclaves governed not by state law, but by physician judgment, as enforced by the United States's mandate to perform abortions on demand.” Stay Reply Brief in No. 23A470, p. 6 (citation omitted). Nor does it purport to deprive doctors and hospitals of conscience protections. Cf. id., at 15. Thus, even with the preliminary injunction in place, Idaho's ability to enforce its law remains almost entirely intact. The United States also clarified that if pregnancy seriously jeopardizes the woman's health postviability, EMTALA requires delivery, not abortion. Brief for United States 10; Tr. of Oral Arg. 75. And it emphasized that EMTALA requires abortion only in an “emergency acute medical situation," where a woman's health is in jeopardy if she does not receive an abortion “then and there.” Tr. of Oral Arg. 79–80. These two temporal points also narrow the scope of EMTALA's potential conflict with Idaho's Act. 6Moyle v. United States Opinion of Jackson, J. Cite as: 603 U. S. (2024)1 Opinion of Jackson, J. Cite as: 603 U. S. (2024)7

Opinion of Jackson, J. SUPREME COURT OF THE UNITED STATES Nos. 23-726 and 23-727 Mike Moyle, Speaker of the Idaho House of Representatives, et al., PETITIONERS 23-726v. United States Idaho, PETITIONER 23-727v. UNITED STATES on writs of certiorari to the united states court of appeals for the ninth circuit [June 26, 2024] Justice Jackson, concurring in part and dissenting in part. In 1986, Congress passed the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals to provide stabilizing treatment when patients present with emergency medical conditions. See 42 U. S. C. §1395dd. Sometimes, an abortion is the only way to stabilize a patient and, therefore, comply with EMTALA. But Idaho law prohibits abortions unless the treating physician believes that the abortion is “necessary to prevent the [patient's] death." Idaho Code Ann. §18-622(2)(a)(i) (Supp. 2023). Recognizing the clear conflict between EMTALA and Idaho law, a Federal District Judge issued an injunction that had the effect of ensuring that Idaho physicians would be able to provide the abortion care EMTALA requires. Five months ago, this Court stayed that injunction. As a legal matter, this Court's stay meant that unless a doctor could actually say that the abortion was necessary to prevent a patient's death, that doctor could no longer provide abortion care that she viewed as reasonably necessary to keep a patient from losing her uterus, going into organ failure, or avoiding any number of other serious health risks. Compare §18–622(a)(i) with 42 U. S. C. §1395dd(e)(1)(A). As a practical matter, this Court's intervention meant that Idaho physicians were forced to step back and watch as their patients suffered, or arrange for their patients to be airlifted out of Idaho. This months-long catastrophe was completely unnecessary. More to the point, it directly violated federal law, which in our system of government is supreme. See Art. VI, cl. 2. As Justice Kagan explains, EMTALA plainly requires doctors to provide medically necessary stabilizing abortions in limited situations. See ante, at 4-6 (concurring opinion). To the extent that Idaho law conflicts with EMTALA, the State's law must give way. I join in Justice Kagan's statutory analysis, see ibid., and I concur in the Court's per curiam decision to lift its stay, which should not have been entered in the first place. I dissent in part because, in my view, the Court is wrong to dismiss these cases as improvidently granted. I . . . This Court typically dismisses cases as improvidently granted based on “circumstances. which 'were not. fully apprehended at the time certiorari was granted.” ” The Monrosa v. Carbon Black Export, Inc., 359 U. S.

180, 183 (1959) (some alterations in original). This procedural mechanism should be reserved for that end—not turned into a tool for the Court to use to avoid issues that it does not wish to decide. The reasons that justified our grant of certiorari in these cases still hold true today. See this Court's Rule 11. The importance of recognizing Congress's judgments in EMTALA remains as imperative as ever. The United States is still hamstrung in its ability to enforce federal law while States pass laws that effectively nullify EMTALA's requirements. And, on the ground, healthcare providers “have been all but paralyzed by legal uncertainties," placing pregnant patients at risk while they are waiting to be transferred out of State to receive the care they need. Brief for St. Luke's Health System as Amicus Curiae 14–15. If anything, the need for a clear answer to the Supremacy Clause question has only increased in the intervening months. Other States across the country have enacted legislation that gives rise to the same sort of legal conflict that Idaho has created. This pre-emption issue is not going away anytime soon and will most certainly return to this Court. Indeed, it already has. Just three days before we granted this petition, the Fifth Circuit decided a similar case, affirming a permanent injunction that prevents the United States from enforcing EMTALA's requirements with respect to stabilizing emergency abortions prohibited by Texas law. See Texas v. Becerra, 89 F. 4th 529, 533 (2024). The United States has already petitioned for certiorari in that case. See Pet. for Cert. in Becerra v. Texas, O. T. 2023, No. 23–1076. Nor has there been any change in today's cases that might eliminate or undermine the need for this Court's review. The Government continues to maintain (correctly, in my view) that EMTALA's plain text requires hospitals to provide certain emergency abortions when doing so is the only way to stabilize an emergency condition. Brief for United States 12-20. Idaho continues to criminalize the provision of such abortions unless doing so is necessary to prevent the patient's death. Idaho Code Ann. §18-622(2)(a)(i). And both Idaho and the United States still agree that Idaho law directly criminalizes emergency care that the Federal Government reads EMTALA to require. See Tr. of Oral Arg. 16-17, 65–66. Idaho's lawyers may have changed their tune about the exact types of medical care that fall in the gap between state and federal law, but the fundamentals of this dispute remain the same. II Most importantly, as Justice Kagan observes, the conflict between the state and federal law―as they are actually being interpreted and applied on the ground—is both substantial and significant. Ante, at 4-6. It is a clash that clearly exists despite the attempt by Idaho's counsel to muddy the waters concerning the scope of the State's law. The textual conflict is plain. EMTALA requires stabilizing treatment if a patient has an acute medical condition that is so severe "that the absence of immediate medical attention could be reasonably expected to" either result in a serious health risk, or seriously threaten bodily functions or organs. 42 U. S. C. §§1395dd(b)(1), (e)(1)(A). In such cases, EMTALA requires hospitals "to provide such medical treatment of the condition as may be necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to... occur." §1395dd(e)(3)(A). Idaho's broad criminalization of abortion-unless the treating physician believes that the abortion is “necessary to prevent the [patient's] death," Idaho Code Ann. §18–622(2)(a)(i)— conflicts with the text of EMTALA. Put simply, under federal law, a hospital must provide an emergency abortion that is reasonably necessary to preserve a patient's health within the meaning of EMTALA. But, under Idaho law, a doctor cannot provide this care (required by federal law) without committing a criminal act. From the beginning of this litigation, the United States has emphasized the host of emergency medical conditions that require stabilizing abortions-even when the procedure is not necessarily life saving. That list includes pre-eclampsia, preterm premature rupture of the membranes (PPROM), sepsis, and placental abruption, to name just a few examples. Having now been sued over its interference with EMTALA's protections for people experiencing these conditions, Idaho has shifted its position, both here and before the District Court, recharacterizing abortions in these scenarios as life-saving care permitted under Idaho law. Some of my colleagues appear to view this convenient rhetorical maneuver as a material change that (also conveniently) reduces the conflict between state and federal law to the point that a ruling from this Court is no

longer warranted. See ante, at 6–7 (Barrett, J., concurring). But it is both legally and factually implausible to say that Idaho's current litigating position actually mitigates the conflict between that State's law and EMTALA. The conflict between state and federal law still exists—in real life. Idaho cannot credibly maintain that its law always permits abortions in cases of PPROM or pre-eclampsia such that its mandate never conflicts with federal law. The same medical condition can present with different risks in different patients. See, e.g., Brief for Physicians for Reproductive Health as Amicus Curiae 10-11; Brief for Physicians for Human Rights as Amicus Curiae 11-19. And, often, a doctor simply does not know what the risks are or whether a patient might face death. See Tr. of Oral Arg. 103-104; 2 App. 615–617. Such a doctor, observing the different legal thresholds for action under state and federal law—not to mention the severe criminal penalties for a miscalculation—would surely be cowed into not providing abortion care that medical standards warrant and federal law requires. Do not take my word for this; it is already happening.* So it is strange, to say the least, that this Court would shirk its duty to resolve a pressing legal issue on the basis of representations that defy medical realities. In any event, the representations Idaho's counsel made during oral argument and in the State's briefs filed in this Court are not a definitive interpretation of Idaho law. That authority remains with the Idaho Supreme Court, which has never endorsed the State's position. To the contrary, the Idaho Supreme Court has emphasized that, to avoid criminal liability, a doctor must subjectively believe that an abortion is necessary to prevent death. Planned Parenthood Great Northwest v. State, 171 Idaho 374, 445–446, 522 P. 3d 1132, 1203–1204 (2023). And that is to say nothing of local prosecutors, who may not be aware of (or care about) Idaho's newfound interpretation of its abortion ban, and who are highly incentivized to enforce the law to the hilt. See Idaho Code Ann. §63–3642 (Supp. 2023) (withholding funding from local governments if their officials decline to enforce Idaho felony laws, which include these felony abortion laws); see also Brief for Idaho Coalition for Safe Healthcare, Inc., as Amicus Curiae 14-24 (discussing myriad ways in which state and local officials in Idaho have targeted physicians). Still, some of my colleagues latch onto the bald representations of Idaho's counsel, using them as an escape hatch that justifies our dispensing with having to issue a merits ruling in these cases. We cannot simply wind back the clock to how things were before the Court injected itself into this matter. Our intervention has already distorted this litigation process. We permitted Idaho's law to go into effect by staying the District Court's injunction in the first place, then allowed this matter to sit on our merits docket for five months while we considered the question presented. It is too little, too late for the Court to take a mulligan and just tell the lower courts to carry on as if none of this has happened. As the old adage goes: The Court has made this bed so now it must lie in it—by proceeding to decide the merits of the critical pre-emption issue this case presents. We have granted certiorari and heard argument. We have had ample opportunity to consider the issues. The parties were well represented on both sides, and dozens of amici have weighed in. What is more, the necessary legal reasoning is straightforward, and the answer to the question presented is―or at least should be―quite clear: Idaho law prohibits what federal law requires, so to that extent, under the Supremacy Clause, Idaho's law is pre-empted. See Mutual Pharmaceutical Co. v. Bartlett, 570 U. S. 472, 479–480 (2013) (“[I]t has long been settled that state laws that conflict with federal laws are ‘without effect” ” (quoting Maryland v. Louisiana, 451 U. S. 725, 746 (1981))). There is simply no good reason not to resolve this conflict now. " * * * Despite the clarity of the legal issue and the dire need for an answer from this Court, today six Justices refuse to recognize the rights that EMTALA protects. See ante, at 4-7 (Barrett, J., concurring); post, at 4-11 (Alito, J., dissenting). The majority opts, instead, to dismiss these cases. But storm clouds loom ahead. Three Justices suggest, at least in this context, that States have free rein to nullify federal law. See post, at 11–14 (Alito, J., dissenting). And three more decline to disagree with those dissenters on the merits. See ante, at 4–7 (Barrett, J., concurring). The latter group offers only murmurs that “petitioners have raised a difficult and consequential argument" about Congress's authority under the Spending Clause. Ante, at 6 (Barrett, J., concurring). So, as of today, the Court has not adopted Idaho's farfetched theories—but it has not rejected them either.

Instead, the Court puts off the decision. But how long must pregnant patients wait for an answer? Until we confront the pending petition that the Government filed with us after the Fifth Circuit enabled Texas's flouting of EMTALA? Until these very cases return to us in a few years? Will this Court just have a do-over, rehearing and rehashing the same arguments we are considering now, just at a comparatively more convenient point in time? Or maybe we will keep punting on this issue altogether, allowing chaos to reign wherever lower courts enable States to flagrantly undercut federal law, facilitating the suffering of people in need of urgent medical treatment. After today, there will be a few months—maybe a few years—during which doctors may no longer need to airlift pregnant patients out of Idaho. As Justice Kagan emphasizes, portions of Idaho's law will be preliminarily enjoined (at least for now). Ante, at 2, 4. But having not heard from this Court on the ultimate pre-emption issue, Idaho's doctors will still have to decide whether to provide emergency medical care in the midst of highly charged legal circumstances with no guarantee that this fragile detente over the State's categorical prohibitions will be maintained. Cf. ante, at 8 (Barrett, J., concurring) ("Even with the preliminary injunction in place, Idaho's ability to enforce its law remains almost entirely intact"). So, to be clear: Today's decision is not a victory for pregnant patients in Idaho. It is delay. While this Court dawdles and the country waits, pregnant people experiencing emergency medical conditions remain in a precarious position, as their doctors are kept in the dark about what the law requires. This Court had a chance to bring clarity and certainty to this tragic situation, and we have squandered it. And for as long as we refuse to declare what the law requires, pregnant patients in Idaho, Texas, and elsewhere will be paying the price. Because we owe them—and the Nation—an answer to the straightforward pre-emption question presented in these cases, I respectfully dissent. *See Brief for Idaho Coalition for Safe Healthcare, Inc., as Amicus Curiae 7-13 (providing examples in Idaho where doctors' lack of certainty prevented them from providing medically necessary abortions); see also Brief for St. Luke's Health System as Amicus Curiae 14-16 (same); Brief for Amanda Zurawski et al. as Amici Curiae 29-30 (same); Brief for Physicians for Human Rights as Amicus Curiae 12-17 (same). 24Moyle v. United States Alito, J., dissenting Cite as: 603 U. S. (2024)1 Alito, J., dissenting Cite as: 603 U. S. (2024)25 Alito, J., dissenting SUPREME COURT OF THE UNITED STATES Nos. 23-726 and 23-727 Mike Moyle, Speaker of the Idaho House of Representatives, et al., PETITIONERS 23-726v. United States Idaho, PETITIONER

23-727v. UNITED STATES on writs of certiorari to the united states court of appeals for the ninth circuit [June 26, 2024] Justice Alito, with whom Justice Thomas joins, and with whom Justice Gorsuch joins as to Parts I and II, dissenting. This case presents an important and unsettled question of federal statutory law: whether the Emergency Medical Treatment and Labor Act (EMTALA), 42 U. S. C. §1395dd, sometimes demands that hospitals perform abortions and thereby preempts Idaho's recently adopted Defense of Life Act, Idaho Code Ann. §18–622 (Supp. 2023). Enacted nearly 40 years ago, EMTALA requires hospitals participating in Medicare to "scree[n]" and "stabilize" "any individual" who comes to an emergency room with an “emergency medical condition" that jeopardizes the patient's “health.” §§1395dd(a), (b)(1)(A), (e)(1)(A). And if the patient is a pregnant woman, the hospital must stabilize both "the woman" and "her unborn child.” §1395dd(e)(1)(A)(i). After this Court's decision in Dobbs v. Jackson Women's Health Organization, 597 U. S. 215 (2022), Idaho and other States enacted new laws restricting the performance of abortions. To protect both "maternal health and safety" and "the life of preborn children," " Planned Parenthood Great Northwest v. State, 171 Idaho 374, 438, 522 P. 3d 1132, 1196 (2023) (quoting Idaho Code Ann. §18-601), Idaho's law permits an abortion only when "necessary to prevent the death of the pregnant woman,” §18–622(2)(a)(i). Shortly before Idaho's law took effect, President Biden instructed members of his administration to find ways to limit Dobbs's reach. Protecting Access to Reproductive Healthcare Services, Exec. Order No. 14076, 87 Fed. Reg. 42053 (2022). In response, Government lawyers hit upon the novel argument that, under EMTALA, all Medicare-funded hospitals—that is, the vast majority of hospitals—must perform abortions on request when the "health" of a pregnant woman is in serious jeopardy. §1395dd(e)(1)(A)(i). In the Government's view, EMTALA trumps laws like Idaho's, which allow abortions only to preserve the life of the pregnant woman. See Dept. of Health & Human Servs. (HHS), Reinforcement of EMTALA Obligations Specific to Patients Who Are Pregnant or Are Experiencing Pregnancy Loss 1 (QSO-22-22-Hospitals, July 11, 2022). The Government sued Idaho on this preemption theory and obtained a preliminary injunction against enforcement of the state law “to the extent it conflicts with EMTALA." 623 F. Supp. 3d 1097, 1117 (Idaho 2022). The Government's preemption theory is plainly unsound. Far from requiring hospitals to perform abortions, EMTALA's text unambiguously demands that Medicare-funded hospitals protect the health of both a pregnant woman and her “unborn child.” §1395dd(e)(1)(A)(i). And even if there were some ambiguity in the statutory text, we would be obligated to resolve that ambiguity in favor of the State because EMTALA was enacted under the Spending Clause, and as we have held time and again, conditions attached to the receipt of federal funds must be unambiguous. Arlington Central School Dist. Bd. of Ed. v. Murphy, 548 U. S. 291, 296 (2006); Pennhurst State School and Hospital v. Halderman, 451 U. S. 1, 17 (1981). Here, no one who has any respect for statutory language can plausibly say that the Government's interpretation is unambiguously correct. And in any event, Idaho never consented to any conditions imposed by EMTALA and certainly did not surrender control of the practice of medicine and the regulation of abortions within its territory. Recognizing the flaws in the Government's theory and Idaho's "strong" likelihood of success, this Court stayed the preliminary injunction pending appeal on January 5. And, wisely or not, the Court also took the unusual step of granting certiorari before Idaho's appeal was heard by the Ninth Circuit. See this Court's Rule 11. Now the Court dismisses the writ and, what is worse, vacates the stay. This about-face is baffling. Nothing legally relevant has occurred since January 5. And the underlying issue in this case whether EMTALA requires hospitals to perform abortions in some circumstances—is a straightforward question of statutory interpretation. It is squarely presented by the decision below, and it has

been exhaustively briefed and argued. In addition to the parties' briefs, we received 46 amicus briefs, including briefs submitted by 44 States and the District of Columbia; briefs expressing the views of 379 Members of Congress; and briefs from prominent medical organizations. Altogether, we have more than 1,300 pages of briefing to assist us, and we heard nearly two hours of argument. Everything there is to say about the statutory interpretation question has probably been said many times over. That question is as ripe for decision as it ever will be. Apparently, the Court has simply lost the will to decide the easy but emotional and highly politicized question that the case presents. That is regrettable. Having already taken the extraordinary step of granting certiorari before judgment in order to decide whether the Government's new interpretation of EMTALA is correct, we have no good reason to change course now. This is especially so because the Court's decision to reexamine the stay issued in January makes it necessary to reassess whether Idaho showed a likelihood of success on the merits, a question that is closely related to the question whether Idaho or the Government has correctly interpreted EMTALA. I will therefore proceed to analyze what EMTALA means. I A The text of EMTALA shows clearly that it does not require hospitals to perform abortions in violation of Idaho law. To the contrary, EMTALA obligates Medicare-funded hospitals to treat, not abort, an “unborn child." EMTALA imposes two main obligations on covered hospitals. First, a hospital must, within its “capabilit[ies],” "screen" "any individual” arriving at the emergency room without regard to the individual's ability to pay. §§1395dd(a), (h). The purpose of this screening is to determine whether the individual has an “emergency medical condition,” which EMTALA defines as follows: "a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in― "(i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy, "(ii) serious impairment to bodily functions, or "(iii) serious dysfunction of any bodily organ or part.” §1395dd(e)(1)(A) (emphasis added). When a hospital determines that an “emergency medical condition" exists, it has two options. It may provide “treatment" within the capability of its “staff and facilities.” §1395dd(b)(1)(A). Or it may “transfer . . . the individual" to another hospital that “has available space and qualified personnel for the treatment” as long as the transfer would effect a net benefit for the patient. §§1395dd(b)(1)(B), (c)(2)(B)(i). At no point in its elaboration of the screening, stabilization, and transfer requirements does EMTALA mention abortion. Just the opposite is true: EMTALA requires the hospital at every stage to protect an “unborn child" from harm. Begin with the screening provision, which requires a hospital “to determine whether or not an emergency medical condition (within the meaning of subsection (e)(1)) exists." §1395dd(a). “[W]ith respect to a pregnant woman," subsection (e)(1) defines an emergency medical condition as one that is sufficiently serious to "plac[e] . . . the health of the woman or her unborn child . . . in serious jeopardy.” §1395dd(e)(1)(A)(i) (emphasis added). Thus, if the hospital identifies an emergency medical condition threatening the child, it must “stabilize” that condition to ensure that the child's health does not remain in “jeopardy.” §§1395dd(b)(1)(A), (e)(1)(A)(i). It goes without saying that aborting an “unborn child” does not protect it from jeopardy.

Similarly, if a hospital wants to transfer a pregnant woman to another facility, it may not do so unless, among other things, a physician certifies directly or through an intermediary that the medical benefits of transfer outweigh any "increased risks" to the woman “and, in the case of labor, to the unborn child." §§1395dd(c)(1)(A) (ii), (e)(1)(B). Thus, regardless of whether a hospital chooses to treat or transfer a pregnant woman, it must strive to protect her "unborn child” from harm. The Government struggles mightily-but unsuccessfully—to get around this language. First, the Government argues that EMTALA's repeated use of the term “individual," coupled with the Dictionary Act's definition of that term, which does not include an "unborn child," shows that "[a]ll of EMTALA's duties—screening, stabilization, and transfer run to the ‘individual' seeking care.” Brief for United States 41. That assertion falls flat in light of EMTALA's express protection of the unborn child. Besides, there is a simple explanation for EMTALA's repeated use of the term "individual," and it provides no support for the Government's interpretation. Most of those references involve conduct in which only the pregnant woman can engage, such as going to an emergency room, receiving medical information, consenting to or refusing treatment, or filing suit. Many references concern transfer to another facility, and when a pregnant woman is transferred, her “unborn child" obviously goes with her. Another reference concerns a woman's "emergency medical condition,” which, as noted, includes conditions that jeopardize her “unborn child." And some references expressly mention both the “individual” and “the unborn child." No use of the term “individual” supports the Government's interpretation. Second, based on a provision stating that an individual may not be treated without consent, § 1395dd(b)(2), the Government infers that “it is for the pregnant woman, not state law, to decide how to proceed" when her health is at risk. Brief for United States 43. The Government's logic is faulty. The right to withhold consent does not necessarily carry with it the right to demand whatever cannot be done without consent. X may withhold consent to a contract with Y, but that does not mean that X may demand to enter into such a contract. A person may not be forced to assume the duties of the Presidency without consent, but it does not follow that this person may demand to be sworn in as President. Or, to provide an example that is more closely related to the matter at hand, the right to refuse medical treatment without consent does not entail the right to demand treatment that is prohibited by law. Cancer patients have the right to refuse treatment that their doctors recommend, but they do not have a right to obtain whatever treatment they want, such as the administration of a drug that cannot legally be used in this country. Cf. 21 U. S. C. §360bbb-0a (granting terminal patients the right to try experimental drugs). Likewise here, a woman's right to withhold consent to treatment related to her pregnancy does not mean that she can demand an abortion. For these reasons, the text of EMTALA conclusively shows that it does not require hospitals to perform abortions. B For those who find it appropriate to look beyond the statutory text, the context in which EMTALA was enacted reinforces what the text makes clear. Congress designed EMTALA to solve a particular problem—preventing private hospitals from turning away patients who are unable to pay for medical care. H. R. Rep. No. 99–241(I), pt. 1, p. 27 (1985); K. Treiger, Preventing Patient Dumping: Sharpening the COBRA's Fangs, 61 N. Y. U. L. Rev. 1186, 1188 (1986). And none of many briefs submitted in this suit has found any suggestion in the proceedings leading up to EMTALA's passage that the Act might also use the carrot of federal funds to entice hospitals to perform abortions. To the contrary, EMTALA garnered broad support in both Houses of Congress, including the support of Members such as Representative Henry Hyde who adamantly opposed the use of federal funds to abet abortion. It is also telling that the Congress that initially enacted EMTALA in 1986 and the one that amended it in 1989 also passed appropriations riders under what is now known as the Hyde Amendment (named after Representative Hyde) to prevent federal funds from facilitating abortions, except in limited circumstances. See Harris v. McRae, 448 U. S. 297, 302 (1980). Between 1981 and 1993—the very period when EMTALA was enacted and amended

-the Hyde Amendment contained only one exception: for abortions necessary to save the life of the pregnant woman. Congressional Research Service, E. Liu & W. Shen, The Hyde Amendment: An Overview 1 (2022); see §204, 99 Stat. 1119 (1986 Hyde Amendment). The Hyde Amendment thus prohibited federal funds from paying for the health-related abortions that the Government says EMTALA mandates. It would have been strange indeed if a Congress that repeatedly sought to prevent federal funding of abortions simultaneously enacted a law that, as interpreted by the Government, requires hospitals and physicians to perform that very same procedure. The Government's reading of EMTALA is doubly strange given that the President who signed that law repeatedly promised not to use federal funds to subsidize or require the provision of abortions. Less than three months before signing EMTALA, President Reagan told participants in the annual March for Life that "the resources of government are not [to be] used to promote or perform abortions." The American Presidency Project, Remarks to Participants in the March for Life Rally (Jan. 22, 1986). The next year, he touted his administration's work "to restrict the use of Federal funds to perform abortions.” Id., Remarks to Participants in the March for Life Rally (Jan. 22, 1987). In another 1987 speech, he promised that his administration would "oppose any legislation that would require individuals or institutions, public or private, to finance or perform abortions." Id., Remarks at a White House Briefing for Right to Life Activists (July 30, 1987). And his 1986 and 1987 messages to Congress repeated that promise. See id., Message to the Congress on “A Quest for Excellence" (Jan. 27, 1987); id., Message to the Congress on America's Agenda for the Future (Feb. 6, 1986). Around the same time, President Reagan's HHS Secretary testified before Congress that "the Administration steadfastly opposes [the] creation of [a] program which would encourage, promote or finance the performance of abortions." Statement of the Hon. Margaret M. Heckler, in Budget Reconciliation: Hearings before the Senate Committee on Finance, 99th Cong., 1st Sess., pt. 1, p. 273 (1985). It beggars belief that President Reagan would have happily signed EMTALA into law if it did what he “steadfastly oppose[d].” Ibid. C Desperate to find some crumb of support for its interpretation, the Government scrapes together a handful of sources that it says evidence a general understanding that EMTALA requires hospitals to perform health-related abortions prohibited by Idaho law. None of these sources stands for that proposition. First, the Government searched a vast database of HHS enforcement decisions and located six occurring between 2010 and 2023 that it finds helpful. It is not obvious why those enforcement decisions—which postdate EMTALA by more than 20 years—shed light on its original meaning. And it is even less clear why they justify the Government's claim that EMTALA preempts Idaho law. Five of the six cases involved ectopic pregnancies, which the Idaho law does not cover. See Idaho Code Ann. §18–604(1)(c) (excluding ectopic pregnancies from the definition of "abortion”). In the remaining case, the hospital was faulted, not for failing to perform an abortion, but for discharging a sick pregnant woman without calling for an ambulance to transport her to another hospital. The Government also seizes upon a provision in the Affordable Care Act stating that "[n]othing in this Act shall be construed to relieve any health care provider from providing emergency services as required by State or Federal law, including . . . EMTALA." 42 U. S. C. §18023(d) (internal quotation marks omitted). Because this provision was placed in a section of the Act concerning abortion, the Government infers that it reflects a congressional understanding that EMTALA sometimes requires abortions. Brief for United States 19–20. That inference is totally unwarranted. The provision in question refers to the entire massive Affordable Care Act, not just the relatively few provisions concerning abortion. Compare §18023(d), with §18023(c) (referring more narrowly to "this subsection"). It reaffirms the duty of participating hospitals to comply with EMTALA, but it does not expand what the text of EMTALA requires. So this provision cannot support the Government's interpretation of EMTALA either. II As the previous Part shows, EMTALA's text and context decisively refute the Government's interpretation. But there is a third strike against the Government's position: EMTALA is an exercise of Congress's spending power.

And when Congress relies on its authority to attach conditions to the receipt of federal funds, special rules apply. Spending Clause legislation operates “much in the nature of a contract: in return for federal funds, the [recipients] agree to comply with federally imposed conditions.” Pennhurst, 451 U. S., at 17. These conditions do not bind unless and until they are accepted, and private parties “can opt out of spending programs” at will, "completely nullifying whatever force the spending conditions once had." Health and Hospital Corporation of Marion Cty. v. Talevski, 599 U. S. 166, 201 (2023) (Thomas, J., dissenting); accord, Townsend v. Swank, 404 U. S. 282, 292 (1971) (Burger, C. J., concurring in result) (“[A]herence to [Spending Clause] provisions . . . is in no way mandatory"). "[T]he 'legitimacy of Congress' power" " to enforce conditions tied to federal funds depends on whether the parties who accepted federal funds also" "voluntarily and knowingly" "accepted the conditions. Cummings v. Premier Rehab Keller, 596 U. S. 212, 219 (2022) (quoting Barnes v. Gorman, 536 U. S. 181, 186 (2002)). Because the enforcement of conditions attached to the receipt of federal money depends on a recipient's knowing and voluntary consent, “the conditions must be set out ‘unambiguously.” ” Arlington Central, 548 U. S., at 296 (quoting Pennhurst, 451 U. S., at 17). And recipients must be given a “legitimate choice whether to accept the federal conditions." National Federation of Independent Business v. Sebelius, 567 U. S. 519, 578 (2012) (opinion of Roberts, C. J.); accord, Steward Machine Co. v. Davis, 301 U. S. 548, 590 (1937). The Government's interpretation founders at both points. First, consider the requirement that EMTALA speak unambiguously. Even if it were possible to read EMTALA as requiring abortions prohibited by Idaho law, it is beyond dispute that such a requirement is not unambiguously clear. The statute does not mention abortion, let alone expressly bind hospitals to perform abortions contrary to state law. 66 The need for clear statutory language is especially important in this suit because the Government's interpretation would intrude on an area traditionally left to state control, namely, the practice of medicine. We typically expect Congress to 'make its intention "clear and manifest" if it intends to pre-empt the historic powers of the States."" Gregory v. Ashcroft, 501 U. S. 452, 461 (1991) (quoting Rice v. Santa Fe Elevator Corp., 331 U. S. 218, 230 (1947)); see also Gonzales v. Oregon, 546 U. S. 243, 274 (2006) (“[T]he background principles of our federal system also belie the notion that Congress would use such an obscure grant of authority to regulate areas traditionally supervised by the States' police power"). Second, consider the requirement that parties be given a choice before being bound by Spending Clause conditions. The Government's interpretation purports to limit Idaho's choices about what conduct to criminalize. But Idaho never “agree[d]" to be bound by EMTALA, Cummings, 596 U. S., at 219, let alone to surrender its historic power to regulate the practice of medicine or the performance of abortions within its borders. The Idaho Legislature takes its argument against preemption even further. It contends that EMTALA cannot preempt the State's abortion regulations because Idaho is not a party to the agreement between the Federal Government and the hospitals that take Medicare funds. See Brief for Petitioners in No. 23–726, pp. 50–51. As it explains, States cannot be bound by terms that they never accepted, so it is hard to see how a third party's agreement with the Federal Government can deprive a State of the ability to enforce its criminal laws. Accord, Talevski, 599 U. S., at 212 (Thomas, J., dissenting) (“[E]ven those who held the broadest conception of the spending power recognized that it was only a power to spend, not a power to impose binding requirements with the force of federal law"). The potential implications of permitting preemption here are far-reaching. Under the Government's view, Congress could apparently pay doctors to perform not only emergency abortions but also third-trimester elective abortions or eugenic abortions. It could condition Medicare funds on hospitals' offering assisted suicide even in the vast majority of States that ban the practice. It could authorize the practice of medicine by any doctor who accepts Medicare payments even if he or she does not meet the State's licensing requirements. While the Government is not troubled by the potential consequences of its preemption argument, Congress was sensitive to state prerogatives. The Medicare Act, in which EMTALA is situated, disclaims any construction that

would "authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided" in a particular State. 42 U. S. C. § 1395. This disclaimer evidences a desire to "minimize federal intrusion” into state healthcare regulation. Massachusetts Medical Soc. v. Dukakis, 815 F. 2d 790, 791 (CA1 1987) (opinion of Breyer, J.). EMTALA's narrow preemption clause also respects core state powers by providing that the Act "do[es] not preempt any State or local law requirement, except to the extent that the requirement directly conflicts with a requirement of this section." §1395dd(f). This phrasing signals that EMTALA's default position is coexistence with state law. In response to the Legislature's argument, the Government claims that a handful of our cases have held that Spending Clause statutes can preempt the laws of non-consenting States, but those cases do not begin to settle the question at hand. Two are entirely inapposite. And the remaining cases simply upheld the Federal Government's ability to prevent the use of federal money for purposes other than those intended by Congress. The Government has not identified any decision holding that a federal law enacted under the Spending Clause preempts a state criminal law or public health regulation. For present purposes, it is not necessary to decide whether the Legislature's theory is correct. At a minimum, however, it provides yet another reason to be wary about interpreting EMTALA to displace the core powers of a non-consenting State without unmistakable clarity regarding the meaning of the federal law. * * * In sum, the Government's new interpretation of EMTALA is refuted by the statutory text, the context in which the law was enacted, and the rules of interpretation that we apply to Spending Clause legislation. We should reject the Government's interpretation and put that matter to rest. III Even if the Court is unwilling to decide the statutory interpretation question, there is no excuse for vacating the stay of the preliminary injunction. In order to obtain that injunction, the Government was required to make a strong showing that it was likely to prevail on the merits. See Munaf v. Geren, 553 U. S. 674, 690 (2008). And as I have explained, its argument was almost certain to lose. That in itself is sufficient to preclude continuation of the preliminary injunction. Why then have six Justices voted to vacate the stay? The per curiam itself provides no explanation. In separate opinions, three of the six agree with the Government's interpretation of EMTALA, see supra, at 15, n. 17, and that at least is an explanation that would make sense if the premise (the correctness of the Government's interpretation) were sound. As for the remaining three, their only explanation is that “the injunction will not stop Idaho from enforcing its law in the vast majority of circumstances" and that therefore Idaho cannot show that it will be irreparably harmed by allowing the injunction to remain in place during the pendency of the appeal. Ante, at 7 (Barrett, J., joined by Roberts, C. J., and Kavanaugh, J., concurring). That justification is patently unsound. "[A]ny time a State is enjoined by a court from effectuating statutes enacted by representatives of its people, it suffers a form of irreparable injury." " Maryland v. King, 567 U. S. 1301, 1303 (2012) (Roberts, C. J., in chambers). And in this case, Idaho's injury is not abstract. As I will explain, it is very likely that the preliminary injunction will lead to more abortions, including in at least some cases where the fetus is viable. The State of Idaho wants to prevent that; the preliminary injunction stands in its way. Isn't that enough to constitute irreparable harm? The Justices who have joined Justice Barrett's concurrence claim that the parties' briefs and oral arguments seem to have narrowed the degree to which EMTALA, as interpreted by the Government, conflicts with the Idaho law, ante, at 7-8, but all the parties continue to insist that the laws conflict. The Solicitor General argued that EMTALA's focus on a pregnant woman's health is broader than Idaho's life-of-the-mother exception. In forceful terms, she told us: "In Idaho, doctors have to shut their eyes to everything except death," whereas under EMTALA, a physician is supposed to think about serious threats to a pregnant woman's health. Tr. of Oral Arg. 102. In light of this perceived conflict, the Solicitor General said it was "gravely mistaken” to suggest that "there really isn't in operation a difference between” EMTALA and Idaho law. Id., at 101–102.

Idaho agreed that the Government's interpretation of EMTALA conflicts with state law. In particular, the State worried that "the United States' novel theory" would "authorize emergency-room doctors to perform abortions" for mental-health reasons and would thus "turn emergency rooms into federal abortion enclaves governed not by state law but by subjective physician judgment.” Brief for Petitioner in No. 23–727, p. 30; see also Tr. of Oral Arg. 45-46. Thus, whatever narrowing may have occurred during briefing and argument in this Court, both the Government and the State of Idaho fervently maintain that it matters whether the Idaho law is enforced. Do any Justices in the majority seriously disagree? Do any of them think that the parties, not to mention their armies of amici, are fighting about nothing? Three of the six Justices in the majority also agree that there is a conflict—and judging from their fiery rhetoric, a big one. See ante, at 1 (Kagan, J., joined by Sotomayor, J., and by Jackson, J., as to Part II, concurring); ante, at 7 (Jackson, J., concurring in part and dissenting in part). And they are correct to this extent: there is a real conflict. A I begin with the Government's argument that "there are numerous conditions" that may afflict a pregnant woman "where a doctor's immediate concern is not death." Tr. of Oral Arg. 103. In those cases, the Government explains, a doctor might be worried about serious risks to the woman's “health.” Ibid. In the Government's telling, EMTALA requires hospitals to perform an abortion on demand in these circumstances. Idaho law says otherwise. An Idaho doctor may not perform an abortion unless the doctor “determine[s], in his good faith medical judgment ..., that the abortion [is] necessary to prevent the death of the pregnant woman.” Idaho Code Ann. §18–622(2)(a)(i). And even then, the doctor must “attemp[t] to perform the abortion in the manner that . . . provide[s] the best opportunity for the unborn child to survive," unless doing so "would... pos[e] a greater risk of the death of the pregnant woman.” §622(2)(a)(ii). 66 These standards do not require a doctor to be “objective[ly] certai[n]" that the abortion is “ “necessary' to save the woman's life." Planned Parenthood, 171 Idaho, at 445, 522 P. 3d, at 1203 (emphasis deleted). Nor does Idaho law require that the risk of death be particularly immediate. Ibid. Indeed, the Idaho Supreme Court has explained that the law “leaves wide room for the physician's ‘good faith medical judgment' on whether [an] abortion was 'necessary." " Ibid.; accord, id., at 446, 522 P. 3d, at 1203 (noting that the Act “imposes a subjective standard based on the individual physician's good faith medical judgment”). And any latitude, it said, “ “operates for the benefit, not the disadvantage, 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). " " 66 These different considerations-health versus life—may lead to different outcomes. For instance, consider the situation of a woman who experiences a condition that was discussed in the briefs and at argument: preterm prelabor rupture of membranes (PPROM), which occurs when a woman's amniotic sac breaks before the 37th week of pregnancy. 1 App. 295. The Members of this Court are not physicians and should therefore be wary about expressing conclusions about medical issues. But guidance provided by prominent medical institutions is sufficient to show how Idaho law and EMTALA, as interpreted by the Government, 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 physician is likely to recommend that labor be induced. In that situation, it does not appear that the risk of conflict is high. On the other hand, when PPROM occurs earlier than that, the chances of conflict are greatly increased. If PPROM occurs before the 34th week and the woman's pregnancy continues, she may experience conditions such as an infection of the amniotic fluid, inflammation of the uterine lining, hemorrhage, or sepsis. However, life-threatening complications are not inevitable, and according to the PPROM Foundation, death is “extremely

rare." A physician may try to delay labor by putting the woman on bed rest and administering steroids to help the baby's lungs grow and antibiotics to prevent infection. When PPROM occurs before the 24th week of pregnancy, the potential for conflict appears to be even higher. But in that situation, it may still be possible to manage the situation until the baby can be delivered, and there is a chance of a good outcome for both the mother and child, although studies have yielded different results. Thus, when PPROM occurs before the 34th week of pregnancy, there is a risk to the health of both the woman and her unborn child. In these situations, the Defense of Life Act requires doctors to consider whether performing an abortion is necessary to prevent the woman's death. Because this is a “subjective” standard, Planned Parenthood, 171 Idaho, at 446, 522 P. 3d, at 1204, different doctors may reach different conclusions about when PPROM endangers the woman's life. At least some may conclude in some cases of PPROM occurring before the 34th week of pregnancy that the woman's life is not endangered since she may never develop a serious infection, let alone life- threatening sepsis or any other potentially fatal condition, if she receives proper treatment. See 1 App. 306–307. Rather, those doctors may believe that Idaho law requires them to try to delay delivery long enough to save the child's life, unless PPROM becomes sufficiently "severe" to cause “infection and serious risk of sepsis." See, e.g., 2 id., at 547. According to the Government's experts, however, EMTALA requires a hospital to perform an abortion at the woman's request whenever PPROM is diagnosed, even if the woman has not yet developed an infection or any other health complications. That is because, they assert, it can be “reasonably expected" that, in “the absence of immediate medical attention," PPROM would "plac[e] the health" of the pregnant woman “in serious jeopardy" or cause “serious dysfunction" to her reproductive organs. §§1395dd(c)(1)(A)(ii), (e)(1)(A)(i) and (iii); see, e.g., 2 App. 594 ("Providing stabilizing treatment in the form of termination of pregnancy at the point of diagnosis would be an appropriate means to preserve the patient's reproductive organs at that time”). Thus, in PPROM cases, there may be an important conflict between what Idaho law permits and what EMTALA, as interpreted by the Government, demands. And the same may be true with respect to other conditions that a pregnant woman may experience. This gap between the Idaho law and the Government's interpretation of EMTALA matters. Idaho has always permitted abortions that are necessary to preserve the life of a pregnant woman, but it has not allowed abortions for other non-life-threatening medical conditions. Planned Parenthood, 171 Idaho, at 391–394, 522 P. 3d, at 1149–1152 (summarizing Idaho's historical restrictions); see also Dobbs, 597 U. S., at 302-330 (compiling other state statutes with identical exceptions). This balance reflects Idaho's judgment about a difficult and important moral question. See Planned Parenthood, 171 Idaho, at 437-438, 522 P. 3d, at 1195–1196. By requiring Idaho hospitals to strike a different balance, the preliminary injunction thwarts the will of the people of Idaho as expressed in law by their elected representatives. B I now turn to Idaho's claim that the Government's reading of EMTALA would authorize abortions for mental- health reasons. My colleagues dismiss this concern because at argument, the Solicitor General “emphatically disavowed the notion that an abortion is ever required as stabilizing treatment for mental health conditions." Ante, at 5 (Barrett, J., concurring). But it is hard to see how the Government could reach that conclusion. At oral argument, the Solicitor General conceded that the term “health” in EMTALA includes mental health, Tr. of Oral Arg. 77-78, and if that is so, it is not difficult to imagine a situation in which the Government's interpretation of EMTALA could require an abortion. Suppose, for example, that a woman in the 10th week of gestation experiences serious depression due to her pregnancy. If she asks emergency medical professionals for treatment, her medical care providers might conclude that her continued pregnancy could "reasonably be expected" to seriously jeopardize the woman's mental health. §1395dd(e)(1)(A). Under the Government's reading of EMTALA, the woman would then have the right to "make an informed decision" about the treatment she received. Brief for United States 41. If the

woman preferred to abort rather than manage her depression alongside her pregnancy, it is not apparent why the Government's reading of EMTALA would not require that abortion. We have seen where a rule permitting abortions to protect the psychological health of pregnant women may lead. In Roe, the Court held that a woman had the right to obtain a post-viability abortion that was deemed “necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.” Roe v. Wade, 410 U. S. 113, 165 (1973). In the companion case Doe v. Bolton, 410 U. S. 179 (1973), the Court wrote that a doctor, in judging whether an abortion was needed to preserve a pregnant woman's health, could consider "all factors- physical, emotional, psychological, familial, and the woman's age-relevant to the well-being of the patient." Id., at 192. That decision was viewed by many as essentially preventing States from restricting post-viability abortions. As Harvard Law School Professor Mary Ann Glendon put it: "[W]hen Roe is read with Doe, third- trimester restrictions are effectively ruled out as well—for Roe's dictum that such restrictions might be permissible if they did not interfere with the mother's health was negated by Doe's definition of ‘health' as 'well-being." " The Women of Roe v. Wade (2003). The Solicitor General tried to explain why the Government's interpretation would not lead down this path, but her explanation is hard to understand. She said that mental-health emergencies "could never lead to pregnancy termination” because abortion “is not the accepted standard of practice to treat any mental health emergency.” Tr. of Oral Arg. 77–78; accord, Brief for United States 26, n. 5. That assertion appears to be inconsistent with the position taken by prominent medical associations that endorse abortion for mental-health reasons as an accepted standard of practice. See, e.g., American Psychiatric Association, Position Statement on Abortion and Women's Reproductive Healthcare Rights (Mar. 2023) ("Freedom to act to interrupt pregnancy must be considered a mental health imperative"); American Psychological Association, Resolution Affirming and Building on APA's History of Support for Reproductive Rights (Feb. 2022). For these reasons, there is a real potential for conflict between the Idaho law and the Government's interpretation of EMTALA, and in my judgment, the Court seriously errs by vacating the stay we issued earlier this year. * * * Today's decision is puzzling. Having taken the unusual step of granting certiorari before Idaho's appeal could be heard by the Ninth Circuit, the Court decides it does not want to tackle this case after all and thus returns the appeal to the Ninth Circuit, which will have to decide the issue that this Court now ducks. What is more, the Court vacates the stay it issued earlier this year even though the majority fails to provide any facially plausible explanation for doing so. I cannot endorse this turn of events and therefore respectfully dissent. For instance, the American Hospital Association (AHA) calculates that 96% of hospitals have at least 50% of their inpatient days paid by Medicare and Medicaid. AHA, Fact Sheet: Majority of Hospital Payments Dependent on Medicare or Medicaid (Mar. 2024). At oral argument, the Solicitor General stated that, in the Government's view, an “impairment” or “dysfunction" under §1395dd (e)(1)(A)(i) and (ii) may be temporary. Tr. of Oral Arg. 80. The Dictionary Act defines an “individual” to “include every infant member of the species homo sapiens who is born alive at any stage of development.” 1 U. S. C. §8(a). But it goes on to provide that this definition is not to “be construed to ... deny... any legal status or legal right applicable to any member of the species homo sapiens at any point prior to being ‘born alive."" §8(c). Thus, the Act itself provides no support for the Government's position. §1395dd(a).

$1395dd(c)(1)(A)(i). §1395dd(b)(2). $1395dd(d)(2)(A). §§1395dd(b)(3), (c), (e)(4). §1395dd(e)(1)(A)(i). §§1395dd(c)(1)(A)(ii) and (2)(A), (e)(1)(A)(i). See House Vote #499 in 1986 (99th Cong.), GovTrack.US (Mar. 20, 1986), https://www.govtrack.us/congress/votes/99-1986/h499; Senate Vote #379 in 1985 (99th Cong.), GovTrack.US (Dec. 19, 1985), https://www.govtrack.us/congress/votes/99-1985/s379. Additionally, it is doubtful that Idaho law would have prevented an abortion in this suit. The woman was diagnosed with “[i]nevitable abortion.” Centers for Medicare and Medicaid Services, Hospital Surveys With 2567 Statement of Deficiencies-2024Q1 (2010-2016 file) Row 16,961. But Idaho law does not apply to "non- viable pregnancies . . . where the unborn child is no longer developing." Planned Parenthood Great Northwest v. State, 171 Idaho 374, 445, 522 P. 3d 1132, 1203 (2023); see also Idaho Code Ann. §§18–604(1), (11). Section 18023(d) also demands compliance with state emergency care requirements, and laws like Idaho's impose requirements regarding permissible emergency care for pregnant women. Only one state psychiatric hospital accepts Medicare funds, and it does not have an emergency room. App. 531. Coventry Health Care of Mo., Inc. v. Nevils, 581 U. S. 87, 95–99 (2017), held that Missouri's anti-subrogation law was preempted by the Federal Employee Health Benefits Act with regard to contracts for health benefits negotiated between the Federal Government and insurance carriers. It did not present the question whether Spending Clause conditions placed on private parties could preempt States from enforcing their criminal statutes against any of their residents—including parties that did not contract with the Federal Government. And in Townsend v. Swank, 404 U. S. 282 (1971), the State itself was the recipient of the funds in question. See Philpott v. Essex County Welfare Bd., 409 U. S. 413, 415 (1973) (attachment of Social Security benefits); Bennett v. Arkansas, 485 U. S. 395, 398 (1988) (per curiam) (same); Lawrence County v. Lead-Deadwood School Dist. No. 40–1, 469 U. S. 256, 271 (1985) (use of federal payments in lieu of taxes made to municipalities with federal facilities). Justice Sotomayor, Justice Kagan, and Justice Jackson endorse the Government's interpretation of EMTALA but barely bother to explain why they think the interpretation is correct. Justice Kagan's opinion, which Justice Sotomayor and Justice Jackson join, argues that “EMTALA unambiguously requires that a Medicare-funded hospital provide whatever medical treatment is necessary to stabilize a health emergency" and in some cases this may require an abortion. Ante, at 4 (concurring opinion). Justice Kagan conveniently fails to note that EMTALA defines the term “emergency medical condition" and that this definition includes any condition that is sufficiently serious to "plac[e] . . . the health of [a pregnant] woman or her unborn child . . . in serious jeopardy." §1395dd(e)(1)(A)(i). Therefore, as I have already explained, EMTALA demands that a covered hospital stabilize any sufficiently serious threat to the health of an "unborn child." Not only is Justice Kagan's analysis of the statutory language faulty, but she fails to say anything about the special rules of interpretation that apply to Spending Clause measures or how Idaho can be bound by conditions to which it has never agreed. Justice Jackson's opinion adds nothing to Justice Kagan's legal analysis, but she reads my opinion to suggest "that States have free rein to nullify federal law." Ante, at 7 (opinion concurring in part and dissenting in part).

Anyone who reads my opinion can see that it makes no such suggestion but simply explains what the federal law in question means. 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). One study found that 14% of women with PPROM before the point of viability developed one or more of these complications, and approximately 1% to 5% developed life-threatening sepsis. 1 App. 298. A review of studies after 1993 indicated that the most common maternal morbidity is infection of the amniotic fluid, "with approximately 37% of women developing this complication.” T. Waters & B. Mercer, The Management of Preterm Premature Rupture of Membranes Near the Limit of Fetal Viability, Am. J. Obstetrics & Gynecology (AJOG), p. 231 (Sept. 2009); see also Brief for Physicians for Reproductive Health as Amicus Curiae 18. PPROM Foundation, PPROM Facts, https://www.aapprom. org/community/ppromfacts (June 21, 2024) (PPROM Facts). Ibid.; see also Children's Hospital of Philadelphia, Premature Rupture of Membranes (PROM)/Preterm Premature Rupture of Membranes (PPROM), https://www.chop.edu/conditions-diseases/premature-rupture- membranes-prompreterm-premature-rupture-membranes‐pprom (June 21, 2024). See, e.g., S. Dayal & P. Hong, Premature Rupture of Membranes (July 17, 2023), https://www.ncbi.nlm.nih.gov/books/NBK532888. "A recent study reports a 90% survival rate for infants exposed to prolonged PPROM occurring between 18-24 weeks who were delivered after 24 weeks." PPROM Facts (citing J. Brumbaugh et al., Neonatal Survival After Prolonged Preterm Premature Rupture of Membranes Before 24 Weeks of Gestation, 124 Obstetrics & Gynecology 992 (2014); see also A. Ozel et al., Outcomes of Pregnancies Complicated by Preterm Premature Rupture of Membranes Before and After 24 Gestational Weeks: A Retrospective Analysis, J. Clinical Obstetrics & Gynecology, p. 231 (Nov. 2023) (reporting that one-third of unborn children survived PPROM before viability at a hospital between 2018–2020); E. Lorthe et al., Preterm Premature Rupture of Membranes and 22–25 Weeks' Gestation, AJOG, p. 5 (Sept. 2018) (determining that, when PPROM occurred between weeks 22 and 25, about half of the children survived, and roughly three-quarters of the survivors did not have severe morbidities); P. Wagner et al., Outcome of Pregnancies With Spontaneous PPROM Before 24+0 Weeks' Gestation (2016) (reporting that "[a]bout half" of fetuses in PPROM pregnancies that make it to viability "will be discharged alive without major complications"). It has been estimated that PPROM occurs in about 2% of all pregnancies involving a single fetus and in 7% of all pregnancies involving twins. See PPROM Facts. It is reported that in 2022, there were 22,391 live births in Idaho. March of Dimes, Fertility Rate: Idaho, 2012-2022, https://www.marchofdimes.org/peristats/data? reg=99&top=2&stop=1& lev=slev=4&obj=1&sreg=16 (Jan. 2024). These statistics suggest that PPROM may have occurred in as many as 500 cases. In some of these cases, the fetus may not have been viable, and in some, the pregnant woman may not have chosen to have an abortion even if the law allowed. Nevertheless, it would not be surprising if the Idaho law, if allowed to be enforced, would result in fewer abortions and more live births. See, e.g., J. Ely, The Wages of Crying Wolf: A Comment on Roe v. Wade, 82 Yale L. J. 920, 921, and n. 19 (1973); J. Dellapenna, Dispelling the Myths of Abortion History 695 (2006) (“Blackmun's definition of a woman's ‘health' in Doe as encompassing anything affecting her ‘well-being' virtually precluded any possible regulation of abortion during the entire months of pregnancy"); R. Ponnuru, The Party of Death 10 (2006) ("Roe required that any ban on late-term abortion include an exception allowing abortion to protect a woman's health; Doe defined that exception so broadly that it swallowed up any possibility of a ban”).