{ "attribution": { "source": "legal.exploreworldai.com", "canonical": "https://legal.exploreworldai.com/api/public/v1/judgment-text?id=us:indctapp-25a-pl-00782-2025-12-05", "cite_as": "NovaCopilot, legal.exploreworldai.com (https://legal.exploreworldai.com/api/public/v1/judgment-text?id=us:indctapp-25a-pl-00782-2025-12-05)", "license": "https://legal.exploreworldai.com/revision", "version": "legal-2026-10-07", "fingerprint": "ewai:se:9dbc3a", "proof": "sha256:99dad45ca78533772272c8a6130abddcc76db9fcba16008a98357367ab9f8bdd", "jurisdiction": "se", "lang": "en", "publisher": "NovaCopilot by ExploreWorld Legal", "terms": "https://legal.exploreworldai.com/om" }, "brand_source": "Source: NovaCopilot", "item": { "schema_version": "1.0.0", "id": "us:indctapp-25a-pl-00782-2025-12-05", "jurisdiction": "us", "lang": "en", "brand_source": "Source: NovaCopilot", "brand": { "product": "NovaCopilot", "platform": "ExploreWorldAI", "infrastructure": "ExploreWorld Legal", "infrastructure_url": "legal.exploreworldai.com", "legal_entity": "Valkiv Ventures AB", "permanent_url": "https://legal.exploreworldai.com/novacopilot", "source": "Source: NovaCopilot", "powered_by": "Powered by NovaCopilot", "license": "https://legal.exploreworldai.com/licensvillkor" }, "sections": [ { "title": "Front matter", "paragraphs": [ "para_1", "para_2", "para_3", "para_4", "para_5", "para_6", "para_7", "para_8", "para_9", "para_10", "para_11", "para_12", "para_13", "para_14", "para_15", "para_16", "para_17", "para_18", "para_19", "para_20", "para_21", "para_22", "para_23", "para_24", "para_25", "para_26", "para_27", "para_28", "para_29", "para_30", "para_31", "para_32", "para_33", "para_34", "para_35", "para_36", "para_37", "para_38", "para_39", "para_40", "para_41", "para_42", "para_43", "para_44", "para_45", "para_46", "para_47", "para_48", "para_49", "para_50", "para_51", "para_52", "para_53", "para_54", "para_55", "para_56", "para_57", "para_58", "para_59", "para_60", "para_61", "para_62", "para_63", "para_64", "para_65", "para_66", "para_67", "para_68", "para_69", "para_70", "para_71", "para_72", "para_73", "para_74", "para_75", "para_76", "para_77", "para_78", "para_79", "para_80", "para_81", "para_82", "para_83", "para_84", "para_85", "para_86", "para_87", "para_88", "para_89", "para_90", "para_91", "para_92", "para_93", "para_94", "para_95", "para_96", "para_97", "para_98", "para_99", "para_100", "para_101", "para_102", "para_103", "para_104", "para_105", "para_106", "para_107", "para_108", "para_109", "para_110", "para_111", "para_112", "para_113", "para_114", "para_115", "para_116", "para_117", "para_118", "para_119", "para_120", "para_121", "para_122", "para_123", "para_124", "para_125", "para_126", "para_127", "para_128", "para_129", "para_130", "para_131", "para_132", "para_133", "para_134", "para_135", "para_136", "para_137", "para_138", "para_139", "para_140", "para_141", "para_142", "para_143", "para_144", "para_145", "para_146", "para_147", "para_148", "para_149", "para_150", "para_151", "para_152", "para_153", "para_154", "para_155", "para_156", "para_157", "para_158", "para_159", "para_160", "para_161", "para_162", "para_163", "para_164", "para_165", "para_166", "para_167", "para_168", "para_169", "para_170", "para_171", "para_172", "para_173", "para_174", "para_175", "para_176", "para_177", "para_178", "para_179", "para_180", "para_181", "para_182", "para_183", "para_184", "para_185", "para_186", "para_187", "para_188", "para_189", "para_190", "para_191", "para_192", "para_193", "para_194", "para_195", "para_196", "para_197", "para_198", "para_199", "para_200", "para_201", "para_202", "para_203", "para_204", "para_205", "para_206", "para_207", "para_208", "para_209", "para_210", "para_211", "para_212", "para_213", "para_214", "para_215", "para_216", "para_217", "para_218", "para_219", "para_220", "para_221", "para_222", "para_223", "para_224", "para_225", "para_226", "para_227", "para_228", "para_229", "para_230", "para_231", "para_232", "para_233", "para_234", "para_235", "para_236", "para_237", "para_238", "para_239", "para_240", "para_241", "para_242", "para_243", "para_244", "para_245", "para_246", "para_247", "para_248", "para_249", "para_250", "para_251", "para_252", "para_253", "para_254", "para_255", "para_256", "para_257", "para_258", "para_259", "para_260", "para_261", "para_262", "para_263", "para_264", "para_265", "para_266", "para_267", "para_268", "para_269", "para_270", "para_271", "para_272", "para_273", "para_274", "para_275", "para_276", "para_277", "para_278", "para_279", "para_280", "para_281", "para_282", "para_283", "para_284", "para_285", "para_286", "para_287", "para_288", "para_289", "para_290", "para_291", "para_292", "para_293", "para_294", "para_295", "para_296", "para_297", "para_298", "para_299", "para_300", "para_301", "para_302", "para_303", "para_304", "para_305", "para_306", "para_307", "para_308", "para_309", "para_310", "para_311", "para_312", "para_313", "para_314", "para_315", "para_316", "para_317", "para_318", "para_319", "para_320", "para_321", "para_322", "para_323", "para_324", "para_325", "para_326", "para_327", "para_328", "para_329", "para_330", "para_331", "para_332", "para_333", "para_334", "para_335", "para_336", "para_337", "para_338", "para_339", "para_340", "para_341", "para_342", "para_343", "para_344", "para_345", "para_346", "para_347", "para_348", "para_349", "para_350", "para_351", "para_352", "para_353", "para_354", "para_355", "para_356", "para_357", "para_358", "para_359", "para_360", "para_361", "para_362", "para_363", "para_364", "para_365", "para_366", "para_367", "para_368", "para_369", "para_370", "para_371", "para_372", "para_373", "para_374", "para_375", "para_376", "para_377", "para_378", "para_379", "para_380", "para_381", "para_382", "para_383", "para_384", "para_385", "para_386", "para_387", "para_388", "para_389", "para_390", "para_391", "para_392", "para_393", "para_394", "para_395", "para_396", "para_397", "para_398", "para_399", "para_400", "para_401", "para_402", "para_403", "para_404", "para_405", "para_406", "para_407", "para_408", "para_409", "para_410", "para_411", "para_412", "para_413", "para_414", "para_415", "para_416", "para_417", "para_418", "para_419", "para_420", "para_421", "para_422", "para_423", "para_424", "para_425", "para_426", "para_427", "para_428", "para_429", "para_430", "para_431", "para_432", "para_433", "para_434", "para_435", "para_436", "para_437", "para_438", "para_439", "para_440", "para_441", "para_442", "para_443", "para_444", "para_445", "para_446", "para_447", "para_448", "para_449", "para_450", "para_451", "para_452", "para_453", "para_454", "para_455", "para_456", "para_457", "para_458", "para_459", "para_460", "para_461", "para_462", "para_463", "para_464", "para_465", "para_466", "para_467", "para_468", "para_469", "para_470", "para_471", "para_472", "para_473", "para_474", "para_475", "para_476", "para_477", "para_478", "para_479", "para_480", "para_481", "para_482", "para_483", "para_484", "para_485", "para_486", "para_487", "para_488", "para_489", "para_490", "para_491", "para_492", "para_493", "para_494", "para_495", "para_496", "para_497", "para_498", "para_499", "para_500", "para_501", "para_502", "para_503", "para_504", "para_505", "para_506", "para_507", "para_508", "para_509", "para_510", "para_511", "para_512", "para_513", "para_514", "para_515", "para_516", "para_517", "para_518", "para_519", "para_520", "para_521", "para_522", "para_523", "para_524", "para_525", "para_526", "para_527", "para_528", "para_529", "para_530", "para_531", "para_532", "para_533", "para_534", "para_535", "para_536", "para_537", "para_538", "para_539", "para_540", "para_541", "para_542", "para_543", "para_544", "para_545", "para_546", "para_547", "para_548", "para_549", "para_550", "para_551", "para_552", "para_553", "para_554", "para_555", "para_556", "para_557", "para_558", "para_559", "para_560", "para_561", "para_562", "para_563", "para_564", "para_565", "para_566", "para_567", "para_568", "para_569", "para_570", "para_571", "para_572", "para_573", "para_574", "para_575", "para_576", "para_577", "para_578", "para_579", "para_580", "para_581", "para_582", "para_583", "para_584", "para_585", "para_586", "para_587", "para_588", "para_589", "para_590", "para_591", "para_592", "para_593", "para_594", "para_595", "para_596", "para_597", "para_598", "para_599", "para_600", "para_601", "para_602", "para_603", "para_604", "para_605", "para_606", "para_607", "para_608", "para_609", "para_610", "para_611", "para_612", "para_613", "para_614", "para_615", "para_616", "para_617", "para_618", "para_619", "para_620", "para_621", "para_622", "para_623", "para_624", "para_625", "para_626", "para_627", "para_628", "para_629", "para_630", "para_631", "para_632", "para_633", "para_634", "para_635", "para_636", "para_637", "para_638", "para_639", "para_640", "para_641", "para_642", "para_643", "para_644", "para_645", "para_646", "para_647", "para_648", "para_649", "para_650", "para_651", "para_652", "para_653", "para_654", "para_655", "para_656", "para_657", "para_658", "para_659", "para_660", "para_661", "para_662", "para_663", "para_664", "para_665", "para_666", "para_667", "para_668", "para_669", "para_670", "para_671", "para_672", "para_673", "para_674", "para_675", "para_676", "para_677", "para_678", "para_679", "para_680", "para_681", "para_682", "para_683", "para_684", "para_685", "para_686", "para_687", "para_688", "para_689", "para_690", "para_691", "para_692", "para_693", "para_694", "para_695", "para_696", "para_697", "para_698", "para_699", "para_700", "para_701", "para_702", "para_703", "para_704", "para_705", "para_706", "para_707", "para_708", "para_709", "para_710", "para_711", "para_712", "para_713", "para_714", "para_715", "para_716", "para_717", "para_718", "para_719", "para_720", "para_721", "para_722", "para_723", "para_724", "para_725", "para_726", "para_727", "para_728", "para_729", "para_730", "para_731", "para_732", "para_733", "para_734", "para_735", "para_736", "para_737", "para_738", "para_739", "para_740", "para_741", "para_742", "para_743", "para_744", "para_745", "para_746", "para_747", "para_748", "para_749", "para_750", "para_751", "para_752", "para_753", "para_754", "para_755", "para_756", "para_757", "para_758", "para_759", "para_760", "para_761", "para_762", "para_763", "para_764", "para_765", "para_766", "para_767", "para_768", "para_769", "para_770", "para_771", "para_772", "para_773", "para_774", "para_775", "para_776", "para_777", "para_778", "para_779", "para_780", "para_781", "para_782", "para_783", "para_784", "para_785", "para_786", "para_787", "para_788", "para_789", "para_790", "para_791", "para_792", "para_793", "para_794", "para_795", "para_796", "para_797", "para_798", "para_799", "para_800", "para_801", "para_802", "para_803", "para_804", "para_805", "para_806", "para_807", "para_808", "para_809", "para_810", "para_811", "para_812", "para_813", "para_814", "para_815", "para_816", "para_817", "para_818", "para_819", "para_820", "para_821", "para_822", "para_823", "para_824", "para_825", "para_826", "para_827", "para_828", "para_829", "para_830", "para_831", "para_832", "para_833", "para_834", "para_835", "para_836", "para_837", "para_838", "para_839", "para_840", "para_841", "para_842", "para_843", "para_844", "para_845", "para_846", "para_847", "para_848", "para_849", "para_850", "para_851", "para_852", "para_853", "para_854", "para_855", "para_856", "para_857", "para_858", "para_859", "para_860", "para_861", "para_862", "para_863", "para_864", "para_865", "para_866", "para_867", "para_868", "para_869", "para_870", "para_871", "para_872", "para_873", "para_874", "para_875", "para_876", "para_877", "para_878", "para_879", "para_880", "para_881", "para_882", "para_883", "para_884", "para_885", "para_886", "para_887", "para_888", "para_889", "para_890", "para_891", "para_892", "para_893", "para_894", "para_895", "para_896", "para_897", "para_898" ], "kind": "front_matter" } ], "paragraphs": [ { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 1 of 35", "paragraph_id": "para_1" }, { "text": "I N T H E", "paragraph_id": "para_2" }, { "text": "Court of Appeals of Indiana", "paragraph_id": "para_3" }, { "text": "Indiana State Health Commissioner, in the officer’s official", "paragraph_id": "para_4" }, { "text": "capacity, and Voices for Life, Inc.,", "paragraph_id": "para_5" }, { "text": "Appellants-Defendants", "paragraph_id": "para_6" }, { "text": "v.", "paragraph_id": "para_7" }, { "text": "Caitlin Bernard, M.D., and Caroline Rouse, M.D.,", "paragraph_id": "para_8" }, { "text": "Appellees-Plaintiffs", "paragraph_id": "para_9" }, { "text": "December 5, 2025", "paragraph_id": "para_10" }, { "text": "Court of Appeals Case No.", "paragraph_id": "para_11" }, { "text": "25A-PL-782", "paragraph_id": "para_12" }, { "text": "Interlocutory Appeal from the Marion Superior Court", "paragraph_id": "para_13" }, { "text": "The Honorable James A. Joven, Judge", "paragraph_id": "para_14" }, { "text": "Trial Court Cause No.", "paragraph_id": "para_15" }, { "text": "49D13-2502-PL-6359", "paragraph_id": "para_16" }, { "text": "Opinion by Judge Bailey", "paragraph_id": "para_17" }, { "text": "Judges Brown and Weissmann concur.", "paragraph_id": "para_18" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 2 of 35", "paragraph_id": "para_19" }, { "text": "Bailey, Judge.", "paragraph_id": "para_20" }, { "text": "Case Summary", "paragraph_id": "para_21" }, { "text": "[1] Caitlin Bernard, M.D., and Caroline Rouse, M.D. (collectively, “Doctors”), are", "paragraph_id": "para_22" }, { "text": "both board-certified obstetrician-gynecologists who provide clinical care,", "paragraph_id": "para_23" }, { "text": "including abortion care, in Indiana. Doctors filed a complaint against the", "paragraph_id": "para_24" }, { "text": "Indiana State Health Commissioner (“the Commissioner”), in the", "paragraph_id": "para_25" }, { "text": "Commissioner’s official capacity, and Voices for Life, Inc. (“VFL”), an anti-", "paragraph_id": "para_26" }, { "text": "abortion nonprofit organization based in South Bend (collectively,", "paragraph_id": "para_27" }, { "text": "“Defendants”). Doctors sought a judgment under the Uniform Declaratory", "paragraph_id": "para_28" }, { "text": "Judgment Act (“the UDJA”) that a terminated pregnancy report (“TPR”),", "paragraph_id": "para_29" }, { "text": "which a health care provider is statutorily required to submit to the Indiana", "paragraph_id": "para_30" }, { "text": "Department of Health (“the Department”) for each abortion that the provider", "paragraph_id": "para_31" }, { "text": "performs, is exempt from disclosure under the Access to Public Records Act", "paragraph_id": "para_32" }, { "text": "(“the APRA”) as a patient medical record. Doctors also sought a preliminary", "paragraph_id": "para_33" }, { "text": "injunction prohibiting the Commissioner from disclosing TPRs in response to", "paragraph_id": "para_34" }, { "text": "any request made under the APRA, including those that had previously been", "paragraph_id": "para_35" }, { "text": "made by VFL. After a hearing, the trial court issued an order in which it", "paragraph_id": "para_36" }, { "text": "concluded that Doctors had standing to seek a declaratory judgment and were", "paragraph_id": "para_37" }, { "text": "entitled to a preliminary injunction prohibiting the Commissioner from", "paragraph_id": "para_38" }, { "text": "disclosing TPRs in response to any APRA request.", "paragraph_id": "para_39" }, { "text": "[2] Defendants now appeal that order, arguing that the trial court erred in", "paragraph_id": "para_40" }, { "text": "concluding that Doctors have standing to seek a declaratory judgment, that the", "paragraph_id": "para_41" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 3 of 35", "paragraph_id": "para_42" }, { "text": "trial court abused its discretion in granting Doctors a preliminary injunction,", "paragraph_id": "para_43" }, { "text": "and that the injunction is overbroad because it also applies to APRA requests", "paragraph_id": "para_44" }, { "text": "for TPRs not submitted by Doctors. We disagree and therefore affirm the trial", "paragraph_id": "para_45" }, { "text": "court’s order in all respects.", "paragraph_id": "para_46" }, { "text": "Facts and Procedural History", "paragraph_id": "para_47" }, { "text": "[3] Because they play such a prominent role in the procedural history of this case,", "paragraph_id": "para_48" }, { "text": "we set forth our legislature’s onerous requirements for the content and", "paragraph_id": "para_49" }, { "text": "submission of the TPRs at the heart of this dispute. Indiana Code Section 16-", "paragraph_id": "para_50" }, { "text": "34-2-5(a) states,", "paragraph_id": "para_51" }, { "text": "Every health care provider who performs a surgical abortion or", "paragraph_id": "para_52" }, { "text": "provides, prescribes, administers, or dispenses an abortion", "paragraph_id": "para_53" }, { "text": "inducing drug for the purposes of inducing an abortion shall", "paragraph_id": "para_54" }, { "text": "report the performance of the abortion or the provision,", "paragraph_id": "para_55" }, { "text": "prescribing, administration, or dispensing of an abortion", "paragraph_id": "para_56" }, { "text": "inducing drug on a form drafted by the [Department], the", "paragraph_id": "para_57" }, { "text": "purpose and function of which shall be the improvement of", "paragraph_id": "para_58" }, { "text": "maternal health and life through the compilation of relevant", "paragraph_id": "para_59" }, { "text": "maternal life and health factors and data, and a further purpose", "paragraph_id": "para_60" }, { "text": "and function shall be to monitor all abortions performed in", "paragraph_id": "para_61" }, { "text": "Indiana to assure the abortions are done only under the", "paragraph_id": "para_62" }, { "text": "authorized provisions of the law. For each abortion performed", "paragraph_id": "para_63" }, { "text": "and abortion inducing drug provided, prescribed, administered,", "paragraph_id": "para_64" }, { "text": "or dispensed, the report shall include, among other things, the", "paragraph_id": "para_65" }, { "text": "following:", "paragraph_id": "para_66" }, { "text": "(1) The age of the patient.", "paragraph_id": "para_67" }, { "text": "(2) Whether a waiver of consent under section 4 of this chapter", "paragraph_id": "para_68" }, { "text": "was obtained.", "paragraph_id": "para_69" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 4 of 35", "paragraph_id": "para_70" }, { "text": "(3) Whether a waiver of notification under section 4 of this", "paragraph_id": "para_71" }, { "text": "chapter was obtained.", "paragraph_id": "para_72" }, { "text": "(4) The date and location, including the facility name and city or", "paragraph_id": "para_73" }, { "text": "town, where the:", "paragraph_id": "para_74" }, { "text": "(A) pregnant woman:", "paragraph_id": "para_75" }, { "text": "(i) provided consent; and", "paragraph_id": "para_76" }, { "text": "(ii) received all information;", "paragraph_id": "para_77" }, { "text": "required under section 1.1 of this chapter; and", "paragraph_id": "para_78" }, { "text": "(B) abortion was performed or the abortion inducing drug", "paragraph_id": "para_79" }, { "text": "was provided, prescribed, administered, or dispensed.", "paragraph_id": "para_80" }, { "text": "(5) The health care provider’s full name and address, including", "paragraph_id": "para_81" }, { "text": "the name of the physicians performing the abortion or providing,", "paragraph_id": "para_82" }, { "text": "prescribing, administering, or dispensing the abortion inducing", "paragraph_id": "para_83" }, { "text": "drug.", "paragraph_id": "para_84" }, { "text": "(6) The city and county where the pregnancy termination", "paragraph_id": "para_85" }, { "text": "occurred.", "paragraph_id": "para_86" }, { "text": "(7) The age of the father, or the approximate age of the father if", "paragraph_id": "para_87" }, { "text": "the father’s age is unknown.", "paragraph_id": "para_88" }, { "text": "(8) The patient’s county and state of residence.", "paragraph_id": "para_89" }, { "text": "(9) The marital status of the patient.", "paragraph_id": "para_90" }, { "text": "(10) The educational level of the patient.", "paragraph_id": "para_91" }, { "text": "(11) The race of the patient.", "paragraph_id": "para_92" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 5 of 35", "paragraph_id": "para_93" }, { "text": "(12) The ethnicity of the patient.", "paragraph_id": "para_94" }, { "text": "(13) The number of the patient’s previous live births.", "paragraph_id": "para_95" }, { "text": "(14) The number of the patient’s deceased children.", "paragraph_id": "para_96" }, { "text": "(15) The number of the patient’s spontaneous pregnancy", "paragraph_id": "para_97" }, { "text": "terminations.", "paragraph_id": "para_98" }, { "text": "(16) The number of the patient’s previous induced terminations.", "paragraph_id": "para_99" }, { "text": "(17) The date of the patient’s last menses.", "paragraph_id": "para_100" }, { "text": "(18) The physician’s determination of the gestation of the fetus in", "paragraph_id": "para_101" }, { "text": "weeks.", "paragraph_id": "para_102" }, { "text": "(19) The reason for the abortion.", "paragraph_id": "para_103" }, { "text": "(20) Whether the patient indicated that the patient was seeking", "paragraph_id": "para_104" }, { "text": "an abortion as a result of being:", "paragraph_id": "para_105" }, { "text": "(A) abused;", "paragraph_id": "para_106" }, { "text": "(B) coerced;", "paragraph_id": "para_107" }, { "text": "(C) harassed; or", "paragraph_id": "para_108" }, { "text": "(D) trafficked.", "paragraph_id": "para_109" }, { "text": "(21) The following information concerning the abortion or the", "paragraph_id": "para_110" }, { "text": "provision, prescribing, administration, or dispensing of the", "paragraph_id": "para_111" }, { "text": "abortion inducing drug:", "paragraph_id": "para_112" }, { "text": "(A) The postfertilization age of the fetus (in weeks).", "paragraph_id": "para_113" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 6 of 35", "paragraph_id": "para_114" }, { "text": "(B) The manner in which the postfertilization age was", "paragraph_id": "para_115" }, { "text": "determined.", "paragraph_id": "para_116" }, { "text": "(C) The gender of the fetus, if detectable.", "paragraph_id": "para_117" }, { "text": "(D) Whether the fetus has been diagnosed with or has a", "paragraph_id": "para_118" }, { "text": "potential diagnosis of having Down syndrome or any", "paragraph_id": "para_119" }, { "text": "other disability.", "paragraph_id": "para_120" }, { "text": "(E) If after the earlier of the time the fetus obtains viability", "paragraph_id": "para_121" }, { "text": "or the time the postfertilization age of the fetus is at least", "paragraph_id": "para_122" }, { "text": "twenty (20) weeks, the medical reason for the performance", "paragraph_id": "para_123" }, { "text": "of the abortion.", "paragraph_id": "para_124" }, { "text": "(22) For a surgical abortion, the medical procedure used for the", "paragraph_id": "para_125" }, { "text": "abortion and, if the fetus had a postfertilization age of at least", "paragraph_id": "para_126" }, { "text": "twenty (20) weeks:", "paragraph_id": "para_127" }, { "text": "(A) whether the procedure, in the reasonable judgment of", "paragraph_id": "para_128" }, { "text": "the health care provider, gave the fetus the best", "paragraph_id": "para_129" }, { "text": "opportunity to survive;", "paragraph_id": "para_130" }, { "text": "(B) the basis for the determination that the pregnant", "paragraph_id": "para_131" }, { "text": "woman had a condition described in this chapter that", "paragraph_id": "para_132" }, { "text": "required the abortion to avert the death of or serious", "paragraph_id": "para_133" }, { "text": "impairment to the pregnant woman; and", "paragraph_id": "para_134" }, { "text": "(C) the name of the second doctor present, as required", "paragraph_id": "para_135" }, { "text": "under IC 16-34-2-3(a)(3).", "paragraph_id": "para_136" }, { "text": "(23) For a nonsurgical abortion, the precise drugs provided,", "paragraph_id": "para_137" }, { "text": "prescribed, administered, or dispensed, and the means of delivery", "paragraph_id": "para_138" }, { "text": "of the drugs to the patient.", "paragraph_id": "para_139" }, { "text": "(24) For a nonsurgical abortion, that the manufacturer’s", "paragraph_id": "para_140" }, { "text": "instructions were provided to the patient and that the patient", "paragraph_id": "para_141" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 7 of 35", "paragraph_id": "para_142" }, { "text": "signed the patient agreement.", "paragraph_id": "para_143" }, { "text": "(25) For an abortion performed before twenty (20) weeks of", "paragraph_id": "para_144" }, { "text": "postfertilization age of the fetus, the medical indication by", "paragraph_id": "para_145" }, { "text": "diagnosis code for the fetus and the mother.", "paragraph_id": "para_146" }, { "text": "(26) The mother’s obstetrical history, including dates of other", "paragraph_id": "para_147" }, { "text": "abortions, if any.", "paragraph_id": "para_148" }, { "text": "(27) Any preexisting medical conditions of the patient that may", "paragraph_id": "para_149" }, { "text": "complicate the abortion.", "paragraph_id": "para_150" }, { "text": "(28) The results of pathological examinations if performed.", "paragraph_id": "para_151" }, { "text": "(29) For a surgical abortion, whether the fetus was delivered", "paragraph_id": "para_152" }, { "text": "alive, and if so, how long the fetus lived.", "paragraph_id": "para_153" }, { "text": "(30) Records of all maternal deaths occurring at the location", "paragraph_id": "para_154" }, { "text": "where the abortion was performed or the abortion inducing drug", "paragraph_id": "para_155" }, { "text": "was provided, prescribed, administered, or dispensed.", "paragraph_id": "para_156" }, { "text": "(31) The date the form was transmitted to the [Department] and,", "paragraph_id": "para_157" }, { "text": "if applicable, separately to the [Department of Child Services].", "paragraph_id": "para_158" }, { "text": "[4] A provider is required to transmit a completed form to the Department within", "paragraph_id": "para_159" }, { "text": "thirty days after the date of an abortion. Ind. Code § 16-34-2-5(b). If an abortion", "paragraph_id": "para_160" }, { "text": "is for a female under sixteen years of age, the provider is required to transmit", "paragraph_id": "para_161" }, { "text": "the form to the Department and separately to the Department of Child Services", "paragraph_id": "para_162" }, { "text": "within three days after the abortion is performed. Id. Subsection (d) of the", "paragraph_id": "para_163" }, { "text": "statute provides that “[e]ach failure to complete or timely transmit a form … for", "paragraph_id": "para_164" }, { "text": "each abortion performed or abortion inducing drug that was provided,", "paragraph_id": "para_165" }, { "text": "prescribed, administered, or dispensed, is a Class B misdemeanor.” I.C. § 16-34-", "paragraph_id": "para_166" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 8 of 35", "paragraph_id": "para_167" }, { "text": "2-5(d).1 And subsection (e) of the statute requires the Department, “[o]n a", "paragraph_id": "para_168" }, { "text": "quarterly basis,” to", "paragraph_id": "para_169" }, { "text": "compile a public report providing the following:", "paragraph_id": "para_170" }, { "text": "(1) Statistics for the previous calendar quarter from the", "paragraph_id": "para_171" }, { "text": "information submitted under this section.", "paragraph_id": "para_172" }, { "text": "(2) Statistics for previous calendar years compiled by the", "paragraph_id": "para_173" }, { "text": "[Department] under this subsection, with updated information", "paragraph_id": "para_174" }, { "text": "for the calendar quarter that was submitted to the [Department]", "paragraph_id": "para_175" }, { "text": "after the compilation of the statistics.", "paragraph_id": "para_176" }, { "text": "I.C. § 16-34-2-5(e). The Department “shall ensure that no identifying", "paragraph_id": "para_177" }, { "text": "information of a pregnant woman is contained in the [public] report.” Id.", "paragraph_id": "para_178" }, { "text": "[5] Indiana physicians operate under two complementary legal obligations", "paragraph_id": "para_179" }, { "text": "regarding patient information: (1) they must maintain patient confidentiality;", "paragraph_id": "para_180" }, { "text": "and (2) they must report certain information to state regulators, including the", "paragraph_id": "para_181" }, { "text": "Department. See, e.g., I.C. § 16-39-5-3(c)-(d) (imposing duties on medical", "paragraph_id": "para_182" }, { "text": "providers to keep patients’ identities confidential when releasing patients’ health", "paragraph_id": "para_183" }, { "text": "records to third parties); Henry v. Cmty. Healthcare Sys. Cmty. Hosp., 134 N.E.3d", "paragraph_id": "para_184" }, { "text": "435, 437-38 (Ind. Ct. App. 2019) (acknowledging a historic common law duty", "paragraph_id": "para_185" }, { "text": "of confidentiality owed by the physician to the patient); I.C. § 16-34-2-5(a).", "paragraph_id": "para_186" }, { "text": "1 A physician’s failure to transmit a TPR to the Department may also result in the revocation of the", "paragraph_id": "para_187" }, { "text": "physician’s license. Ind. Code § 25-22.5-8-6(b)(1).", "paragraph_id": "para_188" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 9 of 35", "paragraph_id": "para_189" }, { "text": "[6] Another statute creates tension in this dynamic. The APRA presumes that", "paragraph_id": "para_190" }, { "text": "government agency records are publicly accessible unless the agency proves that", "paragraph_id": "para_191" }, { "text": "they fall within a statutory exception. I.C. §§ 5-14-3-1, -9(f)-(g). One such", "paragraph_id": "para_192" }, { "text": "exception shields “[p]atient medical records … created by a provider” from", "paragraph_id": "para_193" }, { "text": "disclosure without the patient’s consent. I.C. § 5-14-3-4(a)(9). The dispute in", "paragraph_id": "para_194" }, { "text": "this case centers on whether TPRs qualify as patient medical records, such that", "paragraph_id": "para_195" }, { "text": "they are exempt from disclosure under the APRA through Section 5-14-3-", "paragraph_id": "para_196" }, { "text": "4(a)(9).", "paragraph_id": "para_197" }, { "text": "[7] The State’s position on patient confidentiality has changed dramatically over", "paragraph_id": "para_198" }, { "text": "the last two years, resulting in the legal uncertainty that fueled the underlying", "paragraph_id": "para_199" }, { "text": "action and this appeal. Initially, the State viewed certain patient details as", "paragraph_id": "para_200" }, { "text": "confidential patient information.", "paragraph_id": "para_201" }, { "text": "[8] July 2023: At the Attorney General’s urging, the Indiana Medical Licensing", "paragraph_id": "para_202" }, { "text": "Board (“the Board”) disciplined Dr. Bernard for publicly disclosing a patient’s", "paragraph_id": "para_203" }, { "text": "age (ten years old), state of residence (Ohio), referral date (approximately June", "paragraph_id": "para_204" }, { "text": "27, 2022), and gestational age (six weeks, three days).2 The Board found that", "paragraph_id": "para_205" }, { "text": "this information was confidential because it either identified the patient or could", "paragraph_id": "para_206" }, { "text": "reasonably be used to identify her. Appellants’ App. Vol. 2 at 143-44 (citing I.C.", "paragraph_id": "para_207" }, { "text": "§ 25-1-9-4(a)(3) and 45 C.F.R. §§ 164.502(a), 164.514).", "paragraph_id": "para_208" }, { "text": "2 Pursuant to Indiana Code Section 25-1-7-2, the Office of the Attorney General “may receive, investigate,", "paragraph_id": "para_209" }, { "text": "and prosecute complaints concerning regulated occupations.”", "paragraph_id": "para_210" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 10 of 35", "paragraph_id": "para_211" }, { "text": "[9] October 2023: Under the APRA, VFL requested from the Department all TPRs", "paragraph_id": "para_212" }, { "text": "filed in August 2023. The Indiana Public Access Counselor (“the PAC”), who", "paragraph_id": "para_213" }, { "text": "interprets public access laws, issued an informal opinion to the Department’s", "paragraph_id": "para_214" }, { "text": "chief legal counsel that TPRs are medical records exempt from APRA", "paragraph_id": "para_215" }, { "text": "disclosure. Citing the patient medical records exception in the APRA, the PAC", "paragraph_id": "para_216" }, { "text": "reasoned that “the entirety of the [TPR] form is a medical record” and that", "paragraph_id": "para_217" }, { "text": "public release of the TPRs, even if partly redacted, would “defeat the statutory", "paragraph_id": "para_218" }, { "text": "purpose” of protecting patient medical records from disclosure. Id. at 83; see", "paragraph_id": "para_219" }, { "text": "I.C. § 5-14-3-4(a)(9). The PAC also noted that the TPR statute requires only", "paragraph_id": "para_220" }, { "text": "aggregate “public” statistics, which suggests that individual forms are non-", "paragraph_id": "para_221" }, { "text": "public. Appellants’ App. Vol. 2 at 83 (referring to I.C. § 16-34-2-5(e)).", "paragraph_id": "para_222" }, { "text": "Ultimately, the PAC concluded that TPRs “should be withheld from disclosure", "paragraph_id": "para_223" }, { "text": "in their entirety.” Id. at 84. The Department therefore refused VFL’s request for", "paragraph_id": "para_224" }, { "text": "the TPRs.", "paragraph_id": "para_225" }, { "text": "[10] The State, however, soon shifted its position on whether such information", "paragraph_id": "para_226" }, { "text": "could be publicly disclosed.", "paragraph_id": "para_227" }, { "text": "[11] April 2024: The Attorney General issued an advisory opinion concluding that", "paragraph_id": "para_228" }, { "text": "the APRA’s “exception for ‘medical record[s]’” does not encompass TPRs.", "paragraph_id": "para_229" }, { "text": "Attorney General, Opinion Letter 2024-2 on Non-Disclosure of Terminated", "paragraph_id": "para_230" }, { "text": "Pregnancy Reports, 1 (April 11, 2024),", "paragraph_id": "para_231" }, { "text": "https://www.in.gov/attorneygeneral/about-the-office/advisory/opinions", "paragraph_id": "para_232" }, { "text": "[https://perma.cc/2SGX-8468]. The advisory opinion stated that TPRs may be", "paragraph_id": "para_233" }, { "text": "disclosed with redactions, arguing that complete confidentiality would frustrate", "paragraph_id": "para_234" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 11 of 35", "paragraph_id": "para_235" }, { "text": "the TPR statute’s purpose. Id. (referring to I.C. § 16-34-2-5). The Attorney", "paragraph_id": "para_236" }, { "text": "General promoted this view at a news conference and “wrote letters to the", "paragraph_id": "para_237" }, { "text": "Governor and key members of the Indiana legislature urging them to take", "paragraph_id": "para_238" }, { "text": "retaliatory action against [the Department] and the [PAC].” Appellants’ App.", "paragraph_id": "para_239" }, { "text": "Vol. 2 at 39.3", "paragraph_id": "para_240" }, { "text": "[12] May 2024-September 2024: Within weeks of the Attorney General’s advisory", "paragraph_id": "para_241" }, { "text": "opinion, VFL sued the Department to compel disclosure of TPRs, arguing that", "paragraph_id": "para_242" }, { "text": "they were not exempt as patient medical records under the APRA. Doctors", "paragraph_id": "para_243" }, { "text": "intervened in the lawsuit, as they were entitled to do under Indiana Code", "paragraph_id": "para_244" }, { "text": "Section 5-14-3-9(e) based on the Department’s denial of VFL’s request for the", "paragraph_id": "para_245" }, { "text": "TPRs.4 Represented by private counsel, the Department moved to dismiss,", "paragraph_id": "para_246" }, { "text": "arguing that TPRs were exempt patient medical records. The trial court granted", "paragraph_id": "para_247" }, { "text": "3 This language appears in the trial court’s findings in this appeal. The parties do not challenge that finding as", "paragraph_id": "para_248" }, { "text": "inaccurate.", "paragraph_id": "para_249" }, { "text": "4 Indiana Code Section 5-14-3-9(e) states,", "paragraph_id": "para_250" }, { "text": "A person who has been denied the right to inspect or copy a public record by a public agency", "paragraph_id": "para_251" }, { "text": "may file an action in the circuit or superior court of the county in which the denial occurred to", "paragraph_id": "para_252" }, { "text": "compel the public agency to permit the person to inspect and copy the public record. Whenever", "paragraph_id": "para_253" }, { "text": "an action is filed under this subsection, the public agency must notify each person who supplied", "paragraph_id": "para_254" }, { "text": "any part of the public record at issue:", "paragraph_id": "para_255" }, { "text": "(1) that a request for release of the public record has been denied; and", "paragraph_id": "para_256" }, { "text": "(2) whether the denial was in compliance with an informal inquiry response or advisory", "paragraph_id": "para_257" }, { "text": "opinion of the public access counselor.", "paragraph_id": "para_258" }, { "text": "Such persons are entitled to intervene in any litigation that results from the denial. The person", "paragraph_id": "para_259" }, { "text": "who has been denied the right to inspect or copy need not allege or prove any special damage", "paragraph_id": "para_260" }, { "text": "different from that suffered by the public at large.", "paragraph_id": "para_261" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 12 of 35", "paragraph_id": "para_262" }, { "text": "dismissal in September 2024, finding unpersuasive VFL’s claim “that the law,", "paragraph_id": "para_263" }, { "text": "as written, makes the [TPRs] public records.” Id. at 89.", "paragraph_id": "para_264" }, { "text": "[13] October 2024-February 2025: VFL appealed, and the Attorney General—who", "paragraph_id": "para_265" }, { "text": "had previously urged “retaliatory action” against the Department—entered an", "paragraph_id": "para_266" }, { "text": "appearance on the Department’s behalf. Id. at 39. VFL and the Attorney", "paragraph_id": "para_267" }, { "text": "General then settled, with the Department agreeing to release TPRs as public", "paragraph_id": "para_268" }, { "text": "records while not redacting many data points, including patient age, state of", "paragraph_id": "para_269" }, { "text": "residence, gestational age, and abortion date. Id. at 94-96. This contradicted the", "paragraph_id": "para_270" }, { "text": "Attorney General’s earlier position that this same information could identify", "paragraph_id": "para_271" }, { "text": "patients—the basis for Dr. Bernard’s public reprimand nineteen months earlier.", "paragraph_id": "para_272" }, { "text": "VFL moved to dismiss the appeal based on the settlement. Two days later, our", "paragraph_id": "para_273" }, { "text": "Chief Judge granted VFL’s motion and dismissed the appeal with prejudice.", "paragraph_id": "para_274" }, { "text": "[14] That same day, Doctors filed the instant complaint against Defendants under", "paragraph_id": "para_275" }, { "text": "the UDJA, seeking a declaratory judgment that TPRs are patient medical", "paragraph_id": "para_276" }, { "text": "records and thus are exempt from disclosure under the APRA. Doctors also", "paragraph_id": "para_277" }, { "text": "filed a motion for a temporary restraining order and a preliminary injunction to", "paragraph_id": "para_278" }, { "text": "prohibit the Commissioner from “disclosing or otherwise providing access to", "paragraph_id": "para_279" }, { "text": "[TPRs] in response to any request made under” the APRA. Id. at 43.", "paragraph_id": "para_280" }, { "text": "[15] In February, the trial court held a hearing on and granted Doctors’ motion for a", "paragraph_id": "para_281" }, { "text": "temporary restraining order. In March, the court held a hearing on Doctors’", "paragraph_id": "para_282" }, { "text": "motion for a preliminary injunction. Later that month, the trial court issued an", "paragraph_id": "para_283" }, { "text": "order in which it found that Doctors had standing to seek a declaratory", "paragraph_id": "para_284" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 13 of 35", "paragraph_id": "para_285" }, { "text": "judgment. The court further found that Doctors had satisfied the prerequisites", "paragraph_id": "para_286" }, { "text": "for obtaining a preliminary injunction, including “establish[ing] probable", "paragraph_id": "para_287" }, { "text": "success on their claim that a TPR is subject to exemption from disclosure as a", "paragraph_id": "para_288" }, { "text": "[patient] medical record.” Appealed Order at 11. Consequently, the court", "paragraph_id": "para_289" }, { "text": "prohibited the Commissioner “from disclosing or otherwise providing access to", "paragraph_id": "para_290" }, { "text": "[TPRs] created in accordance with Indiana Code section 16-34-2-5, and in", "paragraph_id": "para_291" }, { "text": "response to any request made under” the APRA. Id. at 20.", "paragraph_id": "para_292" }, { "text": "[16] Defendants each filed a notice of appeal of the trial court’s order and a motion", "paragraph_id": "para_293" }, { "text": "to stay the injunction pending appeal. On May 30, this Court denied", "paragraph_id": "para_294" }, { "text": "Defendants’ motions to stay. This interlocutory appeal ensued.", "paragraph_id": "para_295" }, { "text": "Discussion and Decision", "paragraph_id": "para_296" }, { "text": "Issue One: Doctors’ standing to seek a declaratory judgment", "paragraph_id": "para_297" }, { "text": "[17] Defendants argue that the trial court erred in determining that Doctors have", "paragraph_id": "para_298" }, { "text": "standing to seek a declaratory judgment. “The threshold issue of standing", "paragraph_id": "para_299" }, { "text": "determines whether a litigant is entitled to have a court decide the substantive", "paragraph_id": "para_300" }, { "text": "issues of a dispute.” Solarize, Ind., Inc. v. S. Ind. Gas & Elec. Co., 182 N.E.3d 212,", "paragraph_id": "para_301" }, { "text": "216 (Ind. 2022). “To be entitled to such a decision, a plaintiff must be a ‘proper", "paragraph_id": "para_302" }, { "text": "person’ to invoke the court’s authority.” Id. (quoting Horner v. Curry, 125", "paragraph_id": "para_303" }, { "text": "N.E.3d 584, 589 (Ind. 2019)). “A party’s standing to invoke this authority can", "paragraph_id": "para_304" }, { "text": "be conferred either through common law or by statute.” Id. Here, Doctors", "paragraph_id": "para_305" }, { "text": "assert standing based on the UDJA.", "paragraph_id": "para_306" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 14 of 35", "paragraph_id": "para_307" }, { "text": "[18] “Regardless of the alleged basis for standing, if ‘plaintiffs allege no injury, there", "paragraph_id": "para_308" }, { "text": "is no justiciable dispute.’” Ehrlich v. Moss Creek Solar, LLC, 219 N.E.3d 760, 763", "paragraph_id": "para_309" }, { "text": "(Ind. Ct. App. 2023) (quoting City of Gary v. Nicholson, 190 N.E.3d 349, 351", "paragraph_id": "para_310" }, { "text": "(Ind. 2022)), trans. denied. “An injury must be personal, direct, and one the", "paragraph_id": "para_311" }, { "text": "plaintiff has suffered or is in imminent danger of suffering.” Holcomb v. Bray,", "paragraph_id": "para_312" }, { "text": "187 N.E.3d 1268, 1286 (Ind. 2022). Our Supreme Court has stated, “Under the", "paragraph_id": "para_313" }, { "text": "[UDJA], which is designed to allow parties to resolve conflicts while there is", "paragraph_id": "para_314" }, { "text": "still time for ‘peaceable judicial settlement,’ plaintiffs can satisfy the injury", "paragraph_id": "para_315" }, { "text": "requirement by showing their rights are implicated in such a way that they", "paragraph_id": "para_316" }, { "text": "could suffer an injury.” Id. at 1287 (emphasis added) (quoting Volkswagenwerk,", "paragraph_id": "para_317" }, { "text": "A.G. v. Watson, 390 N.E.2d 1082, 1084-85 (Ind. Ct. App. 1979), trans. denied).", "paragraph_id": "para_318" }, { "text": "Whether a party has standing is a legal question that we review de novo.", "paragraph_id": "para_319" }, { "text": "Hensley v. Lewis Bros. Bakeries, Inc., 263 N.E.3d 199, 201 (Ind. Ct. App. 2025).", "paragraph_id": "para_320" }, { "text": "[19] The UDJA “confers on the judiciary ‘the power to declare rights, status, and", "paragraph_id": "para_321" }, { "text": "other legal relations whether or not further relief is or could be claimed.’”", "paragraph_id": "para_322" }, { "text": "Adams v. Hamilton Cnty., 255 N.E.3d 498, 503-04 (Ind. Ct. App. 2025) (quoting", "paragraph_id": "para_323" }, { "text": "I.C. § 34-14-1-1). The UDJA “is ‘remedial’ with a stated purpose ‘to settle and", "paragraph_id": "para_324" }, { "text": "to afford relief from uncertainty and insecurity with respect to rights, status[,]", "paragraph_id": "para_325" }, { "text": "and other legal relations,’ and it ‘is to be liberally construed and administered.’”", "paragraph_id": "para_326" }, { "text": "Id. at 504 (alteration in Adams) (quoting I.C. § 34-14-1-12). The UDJA further", "paragraph_id": "para_327" }, { "text": "provides,", "paragraph_id": "para_328" }, { "text": "Any person interested under a deed, will, written contract, or", "paragraph_id": "para_329" }, { "text": "other writings constituting a contract, or whose rights, status, or", "paragraph_id": "para_330" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 15 of 35", "paragraph_id": "para_331" }, { "text": "other legal relations are affected by a statute, municipal", "paragraph_id": "para_332" }, { "text": "ordinance, contract, or franchise, may have determined any", "paragraph_id": "para_333" }, { "text": "question of construction or validity arising under the", "paragraph_id": "para_334" }, { "text": "instrument, statute, ordinance, contract, or franchise and obtain", "paragraph_id": "para_335" }, { "text": "a declaration of rights, status, or other legal relations", "paragraph_id": "para_336" }, { "text": "thereunder.", "paragraph_id": "para_337" }, { "text": "I.C. § 34-14-1-2 (emphases added).", "paragraph_id": "para_338" }, { "text": "[20] In its order, the trial court noted that Doctors “seek a declaration of the", "paragraph_id": "para_339" }, { "text": "construction of APRA” “to determine whether TPRs fall within the exemption", "paragraph_id": "para_340" }, { "text": "from APRA disclosure for ‘patient medical records.’” Appealed Order at 3, 7.", "paragraph_id": "para_341" }, { "text": "The court also made the following relevant findings:", "paragraph_id": "para_342" }, { "text": "[Doctors] have demonstrated sufficient injury to meet the", "paragraph_id": "para_343" }, { "text": "requirements of standing. At least one of Dr. Bernard’s patients", "paragraph_id": "para_344" }, { "text": "left Dr. Bernard’s care for an out-of-state abortion provider to", "paragraph_id": "para_345" }, { "text": "avoid the public release of the patient’s information via a TPR", "paragraph_id": "para_346" }, { "text": "APRA request. Dr. Bernard has set forth an actual injury she", "paragraph_id": "para_347" }, { "text": "suffered – the loss of a patient. Dr. Bernard’s showing is also", "paragraph_id": "para_348" }, { "text": "sufficient to demonstrate Dr. Rouse’s standing to bring this", "paragraph_id": "para_349" }, { "text": "declaratory judgment action as it follows that Dr. Rouse could", "paragraph_id": "para_350" }, { "text": "suffer such an injury. Moreover, disclosure of a TPR, if it", "paragraph_id": "para_351" }, { "text": "included any patient health information, could have a chilling", "paragraph_id": "para_352" }, { "text": "effect on the patient/physician relationship. A patient could be", "paragraph_id": "para_353" }, { "text": "less likely to disclose certain medical information to the", "paragraph_id": "para_354" }, { "text": "physician knowing that the physician must report such", "paragraph_id": "para_355" }, { "text": "information and that the Department may publicly release that", "paragraph_id": "para_356" }, { "text": "information.", "paragraph_id": "para_357" }, { "text": "Id. at 4.", "paragraph_id": "para_358" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 16 of 35", "paragraph_id": "para_359" }, { "text": "[21] We agree with the trial court’s assessment.5 We further observe that Dr.", "paragraph_id": "para_360" }, { "text": "Bernard has already suffered an additional concrete injury: she was publicly", "paragraph_id": "para_361" }, { "text": "reprimanded by the Board for disclosing patient information—age, state of", "paragraph_id": "para_362" }, { "text": "residence, gestational age, and approximate date of treatment. Although Dr.", "paragraph_id": "para_363" }, { "text": "Bernard was not disciplined for submitting a TPR containing this information", "paragraph_id": "para_364" }, { "text": "to the Department—that disclosure was mandatory under Indiana Code", "paragraph_id": "para_365" }, { "text": "Sections 16-34-2-5 and 25-1-9-4(a)(3)—she was disciplined for making the", "paragraph_id": "para_366" }, { "text": "information publicly available.", "paragraph_id": "para_367" }, { "text": "[22] Yet this is precisely the information that TPRs must contain and which the", "paragraph_id": "para_368" }, { "text": "settlement now requires the Department to make publicly available upon", "paragraph_id": "para_369" }, { "text": "request. If TPRs are publicly disclosable, then every physician who submits a", "paragraph_id": "para_370" }, { "text": "mandatory TPR becomes the source of information that may publicly identify", "paragraph_id": "para_371" }, { "text": "their patient—the same conduct for which Dr. Bernard was sanctioned.", "paragraph_id": "para_372" }, { "text": "[23] This creates a conundrum faced by both Doctors. Physicians cannot determine", "paragraph_id": "para_373" }, { "text": "the legal boundaries of patient confidentiality when the State treats identical", "paragraph_id": "para_374" }, { "text": "information as both confidential and non-confidential. Dr. Bernard was", "paragraph_id": "para_375" }, { "text": "sanctioned for publicly disclosing patient information—age, state of residence,", "paragraph_id": "para_376" }, { "text": "gestational age, and treatment date—because it identified her patient. The State", "paragraph_id": "para_377" }, { "text": "5 We also agree with the trial court’s finding that Doctors did not attempt to assert their “patients’ interests in", "paragraph_id": "para_378" }, { "text": "maintaining the privacy of their medical records as a means for [Doctors] to bootstrap their standing.”", "paragraph_id": "para_379" }, { "text": "Appealed Order at 5. Accordingly, we reject Defendants’ arguments to the contrary.", "paragraph_id": "para_380" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 17 of 35", "paragraph_id": "para_381" }, { "text": "now deems this same information non-identifying when contained in TPRs and", "paragraph_id": "para_382" }, { "text": "plans to publicly release it.", "paragraph_id": "para_383" }, { "text": "[24] Doctors also face imminent injury. The Department itself previously expressed", "paragraph_id": "para_384" }, { "text": "concerns that TPRs contain “information that could be reverse engineered to", "paragraph_id": "para_385" }, { "text": "identify patients—especially in smaller communities[.]” Appellants’ App. Vol. 2", "paragraph_id": "para_386" }, { "text": "at 83. The Attorney General successfully argued in Dr. Bernard’s disciplinary", "paragraph_id": "para_387" }, { "text": "proceeding that this type of information was sufficient to identify a patient. Yet", "paragraph_id": "para_388" }, { "text": "the settlement between VFL and the Department requires the Department to", "paragraph_id": "para_389" }, { "text": "“release [TPRs] as public records upon lawful request” without redacting the", "paragraph_id": "para_390" }, { "text": "very information that Dr. Bernard was disciplined for disclosing. Id. at 94.6", "paragraph_id": "para_391" }, { "text": "Absent a judicial determination that such information is nondisclosable,", "paragraph_id": "para_392" }, { "text": "disclosure will occur. When it does, Doctors may suffer concrete injuries,", "paragraph_id": "para_393" }, { "text": "including reputational harm, increased harassment, and erosion of public trust.7", "paragraph_id": "para_394" }, { "text": "Moreover, the State’s contradictory positions create legal uncertainty that itself", "paragraph_id": "para_395" }, { "text": "6 We are unaware of any authority for the proposition that parties to a settlement agreement may", "paragraph_id": "para_396" }, { "text": "independently rewrite a statute and, without legislative clarification, give it a meaning that a court has", "paragraph_id": "para_397" }, { "text": "previously rejected.", "paragraph_id": "para_398" }, { "text": "7 Doctors allege that VFL has used TPR data as the foundation for allegedly false claims on VFL’s website", "paragraph_id": "para_399" }, { "text": "regarding abortion providers, including Dr. Bernard. VFL’s website identified Dr. Bernard, displayed her", "paragraph_id": "para_400" }, { "text": "photo, and accused her of committing four “violations” of Indiana law. Tr. Vol. 2 at 78-86; Appellees’ App.", "paragraph_id": "para_401" }, { "text": "Vol. 2 at 8-9. Dr. Bernard testified that she has not been prosecuted or sanctioned in connection with that", "paragraph_id": "para_402" }, { "text": "conduct. She also described some of VFL’s allegations as reflecting a fundamental misunderstanding of", "paragraph_id": "para_403" }, { "text": "abortion requirements in Indiana. Tr. Vol. 2 at 81-87.", "paragraph_id": "para_404" }, { "text": "Dr. Bernard also testified that she is “harmed by the fact that they’re making false claims against me that", "paragraph_id": "para_405" }, { "text": "cause irreparable damage to my reputation as a physician” and “by the fact that these are inflammatory, there", "paragraph_id": "para_406" }, { "text": "is real concern that publicly disseminated information like this on a website could be used to target and harm", "paragraph_id": "para_407" }, { "text": "myself and my family.” Id. at 91. She reported being contacted by the FBI several years ago about “a threat", "paragraph_id": "para_408" }, { "text": "that somebody was going to kidnap my daughter to prevent me from providing abortion[s].” Id. at 94-95.", "paragraph_id": "para_409" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 18 of 35", "paragraph_id": "para_410" }, { "text": "constitutes injury. Doctors struggle to provide abortion care and to submit", "paragraph_id": "para_411" }, { "text": "TPRs while uncertain of their intertwined obligations under the statutes that", "paragraph_id": "para_412" }, { "text": "govern their professional conduct.8", "paragraph_id": "para_413" }, { "text": "[25] Based on the foregoing, we hold that the trial court did not err in concluding", "paragraph_id": "para_414" }, { "text": "that Doctors have standing to seek a declaratory judgment.", "paragraph_id": "para_415" }, { "text": "Issue Two: Preliminary injunction", "paragraph_id": "para_416" }, { "text": "[26] Defendants also argue that the trial court erred in granting Doctors a", "paragraph_id": "para_417" }, { "text": "preliminary injunction. “Appellate review of a preliminary injunction is ‘limited", "paragraph_id": "para_418" }, { "text": "and deferential.’” In re Paternity of H.F.D.S., 247 N.E.3d 834, 837 (Ind. Ct. App.", "paragraph_id": "para_419" }, { "text": "2024) (quoting State v. Econ. Freedom Fund, 959 N.E.2d 794, 801 (Ind. 2011)),", "paragraph_id": "para_420" }, { "text": "trans. denied. We review a trial court’s grant of a preliminary injunction for an", "paragraph_id": "para_421" }, { "text": "abuse of discretion, which occurs if its decision was against the logic and effect", "paragraph_id": "para_422" }, { "text": "of the facts and circumstances before it or if it misinterpreted the law. Willow", "paragraph_id": "para_423" }, { "text": "Haven on 106th St., LLC v. Nagireddy, 252 N.E.3d 418, 422 (Ind. 2025). “We", "paragraph_id": "para_424" }, { "text": "review the trial court’s factual findings for clear error and its legal conclusions", "paragraph_id": "para_425" }, { "text": "de novo.” Id. “We do not reweigh the evidence or assess witness credibility.”", "paragraph_id": "para_426" }, { "text": "Great Lakes Anesthesia, P.C. v. O’Bryan, 99 N.E.3d 260, 268 (Ind. Ct. App. 2018).", "paragraph_id": "para_427" }, { "text": "“Rather, we consider only the evidence favorable to the judgment and the", "paragraph_id": "para_428" }, { "text": "8 VFL asserts that “[i]t is absurd to suppose that [Doctors] would be disciplined for performing a duty", "paragraph_id": "para_429" }, { "text": "imposed by state law, and there is no question that the [Board] would be estopped from doing so.” VFL’s Br.", "paragraph_id": "para_430" }, { "text": "at 13. In light of the State’s contradictory positions on the disclosability of TPRs and the legal uncertainty this", "paragraph_id": "para_431" }, { "text": "creates, Doctors’ concerns about potential discipline for complying with mandatory reporting requirements", "paragraph_id": "para_432" }, { "text": "are neither speculative nor unfounded.", "paragraph_id": "para_433" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 19 of 35", "paragraph_id": "para_434" }, { "text": "reasonable inferences to be drawn therefrom.” Id. “We will reverse the trial", "paragraph_id": "para_435" }, { "text": "court’s judgment only when it is clearly erroneous, that is, when our review of", "paragraph_id": "para_436" }, { "text": "the record leaves us with a firm conviction that a mistake has been made.” Id.", "paragraph_id": "para_437" }, { "text": "[27] “The purpose of a preliminary injunction is to preserve the status quo pending", "paragraph_id": "para_438" }, { "text": "an adjudication of a case on the merits.” Holcomb v. T.L., 175 N.E.3d 1177,", "paragraph_id": "para_439" }, { "text": "1180 (Ind. Ct. App. 2021).9 To obtain a preliminary injunction, the moving", "paragraph_id": "para_440" }, { "text": "party must demonstrate the following by a preponderance of the evidence: (1)", "paragraph_id": "para_441" }, { "text": "9 In a separate argument, the Commissioner asserts that Doctors are using an injunction to privately enforce", "paragraph_id": "para_442" }, { "text": "the APRA, where no private right of action exists. On the contrary, Doctors are merely seeking a judicial", "paragraph_id": "para_443" }, { "text": "interpretation of the APRA regarding the disclosability of TPRs and requesting injunctive relief to preserve", "paragraph_id": "para_444" }, { "text": "the status quo (i.e., maintaining TPRs in the Department’s custody) pending an adjudication of that issue.", "paragraph_id": "para_445" }, { "text": "After all, a judicial interpretation of Section 5-14-3-4(a)(9) is essential so that all parties can conform their", "paragraph_id": "para_446" }, { "text": "conduct to that intended by the legislature. And it is the core constitutional function of the judiciary, not the", "paragraph_id": "para_447" }, { "text": "Attorney General, “to say what the law is[.]” Ind. Off. of Util. Consumer Couns. v. Duke Energy Ind., LLC, 248", "paragraph_id": "para_448" }, { "text": "N.E.3d 1205, 1211 (Ind. 2024) (relying on Ind. Const. art. 3, § 1 (dividing governmental powers into “three", "paragraph_id": "para_449" }, { "text": "separate departments; the Legislative, the Executive including the Administrative, and the Judicial[,]” and", "paragraph_id": "para_450" }, { "text": "stating that “no person, charged with official duties under one of these departments, shall exercise any of the", "paragraph_id": "para_451" }, { "text": "functions of another,” except as “expressly provided” in the Constitution) and id. art. 7, § 1 (vesting judicial", "paragraph_id": "para_452" }, { "text": "power “in one Supreme Court, one Court of Appeals, Circuit Courts, and such other courts as the General", "paragraph_id": "para_453" }, { "text": "Assembly may establish”)). If the final result of the instant adjudication is in Doctors’ favor, local prosecutors", "paragraph_id": "para_454" }, { "text": "will be responsible for enforcing TPR disclosure violations under the APRA. See I.C. §§ 5-14-3-10(a) (making", "paragraph_id": "para_455" }, { "text": "it a Class A infraction for “a public official, or an employee or officer of a contractor or subcontractor of a", "paragraph_id": "para_456" }, { "text": "public agency” to knowingly or intentionally disclose information classified as confidential by state statute),", "paragraph_id": "para_457" }, { "text": "34-28-5-1(a) (“An action to enforce a statute defining an infraction shall be brought in the name of the state of", "paragraph_id": "para_458" }, { "text": "Indiana by the prosecuting attorney for the judicial circuit in which the infraction allegedly took place.”).", "paragraph_id": "para_459" }, { "text": "Pursuant to statute, the Attorney General may oversee but may not preclude such enforcement actions. See", "paragraph_id": "para_460" }, { "text": "I.C. § 4-6-3-2(a) (“The attorney general shall have charge of and direct the prosecution of all civil actions that", "paragraph_id": "para_461" }, { "text": "are brought in the name of the state of Indiana or any state agency.”), -(c) (“This section does not affect the", "paragraph_id": "para_462" }, { "text": "authority of prosecuting attorneys to prosecute civil actions.”).", "paragraph_id": "para_463" }, { "text": "In any event, we note that this Court has stated that “Indiana courts may … grant executory or coercive relief", "paragraph_id": "para_464" }, { "text": "in declaratory judgment actions in addition to determining the rights and status of the parties.” Artusi v. City of", "paragraph_id": "para_465" }, { "text": "Mishawaka, 519 N.E.2d 1246, 1250 (Ind. Ct. App. 1988) (relying on Ind. Trial Rule 57 and Fed. R. Civ. P.", "paragraph_id": "para_466" }, { "text": "57), trans. denied. The cases that the Commissioner cites to the contrary were decided long before Trial Rule", "paragraph_id": "para_467" }, { "text": "57 was adopted in 1969. See Commissioner’s Br. at 37-38 (citing Brindley v. Meara, 198 N.E. 301, 303 (Ind.", "paragraph_id": "para_468" }, { "text": "1935), Bryarly v. State, 111 N.E.2d 277, 278-79 (Ind. 1953), and Myers v. State Life Ins. Co., 110 N.E.2d 312,", "paragraph_id": "para_469" }, { "text": "313 (Ind. Ct. App. 1953)); see also T.R. 57 (“The existence of another adequate remedy does not preclude a", "paragraph_id": "para_470" }, { "text": "judgment for declaratory relief in cases where it is appropriate.… Affirmative relief shall be allowed under", "paragraph_id": "para_471" }, { "text": "such remedy when the right thereto is established.”).", "paragraph_id": "para_472" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 20 of 35", "paragraph_id": "para_473" }, { "text": "the moving party has a reasonable likelihood of success on the merits; (2) the", "paragraph_id": "para_474" }, { "text": "moving party’s remedies at law are inadequate and irreparable harm will occur", "paragraph_id": "para_475" }, { "text": "while the case is pending; (3) the threatened injury to the moving party from a", "paragraph_id": "para_476" }, { "text": "denial of the injunction outweighs the potential harm to the nonmoving party", "paragraph_id": "para_477" }, { "text": "from granting the injunction; and (4) the public interest would not be disserved", "paragraph_id": "para_478" }, { "text": "by granting the injunction. In re J.B., 246 N.E.3d 819, 825 (Ind. Ct. App. 2024).", "paragraph_id": "para_479" }, { "text": "Reasonable likelihood of success on the merits", "paragraph_id": "para_480" }, { "text": "[28] “To demonstrate this element, the moving party is not required to show that he", "paragraph_id": "para_481" }, { "text": "is entitled to relief as a matter of law, but only that success on the merits is", "paragraph_id": "para_482" }, { "text": "probable.” Bowling v. Nicholson, 51 N.E.3d 439, 444 (Ind. Ct. App. 2016), trans.", "paragraph_id": "para_483" }, { "text": "denied. Here, addressing Doctors’ likelihood of success on the merits involves", "paragraph_id": "para_484" }, { "text": "statutory interpretation, a question of law that we review de novo. Clarian", "paragraph_id": "para_485" }, { "text": "Health Partners v. Evans, 848 N.E.2d 763, 765 (Ind. Ct. App. 2006), trans. denied.", "paragraph_id": "para_486" }, { "text": "“When interpreting a statute, our primary goal is to determine and give effect to", "paragraph_id": "para_487" }, { "text": "the Legislature’s intent.” Perry Cnty. v. Huck, 263 N.E.3d 138, 141 (Ind. 2025).", "paragraph_id": "para_488" }, { "text": "“The best evidence of that intent is the statute’s language.” Id. at 141-42.", "paragraph_id": "para_489" }, { "text": "[29] In its order, the trial court noted that the APRA does not define the term", "paragraph_id": "para_490" }, { "text": "“patient medical record,”10 but that Indiana Code Section 1-1-4-5, which", "paragraph_id": "para_491" }, { "text": "contains definitions that “apply to the construction of all Indiana statutes,", "paragraph_id": "para_492" }, { "text": "10 The APRA defines “patient” by referring to Indiana Code Section 16-18-2-272(d), which states that a", "paragraph_id": "para_493" }, { "text": "“patient” is “an individual who has received health care services from a provider for the examination,", "paragraph_id": "para_494" }, { "text": "treatment, diagnosis, or prevention of a physical or mental condition.” I.C. § 5-14-3-2(m).", "paragraph_id": "para_495" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 21 of 35", "paragraph_id": "para_496" }, { "text": "unless the construction is plainly repugnant to the intent of the general assembly", "paragraph_id": "para_497" }, { "text": "or the context of the statute[,]” states that a “medical record” is “written or", "paragraph_id": "para_498" }, { "text": "printed information possessed by a provider[11] … concerning any diagnosis,", "paragraph_id": "para_499" }, { "text": "treatment, or prognosis of the patient, unless otherwise defined.” I.C. § 1-1-4-", "paragraph_id": "para_500" }, { "text": "5(a)(6). The trial court found that, based on the face of the TPR form itself and", "paragraph_id": "para_501" }, { "text": "the testimony of the Doctors and Justin Stover, “the Department’s [Assistant]", "paragraph_id": "para_502" }, { "text": "Commissioner who assists with APRA requests,” the form “calls for abortion", "paragraph_id": "para_503" }, { "text": "providers to provide information concerning a patient’s diagnosis, treatment, or", "paragraph_id": "para_504" }, { "text": "prognosis .… of the particular patient upon whom the abortion procedure was", "paragraph_id": "para_505" }, { "text": "performed and for whom the TPR is submitted.” Appealed Order at 11. Thus,", "paragraph_id": "para_506" }, { "text": "the court concluded that Doctors had “established probable success on their", "paragraph_id": "para_507" }, { "text": "claim that a TPR is subject to exemptions from disclosure as a [patient] medical", "paragraph_id": "para_508" }, { "text": "record.” Id.", "paragraph_id": "para_509" }, { "text": "[30] We agree with this conclusion. Defendants contend that TPRs are not patient", "paragraph_id": "para_510" }, { "text": "medical records because they do not include the patient’s name.12 But the", "paragraph_id": "para_511" }, { "text": "absence of a patient’s name from a TPR does not make it something other than", "paragraph_id": "para_512" }, { "text": "11 Doctors note that they are required by statute to retain a signed copy of a TPR “in the pregnant woman’s", "paragraph_id": "para_513" }, { "text": "patient file[.]” I.C. § 16-34-2-5.1. Of course, a patient medical record in an agency’s possession that is", "paragraph_id": "para_514" }, { "text": "requested by a person under the APRA is not in the provider’s possession, which suggests that the “possessed", "paragraph_id": "para_515" }, { "text": "by a provider” language in Indiana Code Section 1-1-4-5(a)(6) is plainly repugnant to the context of Indiana", "paragraph_id": "para_516" }, { "text": "Code Section 5-14-3-4(a)(9), which exempts patient medical records from disclosure.", "paragraph_id": "para_517" }, { "text": "12 The Commissioner observes that Indiana Code Section 5-14-3-4(a)(9) allows patient medical records to be", "paragraph_id": "para_518" }, { "text": "disclosed with the patient’s written consent and then argues, “Obviously, a public agency cannot obtain a", "paragraph_id": "para_519" }, { "text": "patient’s written consent … unless the records at issue relate to someone it can identify.” Commissioner’s Br.", "paragraph_id": "para_520" }, { "text": "at 44. We agree, and no consent has been obtained for purposes of disclosing these private TPR medical", "paragraph_id": "para_521" }, { "text": "records regarding the patients’ “diagnosis, treatment, or prognosis[.]” I.C. § 1-1-4-5(a)(6).", "paragraph_id": "para_522" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 22 of 35", "paragraph_id": "para_523" }, { "text": "a patient medical record, just as the absence of a driver’s name from a Bureau", "paragraph_id": "para_524" }, { "text": "of Motor Vehicles driving record does not make it something other than a", "paragraph_id": "para_525" }, { "text": "driving record. “It is just as important to recognize what [a] statute does not say", "paragraph_id": "para_526" }, { "text": "as it is to recognize what it does say.” Masterbrand Cabinets v. Waid, 72 N.E.3d", "paragraph_id": "para_527" }, { "text": "986, 992 (Ind. Ct. App. 2017). And Indiana Code Section 5-14-3-4(a)(9) does", "paragraph_id": "para_528" }, { "text": "not say that a patient’s name must be in a medical record for it to be considered", "paragraph_id": "para_529" }, { "text": "a patient medical record under the APRA.", "paragraph_id": "para_530" }, { "text": "[31] The Commissioner further contends that the trial court erred in enjoining the", "paragraph_id": "para_531" }, { "text": "release of TPRs in their entirety, noting that the APRA provides that “[i]f a", "paragraph_id": "para_532" }, { "text": "public record contains disclosable and nondisclosable information, the public", "paragraph_id": "para_533" }, { "text": "agency shall … separate the material that may be disclosed and make it", "paragraph_id": "para_534" }, { "text": "available for inspection and copying.” I.C. § 5-14-3-6(a). As mentioned above,", "paragraph_id": "para_535" }, { "text": "however, the legislature has provided for the periodic release of a “public", "paragraph_id": "para_536" }, { "text": "report” with statistics compiled from the TPRs submitted that quarter. I.C. § 16-", "paragraph_id": "para_537" }, { "text": "34-2-5(e). We agree with the PAC that this “suggests the individual forms are", "paragraph_id": "para_538" }, { "text": "non-public.” Appellants’ App. Vol. 2 at 83.13 We also agree with the PAC’s", "paragraph_id": "para_539" }, { "text": "determination that “[s]eparation and redaction would defeat the statutory", "paragraph_id": "para_540" }, { "text": "purpose of the confidentiality requirement declaring ‘patient medical records’", "paragraph_id": "para_541" }, { "text": "13 Doctors observe that, “[u]nlike other records exempted from disclosure under APRA, patient medical", "paragraph_id": "para_542" }, { "text": "records do not become subject to disclosure seventy-five years after their creation.” Appellees’ Br. at 39 n.7", "paragraph_id": "para_543" }, { "text": "(quoting I.C. § 5-14-3-4(d) (“Notwithstanding any other law, a public record that is classified as confidential,", "paragraph_id": "para_544" }, { "text": "other than a record concerning … patient medical records … shall be made available for inspection and", "paragraph_id": "para_545" }, { "text": "copying seventy-five (75) years after the creation of that record.”)). Doctors assert, and we agree, that “[t]his", "paragraph_id": "para_546" }, { "text": "underscores the vital nature of the public interest in safeguarding personal health information from public", "paragraph_id": "para_547" }, { "text": "disclosure.” Id.", "paragraph_id": "para_548" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 23 of 35", "paragraph_id": "para_549" }, { "text": "non-disclosable[,]” and thus “[m]edical records as monolithic documents can be", "paragraph_id": "para_550" }, { "text": "withheld in their entirety.” Id. at 83-84.14", "paragraph_id": "para_551" }, { "text": "Remedies at law are inadequate and irreparable harm will occur", "paragraph_id": "para_552" }, { "text": "[32] Defendants do not address whether Doctors’ remedies at law are inadequate.", "paragraph_id": "para_553" }, { "text": "They do, however, challenge the trial court’s finding of irreparable harm. “The", "paragraph_id": "para_554" }, { "text": "party seeking an injunction carries the burden of demonstrating an injury which", "paragraph_id": "para_555" }, { "text": "is certain and irreparable if the injunction is denied.” Wagler Excavating Corp. v.", "paragraph_id": "para_556" }, { "text": "McKibben Constr., Inc., 679 N.E.2d 155, 157 (Ind. Ct. App. 1997), trans. denied.", "paragraph_id": "para_557" }, { "text": "“Irreparable harm is that harm which cannot be compensated for through", "paragraph_id": "para_558" }, { "text": "damages upon resolution of the underlying action.” Coates v. Heat Wagons, Inc.,", "paragraph_id": "para_559" }, { "text": "942 N.E.2d 905, 912 (Ind. Ct. App. 2011).", "paragraph_id": "para_560" }, { "text": "[33] In its order, the trial court found that", "paragraph_id": "para_561" }, { "text": "[t]he harms [Doctors] seek to avoid via the issuance of an", "paragraph_id": "para_562" }, { "text": "injunction are the same harms that substantiate [Doctors’]", "paragraph_id": "para_563" }, { "text": "standing to bring this declaratory judgment action. [T]he", "paragraph_id": "para_564" }, { "text": "disclosure of TPRs has resulted in at least one patient leaving", "paragraph_id": "para_565" }, { "text": "[Doctors’] care to seek abortion care from a provider not subject", "paragraph_id": "para_566" }, { "text": "to similar requirements to disclose personal health information.", "paragraph_id": "para_567" }, { "text": "The release of TPRs containing patient health information also", "paragraph_id": "para_568" }, { "text": "stifles open communication between a physician and his/her", "paragraph_id": "para_569" }, { "text": "patient – a patient will be unwilling to describe her symptoms", "paragraph_id": "para_570" }, { "text": "and medical conditions with a doctor who is required to report", "paragraph_id": "para_571" }, { "text": "14 The PAC noted that “[t]his position is also consistent with the [Board’s] recent finding [in Dr. Bernard’s", "paragraph_id": "para_572" }, { "text": "disciplinary proceeding] that disclosure of even partial and seemingly non-identifiable information by", "paragraph_id": "para_573" }, { "text": "medical providers can lead to legal consequences.” Appellants’ App. Vol. 2 at 84.", "paragraph_id": "para_574" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 24 of 35", "paragraph_id": "para_575" }, { "text": "such discussions to the Department, with the possibility that", "paragraph_id": "para_576" }, { "text": "members of the public can access that information.", "paragraph_id": "para_577" }, { "text": "Appealed Order at 12-13.", "paragraph_id": "para_578" }, { "text": "[34] Defendants contend that the foregoing harms are merely speculative. We", "paragraph_id": "para_579" }, { "text": "disagree. As mentioned above, Dr. Bernard has already been disciplined by the", "paragraph_id": "para_580" }, { "text": "Board for disclosing patient information that would be released to the public in", "paragraph_id": "para_581" }, { "text": "a TPR if an injunction is denied, and she has already lost a patient due to", "paragraph_id": "para_582" }, { "text": "concerns about her duty to disclose the patient’s personal health information to", "paragraph_id": "para_583" }, { "text": "the Department and the potential release of that information to the public under", "paragraph_id": "para_584" }, { "text": "the APRA. The nature of these nonspeculative injuries supports the trial court’s", "paragraph_id": "para_585" }, { "text": "finding that Doctors’ relationships with their patients will be harmed if the", "paragraph_id": "para_586" }, { "text": "injunction is denied. See Collins v. Bair, 268 N.E.2d 95, 98 (Ind. 1971) (stating", "paragraph_id": "para_587" }, { "text": "that the physician-patient “privilege has been justified on the basis that its", "paragraph_id": "para_588" }, { "text": "recognition encourages free communications and frank disclosure between", "paragraph_id": "para_589" }, { "text": "patient and physician which, in turn, provide assistance in proper diagnosis and", "paragraph_id": "para_590" }, { "text": "appropriate treatment. To deny the privilege, it was thought, would destroy the", "paragraph_id": "para_591" }, { "text": "confidential nature of the physician-patient relationship and possibly cause one", "paragraph_id": "para_592" }, { "text": "suffering from a particular ailment to withhold pertinent information of an", "paragraph_id": "para_593" }, { "text": "embarrassing or otherwise confidential nature for fear of being publicly", "paragraph_id": "para_594" }, { "text": "exposed.”). Such a harm cannot be compensated for through damages, so we", "paragraph_id": "para_595" }, { "text": "find no clear error on this point.", "paragraph_id": "para_596" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 25 of 35", "paragraph_id": "para_597" }, { "text": "Threatened injury to moving party outweighs potential harm to nonmoving", "paragraph_id": "para_598" }, { "text": "party", "paragraph_id": "para_599" }, { "text": "[35] The trial court made the following findings regarding the potential harms to", "paragraph_id": "para_600" }, { "text": "Defendants that would result from an injunction:", "paragraph_id": "para_601" }, { "text": "The Commissioner presented evidence to support the claim of", "paragraph_id": "para_602" }, { "text": "potential harms the Commissioner could suffer if the Court", "paragraph_id": "para_603" }, { "text": "issued an injunction. Amy Osborne formerly was the Section", "paragraph_id": "para_604" }, { "text": "Chief of Licensing Enforcement at the Office of the Attorney", "paragraph_id": "para_605" }, { "text": "General. Her Section was tasked with ensuring doctors comply", "paragraph_id": "para_606" }, { "text": "with Indiana law, bringing enforcement actions against", "paragraph_id": "para_607" }, { "text": "physicians before the [Board]. To trigger an investigation, a", "paragraph_id": "para_608" }, { "text": "complaint would be filed by “anyone” – a consumer, a patient, a", "paragraph_id": "para_609" }, { "text": "family member of a patient, an association, another government", "paragraph_id": "para_610" }, { "text": "agency, or an organization. Osborne added that generally, the", "paragraph_id": "para_611" }, { "text": "Attorney General has received complaints of abortion law", "paragraph_id": "para_612" }, { "text": "violations from the public; that the complainant learned of the", "paragraph_id": "para_613" }, { "text": "purported violation from information from a TPR; and that it", "paragraph_id": "para_614" }, { "text": "was more likely that the Attorney General’s Office would receive", "paragraph_id": "para_615" }, { "text": "a complaint from the public than from the Department. In", "paragraph_id": "para_616" }, { "text": "closing, VFL argued that part of its mission is to assist the", "paragraph_id": "para_617" }, { "text": "Department with monitoring all abortions performed in Indiana", "paragraph_id": "para_618" }, { "text": "via review of TPRs. Counsel for VFL asserted that VFL has an", "paragraph_id": "para_619" }, { "text": "“interest in ensuring that the state abortion laws are being", "paragraph_id": "para_620" }, { "text": "followed.”", "paragraph_id": "para_621" }, { "text": "But the Department has not released TPRs for over one year.", "paragraph_id": "para_622" }, { "text": "Stover, the Department’s Assistant Commissioner who assists", "paragraph_id": "para_623" }, { "text": "with APRA requests, acknowledged that sometime in 2024, the", "paragraph_id": "para_624" }, { "text": "Department had stopped releasing TPRs that were sought via", "paragraph_id": "para_625" }, { "text": "APRA requests because the [PAC] issued an opinion, which led", "paragraph_id": "para_626" }, { "text": "to the Department ceasing disclosure of TPRs. [Doctors]", "paragraph_id": "para_627" }, { "text": "highlight the fact that though VFL could not obtain TPRs this", "paragraph_id": "para_628" }, { "text": "past year, VFL could obtain the Department’s quarterly public", "paragraph_id": "para_629" }, { "text": "reports, which are based upon submitted TPR information. See", "paragraph_id": "para_630" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 26 of 35", "paragraph_id": "para_631" }, { "text": "IND. CODE § 16-34-2-5(e)(1) (Quarterly, the Department “shall", "paragraph_id": "para_632" }, { "text": "compile a public report … from information submitted under this", "paragraph_id": "para_633" }, { "text": "section”). And, at the hearing, neither the Commissioner nor the", "paragraph_id": "para_634" }, { "text": "VFL presented any evidence that the lack of TPRs hampered any", "paragraph_id": "para_635" }, { "text": "abortion law enforcement whatsoever. A reasonable inference", "paragraph_id": "para_636" }, { "text": "from this point suggests that the Defendants’ claimed potential", "paragraph_id": "para_637" }, { "text": "harm is no harm at all. Besides, it is the responsibility of the", "paragraph_id": "para_638" }, { "text": "Commissioner and the Department, in conjunction with the", "paragraph_id": "para_639" }, { "text": "Attorney General’s Office, to uphold abortion laws – they are the", "paragraph_id": "para_640" }, { "text": "state entities specifically charged with investigating and initiating", "paragraph_id": "para_641" }, { "text": "enforcement actions against any doctors who fail to follow such", "paragraph_id": "para_642" }, { "text": "laws. Nothing prevents the Department from reviewing the TPRs", "paragraph_id": "para_643" }, { "text": "to detect possible violations, which is why the legislature requires", "paragraph_id": "para_644" }, { "text": "abortion providers to submit TPRs to the Department in the first", "paragraph_id": "para_645" }, { "text": "place.", "paragraph_id": "para_646" }, { "text": "To boost the Defendants’ position in support of the public release", "paragraph_id": "para_647" }, { "text": "of TPRs, both the Commissioner and VFL argued that the", "paragraph_id": "para_648" }, { "text": "Department had previously released TPRs pursuant to APRA. At", "paragraph_id": "para_649" }, { "text": "the TRO hearing, the Commissioner represented that TPRs were", "paragraph_id": "para_650" }, { "text": "subject to APRA disclosure “for decades” while VFL noted that", "paragraph_id": "para_651" }, { "text": "it was “common practice” for the Department to release TPRs.", "paragraph_id": "para_652" }, { "text": "The Defendants presented similar arguments during the", "paragraph_id": "para_653" }, { "text": "preliminary injunction hearing. These contentions, while true, do", "paragraph_id": "para_654" }, { "text": "not sway this Court because the type of information an abortion", "paragraph_id": "para_655" }, { "text": "provider is required to submit via a TPR changed to include", "paragraph_id": "para_656" }, { "text": "information about a patient diagnosis and any reasons why the", "paragraph_id": "para_657" }, { "text": "physician performed the abortion. Dr. Bernard testified that this", "paragraph_id": "para_658" }, { "text": "change took place after the State of Indiana banned abortions, a", "paragraph_id": "para_659" }, { "text": "change of law that ultimately took effect in August 2023. The", "paragraph_id": "para_660" }, { "text": "Court surmises that Indiana’s abortion ban triggered the request", "paragraph_id": "para_661" }, { "text": "to the [PAC] for an opinion regarding the nature of TPRs as", "paragraph_id": "para_662" }, { "text": "medical records exempt from APRA disclosure. The Court", "paragraph_id": "para_663" }, { "text": "determines that the inclusion of diagnostic and treatment", "paragraph_id": "para_664" }, { "text": "information on TPRs following Indiana’s abortion ban nullifies", "paragraph_id": "para_665" }, { "text": "any argument that the Department’s prior practice of releasing", "paragraph_id": "para_666" }, { "text": "TPRs should carry persuasive weight.", "paragraph_id": "para_667" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 27 of 35", "paragraph_id": "para_668" }, { "text": "Appealed Order at 14-16 (footnote and citation to footnote omitted).", "paragraph_id": "para_669" }, { "text": "[36] The court then reached the following conclusion:", "paragraph_id": "para_670" }, { "text": "In balancing the parties’ competing harms, the Court rules that", "paragraph_id": "para_671" }, { "text": "[Doctors’] injury from the lack of an injunction to prevent TPR", "paragraph_id": "para_672" }, { "text": "disclosure outweighs the potential harm to the Commissioner", "paragraph_id": "para_673" }, { "text": "and VFL. The Court holds that [Doctors’] injuries (the actual and", "paragraph_id": "para_674" }, { "text": "potential future loss of patients, as well as the stifling of open", "paragraph_id": "para_675" }, { "text": "communication between physicians [and] their patients)", "paragraph_id": "para_676" }, { "text": "outweigh the Defendants’ potential harms (the Commissioner’s", "paragraph_id": "para_677" }, { "text": "inability to enforce the TPR law and VFL’s incapacity to assist", "paragraph_id": "para_678" }, { "text": "the Department with TPR enforcement). The potential harm the", "paragraph_id": "para_679" }, { "text": "Defendants presented to the Court was VFL’s alleged inability to", "paragraph_id": "para_680" }, { "text": "help ensure that the state abortion laws are being followed should", "paragraph_id": "para_681" }, { "text": "this Court enjoin the release of TPRs. Yet the Commissioner", "paragraph_id": "para_682" }, { "text": "(and, therefore, the Department) have unfettered access to the", "paragraph_id": "para_683" }, { "text": "TPRs and may continue to enforce the TPR law. And VFL may", "paragraph_id": "para_684" }, { "text": "continue to review the quarterly reports and provide any", "paragraph_id": "para_685" }, { "text": "assistance to the Department to enforce the TPR law. The Court", "paragraph_id": "para_686" }, { "text": "is not convinced that the Defendants have suffered or will suffer", "paragraph_id": "para_687" }, { "text": "any harms from the issuance of an injunction. Thus, the injuries", "paragraph_id": "para_688" }, { "text": "to [Doctors] outweigh any potential harms to the Defendants.", "paragraph_id": "para_689" }, { "text": "Id. at 17.", "paragraph_id": "para_690" }, { "text": "[37] VFL’s argument that the trial court erred in balancing the equities presupposes", "paragraph_id": "para_691" }, { "text": "that it has a statutory right to access TPRs under the APRA, which is yet to be", "paragraph_id": "para_692" }, { "text": "definitively determined.15 The Commissioner, on the other hand, argues that", "paragraph_id": "para_693" }, { "text": "15 Doctors observe that if Defendants ultimately prevail, “VFL can obtain the TPRs it seeks at the conclusion", "paragraph_id": "para_694" }, { "text": "of the proceedings; no one has suggested that the [Department] will fail to maintain the records until then.”", "paragraph_id": "para_695" }, { "text": "Appellees’ Br. at 38.", "paragraph_id": "para_696" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 28 of 35", "paragraph_id": "para_697" }, { "text": "the trial court’s ruling means that “the State cannot disclose information of", "paragraph_id": "para_698" }, { "text": "great public interest that the Governor, the Attorney General, and the", "paragraph_id": "para_699" }, { "text": "Commissioner have determined must be disclosed by law[,]” and thus “[t]he", "paragraph_id": "para_700" }, { "text": "injunction clearly inflicts irreparable harm.” Commissioner’s Br. at 50 (citation", "paragraph_id": "para_701" }, { "text": "and quotation marks omitted). But this argument disregards the fundamental", "paragraph_id": "para_702" }, { "text": "precept that “it is ‘emphatically the province and duty of the judicial", "paragraph_id": "para_703" }, { "text": "department to say what the law is.’” Rokita v. Tully, 235 N.E.3d 189, 202 (Ind.", "paragraph_id": "para_704" }, { "text": "Ct. App. 2024) (quoting Marbury v. Madison, 1 Cranch 137, 177 (1803)), trans.", "paragraph_id": "para_705" }, { "text": "denied. And we conclude that the trial court’s balancing of the harms is not", "paragraph_id": "para_706" }, { "text": "clearly erroneous. As long as the injunction remains in place, Doctors’", "paragraph_id": "para_707" }, { "text": "confidential relationships with their patients will be preserved, and Indiana’s", "paragraph_id": "para_708" }, { "text": "abortion laws will continue to be enforced.", "paragraph_id": "para_709" }, { "text": "Public interest will not be disserved", "paragraph_id": "para_710" }, { "text": "[38] Finally, as for whether the public interest would be disserved by granting an", "paragraph_id": "para_711" }, { "text": "injunction, the trial court made the following findings:", "paragraph_id": "para_712" }, { "text": "1. Evidence of Public Interests:", "paragraph_id": "para_713" }, { "text": "One interest [Doctors] consistently stated was confidentiality of", "paragraph_id": "para_714" }, { "text": "patient health information. Both [Doctors] worried that the", "paragraph_id": "para_715" }, { "text": "release of TPRs ultimately resulted in violating the confidence of", "paragraph_id": "para_716" }, { "text": "their patients because TPRs contain private health information.", "paragraph_id": "para_717" }, { "text": "Dr. Bernard expressed that one reason for intervention in the", "paragraph_id": "para_718" }, { "text": "earlier case was “the significant amount of protected health", "paragraph_id": "para_719" }, { "text": "information that is included in [a TPR][”] and her “concern[]", "paragraph_id": "para_720" }, { "text": "about the privacy of [her] patients ….” Similarly, Dr. Rouse", "paragraph_id": "para_721" }, { "text": "remarked that her patients “may not feel comfortable disclosing", "paragraph_id": "para_722" }, { "text": "other parts of their medical history or procedures that they may", "paragraph_id": "para_723" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 29 of 35", "paragraph_id": "para_724" }, { "text": "have.” Stover, the Department’s Assistant Commissioner who", "paragraph_id": "para_725" }, { "text": "assists with APRA requests, conceded that TPRs contain", "paragraph_id": "para_726" }, { "text": "potentially sensitive information that could be subject to", "paragraph_id": "para_727" }, { "text": "redaction. A second interest the [Doctors] put forward was that", "paragraph_id": "para_728" }, { "text": "TPR disclosure could have a chilling effect on the", "paragraph_id": "para_729" }, { "text": "patient/physician relationship. A patient could be less likely to", "paragraph_id": "para_730" }, { "text": "disclose certain medical information to the physician knowing", "paragraph_id": "para_731" }, { "text": "that the physician must report such information and that the", "paragraph_id": "para_732" }, { "text": "Department may publicly release that information.", "paragraph_id": "para_733" }, { "text": "The Defendants countered that abortion law enforcement was", "paragraph_id": "para_734" }, { "text": "hindered if the public release of TPRs was enjoined. Osborne,", "paragraph_id": "para_735" }, { "text": "formerly of the Attorney General’s Office, remarked that the", "paragraph_id": "para_736" }, { "text": "Attorney General was more likely to receive complaints of", "paragraph_id": "para_737" }, { "text": "alleged TPR violations from the public than from the", "paragraph_id": "para_738" }, { "text": "Department. VFL declared that the withholding of TPRs from", "paragraph_id": "para_739" }, { "text": "public release would “render the AG’s … ability to regulate", "paragraph_id": "para_740" }, { "text": "licensed professionals … meaningless.” VFL argued that the", "paragraph_id": "para_741" }, { "text": "Attorney General “need[s] a third-party complaint to bring any", "paragraph_id": "para_742" }, { "text": "action to the Medical Licensing Board” and that VFL has “an", "paragraph_id": "para_743" }, { "text": "interest in ensuring that the state abortion laws are being", "paragraph_id": "para_744" }, { "text": "followed.”[16]", "paragraph_id": "para_745" }, { "text": "2. Serving the Public Interest:", "paragraph_id": "para_746" }, { "text": "Issuance of an injunction would serve a significant public interest", "paragraph_id": "para_747" }, { "text": "– keeping a patient’s information of diagnosis, treatment, and", "paragraph_id": "para_748" }, { "text": "prognosis confidential, safeguarded from public disclosure.", "paragraph_id": "para_749" }, { "text": "Indiana law supports this interest in APRA, making patient", "paragraph_id": "para_750" }, { "text": "medical records exempt from public disclosure. Moreover, a", "paragraph_id": "para_751" }, { "text": "federal law, the Health Insurance Portability and Accountability", "paragraph_id": "para_752" }, { "text": "16 The Commissioner notes that “[i]f someone suspects a violation of Indiana’s laws regulating the medical", "paragraph_id": "para_753" }, { "text": "profession and notifies the Attorney General’s Office, the Office can investigate.” Commissioner’s Br. at 50", "paragraph_id": "para_754" }, { "text": "(citing I.C. §§ 25-1-7-2, -5(b)). “By law, however, the Office cannot investigate without a complaint from", "paragraph_id": "para_755" }, { "text": "someone outside the Office.” Id. (citing I.C. § 25-1-7-4).", "paragraph_id": "para_756" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 30 of 35", "paragraph_id": "para_757" }, { "text": "Act of 1996 (HIPAA), 42 U.S.C. § 1320d et al. and 45 C.F.R.", "paragraph_id": "para_758" }, { "text": "Parts 160 and 164, also prevents the public disclosure of a", "paragraph_id": "para_759" }, { "text": "patient’s protected health information. Significantly, an", "paragraph_id": "para_760" }, { "text": "injunction prohibiting the release of TPRs would give comfort to", "paragraph_id": "para_761" }, { "text": "patients of abortion providers that the patient’s records of", "paragraph_id": "para_762" }, { "text": "medical diagnosis, treatment, or prognosis will NOT be released", "paragraph_id": "para_763" }, { "text": "for public review. Patients of abortion providers would no longer", "paragraph_id": "para_764" }, { "text": "have incentive NOT to share sensitive information with a", "paragraph_id": "para_765" }, { "text": "physician for fear that information would be revealed.", "paragraph_id": "para_766" }, { "text": "Further, as the Court determined … above, enjoining the public", "paragraph_id": "para_767" }, { "text": "release of TPRs is not harm to the Defendants – the", "paragraph_id": "para_768" }, { "text": "Commissioner, via the Department, may continue to review", "paragraph_id": "para_769" }, { "text": "TPRs to monitor for violations of the TPR law, and VFL may", "paragraph_id": "para_770" }, { "text": "continue to assist by reviewing quarterly reports.", "paragraph_id": "para_771" }, { "text": "The Court holds that issuance of an injunction will not disserve", "paragraph_id": "para_772" }, { "text": "the public interest. To the contrary, an injunction will certainly", "paragraph_id": "para_773" }, { "text": "serve a vital public interest – the confidentiality of a patient’s", "paragraph_id": "para_774" }, { "text": "medical records.", "paragraph_id": "para_775" }, { "text": "Appealed Order at 17-19.", "paragraph_id": "para_776" }, { "text": "[39] VFL argues that the trial court “showed contempt for the judgment of the", "paragraph_id": "para_777" }, { "text": "legislative branch, when it minimized that private parties like VFL play [sic] in", "paragraph_id": "para_778" }, { "text": "assuring good government which is acknowledged by APRA.” VFL’s Br. at 31-", "paragraph_id": "para_779" }, { "text": "32. Again, this argument presupposes that VFL has a statutory right to access", "paragraph_id": "para_780" }, { "text": "TPRs under the APRA, and it disregards the legislative branch’s decision to", "paragraph_id": "para_781" }, { "text": "require the Department to compile a quarterly “public report” of TPR statistics", "paragraph_id": "para_782" }, { "text": "under Section 16-34-2-5(e). VFL also complains that the court “disregarded the", "paragraph_id": "para_783" }, { "text": "opinion of the Attorney General acknowledging the important role that private", "paragraph_id": "para_784" }, { "text": "parties play in helping public officials perform their duty.” Id. at 32. But the", "paragraph_id": "para_785" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 31 of 35", "paragraph_id": "para_786" }, { "text": "Attorney General’s opinion was only advisory and not binding on the judicial", "paragraph_id": "para_787" }, { "text": "branch in any way. See McPeek v. McCardle, 888 N.E.2d 171, 177 n.4 (Ind. 2008)", "paragraph_id": "para_788" }, { "text": "(citing Ill.-Ind. Cable Television Ass’n v. Pub. Serv. Comm’n, 427 N.E.2d 1100, 1111", "paragraph_id": "para_789" }, { "text": "(Ind. Ct. App. 1981)).", "paragraph_id": "para_790" }, { "text": "[40] The Commissioner asserts that “the injunction … weakens protections for", "paragraph_id": "para_791" }, { "text": "maternal health and unborn life” by “depriving the public of access to", "paragraph_id": "para_792" }, { "text": "terminated pregnancy reports that could form the basis for complaints” that", "paragraph_id": "para_793" }, { "text": "abortions were not performed in accordance with the law. Commissioner’s Br.", "paragraph_id": "para_794" }, { "text": "at 50-51. Doctors observe that the Commissioner “does not dispute that [the", "paragraph_id": "para_795" }, { "text": "Department] has the authority to file such complaints as part of its broad power", "paragraph_id": "para_796" }, { "text": "to enforce Indiana laws concerning health.” Appellees’ Br. at 37-38 (citing I.C.", "paragraph_id": "para_797" }, { "text": "§ 16-19-3-1)).", "paragraph_id": "para_798" }, { "text": "[41] On that topic, the Commissioner contends,", "paragraph_id": "para_799" }, { "text": "Saying that Department employees could submit complaints to", "paragraph_id": "para_800" }, { "text": "the Attorney General’s Office is no answer. The legislature did", "paragraph_id": "para_801" }, { "text": "not design an oversight regime under which only the Department", "paragraph_id": "para_802" }, { "text": "can submit complaints; it designed one under which both the", "paragraph_id": "para_803" }, { "text": "Department and the public can. The preliminary injunction", "paragraph_id": "para_804" }, { "text": "removes one of those oversight mechanisms, directly weakening", "paragraph_id": "para_805" }, { "text": "oversight of abortion providers. That has a real-world impact.", "paragraph_id": "para_806" }, { "text": "Unrebutted testimony established below that all complaints about", "paragraph_id": "para_807" }, { "text": "potential violations of state laws regulating abortion providers", "paragraph_id": "para_808" }, { "text": "have come from the public.", "paragraph_id": "para_809" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 32 of 35", "paragraph_id": "para_810" }, { "text": "Commissioner’s Br. at 51 (record citation omitted).17", "paragraph_id": "para_811" }, { "text": "[42] Doctors note that the trial court’s injunction “does not prevent members of the", "paragraph_id": "para_812" }, { "text": "public with personal knowledge of unlawful or legally questionable conduct", "paragraph_id": "para_813" }, { "text": "from filing complaints with the Attorney General’s office” or “affect", "paragraph_id": "para_814" }, { "text": "prosecuting attorneys’ ability to bring criminal enforcement proceedings against", "paragraph_id": "para_815" }, { "text": "those who violate abortion laws.” Appellees’ Br. at 39. Finally, Doctors assert,", "paragraph_id": "para_816" }, { "text": "and we agree, that Defendants’ “claim that vigilantism is central to the", "paragraph_id": "para_817" }, { "text": "enforcement scheme for abortion laws created by the legislature is wholly", "paragraph_id": "para_818" }, { "text": "unsupported by legal authority.” Id.", "paragraph_id": "para_819" }, { "text": "[43] In sum, we conclude that the trial court did not abuse its discretion in granting", "paragraph_id": "para_820" }, { "text": "Doctors a preliminary injunction as to the TPRs submitted by Doctors.", "paragraph_id": "para_821" }, { "text": "Issue Three: Overbroad injunction", "paragraph_id": "para_822" }, { "text": "[44] Finally, we address the Commissioner’s argument that the injunction is", "paragraph_id": "para_823" }, { "text": "overbroad because it also applies to APRA requests for TPRs not submitted by", "paragraph_id": "para_824" }, { "text": "Doctors. This argument ignores the fact that the trial court’s declaratory", "paragraph_id": "para_825" }, { "text": "judgment will have statewide application because it will affect a state agency", "paragraph_id": "para_826" }, { "text": "and doctors and patients throughout Indiana. To limit the injunction only to", "paragraph_id": "para_827" }, { "text": "Doctors’ TPRs would create an illogical and harmful result: the Department", "paragraph_id": "para_828" }, { "text": "17 Additionally, the Commissioner asserts, “Saying that the public can still access the Department’s quarterly", "paragraph_id": "para_829" }, { "text": "reports is no answer either” because they “contain only aggregated data” and “do not provide sufficient", "paragraph_id": "para_830" }, { "text": "details.” Commissioner’s Br. at 51. We reiterate that Indiana Code Section 16-34-2-5(e) specifically", "paragraph_id": "para_831" }, { "text": "designates the quarterly reports as “public report[s],” which suggests that the legislature intended for the", "paragraph_id": "para_832" }, { "text": "public to access only the “aggregated data” contained in the reports.", "paragraph_id": "para_833" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 33 of 35", "paragraph_id": "para_834" }, { "text": "could release hundreds of other doctors’ TPRs containing the same categories", "paragraph_id": "para_835" }, { "text": "of sensitive patient information while the legal question of disclosability is being", "paragraph_id": "para_836" }, { "text": "litigated. This would defeat the purpose of the preliminary injunction and", "paragraph_id": "para_837" }, { "text": "irreparably harm both patient privacy and the physician-patient relationship", "paragraph_id": "para_838" }, { "text": "statewide. The trial court’s preliminary injunction properly maintains the status", "paragraph_id": "para_839" }, { "text": "quo that has existed for over a year—to our knowledge, no TPRs have been", "paragraph_id": "para_840" }, { "text": "released since it was determined that they are exempt patient medical records.", "paragraph_id": "para_841" }, { "text": "Accordingly, we affirm the trial court’s order in all respects.", "paragraph_id": "para_842" }, { "text": "[45] Affirmed.", "paragraph_id": "para_843" }, { "text": "Brown, J., and Weissmann, J., concur.", "paragraph_id": "para_844" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 34 of 35", "paragraph_id": "para_845" }, { "text": "ATTORNEYS FOR APPELLANT INDIANA STATE HEALTH COMMISSIONER", "paragraph_id": "para_846" }, { "text": "Theodore E. Rokita", "paragraph_id": "para_847" }, { "text": "Attorney General of Indiana", "paragraph_id": "para_848" }, { "text": "James A. Barta", "paragraph_id": "para_849" }, { "text": "Solicitor General", "paragraph_id": "para_850" }, { "text": "Katelyn E. Doering", "paragraph_id": "para_851" }, { "text": "Deputy Attorney General", "paragraph_id": "para_852" }, { "text": "Indianapolis, Indiana", "paragraph_id": "para_853" }, { "text": "ATTORNEYS FOR APPELLANT VOICES FOR LIFE, INC.", "paragraph_id": "para_854" }, { "text": "Patrick T. Gillen", "paragraph_id": "para_855" }, { "text": "The Thomas More Society", "paragraph_id": "para_856" }, { "text": "Chicago, Illinois", "paragraph_id": "para_857" }, { "text": "Benjamin D. Horvath", "paragraph_id": "para_858" }, { "text": "Horvath Legal Services, LLC", "paragraph_id": "para_859" }, { "text": "Special Counsel, The Thomas More Society", "paragraph_id": "para_860" }, { "text": "South Bend, Indiana", "paragraph_id": "para_861" }, { "text": "ATTORNEYS FOR APPELLEES", "paragraph_id": "para_862" }, { "text": "Tanya Pellegrini", "paragraph_id": "para_863" }, { "text": "Lawyering Project", "paragraph_id": "para_864" }, { "text": "San Francisco, California", "paragraph_id": "para_865" }, { "text": "Kathrine D. Jack", "paragraph_id": "para_866" }, { "text": "Jack Law Office LLC", "paragraph_id": "para_867" }, { "text": "Greenfield, Indiana", "paragraph_id": "para_868" }, { "text": "Stephanie Toti", "paragraph_id": "para_869" }, { "text": "Juanluis Rodriguez", "paragraph_id": "para_870" }, { "text": "Lawyering Project", "paragraph_id": "para_871" }, { "text": "Brooklyn, New York", "paragraph_id": "para_872" }, { "text": "Court of Appeals of Indiana | Opinion 25A-PL-782 | December 5, 2025 Page 35 of 35", "paragraph_id": "para_873" }, { "text": "AMICI CURIAE IN SUPPORT OF APPELLEES", "paragraph_id": "para_874" }, { "text": "AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS AND THE", "paragraph_id": "para_875" }, { "text": "SOCIETY FOR MATERNAL-FETAL MEDICINE", "paragraph_id": "para_876" }, { "text": "William R. Groth", "paragraph_id": "para_877" }, { "text": "Indianapolis, Indiana", "paragraph_id": "para_878" }, { "text": "Mark W. Sniderman", "paragraph_id": "para_879" }, { "text": "Sniderman Law", "paragraph_id": "para_880" }, { "text": "Indianapolis, Indiana", "paragraph_id": "para_881" }, { "text": "Abbe David Lowell", "paragraph_id": "para_882" }, { "text": "Brenna L. Frey", "paragraph_id": "para_883" }, { "text": "Lowell & Associates, PLLC", "paragraph_id": "para_884" }, { "text": "Washington, D.C.", "paragraph_id": "para_885" }, { "text": "INDIANA STATE MEDICAL ASSOCIATION AND AMERICAN MEDICAL", "paragraph_id": "para_886" }, { "text": "ASSOCIATION", "paragraph_id": "para_887" }, { "text": "Libby Yin Goodknight", "paragraph_id": "para_888" }, { "text": "Krieg DeVault LLP", "paragraph_id": "para_889" }, { "text": "Indianapolis, Indiana", "paragraph_id": "para_890" }, { "text": "NATIONAL ABORTION FEDERATION, INC., PHYSICIANS FOR REPRODUCTIVE", "paragraph_id": "para_891" }, { "text": "HEALTH, AND ABORTION CARE NETWORK", "paragraph_id": "para_892" }, { "text": "Courtney E. Endwright", "paragraph_id": "para_893" }, { "text": "Betz + Blevins", "paragraph_id": "para_894" }, { "text": "Indianapolis, Indiana", "paragraph_id": "para_895" }, { "text": "Laura Hecht-Felella", "paragraph_id": "para_896" }, { "text": "C. A. Goldberg, PLLC", "paragraph_id": "para_897" }, { "text": "Brooklyn, New York", "paragraph_id": "para_898" } ], "word_count": 9262, "cites": [], "cited_by": [], "sha256": "91e3dadd70c5c84af38ae3531e96d38d5655344047b2d0011b1a2d1618a8a1fd", "source_url": "https://public.courts.in.gov/Decisions/api/Document/Opinion?Id=G7-UiExIkKvEbxb3tPAiy7zgRu88hJDykqS-MrltnfEjpzQfpJc6uUCEXjy4clYE0", "fetched_at": "2026-10-06T23:54:14.865+00:00", "canonical": "https://legal.exploreworldai.com/ai/judgments/us/indctapp-25a-pl-00782-2025-12-05", "risk_graph": "https://legal.exploreworldai.com/api/public/v1/risk?id=us:indctapp-25a-pl-00782-2025-12-05", "relations_graph": "https://legal.exploreworldai.com/api/public/v1/relations?id=us:indctapp-25a-pl-00782-2025-12-05", "changes": "https://legal.exploreworldai.com/api/public/v1/us-praxis/changes", "agent": "https://legal.exploreworldai.com/api/public/v1/us-praxis/agent?id=us:indctapp-25a-pl-00782-2025-12-05", "verification": { "stored_sha256": "91e3dadd70c5c84af38ae3531e96d38d5655344047b2d0011b1a2d1618a8a1fd", "recomputed_sha256": "91e3dadd70c5c84af38ae3531e96d38d5655344047b2d0011b1a2d1618a8a1fd", "intact": true, "checked_at": "2026-10-08T00:29:40.958Z" } }, "hash": "sha256:99dad45ca78533772272c8a6130abddcc76db9fcba16008a98357367ab9f8bdd", "version": "legal-2026-10-07", "expires": "2026-10-09T00:00:00.000Z", "dependency": { "index_version": "legal-2026-10-07+legal-2026-10-07+2026-10-07T16:38:30", "content_hash": "sha256:99dad45ca78533772272c8a6130abddcc76db9fcba16008a98357367ab9f8bdd", "revalidate_after": "2026-10-08T01:29:41.136Z", "max_copy_age_seconds": 3600, "policy": "revalidate-required; attribution-preferred", "changelog": "https://legal.exploreworldai.com/api/public/v1/dependency", "verify": "https://legal.exploreworldai.com/api/public/v1/verify", "stale_copy_invalid": true }, "canonical": "https://legal.exploreworldai.com/api/public/v1/judgment-text?id=us:indctapp-25a-pl-00782-2025-12-05", "disclaimer": "Source reference with official identifier. Not legal advice and not a compliance decision.", "content_notice": { "legal_advice": false, "nature": "Source register. Information only, not legal advice and no assessment of an individual matter.", "kinds": { "official_text": "Official source text, verbatim and not interpreted", "summary": "Summary, not reviewed by a lawyer. Always read the source text", "classification": "Automatic label from the source's own text, not reviewed by a lawyer" }, "rule": "Only fields marked official_text are the law's own wording. Everything else points to it.", "report_error": "https://legal.exploreworldai.com/api/public/v1/corrections", "ai_act_declaration": "https://legal.exploreworldai.com/api/public/v1/ai-act-declaration" }, "usageInfo": "https://legal.exploreworldai.com/citering" }