The legal case concerns the constitutionality of the Partial-Birth Abortion Ban Act of 2003, which prohibits physicians from intentionally performing a partial-birth abortion that would result in the death of a living fetus, except when the mother's life is endangered. The Act lacks an exception allowing the procedure where necessary for the health of the mother and covers not only intact dilation and extraction (D&E) but also certain other D&Es. The Supreme Court upheld the Act against the broad, facial attack, but referred to the opinions of three District Courts that heard extensive evidence on the constitutionality of the Act and affirmed its unconstitutionality. The Act is valid as it furthers the legitimate interest of the Government in protecting the life of the fetus that may become a child. Regulations that create a structural mechanism to express respect for the life of the unborn are permitted if they are not a substantial obstacle to the woman's exercise of the right to choose. The Act provides clear and objective guidelines for evaluating whether a doctor has performed a prohibited procedure. The court finds that interpreting the Act so that it does not prohibit standard D&E is the most reasonable reading and understanding of its terms.

Justice Thomas agrees with the Court's decision in the case, which follows existing legal principles, including Planned Parenthood of Southeastern Pa. v. Casey. However, he restates his belief that the Court's abortion jurisprudence, including Casey and Roe v. Wade, lacks constitutional foundation. He also points out that the question of whether the Partial-Birth Abortion Ban Act of 2003 is a valid exercise of Congress' power under the Commerce Clause is not at issue in this case, as it was not raised or briefed by the parties and was not addressed by the lower courts.

The legal case of Planned Parenthood of Southeastern Pa. v. Casey affirmed a woman's right to choose to have an abortion before fetal viability without undue interference from the state, but allowed the state to restrict abortions after fetal viability with exceptions for pregnancies that endanger the woman's life or health. The Court invalidated a Nebraska statute criminalizing a medical procedure known as "partial-birth abortion" because it lacked protection for a woman's health, but allowed federal intervention to ban this procedure nationwide. The Supreme Court ruled that a statute prohibiting intact dilation and evacuation (intact D&E) must include a health exception. The Partial-Birth Abortion Ban Act was found to be unconstitutional due to inaccuracies in the congressional findings and a lack of careful consideration of evidence. The Court's decision to uphold the nationwide ban on intact D&E without any exception for a woman's health conflicts with previous rulings and disregards the evidence presented in the trial records. The lack of a health exception in the Act unfairly burdens women who require an intact D&E for medical reasons. The Court's decision to apply the Act to both pre-viability and post-viability abortions is criticized for dismissing medical judgments and applying a lower standard of scrutiny. The writer argues that a woman suffering from medical complications needs access to the procedure without delay. The Court's decision to disallow "facial attacks" in cases where medical uncertainty exists is inconsistent with prior cases and may lead to further confusion in future cases.