__________________________________________________________________

No. 19-1578

IN THE UNITED STATES COURT OF APPEALS

FOR THE EIGHTH CIRCUIT

JUDY DOE,
Plaintiff-Appellant

v.

MICHAEL L. PARSON, et al.,

Defendants-Appellees
__________________________________________________________________

Appeal from the United States District Court,

Eastern District of Missouri, The Honorable Henry Edward Autry

BRIEF OF APPELLEES
__________________________________________________________________

OFFICE OF THE MISSOURI ERIC S. SCHMITT

ATTORNEY GENERAL Attorney General
Supreme Court Building
P.O. Box 899 D. John Sauer, MO58721
Jefferson City, MO 65102 Solicitor General
Phone 314-340-7366 Peter T. Reed, MO70756
Fax 573-751-0774 Deputy Solicitor General
Peter.Reed@ago.mo.gov Counsel of Record

Attorneys for Appellees Michael L.

Parson, et al.

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 SUMMARY OF THE CASE AND REQUEST FOR ORAL ARGUMENT

In this case, Jane Doe, a member of the Satanic Temple, challenges Missouri’s

informed-consent law for abortions under the Establishment Clause and the Free

Exercise Clause. Missouri’s law does not require Doe to understand, agree, or even

read the State-provided materials. Mo. Rev. Stat. § 188.027. All it requires is that

she acknowledge receipt of those materials. This Court previously rejected an

undue-burden challenge to a similar law that imposed a relatively greater burden,

holding that States have a vital and compelling interest in ensuring abortion patients

have access to basic biological information that will allow them to reach a more

informed decision. Planned Parenthood Minnesota, N. Dakota, S. Dakota v.

Rounds, 530 F.3d 724 (8th Cir. 2008). The Supreme Court said the same thing in

Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833 (1992).

Doe’s claims fail as well. The Supreme Court has already explained that

abortion statutes motivated by a legitimate State purpose do not violate the

Establishment Clause simply because that State purpose happens to coincide with

some religious belief of some religious group. Harris v. McRae, 448 U.S. 297

(1980). As to Free Exercise, Doe fails to allege that receipt of biologically-accurate

materials violates her religious beliefs. Moreover, Missouri’s informed-consent law

is facially neutral, generally applicable, and rationally related to a legitimate State

interest. The State requests equal argument time.

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 TABLE OF CONTENTS

SUMMARY OF THE CASE AND REQUEST FOR ORAL ARGUMENT ........... i

TABLE OF CONTENTS .......................................................................................... ii
JURISDICTIONAL STATEMENT ..........................................................................1
STATEMENT OF THE ISSUES...............................................................................2
STATEMENT OF FACTS AND OF THE CASE ....................................................3
A. Doe alleges that she is a member of The Satanic Temple. ................... 3
B. Missouri law requires informed consent prior to an abortion. .............. 3
C. The district court dismissed Doe’s complaint and held that the
informed-consent law does not violate the First Amendment......................... 4
STANDARD OF REVIEW .......................................................................................6
SUMMARY OF ARGUMENT .................................................................................7
ARGUMENT .............................................................................................................9
I. Missouri’s informed-consent law does not violate the Establishment Clause
simply because it is consistent with the views of some religions. .............................9
A. The informed-consent law does not establish a religion simply
because it is consistent with the views of some religions. .............................. 9
B. The Lemon test does not apply, but the informed-consent law
satisfies that test even if it did. ......................................................................12
C. Doe’s remaining arguments are mistaken. ..........................................17
II. Missouri’s informed-consent law does not infringe on the free exercise of
religion. ....................................................................................................................20
A. Doe has not alleged that the informed-consent law interferes
with any religious exercise. ...........................................................................21
B. Missouri’s informed-consent law is neutral, generally
applicable, and rationally related to a legitimate State interest. ....................25
C. Missouri’s informed-consent law does not invoke strict scrutiny
through a “hybrid rights” theory. ...................................................................26
D. Doe’s remaining arguments are mistaken. ..........................................29
CONCLUSION ........................................................................................................34

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 CERTIFICATE OF COMPLIANCE .......................................................................35
CERTIFICATE OF SERVICE ................................................................................36

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 TABLE OF AUTHORITIES
Cases

ACLU Nebraska Found. v. City of Plattsmouth, Neb.,

419 F.3d 772 (8th Cir. 2005) ...............................................................................13

Am. Legion v. Am. Humanist Ass’n,

139 S. Ct. 2067 (2019) .........................................................................................12

Ashcroft v. Iqbal,
556 U.S. 662 (2009) .............................................................................................17

Braden v. Wal-Mart Stores, Inc.,

588 F.3d 585 (8th Cir. 2009) ...............................................................................21
Children’s Healthcare Is a Legal Duty, Inc. v. Min De Parle,
212 F.3d 1084 (8th Cir. 2000) ...................................................................... 19, 20
Church of the Lukumi Babalu Aye, Inc. v. City of Hialeah,
508 U.S. 520 (1993) .............................................................................................26
City of Akron v. Akron Ctr. For Reproductive Health, Inc.,
462 U.S. 416 (1983) .............................................................................................29
Collins v. Texas,
223 U.S. 288 (1912) .............................................................................................15

Employment Div., Dep’t of Human Res. of Oregon v. Smith,

494 U.S. 872 (1990) .............................................................................. 2, 8, 25, 28

Fargo Women's Health Org. v. Schafer,

18 F.3d 526 (8th Cir. 1994) .......................................................................... 28, 33

Ford v. McGinnis,
352 F.3d 582 (2d Cir. 2003).................................................................................21

Frazee v. Illinois Dep’t of Employment Sec.,

489 U.S. 829 (1989) .............................................................................................21

GeorgiaCarry.Org, Inc. v. Georgia,

687 F.3d 1244 (11th Cir. 2012) ...........................................................................21

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 Gonzales v. Carhart,
550 U.S. 124 (2007) ................................................................ 7, 14, 15, 16, 18, 31

Halbrook v. Mallinckrodt, LLC,

888 F.3d 971 (8th Cir. 2018) .................................................................................6

Harris v. McRae,
448 U.S. 297 (1980) ..................................................................................... passim

Hobby Lobby Stores, Inc. v. Sebelius,

723 F.3d 1114 (10th Cir. 2013) .............................................................. 21, 22, 23

Jacobson v. Commonwealth of Massachusetts,

197 U.S. 11 (1905) ...............................................................................................16

Karlin v. Foust,
188 F.3d 446 (7th Cir. 1999) .................................................................. 31, 32, 33
Korte v. Sebelius,
735 F.3d 654 (7th Cir. 2013) ...............................................................................24
Lemon v. Kurtzman,
403 U.S. 602 (1971) .............................................................................................12
Lynch v. Donnelly,
465 U.S. 668 (1984) .............................................................................................12
McCreary Cty. v. Am. Civil Liberties Union of Ky.,
545 U.S. 844 (2005) ...................................................................................... 16, 17
McGowan v. Maryland,
366 U.S. 420 (1961) ................................................................................ 2, 7, 9, 10

Planned Parenthood In. & Ky. v. Com’r, Indiana,

DOH, 896 F.3d 809 (7th Cir. 2018) .............................................................. 32, 33
Planned Parenthood Minnesota, N. Dakota, S. Dakota v. Rounds,
530 F.3d 724 (8th Cir. 2008) ....................................................................... passim
Planned Parenthood of Se. Pa. v. Casey,
505 U.S. 833 (1992) ..................................................................................... passim

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 Planned Parenthood of Wisconsin, Inc. v. Van Hollen,
738 F.3d 786 (7th Cir. 2013) ...............................................................................14

Reproductive Health Serv. v. Webster,

851 F.2d 1071 (8th Cir. 1988) .............................................................................29

Reynolds v. United States,

98 U.S. 145 (1878) ...............................................................................................11

Stone v. Henry,
364 F.3d 912 (8th Cir. 2002) ...............................................................................28

Trinity Lutheran Church of Columbia, Inc. v. Comer,

137 S. Ct. 2012 (2017) .........................................................................................25

Valente v. Larson,
637 F.2d 562 (8th Cir. 1981) ...............................................................................19
Van Orden v. Perry,
545 U.S. 677 (2005) .............................................................................................13
Webster v. Reproductive Health Servs.,
492 U.S. 490 (1989) .............................................................................................29

Statutes

28 U.S.C. Section 1291 ..............................................................................................1

28 U.S.C. Section 1331 ..............................................................................................1

Mo. Rev. Stat. Section 1.205.1(1)............................................................................15

Mo. Rev. Stat. Section 177.027.12 ...........................................................................4

Mo. Rev. Stat. Section 188.027 ......................................................... i, 2, 3, 4, 26, 33
Mo. Rev. Stat. Section 188.027.1(2)....................................................................4, 18

Mo. Rev. Stat. Section 188.027.1(4)....................................................................4, 32

Other Authorities

Carlson, Bruce M. Foundations of Embryology 3 (6th ed. 1996) ....................15, 30

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 Ronan O’Rahilly, et al., Human Embryology & Teratology 8, 29
(2d ed. 1996) .................................................................................................15, 30

Oppenheimer, Mark, A Mischievous Thorn in the Side of Conservative

Christianity, N.Y. Times (July 10, 2015) .......................................................22, 25

Senate Bill No. 793 .................................................................................................25

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 JURISDICTIONAL STATEMENT

The district court exercised jurisdiction under 28 U.S.C. § 1331. It entered its

order on February 21, 2019. Op. at A-1. Doe filed a timely notice of appeal. This

Court has jurisdiction over a final decision granting dismissal under 28 U.S.C.

§ 1291.

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 STATEMENT OF THE ISSUES

Missouri’s informed-consent law requires abortion providers to give patients

information from the Department of Health and Senior Services setting forth certain

basic medical facts, an opportunity to view an ultrasound, and a 72-hour waiting

period before seeking informed consent. Mo. Rev. Stat. § 188.027. Judy Doe is a

member of The Satanic Temple and alleges, first, that she disagrees with the

information provided by the Department of Health and Senior Services, and second,

that that information is consistent with the religious beliefs of other groups. Given

these facts:

I. Does Missouri’s informed-consent law violate the Establishment Clause?

Harris v. McRae, 448 U.S. 297 (1980)

McGowan v. Maryland, 366 U.S. 420 (1961)

II. Does Missouri’s informed-consent law violate the Free Exercise Clause?

Employment Div., Dep’t of Human Res. of Oregon v. Smith, 494 U.S. 872
(1990)

Planned Parenthood Minnesota, N. Dakota, S. Dakota v. Rounds, 530 F.3d

724 (8th Cir. 2008)

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 STATEMENT OF FACTS AND OF THE CASE

A. Doe alleges that she is a member of The Satanic Temple.

Judy Doe alleges that she is a member of The Satanic Temple, an “association

of politically aware Satanists, secularists and advocates for individual liberty.”

Compl. at A-20. She does not allege whether she is a “politically aware Satanist,”

or whether she is merely one of the “secularists and advocates for individual liberty”

who do not believe in “Satan” as a supernatural power. Id. Instead, she merely

asserts that, as a member of this “politically aware” organization, she should “make[]

decisions regarding her health based on the best scientific understanding of the

world.” Compl. at A-24. She also believes that nobody else should decide for her

whether to have an abortion. Id.

B. Missouri law requires informed consent prior to an abortion.

Doe challenges Missouri’s informed-consent law. Mo. Rev. Stat. § 188.027.

That law provides that “no abortion shall be performed or induced on a woman

without her voluntary and informed consent, given freely and without coercion.”

Mo. Rev. Stat. § 188.027.1.

Doe challenges three aspects of informed consent. Compl. at A-23. Informed

consent requires that abortion providers present the patient with printed materials

from the Department of Health and Senior Services explaining basic embryological

facts such as the “anatomical and physiological characteristics of the unborn child,”

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 and “information on when the unborn child is viable.” Mo. Rev. Stat.

§ 188.027.1(2). These materials also convey the position of the State of Missouri

that “The life of each human being begins at conception. Abortion will terminate

the life of a separate, unique, living human being.” Id. Doe calls this “The Booklet”

and the “Missouri Tenet” respectively. Doe Br. at 2. Informed consent also requires

that the patient be given an opportunity to view an active ultrasound and hear the

heartbeat of the unborn child if the heartbeat is audible. Mo. Rev. Stat.

§ 188.027.1(4). Lastly, informed consent requires a 72-hour waiting period after the

patient is given an opportunity to view the ultrasound, id., or 24 hours if the 72-hour

waiting period is enjoined, Mo Rev. Stat. § 177.027.12. After taking these steps, an

abortion provider may seek the patient’s written informed consent. Mo. Rev. Stat.

§ 188.027.3. This includes the patient’s acknowledgment that the abortion provider

presented the required information and offered the ultrasound opportunity.

Doe alleges that these provisions violate the Establishment Clause, or in the

alternative, the Free Exercise Clause.

C. The district court dismissed Doe’s complaint and held that the informed-
consent law does not violate the First Amendment.

The district court dismissed Doe’s complaint for failure to state a claim. As

to the Establishment Clause, the district court held that the informed-consent law is

a “permissible expression of the State’s secular interest in protecting the unborn.”

Op. at A-13. This is true “[e]ven though” the law is “harmonious with some religious

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 beliefs.” Id. No element of the informed-consent law “advance[s] a religion or

religious beliefs,” the court explained, so it “follows” that signing a statement

acknowledging receipt of the information booklet and ultrasound opportunity “does

not implicate the Establishment Clause” either. Id. at A-14. As to the Free Exercise

Clause, the district court held that the informed-consent law is a valid and neutral

law of general applicability. Id. at A-14 to A-18. The law is religiously-neutral

because it advances the State’s “legitimate, secular interest in ‘protecting the life of

the unborn.’” Id. at A-15 (citation omitted). The law is generally applicable because

it applies to every woman who seeks an abortion in Missouri, “not just members of

the Satanic Temple.” Id. at A-15 to A-16. The court rejected Plaintiffs’ attempt to

apply Sherbert’s balancing test, which does not apply to generally applicable laws.

Id. at A-16 to A-17. The court also rejected Plaintiffs’ “hybrid rights” argument

because the informed-consent law does not unduly burden a woman’s right to get an

abortion. Id. at 17-18.

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 STANDARD OF REVIEW

This Court reviews de novo the district court’s decision to grant a motion to

dismiss. Halbrook v. Mallinckrodt, LLC, 888 F.3d 971, 975 (8th Cir. 2018).

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 SUMMARY OF ARGUMENT

I. A statute does not violate the Establishment Clause simply because it

“happens to coincide or harmonize with the tenets of some or all religions.”

McGowan v. Maryland, 366 U.S. 420, 442 (1961). Laws against larceny are no less

legitimate because some or all religions also oppose larceny. Id. Missouri’s

informed-consent law serves practical, secular purposes. The State has a strong

legitimate interest in ensuring that the decision to obtain an abortion is voluntary,

informed, and free from coercion, just as it would for a kidney transplant. Planned

Parenthood of Se. Pa. v. Casey, 505 U.S. 833, 882-83 (1992) (making the same

analogy). And the State also has a “legitimate and substantial interest in preserving

and promoting fetal life.” Gonzales v. Carhart, 550 U.S. 124, 145 (2007). That

these legitimate interests coincide with some religious beliefs is not surprising, and

it does not violate the Establishment Clause. The Supreme Court has expressly said

so. Harris v. McRae, 448 U.S. 297, 318 (1980). Doe suggests that Missouri’s law

conveys only religious beliefs and not useful information, but this Court recently

upheld an indistinguishable law, noting that it simply conveyed “biological” facts.

Planned Parenthood Minnesota, N. Dakota, S. Dakota v. Rounds, 530 F.3d 724,

735–36 (8th Cir. 2008).

II. Doe’s Free-Exercise claim suffers from several fundamental

shortcomings. Doe has not alleged that any of her beliefs are actually and sincerely

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 religious. The Satanic Temple itself says that membership may be based simply on

policy preferences. Nor does Doe allege any religious practice that conflicts with

the mere receipt of written materials or the opportunity to view an ultrasound.

Missouri’s law simply requires acknowledgment of receipt: it does not require that

Doe agree with, understand, or even read the provided materials. At any rate,

“[G]enerally applicable, religion-neutral laws” with a rational basis satisfy the Free

Exercise Clause. Employment Div., Dep’t of Human Res. of Oregon v. Smith, 494

U.S. 872, 886 n.3 (1990). Missouri’s informed-consent law applies to all people of

all religions, and it does not mention any religion, much less Satanism. Nor is it

targeted: the Satanic Temple did not even exist when the State passed the relevant

amendments in 2010. And it serves reasonable state interests. Finally, Doe uses

“undue burden” language at several points on appeal. That claim was never alleged

in the complaint. It also lacks merit: Casey expressly held that informed-consent

and waiting-period laws do not pose an undue burden, and this Court has as well.

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 ARGUMENT

I. Missouri’s informed-consent law does not violate the Establishment

Clause simply because it is consistent with the views of some religions.

Central to Doe’s Establishment Clause claim is the contention that the State

violated the Establishment Clause by passing an informed-consent law that is

consistent with the views of some religions. She asserts that the well-established

scientific fact that a unique human being comes into existence at conception is a

view shared not just by the State, but also some religions. See Doe Br. at 22-27, 44-

47 (asserting that the informed-consent law communicates a religious belief). And

she contends that this violates the Establishment Clause. Doe Br. at 37-47 (violates

the Establishment Clause); Compl. at A-27. That argument lacks merit.

A. The informed-consent law does not establish a religion simply because

it is consistent with the views of some religions.

The Supreme Court has expressly rejected the argument Doe raises here and

did so in the specific context of abortion.

A long line of precedent establishes that a statute does not violate the

Establishment Clause simply because it “happens to coincide or harmonize with the

tenets of some or all religions.” McGowan v. Maryland, 366 U.S. 420, 442 (1961).

Disabling the government from passing laws simply because they harmonize with

the views of a religion would establish anarchy and give every religious organization

a veto over the government. Homicide is illegal, for example. The “fact that this

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 agrees with the dictates” of some religions “while it may disagree with others” does

not invalidate homicide laws. Id. Likewise, the fact that some religions “oppose

stealing does not mean that a State or the Federal Government may not, consistent

with the Establishment Clause, enact laws prohibiting larceny.” Harris v. McRae,

448 U.S. 297, 319 (1980). If simply harmony with some religion were enough to

violate the Establishment Clause, then little to nothing would be left. Take Doe’s

argument in this case: it is self-defeating. If the Missouri legislature rescinded the

current requirements, the new law would agree with Doe’s purported “religion” and,

under her argument, would thus establish Satanism as the official Missouri religion.

In fact, the Establishment Clause even permits governmental action that is

inspired by religion or closely coincides with the tenets of a particular religion(s).

The plaintiffs in McGowan challenged Maryland statutes that restricted a wide

variety of behavior on Sundays. McGowan, 366 U.S. at 445. The statutes expressly

referred to Sunday as “the Lord’s day” and prohibited “Sabbath Breaking.” Id. at

445. The statute also had once been entitled “An Act concerning Religion” before

the title was amended. Id. at 446. But despite the status of the laws as “undeniably

religious in origin,” id., the Supreme Court upheld the statutes because they “are no

longer exclusively representative[] of religious interests,” id. at 435. The statutes

had gained a religion-neutral purpose, and the Court held that the pertinent legal

purpose of the statue “is not to aid religion but to set aside a day of rest and

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 recreation.” Id. at 449. The Supreme Court has also upheld prohibitions on bigamy

even though bigamy cases were traditionally heard in ecclesiastical courts. Reynolds

v. United States, 98 U.S. 145, 165 (1878).

The Court does not have to guess how these principles apply in the abortion

context. After Congress passed a law to reduce the availability of federal funds for

abortion, a plaintiff, like Doe, argued that the provision “violates the Establishment

Clause because it incorporates into law the doctrines of the Roman Catholic Church

concerning . . . the time at which life commences.” Harris, 448 U.S. at 319, comp.

Doe Br. at 44-47 (asserting that the informed-consent law is “Catholic dogma”).

Citing McGowan, the Supreme Court unequivocally rejected the plaintiff’s

argument: “that the funding restrictions in the Hyde Amendment may coincide with

the religious tenets of the Roman Catholic Church does not, without more,

contravene the Establishment Clause.” Harris, 448 U.S. at 319–20. The Supreme

Court in Harris also refused to reconsider its precedent in McGowan, deciding

instead that the very rule Doe proposes here would lead to absurd results. Id.

Notably, Doe never mentions McGowan or Harris. These authorities

foreclose Doe’s argument that a law’s harmony with a religion renders it

unconstitutional. She asserts that the informed-consent law is “not merely

‘harmonious’ with Catholic dogma – it is Catholic dogma.” Doe Br. at 44-47. But

that misses the point the Court was making in McGowan and Harris. A law against

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 theft “is Catholic dogma” in the same way that Doe argues, but that “does not mean

that a State or the Federal Government may not, consistent with the Establishment

Clause, enact laws prohibiting larceny.” Harris, 448 U.S. at 319. Informed-consent

laws, whether for abortion or kidney transplant surgery, no more establish a religion

than do laws against larceny.

B. The Lemon test does not apply, but the informed-consent law satisfies
that test even if it did.

This Court need not review Doe’s claim under the test established in Lemon

v. Kurtzman, 403 U.S. 602 (1971). See Doe Br. 41-43 (asserting that the Lemon test

should apply); id. at 45-46 (criticizing district court for not applying Lemon). “In

many cases” the Supreme Court has “either expressly declined to apply the test or

has simply ignored it.” Am. Legion v. Am. Humanist Ass’n, 139 S. Ct. 2067, 2080

(2019). This is one of those instances. In Harris, the Supreme Court directly applied

McGowan rather than analyzing each of Lemon’s factors. See Harris, 448 U.S. at

319-320. Because the Supreme Court has already directly addressed and rejected

Doe’s argument in Harris, this Court’s analysis can start and end there.1

1
Doe relies on Lynch v. Donnelly, 465 U.S. 668 (1984) to argue that the district court
should have applied Lemon. Doe Br. at 45-46. But Lynch, a case involving a
traditional public display, actually falls in the category of cases to which Lemon no
longer applies. Am. Legion, 139 S. Ct. at 2081 (applying a “presumption of
constitutionality for longstanding monuments, symbols, and practices” used for
“ceremonial, celebratory, or commemorative purposes”).

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 Even if this Court were to apply the Lemon test, that test forecloses Doe’s

argument. Under Lemon, a statute is constitutional if “(1) it has a secular purpose;

(2) its principal or primary effect neither advances nor inhibits religion; and (3) it

does not foster an excessive entanglement with religion.” ACLU Nebraska Found.

v. City of Plattsmouth, Neb., 419 F.3d 772, 775 (8th Cir. 2005). These considerations

are not mandatory elements but rather “serve as ‘no more than helpful signposts.’”

Van Orden v. Perry, 545 U.S. 677, 686 (2005) (Rehnquist, C.J., plurality opinion).

Binding authority provides that each of the provisions Doe challenges has a

valid purpose. Doe challenges three provisions in Missouri’s informed-consent law:

one requires abortion providers to give patients information about basic scientific

facts such as the “anatomical and physiological characteristics” of the human fetus;

the second requires abortion providers to give patients an opportunity to view an

active ultrasound; and the third requires abortion providers to afford women at least

72 hours to deliberate before having an abortion. Compl. at A-23. As courts have

held, each provision serves at least two legitimate interests.

First, each provision serves the legitimate State interest in ensuring that the

decision to obtain an abortion is voluntary, informed, and free from coercion. It is

beyond debate that the State has a “legitimate purpose” of ensuring that patients are

“fully informed” when they procure abortions just as with any other medical

procedure. Planned Parenthood of Se. Pennsylvania v. Casey, 505 U.S. 833, 882

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 (1992) (plurality op.). To serve this critical interest, numerous states, including

Missouri, have passed provisions to ensure informed consent.

Each of the challenged provisions is geared toward ensuring informed

consent. Doe challenges a provision that requires disclosure of basic embryological

facts. But the Eighth Circuit has upheld similar provisions. The Court upheld a

statute that required physicians to inform women “[t]hat the abortion will terminate

the life of a whole, separate, unique, living human being” because “this biological

information about the fetus” is “relevant to the patient’s decision to have an

abortion.” Planned Parenthood Minnesota, N. Dakota, S. Dakota v. Rounds, 530

F.3d 724, 735–36 (8th Cir. 2008) (“Rounds I”). Ultrasounds, which allow patients

to visualize these facts, also serve that function. Planned Parenthood of Wisconsin,

Inc. v. Van Hollen, 738 F.3d 786, 803 (7th Cir. 2013) (Manion, J., concurring). And

courts routinely uphold waiting periods because “important decisions will be more

informed and deliberate if they follow some period of reflection.” Casey, 505 U.S.

at 885.

The second goal is the “legitimate and substantial interest in preserving and

promoting fetal life.” Gonzales v. Carhart, 550 U.S. 124, 145 (2007). The State has

a substantial interest in encouraging women to choose to protect and preserve human

life “at all stages in the pregnancy” and other stages of life. Id. at 163. Presenting

patients with embryonic facts about human life at this stage promotes that legitimate

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 State interest. See also Mo. Rev. Stat. § 1.205.1(1) (stating that the Missouri General

Assembly finds that “[t]he life of each human being begins at conception”); id.

§ 1.205.2.

Citing the dissent in Rounds I, Doe expresses disagreement with the Missouri

legislature’s finding that a genetically unique member of the human species comes

into existence at the moment of fertilization. Doe Br. at 25-27; Compl. at A-25. But

the State’s position that an individual, unique human organism comes into existence

at fertilization rests on substantial medical authority—in fact, it is a scientific fact

not subject to reasonable dispute. See, e.g., Bruce M. Carlson, Foundations of

Embryology 3 (6th ed. 1996) (“The time of fertilization represents the starting point

in the life history, or ontogeny, of the individual.”); Ronan O’Rahilly, et al., Human

Embryology & Teratology 8, 29 (2d ed. 1996) (“[F]ertilization is a critical landmark

because, under ordinary circumstances, a new, genetically distinct human organism

is thereby formed.”).

In any event, a State does not violate the Establishment Clause merely by

taking sides in a scientific debate. “The Court has given state and federal legislatures

wide discretion to pass legislation in areas where there is medical and scientific

uncertainty.” Gonzales, 550 U.S. at 163 (collecting cases); Collins v. Texas, 223

U.S. 288, 297–298 (1912) (affirming the “right of the state to adopt a policy even

upon medical matters concerning which there is difference of opinion and dispute”).

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 “The fact that the belief is not universal is not controlling” is not surprising, “for

there is scarcely any belief that is accepted by everyone.” Jacobson v.

Commonwealth of Massachusetts, 197 U.S. 11, 35 (1905) (citation omitted). So

even if the State’s position that a unique human life begins at fertilization were open

to scientific dispute, the State would still have full authority to adopt that position.

Thus, the State’s policy of advising women seeking abortions that life begins

at conception advances the secular purpose in preserving and promoting fetal life.

The Supreme Court has recognized that abortion terminates an “infant life.”

Gonzales, 550 U.S. at 159. “[B]y common understanding and scientific

terminology, a fetus is a living organism while within the womb, whether or not it is

viable outside the womb.” Id. at 147. Accordingly, under governing Supreme Court

case law, the State’s informed-consent law unquestionably serves another legitimate

secular purpose, i.e., promoting and preserving fetal life by encouraging women to

deliberate carefully before making the irreversible decision to have an abortion.

As for the second Lemon factor, the informed consent law neither advances

nor inhibits religion. Doe asserts that the informed-consent law fails this test

because, in her opinion, it states “a religious belief” and then “advances that religious

belief.” Doe Br. at 42. Similarly, Doe “perceived” the law as “disapproval of her

religious beliefs.” Id. But as she admits, Lemon is not a subjective test. McCreary

Cty. v. Am. Civil Liberties Union of Ky., 545 U.S. 844, 862 (2005). Lemon instead

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 looks objectively at the statute’s text, history, and implementation. Id. Examined

objectively, Missouri’s law simply ‘“furthers the legitimate purpose of reducing the

risk that a woman may elect an abortion, only to discover later, with devastating

psychological consequences, that her decision was not fully informed.’” Rounds I,

530 F.3d at 734 (quoting Casey, 505 U.S. at 882). That the State’s position is in line

with some religions does not advance those religions. That the State’s position is

not in line with other religions does not inhibit those religions. Courts will not

presume that a law’s purpose is to advance religion merely because it “happens to

coincide or harmonize with the tenets of some or all religions.” quoting Harris, 448

U.S. at 319.

Doe has also failed to allege that the law causes an entanglement with religion.

She does not appear even to argue this prong on appeal, Doe Br. at 41-43, and made

only a conclusory allegation that entanglement exists in her complaint, see Compl.

at A-27. This Court must disregard conclusory allegations. Ashcroft v. Iqbal, 556

U.S. 662, 678 (2009). Nothing suggests that the State law interacts at all with

religion, much less that it leads to entanglement with religion.

C. Doe’s remaining arguments are mistaken.

Doe’s other arguments are mistaken as well.

At times, Doe seems to suggest that parts of the informed-consent law convey

information that is only a religious belief, in contrast to the “biological disclosure”

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 in Rounds I. Doe Br. 22-27. But Rounds I involved a very similar statement to the

one at issue here. South Dakota defined a “human being” to include an unborn

human being “from fertilization to full gestation” and thus its disclosure accurately

stated that “the abortion will terminate the life of a whole, separate, unique, living

human being.” Rounds I, 530 F.3d at 726. Missouri’s disclosure materials explain

that the life of a “human being” begins “at conception” and thus its disclosure

accurately states that “[a]bortion will terminate the life of a separate, unique, living

human being.” Mo. Rev. Stat. § 188.027.1(2). Doe says the South Dakota law made

a “biological” statement because it separately defined a “human being.” Doe Br. at

26-27 & n.15. Missouri’s law does too: it states that the life of a “human being”

begins “at conception.” Mo. Rev. Stat. § 188.027.1(2). Missouri moved the

definition into the disclosure itself, removing any possible doubt that the statute

refers to “the biological sense in which the embryo or fetus is whole, separate,

unique, and living.” Rounds I, 530 F.3d at 736. This is consistent with the term’s

common meaning. Gonzalez, 127 S.Ct. at 1627 (“[B]y common understanding and

scientific terminology, a fetus is a living organism while within the womb, whether

or not it is viable outside the womb.”).

Moreover, Doe misreads Rounds I. South Dakota required abortion providers

to certify that the patient understood the provided materials, so it was particularly

important for the materials to be easy to understand. This Court explained that South

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 Dakota’s disclosure stated a simple biological fact consistent with the plain meaning

of biological life. Rounds I, 530 F.3d at 736. Missouri’s law only requires patients

to certify receipt of the provided materials. So this case is much easier. Rounds I

held that South Dakota’s disclosure was clear enough that it could not be

misunderstood. Missouri’s disclosure states the same thing as South Dakota’s, and

also does not require the abortion provider to certify the patient’s understanding.

Next, Doe criticizes the district court for relying “on a false dichotomy”: that

Missouri’s law “communicates a secular value judgment or a religious belief.” Doe

Br. at 22-25 (emphasis original). But it is Doe who misunderstands the law. Just

because a secular value judgment happens to coincide with a religious belief does

not violate the Establishment Clause. Courts will not presume that a law’s purpose

is to advance religion merely because it “happens to coincide or harmonize with the

tenets of some or all religions.” Harris, 448 U.S. at 319. Many laws, like laws

against theft, coincide with the religious beliefs of at least some religions.

Doe also mistakenly argues that the Court should apply what she calls the

“Larson test.” Doe Br. 39-41 (citing Valente v. Larson, 637 F.2d 562, 566 (8th Cir.

1981)). Larson applies when a law “on its face grants a denominational preference.”

Children’s Healthcare Is a Legal Duty, Inc. v. Min De Parle, 212 F.3d 1084, 1090

(8th Cir. 2000). Larson might apply, for example, if members of The Satanic

Temple had to comply with the informed-consent law but not Methodists. That is

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 not the case here: abortion providers must seek and obtain informed consent from

every woman who seeks an abortion in Missouri, “not just members of the Satanic

Temple.” Op. at A-15 to A-16. There is no evidence that the Missouri legislature

“sought to include only [members of the Satanic Temple] within the challenged

provisions or, conversely, to exclude any other denomination.” Children’s

Healthcare, 212 F.3d at 1091.

II. Missouri’s informed-consent law does not infringe on the free exercise of
religion.

Doe also asserts that Missouri’s informed-consent law violates her right to the

free exercise of religion. But Doe fails to allege that her beliefs are religious—not

just policy based. Moreover, Doe does not explain how the informed-consent law

actually burdens her religious beliefs. Missouri’s law does not require Doe to

understand, agree, or even read the State-provided materials. All it requires is that

she acknowledge receipt of those materials. Even if Missouri’s law did burden

religious beliefs, the law does not violate the Free Exercise Clause because it is

neutral, generally applicable, and rationally related to the legitimate State interest.

As with any other medical procedure, Casey “recognize[d] a substantial government

interest justifying that a woman be apprised of the health risks of abortion” including

“the consequences to the fetus.” 505 U.S. at 882-83.

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 A. Doe has not alleged that the informed-consent law interferes with
any religious exercise.

Before the Court even reaches Smith and its progeny, Doe must allege that her

beliefs are religious, and explain how the legal provisions interfere with her religious

practice. She has not done so.

First, Doe has not alleged that any of her beliefs are religious. “The Supreme

Court has reiterated time and time again that personal preferences and secular beliefs

do not warrant the protection of the Free Exercise Clause.” GeorgiaCarry.Org, Inc.

v. Georgia, 687 F.3d 1244, 1256 (11th Cir. 2012). “There is no doubt that ‘[o]nly

beliefs rooted in religion are protected by the Free Exercise Clause.’ Purely secular

views do not suffice.” Frazee v. Illinois Dep’t of Employment Sec., 489 U.S. 829,

833 (1989) (citation omitted). Doe makes conclusory allegations that her views are

religious, which this Court must disregard. Braden v. Wal-Mart Stores, Inc., 588

F.3d 585, 594 (8th Cir. 2009). She has failed to allege anything concrete that

differentiates her and The Satanic Temple from a political advocacy group.

“In free exercise cases, scrutiny of the [plaintiff’s] sincerity is often essential

in ‘differentiating between those beliefs that are held as a matter of conscience and

those that are animated by motives of deception and fraud.’” Ford v. McGinnis, 352

F.3d 582, 588 (2d Cir. 2003) (citation omitted). Courts must be vigilant to avoid

permitting “wily [persons] seeking to use an insincere claim of faith as cover” for a

political or personal goal. Hobby Lobby Stores, Inc. v. Sebelius, 723 F.3d 1114,

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 1152 (10th Cir. 2013) (Gorsuch, J., concurring), aff’d sub nom. Burwell v. Hobby

Lobby Stores, Inc., 134 S. Ct. 2751 (2014).

Doe has failed to allege, beyond conclusory statements, Doe Br. at 5-6, that

her views are actually and sincerely religious, not political. She admits that the

Satanic Temple comprises a mixture of Satanists with nonreligious individuals. She

describes the organization as a “politically” engaged group that includes

“secularists” and “advocates for individual liberty” as well as Satanists. Compl. at

A-20. But nothing in the complaint suggests that Doe herself subscribes to Satanism

as a religion, or that she actually possesses any particular religious views. All she

asserts is adherence to a set of tenets she describes as “religious beliefs.” Doe Br. at

5-6; Compl. at A-24 to A-25. But that set of beliefs appears to be shared by all

members of The Satanic Temple. Critically, Doe does not allege whether she

constitutes a “Satanist,” instead of just a “secularist” or “advocate for individual

liberty.” Id. In fact, both founders of The Satanic Temple have publicly stated that

they do “not actually believe in Satan,” and they have stated that The Satanic Temple

was founded, not because of supernatural beliefs, but over “a shared distaste for

organized religion and an inclination to fight back with mischief.” Mark

Oppenheimer, A Mischievous Thorn in the Side of Conservative Christianity, N.Y.

Times (July 10, 2015), http://goo.gl/8KKQ3N. The founders have also publicly

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 admitted that “they are looking for plaintiffs, willing to identify as Satanists, who

will file suit.” Id.

Second, even if Doe were to allege that she is more than just a politically

motivated “advocate for individual liberty,” Compl. at A-20, Doe has failed to allege

any religious exercise that conflicts with the informed consent laws. She alleges that

she must “make[] decisions regarding her health based on the best scientific

understanding of the world,” and that “[s]he alone decides whether to remove [a

fetus] from her body.” Doe Br. at 5-6; Compl. at A-24 to A-25. But she does not

allege that her beliefs forbid exposure to information with which she disagrees. In

fact, she concedes that she has “no objection to the presentation to her by the State

of truthful and non-misleading facts,” Doe Br. at 13, because she believes her

decisions should be based “on the best scientific understanding of the world,” id.;

see also Compl. at A-25 (same).

In other words, Doe asserts that the decision to get an abortion falls within her

“zone of conscience,” Doe Br. at 10-12, but she at no point asserts that her religious

beliefs are burdened by simply having an opportunity to view scientific information

with which she disagrees. Missouri does not require that Doe certify that she

understands the provided materials or even that she has read them, as Doe later

acknowledges. See id. at 30-31. Thus, all Doe can argue is that the informed-consent

law is coercive insofar as it requires her to “either acknowledge receipt” of

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 information or “forego getting medical treatment.” Id. at 29-31. As Doe

acknowledges, the only precondition to her getting an abortion is for her to

acknowledge receipt of materials and give consent. And Doe does not allege or

argue that acknowledging receipt of scientific information about abortion violates

her religious beliefs. That is, the informed-consent law in no way “forces [Doe] to

do what [her] religion tells [her she] must not do.” Korte v. Sebelius, 735 F.3d 654,

685 (7th Cir. 2013). There is no coercion, even if the provided information “might

cause the woman to choose childbirth over abortion.” Casey, 505 U.S. at 883. To

the contrary, the law promotes a more informed and voluntary choice.

Nor does Doe allege that her religion forces her to obtain an abortion more

quickly than the 72-hour waiting period would allow. Indeed, that provision gives

her greater opportunity to discern the “best scientific understanding” of embryology.

Doe Br. at 5-6; Compl. at A-24 to A-25. Doe does not plead that her alleged religion

motivates her desire to have an abortion, or to have an abortion at any particular

time. Just the opposite. She alleges that she “alone decides” whether to abort. Id.

She has that power regardless of the waiting period. At root, Doe seeks to enjoin

government speech because she disagrees with it. But nothing she has identified

conflicts with any religious exercise.

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 B. Missouri’s informed-consent law is neutral, generally applicable,
and rationally related to a legitimate State interest.

Even if Doe had alleged that receipt of information violates her religious

beliefs, Missouri’s informed-consent law withstands constitutional scrutiny under

the Supreme Court’s current free-exercise doctrine.

“[G]enerally applicable, religion-neutral laws . . . need not be justified by a

compelling governmental interest.” Employment Div., Dep’t of Human Res. of

Oregon v. Smith, 494 U.S. 872, 886 n.3 (1990).2 A law is generally applicable and

religion-neutral if it does not, facially or otherwise, “target the religious for special

disabilities based on their religious status.” Trinity Lutheran Church of Columbia,

Inc. v. Comer, 137 S. Ct. 2012, 2019 (2017) (internal quotation marks and citation

omitted).

The provisions Doe challenges are religion-neutral and generally applicable.

At the outset, the notion that the legislature sought to target The Satanic Temple

belies basic historic facts. Missouri passed the pertinent statutory amendments in

2010. S.B. No. 793 (2010). But the “Satanic Temple” in which Doe claims

membership did not even exist at that time. Oppenheimer, supra,

http://goo.gl/8KKQ3N (reporting that the organization began, at the earliest, in

2012).

2
Although it has been subject to criticism, Doe does not ask this Court to reconsider
Smith, so that question is not before the Court.

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 Moreover, the statute is religion-neutral on its face. “A law lacks facial

neutrality if it refers to a religious practice without a secular meaning discernable

from the language or context.” Church of the Lukumi Babalu Aye, Inc. v. City of

Hialeah, 508 U.S. 520, 533 (1993). The informed-consent law does not mention

any religion, much less Satanism. The law also is neutral in purpose. A facially

valid law can impermissibly target religion if it creates “religious gerrymanders.”

Id. at 534 (citations omitted). Such “religious gerrymanders” are created by

narrowly tailoring a statute and granting exemptions so that a provision affects only

disfavored religions. Id. at 536, 544–45. But this statute applies to people of all

religions. The only exemption is for women facing a “medical emergency” who lack

the time to receive all the information. Mo. Rev. Stat. § 188.027.1.

Moreover, the law passes rational-basis review. As the Eighth Circuit held in

Rounds I, informed-consent requirements serve vital interests in ensuring that

women are fully informed before making irreversible decisions of significant moral

gravity. Rounds I, 530 F.3d at 734.

C. Missouri’s informed-consent law does not invoke strict scrutiny

through a “hybrid rights” theory.

As pled, this case is about the First Amendment’s religion clauses. Doe’s

complaint did not allege that Missouri’s informed-consent law created an undue

burden on her right to seek an abortion—either as a freestanding claim or a “hybrid

rights” theory. Compl. at A-19 to A-30. It is easy to see why. The Supreme Court

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 upheld Pennsylvania’s informed-consent statute in Casey. 505 U.S. at 882-83.

Casey “recognize[d] a substantial government interest justifying that a woman be

apprised of the health risks of abortion” including “the consequences to the fetus.”

Id. This is no different from many other medical procedures. “[I]nformed consent

to a kidney transplant operation,” for example, may require the recipient to be

“supplied with information about risks to the donor as well as risks to himself or

herself.” Id. at 883. In short, “requiring that the woman be informed of the

availability of information relating to fetal development . . . is a reasonable measure

to ensure an informed choice.” Id. “[T]here is no undue burden.” Id. This is so

even if such laws “might cause the woman to choose childbirth over abortion.” Id.

Casey’s holdings effectively forecloses any undue-burden challenge to Missouri’s

informed-consent law.

On appeal, however, Doe sometimes frames her free-exercise claim in the

terminology of an undue-burden case. Comp., e.g., Doe Br. at 4 (framing the issue

presented as an undue burden question) with Doe Br. at 9 (asserting a free exercise

claim) with Doe Br. at 28 (asserting a hybrid rights theory).

This argument fails for several reasons. First, any independent undue-burden

claim is not preserved. Doe’s complaint has only two counts, and an undue-burden

claim is not one of them. Compl. at A-19 to A-30. The complaint does not even use

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 the phrase “undue burden.” New claims cannot be raised “for the first time on

appeal.” Stone v. Henry, 364 F.3d 912 (8th Cir. 2002).

Second, Doe has not cited a single case applying a “hybrid rights” theory

simply because a law touches on both free exercise and abortion. Smith’s hybrid

theory only applies in a few specific instances. Smith, 494 U.S. at 882. As in Smith,

“[t]he present case does not present such a hybrid situation” because Doe’s claim is

“unconnected with any communicative activity or parental right.” Id. The Supreme

Court has not recognized any other “hybrid” claims aside from those two scenarios.

Third, any undue-burden claim or “hybrid rights” claim is foreclosed by

Casey. Doe Br. 28-29; 35-37. Casey held that informed-consent laws like

Missouri’s properly inform women “of the availability of information relating to

fetal development” and so are a “reasonable measure to ensure an informed choice.”

Casey, 505 U.S. at 883. There is “no undue burden.” Id. Casey also upheld a 24-

hour waiting period. Id. at 885. This Court has as well. Fargo Women's Health

Org. v. Schafer, 18 F.3d 526, 533 (8th Cir. 1994). Echoing Casey, the Court

reasoned that ‘“important decisions will be more informed and deliberate’ if made

after some period of reflection.” Id. (quoting Casey, 505 U.S. at 885). The same is

true here. Because there is no undue burden, there can be no hybrid-rights claim.

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 D. Doe’s remaining arguments are mistaken.

Doe’s remaining arguments are also mistaken. First, Doe mistakenly relies

on this Court’s subsequently-reversed decision in Reproductive Health Serv. v.

Webster, 851 F.2d 1071 (8th Cir. 1988) (“Webster I”), for the incorrect proposition

that Missouri cannot make any statement about when life begins. Doe Br. at 4, 17-

21. Webster I, however, did not raise or resolve any claims under the religion

clauses, so it does not apply here. 851 F.2d at 1071. As to the claims that it did

resolve, Webster I is not good law. The Supreme Court reversed that decision on

appeal, and in doing so, emphasized “the authority of a State to make a value

judgment favoring childbirth over abortion.” Webster v. Reproductive Health Servs.,

492 U.S. 490, 522 (1989) (Webster II). Doe even relies on Justice Stevens’ partial

dissent in Webster II, even while arguing that Webster I is somehow binding. Doe

Br. at 20. Not so. Doe cites Webster I for the proposition that Missouri’s law is “an

impermissible state adoption of a theory of when life begins.” Doe Br. at 21. That

proposition, in turn, is based on since-rejected reasoning in Akron. See Webster I,

851 F.2d at 1075 (quoting City of Akron v. Akron Ctr. For Reproductive Health, Inc.,

462 U.S. 416, 444 (1983)); see also Doe Br. at 18 (recognizing reliance on Akron).

Akron, however, was subsequently overruled by Casey. Thus, far from being

binding, Doe relies on Webster I for a proposition that has been twice-rejected by

the Supreme Court: first in Webster II itself, then again in Casey. As Casey

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 explained, “we depart from the holding[] of Akron” because the State may “further

its legitimate goal of protecting the life of the unborn by enacting legislation aimed

at ensuring a decision that is mature and informed.” Casey, 505 U.S. at 883 (noting

such legislation may express “a preference for childbirth over abortion”). That is

exactly what Missouri’s informed-consent law does.

Second, Doe sometimes asserts that the informed-consent materials and

ultrasound opportunity contain “misleading” information, while at other points

asserting only that it is “medically irrelevant” or “unnecessary.” Doe Br. at 13-17,

32-34, 34. Take each assertion in turn.

Doe acknowledges that she has “no objection to the presentation to her by the

State of truthful and non-misleading” relevant facts. Doe Br. at 13. Notably, then,

she cannot point to any specific information that is false or misleading. Id. To the

contrary, Doe alleges only medical uncertainty: a lack of “scientific evidence” to

support the claim that a “fertilized egg is a human being.” Id.; see Op. at A-14

(holding Doe did not allege that the State provided “factually inaccurate”

information). Again, the State’s position that an individual, unique human organism

comes into existence at fertilization is a scientific fact not subject to reasonable

dispute. See, e.g., Bruce M. Carlson, Foundations of Embryology 3 (6th ed. 1996)

(“The time of fertilization represents the starting point in the life history, or

ontogeny, of the individual.”); Ronan O’Rahilly, et al., Human Embryology &

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 Teratology 8, 29 (2d ed. 1996) (“[F]ertilization is a critical landmark because, under

ordinary circumstances, a new, genetically distinct human organism is thereby

formed.”). The State’s position already reflects the ‘“best scientific understanding

of the world.’” Doe Br. at 13 (quoting Compl. at A-25). At any rate, Doe dooms

her own argument by alleging medical uncertainty. “The Court has given state and

federal legislatures wide discretion to pass legislation in areas where there is medical

and scientific uncertainty.” Gonzales, 550 U.S. at 163 (collecting cases).

Particularly in medical matters, the State has significant discretion to inform patients

about scientific uncertainty and risks. Apart from information that is truly false or

misleading, “a state has wide latitude in imposing regulations that are designed to

ensure that a woman makes a thoughtful and informed choice.” Karlin v. Foust, 188

F.3d 446, 491 (7th Cir. 1999).

That leaves only Doe’s allegation that the State’s materials, and the

opportunity to view an ultrasound, are somehow “irrelevant” or “unnecessary.” Doe

Br. 16-17, 32-34. This sounds like a rational-basis argument. The Court has already

explained, however, that informed-consent laws serve vital state interests in ensuring

informed medical decisions. Rounds I, 530 F.3d at 734. So Doe frames her

argument slightly differently: either the informed-consent law is coercive because it

causes her to reconsider her religious beliefs, she says, or it is irrelevant and an undue

burden because it has no persuasive effect. Doe Br. at 16-17. Doe is mistaken on

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 both counts. This Court has already explained that an informed-consent law is

constitutional “even if” the provided information might “encourage the patient to

choose childbirth over abortion.” Rounds I, 530 F.3d at 734-35. As the district court

explained, a “woman absolutely maintains the right and ability to legally terminate

her pregnancy.” Op. at A-12. The State simply requires abortion providers to

present medically-relevant information to inform that choice. Rounds I, 530 F.3d at

734. An informed decision is more likely to be voluntary rather than coerced. The

same is true of the opportunity to view an ultrasound. It is voluntary and non-

coercive, but also conveys medically-relevant information about the weighty

decision to get an abortion. Mo. Rev. Stat. § 188.027.1(4). Should Doe change her

mind about an abortion that would be her voluntary choice.

Doe also gets the law’s purpose wrong. The purpose of an informed-consent

law is to help “ensure that a woman makes a thoughtful and informed choice.”

Karlin, 188 F.3d at 491. The Court should measure the relevance of the provided

information by whether it makes a woman’s consent more informed, not simply by

whether it causes patients to forgo getting an abortion. Doe cites a different Seventh

Circuit case for the proposition that Missouri must prove some “legitimate

persuasive effect.” Doe Br. at 16 (Planned Parenthood In. & Ky. v. Com’r, Indiana

DOH, 896 F.3d 809, 834 (7th Cir. 2018) (“PPINK”)). But Missouri is not bound by

Indiana’s statement of the purpose of Indiana’s law—and Seventh Circuit case law

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 proves it. That court’s earlier decision in Karlin found it enough that a law inform

the patient’s choices, regardless of what those choices are.3 Casey said the same.

Casey, 505 U.S. at 885. The same is true of the ultrasound opportunity. The

ultrasound may lead some women to forgo getting an abortion, but the informed-

consent law does not become “irrelevant” or “pointless,” Doe Br. at 32-34, if Doe

proceeds to have an abortion anyway. See Fargo Women's Health, 18 F.3d at 533.

In sum, all medical patients have a right to relevant information before

consenting to medical procedures. Abortion is no exception. Missouri requires

abortion providers—like other medical providers—to present such information to

their patients. By requiring abortion providers to get a patient’s “voluntary and

informed consent, given freely and without coercion,” Mo. Rev. Stat. § 188.027.1,

Missouri advances the State’s compelling interest in ensuring that ‘“important

decisions will be more informed and deliberate.”’ Fargo Women's Health, 18 F.3d

at 533 (quoting Casey, 505 U.S. at 885).

3
PPINK also involves unique circumstances in Indiana. As discussed earlier, Casey
held that informed-consent and waiting-period laws generally do not create an undue
burden and this Court has as well. The Court in PPINK reached the contrary
conclusion because only a few Planned Parenthood facilities in Indiana had
ultrasound machines. PPINK, 896 F.3d at 815. Doe does not allege similar facts
here.

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 CONCLUSION

For these reasons, the district court should be affirmed.

Respectfully submitted,

ERIC S. SCHMITT
Attorney General of Missouri

D. John Sauer, MO 58721

Solicitor General

/s/ Peter T. Reed

Peter T. Reed, MO 70756
Deputy Solicitor General
Counsel of Record

Office of the Mo. Attorney General

Supreme Court Building
P.O. Box 899
Jefferson City, MO 65102
Phone 314-340-7366
Fax 573-751-0774
Peter.Reed@ago.mo.gov

Attorneys for Appellees Michael L. Parsons,

et al.

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 CERTIFICATE OF COMPLIANCE

The undersigned hereby certifies that this filing complies with the typeface

and formatting requirements of Fed. R. App. P. 27 and 32, and that it contains 7,658

words as determined by the word-count feature of Microsoft Word. The brief has

been scanned for viruses and is virus free.

/s/ Peter T. Reed

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 CERTIFICATE OF SERVICE

I hereby certify that on September 9, 2019, I electronically filed the foregoing

with the Clerk of the Court for the United States Court of Appeals for the Eighth

Circuit by using the CM/ECF system.

Participants in the case who are registered CM/ECF users will be served by

the CM/ECF system, and I will serve a copy of the foregoing on all participants in

the case who are not registered CM/ECF users by mailing a copy of the same, first-

class, postage paid, to the address listed on the Court’s CM/ECF system.

/s/ Peter T. Reed

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