LePage v. Center for Reproductive Medicine

James LePage, et al. v. The Center for Reproductive Medicine and Mobile Infirmary Association is a 2024 Alabama Supreme Court case in which the court held that frozen embryos should be considered as living beings, allowing for in vitro fertilization (IVF) clinics to be held liable for the accidental loss of embryos under Alabama's Wrongful Death of a Minor law.

The ruling was highly criticized from political speakers on both sides of the spectrum, particularly in the wake of the overturning of Roe v. Wade by the U.S. Supreme Court two years earlier. Several IVF clinics in the state suspended operations following the ruling.

Embryo destruction incident
Per the Centers for Disease Control and Prevention about 1 in 5 people are unable to get pregnant after a year of trying, with a recent survey reporting that 42% of all American adults indicated they have used or know someone who used fertility treatments. In in vitro fertilization (IVF) a fertilized egg can be manufactured in a lab and cultivated for about five or six days to create a blastocyst that is then flash frozen with liquid nitrogen. One round of IVF in Alabama can cost between $15,000 to $25,000.

In 2020, a patient at the Center for Reproductive Medicine in Mobile, Alabama improperly accessed the cryogenic freezer where frozen embryos were stored, removing and dropping them on the floor after their hands suffered from cold burns. Four parents—James and Emily LePage and Felicia and Scott Aysenne—sued against the Center for Reproductive Medicine, with William Tripp and Caroline Fonde serving as plaintiffs in LePage's lawsuit.

Lower court rulings
The Mobile Circuit Court ruled in favor of the defendants.

Alabama Supreme Court
On February 20, 2024, the Alabama Supreme Court ruled that the state's Wrongful Death of a Minor Act covered frozen embryos, which allowed the case to return to the lower court to be ruled on the liability of the defendants.

The ruling decision cited an 1872 Alabama state law that allowed for parents to sue over the death of a minor child, a right that applies to all unborn children regardless of their location. Therefore, if a frozen embryo is destroyed, those responsible could be sued under the Alabama Wrongful Death of a Minor law. Justice Jay Mitchell wrote in the opinion that an unborn child is a child, without any exception based on developmental stage, physical location, or any other characteristics, concluding that nothing would therefore exclude unborn children located outside the uterus from the law. Mitchell's opinion also referenced a 2018 amendment to the state constitution, arguing that its approval showed that "the public policy of this state [is] to recognize and support the sanctity of unborn life and the rights of unborn children."

Chief Justice Tom Parker wrote a concurring opinion to the ruling, citing the Bible's Book of Jeremiah and Book of Genesis; the Sixth Commandment; the Manhattan Declaration; as well as Christian theologians such as Thomas Aquinas and John Calvin. Parker stated:

"In summary, the theologically based view of the sanctity of life adopted by the People of Alabama encompasses the following: (1) God made every person in His image; (2) each person therefore has a value that far exceeds the ability of human beings to calculate; and (3) human life cannot be wrongfully destroyed without incurring the wrath of a holy God, who views the destruction of His image as an affront to Himself."

Alabama's Human Life Protection Act, which states that it is a felony for a doctor to perform any type of abortion, was discussed by Justice Brady E. Mendheim in an opinion concurring with the result of the ruling decision.

In vitro fertilization access
Following the Alabama Supreme Court's ruling, the University of Alabama at Birmingham announced that it was pausing in vitro fertilization treatments. Two other IVF clinics also paused treatments following the ruling. Alabama's attorney general Steve Marshall that he "has no intention of using the recent Alabama Supreme Court decision as a basis for prosecuting IVF families or providers." The next day, an explosive device was detonated outside of Marshall's office in Montgomery, although no one was harmed in the incident.

State lawmakers from both political parties reacted the same week to protect IVF. A bill with bipartisan support and backing from Alabama's governor Kay Ivey was introduced that "would provide that any fertilized human egg or human embryo that exists outside of a human uterus is not considered an unborn child or human being for any purpose under state law" and allow IVF clinics to proceed as normal. On February 29, 2024, the two houses of the Alabama legislature passed similar bills, stating "no action, suit, or criminal prosecution for the damage to or death of an embryo shall be brought or maintained against any individual or entity when providing or receiving goods or services related to in vitro fertilization." Ivey signed the law on March 6, 2024, with two of the IVF clinics stating they will immediately resume services.

At the federal level, a bill called the Access to Family Building Act was introduced in both houses of Congress in January 2024, which would override any state law so as to offer additional protections to IVF clinics. The bill's co-sponsor Senator Tammy Duckworth urged action on the bill in light of the Alabama court ruling. However, Senate Republicans blocked the bill during voting on February 28, 2024.

According to David Schultz, professor of law at University of Minnesota, this ruling cannot be appealed to the U.S. Supreme Court, as the decision is solely an interpretation of Alabama state law. Schultz also argues that this ruling would have been possible prior to the overturning of federal abortion protection in the 2022 Dobbs decision, because it does not directly relate to abortion.

2024 U.S. presidential election
The Alabama case was seen to have a potentially significant impact on the pending 2024 United States presidential election, following the U.S. Supreme Court decision to overturn Roe v. Wade in the 2022 case Dobbs v. Jackson Women's Health Organization. The Democratic party started to immediately add the issue of protecting IVF treatments to its campaign platform in addition to its fight to protect abortion and other women's rights. President Joe Biden condemned the ruling, stating it was only possible due to the decision from Dobbs and that "the disregard for women's ability to make these decisions for themselves and their families is outrageous and unacceptable." Vice President Kamala Harris said, "On the one hand, the proponents are saying that an individual doesn't have a right to end an unwanted pregnancy and, on the other hand, the individual does not have the right to start a family."

Some members of the Republican party, already trying to push their stance on abortion to the background so as to draw votes from women and swing voters, were critical of the Alabama Supreme Court decision since it left no carve out to protect IVF. Former president Donald Trump, running in 2024 for a second term as president, stated that IVF should remain legal. Nikki Haley, another Republican candidate, initially stated that "embryos are babies," but later said she would need to review the law, stating, "We don't want fertility treatments to shut down." New Hampshire Governor Chris Sununu and Tennessee Governor Bill Lee also spoke out against the decision. Other Republican leaders in the U.S. House of Representatives praised the decision, having previously backed a bill that would codify that life begins at conception.

Parker's concurrence and Christian nationalism
Chief Justice Tom Parker's concurring opinion rested heavily on Christian principles, leading to concern about his overall approach to judiciary duties. The same day of the decision, an interview with Parker was released where he expressed his beliefs in Christian nationalism and support of the Seven Mountain Mandate. Parker said in this interview, "God created government, and the fact that we have let it go into the possession of others, it's heartbreaking. That's why he is calling and equipping people to step back into these mountains right now."

Parker's comments, in addition to his judicial opinion, have led to concern about the push of Christian nationalism by conservative politicians and the Republican party, and the attempted weakening of the separation of church and state.