PLF asks the Supreme Court to affirm that licensure shouldn’t come at the expense of free speech
Dr. Azadeh Khatibi was six years old when her family fled Tehran, leaving behind the fear and repression of revolutionary Iran. Her parents dared to hope that America would be different for their two daughters, and America delivered on that promise.
Dr. Khatibi—whose first name means “freedom” in Farsi—learned English within two months and quickly rose to the top her class. She got a scholarship to UCLA and went on to complete a rigorous joint medical degree program at the Universities of California San Francisco and Berkeley, eventually launching a career as an ophthalmologist in Los Angeles.
But at 36, when she was in the prime of her career with two children at home, a serious illness forced her to slow down. She went to therapy, studied mindfulness, and began to understand how the traumas of her early childhood had quietly shaped her. She came out on the other side with a new outlook on life.
“Now, I really honor who I am, and I honor my voice more,” Dr. Khatibi says. “I live my life with much better boundaries. I spend a lot of time being in addition to doing.”
Not long after she learned to honor her voice, California tried to hijack it.
In 2019, the State passed AB 241, a law requiring that all continuing medical education (CME) courses involving direct patient care include instruction on implicit bias—the idea that medical professionals unconsciously treat patients differently based on race or other immutable characteristics. Every California physician must complete 50 CME hours every two years to renew their license. Now, instructors teaching courses on surgery, cardiac care, or diabetes management must set aside time in each session to address implicit bias, at the expense of other course material.
From a legal perspective, the law compels instructors to convey a specific government-endorsed message and viewpoint to their students. For Dr. Khatibi, the stakes were personal. She had grown up watching what happens when governments decide what people are allowed to say and think.
“When you grow up in a theocracy that’s very repressive, people are constantly worried about someone reporting them or doing the wrong thing… it really messes up your psyche as an individual,” she says.
Pacific Legal Foundation filed suit on Dr. Khatibi’s behalf in 2023, joined by Dr. Marilyn Singleton, a California anesthesiologist and CME instructor, and Do No Harm, a national medical advocacy organization. The Ninth Circuit ruled against them, and PLF is now asking the U.S. Supreme Court to take the case.
“Implicit bias training sends a damaging message to both physicians and patients,” said Caleb Trotter, a senior attorney at Pacific Legal Foundation. “It tells doctors that their colleagues harbor hidden racial prejudices that no amount of training can fully cure, and it tells minority patients that a white physician is likely to damage their health. That’s not medicine. It’s compelled speech.”
The question before the Court is straightforward: Does the First Amendment apply when the government forces a private citizen to deliver its preferred ideological message as a condition of professional licensure? The answer is “No.” A medical license doesn’t strip a person of their right to free thought and free expression.
If the Supreme Court grants the case, its outcome will matter not just for Dr. Khatibi, but for every professional in America who believes that a government license shouldn’t come with a speech requirement.
