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CASE NAME
Azadeh Khatibi et al v. Kristina Lawson et al
Overview
Plaintiffs challenged California’s mandatory implicit bias training requirement for physicians' continuing medical education (CME).
Details
Plaintiffs argued that the implicit bias training requirement violated their constitutional free-speech rights by compelling them to include discussion of implicit bias in CME courses taught by them when they would otherwise remain silent about such topic.
The district court granted Defendants’ . The court held that teaching CME courses constituted government (rather than private) speech, and thus Plaintiffs had not stated a claim that the government had compelled them to engage in protected speech. The court noted: “If Plaintiffs disagree with the Legislature’s judgment in passing A.B. 241 [the law requiring implicit bias training], they can choose to no longer instruct CME courses for credit, as is their right, or err [sic] their grievances at the ballot box.”
Plaintiffs have now this decision to the Ninth Circuit Court of Appeals. In August 2024, Appellants submitted an opening brief, arguing that CME instruction is private speech protected by the First Amendment.
In October 2024, Defendants filed their Answering Brief, reiterating that the implicit bias requirement in CME courses constituted government speech and, therefore, did not violate the Plaintiffs' free speech rights.
On July 25, 2025, the Ninth Circuit Court of Appeals affirmed the district court's dismissal of Plaintiff's case. The court ruled that the CME courses eligible for credit by the Medical Board of California are government speech. Additionally, California has a long tradition of regulating the medical profession and the public would attribute CME speech to the government rather than the instructors. Lastly, California controls the content of the CME courses and imposes restrictions on their form and delivery. Since the CME courses are considered government speech, they are immune from the restrictions of the Free Speech Clause.
On August 8, 2025, Plaintiff filed a petition for the court to rehear the case. Plaintiff asserts that the court of appeals opinion conflicts with the binding decisions of the U.S. Supreme Court and other circuit courts of appeal. Lastly, Plaintiff argues that the opinion presents important questions around whether "continuing professional education courses are government speech, leaving states free to compel the private presenters to convey controversial ideological messages".
On December 29, 2025, the court denied the petition for a panel rehearing.
Litigation History