By Stacy Adams

Published by Doubleday - 432 pages, $30

It seems not a day goes by that we don’t encounter an article, podcast, or broadcast about artificial intelligence. Just look at any ABA Journal over the past couple of years, and you’ll find several articles touching the intersection of AI and the law. Coded Justice explores many of our thoughts and fears of AI in a well-written presentation. This is the third novel in Stacy Abrams's series centered around former United States Supreme Court law clerk Avery Keene, who is now working at a prestigious law firm in Washington, D.C. when a high-profile client seeks her out. 

Camasca Enterprises has a big problem and a short runway. The tech company has developed a new integrated artificial intelligence system poised to revolutionize the medical industry. Camasca’s founder and CEO, retired Major Rafe Diaz, has been evaluating its cutting-edge health care system called “Milo” for his fellow veterans. According to Diaz, Milo is Camasca’s clinical decision support system, tasked with helping doctors help patients by documenting clinical exams, analyzing health records, and even recommending diagnoses and personalized medications.  The upside potential is staggering, but the prototype has been plagued by a series of disturbing anomalies—culminating in the mysterious death of Elisha Hibner, the beloved Camasca senior engineer. Camasca’s General Counsel and CEO Diaz are anxious to have Avery successfully conclude an internal investigation before the firm goes public, with billions of dollars on the line.

After the lengthy opening chapter, the book moves quickly as Avery and her colleagues are brought in to investigate Camasca from the inside out. The team includes Avery's boyfriend and computer expert Jared, her good friend and medical doctor Ling, and her attorney friend Noah. Together they roll up their sleeves to uncover the truth behind the death of the engineer. There seems to be a system flaw generating troubling outcomes that could destroy Camasca’s dream in short order. The group’s work uncovers a baffling piece of the puzzle that could do more than ruin Casmasca’s public launch. It could turn the entire idea of AI on its head. 

The company is concerned there may be bugs in the program potentially causing malfunctions. But when mystery patients, hallucinated diagnoses, and unexplained deaths start piling up, Avery’s job quickly escalates from compliance to crisis management.

In Coded Justice, Abrams’s wonderful storytelling is on full display, combining vibrant characters and a story line set against the fascinating landscape of the capabilities of artificial intelligence and fear of that technology. Character development is a key to the success of this novel. Abrams weaves an interesting story with her core characters. She also develops strong pacing and leaves us to use our imagination throughout this legal and crime thriller. 

As the story progresses, she maintains our curiosity about the ultimate outcome. The technology and its exploration kept me hooked even though there were no trial scenes. The focus on remarkable tech advances that are changing the world of healthcare makes for a fascinating, thought-provoking setting. This thriller dives into medical bigotry, drug compounding, subpar medical care for veterans, the minds of tech executives, and the ins and outs of public offerings. Coded Justice breaks down complicated concepts of phantom patients, hallucinations, faking alignment, and anthropomorphizing AI programs.

Abrams, a Yale Law School graduate and former Georgia House minority leader, is also a voting rights advocate, nonprofit founder, and two-time gubernatorial candidate. Her legal and political experience adds depth and credibility to the story. She is someone who has spent time both in the courtroom and in the war rooms of policy and politics.

This book caused me to ponder the effects of AI on the legal profession, including paralegal or attorney tasks such as document review, footnoting, boilerplate drafting being completed by machine learning tools. There are reported cases where lawyers have submitted AI-aided briefs citing cases that don’t actually exist and have been sanctioned by judges who are not fond of fake citations.

Coded Justice is Abrams’s most entertaining novel to date, with strong legal overtones and one that kept my full attention. I look forward to seeing where Abrams will go next with Avery Keene.

The Bar Association of Metropolitan St. Louis (BAMSL) created its charitable arm – commonly called the Saint Louis Bar Foundation – in 1956. From its founding, the Foundation’s purpose has been to improve the administration of justice by funding legal education and services. It supports this mission through grants and scholarships to law students, legal aid projects, and related programs.

It has adopted a motto, “Promoting the Rule of Law – Advancing the Spirit of Justice.” This motto sets forth the embraced its dual commitment to serving lawyers and the broader community.

Over the decades the Saint Louis Bar Foundation has launched several enduring community programs. For example, BAMSL’s Missouri High School Mock Trial Competition – now its longest-running program – was launched in 1979 (with the Foundation today as a sponsor). We’re going national June 29, 2027, where BAMSL will host the National High School Mock Trial Championship rounds here in St. Louis. Teams will compete against the best of the best from other states.

The Mock Trial Competition annually serves more than 600 students from more than 50 schools throughout Missouri and is supported by up to 400 attorneys who volunteer as coaches, judges, and evaluators. The year 2026 marks the competition’s 47^th year. We had a record-breaking 118 high school mock trial teams from across Missouri in 2026. 

Another Foundation flagship initiative is Motion for Kids, an annual holiday party for foster children and youth impacted by the courts. The Foundation has run Motion for Kids for over 30 years, delivering toys and books to roughly 2,200 children each December in recent years. These educational and service programs demonstrate the Foundation’s long-term commitment to youth and families in the St. Louis community.

In addition to grants, the Foundation honors legal and civic leaders. It now hosts an annual Spirit of Justice awards gala (first held in the late 2000s) to recognize individuals who advance justice and public service. 

The Foundation also funds scholarships (such as a Women in the Legal Profession scholarship) and supports local legal aid initiatives. As of the 2020s, the Saint Louis Bar Foundation remains an active philanthropic arm of BAMSL, continuing to advance its mid-century mission through education, service, and community outreach.

MISSOURI SUPREME COURT AFFIRMS THE LEGISLATURE’S RECENT REDRAWING OF MISSOURI’S CONGRESSIONAL DISTRICTS.

Merrie Suzanne Luther, et al. v. Denny Hoskins and Missouri State Republican Committee, SC 101412 (Mo. banc Mar. 24, 2026).

The Missouri Supreme Court in a 4-3 decision held that although Art. III, § 45 of Missouri’s Constitution obligates the General Assembly to redistrict Missouri’s congressional districts when the United States census is certified to the governor, that provision does not otherwise expressly limit the General Assembly’s plenary power to legislate congressional districts including in years when there is no United States census.

Article III, Section 45 states: 

When the number of representatives to which the state is entitled in the House of the Congress of the United States under the census of 1950 and each census thereafter is certified to the governor, the general assembly shall by law divide the state into districts corresponding with the number of representatives to which it is entitled, which districts shall be composed of contiguous territory as compact and as nearly equal in population as may be.

The most recent United States census was conducted in 2020, and the census results were certified to the governor in August 2021. As required by Art. III, § 45, the General Assembly established new congressional districts in 2022 following certification of the census to the governor. Then, in September 2025, the General Assembly repealed the congressional districts established in 2022 and established new congressional districts without the certification of a new census to the governor.

Four individuals filed suit in Cole County Circuit Court asserting that the redistricting done in 2025 is invalid because Art. III, § 45 limits the General Assembly to a single congressional redistricting every 10 years following certification of the census to the governor. Plaintiffs argued that while the Missouri Constitution does not expressly prohibit mid-decade congressional redistricting, the Constitution denies such power by clear implication because Art. III, § 45 identifies a specific time when the General Assembly shall legislate new congressional districts.

In reaching its decision, the Missouri Supreme Court explained that unlike the U.S. Constitution, which grants specific powers to Congress, the Missouri Constitution only limits the General Assembly’s plenary legislative power, and, thus, it follows that “the General Assembly has the power to do whatever is necessary to perform its functions except as expressly restrained by the Constitution,” citing Liberty Oil Co. v. Dir. of Revenue, 813 S.W.2d 296, 297 (Mo. banc 1991). 

The majority explained that while § 45 obligates the General Assembly to legislate congressional districts once following certification of the census to the governor, it does not prohibit more frequent congressional redistricting. Simply put, “when” does not mean “only when.” The Court held that § 45, therefore, falls squarely within the rule that “an express enumeration of legislative powers … cannot be considered as the exclusion of others not named unless accompanied by negative terms,” citing Bohrer v. Toberman, 227 S.W.2d 719, 723 (Mo. banc 1950). The Court held that the word “when” as used in Art. III, § 45 simply triggers the time that the General Assembly must legislate congressional districts and does not limit redistricting to that time only. Judge Fischer authored the majority opinion and was joined in by Judges Powell, Broniec, and Gooch.

Judge Wilson authored a dissenting opinion joined in by Judges Ransom and Russell. The dissent explained that “when the constitution instructs the General Assembly “when” and “how” the power is to be exercised,” there is a strong presumption that it was designed to be exercised in that time and mode only.” The dissent noted that the Court will not adopt a convoluted meaning that renders words meaningless when the plain language of the provision is clear. Here, the plain language of Art. III, § 45 explicitly instructing the General Assembly “when” and “how” to draw congressional districts necessarily prohibits the General Assembly from drawing districts at any other time or in any other matter.

MISSOURI SUPREME COURT HOLDS THAT CHALLENGERS TO MISSOURI’S STATUTE REQUIRING A FORM OF PERSONAL PHOTO IDENTIFICATION TO VOTE LACK STANDING TO CHALLENGE THE LAW.

Missouri State Conference of the National Association for the Advancement of Colored People, et al. v. State of Missouri, et al., No. SC100965 (Mo. banc Mar. 24, 2026).

In 2022 Missouri enacted a statute that requires individuals who wish to vote to present either one of the required forms of personal photo identification or cast a provisional ballot.

Prior to being amended, the law permitted individuals appearing to vote without photo identification to vote using an array of other documents after attesting that they do not possess the forms of personal identification required for voting. Under the new statute, voters without a compliant form of photo identification may cast only a provisional ballot. For a voter’s provisional ballot to count, the voter must “return to the polling place while it is open” and “provide a form of” valid photo identification or “the election authority verifies the identity of the individual by comparing that individual’s signature to the signature on file with the election authority and determines that the individual was eligible to cast a ballot at the polling place where the ballot was cast. The statute applies the same photo identification requirements for in-person absentee voting.”

The Missouri State Conference of the National Association for the Advancement of Colored People (NAACP), the League of Women Voters of Missouri, and three individuals filed suit in Cole County Circuit Court against the State of Missouri and the Secretary of State alleging that the statute unconstitutionally burdens the right to vote and violates equal protection.

The State moved to dismiss plaintiffs’ petition alleging that plaintiffs lacked standing to bring their constitutional claims. The circuit court initially sustained the State’s motion to dismiss but allowed plaintiffs to file an amended petition in an attempt to establish standing. Plaintiffs filed a first amended petition adding another person as a plaintiff.

The trial court held a five-day bench trial, and following that trial the court entered judgment in the State’s favor, finding plaintiffs lacked standing. The circuit court also ruled that even if they did have standing, plaintiffs’ constitutional challenge to the statute lacked merit.

At trial, plaintiffs testified in person or via deposition about their voting experience after the statute was enacted. Plaintiff Powell was a registered voter and a member of the League of Women Voters. Her non-driver photo identification expired in 2021. She stated that she suffers from a chronic disease disorder that renders her unable to drive and that she has no need for a renewed photo identification except to vote. She testified that she feels unsafe walking or using a bus and that her polling place is a couple blocks from where she lives and she walks there to vote. In the 2022 federal election she used her expired non-driver photo identification. She testified that she was concerned that if she cast the provisional ballot under the new statute, an election official reviewing the signature on her ballot and comparing it to her signature on file will then incorrectly validate  her vote because her seizure disorder distorts her signature. She did state, however, that she did cast a provisional ballot in 2023 and that she knew the ballot was counted. The circuit court found that she had not established standing because there was insufficient evidence that the law would prevent her from voting.

Plaintiff Morgan possesses a non-expired non-driver photo identification. This identification spells her name Kimberley, but her voter card spells her legal first name as Kimberly. She stated that she has not attempted to vote after 2022 for fear of “being mistaken for voting fraudulently or turned away” because the first name on her non-driver photo identification does not match the name on her voter registration. The trial court, however, found that the misspelling on her non-driver photo identification does not legally prevent her from using it to vote because the name on this identification conforms to her name as it appears in her voter registration. The trial court found that nothing prevents her from voting provisionally.

The third individual plaintiff, O’Connor, died during the pendency of the appeal, but was a League of Women Voters member and registered to vote in Missouri. O’Connor testified via deposition and stated that his driver’s license expired in 2016 and at the time of trial, he possessed a non-expiring photo identification that permanently satisfied the requirements of the statute. The trial court found that O’Connor could and had voted since the statute’s enactment using his non-expiring photo identification and any burdens that O’Connor bore in obtaining his non-expiring photo identification did not establish standing to challenge the statute. 

The circuit court also found that the organizational plaintiffs, the NAACP and the League of Women Voters, could not proffer any specific factual allegations regarding the statute’s impact on specific members and thus they had not established associational standing. The circuit court, however, went on to address the merits of appellants’ constitutional claims and found that the new law did not violate a Missourian’s right to vote or the Missouri Constitution’s equal protection clause. 

Plaintiffs appealed to the Missouri Supreme Court. The Court explained that to bring an action in a Missouri court, a person must have standing which means that (a) the plaintiff has a legally protectable interest at stake, (b) a substantial controversy exists between parties with genuinely adverse interests, and (c) the controversy is ripe for judicial determination. A party’s speculation that a challenged action may adversely impact that party is insufficient to establish a threatened or actual injury. The Missouri Supreme Court found that considering the evidence presented at trial in the light most favorable to the prevailing party and disregarding all contrary evidence, the individual Plaintiffs did not establish that the statute actually infringed on their ability to vote, and their fears that the law may do so in the future are merely speculative, and, thus, appellants lacked standing. The Court also affirmed the trial court’s finding that the organizational plaintiffs did not establish a threatened or actual injury stemming from the statute.

The Missouri Supreme Court noted that despite determining that the plaintiffs lacked standing to sue, the circuit court in its judgment alternatively concluded that plaintiffs’ constitutional claims lacked merit even if they had standing. The Court explained that while the circuit court correctly concluded plaintiffs failed to establish standing, such finding then eliminated any remaining judicial issue and requires the Supreme Court to reverse that part of the judgment alternatively resolving appellant’s constitutional claims on the merits.

Judges Fischer, Ransom and Wilson dissented, stating that in their view the parties’ sufficiently pleaded and proved organizational standing, but they would affirm the circuit court’s judgment on the merits concluding that the statute does not violate the Missouri Constitution in the manner alleged.

MISSOURI SUPREME COURT HOLDS THAT VOTER SOLICITATION STATUTE IS UNCONSTITUTIONAL.

State of Missouri , et al. v. League of Women Voters of Missouri, et al., SC 100997 (Mo. banc Mar. 24, 2026).

Missouri enacted a law in 2022 relating to the solicitation of voter registration applications and absentee ballot applications in §§ 115.205.1 and 115.279.2 RSMo.

The League of Women Voters of Missouri and Missouri State Conference of the National Association for the Advancement of Colored People (NAACP) filed suit petitioning for declaratory and injunctive relief, and seeking a declaration that the statutes are facially unconstitutional restrictions on speech, association, and due process.

Section 115.205.1 provides:

No person shall be paid or otherwise compensated for soliciting voter registration applications, other than a governmental entity or a person who is paid or compensated by a governmental entity for such solicitation. A voter registration solicitor who solicits more than ten voter registration applications shall register for every election cycle that begins on the day after the general election and ends on the day of the general election two years later. A voter registration solicitor shall be at least eighteen years of age and shall be a registered voter in the state of Missouri.

Consisting of three restrictions, this provision (1) prohibits payment or compensation for the solicitation of voter registration applications, (2) requires any voter registration solicitor who solicits more than 10 voter registration applications to register with the State, and (3) requires any voter registration solicitor be at least 18 years of age and a registered Missouri voter. 

Section 115.279.2 establishes a complete ban on “soliciting” the person into obtaining an absentee ballot application providing:

Notwithstanding section 115.284, no individual, group, or party shall solicit a voter into obtaining an absentee ballot application. Absentee ballot applications shall not have the information prefilled prior to it being provided to a voter. Nothing in this section shall be interpreted to prohibit a state or local election authority form assisting an individual voter.

Plaintiffs alleged that these restrictions unconstitutionally restrict core political speech, are content-based and viewpoint-based restrictions on speech, and are unconstitutionally overbroad.

The State moved to dismiss the lawsuit. After a hearing, the circuit court sustained the plaintiffs’ motion for a preliminary injunction and overruled the State’s motion to dismiss.

The parties entered into a joint stipulation of facts at trial. The State, however, offered no evidence defending or justifying the restrictions at trial. The circuit court then entered judgment, enjoining the enforcement of §§ 115.205.1 and 115.279.2 and declaring that the statutes are unconstitutional restrictions on rights to free speech, facially and as applied, under the Missouri Constitution. The State appealed to the Missouri Supreme Court.

On appeal, the Missouri Supreme Court explained that when conducting a review of the constitutionality of the statute, a statute is presumed valid unless it clearly contravenes a constitutional provision, and the Court avoids interpretations that will limit or cripple legislation any further than the law requires. The Court further explained that when the language of a statute is plain and unambiguous, the Court must apply the language as written and may not resort to canons of construction.  The Missouri Supreme Court noted that “the issue in this case is whether §§ 115.205.1 and 115.279.2 are facially invalid because they restrict core political speech in violation of Art. I, § 8 of the Missouri Constitution.”

The State argued that the circuit court erred in declaring §§ 115.205.1 and 115.279.2 unconstitutional because the word “solicit,” as used in these provisions, has a narrow definition, which includes distributing and collecting applications and, as such, creates a mere de minimus burden on respondents’ speech and voting rights.

In a 4-3 decision, the court affirmed the trial court’s holdings. Judge Russell authored the opinion, concurred in by Judges Powell and Ransom. Judge Gooch dissented in a separate opinion in which Judges Fischer and Broniec concurred. The Court in its majority opinion noted that the statute does not define the word “solicit.” The Court explained that when the court seeks to determine the plain or ordinary meaning of a statute and the statute does not define an operative word, the word’s ordinary meaning is derived from the dictionary. The Court pointed out that “solicit” is defined as “to disturb, agitate, move, entreat,” to “make petition to: entreat, importune…[especially] to approach with a request or plea,” to “move to action,” and “to strongly urge.” (Solicit, Webster’s Third International Dictionary (1961)). The Court stated that the State acknowledged the breath of “solicitation” in its briefing in the circuit court, citing the broad dictionary definition of “solicit.” The Court noted, however, that despite acknowledging its clear definition in the circuit court, the State contends on appeal that a narrowed definition of “solicit” is appropriate, causing these provisions to regulate only conduct, not speech and not implicating Art. I, § 8 of the Missouri Constitution. The State claimed on appeal that “solicit” as used in the provisions, means someone who provides a voter registration application or absentee ballot application, and also collects the completed application for submission to a local election authority. And thus, solicit, does not equate to “speech.”

The Supreme Court found the State’s assertion unpersuasive for multiple reasons. The Court explained that in the event a solicitor fails to register or submits false information, this subsection provides protection for a voter whose application is collected by that solicitor. This added protection, however, is not a limitation on the definition of “solicit.” While § 115.205.4 contemplates a solicitor procuring or collecting applications, acknowledgement that a solicitor may collect applications does not imply that one must collect applications to be considered a solicitor. The Court found that “solicit” as used in §§ 115.205.1 and 115.279.2 means to “intrigue,” “importune,” or “strongly urge,” a person to register to vote or apply for an absentee ballot.

In addition to determining the definition of solicit, the Court then found that the plain language of the challenged provisions restricts core political speech, citing to Meyer v. Grant, 486 U.S. 414 (1988). The Court observed that “restrictions on the solicitation of voter registration applications and the prohibition on the solicitation of absentee ballot applications naturally involve core political speech. Solicitation requires one to speak to a person regarding an issue of societal concern – participation in the democratic process – and involves advocacy for political change. 

In short, the Missouri Supreme Court found that all of the challenged provisions regulate core political speech and are subject to strict scrutiny. They are not tailored toward any of the state’s asserted interests and thus the provisions are facially unconstitutional.

Judge Gooch in her dissenting opinion would find three of the four challenged provisions constitutional, but would hold that the fourth is unconstitutional.

SUPREME COURT AFFIRMS EXCLUSION OF EXPERT TESTIMONY THAT WAS NOT BASED ON AND SUPPORTED BY RELIABLE RESEARCH METHODS.

Hanshaw v. Crown Equipment Corp., et al., No. SC101091 (Mo. banc Feb. 24, 2026).

Plaintiff Hanshaw was injured while operating a forklift that Crown Equipment designed, manufactured, and distributed. He filed suit against Crown Equipment asserting product liability claims related to the forklift’s alleged defective design and requested punitive damages. His allegation of defective design stemmed from the forklift’s open operator compartment design. He retained an expert witness to testify that the forklift was defectively designed and unreasonably dangerous and that installing a door or a bumper would improve safety.

Crown Equipment simultaneously filed motions for summary judgment and to exclude Hanshaw’s expert witness. Crown Equipment asserted that the expert is not qualified. His opinions are not based on reliable methodology and his deposition testimony “amounts to nothing more than rank speculation and inadmissible ipse dixit.” Crown Equipment further argued that the expert testimony was the only evidence adduced to demonstrate an issue of material fact. Without such testimony, summary judgment is appropriate. 

First, the circuit court sustained Crown Equipment’s motion to exclude the expert’s testimony for failing to carry his burden of demonstrating that the expert witness’s deposition testimony is based on and supported by reliable research methods. The trial court found that no evidence was presented that the expert performed any tests – e.g. testing for injury potential, economic feasibility or general safety – to support the efficacy of his alternative designs or that his alternative design was the subject of any peer preview. Hanshaw, in support of his expert’s reliability, argued that the expert previously had published peer-reviewed papers related to the forklift design at issue in the case. 

The trial court, however, found that Hanshaw failed to demonstrate how these peer-reviewed papers were relevant to or support the expert’s testimony. Hanshaw also argued that the expert’s opinion was based on reports maintained by Crown Equipment and OSHA regarding forklift accidents. The court, however, found that the expert failed to demonstrate how he used the data and how the data supported his opinions and resulted from reliable research methods. The next day, the circuit court also sustained Crown Equipment’s motion for summary judgment. Hanshaw appealed to the Court of Appeals, but the Missouri Supreme Court transferred the appeal to itself.

The Missouri Supreme Court pointed out that the only circuit court action under review in this appeal is its decision to sustain Crown Equipment’s motion for summary judgment, pointing out that the circuit court’s decision to sustain a defendant’s motion in limine regarding the admissibility of a plaintiff's expert is not, by itself, appealable. However, in this case, because Crown Equipment’s motion for summary judgment was premised on the contention that Hanshaw had no admissible expert evidence to support his defective design for failure to warn claims, the circuit court’s analysis of the motion in limine likely was relevant to its decisions to sustain the summary judgment motion.

The Court in its decision noted that § 490.065 RSMo. governs the admissibility of expert witnesses. That statute provides:

A witness who is qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion or otherwise if:

The expert’s scientific, technical, or other specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue;

The testimony is based on sufficient facts or data;

The testimony is the product of reliable principles and methods; and

The expert has reliably applied the principles and methods to the facts of the case[.]

The Supreme Court stated that it will not find a circuit court abused its discretion in excluding an expert witness if (1) the expert witness is determined to be unqualified; (2) the expert witness is irrelevant; or (3) the expert testimony is not based on reliable methodology. The Court noted that it is apparent that if an expert’s proponent fails to provide the methodology, theory, or technique to the circuit court, the court would be unable to evaluate the reliability of said methodology, theory or technique.

The Court further explained that Daubert v. Merrill Dow Pharm, Inc., 509 U.S. 579 (1993), provides a non-exhaustive and flexible set of factors that may be relevant in evaluating reliability, including (1) whether the theory or technique can be and has been tested; (2) whether the theory or technique has been subjected to peer review and publication; (3) the known or potential rate of error of the technique or theory when applied and the existence and maintenance of standards and controls; and (4) whether the technique or theory has been generally accepted in the scientific community. Thus, if an expert’s proponent fails to provide the methodology, theory, or technique to the circuit court, the court would be unable to evaluate the reliability of said methodology, theory, or technique. 

The Missouri Supreme Court found that Hanshaw has not clearly demonstrated the facts or data on which his expert relied in forming his opinions. To the extent that Hanshaw claims to have provided facts or data forming the basis of the expert’s opinions, Hanshaw fails to demonstrate what principles or methods formed the basis for the expert's opinion or how the expert applied those principles and methods to the facts of the case, as required by § 490.065.2(1)(d). The Court concluded that because Hanshaw’s expert’s opinions were excluded under § 490.065, the circuit court properly sustained Crown Equipment’s summary judgment motion.

MISSOURI SUPREME COURT UPHOLDS CONSTITUTIONALITY OF MISSOURI’S STATUTE PROHIBITING GENDER TRANSITION SURGERIES OR DRUGS.

E.N. v. Mike Kehoe, No. SC100933 (Mo. banc Jan. 13, 2026).

Missouri enacted SAFE (Missouri Save Adolescents from Experimentation Act) and a Medicaid ban effective August 28, 2023. The SAFE Act generally prohibits health care providers from performing gender transition surgeries on a minor or prescribing or administering cross-sex hormones or puberty-blocking drugs for the purpose of assisting gender transitions to minors. § 191.1720.3-4. The Medicaid ban precludes MO HealthNet payments “for gender transition surgeries, cross-sex hormones, or puberty-blocking drugs, as such terms are defined in [the SAFE Act], for the purpose of gender transition.  § 208.152.15.”

An individual, on behalf of her minor child, along with interested medical professionals, organizations, and other similar situated minors, alleged that the SAFE Act and the Medicaid ban violate equal protection, due process, and the gains-of-industry clause. The suit was filed in Cole County, Missouri, and following a two-week bench trial the court entered a 74-page judgment in the State’s favor on all counts. Plaintiffs appealed to the Missouri Supreme Court.

In its opinion upholding the constitutionality of the legislation, the Missouri Supreme Court noted that the Supreme Court of the United States and the United States Court of Appeals for the Eighth Circuit recently addressed similar legislation enacted in Tennessee and Arkansas and upheld the legislations constitutionality. See United States v. Skrmetti, 605 U.S. 495 (2025) (upholding Tennessee’s version of the SAFE Act under rational-basis review); Brandt ex rel. Brandt v. Griffin, 147 F.4^th 867 (8^th Cir. 2025) (upholding Arkansas’s version of the SAFE Act under rational-basis review). The Missouri Supreme Court noted that these cases are persuasive and aid the Missouri Supreme Court’s analysis.

The Court noted that plaintiffs here raised only “facial challenges” to the SAFE Act in which the challenger must establish that no set of circumstances exist under which the statute would be valid. Plaintiffs did not assert “an as-applied challenge” which required plaintiffs to show the statute was unconstitutionally applied to their individual circumstances. The Missouri Supreme Court found that plaintiffs had not satisfied the facial challenge burden.

The Court also found that the statute did not violate Missouri’s equal protection clause. The Court noted that the proper test here was a rational-basis test in which a challenged statute will be upheld as long as the statute “is rationally related to some legitimate end.” Similar to the legislation discussed by the Eighth Circuit in Brandt and the Supreme Court in Skrmetti, the SAFE Act prohibits the performance of gender transition surgery on, and the prescription of administration of cross-sex hormones on puberty-blocking drugs for, “any individual under 18 years of age.” The Court found that the SAFE Act classifies based only on age and medical concern, not sex or transgender status.

The Court held that the statute survived a rational-basis review which does not question the wisdom, social desirability, or economic policy underlying a statute. A law will be upheld if it is justified by any set of facts where there exists plausible reasons for the relevant government action. The Court found that plaintiffs had not met the burden of overcoming the presumption that the statute has a rational basis. 

The Court also rejected plaintiffs’ arguments that the act violates parents’ fundamental right to decide the appropriate medical care for their children and children’s fundamental right to healthcare autonomy. The Court explained that although parents have a right to make decisions concerning the care, custody and control of their children, there is no fundamental right of a parent to obtain for his or her child a medical treatment that, although the child desires it and a doctor approves, the State legislation deems inappropriate for minors. The Court also found that the Medicare ban is rationally related to the State’s legitimate interest in ensuring limited public funds are used efficiently.

Oftentimes the role of in-house counsel is viewed as a place lawyers go after “real” practice, or when they are seeking a quieter alternative to firm life. When I went in-house five years ago, many people—both lawyers and non-lawyers—assumed my workdays would be slower-paced and less rigorous. Others assumed my scope of work would be more limited since I was now going to practice law at a pharmaceutical company. A few even expressed some envy and suggested I would finally have time to breathe. However, none of that turned out to be altogether true. 

Going in-house is not just a job change and the work certainly is not easy. It requires a shift in how you think, how you practice law, and how you measure success. It requires skills that law schools never really teach and that law firms discourage in some ways. In-house lawyers are not simply legal advisors; we are also business partners, risk managers, stakeholders, and—my favorite corporate speak term—"thought partners.” At the same time, in-house lawyers often serve as the primary, if not only, interface between a company and its outside counsel, shaping how those relationships develop and how outside counsel perceives the company overall. Understanding these nuances matters not only for lawyers considering an in-house role, but also for outside counsel that advise corporate clients. Many of the most common frustrations between law firm attorneys and their in-house clients stem from misunderstandings about responsibilities, business strategies, and resource constraints, just to name a few. 

To be clear, what follows is not criticism of law firm practice. I spent ample time in private practice to understand how integral firms are to teaching young lawyers the fundamentals, and I credit my success as corporate counsel to the years I spent in private practice.  Instead, this is, in many ways, a tale of two cities: what in-house counsel actually does each day, why our advice sometimes sounds different than expected, and how outside counsel can work more effectively with us.

The Fundamental Shift: From Legal Advisor to Business Partner 

In most law firm settings, your roles and responsibilities are well-defined. For example, in my last role, which was at an Am Law 100 firm, I was an associate in a designated practice group that was part of a larger industry-centric business unit. Law school trained me to issue spot and conduct a legal analysis of identified issues. Law firm practice fine-tuned those skills and added layers of thoroughness, precision, and defensibility. Simply put, my job was to identify legal risks, explain the law, propose a legally sound solution, and then allow the client to decide. In-house, that is only the starting point. 

The real question is almost never “Is this legal?” It is usually some version of “How can we do this in a legal, compliant, and workable way for the business?”  Answering that question requires in-house lawyers to understand the company’s strategic goals, operating model, and commercial realities in order to evaluate the legal risk. In other words, you cannot simply spot the issue and stop there…you must help land the plane.

Law School (and Firms) Struggle to Teach This Skill Set Because It’s Difficult to Replicate 

The in-house mindset is difficult to teach in an academic or firm setting because it relies heavily on context and consequences. Even most law school clinical experiences are akin to practicing at a firm. No one in law school explained that, as in-house counsel, legal advice is often expected in real-time, with little time to prepare—when the business is ready to make a decision and move on. There is rarely time, if ever, for a beautifully footnoted memo because business wants an answer it can quickly act on.

At first, this expectation can feel uncomfortable. Lawyers are trained to be careful, qualified, and precise. In-house, you still must be all those things, but you also must be decisive.

Over time, in-house lawyers learn that while all risks deserve consideration, not all risks deserve equal weight. The business does not need a catalog of every conceivable risk. What it needs is to understand what this risk means now and how to respond in a particular way that aligns with the company’s goals.

In-house Lawyers Don’t Just Give Advice…They Own What Happens Next

One of the most significant differences between firm and in-house practice is what happens after the advice is given. This distinction shapes nearly every aspect of the in-house counsel’s role. 

In a firm, once the advice is delivered the matter often moves on. In-house, when a lawyer recommends a course of action we are implicitly committing to support that decision and see it through its full life cycle, with ownership extending beyond discrete legal issues. 

Over time, the in-house lawyer becomes a custodian of institutional knowledge which is an invaluable asset to companies because of high turnover outside the legal department and shifts in the company’s priorities. But in-house lawyers are not merely great company historians; our extended ownership responsibilities equip us to develop compliance structures, oversee regulatory obligations, and manage processes that persist long after a particular matter ends.

As a result, this influences how in-house lawyers assess risk because we cannot simply consider a legal issue in a vacuum. Instead, it forces us to think beyond the immediate issue and consider how today’s decision fits into the company’s bigger picture, something that may not be fully understood or appreciated by outside counsel, who are usually tasked with addressing individual issues as stand-alone matters.

Why “No” is Usually Not the Right Answer

There is a common misconception that in-house lawyers serve primarily as gatekeepers whose role is to shut things down. In reality, consistently saying no (particularly without a clear legal basis) is rarely welcomed and can signal a failure to meet the expectations of the role.

The business expects its lawyers to help solve problems, not just point them out, to help accomplish objectives, not just block them, and to manage risks, not just avoid them. When something raises a concern from a legal perspective, the more useful response is usually, “Here’s how we can do this,” or “Here’s what we’d need to change to make this acceptable.” For clarity, however, this does not mean ignoring legal requirements or permitting misconduct. There are certainly circumstances where, particularly in highly regulated industries like pharma, “no” is the only answer. But these instances are typically rare so it is imperative for in-house lawyers to reserve outright prohibitions for exceptional cases. We must instead recognize that the business needs advice framed in terms of options and tradeoffs, and that our job is to help navigate that responsibly.

The Inside Scoop on Outside Counsel 

From the in-house side, outside counsel are an extension of the legal department, not a substitute. When the in-house versus outside counsel dynamic works well, it is a true partnership. When it does not it is usually because we are solving slightly different problems.

In-house counsel are often juggling multiple issues, each with business pressure attached. We need advice that is prioritized, practical, and tied to outcomes. Lengthy analyses that identify every conceivable issue and are not actionable can make our jobs harder, not easier. Other common friction points that frequently arise between in-house and outside counsel include over-lawyering, unclear prioritization, cost concerns, and a lack of connection to day-to-day operations.

Over-lawyering. From the in-house perspective, over‑lawyering often means an exhaustive analysis that is unnecessary or treating every issue as equally risky. While thoroughness is valued, advice that does not distinguish between theoretical and material risk can slow decision‑making and obscure what actually matters. Over‑lawyering may also appear in overstaffing, where multiple attorneys are assigned to relatively straightforward matters without adding meaningful value. 

Unclear prioritization. Friction also arises when risks are identified without guidance on relative importance. Because in-house lawyers must translate legal advice into business decisions, it is critical to understand which issues require immediate attention, which can wait, and which are unlikely to matter.

Cost concerns. In terms of cost sensitivity, even when budgets are healthy, in-house lawyers are expected to justify spend internally. Clear communication and transparency around staffing and scope go a long way to avoid misunderstandings.

Disconnect from operations. Advice that is legally sound but disconnected from how the business actually operates can be difficult to implement. In-house lawyers often bridge that gap, translating legal guidance into workable solutions. Outside counsel who understand operational realities are better positioned to deliver advice that sticks.

None of this means that in-house lawyers want less thoughtful or thorough advice. What we want is advice that helps us make a decision.

What Helps Outside Counsel Stand Out (In a Good Way)

The outside lawyers who are most effective for in-house legal departments tend to do a few things consistently:

Seek to understand what the business is trying to accomplish;

Flag the risks but also tell us which ones are most important;

Distill complex issues into recommendations and provide options, not just obstacles;

Understand that timing and business resources matter; and

Respect that in-house counsel has to socialize the decision internally.  

When outside counsel frames their advice with those realities in mind, it builds trust and credibility. 

For Lawyers Thinking About Going In-House

If you are considering an in-house role, it helps you to know that the job will stretch different muscles. You will no doubt still use your legal training every day but you will also rely heavily on judgment, communication, and institutional awareness.

You will not always have the “perfect” answer; instead, you will often have the best available answer. Learning to be comfortable with that distinction is part of becoming effective in-house counsel.

Conclusion

For me, being in-house counsel is not necessarily a retreat from firm life. Sure, there are no billable hour requirements, but I often joke that billable hours at least provided a tangible measure of the work I put in. More importantly, being in-house has changed how I define good lawyering. It is not just about getting the law right; it is about making the law work in a complicated, fast-moving business environment.

For outside counsel, understanding the in-house perspective can lead to better collaboration and stronger client relationships. For lawyers considering an in-house move, knowing what to expect can make the transition both smoother and more rewarding.

When in-house and outside counsel understand each other’s roles, priorities, and constraints, the result is not just better legal work, it’s better outcomes for the company which is an immeasurable value.

I have spent about half of my career as an in-house lawyer and the other half in private practice at larger law firms. I started my in-house career in litigation as a regulatory enforcement lawyer and spent the last three years as a business advice or client-facing lawyer. I like to use an elephant analogy to explain the difference between an in-house litigator and in-house client-facing lawyer. As a litigator, I walk behind the elephant, cleaning up the mess. As a client-facing lawyer, I walk in front of the elephant, feeding it fruits and vegetables and trying to prevent the mess in the first place. Either way, a few things have proven true across every in-house role I have had. Here is my top ten list for surviving—and actually enjoying—life in-house. The list is in no particular order, and it applies to legal work more generally.

Get to the Point and Don’t Talk Like a Lawyer

Most business partners do not want a long legal lecture or explanation. A lot of the time you will get five minutes—so lead with the answer, then the “why.” Skip the legalese and talk like a normal person. If they want details, they’ll ask—so be prepared to go deep.

Think Like a Businessperson, not a Lawyer

I did not go to business school (and at the time, I definitely did not want to). Early on as an in-house lawyer, I felt unprepared for how much “business jargon” you are expected to understand—terms, acronyms, numbers, and how decisions really get made. So, I worked hard to learn the business. I found trusted peers and leaders who let me ask “basic” questions—and they helped me connect the dots.

I also learned that when I was insecure or had what I thought was a “dumb question” playing out in my mind, a lot of people in the room had the same questions. I learned to get comfortable being uncomfortable and started asking those questions out loud. Doing that made me faster, more valuable, and a better partner.

When you really understand the business, you can spot misalignment early and see how a “small” fix in one area can ripple into others. Dot-connecting is a big part of being a trusted advisor and makes you a valuable asset to the business.

Avoid Becoming the "No Department"

Be flexible and creative. When someone brings you an issue, look for a risk-appropriate path forward instead of defaulting to “no.” Sometimes the right answer really is “no,” but more often you can help find a workable solution.

Good News Travels Fast, and Bad News Should Travel Faster

News moves quickly inside a company. It is never a great day when your boss or client hears bad news from someone else first—so stay ahead of it.

When it is not urgent, I think about how the message should flow: who needs to know, in what order, and whose buy-in I need before I give the advice. In a big organization, you will miss stakeholders sometimes—learn from it and keep improving. This is a bigger part of the job than people realize.

Find Outside Counsel that Makes You Look Good

Most days, I am acting as a business partner: learning the business, communicating clearly, and helping decisions move forward. I am not drafting briefs all day. When I need technical expertise, a memo that applies law to facts, or someone to try a case, that is when I call outside counsel.

I use different firms for different situations, but the best outside counsel will all do the same thing: they make it easy to get to the right answer. They ask smart questions, show good judgment, flag risk, and turn messy information into a usable summary. And they send “flippable” emails I can quickly share with the business (which, honestly, makes me look good).

Surround Yourself with Excellent Executive Assistants and Paralegals 

Law is a team sport. Strong executive assistants and paralegals make the whole legal function more efficient and effective. Everyone should know what to delegate, when to delegate, and to whom—and feel comfortable speaking up with ideas and solutions. When that is working well, it creates a great team environment and better results for clients and the business.

Own Your Calendar

I am invited to a lot of meetings, and I have had weeks with basically no free time. That is not sustainable. I once read about a start-up that had “no-meeting Wednesdays,” and it stuck with me.

At a big company, a company-wide no-meeting day may be a dream—but you can often create your own. I started blocking Wednesdays, and it was a game changer. It gave me time to do real work, learn, keep up with changes, and build relationships outside my back-to-back meeting days.

After that, I got serious about calendar blocks in general. They force you to prioritize (importance over urgency) and protect time for focused work. If you have not tried it yet, it is worth a test run.

Develop Professional Courage

As in-house counsel, you will sometimes see issues others do not see or do not want to see. Speak up, even when it is unpopular or uncomfortable. Challenge the default thinking, raise concerns early, escalate thoughtfully, and take responsibility. It is hard, but these are the moments where trust and respect grow.

Know When Perfection Is the Enemy

At some point, more analysis stops helping. The extra “perfecting” costs the business time and momentum, and the payoff gets smaller and smaller. Most of the time, you cannot chase every rabbit hole—you need to trust your judgment and give a clear, defensible answer.

Say Yes to Stretch Assignments

In-house gives you a lot of career paths. You can go deep in one subject area or move around and learn a little bit of everything. You can also lean into partnership with the business and risk functions. Stay open to options—especially stretch assignments and non-traditional opportunities (or even create them when you see a need). Those experiences can open doors you did not even know were there.

I have enjoyed working in-house over the last decade-plus. It is never boring, and it has opened doors I never expected back when I took the leap from private practice to the corporate world. It has made me a more well-rounded lawyer and continues to offer an abundance of growth opportunities for me and my career.

Carrie Bechtold leads a team of lawyers and legal professionals that provides advice in the delivery of investment products to Wells Fargo Wealth & Investment Management clients. Carrie began her career at Wells Fargo in August 2014 advocating on behalf of Wells Fargo in regulatory inquiries and enforcement matters and leading internal investigations concerning potential law and policy violations.  

Prior to joining Wells Fargo, Carrie enjoyed 15 years of private practice, most recently at Bryan Cave LLP, specializing in securities regulatory and litigation matters.  

Carrie holds a BS from Quincy University and a JD from Southern Illinois University at Carbondale. She lives in St. Louis, Missouri with her wife (Rechelle), son (Spencer, 20) and daughter (Mason, 17). 

In 1987, nine-year-old John O’Leary was playing with gasoline and triggered an explosion that burned 100% of his body.¹ Given less than a one percent chance to live, he endured years of painful recovery to beat the odds.² Today, he is a best-selling author and internationally recognized speaker who motivates others to live inspired. His message to the Saint Louis chapter of the Association of Corporate Counsel (ACC) last year was that “your life is a precious, priceless gift. Say ‘Yes’ to being used for good.” 

Lawyers hold a unique role in society, beyond the law firm, courthouse, and corporate desk. They are trusted advisors, stewards, leaders, and change-makers. And with these roles come the opportunity to be used for good.

In the 1930s, Saint Louis lawyer Luther Ely Smith saw one such opportunity. He founded the Jefferson National Expansion Memorial Association to build a memorial to the city’s role in the Westward expansion, laying the groundwork for the Saint Louis Arch.³

In 1981, Dan Glazier started his first job with Legal Services of Eastern Missouri (LSEM), which has provided no-cost legal services to over a million low-income families since its founding. He just announced his retirement after more than 20 years as Executive Director and General Counsel of the organization. Glazier said “the need for civil legal aid is great, and volunteer attorneys help to fill the justice gap between the need for this critical legal help and the funding resources available to provide this help—plus volunteering can be so fulfilling and rewarding for those who do it. [When you volunteer,] you are really making a difference for those in need!” 

In 2005, Beth Boggs, of Boggs, Avellino, Lach & Boggs, started the charity Step it Up, Inc., to provide free shoes to children in need. Since COVID, it has added a focus on food insecurity and helped procure significant food resources for the community. Her email signature block includes [the] quote from Helen Walton: “It is not what you gather, it is what you scatter…”

And one Saint Louis lawyer, who asked to remain anonymous, founded a school in Malawi, Africa.

If you’re like me, you may find these examples somewhat daunting. I don’t have the means to found a school or time to start or run a nonprofit. 

But John O’Leary challenges others to ask themselves daily “what more can I do?”

This helps bring the focus down. What good can I do today?

Many Saint Louis lawyers serve on nonprofit boards. In fact, it’s hard to find a local nonprofit board without one.

Cardina Johnson, Deputy General Counsel for the Illinois Education Association, serves on the Boards of the Bar Association of Metropolitan Saint Louis (BAMSL), the ACC, and the Missouri Baptist Foundation, and is Board Secretary for the Mound City Bar Association. Johnson started volunteering at the suggestion of Saint Louis University Law School classmate Ronda Williams. After her classmate passed away, Johnson realized how many people she had impacted. “She showed up for people and causes in a way that was completely selfless, and that stayed with me.”

Keith Williamson, Centene Charitable Foundation President and former Centene Corporation EVP, Secretary & General Counsel, recently served as Board Chair for the United Way, a role now held by Thompson Coburn partner Roman Wuller. Williamson currently is Board Chair of The Opportunity Trust and on the Board of the Mound City Bar Foundation and Co-Chair of its capital campaign. He served as Board Chair of the Urban League of Metropolitan St. Louis and remains active with its Executive Committee. He also was a Commissioner of the Saint Louis Art Museum. Williamson said he is inspired to volunteer by all his parents and siblings have done and by his daughter, who is forging a path in public interest law. 

Matt Geekie, SVP, Secretary & General Counsel of Graybar Electric Company, Inc., was President of the Saint Louis Zoo Association (Zoo) Board and Chairman of The Oasis Institute (Oasis) and St. Louis Community Foundation Boards and continues serving on the Zoo and Oasis Boards.

Beyond the boardroom, some Saint Louis lawyers use their vacation time for good.

BAMSL CEO Susan McCourt Baltz recently returned from a mission trip with Watts of Love, which distributes solar lights to 35 countries. Baltz said she had not considered herself the "missionary type," but when her sister asked her to go, she immediately agreed, “not with the goal to do good in the world, I said yes to do good for me. And it turned out to be good for both.”

The ARCO family of construction companies gives employees a week of paid time off to volunteer. Assistant General Counsel Michele Gardner has used this time to serve at the St. Louis Area Food Bank, Ritenour Co-Care Food Pantry, Our Lady of Perpetual Help Food Pantry, and the LifeWise STL Holiday Market, including her children in some of her volunteer activities, and is on the Board of the Northside Youth and Senior  Service Center.

World Wide Technology gives employees a paid “Day of Caring” and holds an annual “May of Caring,” for employees to volunteer. This May, its General Counsel & EVP Corporate Compliance Erika Schenk will lead employees to volunteer with Forest Park Forever, for which she is a prior Board member.

If you are motivated to volunteer but not sure where to start, the United Way offers a matching service, for one-time, short-term, and long-term volunteer opportunities: https://www.stlvolunteer.org/search.

BAMSL and its Saint Louis Bar Foundation offer opportunities to participate in mock trials and fight against hunger, among other things. Members can find opportunities through the BAMSL website at https://www.bamsl.org/?pg=ProBono. 

The ACC offers annual estate planning services to veterans and opportunities to teach children in its Street Law program. Members can sign up for these or other pro bono programs or to serve on an ACC Board committee through its homepage at https://www.acc.com/chapters-networks/chapters/st-louis. 

BAMSL and the ACC work together for good, partnering on the Corporate Counsel Institute (CCI), which brings over 300 lawyers together annually, contributing to make them better lawyers, leaders, and corporate citizens. You can sign up for the May 13^th CCI here: https://www.acc.com/education-events/2026/2026-corporate-counsel-institute-cci. 

The Missouri Bar lists over a dozen volunteer opportunities on its pro bono page: https://mobar.org/site/content/Lawyer-Resources/Pro_Bono_Volunteer_Opportunities.aspx. 

And you can sign up to volunteer at LSEM at https://lsem.org/volunteer/.

Abraham Lincold said, “As a peacemaker, the lawyer has superior opportunity of being a good [person].”  

Say “yes” to being used for good.

Jenny Herner is Assistant General Counsel for the ARCO family of construction companies, where she is responsible for M&A, finance, governance, and corporate compliance. She is a graduate of the University of Missouri School of Journalism and Georgetown University Law Center, past President of the ACC, former Board Chair of UCP Heartland, and this year’s recipient of the ACC’s William E. Jaudes Service Award.

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¹ John O’Leary, John’s Story, https://johnolearyinspires.com/johns-story/ (last visited Apr. 1, 2026).

² Id.

³ National Park Service, Jefferson National Expansion Memorial Association Records, U.S. Nat’l Park Serv., https://www.nps.gov/jeff/learn/historyculture/jnema-records.html (last visited Mar. 31, 2026).

⁴ Legal Services of Eastern Missouri, About Us, https://lsem.org/about/ (last visited Apr. 1, 2026).