In a 13-4 decision on Thursday, the 5th U.S. Circuit Court of Appeals held that a hospital’s interest in preventing disruption of its services by banning an employee from wearing a pro-union button trumps the employee’s First Amendment free-speech right.

Sitting en banc, the 5th Circuit reversed a three-judge panel’s December 2004 decision in Communications Workers of America and Urbano Herrera. v. Ector County Hospital District, d/b/a/ Medical Center Hospital, et al.