Cook, an Ohio Supreme Court justice, was confirmed to the United States Court of Appeals, 6th Circuit, by a 66-25 vote on May 5, 2003.

• A member of the Federalist Society, an ultra-conservative legal organization.

• Cook wrote the dissenting opinion in Gliner v. Saint Gobain Norton Industrial Ceramics Corp. (2000), a 4-3 decision affirming a jury award of over a million dollars in a sex discrimination case filed by several women regarding pay discrimination, discrimination in assignments, working environment, and retaliation.*

• In Sutowsky v. Eli Lilly & Co. (1998) Cook wrote the majority opinion denying remedies to thousands of Ohio women who suffered damage to their reproductive systems and numerous other serious health effects after utero exposure to a defective drug (DES).*

• Cook was the lone dissenter in Humphrey v. Lane Cook, a case that the Ohio Supreme Court reversed. The appellate court ruling would have allowed the Ohio Department of Rehabilitation and Correction to fire an employee for refusing to cut his hair to collar-length. His refusal was in violation of a male-only grooming policy but his Native American religious doctrine stated that hair should be cut only in times of mourning. Prior to his termination, he had arranged an agreement with his employer that he would pin his hair up under his work cap to conform to standards.*

• Cook was described as the most conservative member of the Ohio Supreme Court by the Columbus Dispatch. The Dayton Daily News described her as a "conservative combatant".*

• Cook received more money from manufacturing and other business interests than any other Justice. During 1999-2000 she received nearly $350,000 from such interests (including finance, insurance, manufacturing and communications).*

• Endorsed by the Ohio Right to Life in the last election for Ohio Supreme Court Justice.

• In the DeRolph v. State of Ohio case involving the constitutionality of Ohio's funding of public schools, Cook's dissent stated that education was not a fundamental right under the states equal protection laws.
• In 1996, Justice Cook wrote the majority opinion upholding Case Western Reserve University's denial of admission to a blind student to its medical school.** Justice Cook believed the plaintiff did not meet the qualifications for discrimination.

• Nearly 30 percent of Cook's campaign contributions came from the financial, real estate, and insurance sectors. According to the Ohio Chamber of Commerce, Cook sided with business interests in 59 percent of the cases affecting the business community.