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Supreme Court upholds broad access to abortion drug mifepristone

Supreme Court upholds broad access to abortion drug mifepristone
Supreme Court upholds broad access to abortion drug mifepristone


The Supreme Court on Thursday upheld access to a widely available abortion pill, rejecting a challenge by anti-abortion groups and doctors' groups to overturn the drug's approval by the Food and Drug Administration.

in Unanimous decisionIn the decision, written by Justice Brett M. Kavanaugh, the court ruled that the anti-abortion groups had no direct interest in the dispute and therefore did not meet the requirements to challenge the FDA's approval of mifepristone.

“Plaintiffs have not prescribed or used mifepristone,” Justice Kavanaugh wrote, “and FDA has not required them to do or refrain from doing anything.”

He added that “plaintiffs' desire to make it harder for others to obtain the drugs does not create standing to sue.”

The lawsuit originally sought to overturn the FDA's approval of mifepristone, but by the time it reached the Supreme Court, the issue had narrowed to whether the FDA acted lawfully when it expanded distribution of the pill in 2016 and again in 2021, eventually to include telemedicine and mail-order options.

The ruling was a modest victory for abortion rights groups, who praised the decision for avoiding severe restrictions on access to the pill but warned that it may not last.

Anti-abortion groups promised the fight is not over and vowed to press forward, raising the possibility that other plaintiffs, particularly states, will challenge the drug.

The ruling did not affect individual restrictions on the pill in more than a dozen states that have passed near-total bans on abortion since the court stripped away the constitutional right to an abortion in Dobbs v. Jackson Women's Health Organization. (The bans do not distinguish between medication and surgical abortions.)

Access to abortion remains widely supported and has been a major focus of political campaigns since the Supreme Court overturned Roe v. Wade two years ago, allowing some states to quickly enact abortion bans, and Democrats have had success galvanizing voters. Blocking anti-abortion measures She plans to highlight abortion rights in the November election.

The justices avoided ruling on the substance of the case, avoiding delivering a clear, substantive victory for either party or a ruling that could be used to galvanize their base.

“This decision does not change the fact that the fight for reproductive freedom continues,” President Biden said in a statement.

He added: “The fact remains that the Supreme Court overturned Roe v. Wade. Two years ago, women lost their basic freedoms.”

The Biden campaign also expressed concern that if former President Donald J. Trump is re-elected, the ruling will not go far enough to protect access to abortion pills and said his administration would implement new restrictions through executive orders.

Trump has struggled with where to stand on abortion access after the Supreme Court, a conservative supermajority that he appointed, overturned the landmark abortion rights case, Roe v. Wade. A few weeks ago, he He said each state should set its own policy..

The Trump campaign suggested that Trump had taken a similar position on the abortion pill ruling, but did not say how the administration would address regulating the drug. “The Supreme Court ruled unanimously, 9-0. The issue is resolved,” said Daniel Alvarez, a spokesman for Trump.

Abortion rights groups warned that the ruling merely maintains the status quo.

“The anti-abortion movement knows how important the abortion pill is in a post-Roe world and is determined to cut off access,” Nancy Northup, executive director of the Center for Reproductive Rights, said in a statement.

Erin Hawley, senior counsel at the Alliance Defending Freedom, a conservative legal group representing the plaintiffs, suggested the litigation could be reopened through three Republican-led states – Idaho, Kansas and Missouri – that have intervened as plaintiffs at the lower court level.

“I am grateful that three states are prepared to hold the FDA accountable for endangering the health and safety of our nation's women and girls,” Hawley said in a statement.

Mifepristone is part of a combination therapy used in about two-thirds of abortions in the United States. The pill was found to be safeand many years of research Indicated Serious complications are rare.

Use of the drug has only increased since the FDA relaxed restrictions on access to the drug during the pandemic, allowing it to be prescribed online or by mail, and the number of medication abortions prescribed via telehealth has risen. On one countFrom July to September 2023, roughly one in six abortions, or about 14,000 per month, were performed via telehealth.

Medication abortion remains a practical option for women in states where abortion is prohibited. Clinicians should: Protected by the so-called shield law Some states where abortion is legal are mailing the pill to women who live in states that ban abortion.

Justice Kavanaugh focused part of his majority opinion on why he disagreed with the lower court decisions, both of which had found the groups had the authority to sue.

Citing Justice Antonin Scalia, Justice Kavanaugh wrote that to bring a lawsuit, a plaintiff must first answer a fundamental question: “What's in it for you?”

Plaintiffs must show a “foreseeable chain of events leading from the government's conduct to the alleged injury,” Justice Kavanaugh wrote.

In that case, he wrote, the doctors and medical associations seeking to challenge the FDA's regulations couldn't prove actual damages because their plaintiffs didn't include people actually involved with the pill, such as the doctors who prescribed mifepristone or the pregnant women who took it.

The plaintiffs argue that they have “bona fide legal, moral, philosophical and policy objections to the prescription and use of mifepristone by others,” but this does not meet the standard of standing, Judge Kavanaugh wrote.

The justices also rejected arguments by anti-abortion doctors that they had the right to sue because they feared they would be forced to perform emergency abortions against their conscience.

Federal conscience laws already protect doctors from being forced to perform abortions or other treatments that violate their conscience, and no doctor has demonstrated otherwise, Judge Kavanaugh wrote.

In his concurring opinion, Justice Clarence Thomas said he “fully” supported the ruling but cautioned that the court should take a qualified view on whether to allow associations to sue as parties on behalf of their members.

The case sent the abortion issue back to the Supreme Court, where the conservative majority had declared in overturning Roe v. Wade that it was leaving the issue of abortion access to “the people and their elected representatives.”

Thursday's ruling appeared to vindicate that promise, but the court is likely to issue a decision soon. Another big abortion lawsuitIt involves a clash between federal law and strict state regulations.

The abortion pill case, FDA v. Hippocratic Medical Association, reflected a new chapter in the bitter battle over abortion.

In the fall of 2022, an umbrella group of anti-abortion medical groups joined several doctors in challenging the FDA's approval of mifepristone more than 20 years ago. In a preliminary ruling, federal Judge Matthew J. Kacsmarik of Texas said the FDA's approval of the drug should be halted and mifepristone removed from the market.

Judge Kacsmalik, who was appointed by President Trump, joined the federal bench after years of litigation at the conservative religious liberty law firm First Liberty Institute.

The New Orleans Court of Appeals overturned part of Judge Kacsmarik's ruling that invalidated the FDA's approval of the drug, but imposed certain restrictions on its distribution, including a ban on dispensing the drug by mail or via telemedicine.

Maggie Haberman and Lisa Lehrer He contributed reporting from New York.




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