Health

US supreme court blocks ruling limiting access to abortion pill


The supreme court decided on Friday to block a lower court ruling that had placed significant restrictions on the abortion drug mifepristone.

The justices granted emergency requests by the justice department and the pill’s manufacturer, Danco Laboratories, to halt a preliminary injunction issued by a federal judge in Texas. The judge’s order would significantly limit the availability of the medication as litigation proceeds in a challenge by anti-abortion groups.

The decision offered a victory to the Biden administration as it defends access to the drug in the latest fierce legal battle over reproductive rights in the US. The president praised the decision and said he continues to stand by the FDA’s approval of the pill.

“As a result of the supreme court’s stay, mifepristone remains available and approved for safe and effective use while we continue this fight in the courts,” Biden said in a statement. “The stakes could not be higher for women across America. I will continue to fight politically driven attacks on women’s health.”

The court’s ruling means that access to mifepristone will remain unchanged at least into next year as appeals play out and patients can still get medication abortions with the drug in states where it was previously available.

The decision came in the most pivotal abortion rights case to make its way through the courts since Roe v Wade was overturned last year. More than half of abortions in the US are completed using pills.

The case was brought by a conservative Christian legal group arguing the Federal Drug Administration improperly approved mifepristone more than 23 years ago.

The Biden administration vigorously defended the FDA against the charge, emphasizing its rigorous safety reviews of the drug and the potential for regulatory chaos if plaintiffs and judges not versed in scientific and medical arguments begin to undermine the agency’s decision-making.

Conservative justices Clarence Thomas and Samuel Alito dissented , writing that the Biden administration and Danco “are not entitled to a stay because they have not shown that they are likely to suffer irreparable harm in the interim”.

Pro-choice activists protest the Texas judge’s ruling in New York in April 2023.
Pro-choice activists protest the Texas judge’s ruling in New York in April 2023. Photograph: Olga Fedorova/SOPA Images/Shutterstock

The case has moved quickly through the courts in recent weeks, as contradicting rulings have thrown the future of the drug into question.

In early April, a federal judge in Texas, Matthew Kacsmaryk, first ruled in the lawsuit brought by a coalition of anti-abortion groups to suspend the FDA’s 23-year old authorization of mifepristone entirely, writing that the agency wrongly approved the drug. Following a challenge by the Biden administration in the fifth circuit court of appeals, a divided three-judge panel said the drug’s approval could stand, but imposed restrictions on it, limiting its use to seven weeks of pregnancy instead of the current 10-week limit, and banning delivery of the pill by mail.

The Biden administration then asked the supreme court to intervene before the restrictions went into effect. Justice Samuel Alito twice stayed the lower court ruling, keeping access to mifepristone unaltered while the court deliberated.

Complicating matters, another federal judge issued a ruling directly contradicting Kacsmaryk’s, ordering the FDA to refrain from making any changes to the availability of mifepristone in 18 jurisdictions.

That judge – Judge Thomas O Rice, in Washington – reaffirmed that order after the fifth circuit’s ruling.

Both the Biden administration and pharmaceutical companies have warned of regulatory chaos around drug approvals, should the supreme court allow the restrictions on mifepristone to go into effect.

“If this ruling were to stand, then there will be virtually no prescription, approved by the FDA, that would be safe from these kinds of political, ideological attacks,” President Biden said in a written statement following the Kacsmaryk’s decision in early April.

The US vice-president, Kamala Harris, echoed the point in a statement responding to the appellate decision: “If this decision stands, no medication – from chemotherapy drugs, to asthma medicine, to blood pressure pills, to insulin –would be safe from attacks.”



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