The Supreme Court of the United States has ruled that a commonly used abortion medication can remain available while a legal case is ongoing.
In a split decision, the Supreme Court also denied restrictions imposed by a lower court on the use of mifepristone, effectively maintaining the status quo.
After a Texas magistrate attempted to invalidate the drug’s long-standing approval, the drug’s future became uncertain.
The case could have far-reaching consequences for abortion access.
It comes after the Supreme Court’s conservative supermajority of 6-3 overturned Roe v. Wade in June of last year, thereby terminating the national right to abortion and granting states the authority to ban the procedure.
With Friday’s decision, the mifepristone case has been returned to the 5th Circuit Court of Appeals’s lower court.
It is probable that the case will return to the Supreme Court, setting the stage for the most consequential ruling on the abortion issue since Roe was overturned.
For the Supreme Court, the abortion fight may have just begun.
How safe is mifepristone, the abortion pill?
What is next for abortion pills in the United States?
Mifepristone is part of a two-drug regimen that accounts for more than fifty percent of abortions in the United States. More than five million women in the United States have used it to terminate pregnancies.
Four years of review preceded its approval by the US Food and Drug Administration (FDA) more than two decades ago.
Additionally, the FDA placed mifepristone in a category of 60 medicines that are subject to additional restrictions and regular evaluations.
The abortion pill is deemed safe and efficacious by mainstream medical organisations, including the American College of Obstetrics and Gynecology and the World Health Organization.
Judge Matthew Kacsmaryk of a Texas court ruled earlier this month to suspend the FDA’s approval of mifepristone, stating that the agency had violated federal regulations allowing for the accelerated approval of certain drugs and made an error in its scientific evaluation of the drug.
A group of anti-abortion health practitioners filed a lawsuit challenging the safety of mifepristone, which resulted in Judge Kacsmaryk’s preliminary decision.
His ruling on April 7 was rendered mere minutes before a Washington state magistrate ordered the FDA to make no changes to the drug’s availability, preserving access to mifepristone in 17 U.S. states.
The administration of US President Joseph Biden appealed the Texas ruling and requested a stay of the Texas court’s order.
While the appeal is pending, a divided court of appeals ruled that mifepristone could remain available, but with certain restrictions.
Among the restrictions imposed by the 5th Circuit Court of Appeals was a restriction on the mailing of medications, effectively mandating in-person consultations. The Supreme Court has now temporarily overturned these restrictions.
Two conservative members of the Supreme Court, Justices Clarence Thomas and Samuel Alito, publicly disagreed with the decision, which was issued in a single paragraph hours before a self-imposed deadline.
Justice Thomas did not provide reasons for his dissent, whereas Justice Alito wrote that the Supreme Court has been criticised in the past for issuing emergency orders, which critics refer to as the “shadow docket.”
A complete vote breakdown was not made public.
Legal battle persists
Anti-abortion activists, who have focused their efforts on abortion medications since Roe v. Wade’s overturning, reacted immediately to the decision.
Alliance Defending Freedom, the conservative advocacy group that initially submitted the lawsuit, stated that the FDA “must account for the harm it has caused to the health of countless women and girls.”
“We anticipate a verdict in this case that will hold the FDA accountable,” the statement said.
The president of the anti-abortion group Students for Life, Kristan Hawkins, labelled the Supreme Court’s decision a “tragedy.”
She stated that pro-choice advocates have “weaponized and compromised medical standards to serve the interests of the abortion industry.”
Medical professionals and organisations such as the American College of Obstetricians and Gynecologists applauded the most recent ruling.
Professor of global health law at Georgetown University Lawrence Gostin stated, “Imposing restrictions on access to mifepristone, a substance on the market for two decades, is a bridge too far for even the most aggressive and conservative Supreme Court.”
According to him, restrictions on mifepristone would cause “incalculable” damage to the drug approval procedure in the United States. In some respects, it would be open season for all FDA-approved drugs.
Mr. Biden, a pro-choice politician, stated that he would continue to defend the FDA’s independence and combat political “attacks on women’s health” in response to the decision.
Mid-May will mark the beginning of oral arguments before the 5th Circuit Court of Appeals in this case.
However, the immediate effect of Friday’s ruling was to reassure healthcare providers that access would continue, at least for the time being.
New Jersey gynaecologist and abortion provider Kristyn Brandi said she was relieved to learn about the ruling. Before the weekend, she and other providers did not know what services they would be able to offer to patients attending clinics over the weekend.
“Beginning at 7:00 a.m. tomorrow, patients will have access to the necessary services,” she said. Today, that is all that matters.