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Less than two years after the U.S. Supreme Court overturned the federal right to an abortion established by Roe v. Wade, the conservative-majority court is about to weigh in on the issue again. This upcoming case focuses on the Food and Drug Administration’s decision to loosen restrictions on how mifepristone, a drug commonly used to induce abortions, can be prescribed and dispensed. The decision could impact access to the abortion medication, as nearly two-thirds of all abortions in the U.S. in 2023 were medication abortions. If the Supreme Court rules against the FDA, restrictions on mifepristone would revert back to what they were in 2000 when the drug was approved.

The cases before the court involve challenges to the FDA’s approval of mifepristone by the Alliance for Hippocratic Medicine, a group of anti-abortion rights physicians and organizations. The group argues that the FDA did not study the drug enough and that it is not safe. The focus of Tuesday’s hearing was on whether the plaintiff has legal standing to challenge the FDA’s approval of mifepristone. The Alliance for Hippocratic Medicine claims doctors they represent are harmed by treating patients who experience complications from a medication abortion. However, the FDA and the manufacturer of mifepristone argue that there is no evidence to support this claim.

During the hearing, the issue of in-person vs. telehealth prescriptions was also discussed. In 2021, the FDA eliminated the requirement for in-person visits for patients to receive a prescription for mifepristone, citing safety and effectiveness data. Justices questioned the potential risks of not having an ultrasound to determine the stage of pregnancy without an in-person visit. The topic of obtaining mifepristone by mail was also raised, referencing the Comstock Act, which prohibits the mailing of “lewd” materials. The Supreme Court will issue a decision on mifepristone access by the end of June or early July.

The case highlights the broader implications of federal court decisions on abortion access, potentially overriding state laws and voter initiatives. Justices from both sides of the ideological spectrum expressed skepticism about restricting access to the abortion medication. The hearing also touched on the issue of doctors’ conscience objections and whether they have the right to challenge FDA decisions in court. The decision in this case could impact how abortion medication is prescribed and dispensed, affecting access for women seeking these services.

The Alliance for Hippocratic Medicine’s challenge to the FDA’s approval of mifepristone has raised questions about legal standing and potential harm to patients. While the plaintiffs argue that doctors are forced to treat patients harmed by mifepristone against their conscience, the FDA and manufacturer of the drug dispute these claims. The Supreme Court’s decision on this case will have far-reaching consequences for access to medication abortions in the U.S. and could shape future regulations around prescribing and dispensing these drugs.

The hearing also discussed the role of the FDA in regulating medication abortions and the impact of changes to regulations during the COVID-19 pandemic. Justices questioned the potential risks associated with obtaining mifepristone by mail and whether current regulations adequately protect patients. The decision in this case will have significant implications for women’s reproductive rights and access to abortion services, highlighting the ongoing legal battles surrounding abortion rights in the United States.

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