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Supreme Court rejects challenge to medication abortion drug

Doctors who object to mifepristone can't bring lawsuit to challenge FDA rules, court says

An abortion rights advocate shows a box of mifepristone outside the Supreme Court building in March.
An abortion rights advocate shows a box of mifepristone outside the Supreme Court building in March. (Shuran Huang/The Washington Post via Getty Images)

The Supreme Court upheld access to the commonly used medication abortion drug mifepristone in a unanimous decision Thursday, wiping out a lower-court opinion that would have restricted access.

The justices ruled that an association of doctors who object to abortion could not meet the legal standard for bringing a challenge to Food and Drug Administration rules that made mifepristone easier for doctors to prescribe and for pregnant women to obtain.

Justice Brett M. Kavanaugh wrote the opinion for the court, which said the doctors could not prove they were harmed by the FDA’s decisions to expand access to the drug nationwide in 2016, 2021 and 2023.

“For that reason, the federal courts are the wrong forum for addressing the plaintiffs’ concerns about FDA’s actions,” Kavanaugh wrote. “The plaintiffs may present their concerns and objections to the President and FDA in the regulatory process, or to Congress and the President in the legislative process. And they may also express their views about abortion and mifepristone to fellow citizens, including in the political and electoral processes.”

The cases, FDA v. Alliance for Hippocratic Medicine and Danco Laboratories v. Alliance for Hippocratic Medicine, came to the Supreme Court after a district judge and the U.S. Court of Appeals for the 5th Circuit ruled that the FDA violated federal law in granting access to the drug.

The doctors had argued that by initially approving the drug in 2000, and expanding access to it in later decisions, the FDA made it likely that they would have to treat abortion patients despite their moral objections to the practice.

The 5th Circuit rejected the doctors’ claims about the original drug approval in 2000 but ruled against the FDA decisions expanding access to the drug in 2016 and 2021.

The Biden administration had argued that the court decisions effectively second-guessed an expert agency’s decision, imperiling access to a drug used nationwide for decades and upending the FDA’s long-standing drug approval process.

Kavanaugh wrote that the doctors who challenged the law do not prescribe or use mifepristone, and the FDA “is not requiring them to do or refrain from doing anything.”

“Rather, the plaintiffs want FDA to make mifepristone more difficult for other doctors to prescribe and for pregnant women to obtain,” a goal which does not give them the legal right to bring the case, Kavanaugh wrote.

The justices did not address the broader issues surrounding access to abortion in the case, the first related case the court has taken since the 2022 decision in Dobbs v. Jackson Women’s Health that overturned the constitutional right to an abortion.

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