In unanimous decision, SCOTUS rejects doctors’ challenge to abortion pill

supreme court abortion The Supreme Court heard oral arguments on March 26, 2024, for a lawsuit brought by the Alliance for Hippocratic Medicine (AHM), which seeks to impose more restrictions on the prescription of mifepristone. | Credit: Peter Pinedo/CNA

The Supreme Court on Thursday unanimously ruled against a physician-led challenge to the abortion pill, rejecting an attempt by advocates to impose stricter regulations on the drug. 

The court said in its Thursday ruling that the plaintiffs, represented by the Alliance for Hippocratic Medicine (AHM), lacked standing to challenge U.S. Food and Drug Administration’s (FDA) regulation of the abortion drug mifepristone.

AHM, which represents pro-life medical groups, sued the FDA in November 2022 to challenge the agency’s long-standing approval of the drug. 

The lawsuit further challenged the FDA’s subsequent deregulation of the drug, particularly its permission to prescribe the medicine without an in-person doctor’s visit and to dispense the drug through the mail. The high court heard oral arguments in the case in March of this year.

In their ruling on Thursday, the justices argued that the plaintiffs had failed to establish the necessary legal standing to sue the FDA for its regulation of the pill. 

The medical groups “are pro-life” and opposed to elective abortions, including the use of mifepristone, the court said.

“Because plaintiffs do not prescribe or use mifepristone, plaintiffs are unregulated parties who seek to challenge FDA’s regulation of others,” the ruling said. 

The advocates advanced “several complicated causation theories” to justify the suit, the court ruled, but “none of these theories suffices” to establish standing. 

The doctors had argued that under FDA regulations they might be forced to violate their consciences with regard to the abortion pill; the justices dismissed that assertion, claiming that “federal conscience laws definitively protect doctors from being required to perform abortions or to provide other treatment that violates their consciences.”

The doctors had also argued that the FDA’s relaxed mifepristone regulations could lead to economic injuries in the form of increased liability complaints and time-consuming medical treatments of women who take the drug. The court described these claims as “too speculative” and “too attenuated to establish standing.”

To “establish causation” in injury claims, the ruling said, “the plaintiff must show a predictable chain of events leading from the government action to the asserted injury — in other words, that the government action has caused or likely will cause injury in fact to the plaintiff.”

The court acknowledged that the pro-life plaintiffs “have sincere legal, moral, ideological, and policy objections to elective abortion and to FDA’s relaxed regulation of mifepristone.”

But “those kinds of objections alone do not establish a justiciable case or controversy in federal court,” it said. 

Pro-life leaders and advocates responded with disappointment to Thursday’s ruling. 

SBA Pro-Life America said in a post on X that it was “a sad day for women’s health and unborn children’s lives.”

The abortion lobby “gaslights women about the risks of these drugs and seeks to block states from even collecting safety data — even though the FDA’s own data show abortion drugs send 1 in 25 women to the ER,” the group said. 

“[T]he fight isn’t over,” the pro-life group said. 

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Ingrid Skop, a board-certified OB-GYN and the vice president and director of medical affairs at the Charlotte Lozier Institute, told the press that it was “deeply disappointing that the FDA was not held accountable today for its reckless decisions.” 

“As a practicing OB-GYN with over 30 years’ experience, I have seen firsthand that mail-order abortion drugs harm my patients, both mothers and their unborn children,” she said. 

The abortion pill is “not health care, it’s abandonment, and the pro-life community will never stop advocating for patients,” she argued. 

Erin Hawley, meanwhile — who serves as senior counsel at the legal advocacy group Alliance Defending Freedom — said in a statement that the group was “disappointed that the Supreme Court did not reach the merits of the FDA’s lawless removal of commonsense safety standards for abortion drugs.”

“While we’re disappointed with the court’s decision, we will continue to advocate for women and work to restore commonsense safeguards for abortion drugs,” Hawley said.

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