Physicians who oppose mifepristone are under investigation due to their scant knowledge of the abortion medication.

The focus of the high-profile Supreme Court case, which may potentially restrict millions of Americans’ access to the abortion pill mifepristone, is mostly on 11 pro-abortion physicians and activists who claim that their work has been disrupted by patients who have developed difficulties from the medication. In Indiana, one of the physicians serves as a Republican state senator. Another person represents themselves as an authority on a “abortion pill reversal” technique that a reputable medical organization called “unproven and unethical.” A third has been without a medical license for many years. The majority of the physicians directly involved in the case—which the Supreme Court will hear on Tuesday—have a long history of opposing abortion. None of the physicians who filed declarations recommend mifepristone, and none of them have described a situation in which they were forced to conduct an abortion on a patient who experienced problems after using the medication.

The Supreme Court is being asked whether the Food and Drug Administration overreached its authority by making mifepristone easier to obtain, such as by expanding who may prescribe the drug and allowing it to be dispensed through the mail, in what has emerged as the most significant abortion case since the overturning of Roe v. Wade in 2022. However, the court must first determine whether the doctors and medical groups that brought the lawsuit have suffered enough harm from the medicine to warrant a right of action, a legal doctrine called as “standing.” Renowned Supreme Court litigator Adam Unikowsky has questioned whether the groups even come close to satisfying that standard. The doctors have presented a lot of hazy, at best, data to support their claims that the availability of mifepristone is hurting them, which has given the case tenuous legal support. According to Unikowsky, a former clerk of the late conservative Justice Antonin Scalia, “They’re not forced to prescribe it.” “The basis for their theory of standing is the fact that other doctors have prescribed the drug to other people.”

The doctors state in a number of declarations submitted early in the case that they occasionally have to treat patients who are experiencing drug-related complications, like heavier-than-expected bleeding, and that treating these women based on priority has a significant negative influence on their practices and the care of other patients. Some claim they or their coworkers have been made to carry out post-medication procedures against their moral convictions. Dr. Christina Francis, an OB-GYN from Indiana and the CEO of one of the anti-abortion organizations involved in the case, testified in court that although she felt “forced to participate in something that she did not want to be a part of,” a colleague had to perform a “emergency abortion” on a patient who arrived at the emergency room in 2022 due to her unstable condition.

Prominent medical organizations including the American Medical Association have informed the Supreme Court that mifepristone is “very safe.” Pregnant women had to make several in-person appointments at a doctor’s office when the FDA initially approved the medication more than 20 years ago. Later, the FDA did away with that mandate. Francis asserted that “a significant increase in women coming into our emergency rooms has resulted from the removal of that requirement.” Francis said that allegation was anecdotal and that it sometimes take years for these changes to show up in studies that are published. Francis stated, “The issue we have is that women are coming into our emergency rooms with incomplete abortions.” “We are being asked to then finish a process that we find morally repugnant.” A recent study examined whether medication abortion delivered through telemedicine could be just as safe and successful as medication abortion administered in a clinic.

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