US Supreme Court preserves access to abortion pill

Sub: Science and tech

Sec: Public Health

Context:

The US Supreme Court on Thursday rejected a petition by anti-abortion groups seeking to undo the Food and Drug Administration’s (FDA) approval of a commonly available abortion pill, called mifepristone.

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In a unanimous ruling, authored by Justice Brett M Kavanaugh — the court held that as the petitioners lacked a direct stake in the dispute, they could not sue the FDA.
The development has come nearly two years after the apex court of the US overturned Roe v. Wade, which effectively repealed a federal right to abortion.

What was the case?

In 2022, four pro-life medical associations, as well as several individual doctors, sued the FDA in the US District Court for the Northern District of Texas.
The petitioners had challenged the FDA’s approval of mifepristone and the changes the federal agency made in the pill’s conditions of use — the modification broadened mifepristone’s distribution through mail and telemedicine (the provision of remote clinical services).
In April 2023, federal court held that the FDA’s approval of the drug should be suspended, removing mifepristone from the market.
An appeals court in New Orleans overturned this ruling partially to the extent that it invalidated the FDA’s approval of the pill.
It also imposed restrictions on the pill’s distribution, including prohibiting sending the medication by mail or being prescribed by telemedicine.

What is mifepristone?

Mifepristone is part of the two-drug regimen used for medical abortion.
A patient first takes mifepristone to induce an abortion and then misoprostol to empty the uterus.
While mifepristone blocks progesterone — a hormone that supports menstruation and maintaining a pregnancy — misoprostol triggers uterine contractions, causing the body to expel the pregnancy as in a miscarriage.
The regimen was approved for use up to 10 weeks of pregnancy by the FDA in 2000.
Studies have found the pill to be safe, and years of research have shown that serious complications are rare.

What did the court rule?

To reject the petition by the anti-abortion groups and individual doctors, the Supreme Court cited the “personal stake requirement” laid down in one of its 1982 judgments.
The personal stake requirement basically means that the party seeking relief has to have a “personal stake in the outcome of the controversy.
The appellant should show that they have suffered or been threatened with some distinct and palpable injury.
There must also be some causal connection between the appellant’s asserted injury and the defendant’s challenged action.
It said the plaintiffs could not show any harm suffered from mifepristone’s availability.

Abortion law in India:

India’s Medical Termination of Pregnancy Act 1971 allows abortion up to 24 weeks, post which termination is permitted only if a board of doctors attests that continued pregnancy presents a risk to the woman’s life or if there are foetal abnormalities.
In ‘X v NCT case 2022’ Supreme Court declared that ‘it is the woman alone who has the right over her body’ and is the ‘ultimate decision-maker’ in deciding if she wants an abortion.
The court also said that “continuing with an unwanted pregnancy has an adverse impact on the pregnant woman’s mental health and can be a ground for abortion”.
The Court eventually decided that the mental health grounds for abortion did not extend beyond 24 weeks of gestation.
However in this case, there is a conflict between foetal right to life against women’s right to autonomy.