AMSA Statement: Court Decision Wrong on Science & Medicine Threatens Safe, Effective FDA-Approved Abortion Medication

April 13, 2023


Statement from the AMSA Board of Trustees

Alliance for Hippocratic Medicine v. FDA
Decision Threatens Safe & Effective FDA-Approved Medication Abortion Across the Country
Appellate Court Ruling is Wrong on Facts, Science & Medicine

On the evening of Friday, April 7th, a federal district judge in Texas, Matthew Kacsmaryk, whose own anti-abortion ideology is well documented, issued a ruling that challenges the 23 year old FDA approval of Mifepristone, a medication that is part of a two-drug regimen for medication abortion. In ruling against the FDA-approved status of Mifepristone, Judge Kacsmaryk is making a direct attack against the universal human right to bodily autonomy and against the professional right and responsibility of healthcare providers to practice evidence-based, compassionate, person-centered care. The case in question, Alliance for Hippocratic Medicine v. FDA, reveals the extent to which the anti-abortion movement – which fundamentally overlaps with white supremacist authoritarian movements – will weaponize the judiciary in order to enact deeply unpopular, undemocratic policies through ruthless exertion of power. 

The Federal Drug Administration (FDA) is the gold standard for drug safety and efficacy in the United States and its approval process is highly esteemed worldwide. Mifepristone has been FDA approved since 2000 and the attempt to invalidate its approval by way of a single judge’s decision has immediate and unprecedented implications for abortion care and beyond. The FDA approval process for medications is a comprehensive and rigorous evaluation of safety, efficacy, and quality of drugs. It involves scientific research, clinical trials, and continuous surveillance after approval. Kacsmaryk’s decision directly undermines the valid scientific and regulatory processes of the FDA, and even opens the door to more politically and ideologically-motivated attacks against evidence-based market regulations in this country. This case should not have moved forward. The decision is not based on facts or science, nor medical evidence. The ruling is deplorable.  

Even though the U.S. Court of Appeals for the Fifth Circuit has upheld the FDA approval of mifepristone, the restrictive measures from 2016 were held. This includes restricting mifepristone use to 7  weeks gestation, not being able to mail medication abortion pills, and in some cases, non-physician prescribers may not be able to administer mifepristone. The misoprostol-only method remains unaffected. The Justice Department has issued a statement immediately upon the release of the Fifth Circuit decision to seek an emergency relief from the Supreme Court to “defend the FDA’s scientific judgment and protect Americans’ access to safe and effective reproductive care”. Almost simultaneously to the release of Kacsmaryk’s decision, U.S. District Judge Thomas Rice in Washington State issued a decision in a different case regarding Mifepristone that directly contradicts Judge Kacsmaryk’s decision and ruled that the FDA must maintain access to Mifepristone, but Rice’s decision applies only to 16 Democratic states (AZ, CO, CT, DE, IL, HI, MD, MI, MN, NM, NV, OR, PA, RI, VT, WA) and Washington D.C. that were involved in the lawsuit before him. Consequently, we are in a legal standoff, with evidence-based abortion care, those who need it, and those who provide it, caught in the middle.  

As a community of future physicians committed to a progressive and humanistic vision for a just and equitable society, AMSA affirms the moral good of abortion care whenever and wherever it is needed, and unreservedly asserts that abortion care is a regular, essential component of reproductive healthcare, supported by the evidence upon which physicians base our standards of care. 

Judge Kacsmaryk’s ruling is a direct attack against the bodily integrity of anyone who has the capacity to become pregnant, and is also an ideologically-motivated attack against the professional autonomy of physicians and healthcare workers to provide the standard of care that is our ethical, moral, and legal duty.  

Our nation was founded on the premise of justice for all, we claim honor in being a society governed by the people, for the people, yet despite majorities who consistently say abortion should be legal in all or under most circumstances across the country, states and courts are now passing laws and issuing rulings that deny people the right to decide for themselves the care that is best for them.  

As future physicians, we condemn Judge Kacsmaryk’s ideologically-motivated, deeply uninformed ruling to invalidate FDA approval of mifepristone.  In the face of this ruling, we affirm the universal human right to equitable healthcare, including access to comprehensive reproductive health services. We affirm the universal human right to legal and safe abortion care wherever and whenever such care is needed, for whomever needs it regardless of how much they earn, where they work, or what state they live in. This is a time in history where we choose what side we fight on. Do we let ourselves be complacent while we as a country are pulled into fascism or do we as a collective challenge and stand up to the unjust rulings?  

If you feel the same inner fire to fight against those who are systematically breaking down our rights, join us at our Reproductive Health Project to learn more about what you can do. We will certainly be fighting on the side of history that gives the due respect to science and autonomy of people.