US Court of Appeals Considering Limiting Access to Mifepristone

May 18, 2023

Comments from Republican-appointed federal judges on the US Court of Appeals for the Fifth Circuit reveal their openness to restricting access to mifepristone, a key component for medication abortions. The judges and the plaintiffs, a group of conservative care providers, noted that the drug is more dangerous than decades of real-world evidence (RWE) indicate. In addition, the judges’ comments revealed they were largely unaware of the approval process of the Food and Drug Administration (FDA) and did not understand how telehealth worked.

According to Shefali Luthra, “Judge Cory Wilson suggested that if mifepristone is prescribed by any health care provider other than a physician, it would be “much more likely” that a patient requires emergency care. That, government lawyers noted, is incorrect — currently, medication abortion can be administered in some states by nurse practitioners and physician assistants, and the rate of complication remains incredibly low. Judge Jennifer Walker Elrod, appointed by Bush, asked lawyers to clarify how telemedicine works, inquiring at one point if health care providers simply summarize the risks of medication abortion “in an email.” Virtual medical care is rarely provided over email, and usually the prescriber communicates with a patient over some form of phone or video service.”

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