In their zeal to continue upending abortion access after the overturning of Roe v. Wade, legislators, activists and litigants have pushed increasingly extreme measures that disregard medical science, insert government into the exam room and increase the odds of maternal deaths. Not satisfied with banning abortion in their home states, some lawmakers are trying to restrict access in other states as well — a chilling attempt to intimidate patients and physicians alike.
Against this backdrop, the Supreme Court faces a decision that lays bare the threat to facts, evidence and the health of America’s patients. The case, Alliance for Hippocratic Medicine v. F.D.A. — in which anti-abortion organizations and doctors who have never prescribed the pill mifepristone argue, absurdly, that 23 years ago the F.D.A. did not follow proper protocol in approving it as part of a two-drug regimen for abortion — is one of the most brazen attacks yet against reproductive health. If the lower courts’ rulings on mifepristone are not reversed entirely, it could also upend the Food and Drug Administration’s drug regulatory process. This would throw our health care system into chaos in ways that extend far beyond the specific fight over mifepristone, a highly effective drug that has been used safely by millions of patients for medication abortions and for miscarriage care for more than two decades.
In seeking to restrict access to abortion across the United States, the plaintiffs in this case have, intentionally or not, seriously jeopardized our nation’s 85-year-old drug regulatory system. We must be cleareyed; upholding any parts of the district court’s dangerous ruling would in all likelihood almost immediately prompt challenges to other longstanding safe and effective F.D.A.-approved drugs that doctors and patients rely on every day.
After three years of politicization fueled by disinformation, this would surely include challenges to many vaccines, including those that reduce the risks of serious illness from Covid-19. We should expect lawsuits against common types of safe and highly effective hormonal birth control, including emergency contraception. Also at risk: drugs used to treat cancer and arthritis that can incidentally affect unexpected pregnancies, drugs to prevent or treat H.I.V., and medications aimed at providing gender-affirming care.
The threat may ultimately include promising drugs and treatments built around stem cell technology to treat Parkinson’s, Alzheimer’s, multiple sclerosis or even more common types of chronic disease, such as diabetes. With ever-growing anti-science aggression, disinformation campaigns and vitriol about all types of medical advancements, there is no telling where the court challenges may lead — perhaps even to widely used drugs now sold over the counter to treat pain, allergies or heartburn that happen to have been studied with fetal stem cells.
This would represent a dangerous and reckless step backward for our country. More people would live sicker, suffer more and die younger while the scientifically proven safe and effective drugs they need remain locked away.
We simply cannot be a country where your access to the care you need is determined by the whims of ideologically driven judges and lawmakers without medical or scientific training. That’s why a dozen of the nation’s leading medical organizations, including the one I head, the American Medical Association, strongly oppose this politically motivated assault on patient and physician autonomy and have filed amicus briefs to make our case.
We cannot allow pseudoscience and speculation to override the substantial weight of scientific evidence from more than 100 studies and millions of patients that confirm the safety and efficacy of a drug or course of treatment.
The legal challenge to mifepristone threatens grave harm to our patients, public health and the shared decision-making at the core of the physician-patient relationship. But there are even broader implications of this case: the integrity of the long-established F.D.A.-approval process and whether we want science — or ideologues — informing decisions about our individual and collective health.
Jack Resneck Jr. (@JackResneckMD), a physician at the University of California, San Francisco, is president of the American Medical Association.
Source photograph by James Worrell/Time & Life Pictures, via Shutterstock.
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