A doctor at the center of the Supreme Court case on Food and Drug Administration approval abortion pill said the rights of anti-abortion physicians are violated when they are forced to treat patients with complications from mifepristone, an argument that bears on the key consideration before the justices.
OB/GYN hospitalist and plaintiff in the case Alliance for Hippocratic Medicine v. FDA Ingrid Skop said in an exclusive interview with the Washington Examiner that, when faced with a patient suffering complications from mifepristone that was delivered by mail or dispensed at an abortion clinic, emergency physicians ethically opposed to abortion are faced with a dilemma. They must choose between participating in an abortion or risking the mother’s life when they are the only ones available to care for the patient.
“There is no doubt that I and the other physicians of Alliance for Hippocratic Medicine will continue to be faced with women suffering from complications of abortion drugs,” Skop said following the oral arguments at the court on Tuesday.
Supreme Court justices who heard oral arguments in the case honed in on the legal principle of standing, or whether or not the doctors involved in the case had been sufficiently harmed to bring suit because of the FDA’s deregulation of mifepristone in 2016 and 2021, which allowed the drug to be mailed directly to patients.
Skop, the vice president of the anti-abortion think tank the Charlotte Lozier Institute, and her fellow plaintiff Christina Francis, CEO-elect of the American Association of Pro-Life Obstetricians and Gynecologists, were the only two out of the seven doctors in the case who expressed a violation of conscience due to the FDA’s deregulation of mifepristone in their written testimony from when the case was originally filed in November 2022.
During oral arguments, the justices’ main line of questioning was the degree to which treating women in the emergency room following complications from a self-managed abortion violated the conscience rights of doctors who object to elective abortions under nonemergency circumstances.
If the court finds that the conscience rights of the physicians in the case either have not been violated or are highly unlikely to be violated, then the case is likely to be dismissed on the issue of standing rather than whether the FDA’s decision was backed by sufficient scientific evidence.
Skop said that, based on her experience, there is no time to consider the conscience objections to assisting in an abortion when treating a patient with a life-threatening condition that could deteriorate within minutes.
“A typical situation that we might care for would be a woman who presents with a hemorrhage, threatening her life and health in the middle of the night. She needs urgent surgery to remove the pregnancy tissue that has been retained or otherwise resolve the hemorrhage. So that needs to happen right now,” Skop said. “So the reality is, even though we are opposed to electively ending unborn life, what is more important is for us to provide high-quality care for women.”
In her written testimony, Skop testified that in her over three decades of practice, she had “cared for several dozens of women in the emergency department who were totally unprepared for the pain and bleeding they experienced due to chemical abortion.”
Skop also wrote in 2022 that she cared for “at least a dozen women” who required surgery to remove what is medically called the “retained products of conception,” which includes the embryo or fetus and the placental tissue.
Justice Elena Kagan pressed AHM’s attorney Erin Hawley during oral arguments on whether Skop and Francis voiced their objections to aiding abortion patients before providing care. Hawley explained to the court that it is nearly impossible to do so in an emergency situation when there are no other trained OB/GYNs present in the hospital.
“Clearly we have standing because we will continue to need to care for these women. And more importantly, women will come will continue to suffer unnecessary complications,” Skop said.
The FDA warning label for mifepristone says that between 2.9% and 4.6% of women who self-manage an abortion will require emergency treatment for life-threatening conditions, including severe bleeding and infections. This means approximately one in 25 mifepristone patients will experience a complication.
In 2023, nearly 643,000 abortions in the United States involved mifepristone, over 63% of the total number of abortions that year.
Francis provided in her testimony a story of a fellow physician who needed to surgically end the life of a fetus in the womb of a chemical abortion patient who sought emergency medical attention following sustained and profuse bleeding.
“Because the pre-born baby still had a heartbeat when the patient presented [to the hospital], my partner felt as though she was forced to participate in something that she did not want to be a part of–completing the abortion,” wrote Francis.
Justices Amy Coney Barrett and Ketanji Brown Jackson, along with Kagan, further probed Hawley on whether her clients’ objection was solely in the physical act of taking the life of an unborn child or if they experienced a broader violation of conscience by providing any type of care to a patient with mifepristone complications.
Hawley argued that the conscience violations stemmed from any removal of pregnancy tissue following the use of mifepristone, regardless of whether the embryo or fetus was still alive. Hawley also pointed to the court’s precedent in Burwell v. Hobby Lobby and Little Sisters of the Poor v. Pennsylvania that takes a broad interpretation of conscience rights.
The FDA’s attorney, Solicitor General Elizabeth Prelogar, presented a narrower interpretation of the doctors’ testimony during oral arguments, saying that the doctors’ testimony did not “provide any specific detail about exactly what care would violate their conscience.”
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“They object to ending the life of a human being in the womb and fear that they might have to complete an abortion for a woman who has an ongoing pregnancy,” Prelogar said.
A decision in the case is anticipated in June.