The American Civil Liberties Union has issued a warning to the Supreme Court regarding lower court rulings in Washington.
According to the source, the credibility of a commonly used abortion medication was based on witnesses who were deemed untrustworthy and biased due to their ideological beliefs.
The ACLU, along with the Center for Reproductive Rights and The Lawyering Project, filed a brief as a “friend of the court” in which they argued the following:that have
The decision was made in the case.
The use of mifepristone in this case disregarded the Food and Drug Administration’s expertise and instead relied on unproven claims from medical groups and doctors who oppose abortion, regarding the supposed negative effects of medication abortion.
The judges’ decision to accept those claims was unusual, according to reports. Other courts that have dealt with abortion-related cases have also examined the same witnesses and research, and have frequently rejected the evidence presented by anti-abortion doctors due to its lack of scientific integrity.
The status quo will remain in effect until the Supreme Court makes a final ruling, which is anticipated to occur by the end of June and would have implications across the country, including in states where abortion is currently permitted.
According to Julia Kaye, senior staff attorney with the ACLU’s Reproductive Freedom Project, it is the duty of the Supreme Court to evaluate whether the evidence presented in the case sufficiently supports the 5th Circuit’s findings that the plaintiffs have the right to pursue the case and that the courts were justified in overruling the FDA’s scientific decisions. This process requires a thorough examination of the witnesses and research referenced in the 5th Circuit’s opinion.
Worries regarding witness statements
The lower courts have accepted the arguments of anti-abortion doctors in their rulings against the FDA. These arguments are central to several important matters currently being considered by the Supreme Court. One of the main issues is whether the doctors and medical organizations involved in the case have the legal standing to bring a lawsuit, as well as whether the FDA’s actions in 2016 and 2021, which loosened restrictions on the use of mifepristone, were lawful.
The FDA’s approval of mifepristone in 2000 was blocked by a federal district court, as well as subsequent attempts by the FDA to simplify the process of obtaining it. However, the U.S. Court of Appeals for the 5th Circuit ultimately made the decision.
The FDA’s approval of the drug will remain unchanged, but it has been determined that the agency may have acted illegally by making changes to the acquisition process, prescribing eligibility, and time frame for taking mifepristone.
However, the three organizations that advocate for abortion rights argued that the evaluations carried out by the lower courts regarding standing, merits, and potential harm to challengers due to the FDA’s actions were all based on unreliable research and testimony from witnesses with questionable credibility.
The brief submitted by a third party raises objections to statements made by six doctors who provided written statements during a previous phase of the legal proceedings regarding the safety of mifepristone. The credibility of five out of the six doctors has been called into question by other courts in similar cases involving limitations on abortion.
In a 2014 ruling on medication abortion, a North Dakota Supreme Court judge stated that Dr. Donna Harrison’s viewpoints lack scientific backing, rely on unsupported fears, and contradict reliable medical evidence.
An OB-GYN named Harrison was employed in a private practice until the year 2000. In a 2021 filing for a different case in Indiana, it was mentioned that she worked in this field until the FDA approved mifepristone. The district court’s ruling against the FDA referred multiple times to her statement submitted as evidence in the mifepristone case. In her statement, she asserted that patients who experience complications from chemical abortions require a greater amount of time and care from providers compared to the average OB-GYN patient.
Senior counsel at the Alliance Defending Freedom and lead attorney in the mifepristone challenge, Erik Baptist, stated that questioning Harrison’s credibility disregards the numerous individuals who rely on her expertise in caring for women and their babies. It is important to note that the judge in this case openly supported abortion during the hearing.
In a different situation, concerning Dr. Ingrid Skop, a Florida state court dismissed her testimony as “incorrect and exaggerated, or based on outdated data.” The court also noted that Skop acknowledged that her beliefs about abortion safety differ from those of mainstream medical organizations and she did not offer any reliable scientific evidence to support her dissent from recognized medical organizations in the US.
In the case involving mifepristone, the 5th Circuit referenced Skop and her opinions on the potential dangers of the drug a total of 17 times.
Skop stood by her study and provided a statement to CBS News, stating that as an OB-GYN with 30 years of experience and having delivered more than 5,000 babies, she relies on facts and research rather than personal attacks. She also mentioned that mainstream medical organizations, who advocate for abortion at any stage of pregnancy, tend to disregard any data that contradicts their viewpoint.
Harrison holds the position of research director for the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) and has also served as its CEO, while Skop is a member of the organization.
Despite various reasons to doubt, the lower courts based their legal analysis on the testimony of these individuals, who provided scientific conclusions. They favored their opinions over the FDA’s expert evaluation and the widespread medical agreement concerning the safety of mifepristone. This information was stated by the ACLU, Center for Reproductive Rights, and Lawyering Project in their submission to the Supreme Court.
“Glaringly flawed” studies
Furthermore, the groups contended that the lower courts based their decisions on “blatantly flawed research” that portrayed the data inaccurately and made sweeping assumptions about the effects of abortion. They expressed doubts about the reliability of the witnesses.
In April, Judge Matthew Kacsmaryk, of the U.S. District Court, referenced a 2021 study in his decision to block the FDA’s 2000 approval of mifepristone and subsequent actions by the agency. The study looked at the potential mental health effects of medication abortion and found that 77% of women who underwent a “chemical abortion” experienced a negative change, while 38% reported struggles with anxiety, depression, substance abuse, and suicidal thoughts as a result of the procedure.
The research mentioned analyzed 98 unidentified blog entries on the website abortionchangesyou.com. These posts were written by women claiming to have undergone a medication abortion and then shared their story on the site from October 2007 to February 2018. The website is managed by the organization Institute of Reproductive Grief Care.
The belief that abortion can negatively impact women’s mental well-being has been disproven by the National Academies of Science, Engineering and Medicine, and the American Psychological Association. However, Kacsmaryk determined that the medical organizations had the legal grounds to file a lawsuit, citing a 2011 meta-analysis by Priscilla Coleman that claimed to have found a connection between abortion and mental health issues.
Professor Ushma Upadhyay, a faculty member at the University of California, San Francisco, and an authority on abortion availability and safety in the United States, objected to Coleman’s approach and noted that she did not consider the factors that may influence a patient’s desire for pregnancy when comparing wanted and unwanted pregnancies.
According to Upadhyay, the author’s research does not consider any varying factors between individuals who have undergone abortions and those who have not. This is a crucial aspect because the author may mistakenly attribute differences in mental health status to the abortion itself, when it is evident that the variations are caused by a multitude of other life circumstances among the two groups.
Upadhyay stated that the referenced research used by the lower courts is “flawed,” and particularly countered assertions that there is a high number of emergency room visits linked to mifepristone.
The information used in a 2021 examination of emergency room visits following medical abortion, which was brought to attention by Kacsmaryk, dates back to before 2015 and follows stricter guidelines for the use of mifepristone that were in effect prior to the FDA’s rule changes in 2016. The editor and publisher of the journal that published the study released a statement of concern in the previous year, stating they were made aware of possible concerns regarding the accuracy of data in the article and potential conflicts of interest among the authors, and are currently carrying out an investigation.
Upadhyay noted that the researchers neglected to investigate the motivating factors behind a patient’s decision to seek abortion care at an emergency room. This could be due to lack of access to a nearby abortion clinic or a regular healthcare provider. Furthermore, the symptoms of bleeding and cramping caused by the abortion pill may prompt patients to seek confirmation from the emergency room that their experience is within the realm of normalcy.
According to Upadhyay, there is confusion between emergency room visits and negative outcomes. She pointed out that when mifepristone is used in conjunction with another drug, it has a success rate of 95% to 97%. Therefore, it is normal for 3% to 5% of medication abortions to not be fully effective and need further medical attention.
In a 2015 research conducted by Upadhyay, it was discovered that significant complications from medication abortion, which includes the need for hospitalization, surgery, or blood transfusion, were rare, with less than 0.32% of patients experiencing them. Additional studies referenced by the FDA in legal documents also showed low rates of hospitalization (0% to 0.7%), serious infections (0% to 0.2%), and bleeding requiring transfusion (0% to 0.5%) among thousands of women who have taken mifepristone.
According to Upadhyay, it is certain that the courts would have sided with the FDA if they had based their decision on scientific evidence. He stated that there is more than two decades of solid proof supporting the safety of mifepristone, with 5 million individuals having successfully used it and a strong track record for the medication.