Arizona doctors may continue to administer an abortion-inducing drug off-label, at least for now, after the U.S. Supreme Court on Monday announced it would not hear a case concerning the issue.
A federal appeals court in San Francisco had ruled in June in the case, now known as Humble v. Planned Parenthood Arizona, to grant a preliminary injunction temporarily stopping Arizona from enforcing a state law banning off-label use of drugs to cause medical abortions. Arizona's director of the Department of Health Services had appealed that ruling to the Supreme Court.
The Supreme Court's decision Monday to pass on the case means that the preliminary injunction stands. Planned Parenthood cheered that call.
“The court did the right thing today. Politicians across the country should take note—these harmful and unconstitutional restrictions won't be tolerated by the courts or the public,” Cecile Richards, president of Planned Parenthood Federation of America, said in a statement. “Politicians are not medical experts—but politicians have written this law with the ultimate goal of making safe, legal abortion hard or even impossible to access.”
But Michael Tryon, an assistant attorney general with the Arizona attorney general's office, which is representing the state in the case, called the decision disappointing.
“It's an issue of nationwide importance that needs to be resolved by the highest court in the country, and it will continue to come up until they do,” Tryon said Monday. The state had argued, among other things, that the law was designed with women's safety in mind.
The state had argued in court documents that “an injunction would thwart the important public interest in ensuring that abortion clinics apply a safe, uniform, FDA-approved protocol rather than the non-conforming, malleable protocol the Appellants prefer.”
The most common way to medically abort involves a combination of two prescription drugs, mifepristone (also known as RU-486) and misoprostol, according to the 9th Circuit opinion. Mifepristone works by blocking the hormone progesterone, causing the fertilized egg to detach from the uterus wall. Misoprostol makes the uterus contract, expelling the egg.
That first drug, also known as Mifeprex, is approved by the Food and Drug Administration for use up to seven weeks of pregnancy. Studies, however, have shown that it's safe and effective through nine weeks of pregnancy, along with misoprostol taken at home (rather than at a clinic), and this off-label use has become common. In Arizona in 2012, 43% of all abortions in the first nine weeks of pregnancy were accomplished through medication. Nationwide, 41% of first-trimester abortions at Planned Parenthood clinics are done through medication, according to the circuit opinion.
A U.S. district court originally denied Planned Parenthood's request for a preliminary injunction, saying partly that the law did not violate “equal protection or a woman's right to bodily integrity” or “impose an undue burden on Arizona women's right to abortion,” according to court documents.
The appeals court in San Francisco reversed that decision, calling for an injunction, and saying, in part, that the plaintiffs “have shown a likelihood of success on their claim that the Arizona law imposes an undue burden on a woman's right to abortion.”
Follow Lisa Schencker on Twitter: @lschencker
