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“How Conflicting Federal Court Decisions Led to the Supreme Court’s Ruling on the Availability of Mifepristone”


The U.S. Supreme Court issued an emergency ruling on April 21, 2023 allowing access to the abortion pill mifepristone in states where abortion is legal.

The decision of the court, which included some details and indicated only that Justices Clarence Thomas and Samuel Alito disagreed, follows a swirling legal process over whether people should be able to buy mifepristone, one of two drugs used in a two-dose series for inducing a medical abortion.

on April 7 two federal district court judges halfway across the country of each other have made conflicting statements about the validity of the Food and Drug Administration’s approval of mifepristone.

Within a week, yet another court issued a third opinion, allowing mifepristone to be prescribed, but under more limited circumstances. Two days later, on April 14, the US Supreme Court issued a fourth dissent, albeit a temporary one, contends that the drug should be kept available while the court considers the most recent emergency ruling.

If scientists of reproduction justice, we have have carefully followed these cases to understand what they mean for the FDA’s authority to approve drugs — and where that opens up access to drug-induced abortion, which is used in more than half of all abortions today.

One issue that confuses many people is how different courts can rule in conflicting ways.

But in fact, there are many cases where federal courts in one part of the country make decisions that conflict with those of other jurisdictions.

The federal system

First of all, it is helpful to understand how the federal justice system works in the US. State-run court systems are completely separate from the federal court system, which is where the mifepristone rulings play out.

Federal courts deal with a variety of issuesincluding those involving the United States government, the Constitution or federal laws, or controversies between states or between the United States government and foreign governments.

There are 94 federal district courts organized into 12 regional circuits. The district courts are courts, where cases are brought before a judge or jury. Their decisions are bound by the doctrine established by their respective circuit courts, which hear appeals from their constituent district courts. All of these courts are bound by Supreme Court rulings.

If there is no preliminary ruling to set a precedent in the case, the judges of the Federal District Court may make rulings based on their independent legal judgment. This allows courts in different circuits to make separate rulings that contradict each other.

It is relatively common differences arise between the courts – or even before different circuit courts to decide otherwise on appeals in similar cases.

Only the Supreme Court can issue an advice that binds all circuits. So if there are disagreements between circuit courts, the The Supreme Court can intervene and make a decision for the whole country.

For example, in 2014 the 6th Circuit, which serves Kentucky, Ohio, Michigan and Tennessee, upheld same-sex marriage bans in all four states. four other circuits had achieved the opposite result and removed the ban on same-sex marriage. This setup, like explained one commenterAn “virtually certain review by the Supreme Court”, especially since this was “a matter of fundamental constitutional importance.”

Till the The Supreme Court ruled on the matter in 2015However, same-sex marriage was legal in some states but not others.

Other examples

There are many other examples that federal circuit courts disagree with.

In 2018, the 7th Circuit Court of Appeals, which serves Illinois, Indiana and Wisconsin, ruled that an Indiana state law banning abortions based on genetic defects was not constitutional. The Supreme Court decided not to hear Indiana’s appeal of that ruling.
But in 2021, the 6th Circuit Court of Appeals enforced a law in Ohio that banned abortions based on one type of genetic defect, Down syndrome. That led to a circuit court split, the kind usually resolved by the Supreme Court.

The Dobbs decision, which settled another abortion case, essentially resolved the conflict by stating that the U.S. Constitution does not prevent states from prohibiting abortion for any reason: they simply must demonstrate a “rational basis” that would “serve legitimate state interests.”.”

Another thing that confuses a lot of people is how district courts can issue orders that go beyond the boundaries of their districts, and even their circuits, which sometimes apply nationally. There is any scientific disagreement about this. Nevertheless, many judges have issued rulings nationwide on a wide variety of issues, including protocols for the protection of migrants, loan forgiveness And mandates for wearing masks.

The case of mifepristone

With this latest instance of bumping courts, federal district judge Matthew Kacsmaryk in Texas ruled firston April 7. His decision took the form of one preliminary injunction, which is essentially a temporary ruling, until the court has a chance to go through a full process. Kacsmaryk concluded that the FDA had overstepped its authority by approving mifepristone in 2000 and relaxing prescribing restrictions over the years. As a result, he ruled that the the approval of the drug should be withdrawn completely.

Within an hour of Kacsmaryk’s ruling, Federal District Judge Thomas Rice in Washington state issued a contradictory ruling, which was also a preliminary injunction, stating that FDA approval of the drug and its use should not be withdrawn.

While Kacsmarkyk’s ruling applied nationwide, Rice’s ruling only applied to the 17 states and the District of Columbia that were the plaintiffs in the lawsuit he heard. He noted that he had the authority to make his ruling nationwide, but he also had the authority to limit the reach of the ruling to the parties suing.

Where the problems are

The Supreme Court ruling means that mifepristone will remain as widely available as before. Fifteen states already restrict access to medication abortions.

“As a result of the stay of the Supreme Court, mifepristone remains available and approved for safe and effective use as we continue this battle in court,” President Joe Biden said in a White House statement.

But that decision is only in effect while the case is being decided by the 5th Circuit. Undoubtedly, this decision will again be appealed to the Supreme Court.

So far, no one has appealed the Washington District Court’s opinion, although a possible future Supreme Court ruling following the 5th Circuit’s decision would also affect the outcome of that case. And the situation gets even more complicated, with a third lawsuit filed in federal court in Maryland on April 19. That case was brought by GenBioPro, the manufacturer of a generic version of mifepristone, which the FDA approved in 2019. GenBioPro is trying to keep its drug’s approval despite all the conflicting and confusing court rulings.

Although the Supreme Court majority said it had hoped Dobbs’ opinion would end the federal battle over abortion rights, there is more confusion and conflict than ever, in every corner of the country. And the confusion may continue for a while.

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