January 31, 2023
CMA Opposes FDA Decision Allowing Retail and Mail Order Abortion Pills
On January 3, 2023, the U.S. Food and Drug Administration (FDA) modified the Risk Evaluation and Mitigation Strategy (REMS) for the dispensing of mifepristone, the first of two drugs taken for the purpose of aborting a child. Any retail pharmacy or mail-order pharmacy that applies for certification from the manufacturer will be able to dispense the drug to the patient. The Catholic Medical Association opposes this action by the FDA, and warns of the harms that will result with this misguided decision.
Prior to the pandemic, mifepristone had to be dispensed in-person by a certified abortion provider. Under this new rule, a retail pharmacy can dispense the medication in-person or by mail after receiving a prescription. The second drug used in chemical abortions, misoprostol, is already available in retail pharmacies. This action on the part of the FDA will greatly expand the number of women and girls choosing to abort their unborn children, resulting in numerous complications.[1] Because of the potentially dangerous side effects of these drugs, the medical liability for these pharmacists and pharmacies will increase.
Many retail pharmacies and grocery stores with pharmacies have clinics associated with them. The prescription for the abortion drugs could be dispensed by a certified prescriber in the clinic and filled by the pharmacy, thus converting a retail business that sells many other products into an abortion clinic. This will violate the rights of conscience of those opposed to abortion, including pharmacists and store employees. In addition, customers of the pharmacy who oppose abortion will be rightfully motivated to seek a pharmacy that does not participate in this activity.
Not only is access to this drug through the mail allowed, but dispensing it via a telemedicine visit only is permitted as well, which facilitates the potential for even further harmful effects. “Mail order abortions” will leave women without a nearby provider for follow-up care or management of complications, which occur in more than seven per cent of cases [2]. In addition, such impersonal provisions of the drugs will allow many other tragic consequences, including: the concealment of the rape of a minor; inability to diagnose an ectopic pregnancy; obtaining the drugs for someone other than the alleged patient; and, use of the drugs for a pregnancy beyond the ten weeks gestation allowed by the FDA.
As health care professionals, medical ethicists, pharmacists and patient advocates, the Catholic Medical Association is strongly opposed to these actions that will harm the quality of care that women need and deserve, and also ignore the rights of those working in and patronizing the businesses that may participate. These decisions must be reconsidered and rescinded for the benefit of all concerned parties.
______________________
[1] ACOG Practice Bulletin, Number 225. Medication abortion up to 70 days of gestation. Obstet Gynecol. 2020; 136(4): e31-e47.
[2] Carlsson I, Breding K and Larsson P-G. Complications related to induced abortion: a combined retrospective and longitudinal follow-up study. BMC Women’s Health. 2018; 18:158. https//doi.org/10.1186/s12905-018-0645-6
