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Court rulings against mifepristone backed by misinformation



This article was originally posted on Talk.

Early April 2023 decision of the U.S. District Judge in Texas cancel 23 years of approval Mifepristone abortion pill sparks heated debate.

Mifepristone is a drug that blocks the receptors for the hormone progesterone, which is necessary for the development of the fetus. It is part of a two-stage medical abortion regimen along with misoprostol, a drug used to prevent stomach ulcers that also causes uterine contractions. Medical abortion with this two-stage approach, or slightly less efficient a misoprostol-only regimen is currently used in more than half of all abortions in USA

The Food and Drug Administration approved mifepristone in 2000 for use in medical abortion for up to seven weeks. Along with the approval The FDA also required a personal visit. as an additional security measure. In 2016, the FDA extended its approval for the use of mifepristone up to 10 weeks of gestation.

In January 2023 FDA changed the rules even more in light of the many studies that show that mifepristone is a very safe drug. It was decided not to apply the personal visit requirement, allowing the drug to be offered certified pharmacies with a prescription.

A decision by U.S. District Judge Matthew J. Kachsmarik in Texas revoking the FDA’s approval would have removed the drug from sale in the United States entirely. V The Fifth U.S. Circuit Court of Appeals responded quicklystating on 12 April 2023 that the plaintiffs couldn’t challenge the original FDA approval mifepristone because it’s too late.

However, the 5th Circuit agreed with plaintiffs that the 2016 FDA approval of mifepristone for up to 10 weeks post-pregnancy was invalid. Besides, based on the law of 1873., Comstock’s lawboth the Texas District Court and the Court of Appeal said mifepristone could no longer be mailed.

In order to make these rulings, the Texas Judge and the Court of Appeal had to first determine that the groups that filed the case were harmed by the original FDA approval and thus had what is called “capacity” in legal terms to be eligible Sue The plaintiffs include a coalition of anti-abortion physician associations that sued in Texas to have him assigned to this judgewho was opposed to abortion prior to his court appointment.

This and another case in which a Washington federal judge did another solution about mifepristone, now headed to the supreme court. But no matter what this court decides, we – jurist another academic obstetrician-gynecologist and specialist in integrated family planning – see multiple allegations about mifepristone in decisions with potential reproductive health and regulatory ripple implications.

Texas decision will affect the availability of abortion in the US

Both decisions are based on decades of court decisions that interpret medical science for legal purposes. V Dobbs decision 2022 What rolled over almost 50 years belonging constitutional right to abortion opened the door to legal challenges for any and all abortions. Dobbs sought medical help related to pregnancy and childbirth, but the case was mainly about rethinking the legal history of abortion to justify setting a precedent.

While in some states further restricting access to abortion after Dobbs’ decision, they were unable to successfully stop the distribution of drugs that can cause abortions. This is partly because like the FDA And Department of Justice allowed abortion-inducing drugs to be mailed from states with fewer legal restrictions.

The Texas case illustrates how judges apply their own understanding of science to a sensitive political issue. Kaczmarik’s argument echoes that of Judge Anthony Kennedy in Supreme Court case known as the Carhart decisionwhich restricted doctors from performing second-trimester abortion procedures.

In that 2007 case, Kennedy argued that abortion causes psychological harm to women. However, scientific studies show that the harms of not having an abortion and forcing women to give birth bigger and longer, with higher mortality rates. The law influences public discourse, and these claims of psychological harm are now a common place in anti-abortion communications. These arguments were central to the Texas judge’s critique of the FDA’s scientific process.

Harm assessment

Before arguing that the FDA’s scientific determination was inadequate, Kaczmarik and the 5th Circuit Court of Appeals had to decide whether the plaintiffs were eligible to sue. The first persistent argument of the plaintiff doctors includes the claim that they have been harmed because in the future they may have to care for a woman who has an extremely rare complication from mifepristone prescribed by another doctor.

potential harm does not conform to old principles related to judicial reputation; plaintiffs must show that the agency’s rule would harm them.

The decision to prosecute is based on a highly dubious interpretation of the scientific evidence for harm. The Fifth Circuit uses medical abortion complications statistics from 2000 to suggest that at least one doctor from the Plaintiff’s association, which they claim includes about 8,200 healthcare professionals, will see a patient who seeks emergency care for the use of mifepristone. However, he does not provide evidence – because there is none – that mifepristone itself causes complications. In addition, he provides no evidence that access to mifepristone by mail order or before 10 weeks of pregnancy increases the rate of complications.

The Fifth District Court, which upheld Kaczmarik’s decision on the lawsuit, is a narrow award award for plaintiffs. The court stated that these physicians have legal standing because complications from medical abortion are statistically likely, that the FDA has excluded physicians from the process of issuing mifepristone, and that providing care to women who have taken mifepristone is emotionally draining for physicians.

Unpacking the federal appeals court decision that partially blocks the Texas decision.

Invalid Arguments

The Supreme Court has recently struggled to balance the overall impact – burdens and benefits – of various rules such as student debt relief another immigration policy.

In this case, using doctors’ own theory of harm, there are actually many benefits plaintiff doctors get from giving mifepristone to pregnant women in Texas. Those without access to mifepristone will either have to use less effective regimens or be forced to have surgical abortions later in pregnancy. Delays mean that the fetus continues to grow. deeply troubled Judge Kennedy.

All of the risks associated with medical abortion, and therefore the time and resources that physicians must spend on patient care, will be greater if pregnant women are forced to undergo surgical abortion or give birth.

Judge Kaczmarik framed the decision as a decision to protect women and girls, but mifepristone is a drug that has more benefits than just safe abortion. It has been shown in numerous studies to help women safely treat incomplete miscarriage and is now used off-label for that purpose. Studies have also shown that mifepristone helps with labor induction, increasing the safety of the delivery process for those who continue the pregnancy. Ongoing research into other uses of mifepristone may be interrupted by these judges’ decisions, which limit how the drug can be used.

Finally, it is difficult to see how FDA approval of other drugs is not vulnerable. For example, COVID-19 vaccines do not require a personal visit to a doctor. Doctors who openly opposed the COVID-19 vaccine information can be easily found to support the argument that they will have to take care of vaccine injuries.

Physicians who oppose vaccines and other drugs may also argue that it is too emotionally draining to treat patients who need their help, and therefore prevent other doctors who do not find it too emotionally draining from doing this important work for people, in need of medical attention.

The legal and medical implications make clear just how much is at stake in these abortion decisions.

Jamie Rowan is an associate professor of the Department of Law and Political Science in Massachusetts Amherst. Jamie Rowan receives funding from the National Science Foundation and Humanity United. Tami C Rowan Associate Professor of the Department of Obstetrics, Gynecology and Gynecological Surgery University of California, San Francisco.

This article has been reprinted from Talk under a Creative Commons license. Read original article.


The decision of the Federal Court of Appeals again changed the situation with abortion in the United States



A federal appeals court left the abortion pill available, clearing up the abortion situation in the US but not resolving it. A court decision late Wednesday preserved but narrowed access to abortion pills in the US. This was an important development in a rapidly changing landscape. on the move since Junewhen the Supreme Court overturned the nationwide right to abortion.


Most abortions in the US are done with combination of two drugs. Anti-abortion groups have tried to limit access to one of them, mifepristone.

The Fifth US Circuit Court of Appeals in New Orleans held that the FDA’s original approval of mifepristone in 2000 must remain in effect, overturning the district court’s ruling less than a week earlier. Without Wednesday’s decision, the drug would not be available, at least in some places, starting on Saturday.

The 2-1 decision came with one snag: the judges delayed the regulator’s 2016 decision to relax some prescription and dispensing rules. The decision means that the drug can only be used in the first seven weeks of pregnancy, not 10, and it cannot be distributed by mail to a person who does not first see a doctor.


Either party can appeal Wednesday’s decision to the U.S. Supreme Court.

Meanwhile, what this means is not entirely clear.

The latest decision comes in response to a statement by an Amarillo, Texas judge last week, who ruled that mifepristone should not be available while his statement is being reconsidered. The same day, another federal judge in Spokane, Washington, ruled in favor of the 17 Democratic-led state attorneys general who sued trying to keep it on the market.

States: Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Michigan, Minnesota, New Mexico, Nevada, Oregon, Pennsylvania, Rhode Island, Vermont and Washington, and the District of Columbia.

The US Department of Justice has asked a Washington court to clarify its decision. It’s also unclear what the 5th Circuit’s decision means for him.

Meanwhile, some Democratic-controlled states stocks of abortion pills, while Wyoming last month became the first state outright ban abortion drugs.


In the US, lawyers have sued dozens of abortion laws.

In 2019, the Iowa Supreme Court blocked a law banning abortion when a heart is detected, which occurs after about six weeks of pregnancy and often before women know they are pregnant. Officials in the Republican-dominated state are pushing for the decision to be reversed.

On Tuesday, the matter was taken to the state Supreme Court, where all seven justices are GOP appointees. A decision is expected this summer.

Also on Tuesday, a Montana judge denied a request by Planned Parenthood of Montana to preventively block legislation banning dilation and evacuation abortions, which are most commonly used in the second trimester of pregnancy. Opponents said they wanted to act quickly because the law would take effect immediately if the governor retracted it. Greg Gianforte signs. Gianforte had previously approved other abortion restrictions.


Nebraska legislators on Wednesday introduced a bill to ban abortion as soon as cardiac activity is detected.

In February, the South Carolina Senate passed such a ban. That same month, the House of Representatives approved legislation that would apply throughout pregnancy. The two chambers have yet to agree on which version to send to the governor.

In Florida, Gov. Ron DeSantis, who is expected to run for the Republican presidential nomination next year, supported ending access to abortion sooner than the 15-week deadline currently in effect there. He will now have a chance to sign the law after the State House approved the ban on Thursday after six weeks of pregnancy. He’s already passed the Senate.

Most Democratic-controlled states have passed laws, issued executive orders—or both—to protect access to abortion. After passing by the Senate on Monday, both houses of the Washington state legislature passed it, but it has yet to be signed by the governor.


Abortion has already been effectively banned at all stages of pregnancy in 13 states, and when a heart activity is detected, in one.

Courts have blocked pregnancy bans in five more states and one state of Georgia, which bans abortion when a heart activity is detected.

Republicans in many places are pushing for even tougher policies.

This month the governor of Idaho. Brad Little signed the law make it a crime for an adult to help a minor have an abortion without parental consent.

This month, the Iowa Attorney General took it a step further by announcing that her office stop paying for emergency contraception and abortions for victims of sexual assault while he studies politics.

Abortion bans have a big impact on where women go to have their pregnancies terminated.

Report published this week The Planned Parenthood Society found that the number of monthly abortions in states that ban them throughout pregnancy has fallen to zero or near zero, and abortions in medical facilities have generally declined.

But a significant increase in the number of abortions has occurred in states that have retained the legality of abortion and are close to and easily accessible to the states with the most severe restrictions.

States with large increases include Florida, Illinois, and North Carolina.

In some other states that have taken the boldest steps to maintain access to abortion, the number of granted abortions has increased relatively modestly.

The survey does not measure the number of self-abortions, for example, with pills that were not prescribed to the user.

Mulvihill reported from Cherry Hill, New Jersey. Associated Press reporter Margery Beck in Omaha, Nebraska; Amy Beth Hanson of Helena, Montana; Anthony Izaguirre in Tallahassee, Florida; Scott McPhetridge of Des Moines, Iowa; and James Pollard of Columbia, South Carolina contributed to this report.

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How long COVID has turned the lives of one California couple



On a Monday morning in Irvine, Courtney Garvin eats her breakfast in bed prepared by her partner before leaving for work.

She finishes and heads to the bathroom. She sits down to brush her teeth and wash her face.

From there, she takes her longest walk of the day: 25 steps to her unused office, where she gets into bed and starts knitting and petting her cat.

At lunchtime, she rides a lift—a motorized chair attached to a ladder—to the kitchen to eat lunch prepared by her partner, Connor Mayer. She puts the food in the microwave and sits down again.

Courtney Garvin, riding the stair lift from her upstairs room, gets help from partner Connor Meyer for basic household chores. Meyer gets his wheelchair ready to go out into the fresh air.

(Allen J. Cockroaches/Los Angeles Times)

Garvin, 37, contracted COVID-19 three years ago and now long COVIDa condition reported by approximately 15% of California adults, according to data compiled by Centers for Disease Control and Prevention. She and Mayer say their world has shrunk. She can no longer work.

“I didn’t expect to be in this situation for another 50 or 60 years where I lose so many functions and need constant care. Chronic illness takes away so many of life’s joys, both big and small,” Garvin wrote in an email. (Due to debilitating fatigue, some of Garvin’s interviews were conducted via email or Mayer spoke on his behalf.)

Mayer’s life has also completely changed.

Connor Mayer pushes his partner Courtney Garvin in a wheelchair as they go outside for some fresh air.

Connor Mayer pushes his partner Courtney Garvin in a wheelchair as they go outside for some fresh air.

(Allen J. Cockroaches/Los Angeles Times)

In the morning when he works, he wakes up, makes coffee and goes for a run. He then makes her oatmeal and tea for breakfast, leaving them in thermoses to keep warm. He also prepares lunch and a cocktail for her. After making sure she has what she needs, he rides his bike to work. After 5:30 pm, he washes the dishes and prepares dinner.

She walks about 150 steps a day and takes a short walk around the neighborhood, she says, with Mayer pushing her in her wheelchair.

Garvin and Mayer said they shared their story in hopes of helping others understand the impact this disease has had on their lives.

“I don’t think anyone expects anything like this to happen to them, but here we are,” Mayer wrote in an email. “When we became ill with COVID in March 2020, we had no idea about the long-term risks associated with it. This sudden loss of independence was hard on both of us.”

A look at the medication Courtney Garvin is taking during her long fight against COVID.

A look at the medication Courtney Garvin is taking during her long fight against COVID.

(Allen J. Cockroaches/Los Angeles Times)

Prolonged COVID is a broad term used to describe multiple symptoms that can last weeks or longer after initial infection with COVID-19. These include circulation problems, shortness of breath, neurological problems, gastrointestinal problems, and fatigue, among others. The severity of symptoms and their impact on people’s daily lives can vary greatly.

Some people see symptoms improve over time while others get better and then some symptoms return.

V The CDC provided $25 million. continue to study the long COVID, and groups such as Patient-led collaborative research are working on research into the long-term effects of COVID-19.

While much of the population has begun to shake off the pandemic, people like Garvin are forced to deal with a complex medical system and a condition for which there are no known cures. Navigation in medicine, finance, mental and the physical problem of this disease is challenging.

Prior to falling ill in March 2020, Garvin worked as a storyboard artist and touring musician with Courtney, while Mayer was in graduate school. Mayer is now assistant professor in the Department of Linguistics at the University of California, Irvine. When he is not working, he constantly grooms Garvin and limits his social interactions to avoid reinfecting her.

Courtney Garvin used to play in several bands, but until she recovers from long COVID.

Courtney Garvin used to play in several bands, but until she recovers from long COVID.

(Allen J. Cockroaches/Los Angeles Times)

Garvin stopped working in the fall of 2020 when fatigue, migraines and shortness of breath made it difficult for her to walk more than a few steps and speak more than a few words.

She became disabled and began seeing doctors, many of whom ignored her symptoms as her health continued to deteriorate. In the summer of 2021, she moved to Irvine where she was diagnosed with long-term COVID.

“The consistency of the experience of going to doctor after doctor, seeking help, distrust and indulgence really surprises me,” Garvin said. “This points to a major systemic problem in our culture when we view chronic illness as a moral failing.”

In addition to mental and physical issues, Garvin noted that infrastructure issues, such as a lack of wheelchair racks and a lack of automatic doors in doctors’ offices and the Department of Motor Vehicles, made her feel invisible.

Courtney Garvin first contracted COVID in March 2020.

Courtney Garvin first contracted COVID in March 2020.

(Allen J. Cockroaches/Los Angeles Times)

The couple live in a townhouse provided by the University of California, Irvine, which is considered compliant with the Americans with Disabilities Act, but the stairs in the house create difficulties for Garvin. After several phone calls to the housing authority, letters from doctors and insurance companies, the couple installed a stairlift, but paid for it out of their own pocket.

Garvin and Mayer spent about $62,000 on medical expenses, including compression stockings ($450), a stair lift ($2,750), support groups ($860), and co-payments ($3,300). They also spent countless hours in waiting rooms, waiting for doctors, and handling insurance and disability paperwork.

Post-viral diseases such as prolonged COVID, Not newbut some doctors in California are treating the long-standing COVID as a new phenomenon.

“It’s grim to think about how many lives could be changed for the worse because we didn’t understand the long-term consequences well enough to consider when considering preventative safety measures,” Mayer said.

Courtney Garvin takes a break as she walks down the stairs from her room upstairs.

Courtney Garvin takes a break walking down the stairs from her room upstairs while her partner Connor Meyer gets ready to help her with basic household chores.

(Allen J. Cockroaches/Los Angeles Times)

Dr. William W. Stringer, a pulmonologist and critical care physician who started a post-COVID program at Harbor-UCLA Medical Center, is trying to better understand these long-term effects.

“I think there are a lot of people that specialists and doctors don’t recognize,” said Stringer, who has treated patients with some of the most severe long-term symptoms of COVID. “It’s also a huge financial issue, between the lack of social work and help with food and doctor visits.”

Mayer said he was disappointed that a serious health issue has low public awareness and sympathy. Near the end of the interview, Garvin said she was tired and asked Mayer to speak on her behalf.

“Strength is what I lack right now,” she said. “I’m completely exhausted.”

How long have you had COVID in California?

The Los Angeles Times is working on a series of articles to understand the experience of long-term COVID-19 patients and their caregivers. You can contact The Times here.

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SpaceX cancels first giant rocket launch attempt in Texas



SOUTH Padre Island, Texas (AP) — SpaceX canceled the first attempt to launch its giant rocket on Monday after there was a problem during refueling.

Elon Musk’s company planned to launch a nearly 400-foot Starship rocket from the southern tip of Texas, near the Mexican border.

The test flight was canceled with just over eight minutes left on the countdown due to a stuck valve needed to pressurize the first stage booster. The launch controllers were unable to fix the frozen valve in time, but for practice they lowered the clock to the 40-second mark before stopping the countdown.

There were no people or satellites on board. There won’t be another attempt until at least Thursday.

“Learned a lot today,” Musk tweeted after the flight was delayed.

The company plans to use Starship to send people and cargo to the Moon and eventually Mars.

On the eve of the launch attempt, campers, SUVs, and even bicycles and horses filled the only road leading to the launch pad, where the stainless steel rocket towered over flat brush and prairie. Enthusiasts posed in front of the giant Starbase letters at the entrance to the SpaceX complex and in front of the rocket two miles down the road, which ended at a beach in the Gulf of Mexico.

On Monday, spectators were banned from the area and instead filled a beach about six miles from South Padre Island.

Ernesto and Maria Carreon drove two hours from Mission, Texas with their two daughters, ages 5 and 7, to watch.

“I felt sad. They became sad,” Maria Carreon said when the launch attempt was cancelled.

They can’t come back for another try, but plan to have some fun on the beach on Monday.

Michelle Vankampenhout, who is on vacation in Green Bay, Wisconsin, said she would return.

“Seeing this is a unique experience,” she said.


The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute Science and Education Media Group. AP is solely responsible for all content.

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