NRL News

The Day the FDA Abandoned the First Principle of Medical Ethics

by | Sep 29, 2020

20th Anniversary of the Abortion Pill Mifepristone’s Approval

By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research

The first principle of medical ethics is “primum non nocere” – “first, do no harm.”  It is a reminder that at a patient’s most physically vulnerable moment, a doctor must take care with all his sharp tools and skills not to do anything to make things worse.

On September 28th, 2000, the U.S. Food and Drug Administration (FDA), under pressure from the outgoing Clinton administration, approved the abortifacient RU-486 (or mifepristone) for sale in the United States, opening the door to chemical (pill-induced) abortion.

In doing so, it only made a bad situation worse. And the lethal damage has continued  for two decades.

Ostensibly, the FDA approval was because American women needed a newer, safer abortion option, though more than a million a year were obtaining surgical abortions at clinics all across the country from private “providers” such as Planned Parenthood.

But the numbers of abortions at these clinics was falling, clinics were closing, and abortionists were quitting the business. Women weren’t satisfied with their product, finding surgical abortions cold, mechanical, and abrupt. They didn’t like the cutting, the scraping, the violation of the self as they sat exposed on an operating table while instruments cut and machines sucked life out of their wombs.

Mifepristone, advocates promised, would give them a new way to market their product, as something safer, simpler, that could be done in the “privacy of their own homes.” That might bring in customers who found surgical abortion problematic.

Though chemical abortions turned out to be neither safe nor simple, that didn’t matter to the merchants of death. They were able to attract new customers and convince a few new doctors to try the new pills.

In spite of all the assurances, every “successful” chemical abortion involved considerable pain and extensive bleeding, more than one might expect from a surgical abortion. Pain and cramps were intense, often requiring analgesics or even opioids, along with spells of nausea or vomiting.  Bleeding could be copious and would often last for days or even weeks. Those horrible side effects were usually not advertised.

Nor were the numbers of women hospitalized, the number requiring transfusions, or the two dozen or more women who died of undiscovered ruptured ectopic pregnancies, rare bacterial infections, or simply bled to death. Those truths were unspoken by advocates,

Along with the FDA, the sponsors and promoters of the abortion pill (now called “medication abortion”) saw hints of these harms in trials of the drug but pushed forward anyway.  The health and safety of women were not going to stand in the way of the pro-abortion cause of “increasing access.” 

Despite getting full approval of the drug and even being allowed to continue sales of the drug when news of deaths and injuries began to surface, abortion pill advocates pushed further. With another Democrat supportive of their agenda in the White House, they pushed the FDA to loosen what limited restrictions it had in place for the drug.

The FDA, at behest of the drug’s sponsor and supporters, altered dosages to make chemical abortions cheaper (and more profitable for clinics), reduced the number of required visits to the clinic where women’s use and health could be monitored, and allowed women to take these drugs later in pregnancy. They did this even knowing that this meant reduced effectiveness and the possibility of increased complications.

Even this did not satisfy abortion pill advocates, who finally made their intentions known. They seek to be able to bypass the clinics altogether and allow women to order and take these dangerous pills at home without ever having to see a doctor in person.

This would enable abortion advocates to promote and sell their product in places where there were no abortion clinics, relieving the problem of an abortionist shortage in communities where they were not wanted. That change also meant that women would obtain the pills and face complications in places where there might not be doctors qualified to treat them. This, too, did not trouble advocates.  The cause must go forward, more women must have ”access,” more babies must die.

So far, to its great credit, the FDA has resisted the efforts of advocates and their institutional and media allies to loosen regulations further. They want the pill to be prescribed and sold by webcam and over the internet by doctors and lower level clinicians whom the women have never actually met and who would not be available to help her if she began to hemorrhage or if her ectopic pregnancy ruptured or if she contracted a deadly infection from tissue from the aborted baby still in her uterus.

But the pressure of mifepristone’s well placed, well heeled advocates is unrelenting. Twenty years after the FDA first approved the sale of mifepristone, backer keep pushing in the backrooms of the FDA, the halls of Congress, the courts, and in the courts of public opinion.

It’s what they were after from the beginning. More abortions to more women in more locations than ever. In fact the goal is access as easy as one’s own personal computer or smart phone, as near as one own house, one’s own mailbox so as to be able to perform “Do-It-Yourself” abortions.

There is another part of the Hippocratic Oath that the approval of mifepristone specifically violated: “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.” In case the intent wasn’t clear, the oath further specifies, “Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.”

The FDA may not have realized what it was getting itself in for when it compromised that first principle twenty years ago. But once medicine has given up the idea that its job is always and only to heal, and never to kill patients–that drugs can legally be used to kill unborn children and wantonly endanger their mothers–it has set itself up for a deeper and deeper descent into the dark abyss.

Twenty years. But it’s not too late to reverse course, not so long as pro-lifers never give up—which they never will!

Categories: RU486