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Different thinking about abortion


In this story:

A history of controversy

Making abortion too easy?

Between a patient and her doctor



by Jeffrey P. Kahn, Ph.D., M.P.H.
Director, Center for Bioethics
University of Minnesota

This week, the U.S. Food and Drug Administration (FDA) approved the sale and use of mifepristone, the drug labeled RU-486 in Europe. Mifepristone, a drug with a nondescript name but far-reaching practical and political implications, allows abortions to be done without surgery and by many more physicians and in many more settings than is currently possible. The drug will be marketed under the drug name Mifeprex, and can be taken during the first seven weeks of pregnancy to effectively cause a miscarriage.

Center for Bioethics

What's your opinion?

It seems to offer another safe and effective option for abortion; but will it also make abortion more morally palatable and therefore acceptable to a wider proportion of the population? What restrictions ought to be placed on its prescription and use, and how will it shape the future of the abortion debate?

A history of controversy

Mifepristone has been around for a number of years, originally known by the name RU-486. The potential political ramifications of marketing and selling the drug in the United States were so great, however, that the French pharmaceutical company that developed it relinquished rights to the drug rather than confront the fallout. Numerous population and family planning groups hoped to find another manufacturer to make the drug, but none would take on the political hot potato it represented. Even now, no U.S.-based manufacturer would agree to produce mifepristone, and its U.S. distributor, Danco, Inc. apparently has contracted with an undisclosed overseas company to produce Mifeprex.

Making abortion too easy?

The FDA chose to treat the prescription of mifepristone as parallel to the way surgical abortions are regulated -- the drug must only be administered by a health care professional in a physician's office, hospital or clinic. This will make it harder to get than allowing physicians to prescribe the drug so women to pick it up at a pharmacy and take it at home -- an option also considered by the FDA. But approval of mifepristone will certainly create greater access to abortion, since there are relatively few physicians who will perform surgical abortions, and women often need to travel substantial distances to visit their clinics.

Between a patient and her doctor

There is no way to know how many additional physicians will provide medical abortions now that Mifeprex is available. Requiring the drug to be administered in a health care facility means that each state's abortion reporting requirements will apply, but privacy for both doctors and patients will be far easier to maintain since Mifeprex makes it possible for abortions to take place in any doctor's office. Up to now, having an abortion has required that women go to a special clinic or hospital, and in many communities run the gauntlet of protesters outside. Patients are not anonymous, so their decision could hardly be private. And the trauma of the decision would be multiplied by the anxiety of having to confront protesters whom they may even know.

By offering a safe non-surgical technique for abortion, Mifeprex will shift the policy debate. No longer will the flash point for the abortion debate be the relatively small number of late-term abortions performed in special clinics. Instead, advocates on both sides of the abortion issue will see the debate shift to how much or how little intrusion there ought to be in early term medical abortions that can be performed in the privacy of any physician's office.

After the graphic depictions and fiery rhetoric around late term abortion, the public may be relieved to see an abortion option that takes place very early in pregnancy, and embrace it as a morally acceptable compromise. Or they may see it as making abortion too easy and too private, creating an environment that fails to take seriously the moral gravity of the decision. Whichever way the debate shifts, the introduction of Mifeprex seems certain to alter the future of abortion policy.


This week, the U.S. Food and Drug Administration approved the sale and use of mifepristone, the drug formerly labeled RU-486. It seems to offer another safe and effective option for abortion. But will it also make abortion more morally palatable and therefore acceptable to a wider proportion of the population? Or does it make abortion too easy and too private? What restrictions ought to be placed on the use of mifepristone, and how will it shape the future of the abortion debate?



Post your opinion here.


Visit the
"Ethics Matters" Archive
where you'll find other columns from Jeffrey Kahn
on a wide range of bioethics topics.


"Ethics Matters" is a biweekly feature from the
Center for Bioethics and CNN Interactive.


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