A medication banned in America


MIFEPRISTONE is a medication that would enable 750,000 Americans each year to avoid surgery.

By avoiding this surgery, patients have much less risk of infection in their internal organs. Eighty percent of patients prefer the drug to surgery. Half of American cities and 93 percent of rural counties do not have a doctor who performs the surgery. Mifepristone can be given in any doctor's office. The drug also would make a half-million other operations easier and less traumatic. The American Medical Association calls it an "efficacious and safe" treatment. But though it has been used for 10 years in Europe and developing countries, mifepristone is not available in the United States.

Mifepristone is the generic name for RU-486, a pill that terminates early pregnancy. The surgical alternative is abortion -- the scraping or suctioning of the uterus. The patients are women. Though RU-486 is approved in France and England and will soon be approved in Sweden, the manufacturer has not even sought approval to sell it in this country because of fear of boycotts and violence.

The Food and Drug Administration allows Americans to import unapproved or even quack medicines like laetrile for private use. There are buyer clubs and mail-order businesses for those who want such drugs. The FDA says that RU-486 is the one medicine that may not be imported for personal use. Last month, the Supreme Court upheld that ban.

Access to RU-486 is gridlocked in the politics of abortion. Women suffer. The FDA's credibility also suffers.

Why would the FDA block access to a safer, less arduous alternative to abortion? A cynic might say that federal policy is tailored to enable anti-abortion activists to target abortion clinics, harass doctors and patients, intimidate clinic landlords, and shake plastic fetuses in the faces of patients and staff. When RU-486 finally becomes available, abortions will move into the privacy afforded by thousands of ordinary clinics.

Or perhaps the administration is trying to deter abortions by keeping them surgical rather than medical, even if it means they are more dangerous. Or perhaps the administration knows that if abortion were ruled illegal and women did not have access to RU-486, lives would be lost to "coat-hanger" abortionists.

That is hardly "pro-life."

Steven Miles is an associate professor of medicine at the University of Minnesota.

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