2026年5月1日 晚上8:46 UTC / 路透社
作者：丹尼尔·威斯纳
2026年5月1日 晚上8:46 UTC 更新于1小时前
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2024年4月9日，美国伊利诺伊州卡本代尔市阿拉莫妇女诊所内，米非司酮包装盒清晰可见，该药是药物流产的首种药物。路透社/伊芙琳·霍克斯坦/档案照片
- 路易斯安那州就堕胎药物米非司酮相关规定提起诉讼
- 上诉法院一致裁决支持路易斯安那州
5月1日（路透社）——美国一家上诉法院周五暂时叫停了一项允许通过邮寄方式分发堕胎药物米非司酮的联邦规定，此举大幅限制了该药物在全国范围内的获取，尤其是在已禁止堕胎的州。
总部位于新奥尔良的美国第五巡回上诉法院由三名保守派法官组成的合议庭一致裁定，由共和党领导的路易斯安那州很可能在其对民主党前总统乔·拜登政府2023年通过的该项规定的诉讼中胜诉。
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尽管该项裁决只是临时措施，但这是一系列挑战米非司酮2000年最初获批以及后续简化获取途径规定的诉讼中，首次大幅限制其获取的裁决。2023年美国食品药品监督管理局（FDA）的规定取消了米非司酮必须当面配药的要求。
路易斯安那州共和党总检察长莉兹·默里尔对该裁决表示欢迎，她在一份声明中表示，她将“期待在本案继续推进的过程中继续捍卫女性和婴儿”。
堕胎权利倡导组织古特马赫研究所副主席凯利·巴登表示，该裁决并非该问题的最终定论，但却是自2022年最高法院推翻堕胎权利以来，对堕胎服务获取范围最广泛的一次打击。
“重新实施 medically unnecessary（医疗上非必要）的当面配药要求，将在全国范围内引发混乱和困惑，并严重破坏患者获得堕胎护理的能力，”巴登在一份声明中说道。
FDA未立即回应置评请求。
一系列法律斗争
包括路易斯安那州在内的已禁止堕胎的共和党领导州，一直将限制米非司酮的获取渠道——包括通过州外医疗服务提供者进行远程医疗问诊开方——作为首要任务。
自2022年美国最高法院推翻了对女性堕胎权的宪法保护以来，近一半的州已经禁止或严格限制堕胎。这推动了药物流产的激增，也引发了一系列围绕药物获取渠道的法律斗争。
药物流产是两种药物的联合疗法：米非司酮（约三分之二的美国堕胎手术使用该药），随后是米索前列醇，用于在怀孕前10周内终止妊娠。
南加州大学的研究显示，在堕胎合法且允许医生通过远程医疗开处方药的州，仅有不到2%的堕胎药物处方需要当面配药。
路易斯安那州去年起诉FDA，称该机构在2023年出台该项规定时，忽视了米非司酮可能引发的严重不良反应风险，包括败血症和大出血。
拜登政府坚称米非司酮有效且安全，并援引研究称，不到1%的患者会出现严重不良反应。
制药企业GenBioPro和丹科实验室已介入路易斯安那州的诉讼，以捍卫FDA的这项规定。两家公司在法庭文件中表示，米非司酮的品牌版药物Mifeprex是丹科的唯一产品，而GenBioPro的大部分收入都来自其仿制药版本。FDA去年批准了另一家由Evita Solutions生产的仿制药。
“我们对该法院无视FDA严谨的科学依据和米非司酮数十年的安全使用历史的裁决感到震惊，这起案件是由极端堕胎反对者提起的，”GenBioPro首席执行官埃文·马辛吉尔在一份声明中说道。
他表示，该公司将采取一切必要行动，尽可能广泛地推广米非司酮。制药商以及特朗普政府时期的FDA，既可以请求第五巡回上诉法院全体法官重新审议该项裁决，也可以向由6名保守派法官、3名自由派法官组成的美国最高法院提起上诉。
最高法院2024年曾受理了医疗团体和医生对邮寄配药规定的挑战，但裁定他们不具备起诉的法律资格。密苏里州、堪萨斯州和爱达荷州接手了该案，目前该案件仍在审理中。
“逐步放宽限制”
美国地区法官大卫·约瑟夫在4月7日的裁决中，暂停了路易斯安那州的诉讼，以待唐纳德·特朗普政府对米非司酮的安全性进行审查。据媒体报道，该审查已被推迟至11月中期选举之后。
该法官驳回了路易斯安那州叫停2023年规定的请求，但同意该州的说法，即这项规定可能是非法的，并表示在案件恢复审理时他会作出相应裁决。
路易斯安那州曾请求第五巡回上诉法院暂停该裁决并叫停该项规定，同时该州提起上诉，整个过程可能需要数月时间才能得出结果。
周五，由三名由共和党总统任命的法官组成的第五巡回上诉法院合议庭同意路易斯安那州的观点，即FDA未能证明取消当面配药要求的合理性。
“该机构逐步放宽米非司酮安全限制的做法，很可能缺乏数据和科学文献的支持，”由特朗普任命的美国巡回法官斯图尔特·凯尔·邓肯为法院撰写的意见书中写道。
他表示，“FDA的这一举措所促成的每一例堕胎，都抵消了路易斯安那州对医疗堕胎的禁令。”他写道，一旦禁令被打破，“这种保护未出生生命的主权特权，就无法通过法律救济重新获得。”
另有五个共和党领导的州正在就FDA的堕胎药物规定提起两起独立诉讼，包括对26年前米非司酮最初获批的质疑。特朗普政府已申请暂停这两起案件，以待对该药物的审查。
路易斯安那州和德克萨斯州还起诉或传唤了其他州的医疗服务提供者，指控他们向本州居民开具米非司酮，此举正在测试包括纽约州和加利福尼亚州在内的州的“盾牌法”——这些法律保护医疗服务提供者免受州外调查和起诉。
丹尼尔·威斯纳在纽约奥尔巴尼报道；内特·雷蒙德和艾哈迈德·阿布勒内恩补充报道；马克·波特、威尔·邓纳姆、亚历克西亚·加拉姆福尔维和奥罗拉·埃利斯编辑
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US court blocks mail-order access to abortion drugs, for now
2026-05-01 8:46 PM UTC / Reuters
By Daniel Wiessner
May 1, 2026 8:46 PM UTC Updated 1 hour ago
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Boxes of Mifepristone, the first pill in a medical abortion, are seen at Alamo Women’s Clinic in Carbondale, Illinois, U.S., April 9, 2024. REUTERS/Evelyn Hockstein/File Photo
- Louisiana challenged rule concerning abortion drug mifepristone
- Appeals court backed Louisiana in unanimous decision
May 1 (Reuters) – A U.S. appeals court on Friday temporarily blocked a federal rule allowing the abortion drug mifepristone to be dispensed through the mail, significantly curtailing access to the drug nationwide and particularly in states that have banned abortion.
A conservative three-judge panel of the New Orleans-based 5th U.S. Circuit Court of Appeals ruled unanimously that the Republican-led state of Louisiana was likely to prevail in its challenge to the 2023 rule adopted by Democratic former President Joe Biden’s administration.
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While the ruling is temporary, it is the first to significantly curtail access to mifepristone in a series of lawsuits challenging the drug’s initial approval in 2000 and subsequent rules making it easier to obtain. The 2023 U.S. Food and Drug Administration regulation removed a requirement that mifepristone be dispensed in person.
The ruling was hailed by Louisiana’s Republican Attorney General, Liz Murrill, who in a statement said she will “look forward to continuing to defend women and babies as this case continues.”
The decision is not the final word on the issue, but is for now the most sweeping threat to abortion access since the Supreme Court rolled back abortion rights in 2022, said Kelly Baden, vice president at the Guttmacher Institute, an abortion rights advocacy group.
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“Reimposing medically unnecessary in-person dispensing requirements for mifepristone will send shockwaves of chaos and confusion across the country and dramatically upend patients’ ability to obtain abortion care,” Baden said in a statement.
The FDA did not immediately respond to requests for comment.
SERIES OF LEGAL BATTLES
Restricting access to mifepristone, including through telehealth appointments with out-of-state providers, has been a top priority for Republican-led states that have banned abortion, including Louisiana.
Nearly half of states have banned or severely restricted abortion since the U.S. Supreme Court rolled back its recognition of a woman’s constitutional right to the procedure in 2022. That has driven a surge in medication abortion, which has spurred a series of legal battles over access to the drugs.
Medication abortion is a two-drug regimen consisting of mifepristone, which is used in about two-thirds of U.S. abortions, followed by misoprostol, used to terminate a pregnancy within the first 10 weeks.
In states where abortion is legal and doctors are permitted to prescribe drugs via telehealth, fewer than 2% of prescriptions for abortion drugs are filled in person, according to research from the University of Southern California.
Louisiana sued the FDA last year, claiming the agency in adopting the 2023 rule had ignored the risks of serious adverse events posed by mifepristone, including sepsis and hemorrhaging.
The Biden administration had maintained that mifepristone is effective and safe, citing studies that showed major adverse events occurring in fewer than 1% of patients.
Drug companies GenBioPro and Danco Laboratories have intervened in Louisiana’s lawsuit to defend the FDA regulation. The brand-name version of mifepristone, Mifeprex, is Danco’s only product, and GenBioPro derives most of its revenue from the generic version, the companies said in court filings. The FDA last year approved another generic version made by Evita Solutions.
“We are alarmed by this court’s decision to ignore the FDA’s rigorous science and decades of safe use of mifepristone in a case pursued by extremist abortion opponents,” GenBioPro CEO Evan Masingill said in a statement.
He said the company is committed to taking any actions necessary to make mifepristone as widely available as possible. The drugmakers, as well as the FDA under Trump, could either ask the full 5th Circuit to reconsider the ruling or appeal to the 6-3 conservative majority U.S. Supreme Court.
The Supreme Court in 2024 took up a challenge to the mail-order rule by medical groups and doctors, but ruled that they lacked legal standing to sue. Missouri, Kansas and Idaho have taken over that case, which is pending.
‘PROGRESSIVE RELAXATION’
U.S. District Judge David Joseph in an April 7 decision had paused Louisiana’s lawsuit pending a review by President Donald Trump’s administration of the safety of mifepristone, which, according to media reports, has been delayed until after the November midterm elections.
The judge denied Louisiana’s request to block the 2023 rule but agreed with the state that it was likely unlawful, indicating he would rule that way when the case resumes.
Louisiana had asked the 5th Circuit to pause that ruling and block the rule while the state pursues an appeal, which could take months to resolve.
On Friday, a 5th Circuit panel composed of three judges appointed by Republican presidents agreed with Louisiana that the FDA had failed to justify eliminating the in-person dispensing requirement.
“The agency’s progressive relaxation of mifepristone’s guardrails likely lacked a basis in data and scientific literature,” U.S. Circuit Judge Stuart Kyle Duncan, a Trump appointee, wrote for the court.
He said that “every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions.” Once lost, he wrote, “that sovereign prerogative of protecting unborn life cannot be regained by legal remedy.”
Five other Republican-led states are pursuing two separate lawsuits over FDA abortion drug regulations, including the initial approval 26 years ago. The Trump administration has moved to pause both cases pending its review of the drug.
Louisiana and Texas have also sued or indicted healthcare providers from other states for prescribing mifepristone to their residents, testing so-called shield laws in states including New York and California that protect providers against out-of-state investigations and prosecutions.
Reporting by Daniel Wiessner in Albany, New York; additional reporting by Nate Raymond and Ahmed Aboulenein; Editing by Mark Porter, Will Dunham, Alexia Garamfalvi and Aurora Ellis
Our Standards: The Thomson Reuters Trust Principles.