WASHINGTON The Supreme Court on Monday let stand a decision temporarily blocking

an Arizona law that limits the availability of medicinal, nonsurgical abortions. As is its
custom when it denies review, the court gave no reasons for its action.
The law, enacted in 2012, requires abortion providers to comply with a 2000 protocol from
the Food and Drug Administration for mifepristone, an abortion-inducing drug that is
sometimes called RU-486. The Legislature said the law was meant to protect women from
the dangerous and potentially deadly off-label use of abortion-inducing drugs.
The 2000 protocol calls for the drug to be given in higher doses than is customary today, and
only in the first seven weeks of pregnancy.
In the years since the protocol was issued, doctors have found that a lower dose of the drug is
effective and that it can be taken safely through the ninth week of pregnancy.
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Mifepristone blocks the action of progesterone, a hormone required to maintain a pregnancy.
It is used in combination with a second drug, misoprostol, which causes the uterus to contract
and to expel its contents. The F.D.A. has not approved misoprostol for abortions.
Medical experts say the agencys protocol for mifepristone is outdated, cumbersome and
dangerous. The new protocol, used by most providers today, involves lower doses in fewer
visits at less cost and is available through the ninth week of pregnancy.
Under the protocol required by the Arizona law, many women would be forced to have
unnecessary surgical abortions, according to Planned Parenthood, which sued to block
enforcement of the law. The group added that the law would make it hard for women in
Northern Arizona, where only medicinal abortions are offered by the sole clinic there, to
obtain abortions at all.
In June, a unanimous three-judge panel of the United States Court of Appeals for the Ninth
Circuit, in San Francisco, blocked the law, saying it had imposed an undue burden on the
right to abortion. The meaning and proper application of the undue-burden standard,
announced by the Supreme Court in Planned Parenthood v. Casey in 1992, have divided the
lower courts.
Two federal appeals courts have upheld laws restricting medicinal abortions in Texas and
Ohio using a relaxed understanding of the scrutiny required by the standard. They ruled that it

was enough to find that the laws were rationally related to the goal of protecting womens
health.
The Ninth Circuit, by contrast, said the undue-burden standard required it to weigh the
extent of the burden against the strength of the states justification.
Judge William A. Fletcher, writing for the court, said that such weighing of the competing
interests warranted blocking the Arizona law from going into effect. Arizona has presented
no evidence whatsoever that the law furthers any interest in womens health, he wrote. On
the other side of the balance, he said, the law delayed and deterred abortions by making them
more costly, cumbersome and dangerous.
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For a significant number of women, the law will ban medication abortions outright, Judge
Fletcher wrote, because many women do not discover they are pregnant in the seven-week
period allowed under the F.D.A. protocol.
Thomas C. Horne, Arizonas attorney general, urged the Supreme Court to hear the states
appeal in order to give lower courts guidance on how to apply the undue-burden standard. He
said the continued availability of surgical abortions in Arizona was enough to satisfy the
standard.
In response, Planned Parenthood told the justices that they should not hear the case, Humble
v. Planned Parenthood Arizona, No. 14-284, for three reasons: It was still at an early stage, a
related state challenge was pending, and the precise meaning of the Arizona law remained
unresolved.
Under one reading of the law, it banned all medicinal abortions by requiring adherence to
F.D.A. protocols. That is because the F.D.A. has never approved the second drug,
misoprostol, for use in abortions.
In 2013, the Supreme Court dismissed a case concerning a similar Oklahoma law that it had
agreed to hear after the Oklahoma Supreme Court interpreted the law to ban all medicinal
abortions.
Mr. Horne said the correct reading of the Arizona law allowed a role for the second drug.
The Supreme Court has not decided a major abortion case since 2007, when it upheld the
federal Partial-Birth Abortion Ban Act.