FDA preemption of conflicting state drug regulation and the looming battle over abortion medications

Over the past 25 years, Congress and the FDA have determined the safest and most beneficial way to regulate the use of mifepristone (Mifeprex), the medication that accounts for the majority of abortions in the United States. The Dobbs decision has renewed the importance of those scientific determinations, especially FDA's decisions implementing the Risk Evaluation and Mitigation Strategy (REMS) provisions of the Federal Food Drug and Cosmetic Act (FDCA), that mifepristone may be taken by patients outside the presence of any healthcare provider (often through telemedicine prescription and shipment across state lines). Now that Dobbs has been decided, state officials have indicated that they will seek to enforce state statutes which conflict with FDA's regimen for the proper use of mifepristone, by banning its use entirely, prohibiting telemedicine prescription, or imposing other requirements which FDA has specifically considered and now rejected as contrary to the congressional mandate that FDA-approved drugs be as accessible as safety considerations allow. Litigation has already been filed to invalidate such statutes on the grounds that they are preempted by the doctrine that state law which conflicts with, or undermines the purposes of, FDA actions with respect to approved drugs are preempted under the Supremacy Clause of the Constitution. This article examines the Supreme Court caselaw and FDA actions which will dictate the outcome of that litigation. Part I details the statutory basis for FDA preemption of conflicting state law and the four decisions by the Supreme Court over the last 13 years (Levine, Mensing, Bartlett and Albrecht) which enunciate the governing legal standards for FDA preemption. We pay particular attention to the opinions of Justice Alito and the other conservative justices, which hold that such FDA preemption should be robust to ensure that there is one consistent, national policy for the distribution and regulation of drugs, under the science-based decisions of the FDA, rather than the 'parochialism' of differing state standards. Part II details FDA's comprehensive program for the balanced, though appropriately restricted, use of mifepristone, and the 22 years of FDA actions that brought that about. It then catalogs the state statutes limiting the use of the drug which, in material ways, conflict with those FDA determinations. Part III outlines the arguments made in one early lawsuit seeking preemption of the statutes of one state (Mississippi)-a law suit which previews the wider litigation to come. It then sets forth the strong arguments for FDA preemption of each type of state restriction and responses to the 'defenses' of those statutes that have been offered in an effort to avoid FDA preemption under the Supremacy Clause. That review shows that a straight-forward application of the FDCA and the Supreme Court caselaw should result in the preemption of the state restrictions that squarely conflict with the relatively free access to abortion medications which FDA has mandated.

What is episodic memory and how do we use it?

What are the neural and computational principles that give rise to episodic memory? Although memory is probably the most studied topic in psychology and cognitive neuroscience, most research has focused on learning at the micro-level. I outline the limitations of this approach and propose a 'molar' approach to tackle episodic memory at the scale of life.

Terahertz Imaging of Thin Film Layers with Matched Field Processing

Terahertz (THz) time of flight (TOF) tomography systems offer a new measurement modality for non-destructive evaluation (NDE) of the subsurface layers of protective coatings and/or laminated composite materials for industrial, security and biomedical applications. However, for thin film samples, the time-of-flight within a layer is less than the duration of the THz pulse and consequently there is insufficient range resolution for NDE of the sample under test. In this paper, matched field processing (MFP) techniques are applied to thickness estimation in THz TOF tomography applications, and these methods are demonstrated by using measured THz spectra to estimate the the thicknesses of a thin air gap and its depth below the surface. MFP methods have been developed over several decades in the underwater acoustics community for model-based inversion of geo-acoustic parameters. It is expected that this research will provide an important link for THz researchers to access and apply the robust methods available in the MFP literature.

Sociocultural mediators of remembering: an extension of Bartlett's method of repeated reproduction

The reported research uses an extension of Bartlett's method of repeated reproduction to provide data on the sociocultural processes underlying reconstructive remembering. Twenty participants worked in pairs to remember the War of the Ghosts story 15 min and 1 week after presentation. The observed transformations were comparable to previous research with individuals. Going beyond previous research, we analyse participants' discourse to provide a window on the processes underlying these transformations. Textual excerpts demonstrate how imagery, narrative coherence, deduction, repetition, gesture, questioning and deferring contribute to the transformation and conventionalization of the material. These diverse sociocultural mediators are integrated into a partially coherent recollection by participants self-reflecting, or as Bartlett termed it, turning around upon their schemas. We demonstrate that this self-reflection is both a social and a psychological process, occurring because participants are responding to their own utterances in the same way that they respond to the utterances of other people. These empirical findings are used to make a case for using discursive data to look not only at discursive processes but also at socially situated and scaffolded psychological processes.