Controversy is growing after President Lee Jae-myung ordered a review of allowing physicians, at their discretion, to prescribe abortion pills ahead of amending the relevant law. The medical community went public with its opposition, saying, "Administrative permission without legislation undermines the constitutional order and could cause confusion in clinical settings."
People Power Party lawmakers Cho Bae-sook, Kim Mi-ae, Baek Jong-heon, Ahn Sang-hoon, Seo Myeong-ok, and Han Ji-a held an emergency academic seminar titled "Problems with the Lee Jae-myung administration's lawless approval of abortion pills" at the National Assembly Members' Office Building on the 23rd. At the event hosted by the National Alliance for the Protection of Fetuses and Women, presenters argued that if the government proceeds with introducing abortion pills without a legal basis, it could burden both the constitutional order and the medical system.
The government has included the introduction of abortion pills among its 123 national agenda items and is moving discussions into full swing. President Lee Jae-myung said at a Cabinet meeting on the 14th, "Debating in law how many weeks to allow could run out the clock on the term," adding, "Leaving it to a physician's conscience and discretion is one option." Minister Won Min-kyong of the Ministry of Gender Equality and Family also said, "With the resolve to stake my position, I will push for it within the term."
◇ "An issue the Constitutional Court left to the National Assembly... the executive branch should not decide in its place"
Seoul National University Graduate School of Public Health Professor Park Seong-min noted that the president's recent remarks conflict with his prior stance.
Last year, during a Ministry of Gender Equality and Family briefing, President Lee Jae-myung asked, "Absent clear legislation, is there no way to handle it through administrative measures?" At this Cabinet meeting, he offered physician discretion as a solution, saying, "Even a half-baked patch is better than leaving it unaddressed."
Park cited the intent of the Constitutional Court's 2019 decision of constitutional nonconformity. At the time, the court did not immediately abolish the abortion crime but set a legislative deadline and left it to the National Assembly to determine by law the standards between a fetus's right to life and a woman's right to self-determination.
Park argued, "In a situation where legislation has not been enacted, allowing medication abortion through administrative action alone runs counter to the court's intent," adding, "It also violates the separation of powers, as it amounts to the executive branch making a decision the National Assembly should make."
Park also said the legal vacuum has already materialized. Citing a Supreme Court ruling that recognized murder for a physician but acquitted on the abortion charge, Park said, "If medication abortion is allowed without legislation, the legal vacuum the court feared could become further entrenched."
Park emphasized, "How many weeks into pregnancy to allow, how far to recognize social and economic grounds, whether to require counseling and a reflection period—all are matters for legislation," adding, "They are not for physicians to determine case by case."
Park also raised potential conflicts with the current Pharmaceutical Affairs Act provision that bans labeling on medicines suggesting pregnancy termination, and the possibility that if the Ministery of Food and Drug Safety reverses its prior position and forces approval, responsible officials could become embroiled in allegations of dereliction of duty or abuse of authority.
He also mentioned approval procedures and safety verification. Park argued that because the drug metabolism characteristics of Koreans have not been sufficiently verified, granting approval based only on foreign clinical data should be approached with caution, and that a bridging clinical trial on Koreans should come first.
◇ "Twenty-two times the complications than official statistics"... safety concerns raised
Ewha Womans University Seoul Hospital Professor Jang Ji-young argued that existing statistics supporting the safety of abortion pills do not sufficiently reflect the real risks.
Jang then introduced a U.S. case. An analysis by the Ethics and Public Policy Center (EPPC) of about 860,000 insurance claims from 2017 to 2023 found that 10.9% of women who used medication to terminate pregnancy experienced serious adverse events. That figure is about 22 times higher than the less-than-0.5% presented by the U.S. Food and Drug Administration (FDA) and the manufacturer.
In the United Kingdom, an analysis of National Health Service (NHS) data found that actual complications exceeded 11,000 cases, but only 300 were reflected in the government's official statistics. Jang said, "Medication abortion carries risks that are not fully captured in the statistics, rather than being a 'safe procedure.'"
A study analyzing Finland's national health registry data found that the overall complication rate for medication abortion was about four times higher than for surgical abortion, and Jang also noted that the FDA is reexamining the safety of mifepristone.
Jang also pointed out that in overseas cases where telemedicine and mail delivery have expanded, it is difficult to confirm ectopic pregnancy, and checking contraindications or responding to emergencies can be delayed. Introducing a lawsuit in Texas in which an ex-boyfriend allegedly secretly put the drug in food to cause a miscarriage, Jang said, "Expanding access can bring new medical and social risks together."
Jang also emphasized that the medical safety net should be established before introducing the drugs. Jang said, "Studies show that many women who underwent abortion made the decision under pressure from family or spouses," adding, "Before expanding access to the drugs, we should first build a social safety net to support women with crisis pregnancies."