Alone in the Bathtub: Abortion Pills, Informed Consent, and What Medicine Owes Its Patients

Haile McAnally was alone in her apartment when she began to hemorrhage. She had taken abortion pills and, in her account published by EWTN News on July 18, 2026, had just enough strength to move herself from the toilet to the bathtub before losing consciousness.[^1] Her phone was across the room. "I didn't have enough strength to get up and call anybody, so I laid there," she said. A friend found her, called 911, and McAnally woke up in the hospital having received a blood transfusion. She described the experience as "horrifying for someone so young that thought that they could trust these medical professionals."

What makes her account harder to dismiss as an outlier is that she had been examined at a clinic, with nurses and a doctor present, when she took the medication. She nearly died anyway. The contrast she draws is exact: "Mailing these [abortion pills] across the country and putting them in dorm rooms and in bathrooms all around the country with no oversight is, I believe, very reckless."

McAnally is one of more than a dozen women who signed a July 8, 2026 letter asking Acting Attorney General Todd Blanche to settle an ongoing lawsuit over abortion pill safeguards, a suit brought forward by Rosalie Markezich, who states that her boyfriend at the time coerced her into taking the medication. "If mail-order abortion wasn't a thing," Markezich is quoted as saying in the letter, "I'm 100% sure I would have my child."

The oath and its original weight

The Hippocratic tradition's foundational obligation, primum non nocere, first do no harm, has historically been understood as requiring physicians to weigh the risks of any intervention against its benefit to the patient's health, orienting clinical authority toward the whole good of the person rather than toward access or throughput. That framing carries a specific claim: the physician's role is defined by the patient's welfare, and any protocol that subordinates that welfare to a policy goal, whether ideological or commercial, breaks the covenant that makes medicine trustworthy.

Catholic Christian anthropology sharpens the problem. The person is a unified body-soul whole: her physical systems cannot be managed independently of the rest of who she is.[^2] Medical decisions affecting the body carry moral weight that cannot be bracketed from questions about the patient's integral good. A drug that terminates a pregnancy also acts on a woman's physiology with acute, sometimes life-threatening force. To dispense it at a distance, without examination, without follow-up, and without a plan for the hemorrhage that McAnally and others experienced, treats the body as a site of transaction rather than as the living form of a person who deserves the physician's full attention.

How we arrived here

The structural conditions that produced this moment did not emerge overnight. The normalization of abortion as routine healthcare gradually shifted the regulatory frame from "does this drug protect the patient?" to "does this drug achieve the desired outcome?" Pharmaceutical incentives ran in the same direction: broader access meant a larger market, and the risk-benefit calculation was presented publicly as though the only risks worth weighing were those of continued pregnancy.

The mail-order dispensing model, which the FDA permitted through a series of regulatory changes, removed the one remaining checkpoint: the in-person clinical encounter at which a prescribing physician might have identified contraindications, assessed the patient's social circumstances, or been present when things went wrong.

The women in the July 8 letter ask for in-person prescription requirements for chemical abortions. That is a restatement of what informed consent has always required. Informed consent demands that patients receive complete information about risks before agreeing to a procedure or drug; a patient who receives pills in the mail cannot be said to have consented to risks she was never told about, in a setting where no one is present to manage the consequences.[^3]

Women asking medicine to return to them

McAnally signed the July 8 letter in support of Markezich's lawsuit against the FDA. The letter, co-signed by more than a dozen women harmed by abortion drugs, is precise in its moral claim: "We grieve with Rosalie because many of us recognize parts of our own stories in hers." These women are asking medicine to return to caring for them rather than processing them.

The coercion element in Markezich's case adds a dimension that the informed-consent standard alone cannot fully address. A woman pressured into taking a drug she has not freely chosen has given no real consent at all; the ethical requirement is the prior condition that the patient act freely, without coercion, and with access to alternatives. The in-person clinical encounter is, in practice, the only moment at which coercion might be identified and interrupted. Mail-order dispensing eliminates it.

The obligation of foresight

Thomas Aquinas's account of prudence holds that foresight, providentia, is one of its integral parts, and that those in positions of authority bear a particular obligation to foresee the harmful consequences of their decisions for those under their care.[^4] Regulators who removed in-person prescription requirements for mifepristone knew, or should have known, that the absence of clinical oversight would shift the burden of managing complications from the healthcare system onto the patient, alone, at home. The foreseeable consequence was Haile McAnally in a bathtub, without the strength to reach her phone.

McAnally, Markezich, and the women who signed that letter in July name an institutional failure with precision: medicine dispensed a drug known to cause hemorrhage, removed the clinical structures that could manage that hemorrhage, and called the result healthcare. Their grief is a demand. Catholic institutions, medical schools, and professional bodies that hold to a standard of care ordered toward the whole good of the patient must answer it with public advocacy for the reinstatement of the clinical oversight these women were denied. When medicine abandons the woman hemorrhaging alone in her apartment, the Church's witness to the unity of body and soul requires more than theological clarity. It requires that those with standing in the profession say, plainly and on record, that what happened to Haile McAnally must not be permitted to happen again.

References

[^1]: Celeste McGovern, "Surviving the abortion pill: Women call for safety regulations," EWTN News, July 18, 2026, https://www.ewtnnews.com/world/us/surviving-the-abortion-pill-women-call-for-safety-regulations.

[^2]: Paul C. Vitz, William Nordling, and Craig Steven Titus, A Catholic Christian Meta-Model of the Person (Steubenville, OH: Emmaus Academic, 2020), ch. 4 (on the unity of body and soul and integral human dignity).

[^3]: Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York: Oxford University Press, 2019), pp. 120–139 (on the conditions for valid informed consent, including disclosure, understanding, and voluntariness).

[^4]: Thomas Aquinas, Summa Theologiae II-II, q. 47 (on the nature of prudence) and q. 49, a. 6 (on foresight, providentia, as an integral part of prudence, including the obligation of those who govern or make decisions affecting others).