More Thoughts on Plan B

The controversy continues surrounding Secretary of Health and Human Services Kathleen Sebelius’s decision not to make Plan B, the morning after pill, available to girls under the age of seventeen without a prescription. As I noted last week, critics of the decision espouse a new religion, scientism, and believe that anything the high priests of the laboratory conclude is safe and effective must be just fine.

But, even on their own terms, the advocates of scientism hold a shockingly weak hand. As Sr. Carol Keehan, head of the Catholic Health Association, noted in her statement on Sebelius’ decision: “CHA has great respect for the FDA, but there are no significant studies in 11 to 13-year olds over a long period of time that have demonstrated the safety of this very significant drug. We do not want to learn in 10 to 20 years about this drug what we now know about hormone replacement therapy and its connection to breast cancer.” That’s right. Hormone replacement therapy was once the rage, backed by science, and guaranteed by the FDA to be completely safe. Except it wasn’t. Short-term trials did not reveal what long term use revealed, namely, that hormone replacement theory increased the incidence of breast cancer. As Rick Perry would say, “Oops.”

It would have been one thing if Sebelius’s detractors raised a different argument. It would be different if they said, “Why not make this drug available to sixteen year olds?” Instead, they pick an admittedly definable, and scientifically significant, line of demarcation – child-bearing age – and invest it with significance it does not have. Surely, there are scientific studies in the area of child psychology that would show there are important cognitive and emotional differences between a twelve year old and a sixteen year old? Does that science not matter? Or do conclusions that are obvious to anyone who has spent time with teenagers not matter because they are not the kind of thing tested in a lab?

In an article in yesterday’s Washington Post Outlook section Susan F. Wood, a former assistant commissioner at the FDA, and one of the loudest critics of Sebelius’s decision, contradicts Sr. Carol and Sebelius on the lack of data regarding the use of Plan B by youngsters. The key paragraph of Wood’s argument is worth quoting in toto:

Yet this type of age restriction, and worries about the use of medicines by teenagers, have not been applied to other products. Apparently there is no problem in allowing younger teens to purchase products such as acetaminophen, and others with known and serious risks, over the counter. There are no age restrictions for condoms, spermicides or treatments for yeast infections, either. Indeed, for no other over-the-counter medication has the FDA ever required extra data for a particular age group. (This extra data on younger teenagers was provided to the FDA in the latest application by the company.)

Let’s parse this. Because previous decisions have allowed risky drugs to be sold over-the-counter, all risky drugs should be sold over the counter. Huh? Besides, acetaminophen helps deal with pain which may, or may not, have been caused by an incident with psychological significance. Pregnancy obviously is not a headache. Wood notes that condoms are not age restricted, which is true. I wonder if a twelve year old understand that not all birth control is like all other birth control? For example, a condom might help prevent a sexually transmitted disease, something Plan B does not do. But, how would a twelve year old, who may have seen an ad on TV for Plan B, know that the pill doesn’t prevent transmission of the AIDS virus?

The clincher however is in the parentheses. Wood notes that “This extra data on younger teenagers was provided to the FDA in the latest application by the company.” That would be the company that makes the drug. Oh, the company chieftains who made that data available, and who sign the paychecks of the company’s scientists and lab technicians, they must be disinterested observers on the subject. And, to be sure, some of those scientists at the FDA may be thinking of going to work at a giant pharmaceutical company in the future too. When science meets politics, no one is pristine.

Sr. Mary Ann Walsh of the USCCB, in her blog post on the subject, concludes:

After she announced her veto Sebelius was criticized for making a political decision which might please the Catholic vote. This decision would be more apt to please the parent and grandparent vote. People with pre-adolescent and adolescent children probably hope their offspring are not sexually active. They certainly hope they aren’t secretly self-medicating with anything as serious as Plan B.

I am sure there are instances in which, because of incest or other familial problems, a child might want to keep the fact that they have become sexually active a “secret.” I also know that we have age of consent laws that are based on the correct assumption that a child is not in a position to consent to sex and we charge those who have sex with children with statutory rape. I wonder if any of the studies Wood cites, or which the company produced, examined this question: Would allowing a child who has been raped, who may well feel ashamed even though she has nothing about which to be ashamed, to secretly self-medicate not be a pedophiles dream? “Here little girl – take this.” The requirement that a child get a prescription for Plan B may delay the use, and therefore the effectiveness, of the drug. Let’s stipulate that. But, it also makes the intervention of an adult imperative. And that adult can ask important questions: What happened? Why did you engage in sex? Have you thought about the consequences? Were you forced to do this? I am no scientist, but it is my understanding that science proceeds by asking difficult questions.

I hope the White House conducts some polling on this issue. For several days now, the liberal blogosphere and the editorial pages of left-leaning publications have been beating up on Sebelius and President Obama over this decision. Women’s advocacy groups are in high dudgeon. But, my hunch is that all that sound and fury does not carry over outside the Beltway. I suspect most people would agree with the President’s common sense approach, as a parent, to this issue. As one person wrote in a letter to the editor of the Post, “As a feminist, I was disappointed to read of the decision by the Department of Health and Human Services not to allow emergency contraception over the counter for minors [“Wider access to Plan B is rejected,” Dec. 8]. But my parental instincts kicked in when I read that advocates thought the morning- after pill should be available to girls as young as 11. I have a pretty mature sixth-grader, but I know that if she were to need Plan B tomorrow, it would be because she was raped. I’m no prude, but I think activists are shooting themselves in the foot when they advocate for sexual freedom for 11-year-olds. From what I observe, 11-year-old girls want to steer clear of boys — whom they view as immature, gross and disruptive.”

White House political alert: The advocates who make their living by advocating orthodoxy on any given issue do not reflect the broad center of the electorate. They dominate the blogs not the swing states. Remember this when you consider other issues like the need to broaden conscience exemptions. Common sense is still the guiding star for most Americans, not the rantings of a few advocates whose biases are as obvious as the fact that, well, twelve year olds should need an adult to get Plan B.

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