On Wednesday, Health and Human Services Secretary Kathleen Sebelius overruled an expert panel at the FDA which had recommended allowing children under 17 to purchase the “morning after pill” Plan B One-Step over the counter. Under current regulations, Plan B is available without a prescription to people 17 and over, but those 16 and under would need a prescription in order to purchase it. The pill is designed to be taken within 72 hours after having “unprotected” sex and is claimed to reduce the chances of pregnancy from such sex from 1 in 20 to 1 in 40. It does this by preventing ovulation through a boost in hormones. Like other forms of hormonal birth control, it also serves to make the uterine lining more resistant to implantation by a fertilized egg, so even if ovulation does occur (or has already done so) it can make spontaneous miscarriage/abortion of the zygote far more likely. As such, it is often considered potentially a form of early abortion, though the frequency with which it acts through preventing a zygote from implanting (versus acting through preventing ovulation) is not known.
In prior policy moves in relation to Plan B, the Bush Administration had originally overruled a request that the pill be made available over the counter, but eventually allowed it for purchasers who were 18 or over. The Obama administration acted in 2009 to make Plan B available to those 17 and over, but until now has continued to require a prescription for those young. This means that the pill (which costs around $50 per dose) is generally held behind the pharmacy counter and provided without a presciption to those who show ID proving they are 17 or over.
This latest move on Plan B has many left leaning commentators up in arms, accusing the Obama Administration of ignoring ‘science’ and bowing to the interests of the religious right. James Fallows at The Atlantic compares the move to something one would expect from a Michelle Bachman administration and suggests Sebelius and Obama should be criticized accordingly. The New York Times says:
“Very few medications are this simple, convenient and safe,” said Dr. Kathleen Hill-Besinque, an assistant dean at the University of Southern California School of Pharmacy.
Jeanne Monahan of the Family Research Council, a conservative advocacy group, said that making Plan B available to young women without a prescription would mean fewer chances that doctors would be able to save them from sexual exploitation, abuse and related diseases. “Secretary Kathleen Sebelius was right to reject the F.D.A. recommendation to make this potent drug available over the counter to young girls,” she said.
Kirsten Moore, president of the Reproductive Health Technologies Project, said Ms. Sebelius had no credible scientific rationale for her decision. “We are outraged that this administration has let politics trump science,” she said.
It’s probably inevitable that people will ask whether pro-lifers should consider this an olive branch from the Obama administration, though this seems hard to credit given Obama and Sebelius’ hard line support of abortion in all circumstances and the recent moves by Sebelius’ DHHS to punish the Catholic bishops for political support for moral causes by defunding Catholic run charitable programs.
The far more likely explanation is that this represents a basic political and cultural calculus on the part of the Obama administration as it nears reelection season. While on the cultural hard left, the only question may be a scientific one of whether Plan B will work as intended on children and young teens, for much of the country situations in which young teens would think they need to take Plan B have a moral dimension as well as a scientific one. While in some sectors of our society there is an almost magical belief that “birth control and abortion make anything better” (I actually read commenters on some articles suggesting this was a bad decision because it might force a 11 or 12 year old girl being sexually abused to have to talk to an adult about the fact she feared she needed Plan B, rather than being able to purchase it without trouble) a lot of people would react against Obama if Republicans were able to claim, “Obama wants your twelve year old daughter to be able to buy the Morning After Pill without talking to you or a doctor!” While most Americans are fine with birth control and probably accept as a given that their teens will eventually have sex outside of marriage, the idea of the government actively making it easier for their children to pursue birth control and abortions without talking to their parents is not widely popular among those parents.
As such, this can be seen as some mainstream positioning by the Obama administration. The cultural far left, after all, has no where else to turn to. Obama is reaching for the cultural center. If he wins, this decision may well get reconsidered in 2013.
“If he wins, this decision may well get reconsidered in 2013.”
We can bank on that! The reaction of the Left is interesting as they completely miss the moral element involved here, which is intriguing as no group in our society uses more morally drenched argument, at least rhetorically, than the Left, except in one area, sex. If sex can be brought into the picture all moral arguments are to be banished to the nether regions. This is the one area of life where moral calculus seems to completely dissipate, unless it can be dressed up as sexual harassment, and even there the moral aspect flies right out the window if he harasser, Bill Clinton is the prime example, is a powerful Democrat elected official who is a pro-abort. I recall Alexandra Kollantai, a Bolshevik contemporary of Lenin thought that under the Bolshevik regime sex would have no more moral significance than drinking a glass of water. Lenin, even though he had a mistress earlier in his life, was shocked and Communist official morality in regard to sex was fairly straight-laced, but the view of Kollantai has ultimately triumphed on the Left.
This analysis sounds about right. Obama has to know that no decision on his part is going to garner a vote from social conservatives already opposed to him. A politically-calculated appeal to moderates makes much more sense.
Four moral concerns are brought up.
1. Contraception is immoral. This point isn’t within the realm of science so it’s not anti-science. However, only a small minority (very conservative Catholics) actually take this view. This doesn’t explain why Protestants would want to restrict access to Plan B.
2. It may prevent implantation. This is a legitimate concern though, since it isn’t intended to prevent implantation, one may not be morally culpable for abortion. If contraception is morally permissible and it isn’t used as a method of abortion, though abortion may unintentionally result, Plan B is morally permissible. This is probably the view of most Americans including religious Protestants.
3. It encourages promiscuity. Empirical data says otherwise. This is part of the “anti-science” criticism.
4. Parental rights. What right is being infringed? The right to deny medical treatment for your children? If none of the previous points apply, why would you want to deny it for your children? It would be completely irrational.
Basically, if you aren’t Catholic, opposition is probably irrational or anti-science.
RR if you are ever around Pontiac, Illinois, I could introduce you to the staff and volunteers, all evangelical women, at the crisis pregnancy center that I have the honor of serving as chairman of the board. They would explain to you that they are neither irrational or anti-science and that they oppose this human pesticide. When you have kids, my daughter is 16, perhaps you will understand why most parents would not want anyone dispensing either abortifacients or contraceptives to them behind their back.
RR,
2) Actually, Plan B is intended prevent implantation. That is an effect which the makers seek to achieve and specifically describe as a purpose of the medication, as the NY Times article describes. I’m not clear how often it happens, as (as the NY Times article also notes) studies have not shown Plan B to actually reduce either pregnancy rates or abortion rates to any measurable degree. So although in controlled test environments it does reduce the chance of pregnancy, when you actually throw it out there into the realm of real human behavior it appears that if it’s being taken by the right people at the right time, it’s happening infrequently enough that it’s now showing up clearly in the final data. But preventing implantation is an intended and advertised effect of the drug, however infrequent.
3) I’m not clear where you get the idea that increased promiscuity is a claim. Certainly, there has been a significant increase in promiscuity in coordination with the wide availability of birth control in general, but I am not aware of anyone (certainly not the Department of Health and Human Services) making the claim that Plan B in particular measurably increased promiscuity in a way distinct from other forms of birth control.
4) This is where your argument simply doesn’t make any sense. The purpose of requiring a prescription for a medication is simply to get a responsible expert or adult involved in the dispensing of the medication, it’s not necessarily to “deny treatment”. The DHHS ruling did not say that children under 17 cannot be given Plan B at all, it said that they can’t buy it without a prescription. In many states, it’s legal for a pharmacist to write a prescription right there. In other cases, a doctor would have to be consulted, or the minor would have to get someone 17 or older to go buy the prescription for them. That’s a pretty low hurdle. Sebelius’ stated rationale was that the studies conducted did not satisfy her that the medication was safe for girls as young as 11, and that girls that young could be relied on to use it safely. Also operative, however, I think, is that most Americans would simply be much more comfortable with a doctor, parent, or other adult being pulled in to a situation in which a girl that young (in many cases, under the legal age of consent) is given a medicine which is only needed once she has already had sex under conditions which may suggest poor judgement or abuse. There’s certainly nothing irrational (even from a strictly secular and pro-birth-control point of view) in not liking the idea of actively helping to cover up the kind of situations that would lead to very young teens wanting to get hold of the Morning After Pill.
“This is a legitimate concern though, since it isn’t intended to prevent implantation, one may not be morally culpable for abortion.”
Aside from the question of whether it prevents implantation or not, one would be morally culpable if it does and one does not intend the abortion. Just as someone who sets fire to a building to get the insurance money is culpable for murder if he knows someone is in the building when he sets fire to it.
Perhaps there would be mitigation of the moral culpability due to the person being ignorant of the full effects of Plan B (if it is indeed also an abortifacient) but the material aspect of the sin would remain.
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I completely agree with DarwinCatholic– if (God between us and evil) Obama is
re-elected, this decision will be reversed. It’s merely a sop to the center, and costs
the administration nothing politically. Freed from the need to give lip service to
any voters, a re-elected Obama would probably try to have Plan-B One Step passed
out in elementary schools.