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This week Health and Human Services Secretary Kathleen Sebelius overruled the FDA's recommendation to allow girls under 16 access to emergency contraception without a prescription.
This week Health and Human Services Secretary Kathleen Sebelius overruled the FDA's recommendation to allow girls under 16 access to emergency contraception without a prescription. Mark Wilson/Getty Images
Douglas Kamerow is a family physician and former assistant surgeon general.
This is not complicated. The Obama administration overruled its own Food and Drug Administration for political reasons, to make life easier in the coming campaign. It is a bitter disappointment for those, including me, who condemned the George W. Bush administration for its interference with science on this issue and others, ranging from the effectiveness of abstinence-only sex education to the health hazards of climate change. We were heartened when President Obama said in 2009 that this tampering with scientific evidence would stop.
And whether Health and Human Services Secretary Sebelius acted on orders from the White House or on her own to stop Plan B is irrelevant. She is a former Democratic governor of a very conservative state (Kansas), and she knew what had to be done.
It is worth noting, of course, that this was unprecedented public theater, with dueling press releases by HHS and FDA. I can't recall a prior case of such a public disagreement between the department and the FDA commissioner. Kudos to Dr. Peggy Hamburg for standing up to her bosses.
However, let's put politics aside, if that's possible, and be clear what this issue is, and has always been, about.
It is not about abortion. According to all medical definitions, there is no fetus to abort here, folks. We're talking about the first three days after intercourse. Lots of sperm and maybe an egg. Pregnancy is being prevented, not terminated.
It is not about whether Plan B works. It is proven to decrease the risk of pregnancy if taken soon after unprotected sex.
It is not about safety. Plan B is very safe and, of course, way safer than pregnancy.
It is not about whether 11- or 12-year-olds can understand what the medicine can and cannot do. Likely, some can and some can't. We don't hold any other over-the-counter medicine to that age-related standard.
It is not about encouraging promiscuity. There is no evidence that young women have more premarital unprotected sex because they know they can just hop on down to the drugstore the next morning, plop down their money, and pick up a Plan B pill.
Finally, it is not about family values. No one wants his daughter to have unprotected intercourse when she doesn't want to get pregnant. No one wants his daughter to do this without discussing it with him. And no one wants his daughter to lack a trusted doctor to consult in such a situation. But all of these things happen. Every day.
This medicine, and the over-the-counter policy that was rejected, are for young women who have unprotected sex and need to do something about it on their own.
I was in clinic when the news of this decision came out. The doctors there care for pregnant women as young as 11 or 12. To them the answer was clear. This issue is about the 12-year-old girl (and I say "girl" advisedly here) who delivered an unwanted baby last month.
Which would have been safer: Plan B or an unwanted pregnancy? Which would have been less damaging, in every sense of the word?
If you are old enough to get pregnant, or to get someone pregnant, you are old enough to have unrestricted access to emergency contraceptives like Plan B.