Could Hillary Clinton Be Right?

The FDA has failed to approve the emergency contraceptive Plan B for over-the-counter sales despite an overwhelming vote in favor of doing so by its scientific advisory panel. Frustrated by FDA inaction, Senators Hillary Clinton (D-NY) and Patty Murray (D-WA) have placed a hold on voting to approve the appointment of Lester Crawford as FDA Commissioner. Clinton tells the Post: "the FDA has had the Plan B application for years and the American people simply need an answer, yes or no. Science should never take a back seat to politics and ideology."

Comments

[The Wine Commonsewer]

Before you assume she's right better check the back log on all the other crap that FDA has stacked up.

[David]

Science should never take a back seat to politics and ideology. She might be right with that line. Of course, I'm sure she means opposing politics and ideology, like any good politician.

[Larry A]

What goes around, comes around.

[Evan Williams]

"Science should never take a back seat to politics and ideology"

This, from the one who wants nationalized healthcare, which flies in the face of all established economic science?

I wonder if she'd be trumpeting science over politics and ideology if the scientific advisory panel had voted against it. Wait, no I don't.

[R C Dean]

Well, she's right that science should never, etc. That doesn't mean that she's sincere or honest.

[Adam]

Regardless of the rest of the backlog, she's right on this one. I find it hard to believe there's a secret cancer-fighting or cholesterol-fighting or anything-else-fighting drug that won a vote on safety with a 23 to 4 margin and then continued to be held up.

[wellfellow]

Stopped clock what?

[Girth]

Too true, Adam. I'll bet if Plan B gave old fat white men erections it would have been out long ago.

[Dan]

It is bad for science to take a back seat to ideology in matters of scientific research. It is not bad for science to take a back seat to ideology in matters of public policy. Just because something has been demonstrated to be possible -- or even demonstrated to be beneficial to individual people or groups -- doesn't mean that the government ought to do it.

Science tells us a lot of things about Plan B. It tells us that it prevents women from having to carry a fertilized egg to term. It tells us that Plan B presents no significant risk of harm to the woman who takes it.

But it also tells us that lowering the cost of an activity increases the frequency of that activity, and that therefore we can expect an increase in sexual promiscuity in general and risky (e.g., condom-free) sex in particular if emergency contraception was more widely available. This means an increase in the number of eggs that are initially fertilized before emergency contraception is taken (it also means an increase in STDs, but that's not really the main point of the debate over Plan B).

So science tells us that readily-available emergency contraception means X fewer aborted fetuses, but Y more terminations of fertilized eggs, where Y>X.

What do we do with these facts? Well, that's where ideology comes into play. If you think a fertilized egg is a person, then it's obvious that Plan B is bad. If you think a fertilized egg is not a person, then it is obvious that Plan B is good. Science can't tell you which answer is correct, because science can't tell you what a "person" is.

[Sarah]

The birth control pill works the same way; it does not prevent the fertilization of the egg, it merely prevents its attachment to the inner lining of the uterus. There is not much difference between this and the birth control pill; one is for women who plan ahead, and one is for those who haven't (or potentially have been raped).

[Evan Williams]

What do we do with these facts? Well, that's where ideology comes into play. If you think a fertilized egg is a person, then it's obvious that Plan B is bad. If you think a fertilized egg is not a person, then it is obvious that Plan B is good. Science can't tell you which answer is correct, because science can't tell you what a "person" is.

So, instead of "science" telling us which answer is correct, we have 50%+1 telling everyone else which answer is correct? Oh, boy, I sure love the "whichever ideology is more popular is the one right way" line of thought...

How about this: if you think a fertilized egg is a human, then don't take plan B. If you don't think a fertilized egg is a person, then feel free. The problem with the FDA making these decisions is that the FDA is not (or, should not be) an ideologically-charged political machine. The other problem is that the FDA is centrally controlling, which spits in the face of the obvious solution here: federalism.

[Evan Williams]

Sarah:

the folks who are against EC for moral reasons are the same ones who are against traditional birth control for moral reasons. your argument, however true, won't make them flinch, they'll just reply, "yeah, and we should also retroactively outlaw birth control pills!"

[William]

I hate Hillary even more than I hate Bill, but I have to admit shes right here. I don't really care if shes sincere or just trying to score political points, all that matters is that she wins. I'm sick of hearing conservatives whine about plan B. Its another form of birth control and it prevents the abortions they so loathe. It was their generation that took sexuality out of the box, they don't get to try to cram it back in. As for the argument about it increasing risky behavior, thats not the government's buisness. Congress should NEVER seek to protect citizens from themselves, especially when that protection abridges the rights and freedoms of far more citizens than it "helps."

Furthermore, I'm sick of this person argument. Plan B, like the pill, prevents a nonsentient clump of nonspecific cells from implanting. If you think thats a person, fine, but thats a belief unsupportable by science or reason. I fully support your right to believe it, but you don't get to legislate dogma. Even when that clump of cells becomes a "person" it doesn't matter. No one should be forced to carry a parasite. If I break into your house in the middle of the night and pass out on your couch, you don't have to make me dinner.

The FDA exists to make sure drugs are safe and effective. It doesn't exist to engage in social engineering. It doesn't exist to push morality. It doesn't exist to protect us from our choices. I'm sick to death of having people who quiver in fear of some 5000 year old father-figure myth try to tell me what I can and cannot do with my own time or my own body. If you don't like it, don't do it, but stay the hell away from my rights.

[thoreau]

Sarah-

Correct me if I'm wrong, but I always thought that contraceptive pills also prevented the ovaries from releasing eggs.

Like I said, correct me if I'm wrong.

[Don]

Expect Hillery to say more "right" things as 2008 comes closer.

The bottom line is that the leftism of MoveOn et al doesn't sell, the Clinton's know it, and they are willing to triangalize to win as "republicans lite".

[Adam]

thoreau - depends on the pill.

[SM]

"But it also tells us that lowering the cost of an activity increases the frequency of that activity, and that therefore we can expect an increase in sexual promiscuity in general and risky (e.g., condom-free) sex".

Is that whithin the purview of the FDA ? Maybe Congress can enact a "Sexual Licence And Uninhibited Tramps Steerage" Act (refered to as the SLUTS act from hereon) to ban contraceptives. But the FDA is supposed to rule on the safety and efficacy of drugs, not on it's societal ramifications.

[rst]

Just because something has been demonstrated to be possible -- or even demonstrated to be beneficial to individual people or groups -- doesn't mean that the government ought to do it.

It is not appropriate that ideology *ever* enter into a decision as to whether a drug should be available on the market to those who want to purchase it. The problem is that we're waiting for the government to do anything at all.

But it also tells us that lowering the cost of an activity increases the frequency of that activity, and that therefore we can expect an increase in sexual promiscuity in general and risky (e.g., condom-free) sex in particular if emergency contraception was more widely available.

This is not an issue for the government to concern itself with. The government is not able to protect us from ourselves and it should get out of the business of trying.

Ideology is cheap; the phenomenon is where it's at. Let the market decide.

[trainwreck]

"Economic science"????

Who are you kidding?

[Shem]

Actually Dan, that's not true. According to the Journal of the American Medical Association, Plan B doesn't have any significant effect on sexual behavior. For that matter, it didn't reduce unplaned pregnancies either, but that has little to do with the effects of the drug on society.

And I'm with trainwreck. Economics is a science in the same way psychology is a science. Both are useful, but neither one is big on scientific method.

[Dan]

Actually Dan, that's not true. According to the Journal of the American Medical Association, Plan B doesn't have any significant effect on sexual behavior

The same study also found that availability of emergency contraception had no effect on a woman's chances of becoming pregnant. So if you assume that the study is scientifically valid, then what science is telling us is that it doesn't matter if EC is made more widely available or not. So we're back deciding on ideological grounds again regardless.

But personally, I find the study's findings hard to swallow -- Plan B is not a placebo, and it isn't that hard to use either, so it is hard to see why (as the study found) women who are twice as likely to use it after unprotected sex still get pregnant just as often. I would like to see what a followup study finds (preferably one with a more representative sample -- this one studied regular visitors to family planning clinics, a category most American women don't fall into).

Economics is a science in the same way psychology is a science. Both are useful, but neither one is big on scientific method

I'm not going to defend all of economics as a science (or all of medicine, for that matter). But the basic laws of supply and demand are every bit as real and empirically demonstrable as the laws of thermodynamics, and significantly more firmly grounded than almost anything in medicine. If you lower costs without lowering demand, more people will "buy" (unless all of the demand is already being met, of course).

[crimethink]

Science should never take a back seat to politics and ideology

Science is enormously useful for understanding and predicting phenomena, for telling us that if we do X, then Y is likely to occur.

However, deciding whether we should do X depends on a value judgement -- is Y a desirable or undesirable outcome? And that judgement has to be made according to some non-scientific standard, commonly referred to as ideology when it's someone else's, or principles when it's your own.

[Dan]

How about this: if you think a fertilized egg is a human, then don't take plan B. If you don't think a fertilized egg is a person, then feel free.

That just doesn't work, Evan. If you think that a fertilized egg is a human, then "take Plan B" equates to "kill a human". So what you're proposing, from a pro-lifer's perspective, is this: "if you think that killing humans is wrong, then don't kill them. If you don't think that killing humans is wrong, then feel free to kill them". It is pretty easy to see why they don't find that suggestion very appealing, don't you think?

That's why this comes down to a matter of ideology. There is no such thing as a scientifically-demonstrable moral rule. You can't empirically prove that anything is or isn't entitled to have its life respected. All you can do is start with whatever ideological beliefs you have, and then apply scientific reasoning to those.

It is scientifically demonstrable that, if you believe fertilized eggs are human, Plan B causes the death of humans. It is also scientifically demonstrable that, if you don't believe fertilized eggs are human, Plan B prevents pregnancies without killing humans. But you can't reach any useful conclusions as to a course of action if you don't have an underlying ideology informing you of the relative values of fertilized eggs vs. reproductive choice.

[Shem]

Dan, I think either you or I am misunderstanding the findings. The impression that I got from it was not that Plan B had no real effect on conception, but rather that the location from which they got the pill (A doctor, a pharmacy or in advance) made no difference wrt their ultimate conception. Although, I admit that I have yet to give the study a great deal of attention, and so if you can point me to something that contradicts that I'll gladly reform my position.

And the rules underpining psychology are just as empirically demonstratable, but that doesn't change the fact that it's still based more or less totally on human nature, which will never really be able to provide a basis for a scientific discipline. As for the laws of supply and demand, interpreting how markets work will always be more of an art than a science, which, although not a bad thing, ought to be recognized lest people begin to get the idea that they can engineer a perfect economy. Either way the entire thing was more of an offhanded remark than anything else.

[thoreau]

Dan-

Good to have you back!

You just missed garypalooza, where Gary got banned from the forum and I got banned by accident when I spoofed him.

[Evan Williams]

Dan sayeth, "That's why this comes down to a matter of ideology. There is no such thing as a scientifically-demonstrable moral rule. You can't empirically prove that anything is or isn't entitled to have its life respected. All you can do is start with whatever ideological beliefs you have, and then apply scientific reasoning to those."

Yet, even "scientific reasoning" cannot pinpoint the definition of "human", since attempting to define ourselves as sentient beings deserving of human rights is essentially an ideological process. Yes, you use scientific reasoning to define certain factors which you use for your ultimate decision, but, you are correct that science cannot craft ideology. Science is ideally universal, ideology is not. How do we reconcile varying ideologies with regard to when life begins? Ah, the F-word! Federalism. It's either that, or, um, majoritarianism (IOW, if 50%+1 people in this country decide that human life begins when the ejaculate leaves the penis, then everyone must abide). It's obvious that we're not going to come to an agreement on this, and that's why Roe v Wade should be overturned, and the states or localities should decide.

The problem is, most of the folks who want RvW overturned, outside of libertarians, would like to see the reverse of RvW (where the federal government outlaws abortion), not a federalist approach. Even if they live in Texas, they want control over reproductive rights of folks in Vermont. Both approaches are the worst ways with which to deal with this clash of ideologies.

[ed]

A couple of things, first

Expect Hillery to say more "right" things as 2008 comes closer.

The bottom line is that the leftism of MoveOn et al doesn't sell, the Clinton's know it, and they are willing to triangalize to win as "republicans lite".

how does this apply given that her postition here is a liberal one?

Second,

But it also tells us that lowering the cost of an activity increases the frequency of that activity, and that therefore we can expect an increase in sexual promiscuity in general and risky (e.g., condom-free) sex in particular if emergency contraception was more widely available.

If you've had any experience with Plan B then you would know what a load of crap that is. There is nothing easy about these pills, it's a painful hormonal experience that doesn't rate high on a lot of peoples to-do lists.

[Dan]

The impression that I got from it was not that Plan B had no real effect on conception, but rather that the location from which they got the pill (A doctor, a pharmacy or in advance) made no difference wrt their ultimate conception.

Well, the study definitely found that the advance provision group used EC more often and got pregnant just as often as the control group. The abstract of the study is here.

And the rules underpining psychology are just as empirically demonstratable, but that doesn't change the fact that it's still based more or less totally on human nature, which will never really be able to provide a basis for a scientific discipline.

Unless you're arguing for the existance of some metaphysical component to human nature such as a soul, "human nature" is nothing more than the product of the interaction of human biology with its environment. If that can't form the basis for a science, then medicine cannot be a science either.

I think you're holding economics and psychology to a different standard than you're holding medicine to. All of the techniques and drugs used by medicine are used for the same reason: because experience has shown that they are, on average, effective. But there isn't a doctor alive who can honestly tell you "if you take this drug, or have this operation, you are guaranteed to get better". All they can say is that most people improve.

So yeah, economics can't predict what a given human being will choose to do or buy. But it can damned well predict that if you cut the price of something lots of people want, you'll get more sales. Can it predict who those sales will be to? No, just as medicine can't predict exactly which of the millions of smokers will die of cancer.

[Dan]

You just missed garypalooza

Actually, no, I saw that. I still read Hit&Run (and the forums sometimes), I just don't post much.

[Shem]

Well, the study definitely found that the advance provision group used EC more often and got pregnant
just as often as the control group.

I stand corrected.

And, for the record, I wouldn't (nor did I) say medicine is a science either. Doctors are really little more than mechanics. "If part of the body is not functioning, then this action ought to fix it, even though I have no objective proof that it will." That's not science.