Food, Drugs, and Promiscuity

Nearly two years after Barr Pharmaceuticals first asked the FDA for permission to put emergency contraception over the counter, here's where we stand:

The Food and Drug Administration delayed for 60 days a decision on whether to allow nonprescription sales of the emergency contraceptive pill known as Plan B, FDA Commissioner Lester Crawford said Friday…Crawford said public comments will be sought in the next 60 days, and didn't know how long after that a decision would be announced.

From Wikipedia:

Emergency contraception is available without prescription in the following 41 countries: Albania, Australia, Belgium, Benin, Cameroon, Canada, China, Congo, Denmark, Estonia, Finland, France, French Polynesia, Gabon, Ghana, Guinea-Conakry, Iceland, India, Israel, Ivory Coast, Jamaica, Latvia, Lithuania, Madagascar, Mali, Mauritania, Mauritius, Morocco, Netherlands, New Zealand, Norway, Portugal, Senegal, South Africa, Sri Lanka, Sweden, Switzerland, Togo, Tunisia, Turkey and the United Kingdom.

Back in January, Reason's Ron Bailey called out the FDA's War on Promiscuity here.

Comments

[MerckRep]

Why bother with FDA approval?

Not like it protects the public from harm nor the pharmaceutical from liability.

[Rich Ard]

Call for public comments? Isn't the idea to protect us from those substances too dangerous for us to be trusted with?

[sigh]

[SR]

Someone needs to kick Lester Crawford in the crotch until he passes out for saying stupid things like this in response to a question about whether there could just be an ID requirement:

FDA Commissioner Lester Crawford said the agency "cannot have an inspector in every pharmacy."

[jc]

At this point it might be wiser to see a list of countries that don't sell emergency contraception without a prescription or at all. Then maybe we'll be embarassed by the company we seem to be keeping.

[MP]

I think it is a mistake for Reason to utilize the international consensus argument here, while railing against it in the Kyoto debate. The argument for Plan B can be made on grounds much more sustainable than "see, everyone else is doing it!".

[Phillip Conti]

There are lots of substances that the public cannot be trusted with, that is why there is the black market.

[anon]

Isn't it the case that Plan B is not a contraceptive, but actually used soon after conception to terminate a pregnancy?

[Jennifer]

Portugal outlaws abortion, yet still allows the emergency contraceptive.

[joe]

anon,

Plan B stops a fertilized egg from implanting itself in the uterine wall, and may cause an early (like, within a couple weeks of fertilization) embryo that has implanted to be sloughed off.

[Jennifer]

Funny thing--a couple of weekends ago I was at a book fair, and one thing I found there was the "1923 Time Capsule," a collection of articles reprinted from TIME Magazine issues from 1923. There were articles discussing the fact that birth control information was still strictly prohibited in the United States, and many people in the US, including members of Congress, opposed letting people learn about birth control because, they said, the fear of pregnancy was the only thing that prevented people from engaging in promiscuity.

Eighty-two years later, and not a hell of a lot of progress has been made.

[Robert Goodman]

There's a fairly simple way around the FDA on this, state by state. Simply have your state expand the manner or type of prescriptions to be honored by the pharmacy for the drug in question. For instance, California does it by having gynecologists file standing prescriptions, the name of the patient to be filled in by the pharmacist.

[crimethink]

The majority of people opposed to Plan B are not opposed to it because it might encourage promiscuity. They are opposed to it because it can, as joe states, destroy an already-conceived embryo.

Ron Bailey's attempt to paint Plan B opponents with the "promiscuity" broad brush was one of the most dishonest articles I've ever seen here. I could just as easily "prove", by being selective with the sources I quote, that pro-choice people think abortion is a wonderful thing.

[crimethink]

Here's the link to the comments section on the Bailey article:

http://www.reason.com/hitandrun/2005/01/new_at_reason_364.shtml#comments

[Jennifer]

Crimethink-

In many articles I've read, not just this one, one of the main arguments against Plan B was that it would encourage teenagers to run out and have sex.

[kanabiis]

Boobies and enlarged penis' cause teenagers to run out and have sex, even if thier puritan parents are't smart enough to assist them in birth control. A smart society attempts to give thier kids any means they can to prevent a costly mistake from some night out in the car in a dark alley, or after too many drinks at the prom.

Why is American society so sexualy inept that they cant get it through thier think heads that KIDS HAVE SEX.

Well so do adults, which leads to my other point. Stop punishing adults for what kids might do with adult toys.

Shesh.

[Hakluyt]

crimethink,

The majority of people opposed to Plan B are not opposed to it because it might encourage promiscuity.

Right! You nanny-staters have been all about controlling people's sexual behaviors for thousands of years; now it suddenly has nothing to do with that at. Sure. 🙂

Note that I expect that you'll soon be finding a picture of yourself next to the definition of disingenuous in the dictionary.

[ATR]

One the arguments often made against putting Plan B over the counter is that then women won't bother to use any form of birth control. This might be the case for a percentage of people, but many of them would have been irresponsible anyone. Frankly, any woman I've known who has had to result to Plan B reports its' not the most comfortable experience in the world, and is thus more inclined to be careful

[Kerry Howley]

Joe and Anon,

Plan B prevents implantation. It has no effect whatsoever after that point.

[Phil]

Jennifer: Much as the Christian Right opposes the HPV vaccine, which could save the lives of 4,000 women a year but which they oppose because sex that doesn't carry the risk of fatal cancer might encourage kids to lose their virginity.

[Jennifer]

Phil-
I'm not surprised at all. Better to let kids die than let them do things I disapprove of, is the basic attitude.

Incidentally, I typed the phrases "Plan B" and "promiscuity" into Google news, to see what came up. Crimethink would say it's purely coincidence, that so many of those who oppose Plan B also support abstinence-only sex ed.

[Jennifer]

Phil, again--

I loved that one line in the article you linked to--"honor killing on the installment plan."

[Hakluyt]

Jennifer,

Recall that the Catholic Church went apeshit over the development of a syphilis vaccine.

[Jennifer]

Phil, again--

I loved that one line in the article you linked to--"honor killing on the installment plan."

[thoreau]

Somebody correct me if I'm wrong, but I thought that Plan B also inhibits ovulation (if it hasn't happened yet) by starting the cycle all over.

[smacky]

thoreau,

I'm not sure if it inhibits ovulation or not, but if a woman takes it she will typically get two periods in the span of what would normally be one period per month. (So she'd be bleeding a total of about half a month for one month).
A literal pain in the ass.
I can't believe that this is still an issue.

[thoreau]

I think crimethink's point is that one can raise objections other than alleged promotion of promiscuity.

The problem, of course, is that the objection raised is the destruction of a fertilized egg/embryo/fetus/unborn child/unborn angle/insert-preferred-term-here.

And we all know the cans of worms you get when that objection is raised....

[crimethink]

Crimethink would say it's purely coincidence, that so many of those who oppose Plan B also support abstinence-only sex ed.

correlation <> causation

Most who support Plan B's availability oppose school prayer, but that doesn't mean they oppose Plan B because they oppose school prayer...

[crimethink]

make that ...doesn't mean they support Plan B...

[crimethink]

thoreau,

You're right, and I understand not wanting to open up the discussion of the beginnings of life over and over again. But Bailey's attempt to sweep it under the rug, by concentrating on the silly arguments of some opponents of Plan B, is no better than the hawks portrayal of those who oppose(d) the Iraq war as sissy pacifists.

[zach]

i don't really care what underlying motives people may have for trying to restrict the availability of Plan B. it's their arguments i'm concerned with. if you argue that access to Plan B must be restricted because it would promote promiscuity, then i'll laugh in your face. but if you present any other, more rational, arguments, they don't deserve any more or less consideration simply because of what your "true motives" might be.

[Jennifer]

Most who support Plan B's availability oppose school prayer, but that doesn't mean they oppose Plan B because they oppose school prayer..

So you're seriously arguing that the anti-sex stance of the abstinence-only sex ed people has nothing to do with their opposition to Plan B?

[Brian Courts]

I'm not sure why so many of you are so sure about how Plan B works since from what I've heard even the medical community is not sure. From the FDA website:

Plan B acts primarily by stopping the release of an egg from the ovary (ovulation). It may prevent the union of sperm and egg (fertilization). If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation). If a fertilized egg is implanted prior to taking Plan B, Plan B will not work.

But all that is really beside the point. Even if it only worked by preventing implantation how would that fact help the argument against Plan B being available OTC? After all, abortion is legal - so if that is your real complaint you would need to change that before this argument will make any sense. Whatever the mechanism, the pill is effective in rendering a woman non-pregnant and it is clearly safe by any reasonable standard of safety. It works and it's safe; end of story as far as the FDA should be concerned.

[crimethink]

Brian Courts,

It's not safe for the embryo trying to implant.

[crimethink]

Jennifer,

Even considering the evidence you presented via your google search, that is not an impossibility. What I'm saying is, just because people who hold one particular belief tend to hold another one, doesn't mean that one is the cause of the other. Which is what Bailey and the titler of this threat seek to imply.

[Brian Courts]

crimethink,

I believe I addressed that:

After all, abortion is legal - so if that is your real complaint you would need to change that before this argument will make any sense.

I can understand your belief about life, but that is not what the FDA is charged with deciding. The law, as it stands now, clearly gives the woman the right to terminate a pregnancy at that point. So given that it is none of the FDA's business how she chooses to do it; only whether it is safe and effective, for the mother.

[Col DuBois]

Are you threatening me???!!!!

[ChicagoTom]

even if some of the people who oppose plan B ONLY oppose it because they view it as a type of abortion, than the reality is that they are opposed to abortion, not plan B. But abortion is legal so why should that line of argument even be addressed in a discussion of whether or not Plan B should be OTC ?

[crimethink]

Brian Courts,

Thallydomide was safe and effective for the mother, but for some reason the FDA hasn't yet approved it.

[Brian Courts]

crimethink,

Do you have a relevant point to make?

[crimethink]

Perhaps I left too much unsaid -- the FDA generally does concern itself with a drug's effect on the unborn life in the womb of a pregnant woman, despite its lack of legal personhood. EG, thallydomide.

[ChicagoTom]

I know Im preaching to the choir about this, but isn't the FDAs only job to regulate the safety and distribution of drugs and not to worry about how said drugs will effect the morals of the users?

I mean, is it safe for a patient to use OTC or not? Why should the FDA even consider the whole "will it lead to more sex" or "will it be a primary form of contraception" questions? Shouldn't they really be ignoring those lines of argument for or against?

[thoreau]

Let me ask you this, crimethink:

Suppose, hypothetically, that the ONLY mechanism of Plan B was to prevent fertilization of an unfertilized egg. It didn't do anything to interfere with already-fertilized eggs/embryos/fetuses/unborn children/unborn angels/insert-preferred-term-here.

Let's also presume that there are no "unacceptable" side effects to the woman taking it. ("Unacceptable" can have however high or low a threshold one would like, so you can just assume that safety issues have been addressed to your satisfaction.)

What would you say then?

[crimethink]

And before you say that's different because in this case the mother is obviously not concerned about the embryo's safety, I don't think that pregnant women who want to have a flipper baby are allowed to use thallydomide, either.

[crimethink]

thoreau,

That's easy; I would have no problem with it being available then. Of course, I would still consider its use immoral, but that doesn't necessarily mean it must be illegal, because its use wouldn't violate anyone's rights.

[Brian Courts]

crimethink,

The inconvenient fact that you keep avoiding is that, notwithstanding your disapproval, abortion is legal. The FDA has no authority to ban abortion. Any argument that rests on your view that abortion should be illegal, at least as far as the FDA is concerned, is irrelevant.

[ChicagoTom]

crimethink,

I don't see how your references to thalidomide are relevant to the discussion at hand. In the case of thalidomide the unborn life being hurt was an uninteded consequence of taking the drug, with "Plan B", what it does to the "unborn life in the womb" is exactly the consequence that was intended. The drug does what it says it does. Thalidomide did not in fact do what it was supposed to do (it damaged fetuses when it was billed as safe for pregnant moms)

[Randolph Carter]

If the FDA won't approve Plan B because it might lead to more sex, then how can the government allow "Horny Goat Weed" to be sold in every damn gas station on the road?

[zach]

the main issue still is that the drug does what it's supposed to do with few unintended effects for the user. in my mind, if a drug comes out with the sole purpose of killing oneself, and has a low incidence of unintended effects (such as failing but paralyzing you for life), then it ought to be approved for use in suicide by the FDA. so using this standard, in the case of Plan B, the negative effect of the death of the embryo wouldn't be relevant, because it also happens to be the intended effect. unfortunately, the FDA doesn't conduct itself in such a logically consistent manner.

[thoreau]

Alright, we've gotten to the heart of crimethink's objection, as I thought. He's not making the promiscuity argument as a basis for banning something.

As to the objection that he DOES raise? Well, I'm not dumb enough to open that can of worms.

[thoreau]

FWIW, I know we all love to argue, but I doubt that anybody here will change crimethink's mind on the matter, or that crimethink will change anybody else's minds on the matter. The subject of fertilized eggs/embryos/fetuses/unborn children/unborn angels/insert-preferred-term-here seems to be one where most minds are firmly made up.

Oh, and in honor of crimethink, I will continue to include "unborn angel" on my list of possible names for the controversial subject in question. ;->

[crimethink]

thoreau, unborn angel doesn't advertise! 😉

And, tbh, it was Tim Cavanaugh who coined that particular phrase, though my involvement with it later on may have made it memorable.

[thoreau]

crimethink, the history of mathematics is full of things that got named after textbook authors rather than the people who first discovered them. In physics there's a phenomenon (Poisson's spot) named after the guy who said it was impossible.

unborn angel will always be associated with you.

[zach]

The subject of fertilized eggs/embryos/fetuses/unborn children/unborn angels/insert-preferred-term-here seems to be one where most minds are firmly made up.

it is funny how that works, since there's so much confusion surrounding these things. which is why i'm firmly pro-choice. 😉

[Hakluyt]

He's not making the promiscuity argument as a basis for banning something.

Which has nothing to do with his argument that the main objection of most of the nanny-staters concerns fertilized eggs, etc.

crimethink,

Your thalidomide (note the proper spelling) analogy is inapposite.

Jennifer,

Remember that the Catholic Church didn't abjure the inquisition until the 19th century. We'll be dragging these thugs and barbarians into modernity for quite some time to come.

[Phil]

It's not safe for the embryo trying to implant

"Trying?" Er . . . Objection! Assumes facts not in evidence.

[Jennifer]

if a woman takes it she will typically get two periods in the span of what would normally be one period per month. (So she'd be bleeding a total of about half a month for one month).

Half a month? Eeeeeeew. If anything, it sounds to me like Plan B would discourage promiscuity.

[smacky]

Jennifer,

Exactly.

[joe]

Kerry, Brian, I stand corrected. Thank you.

[joe]

thoreau saw Brain Candy!

[thoreau]

Huh?

[joe]

The Kids in the Hall movie. I believe they coined the phrase "flipper babies."

[thoreau]

I never said "flipper babies." I think that was crimethink. And I've never seen the movie.