That, of course, is what makes the decision by Kathleen Sibelius, the head of Health and Human Services, to overrule the FDA on extending over-the-counter status for Plan B to girls under 17 so appallingly awful. You would have expected this outcome under George W. Bush — under Barack Obama, it is a stunning betrayal of both scientific integrity and women’s health, by a President (and I don’t buy Obama’s line about playing no part in Sibelius’s decision) who promised to champion both if Americans put him in the White House.
Medical News Today has a blistering response to Sibelius’s action. It’s one of those articles where you want to quote the whole thing, but I will content myself with the first two paragraphs, and urge you (strongly) to read the piece in its entirety:
Even though America has, by far, the highest rates of unwanted and unplanned teenage pregnancies in the developed world, and the FDA wanted to make the Morning-After-Pill, otherwise known as Plan B One-Step, available as an over-the-counter (OTC) drug to all females of reproductive age, HHS Secretary Kathleen Sebelius slapped them down and said “No”. So, the drug continues as an OTC for females aged 17 years or more, and a prescription-only one for females below 17.
The outcry is growing. Many say this is another example of politics doing things for the sake of politics, rather than responding to sound science and acting in the public good. In America, there are presidential elections next year and many niche votes to win – at times like this, politics is king, say hundreds of Americans who have been writing in with their comments.
As everyone responding to this outrage has pointed out, this is the first time in the FDA’s history that a presidential administration has overruled one of its decisions.
The smarmy defense Pres. Obama offered about Sibelius’s decision, as quoted by Alexandra Petri in the Washington Post, gives the game away:
“I will say this. … As the father of two daughters, I think it is important for us to make sure that we apply some common sense to various rules when it comes to over-the-counter medicine.
“And as I understand it, the reason Kathleen made this decision was she could not be confident that a 10-year-old or an 11-year-old, going to a drug store, should be able to, alongside bubble gum or batteries,” purchase a powerful drug to stop a pregnancy, Obama said. “I think most parents would probably feel the same way.”
So now Barack Obama and Kathleen Sibelius are the arbiters of what “most parents” would feel. Petrie, quoting this, observes (emphasis is mine):
It’s a policy decision. Whether the under-17 set is allowed access to Plan B is something the government gets to decide and that involves considerations that go beyond safety. Eleven-year-olds having sex is the canonical Extreme Example Everyone Agrees Is Wrong.
In other words, keeping Plan B prescription-only for teenagers under the age of 17 is a policy this administration has adopted that is rooted in a moral judgment about under-17-year-olds having sex. It’s not about safety at all.
Jezebel compares potential side effects of the morning after pill to five other common over-the-counter medications: Tylenol, Advil, Prilosec OTC, Benadryl, and Robitussin. All five are potentially more dangerous than Plan B. This does not mean those medications should not be sold over the counter — it’s simply “evidence that the United States trusts consumers to educate themselves and take reasonable precautions with over-the-counter medications” — something that the “FDA’s study indicated that young girls were eminently capable of doing … with Plan B,” but that “apparently Sebelius still doesn’t trust them to do. …”
In the column I quoted from above, Alexandra Petrie makes this point even more forcefully:
This [risks of misusing medication] is something Plan B shares with everything sold over the counter or in the aisles of CVS. Misuse a plunger and you could be looking at costly surgery. Misuse the Sudafed and you’re looking at jail time, or at least an AMC series. Laxatives, too, are liable to misuse — you can disguise them as candy sprinkles and bake them into cakes — and you don’t need an ID to purchase those. Name a substance, and I will name a misuse for that substance.
Here is Katha Pollitt about those “confusing” directions on the Plan B package that 11- or 12-year-olds would supposedly have trouble understanding, or would misunderstand:
Sebelius claims that her reason is that the FDA didn’t show that 11-year-old girls, some 10 percent of whom are fertile, understand how to follow the EC directions. Here are the instructions, courtesy of an alert commenter atwww.nytimes.com:
“Plan B One-Step dosage consists of a single tablet taken once. A second tablet or dose is not required. The Plan B One-Step tablet should be taken as soon as possible and not more than 72 hours (3 days) after unprotected intercourse or contraceptive failure.”
If a sixth grader can’t understand those elementary, crystal-clear instructions, we should just move back to the caves, because civilization is finished. As has been pointed out, we assume middle-schoolers can handle Tylenol, which is not only easy to overdose on but has been used in suicides. If Sebelius is really worried about what kids can purchase at Duane Reade, she should start with products that actually can be used dangerously.
Pollitt also asks Pres. Obama “who died and made [him] daddy in charge of teenage girls?” As she points out, lots of pro-choice women also have daughters, including herself — and, I’ll add, including me.