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A bitter pill

September 06, 2005

IN ANNOUNCING HER RESIGNATION, Dr. Susan F. Wood did not resort to euphemism, those mealy-mouthed phrases about spending more time with her family or seeking new opportunities. Her e-mail broadside to friends and colleagues at the Food and Drug Administration, where she was until last Wednesday the director of the office of women's health, is but the latest documentation of the Bush administration's politicization of science.

The FDA's repeated refusal to grant over-the-counter availability to a morning-after contraceptive pill was "contrary to my core commitment to improving and advancing women's health," Wood wrote. "I can no longer serve as staff," she added, "when scientific and clinical evidence, fully evaluated and recommended for approval by the professional staff here, has been overruled."

The furor is over a drug marketed as Plan B, available in most of the United States only by prescription. The FDA's own staff and the overwhelming majority of an advisory board recommended in 2003 that it be made available over the counter, as such contraception is in most of Europe. For one thing, the drug is most effective within 24 hours of intercourse. The delay and cost of seeing a doctor to get a pill deemed safer than Tylenol are obvious barriers to its effective use. Some states, including California, have made the pills available from pharmacists, though many refuse to provide it.

Since 2003, the FDA, now headed by Bush appointee Lester M. Crawford, has hemmed, hawed and made excuses, worrying that teenage girls could misuse, or somehow abuse, the drug. One non-FDA opponent suggested that pedophiles might buy it and force it on their victims. Others charge that Plan B would reduce condom use, despite evidence to the contrary.

Then again, the administration's own sex-education advice discourages teen condom use. Even the Justice Department's medical guidelines for dealing with rape victims of any age omit discussion of emergency contraception, an established medical standard in such treatment.

The real issue is that there is a minority opinion among those who oppose abortion that morning-after contraception is itself abortion. Almost all doctors, and most laypeople, reject this equation. But this minority holds disproportionate sway in the Bush administration. And that's why Crawford, absurdly calling for more study, reneged last week on a promise to deliver a decision on Plan B by the beginning of this month.

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