Science vs. Politics

Does President Barack Obama care more about politics than about science? This week’s debacle over the emergency contraception Plan B has several critics answering that question with a resounding “yes.” But before claiming Obama has reneged on his 2009 promise to “base our public policies on the soundest science,” a closer look at the debate is in order.

In 2009, the Food and Drug Administration ruled that women over 17 would no longer need a prescription to use Plan B, though women 16 and under would still require a prescription. In February 2011, Teva Women’s Health — who makes Plan B —petitioned the FDA to legalize the emergency contraceptive for all women of childbearing age. This resulted in a review of the drug by the FDA’s Center for Drug Evaluation and Research, which concluded that the drug was not only physically safe for use by younger women, but also that young women understood key facts about it, such as that it does not protect against sexually transmitted diseases and should not be used routinely. As a result of this report, FDA Commissioner Margaret Hamburg approved the drug for use by females under 17 without a prescription.

But on December 7, Health and Human Services Secretary Kathleen Sebelius — a member of Obama’s cabinet — overruled Hamburg’s decision, apparently the first time a cabinet member has overruled an FDA decision. Sebelius acknowledged that the drug is safe, but disagreed with the FDA’s suggestion that the drug is fully understood by all young women who would gain access to it, as the studies verifying this fact “did not contain data for all ages for which this product would be available for use,” according to the HHS press release. Obama publicly stated the next day that though he was not involved in Sebelius’ decision, he supports it.

So, in considering whether Plan B is safe for younger girls to use, all players — Obama, Sebelius and Hamburg — are on the same page. Plan B, which works in the same way as oral contraceptives by preventing ovulation and thus pregnancy, is not harmful for young women. The concern is whether they will let its legality compromise their use of other forms of birth control. Obama’s comments concerning his feelings as a father, added the moral question of whether it’s right to allow young girls access to a drug without parental or physician intervention. A 2009 study found that only 26.7 percent of pharmacy students felt confident in instructing a patient to correctly use Plan B. A 2010 study found that more work is needed in educating everyone, particularly young adults, about emergency contraception, and although other studies have yielded contradictory results, the data is clearly not conclusive in either direction. And while the CDER and the FDA felt confident in their analysis, many other countries impose similar restrictions, indicating that when the data aren’t conclusive, institutions often err on the side of the status quo.

So it seems that before throwing Obama under the bus, a little more research is in order. Isn’t that what the scientific method is about, after all?