Should the ‘Morning After’ Pill Be Available to All Ages?
The idea of handing them out to 10 and 11 year olds with no questions asked seems callous and unfeeling.
January 26, 2012 - 12:00 am
Although man is a political animal, most doctors like to believe that they are not primarily motivated by politics. But the difficulty, or impossibility, of avoiding politics altogether was illustrated by a recent editorial in the New England Journal of Medicine about the decision of Health and Human Services Secretary Kathleen Sebelius not to allow the over-the-counter sale of the morning-after contraceptive pill to women and girls of all ages, only to those over 17 years. Girls under that age will need a prescription.
This was against the recommendation of the FDA’s committee that the contraceptive should be available over-the-counter to everyone of whatever age, with no questions asked. The editorial accused the secretary of playing politics and of disregarding science.
That the secretary was making a political decision is certain; what is not certain is that she or anyone else could make a non-political decision, for facts do not compel policies as if, once enunciated, there was no choice to be made — though, of course, facts (one may hope) do affect policy decisions.
“First, the facts,” says the editorial magisterially, if a little condescendingly, as if bringing enlightenment to the benighted. But, as the on-line commentary that the editorial provoked demonstrated, facts do not always speak for themselves, nor is there universal agreement about which facts are relevant, conclusive, or even best-described.
“The best available evidence,” we are told, “indicates that it [the morning-after pill] prevents pregnancy largely by delaying or preventing ovulation, but prevention of implantation cannot be ruled out. [It] does not cause abortion…” But, according to a doctor from Fredericksburg, Virginia, “since life begins at conception, abortion involves the termination of the embryo from the moment of conception”; and therefore, if he is right, the morning-after-pill acts, sometimes at least, as an abortiofacient. And this would be so irrespective of one’s attitude to abortion.