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YOU HAVE TO at least credit the Bush administration for its consistency. Once again it's pandering to the religious right, and once again that comes at the expense of women's reproductive health and freedom.
The issue this time is whether to allow emergency contraception--often called the "morning-after pill"--to be sold over the counter.
Now available by prescription, the contraceptive is highly effective in preventing pregnancy (it does not end a pregnancy) if taken within 72 hours after unprotected intercourse. It is most effective if taken within 24 hours after intercourse.
But getting a prescription written and filled can be difficult during weekends when, research shows, most unprotected sex occurs. And finding a doctor to write a prescription can be a major challenge for all the women in this country with poor access to medical care.
To make matters worse, a number of pharmacists, citing religious convictions, have refused to fill prescriptions for emergency contraception. Moreover, many hospitals--especially Catholic ones--do not offer emergency contraception to survivors of sexual assault.
So reproductive-health advocates were understandably happy in December when 23 of 27 members of a Food and Drug Administration advisory panel voted to recommend making emergency contraception available without a prescription.
If this were any other type of drug, the FDA already would have heeded that recommendation and declared the treatment fit to be sold over the counter. After all, the drug does what it's supposed to--the reduction of risk of pregnancy after treatment is about 85 percent--and it's safe. As two FDA advisory panel members noted recently in an editorial for the New England Journal of Medicine, thousands of women in numerous countries have been treated in safety studies, and evidence shows that even if the contraception is used repeatedly, the effects are minimal, consisting mostly of menstrual irregularities.
But in the minds of the life-begins-at-conception zealots, emergency contraception causes abortions, because it occasionally prevents a fertilized egg from implanting in the uterus. The Web site of the Stafford-based American Life League--which refers to a fertilized egg as a "tiny baby boy or girl"--asserts that the morning-after pill can cause a "chemical abortion."
Some not-so-circumspect politicians espouse this view publicly. Earlier this year, while urging colleagues to pass a bill that would have barred emergency contraception from being distributed on the campuses of state-supported colleges and universities, Del. Bob Marshall, R-Prince William, declared that the morning-after treatment is "an abortion done early on."
This sentiment may explain the real reason why 49 social conservatives in Congress--including Rep. Jo Ann Davis, R-1st District--sent a letter to President Bush in January calling on him to ignore the advisory panel's recommendation. Soon after the letter reached the president, the FDA announced that it would delay until next month a final decision on whether to expand access to emergency contraception.
The letter raised questions about the effect over-the-counter sales of the pill might have on teens' sexual behavior. But Dr. Alastair J.J. Wood, who served on the FDA advisory committee and co-authored the recent New England Journal of Medicine piece, told me that studies the panel examined showed ready access to the morning-after pill caused no difference in the sexual behavior of women who are its potential users.
Nevertheless, the pressure from social conservatives has caused the company that applied to sell nonprescription morning-after pills to seek a deal with the FDA that would establish a minimum age for purchasing the drug and keep it behind counters so pharmacists can oversee sales. The effect of these restrictions no doubt would be to keep the contraceptive out of the hands of some women.
The whole fiasco has put the FDA's integrity at stake. In this instance, politicians have openly pressured the agency. Should they succeed in influencing the FDA's final decision, how could we ever again be certain that other drugs were not being approved or rejected because of political considerations, Wood asked.
It's a good question. Maybe the Bush administration hasn't considered it, or maybe it has but just doesn't care about what's being jeopardized.
What's certain is that women in the United States currently are denied the same over-the-counter access to an effective form of contraception that women in 33 other countries already have--with no serious downside to their health.
Experts have determined that women in this country ought to be able to easily obtain emergency contraception. FDA officials should heed their recommen- dation and allow women to decide for themselves what's best for them.
RICK MERCIER is a writer and editor for The Free Lance-Star.