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Sex and Bad Decisions in Washington
President Bush cast his first veto of his presidency last month when he rejected a bill that would have expanded federal funding for embryonic stem cell research. Those tens of thousands of unused, frozen 100-cell blastocysts in fertility clinics are apparently better suited for the trashcan than for research into Parkinson's and Alzheimer's cures.
Presidential vetoes can be ugly, which is why the President usually gets others to veto good ideas for him. Consider how the Food and Drug Administration last year vetoed the approval of emergency contraception as an over-the-counter drug.
As with stem cells, the FDA contraception veto, now under investigation, was a moral decision outside the context of health, despite the protection of health being part of the mandate of the FDA.
Emergency contraception prevents pregnancy. It does so primarily by preventing an egg from leaving the ovary or preventing sperm from reaching an ovulated egg. If the egg is fertilized, emergency contraception might be able to prevent the egg from attaching tothe uterus, which is the medical and governmental definition of pregnancy. Emergency contraception is also called the morning-after pill, and one marketed form is called Plan B.
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This is not an abortion pill. That's called RU-486, and it terminates an established pregnancy.
An emergency, as the name implies
For emergency contraception to work, it should be used within 72 hours after unprotected sex---which can and often does include date rape and other assaults. Unprotected sex on a Friday night could leave a woman scrambling over the weekend to find a doctor to get a prescription as the clock ticks. So an over-the-counter version would be a fine solution.
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Emergency contraception is safe-it's just various doses of the regular birth control pill-and the FDA scientific committee approved over-the-counter status overwhelmingly, 23 to 4.
Unfortunately one of the holdouts was Dr. David Hager, a devout Christian placed on the committee by the White House. Claiming at various venues that he's working for God's cause, Hager was worried the pill would increase sexual activity among adolescents.
Still, what's one man's opinion when the vast majority of experts rule against you? That opinion is everything when you're assigned by the White House. You get veto power. FDA Commissioner Lester Crawford, also installed by President Bush, overruled his scientific staff for one of the few times in FDA history and postponed the decision of emergency contraception to an unspecified date. Then he retired.
Plan C
By doing God's work, Hager, of course, has essentially enabled countless avoidable abortions. Women seeking emergency contraception clearly don't want to get pregnant. The longer they wait for the morning-after pill, the greater the chance of fertilization and pregnancy.
The new acting FDA commissioner, Dr. Andrew von Eschenbach, is scheduled to appear before a Senate committee today to explain this mess. Yesterday, as a result of tens of thousands of public comments, the FDA announced it would reconsider the plan perhaps by restricting sales to women over 18. Letter writing works.
That's part one. The next de facto presidential veto could be the cervical cancer vaccine. What's the White House got against cancer preventions? Not too much, aside from the kind of cancer associated with sex.
A new vaccine can protect against the human papillomavirus, the most common sexually transmitted disease and the chief cause of cervical cancer, which kills thousands of the more than 10,000 mostly poor women diagnosed with it each year. The plan is to inoculate girls ages 11 and up. A federally appointed scientific committee as unanimously approved it. Once again, religious groups close to the White House are dead-set against it.
Tacit approval
Drug safety isn't the issue. The worry is that the vaccine is tacit approval of premarital sex. The logic is clear. I have airbags, so I enjoy crashing into other cars. And my polio immunization has encouraged me to handle other people's feces. So we can only assume that once girls get the cervical cancer vaccine, tongue piercing and orgies will follow.
While the FDA has approved the vaccine, the question now is whether to make it mandatory and federally funded. The vaccine is expensive and complicated, requiring three shots in six months. And cervical cancer rates have been dropping anyway with an increase in Pap smears for precancerous cell detection. But here's a chance to wipe out the most common STD. But then again, treatment for this form of cancer is usually successful, although women could lose their fertility.
I wouldn't mind a thoughtful decision based on these issues. But if recent history is any indication, a veto could come from a presidential appointee acting for a president squeamish about sex and seemingly oblivious to women's health concerns. Consider that Dr. Reginald Finger of Focus on the Family, the abstinence-only group, is an influential Bush-appointed member of the Advisory Committee on Immunization Practices, which tells the government what to do about vaccines.
Finger already voiced his dislike for the cervical cancer vaccine. I wonder what he'll tell the government to do?
Christopher Wanjek is the author of the books “Bad Medicine” and “Food At Work.” Got a question about Bad Medicine? Email Wanjek. If it’s really bad, he just might answer it in a future column. Bad Medicine appears each Tuesday on LIveScience.
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Christopher Wanjek is a Live Science contributor and a health and science writer. He is the author of three science books: Spacefarers (2020), Food at Work (2005) and Bad Medicine (2003). His "Food at Work" book and project, concerning workers' health, safety and productivity, was commissioned by the U.N.'s International Labor Organization. For Live Science, Christopher covers public health, nutrition and biology, and he has written extensively for The Washington Post and Sky & Telescope among others, as well as for the NASA Goddard Space Flight Center, where he was a senior writer. Christopher holds a Master of Health degree from Harvard School of Public Health and a degree in journalism from Temple University.