The Essay

Contraception, Etc.

Last week, one man made a decision that could potentially affect millions of American women and, by proxy, men.

It’s been decided that making the morning-after pill available in pharmacies is a bad idea and could result in more promiscuity among young women, particularly those under the age of 14, and put them at an increased risk of contracting a sexually transmitted disease. That’s according to Dr. Steven Galson, acting director of the Food and Drug Administration, who was speaking out against the pill in a recent article in The New York Times.

It reminds me of the argument that emerged during the height of the AIDS epidemic; that is, making condoms available to teens was paramount to telling them to have sex.

I’ll say it: they’re having sex, regardless of what we tell them.

There’s something quite warped in thinking that denying someone a safe means to prevent unwanted pregnancy will result in fewer unwanted pregnancies and less disease. We may as well argue that we should get rid of all guns because in doing so, we will prevent all bank robberies.

Lest you think that getting a prescription to the morning-after pill isn’t such a big hurdle, think again.

The pill is aptly, even literally, named. It’s most effective when administered within the first 12 hours following conception. Although it’s fairly effective for up to 72 hours, its efficiency drops markedly with each passing hour. Theoretically, then, if a condom breaks during intercourse at 10 p.m. Sunday night (and let’s hope it’s not a Saturday night,) a woman is on a countdown to get to the doctor by 10 a.m. Monday morning. That means getting an appointment and rushing to the clinic. For most American women that means getting to work late, missing a class, a test or a “mandatory” meeting. In other words, it means most women roll the dice and they don’t get to the clinic. Some of these women won’t luck out and instead will have either an abortion or an unwanted pregnancy.

Imagine a less patriarchal and self-righteous America where a woman could just house a few of these pills in her nightstand drawer. Or she could walk, not run, to the drugstore and handily, that is to say, without pain or emotional trauma or social moralizing, avert the problem.

Instead, our enlightened government worries that the remedy will cause the disease. In this highly charged political environment, having over-the-counter access to the morning after pill will result in scads of unprotected sex, which will lead to more sexually transmitted disease. A handy argument, is it not?

“The worse-case scenario is that you've got a young couple and they would normally use a condom when they were having intercourse, but since they know they can run to the CVS to get Plan B [the proposed brand name for the morning-after pill], are they going to worry about that?” Galson told The Times.

Even if this were to occur, the job of the FDA is not to regulate behavior. If it is, then perhaps we should pull all potential inhalants from the shelves since, in a worst-case scenario, they might sometimes be used to gain a high; or, in another worst-case scenario, since some people have overdosed on aspirin, maybe we should pull that from the shelves as well.

The FDA’s decision to refuse approval to the morning-after pill is unprecedented. The Federal Advisory Panel last December voted to approve the pill 23-4. Moreover, selling the pill over the counter had the support of more than 70 medical and health organizations, according to The Times. It also had the support of Dr. Galson’s staff.

Instead of continuing to compromise, and to endure decisions that affect the day-to-day outcome of our lives, we need to imagine the kind of country we’d like to have and actively pursue our vision of it. I’m not convinced that writing the FDA is the best plan to pursue, but while I was thinking about it, I dropped them a quick comment—you might do it too. Write them online here: http://www.fda.gov/cder/comment/commentdrug.htm
—A.M. McNary?