And How: The Keroack Saga Continues

Andrea Lynch

Just when you thought the information surfacing about "Dr." Eric Keroack's professional practice and extracurricular pseudo-medical activities couldn't get any weirder ... it just got weirder. Back in November, Keroack was appointed by Bush to head the Title X Federal Family Planning Program, amidst widespread outrage over the fact that he runs a chain of highly unethical crisis pregnancy centers, believes contraception is demeaning to women, and has used junk science to argue that premarital sex undermines women's biological capacity to fall in love. After just five months on the job, on March 29 Keroack abruptly resigned as Head-Anti-Family-Planning-Zealot in charge of meeting low-income women's family planning needs, amidst investigations into the legitimacy of his professional practice. This week, the Boston Globe took a closer look at the Mass. board of medicine's accusations, and their report indicates a disturbing series of ethical lapses that should come as no surprise to those who have been following the coverage of Keroack to date.

Just when you thought the information surfacing about "Dr." Eric Keroack's professional practice and extracurricular pseudo-medical activities couldn't get any weirder … it just got weirder. Back in November, Keroack was appointed by Bush to head the Title X Federal Family Planning Program, amidst widespread outrage over the fact that he runs a chain of highly unethical crisis pregnancy centers, believes contraception is demeaning to women, and has used junk science to argue that premarital sex undermines women's biological capacity to fall in love. After just five months on the job, on March 29 Keroack abruptly resigned as Head-Anti-Family-Planning-Zealot in charge of meeting low-income women's family planning needs, amidst investigations into the legitimacy of his professional practice. This week, the Boston Globe took a closer look at the Mass. board of medicine's accusations, and their report indicates a disturbing series of ethical lapses that should come as no surprise to those who have been following the coverage of Keroack to date.

The Globe reports that earlier this year, Keroack received a pair of warnings from the Massachusetts board of medicine—one that ordered him to stop prescribing drugs to people who weren't his patients, and one that cautioned him against providing unlicensed mental health counseling. The warnings came in response to a May 2005 letter of complaint from the daughter of one of Keroack's patients, who wrote to the Mass. board of medicine after Keroack overmedicated her mother with Zoloft (by writing a prescription for the drug in her sister's name) and gave her mother money for "groceries, evenings out with her husband, and a Cape Cod getaway." Overstepping the boundaries of professionalism even further, Keroack sent the patient's daughter a creepy letter about her family responsibilities, filled with "exclamation points, all-capitalized sentences, and quotes from country singer Randy Travis," and offering the following doctorly advice: "If either of your parents were to die tomorrow … YOU and ONLY you will be responsible for the losses that will surely follow." Epistolary style sound familiar?

Of course, Keroack is contesting the charges, and has a somewhat different interpretation of the debacle. In response to the complaint, he wrote to the Mass. board of medicine, "It seems that being aware of the dynamics in a family that I have taken care of for over 12 years has somehow been interpreted to be atypical, abnormal, and a violation of boundaries. This is a sad reflection on the state of what is considered normal within today's medical care system." Yeah, and this isn't.

All told, it's been a rough few weeks for the Bush administration on the sexual and reproductive health front. State governments from the Atlantic to the Pacific are lining up to respectfully decline federal funding for abstinence-only programs that don't work, so much so that the Administration has hired the geniuses who brought us the 2004 "Swift Boat Veterans" ads to come up with a little emergency pro-abstinence-only PR. On March 29, Keroack resigned. Then, on April 2, abstinence czar Wade Horn unexpectedly followed suit, stepping down from his post as Assistant Secretary for Children and Families at the Department of Health and Human Services (check out his record). And now, the true depth of Keroack's incompetence is beginning to be revealed.

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As the outrageousness continues to pile up, part of me is baffled by the Bush administration's strategic blunder of nominating someone as obviously off-the-deep-end as Keroack to a federal post. But then again, how many sane, ethical, reputable OB/GYNs out there could pass the Bush administration's ideological purity test? I can see the job description now: "The ideal candidate will possess the professional experience necessary to head a federal agency responsible for ensuring the sexual and reproductive health of low-income women, but must also have a strong record of opposition to contraception, abortion, sexuality education, and homosexuality, and at least 10 years' experience in applying Biblical teachings in a variety of professional and policy contexts." When you cross all the candidates off the list who don't match that description, it's only natural that you wind up with guys like Keroack and W. David Hager: pseudo-professional zealots with no sense of ethics and no sense of boundaries. And they'll need more than the Swift Boat crack PR team to spin that.

P.S. I have a small bone to pick with the mainstream media's representation of the entire Keroack debacle (and though I appreciate the Globe's coverage, the latest Globe article is no exception). Fact check: Keroack's appointment was opposed by a bipartisan group of Congresspeople, editorial writers across the country, a chorus of bloggers, and tens of thousands of ordinary citizens—not just by a handful of "abortion-rights activists," as articles about him continue to uncritically repeat. Furthermore, isn't it finally time for the media to come up with a better identifier for groups like Planned Parenthood than "abortion-rights activists"? We are, after all, talking about organizations committed to providing American women from across the socioeconomic spectrum with safe, affordable birth control and quality comprehensive reproductive health care (including, but not limited to, abortion). And every time Washington takes a swipe at Title X or Medicaid, these same "abortion-rights activists" are among the only people to whom American women of reproductive age can turn to avoid winding up in a situation where abortion is their best option. Just saying.

News Abortion

Anti-Choice Leader to Remove Himself From Medical Board Case in Ohio

Michelle D. Anderson

In a letter to the State of Ohio Medical Board, representatives from nine groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Anti-choice leader Mike Gonidakis said Monday that he would remove himself from deciding a complaint against a local abortion provider after several groups asked that he resign as president of the State of Ohio Medical Board.

The Associated Press first reported news of Gonidakis’ decision, which came after several pro-choice groups said he should step down from the medical board because he had a conflict of interest in the pending complaint.

The complaint, filed by Dayton Right to Life on August 3, alleged that three abortion providers working at Women’s Med Center in Dayton violated state law and forced an abortion on a patient that was incapable of withdrawing her consent due to a drug overdose.

Ohio Right to Life issued a news release the same day Dayton Right to Life filed its complaint, featuring a quotation from its executive director saying that local pro-choice advocates forfeit “whatever tinge of credibility” it had if it refused to condemn what allegedly happened at Women’s Med Center.

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Gonidakis, the president of Ohio Right to Life, had then forwarded a copy of the news release to ProgressOhio Executive Director Sandy Theis with a note saying, “Sandy…. Will you finally repudiate the industry for which you so proudly support? So much for ‘women’s health’. So sad.”

On Friday, ProgressOhio, along with eight other groupsDoctors for Health Care Solutions, Common Cause Ohio, the Ohio National Organization for Women, Innovation Ohio, the Ohio House Democratic Women’s Caucus, the National Council of Jewish Women, Democratic Voices of Ohio, and Ohio Voice—responded to Gonidakis’ public and private commentary by writing a letter to the medical board asking that he resign.

In the letter, representatives from those groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Contacted for comment, the medical board did not respond by press time.

The Ohio Medical Board protects the public by licensing and regulating physicians and other health-care professionals in part by reviewing complaints such as the one filed by Dayton Right to Life.

The decision-making body includes three non-physician consumer members and nine physicians who serve five-year terms when fully staffed. Currently, 11 citizens serve on the board.

Gonidakis, appointed in 2012 by Ohio Gov. John Kasich, is a consumer member of the board and lacks medical training.

Theis told Rewire in a telephone interview that the letter’s undersigned did not include groups like NARAL Pro-Choice and Planned Parenthood in its effort to highlight the conflict with Gonidakis.

“We wanted it to be about ethics” and not about abortion politics, Theis explained to Rewire.

Theis said Gonidakis had publicly condemned three licensed doctors from Women’s Med Center without engaging the providers or hearing the facts about the alleged incident.

“He put his point out there on Main Street having only heard the view of Dayton Right to Life,” Theis said. “In court, a judge who does something like that would have been thrown off the bench.”

Arthur Lavin, co-chairman of Doctors for Health Care Solutions, told the Associated Press the medical board should be free from politics.

Theis said ProgressOhio also exercised its right to file a complaint with the Ohio Ethics Commission to have Gonidakis removed because Theis had first-hand knowledge of his ethical wrongdoing.

The 29-page complaint, obtained by Rewire, details Gonidakis’ association with anti-choice groups and includes a copy of the email he sent to Theis.

Common Cause Ohio was the only group that co-signed the letter that is decidedly not pro-choice. A policy analyst from the nonpartisan organization told the Columbus Dispatch that Common Cause was not for or against abortion, but had signed the letter because a clear conflict of interest exists on the state’s medical board.

Commentary Contraception

Hillary Clinton Played a Critical Role in Making Emergency Contraception More Accessible

Susan Wood

Today, women are able to access emergency contraception, a safe, second-chance option for preventing unintended pregnancy in a timely manner without a prescription. Clinton helped make this happen, and I can tell the story from having watched it unfold.

In the midst of election-year talk and debates about political controversies, we often forget examples of candidates’ past leadership. But we must not overlook the ways in which Hillary Clinton demonstrated her commitment to women’s health before she became the Democratic presidential nominee. In early 2008, I wrote the following article for Rewirewhich has been lightly edited—from my perspective as a former official at the U.S. Food and Drug Administration (FDA) about the critical role that Clinton, then a senator, had played in making the emergency contraception method Plan B available over the counter. She demanded that reproductive health benefits and the best available science drive decisions at the FDA, not politics. She challenged the Bush administration and pushed the Democratic-controlled Senate to protect the FDA’s decision making from political interference in order to help women get access to EC.

Since that time, Plan B and other emergency contraception pills have become fully over the counter with no age or ID requirements. Despite all the controversy, women at risk of unintended pregnancy finally can get timely access to another method of contraception if they need it—such as in cases of condom failure or sexual assault. By 2010, according to National Center for Health Statistics data, 11 percent of all sexually experienced women ages 15 to 44 had ever used EC, compared with only 4 percent in 2002. Indeed, nearly one-quarter of all women ages 20 to 24 had used emergency contraception by 2010.

As I stated in 2008, “All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.”

Now, there are new emergency contraceptive pills (Ella) available by prescription, women have access to insurance coverage of contraception without cost-sharing, and there is progress in making some regular contraceptive pills available over the counter, without prescription. Yet extreme calls for defunding Planned Parenthood, the costs and lack of coverage of over-the-counter EC, and refusals by some pharmacies to stock emergency contraception clearly demonstrate that politicization of science and limits to our access to contraception remain a serious problem.

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Today, women are able to access emergency contraception, a safe, second chance option for preventing unintended pregnancy in a timely manner without a prescription. Sen. Hillary Clinton (D-NY) helped make this happen, and I can tell the story from having watched it unfold.

Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told. On August 31, 2005 I resigned my position as assistant commissioner for women’s health at the Food and Drug Administration (FDA) because the agency was not allowed to make its decisions based on the science or in the best interests of the public’s health. While my resignation was widely covered by the media, it would have been a hollow gesture were there not leaders in Congress who stepped in and demanded more accountability from the FDA.

I have been working to improve health care for women and families in the United States for nearly 20 years. In 2000, I became the director of women’s health for the FDA. I was rather quietly doing my job when the debate began in 2003 over whether or not emergency contraception should be provided over the counter (OTC). As a scientist, I knew the facts showed that this medication, which can be used after a rape or other emergency situations, prevents an unwanted pregnancy. It does not cause an abortion, but can help prevent the need for one. But it only works if used within 72 hours, and sooner is even better. Since it is completely safe, and many women find it impossible to get a doctor’s appointment within two to three days, making emergency contraception available to women without a prescription was simply the right thing to do. As an FDA employee, I knew it should have been a routine approval within the agency.

Plan B emergency contraception is just like birth control pills—it is not the “abortion pill,” RU-486, and most people in the United States don’t think access to safe and effective contraception is controversial. Sadly, in Congress and in the White House, there are many people who do oppose birth control. And although this may surprise you, this false “controversy” not only has affected emergency contraception, but also caused the recent dramatic increase in the cost of birth control pills on college campuses, and limited family planning services across the country.  The reality is that having more options for contraception helps each of us make our own decisions in planning our families and preventing unwanted pregnancies. This is something we can all agree on.

Meanwhile, inside the walls of the FDA in 2003 and 2004, the Bush administration continued to throw roadblocks at efforts to approve emergency contraception over the counter. When this struggle became public, I was struck by the leadership that Hillary Clinton displayed. She used the tools of a U.S. senator and fought ardently to preserve the FDA’s independent scientific decision-making authority. Many other senators and congressmen agreed, but she was the one who took the lead, saying she simply wanted the FDA to be able to make decisions based on its public health mission and on the medical evidence.

When it became clear that FDA scientists would continue to be overruled for non-scientific reasons, I resigned in protest in late 2005. I was interviewed by news media for months and traveled around the country hoping that many would stand up and demand that FDA do its job properly. But, although it can help, all the media in the world can’t make Congress or a president do the right thing.

Sen. Clinton made the difference. The FDA suddenly announced it would approve emergency contraception for use without a prescription for women ages 18 and older—one day before FDA officials were to face a determined Sen. Clinton and her colleague Sen. Murray (D-WA) at a Senate hearing in 2006. No one was more surprised than I was. All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.

Sometimes these success stories get lost in the “horse-race stories” about political campaigns and the exposes of taxpayer-funded bridges to nowhere, and who said what to whom. This story of emergency contraception at the FDA is just one story of many. Sen. Clinton saw a problem that affected people’s lives. She then stood up to the challenge and worked to solve it.

The challenges we face in health care, our economy, global climate change, and issues of war and peace, need to be tackled with experience, skills and the commitment to using the best available science and evidence to make the best possible policy.  This will benefit us all.

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