Commentary Contraception

“Dr.” Sebelius’s Bitter Pill: A Case of National Malpractice

Kirsten Moore

"Dr." Kathleen Sebelius prescribed us a bitter pill when she ignored overwhelming evidence on the safety and effectiveness of emergency contraception to prohibit its sale over-the-counter.  Is this change we can believe in?  It’s certainly not a “common sense” solution. President Obama and Secretary Sebelius should listen to real doctors and the FDA Commissioner, and make this decision based on science, not politics.

See all our coverage of the Administration’s 2011 Emergency Contraception Reversal here.

This week Doctor Kathleen Sebelius prescribed us a bitter pill…

But wait, she’s not a doctor, but rather a political bureaucrat, former politician, former lobbyist for the Kansas Trial Lawyers. This week she only played a doctor, and in so doing she ended up committing national malpractice.

Despite the overwhelming recommendation of medical experts, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Medical Association, as well as her own Federal Drug Administration (FDA) Commissioner, Not-a-doctor Sebelius decided to substitute her own medical judgment and continue to limit the accessibility of the Emergency Contraceptive Plan B One-Step.

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On the same day that FDA Commissioner Hamburg confirmed that Plan B One-Step had been carefully evaluated for more than a decade and as a result deemed safe and effective for its intended use based on scientific evidence, Secretary Sebelius formally kicked off the 2012 election by siding with the political professionals over the medical professionals.

Even though the Administration’s own FDA Commissioner along with a group of experts from the Center for Drug Evaluation and Research, which included obstetricians, gynecologists and pediatricians “reviewed the totality of the data and agreed…that Plan B One-Step should be approved” for non-prescription, over-the-counter access, Secretary Sebelius thought otherwise.

She ignored the experts, a decision that will have far reaching public health ramifications, not least of which is undermining the FDA decision-making process itself.

And remember, this comes from an Administration that vocally and quite often accused the previous administration of elevating politics over science.

Just newly elected, in March of 2009, the Obama Administration declared: “…in this new administration, we base our public policies on the soundest science…(not) politics or ideology…”

Unfortunately, this week’s decision on whether to grant over-the-counter access to Plan B One-Step confirms that President Obama’s declaration of science first may in fact be nothing but politics.

And today the Obama Administration looks a lot more like the Bush Administration it used to so openly mock for its prioritization of politics over science. And there have to be those in the Administration wondering how politically astute it is to have become Bush Lite on vital national health considerations.

But let’s not allow Secretary Sebelius’ bad advice to the President to diminish just how profound a change this would have been for America’s women.

It would have been the first new contraceptive readily available on store shelves in more than a generation. It would have been a groundbreaking step in normalizing contraception. It would have provided women greater access to safe and reliable contraception, an essential part of basic health care.

On-the-shelf access emergency contraception just makes sense, because things don’t always work out as planned. All women need timely access to a safe, effective backup method of contraception if they (or their partner) failed to use a method, or if their chosen method failed them. And for those concerned about providing emergency contraception to teenagers, the National Campaign to Prevent Unintended Pregnancy has confirmed that there is “no evidence to suggest making contraception, including emergency contraception, available to teens encourages them to begin having sex, to have sex at younger ages, or to have more sexual partners”.

Most of the nation’s medical professionals agree that Plan B One-Step should be available without prescription, just not Doctor Sebelius.

And so when presented an opportunity to take a significant step forward for women and correct the rightwing, ideologically driven decision of the Bush Administration, the Administration has taken two huge steps backward.

They took the bait that the best way to protect teens was to limit access to contraception instead of recognizing that when teens do become sexually active, the best way to protect them is to ensure they have access to safe, effective birth control, including backup methods.

Is this change we can believe in?

It’s certainly not a “common sense” solution.

And now we can only ask that President Obama do what Secretary Sebelius should have done in the first place, listen to the real doctors and the FDA Commissioner, and have this decision driven by science, public health and clinical expertise, not politics.

Because this is a bitter pill no American woman should have to take.

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Reproductive Health Technologies Project advances the ability of every woman of any age to achieve full reproductive freedom with access to the safest, most effective, appropriate and acceptable technologies for ensuring her own health and controlling her fertility.  

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