In this past week of classes, the discussion in our HUBI B400 section was focused on how science interacts with politics. The main subject matter we used for this discussion, led by guest graduate student, was the discourse that occurred when the Food and Drug Administration (FDA) was in charge of deeming whether or not the emergency contraceptive, Plan B, should be available over the counter.
Plan B is a “back up” contraceptive commonly known as the morning after pill. If a woman engages in sex and feels as though she may get pregnant, she can take Plan B within 72 hours to prevent pregnancy. When this drug was first put on the market in the U.S., it was for women 18 and older by prescription only. Due to the nature of the pill, however, women’s health advocates pushed for over the counter access. This request was very controversial because for some, it is seen as an abortion pill, whereas to others, it is a preventative method.
In this time period circa 2006 and even now a days, the abortion debate still has divides between those who are pro-life and those who are pro-choice. Much of the discourse around contraceptives like Plan B is the question, when does life begin? Even if we try to take personal views out of this discussion, the question at hand goes beyond science. Science itself has intrinsic uncertainty and there cannot be a right or wrong difference of standard of evidence. On the back label describing how the drug works, it says that it “prevents fertilization and might have implantation effect.” Because people have different opinions on when life begins, some think that even the slightest chance that it prevents implantation if a form of murder and do not think that evidence is sufficient to know how the drug works. Science can show that the drug is effective, and partially how it works but it cannot tell people how to interpret what information is had. For this reason, scientific data can be interpreted differently, depending on who is reviewing the information, and what their moral values are.
The FDA is in charge of approving over the counter (OTC) drugs, but though there was nothing scientific that made them think Plan B should not be OTC, they delayed in its approval due to the political debate if Plan B would have negative social effects. Women’s’ rights activists continued to push for more easy access to this back up drug to prevent pregnancy. On the contrary, many conservatives thought that the drug would be misused if so readily available, or may encourage girls to engage in more unsafe sex.
The FDA had sufficient evidence that supported making it available without a prescription was beneficial and, in our opinion, outweighed any negative consequences the critics proposed. Despite this, Drazen et al. suggested that an argument would be that there would be an increase in unsafe sexual practices. Some people in the class found this to be irrational and I completely agree. The underlying issue continues to be that science cannot tell us 100% how the drug actually works, especially because it varies between women.
When we tried to visualize what the actual influence of politics was on the medical/scientific side of approving the drug OTC, we decided to make two parallel lists. The two lists had people who were zygote centrists, or more concerned with the potential zygote, versus the views of people who were gynocentric, or more focused on the women’s right to have a choice. Though both had different focuses, it all boiled down to levels of evidence that science can provide. The reason so much controversy has occurred is because science is being used in different ways to back up varying political views. This process of approving Plan B over the counter (which took eight years to do) was yet another example of the complexity of communicating science and its effects on politics which effects the general population and in this case, women’s health.