“Father Knows Best” is Not Common Sense

It was bad enough that last week when Kathleen Sebelius, secretary of the Department of Health and Human Services (HHS), in an unprecedented move for an HHS secretary, overturned the FDA’s approval of her department’s decision to release the Plan B One Step morning after emergency contraceptive for women  as an over-the-counter medication, regardless of age.

Those who expected President Obama to admit this was a wrong call were sorely disappointed when he let election year politics trump science.

Apparently, calculating that he now needs to move to the political right on social issues like contraception, Obama stood before the country like a “father knows best” caricature.

He told us that, as the father of two daughters, this was a “common sense” decision. Never mind the years of scientific research supporting the pill’s safety and efficacy or the considered opinions of physicians who care for the nation’s children, many of whom also have children of their own.

This is the same president who, on April 27, 2009 in a speech to the US National Academy of Sciences in Washington DC.,  said:

 “We have watched as scientific integrity has been undermined and scientific research politicized in an effort to advance pre-determined ideological agendas.”

Yet that’s exactly what the Obama administration has just done

After a 3 year struggle within the highly politicized FDA under Bush, in 2006 a Plan B over-the-counter oral emergency contraception was made available to women over the age of 18. [1]

In 2009,the age was reduced to 17 and over.

If taken up to 72 hours after sexual intercourse, the drug (1.5 mg of levonorgestrol) works to prevent the possible implantation of a fertilized egg, thereby preventing a pregnancy.

Based on studies showing no adverse effects on younger women, in February, Teva, the manufacturer, requested FDA approval to make the drug available without a prescription to women age 16 and younger.

Dr. Susan Wood, a former FDA assistant commissioner for Women’s Health who in 2005 resigned her position over the Bush administration’s handling of emergency contraception appeared on Chris Hayes’ Sunday MSNBC show, calling this administration’s block of the drug “shocking and surprising.” She stated that she never thought she would be reliving this issue  today.

In a joint statement, three major medical groups, the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists, Society of Adolescent Health and Medicine (SAHM) and American Society for Reproductive Medicine (ASRM)) quickly denounced the federal government’s decision.

“As advocates for the health and well-being of all young people, the AAP recommends that adolescents postpone sexual activity until they are fully ready for the emotional, physical and financial consequences of sex,” said Dr. Robert Block, AAP president. “However, as physicians who care for our nation’s children, it is our responsibility to protect the health of our teenage patients, and an unintended pregnancy can have significant implications for adolescents’ physical and emotional health.”

Dr. Leslie Walker, president of SAHM called the HHS decision “a profound disappointment for the health of adolescent girls and is inconsistent with what we know about the safety and benefits of emergency contraception. Emergency contraception is a safe, effective back-up birth control method for teens and women of all ages to prevent unintended pregnancy.”

Dr. James N.Martin, Jr., president of ACOG added that the physician organization would “continue to push for removing “unnecessary age restrictions.”

Dolores J. Lamb, president of ASRM, stated disappointment in Sebelius’ decision  to “insert herself into what should be a scientific decision made by the experts at FDA. The data are clear that emergency contraception can be safely used by adolescent women without requiring a prescription. Sadly, it appears that once again our leaders are putting political expediency ahead of reproductive health.”

After eight years of marginalizing evidence produced by scientific research, a significant Obama constituency in 2008 were voters yearning for a return to true common sense.

In this case, common sense would mean listening to the actual experts: Doctors and scientists who understand that  no matter how much we may want young teens to avoid sexual activity until they are more mature, the reality is some will indulge anyway. And while Sibelius correctly points out the significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age, it is hardly common sense to deny those under seventeen a safe drug that could prevent the documented increased physical and psychological risks of unwanted pregnancies at such a young age.

Mr. Obama once promised no more government intrusion into health related issues. Now that would be common sense. Affecting a paternalistic “father knows best” stance, characterizing Sibelius’ decision as “common sense”, is anything but.

It’s not only disingenuous. It’s a very dangerous precedent.

About Deborah Shlian

Deborah Shlian is a physician, medical consultant and author of numerous non-fiction articles and books as well as three published novels co-authored with her husband Joel (Double Illusion, Wednesday’s Child and Rabbit in the Moon). Rabbit in the Moon, an international thriller, won the 2008 Gold Medal, Florida Book Award, ForeWord Magazine's Silver Award for best mystery, the Royal Palm Literary Award and Honorable Mention for best Audiobook for the San Francisco Book Festival. Deborah is co-author with Dr. Linda Reid, of the Sammy Greene thriller series. Dead Air, the first in the series won the 2010 Royal Palm Literary Award for Best Thriller. Devil Wind, the second in the series, won the Hollywood Book Award for best Audiobook and the 2011 Royal Palm Literary Award for Best Thriller. "Deep Waters", the third in the series was released in 2019. "Silent Survivor" by Deborah Shlian is a stand-alone medical mystery/thriller that has won the 2018 Royal Palm Literary Award among several other awards. Her nonfiction book, "Lessons Learned: Stories from Women in Medical Management" was released in March, 2013. After 25 years in Los Angeles, Deborah and her husband now reside in Boca Raton, Florida.

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