Why not 14-year-olds?

planb8-24-06-fda-otc-741027A federal judge ordered the Food and Drug Administration this week to make the Plan B “morning-after” birth control pill available over the counter to girls aged 17. It was already available over the counter to women aged 18 and older.

Associated Press Writer Larry Neumeister wrote up the story:

The Food and Drug Administration let politics cloud its judgment when it denied teenage girls over-the-counter access to the Plan B morning-after pill, a federal judge said Monday as he ordered the FDA to let 17-year-olds obtain the medication. . . .

The morning-after pill is a source of tension for social conservatives who held great sway in the Bush administration and who believe the pill is tantamount to abortion.

Guess how many times we read about social liberals in this story? They’re featured, but they’re not identified as liberals. Thrice we read of “social conservatives.” But the story is framed as objective science lovers vs. ideologically driven conservatives.

Let’s be clear. Both sides are arguing from a scientific perspective. To wit, the morning-after pill can work by either preventing ovulation or preventing implantation of the fertilized egg.

Science holds that a genetically distinct being is created at the moment of fertilization with the creation of an embryo. This is when human life begins. You can see examples of this from various medical and scientific texts here. Up until the past four or five decades, conception meant the union of sperm and ovum. Beginning at some point in the 1960s, we’ve seen a bit of a definition change. Now we have medical texts that describe conception as the moment when that genetically distinct human embryo implants in the lining of its mother’s uterus. Some describe this — and not the union of the sperm and ovum — as the beginning of pregnancy.

For people who object to the destruction of unborn life, the important moment is fertilization. For people who think that the rights of the mother vastly outweigh any other considerations, these distinctions don’t matter. And then you have people all along the spectrum inbetween. But the science doesn’t change. What we have is a debate over the values and rights ascribed to the various lives involved.

There is a lot of politicking in this story, but it’s important for reporters to understand the underlying science.

The story also fails to explain why the judge ordered that the drug be made available to 17-year-olds without a prescription but not other underage teenagers. Instead, we get more information that enforces the reporter’s narrative that this is a debate between reasonable people and crazy fanatics:

Susan Wood resigned as the top FDA official for women’s health in 2005 to protest agency delays in issuing a decision on the morning-after pill. Now a professor at George Washington University’s school of public health, Wood said the ruling represents a vote of confidence in the FDA’s scientific staff.

“What happened with Plan B demonstrated that the agency was off track, and was not being allowed to do its job properly,” Wood said. “This is telling the FDA to move forward with a focus on good science.”

But how does “good science” make the policy decision about what age is the proper cut-off for drug availability? What does “good science” have to say about a 17-year-old girl being able to take this drug without her parents’ — or her doctor’s — know how? Parents are still legally responsible for 17-year-olds, aren’t they? To suggest that this is an issue where science — and only science — comes into play is anything but journalism.

The reporter then inserts a somewhat random quote from the “conservative” Family Research Council — not, it should be noted, someone with the Bush-era FDA, not someone with legislative oversight on the matter, not a medical practitioner with a view in support of the FDA’s policy. The quote adds little to the story and seems included solely so the reporter can have a claim of balance. Later we hear from the “(note the absence of any adjective)” Center for Reproductive Rights.

One of my biggest problems with the story was the failure to explain anything about why the judge only opened up the pill to 17-year-olds, particularly in light of this paragraph:

In February 2001, the Association of Reproductive Health Professionals and 65 other organizations petitioned the FDA to make Plan B available over the counter to all, regardless of age. The FDA did not respond for five years, announcing in 2006 that the petition was denied.

So why can 17-year-olds have the pill but not 16-year-olds? 15-year-olds? 14-year-olds? 13-year-olds? 12-year-olds? Need I go on? If “good science” wants the pill available over the counter to anyone, regardless of age, why did the judge rule only that it be made available without a prescription to 17-year-olds?

Note that the reporter doesn’t explain that the Association of Reproductive Health Professionals was founded as Planned Parenthood’s educational arm. The two groups still work together.

Instead of learning the answer to that rather obvious question, we learn only that big, bad social conservatives wouldn’t let science make all our decisions for us:

“Moreover, they were told that the White House had been involved in the decision on Plan B,” [the judge] said.

“Today’s ruling is a tremendous victory for all Americans who expect the government to safeguard public health,” said Nancy Northup, president of the center.

I assume, although it is quite unclear, that the “center” is the Center for Reproductive Rights, mentioned above. Once again, there is no adjective to tell readers about Northup or the center’s political leanings. But smart readers should know this one-sided labeling is an unfair journalism trick.

Now, certainly there is someone in Neumeister’s universe who could balance out these quotes or provide any sort of nuance or context. Instead we just get a completely one-sided framing of a complex story. He also leaves to the very end any discussion of the actual science of what Plan B accomplishes — if not prevention of ovulation, then preventing implantation of the fertilized egg. It might have helped to explain that significant detail to readers earlier on.

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  • hoosier

    “Science holds that a genetically distinct being is created at the moment of fertilization with the creation of an embryo. This is when human life begins.”

    Wrong. Human life began with the first human. To say that it begins at the moment of fertilization is to deny the humanity and the aliveness of the sperm and the egg. Both are human and both are alive. That we don’t think of them as “human lives” and don’t accord them many, if any, legal rights, has everything to do with our perceptions of what is a fully moral human life and what isn’t, and nothing to do with the humanity or aliveness, scientifically, of these entities.

    Fertilization is not when human life begins, rather it is when a genetically distinct entity comes into being. The question that must be answered is not when human life begins (it began a long time ago, and it has yet to end) but when a genetically distinct human being obtains the legal rights of a fully moral human person.

    “What we have is a debate over the values and rights ascribed to the various lives involved.”

    Now you’re talking sense. But note that the debate is not over “when human life begins” but rather over the rights of lives along the continuum.

    “There is a lot of politicking in this story, but it’s important for reporters to understand the underlying science.” It’s also important for media critics to understand the science.

    The other problems you point out in this piece are legitimate concerns, but I hardly think it wise to criticize the science of reporters when your own scientific explanation is so inadequate.

  • MichaelV

    Hoosier, maybe it would make more sense for us to speak of “when a human life begins?” I think that’s what people really mean.

  • http://www.getreligion.org Mollie

    Hoosier is giving what I believe is called a metabolic view of when life begins.

    Perhaps I should have used the phrase “human being” since the sperm and egg — and many other non-human beings — posess human life.

  • http://www.getreligion.org Mollie

    argh. Possess.

  • Jerry

    Speaking to the comments about personhood, I can’t find any better site than this one. If someone has a better, more balanced site, please let me know. http://www.religioustolerance.org/abo_when1.htm outlines the differences about when “human personhood begins” and outlines what everyone agrees on and what people disagree on. It’s part of a series of discussions originating at http://www.religioustolerance.org/abo_when.htm There are multiple Biblical interpretations at that site as well as some novel definitions of fetal personhood based on different arguments such a first blood and the development of a brain.

    That said, I agree with Mollie’s comments. It does no one any good no matter what side one is on to have a story this important told the way it was. There is a question about what age teenagers should have the ability to do things free of parental involvement.

    Also, using my usual how fast it takes to find information using google, I found the FDA site http://www.fda.gov/CDER/DRUG/infopage/planB/planBQandA.htm which gives a fairly complex picture depending on which mechanism is involved and which probably depends on how soon the drug is taken:

    Plan B acts primarily by stopping the release of an egg from the ovary (ovulation). It may prevent the union of sperm and egg (fertilization). If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation). If a fertilized egg is implanted prior to taking Plan B, Plan B will not work.

  • http://www.suburbansweetheart.com Kate

    Simple answer: When the FDA investigated the safety of Plan B back in 2005 and 2006, they deemed it absolutely & unquestionably safe for women 17 and older. Unfortunately, they made the over-the-counter age 18, rather than 17, as a result of political pressure, which was the focus of the recent court case that led a NY judge to rule that they make it available to 17-year-olds — because it had already been declared safe.

    It has NOT been found to be entirely & unquestionably safe for women under the age of 17, so the judge didn’t rule that it be made OTC to them. That said, he DID order the FDA to investigate whether it’s safe for those under 17, which is the first step, I think, in the path toward making it available OTC for all women.

    While I agree with your sentiments, I’d encourage you to get all the facts next time before jumping to hissy-fit conclusions.

  • http://www.getreligion.org Mollie

    Kate,

    Moving past the tone of your comment . . .

    I didn’t say that there was no possible answer for the inclusion of 17 year olds — but not younger teens — in the judge’s ruling.

    I said the STORY DID NOT EXPLAIN ANY ANSWER for that 17-year age limit. In fact, the story said the recommendation was for all ages.

    This is a journalism blog. We’re dealing with questions of journalism.

    Also, please do provide us a link for your claim.

  • chris

    There are some errors of omission here. Yes there was clearly some reporting bias in the article BUT that is not the entire story. The article was about the fact that the FDA had not listened to its own panel of self appointed experts. The FDA did not follow protocol in denying the ban previously. The article further suggests that the reason that this is the case was the White House’s involvement in the process. So the “victory of science” was the overturn of the improper protocol in the ban and the reversal of ignoring expert opinions. The ideological conservatives that they overcame does not represent all ideological conservatives but rather the small group that broke a set of rules to overturn the work of a panel of experts.

  • http://www.getreligion.org Mollie

    Chris,

    I agree with your point. But the idea that whether an underage teenager should have unrestricted, unsupervised access to a pill that prevents a fertilized egg from implanting in the lining of her uterus is a question that scientists — or even policy wonks at one particular level but not at a higher level — alone can answer is not settled.

  • Dave

    The press is responding to a generally accurate trope that science was trumped by politics during the Bush administration. Plan B and embryonic research get swept into this trope because you had the same kind of conservative — and one can’t claim the word isn’t accurate, only unbalanced by lack of labeling of liberals — forces were arrayed against what some scientists wanted to do. The point might be more effectively made for reporters who follow this blog with a tone of less outrage.

  • Clare Krishan

    Has any one reported on waiver forms common in church youth or volunteering scenarios, to wit this one
    http://www.adventhuddle.com/Forms/medical.pdf
    that gives the church the right to administer OTC medications. What are the ramifications of liability?

    May a 17 year old purchase OTC for a younger friend, e.g. a male 17 year old for his 14-yr sweetheart to hide his statutory rape? Do the parents of a minor who has been subjected to such inappropriate and very-illadvised medical intervention have rights to prosecute another minor for abusing the privilege of purchasing this OTC medical intervention? Precendence in the commercial realm with OTC painkillers would indicate this is very thin ice:
    http://blog.lawinfo.com/2009/03/11/employees-have-a-headache-dont-dish-out-the-pain-killers/

    This is about so much more than religious sensitivities to a particular doctrine, its about how we fundamentally treat each other in the most intimate sphere we have to conduct intercourse: are we special as human persons, more so than the animals, and thus deserve to be treated with dignity and concern for a minor’s self-abuse?

    Or not, and so promiscuous teens deserve to be herded around like chattel by those with very narrow self-interests? [ Well its so much more profitable to let the kids enjoy the freedom of "pay-as-you-go" at $30 a pop than remember to sign up for the "family plan"[ning] 30-day supply. Repeat sales are great: “Doctors in Spain… recorded some women taking the drug as often as seven times a month.” see http://www.noroomforcontraception.com/Articles/Plan-B-Politics-Science-FDA.htm ]

  • http://www.getreligion.org Mollie

    Keep comments about your personal views about the goodness or badness of abortion or religion out of the comments. I just had to delete a comment for lacking any connection to the purpose of this blog.

    Which is, again, to discuss media coverage.

    If you’re not discussing media coverage, you’re on the wrong blog!


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