Weeks after he took office in 2009, President Obama appeared before an applauding room full of scientists to announce he was lifting restrictions on human embryonic stem cell research, a clear repudiation of his predecessor’s policies. The George W. Bush administration had been repeatedly accused of favoring politics over science in areas ranging from breast cancer to climate science. Obama said no more.
The administration kept its word on stem cells, fighting hard against lawsuits meant to limit the research.
But Obama’s record is getting tarnished in another area where politics crash up against science: reproductive health.
The month before the stem cell decision, Obama’s HHS rescinded Bush conscience exemptions that had allowed hospitals and doctors to pass on giving patients advice on family planning, particularly emergency contraception, which anti-abortion groups view as abortion.
But Wednesday’s move by Health and Human Services Secretary Kathleen Sebelius to overrule the Food and Drug Administration on the morning-after pill opens the administration up to accusations of political bias. Congress could, in theory, override the decision, but the actual chances this would happen are zero.
Sebelius’s move was clearly galling to medical experts. FDA Commissioner Margaret Hamburg, a physician and public health expert, broke the news in an unusual statement that first said she had OK'd the over-the-counter sale of morning-after contraception to all women.
Then she noted that she had been overruled by Sebelius, a former governor and state insurance commissioner in Kansas.
Virtually every medical organization with expertise in the area supports the sale of emergency contraception to girls and women of all ages who might need it. The American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, and the Society for Adolescent Health and Medicine joined forces to denounce—their word—HHS’s action.
“The decision to continue restricting access to this safe and effective product is medically inexplicable,” AAP President Dr. Robert Block said in a statement.
One of the reasons Sebelius gave for her decision was the worry that girls as young as 11 might get the pills and might not understand the consequences. But the pediatricians say they do not share that worry. And Teva, the company seeking approval to sell the pill over-the-counter to all women without restrictions, presented data showing it tested the drug in 11-to-16-year-old girls.
It was déjà vu for Dr. Susan Wood, former head of the FDA's Office of Women's Health, who resigned in protest over the agency's handling of the drug in 2005, under the Bush administration.
“This decision is stunning," Wood said in a statement. "I had come to believe that the FDA would be allowed to make decisions based on science and the public's health. Sadly, once again, FDA has been overruled and not allowed to do its job.”
It’s not the first time Sebelius has defied the FDA’s advice. FDA revoked its approval last month of the enormously successful cancer drug Avastin to treat breast cancer. HHS immediately said Medicare would continue to pay for the drug if doctors prescribed it for breast cancer.
The administration has been in a delicate dance over another touchy issue—the requirement that all medical professionals provide reproductive health care to women.
There has been strong push-back from Catholic medical institutions, which say their workers shouldn’t be forced to provide contraception, or even counsel about it. Roman Catholic teaching forbids the use of artificial birth control. A decision had been expected this week on whether HHS would change some of its wording.
Some activists suspect HHS may have been making a trade-off.
Jessica Arons, who directs women’s health and rights issues at the left-leaning Center for American Progress, is flummoxed by this idea. “It could be, but I think it would be a pretty bad deal overall,” Arons said in a telephone interview.
“I think the Catholic bishops and Focus on the Family and all the right-wing organizations that have lobbied against plan B approval… are never satisfied,” Arons added.
And it could hurt Obama in the 2012 elections. “It does nothing but upset the base. People feel very betrayed by this decision. The administration is just politicizing contraception in so many ways,” Arons said.