{"id":53251,"date":"2016-09-30T11:27:00","date_gmt":"2016-09-30T16:27:00","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-legal\/supreme\/legal-commentary\/the-battle-over-abortion-and-contraception-part-two-how-its-playing-out-in-the-bush-administration.html"},"modified":"2016-09-30T11:27:00","modified_gmt":"2016-09-30T16:27:00","slug":"the-battle-over-abortion-and-contraception-part-two-how-its-playing-out-in-the-bush-administration","status":"publish","type":"supreme","link":"https:\/\/supreme.findlaw.com\/legal-commentary\/the-battle-over-abortion-and-contraception-part-two-how-its-playing-out-in-the-bush-administration.html","title":{"rendered":"The Battle over Abortion and Contraception, Part Two How It&#8217;s Playing Out in the Bush Administration"},"content":{"rendered":"\n<div class=\"wp-container-core-columns-is-layout-9d6595d7  fl-block-columns fl-sectionWithSidebar fl-container fl-flex fl-flex-wrap fl-gap30\">\n    \n    <div class=\"fl-page-articles   fl-block-column fl-section-main fl-section-main-full-width\">\n        <div class=\"yui-g\" id=\"leftcol-module\">\n      <!-- Right Line of Links Section -->\n      <!-- BEGIN PICTURE INSERTION -->\n      <!-- BEGIN TITLE AND AUTHOR INSERTION -->\n      <table>\n        <tr>\n\n          <td width=\"100\" rowspan=\"3\" class=\"wiauthor\"><a href=\"\/legal-commentary\/elaine-cassel-archive\"><img decoding=\"async\" src=\"https://supreme.findlaw.com/static/f/images\/writ\/elaine.cassel.jpg\" border=\"0\"><\/a><\/td>\n          <td class=\"wititle\"><h1>The Battle over Abortion and Contraception, Part Two: How It&#8217;s Playing Out in the Bush Administration<\/h1><\/td>\n        <\/tr>\n        <tr>\n          <td class=\"wiauthor\"><a href=\"\/legal-commentary\/elaine-cassel-archive\" class=\"graybold\"><h2>By ELAINE CASSEL<\/h2><\/a><\/td>\n        <\/tr>\n        <tr>\n          <td class=\"widate\">Monday, Mar. 20, 2006<\/td>\n\n        <\/tr>\n      <\/table>\n      <span class=\"smalltext\"><p>In <a href=\"\/legal-commentary\/the-battle-over-abortion-and-contraception-part-one-how-its-playing-out-in-the-states-and-in-the-supreme-court.html\" class=\"left-link\">the first column<\/a> in this two-part series on the law and regulation of abortion and contraception, I discussed a recent spate of harsh state anti-abortion laws and bills. Underlying these bills is the states&#8217; hope that the Supreme Court might either overturn <a href=\"https:\/\/caselaw.findlaw.com\/court\/us-supreme-court\/410\/113.html\" class=\"left-link\" rel=\"noopener\"><i>Roe v. Wade<\/i><\/a>, or, while stopping short of overruling <i>Roe<\/i>, drastically curtail abortion rights. I also discussed the Court&#8217;s recent abortion decisions, and in particular, the views of the Justice with the crucial swing vote, Anthony Kennedy.<\/p>  <p>In this column, I&#8217;ll turn to other issues of abortion law and regulation &#8211; covering events in the Bush Administration &#8211; concerning, respectively, the Food and Drug Administration (FDA) and Centers for Disease Control (CDC).<\/p>  <!-- 300x250 AD -->\n\n\n<p><b>The FDA and &#8220;Plan B&#8221;<\/b><\/p>  <p>&#8220;Plan B&#8221; is the nickname for emergency contraception, also known as the &#8220;morning-after pill.&#8221; Two years ago, the FDA Nonprescription Advisory Committee voted 24-3 that Plan B be made available for over the counter (OTC) use, without a prescription, having found it safe.  But the pill is still not available OTC. <\/p>  <p>That&#8217;s especially unfortunate, of course, due to the nature of Plan B: As soon as intercourse occurs, the clock begins ticking, for soon the pill will be ineffective. <\/p>  <p>Imagine the plight of, for instance, a working mom: One night, she and her husband are having sex, but she realizes she forgot to take her birth control pill. The couple isn&#8217;t able to welcome another child &#8211; they already have three &#8212; but she doesn&#8217;t want to risk an abortion either, perhaps for health reasons or because her religious beliefs counsel against it. <\/p>  <p>Thanks to Plan B opponents, the next morning, she must not only handle all her job and family responsibilities, but must also find the time and money for a doctor appointment and a visit to the pharmacy &#8211; all to get a pill whose safety and efficacy are undisputed, and that actually allows women to <u>avoid<\/u> abortions. <\/p>  <p>Despite the advisory panel&#8217;s advice, the FDA punted, rendering no decision on the OTC request. With this cowardly move, FDA Commissioner Lester Crawford broke his promise to the Senate that, if confirmed as FDA Commissioner, he would see that the FDA gave Plan B an &#8220;up or down vote.&#8221; In September 2005, Crawfordresigned hisFDA post under a cloud of controversy surrounding his ties to drug companies. President Bush namedNational Cancer Institute Director Andrew von Eschenbach as acting FDA Commissioner (an unusual move since he wore two hats), and on March 15, Bush nominated him as FDA Commissioner.  His nomination immediately raised the ire of Democrats, who felt they were double-crossed by Crawford, and who charged that von Eschenbach had done nothing to resolve the Plan B controversy.<\/p>  <p>FDA Assistant Commissioner for Women&#8217;s Health Susan Wood, and Frank Davidoff, a member of the Nonprescription Advisory Committee, both left the FDA in protest over Crawford&#8217;s decision. <\/p>  <a href=\"#continue\">Column continues below \u2193<\/a>\n\n<script language=\"JavaScript\" src=\"http:\/\/pagead2.googlesyndication.com\/pagead\/show_ads.js\">\n\n<\/script>\n\n<a name=\"continue\"><\/a>\n\n<p>At the request of the Senate, the Government Accountability Office (GAO) investigated and <a href=\"http:\/\/www.gao.gov\/new.items\/d06109.pdf\" class=\"left-link\" rel=\"noopener\">issued a report<\/a> on the FDA&#8217;s actions with regard to the OTC use of Plan B.  The report noted that it was the only time in ten years that the FDA did not approve an OTC request endorsed by the advisory panel. <\/p>  <p>The reason for the decision is obvious: The FDA bowed to pressure from Republicans in Congress who argued that teenage girls might become sexually promiscuous if they knew Plan B was available. <\/p>  <p>The argument was absurd: After all, Plan B is supposed to be just what its name implies: <u>backup<\/u> contraception for the rare instances in which contraception fails. Few teenage girls are risk-averse enough to forego sex, or change their sexual frequency, simply because their <u>first-line<\/u> contraception is only 98% or 99% effective. (And girls who really are that risk-averse could double-up with a condom plus another method, such as the pill.) <\/p>  <p>Also, girls are aware that abortion is still available. So the argument must be that girls who are so religious that <u>any<\/u> risk of having to have an abortion would deter them from having sex, would suddenly throw caution to the wind, sexually, if Plan B were available. That is incredibly implausible.  <\/p>  <p>But even assuming that keeping teenage girls chaste was the FDA&#8217;s only goal, why was the drug not approved for OTC sale to adult women?  Therein lies the truth about what the FDA is up to&#8211;it is not just withholding the contraception for teens, it is denying it to all women.<\/p>  <p><b>The CDC and the Cervical Cancer Vaccine<\/b><\/p>  <p>Much more disturbing than the senseless refusal to approve Plan B, is the battle over what should be a no-brainer: the development and approval of a vaccine against the human papilloma virus (HPV) &#8212; which causes cervical cancer. <\/p>  <p>HPV is responsible for a majority of cervical cancer cases.  Each year, more than 10,000 American women find out that they have invasive cervical cancer. Nearly 4,000 of them die. <\/p>  <p>Even when it is not fatal, cervical cancer may result in a hysterectomy, which destroys the woman&#8217;s ability to bear children. (A radical trachelotomy may allow childbearing, but is an option for only some women.)  Radiation treatment may also destroy ovarian function.  <\/p>  <p>HPV transmission is essentially impossible to prevent. It is controversial whether even condom use protects against its transmission. It may, as condom use is associated with a lessened cervical cancer risk. But no one can yet confidently say that a condom is any guarantee against transmission of the cancer-causing virus. <\/p>  <p>If a girl receives the HPV vaccine before she becomes sexually active, it is almost 100% effective. Yet some oppose the vaccine based on the same argument used against Plan B, especially in its OTC form: That it would encourage sexual promiscuity. Indeed, the Bush administration has appointed someone from the fundamentalist Christian organization &#8220;Focus on the Family,&#8221; to sit on the vaccine&#8217;s advisory panel working with the CDC. <\/p>  <p>The opposition to the vaccine is, to put it bluntly, insane. It also puts the lie to any claim that opponents are putting motherhood, or children, or families first. Half of cervical cancer cases occur in women between the ages of 35 and 55 &#8211; meaning that statistically, the overwhelming majority of patients will <u>be<\/u> mothers. Also, the virus can be transmitted from mother to infant during childbirth. <\/p>  <p>The opposition to the vaccine comes from an ugly view of women. On this view, it is better to compel women into abstinence, than to persuade them into it. If the case for abstinence is so strong, why won&#8217;t the pro-abstinence movement allow women to choose it &#8211; rather than being terrified into it, by the threat of cancer, or of contraceptive failure? <\/p>  <p>This point of view is very accurately described as anti-choice. What is really is, is a struggle to force an extreme religious viewpoint about sex and contraception on all women, not just the mothers and daughters of the fundamentalist Christians. <\/p>  <p>Religious politics has overtaken the common good and common sense in many statehouses, as they legislate their moral judgments with anti-abortion laws. Now regulatory agencies designed to promote the health of all Americans are beholden to the same extremists.  It&#8217;s time to return the FDA to the respected position it once held&#8211; as the least partisan of the regulatory agencies, and one that took seriously its mandate to protect the health of Americans. <\/p>  <p>As for the CDC, it needs an inoculation against religious fanaticism, which has no place in its decisionmaking.<\/p> \n\n\n\n\n\n<\/span>\n\n\n\n\n\n\n<hr size=\"1\">\n\n<p class=\"authorfoot\">\n\n\n\n<!-- BEGIN AUTHORS FOOTNOTE -->\n\n<a name=\"bio\"><\/a>\n\nElaine Cassel practices law in Virginia and the District of Columbia and teaches law and psychology. Her textbook, <i>Criminal Behavior<\/i> (2nd ed., in press, Erlbaum), explores crime and violence from a developmental perspective. Her book, <i>The War on Civil Liberties: How Bush and Ashcroft Dismantled the Bill of Rights<\/i>, was published by Lawrence Hill in 2004. Her website, <a href=\"http:\/\/blogs.citypages.com\/ecassel\/\" target=\"_blank\" class=\"author-link\" rel=\"noopener\">Civil Liberties Watch<\/a>, is published under the auspices of Minneapolis, Minnesota&#8217;s City Pages. \n\n<br><br>\n\n\n\n<\/p>\n\n\n\n\n\n\n\n\n<\/div>\n\n\n<div class=\"was-this-helpful\">\n    <div\n            class=\"was-this-helpful__question-container\"\n            aria-labelledby=\"was-this-helpful__question\"\n            role=\"group\"\n    >\n        <span\n                id=\"was-this-helpful__question\"\n                class=\"was-this-helpful__question fl-text-lg-bold\"\n        >Was this helpful?<\/span>\n        <button\n                class=\"was-this-helpful__button fl-text-sm\"\n                aria-label=\"Yes\"\n                value=\"yes\"\n        >\n            <span class=\"was-this-helpful__button-text fl-text-bold\">Yes<\/span>\n            <i class=\"was-this-helpful__button-icon\">\n                <svg width=\"22\" height=\"22\" viewBox=\"0 0 22 22\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <g id=\"thumbs-up\" clip-path=\"url(#clip0_604_3418)\">\n                        <path id=\"Vector\"\n                              d=\"M6 21H3C2.46957 21 1.96086 20.7893 1.58579 20.4142C1.21071 20.0391 1 19.5304 1 19V12C1 11.4696 1.21071 10.9609 1.58579 10.5858C1.96086 10.2107 2.46957 10 3 10H6M13 8V4C13 3.20435 12.6839 2.44129 12.1213 1.87868C11.5587 1.31607 10.7956 1 10 1L6 10V21H17.28C17.7623 21.0055 18.2304 20.8364 18.5979 20.524C18.9654 20.2116 19.2077 19.7769 19.28 19.3L20.66 10.3C20.7035 10.0134 20.6842 9.72068 20.6033 9.44225C20.5225 9.16382 20.3821 8.90629 20.1919 8.68751C20.0016 8.46873 19.7661 8.29393 19.5016 8.17522C19.2371 8.0565 18.9499 7.99672 18.66 8H13Z\"\n                              stroke=\"#666666\" stroke-width=\"2\" stroke-linecap=\"round\"\n                              stroke-linejoin=\"round\"><\/path>\n                    <\/g>\n                  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11.0745 20.2154 11.4432C19.7859 11.8119 19.236 12.01 18.67 12H16M9.00003 14V18C9.00003 18.7956 9.3161 19.5587 9.87871 20.1213C10.4413 20.6839 11.2044 21 12 21L16 12V0.999995H4.72003C4.2377 0.994543 3.76965 1.16359 3.40212 1.47599C3.0346 1.78839 2.79235 2.22309 2.72003 2.7L1.34003 11.7C1.29652 11.9866 1.31586 12.2793 1.39669 12.5577C1.47753 12.8362 1.61793 13.0937 1.80817 13.3125C1.99842 13.5313 2.23395 13.7061 2.49846 13.8248C2.76297 13.9435 3.05012 14.0033 3.34003 14H9.00003Z\"\n                              stroke=\"#666666\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/>\n                    <\/g>\n                    <defs>\n                        <clipPath id=\"clip0_604_3423\">\n                            <rect width=\"22\" height=\"22\" fill=\"white\"\/>\n                        <\/clipPath>\n                    <\/defs>\n                <\/svg>\n            <\/i>\n        <\/button>\n    <\/div>\n    <span class=\"was-this-helpful__taken-action 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was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--solved-problem\"\n                        >Solved my problem<\/label>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--other\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"positive-feedback\"\n                                value=\"Other\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--other\"\n                        >Other<\/label>\n                    <\/div>\n                <\/fieldset>\n     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