Looking for the Less-Obvious on Plan B

Acting FDA Commissioner Andrew von Eschenbach's decision, supported by President Bush, to approve Plan B for over-the-counter (OTC) status for women over 18 was a political decision. The question is not whether it was politically motivated, but what kind of political motivations were at play here.

I don't think this decision should be too quickly underestimated as political caving toward either direction. With today's decision, the FDA has crafted a unique policy that will for the first time permit a drug to be distributed with separate rules for different age groups. It's a decision that neither side of the debate is excited about: social conservatives don't like that it was approved at all, and reproductive health advocates are upset that the approval was made arbitrarily for a certain age group, irrespective of the science. Both sides are upset. In the search for an answer about motives, aren't we supposed to first discern who benefits?

Acting FDA Commissioner Andrew von Eschenbach's decision, supported by President Bush, to approve Plan B for over-the-counter (OTC) status for women over 18 was a political decision. The question is not whether it was politically motivated, but what kind of political motivations were at play here.

I don't think this decision should be too quickly underestimated as political caving toward either direction. With today's decision, the FDA has crafted a unique policy that will for the first time permit a drug to be distributed with separate rules for different age groups. It's a decision that neither side of the debate is excited about: social conservatives don't like that it was approved at all, and reproductive health advocates are upset that the approval was made arbitrarily for a certain age group, irrespective of the science. Both sides are upset. In the search for an answer about motives, aren't we supposed to first discern who benefits?

This arbitrary choice of age only compounds an already unique situation. Research and statements by FDA's approval board have concluded that the drug is certainly safe for women over 16. But Andrew von Eschenbach's decision is to approve Plan B for OTC sales for women 18 and older. Certainly, 18 is kind of a magic number culturally and it might make sense to some observers that he would select this as the cutoff. But when tested in the courts – and tested it shall be – the fact that he made an arbitrary choice might factor into the arguments.

Let me sidetrack for a moment… The President is getting used to remarkably low approval ratings. His party is jumping ship and is gathering around a radical conservative base that even his Administration is no longer prone to support outright, as we've seen today and with the immigration debates of the past couple months. The media is fueling this process, and if that is your only source of information, you might actually believe that every registered Republican – if not fully half or more of all Americans – is xenophobic, anti-gay, anti-choice, pro-war, and so forth. Except that is simply not the case. The majority of Americans live their lives somewhere in the middle between that extreme and its logical opposite.

I wonder if the President has been reading the polls and finally realized this, and if we see some of that realization in today's announcement from FDA. While his party is streaming to the far right in hopes of surviving this political season, perhaps he's of the mind that sustaining the soul of the Republican party might require a move toward the center, or at least a move toward supporting objectivity, science, and the orderly execution of government protocols (an example of which the current FDA debacle is not). Supporting this decision on Plan B – on its surface – would nonetheless look like a move toward the middle.

With that in mind, it bears noting that Family Research Council's first statement today in response to Plan B's approval brought with it mention of a legal action that pinpoints the rule-making process for this new form of OTC approval for certain age groups; it does not challenge the safety of the drug. When the approval of Plan B for OTC sales goes to court and it is questioned solely on the grounds of the rule-making procedure (since the science can't really be taken to task), Andrew von Eschenbach's choice of an arbitrary age might be introduced as a piece of evidence in the arguments. He's not following the science, he's just making up rules for political reason, they could say. And if the judges agree… Well, then it will remain up to you to decide whether his choice to approve the drug in this way was a calculated political decision all along.

OTC sales could stand to be revoked, or at least postponed while it's all sorted out. The Bush Administration will appear to have moved center, while at the same time having given its far right base a nice piece of evidence to serve the pursuit of their cause. FDA will appear to have chosen science but could plead ignorance as to law and rule-making – an innocence for not getting it right. And everyone would go home happy, except for the women and reproductive health advocates who had hoped to see Plan B made more widely available.