On March 9, 2009, President Barack Obama—surrounded by lawmakers and scientific luminaries in the White House’s East Room—made a promise: his Administration, unlike his predecessor, would “guarantee scientific integrity” in federal policymaking. As Obama said in a Presidential memorandum released that day:
The public must be able to trust the science and scientific process informing public policy decisions. Political officials should not suppress or alter scientific or technological findings and conclusions. If scientific and technological information is developed and used by the Federal Government, it should ordinarily be made available to the public. To the extent permitted by law, there should be transparency in the preparation, identification, and use of scientific and technological information in policymaking. The selection of scientists and technology professionals for positions in the executive branch should be based on their scientific and technological knowledge, credentials, experience, and integrity.
For those who’d sat by frustrated while the George W. Bush Administration muzzled its own scientists on issues like climate change and reproductive health, Obama’s announcement was cause for celebration—and a reminder of why he’d won their support.
One of the issues that supporters hoped Obama would show more respect for science than his predecessor was on the Plan B or “morning after” pill, a drug that can help prevent pregnancies if taken shortly after unprotected sex. Under Bush, Food and Drug Administration (FDA) scientists had ruled that Plan B was safe and effective, and that it could be given to women below age 18 without a prescription. Yet the Bush White House reportedly put political pressure on FDA officials to reject their own scientists’ recommendations—interference severe enough that the then-director of the FDA’s Office of Women’s Health, Dr. Susan Wood, resigned in protest. Surely Obama’s White House would listen to their scientists and move ahead on allowing greater access to Plan B, which could help prevent some of the 3 million unplanned pregnancies that occur each year in the U.S.
Or possibly not. On December 7—after FDA Commissioner Margaret Hamburg came out in support of allowing all women of child-bearing age to buy Plan B without a prescription—White House officials decided to ignore science. Health and Human Services (HHS) Secretary Kathleen Sebelius overruled the FDA—the first time a HHS secretary had ever done so—and vetoing the move to make Plan B more widely available. This time—just as it had with the Bush White House—politics beat science.
Sebelius’s statement made that much clear:
After careful consideration of the FDA Summary Review, I have concluded that the data, submitted by Teva [the Plan B manufacturer], do not conclusively establish that Plan B One-Step should be made available over the counter for all girls of reproductive age.
The average age of the onset of menstruation for girls in the United States is 12.4 years. However, about ten percent of girls are physically capable of bearing children by 11.1 years of age. It is common knowledge that there are significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age. If the application were approved, the product would be available, without prescription, for all girls of reproductive age.
Reproductive health experts were not impressed with Sebelius’s reasoning or with President Obama:
“We are outraged that this administration has let politics trump science,” said Kirsten Moore of the Reproductive Health Technologies Project, a Washington-based advocacy group. “This administration is unwilling to stand up to any controversy and do the right thing for women’s health. That’s shameful.”
Personally, I agree with the critics here—Plan B does not cause abortions, and restricting access to it will only increase the number of unwanted pregnancies. The decision doesn’t just affect teenage girls—even adults who don’t need prescriptions will still need to ask a pharmacist for the pill, and if you don’t think that’s problematic, check out this post from Amanda Hess at Good:
After a condom broke in college, I went to the CVS pharmacy for Plan B. The pharmacist mumbled something under his breath as he checked my ID, then slowly shook his head as he rang up the sale. (Later, at the same CVS, an employee would unlock a glass box, hand me a pregnancy test, and point helpfully to the nearby condoms. “Should have used these,” he told me). I took the test in the bathroom of the gay bar down the street. It was negative. Thanks for everything, Plan B! Thanks for nothing, CVS.
The White House says that Sebelius—a former governor of Kansas who knows how to toe the line with conservative audiences—made the decision on her own, though today Obama backed her, citing his own young daughters as a reason:
The reason Kathleen made this decision is that she could not be confident that a 10-year-old or an 11-year-old going to a drug store should be able — alongside bubble gum or batteries — be able to buy a medication that potentially, if not used properly, could have an adverse effect.
Of course, if you believe in purely science-informed policymaking, you’d have to accept that the person who would most be able to gauge how dangerous Plan B is would be Margaret Hamburg, M.D., not Kathleen Sebelius, M.B.A. And while we’re worrying about chemicals that may or may not be hurting young girls, I might suggest that we look at some of the 80,000 chemicals used in commerce today, of which just a handful have been directly tested by the government for their impacts on human health.
This isn’t the first time the Obama Administration has seemed to override the expertise of its scientists in favor of politics. Obama’s decision to reject tougher ozone standards proposed by the Environmental Protection Agency would certainly seem to qualify, as the White House traded increased public health protections for support from the business community, which had been vocally against the stronger rules. In his moves to allow expanded access to offshore drilling in Alaska to his climate team’s less that constructive work at the U.N. global warming summit in Durban, Obama has acted against the advice of environmental experts. His White House has also been slow to implement its own plan to restore scientific integrity to federal policymaking, and government scientists rarely speak with reporters without a public affairs minder on the phone.
None of this is really to criticize Obama, even if I have disagreed with some of his moves. For all his faults he still runs a White House that gives science and scientists a more prominent place than his predecessor did. Sebelius may have decided to overrule them on Plan B, but the FDA was allowed to do its job and approve the drug as the science suggested. The National Oceanic and Atmospheric Administration (NOAA) under Obama has produced excellent—and often frightening—research on climate change, and outspoken government scientists like the climatologist James Hansen have remained outspoken.
Instead, we have to be more realistic about how science is used in policymaking, as one scientist explained after Obama’s memorandum back in March 2009:
“Scientists should have no illusions about whether they make policy — they don’t,” said Harold Varmus, president of the Memorial Sloan-Kettering Cancer Center and co-chairman of a panel that advises Mr. Obama on science matters.
The directive, Dr. Varmus said, was simply intended “to provide the best available scientific information” to those who make policy decisions.
Ultimately, science can only tell us so much. It can tell us that there is little evidence that Plan B would pose any danger to women below the age of 18, but it can’t tell us whether it’s right that they should be able to have the drug without a prescription. Obviously, not every American feels that way—including, I suspect, President Obama, who has often leaned conservative on many social issues. I think they’re wrong—and maybe you do, too—but it’s my ethics and my values and my experience that inform that position, as much or more than any scientific study.
That goes for climate change and other environmental policy issues as well. Climate science is getting better and better—no thanks to Republicans in Congress who would zero out funding for U.N. climate research—but the future in warmer world is still cloudy and uncertain. Environmentalists often call on us to act on the science of climate change, but in most cases science can offer guidelines, not dictates. Not to mention the fact—as Andrew Revkin has noted at Dot Earth—for every Nobel winner who recommends one course of action, you can usually find a different Nobel winner who recommends the opposite course.
The responsibility falls on us—and on our leaders—to interpret that science in the form of social and political choices. What do we value—and what do we think we can live without? Even more than harping on the science, advocates of strong climate action need to work on people’s values—and their politics, to convince them that this issue really is as important as we say it is. That’s an uphill battle, but it’s one that must be fought.