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Emily, thanks for the link to that meta-analysis in cautious support of over-the-counter birth control. For what it's worth, I certainly didn't mean to imply that annual cancer screenings are a waste of time. I am arguing that doctor's visits made solely for the purpose of obtaining permission to access a relatively safe form of contraception are pointlessly and harmfully burdensome. I've had to make quite a few such visits, in part because I move frequently and am incapable of getting an overworked doctor on the phone with an understaffed pharmacy. It's possible that I am overgeneralizing from my own deeply annoying experiences.
I've lived in countries where the pill is kept behind the counter and would be more than happy with such a compromise. But the FDA, unlike its counterpart agencies in England and Canada, only very rarely considers this third option due to complex regulatory barriers. (When the FDA rejected OTC status for Merck's Mevacor, for instance, several panelists said they'd be comfortable with the drug as it is sold in British pharmacies; in other words, behind the counter. They weren't given such an option, so the panel overwhelmingly voted down the application.) It's not clear that the FDA even has the authority to create a third class of drugs. But thanks in small part to Plan B, it looks like our binary classification system might be changing.
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Kerry, interesting point about making regular birth-control available without a prescription. I wonder what the medical reasons for classifying it as a prescription drug are—do you know?
In the meantime, I'm relishing Monday's Plan B decision as a rare fact-based inquiry and denouncement, by a federal judge, of the kind of monkeying around with science that we've long heard pervaded Bush agencies. Federal judges don't interfere with the decisions of federal agencies unless those decisions really, really have no legitimate basis—in legal-ese, they have to be deemed "arbitrary and capricious." This is what Judge Edward Korman concluded in his ruling kicking the Food and Drug Administration for its denial of access to Plan B (the morning-after pill that prevents pregnancy) to girls who are 17 as opposed to women 18 and older.
Because of the FDA's stubborn insistence on its arbitrary age-based distinction, the Plan B pill, which is not a prescription drug, had to be stocked behind the pharmacy counter rather than out on the shelves. And 17-year-olds, of course, weren't allowed to buy it at all. I hear you, Rachael, in wondering whether feminism is broad enough to include women who are pro-life. But making birth control harder to get is a whole different ball game to me. I understand that Plan B falls into a tricky in-between zone because it's post-sex, but I'd like to think we could draw the line on the side that helps the girls and women who want to take it. I only wish Judge Korman's ruling had come earlier, when it would have forced the Bush FDA to get its act together.
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