contraception for teenagers is and must be a political question

The headline in Woman’s Health News says: “Evidence Trampled By Politics: Sebelius Overrides FDA Decision on OTC Emergency Contraception.” This is a common framing; Google finds more than 100,000 pages that use the words “Sibelius,” “FDA”, “TEVA” (the brand name of the morning-after pill) and “political.”

HHS Secretary Kathleen Sibelius used her authority to overrule the FDA’s decision that it was safe for girls younger than 17 to purchase “Plan B” morning-after contraceptives. When her decision was  denounced as “political,” in contrast to “scientific,” she explicitly denied the charge, adopting the rhetoric of science: “There are always opportunities for the company to come back with additional data. … It is commonly understood that there are significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age.”

It might be helpful for me to state my position (mainly as an example). I think that a newly fertilized human egg has no moral weight, and therefore morning-after contraception is morally equivalent to traditional contraception–but generally inferior to condoms, which protect against STDs. I think that young teenagers generally shouldn’t have sex, especially unprotected sex, but the fault when they do is shared, and the consequences should be mild. I think that good parents have a right to know when their young adolescent children have unprotected sex, because they can intervene supportively and lovingly. But some parents will react by blocking access to the morning-after pill or by abusing their children. Those outcomes are unjust, and for that reason, it is better to allow adolescents to purchase the morning-after pill without permission.

All the beliefs I tallied in the previous paragraph are moral. Science hardly comes into it. If the morning-after pill were dangerous for young girls (but not for older women), that might be an argument against allowing adolescents to purchase it–but it hardly seems the central issue. Finding that it isn’t dangerous is not an argument for permitting its use.

In a strongly positivist culture, many people carry around a simple distinction: facts and truths belong to science, and morality is a matter of opinion–or worse, an excuse for repression. But it is a moral, not a scientific, position to say that girls have a right to purchase a morning-after pill unless it harms their physical health. The right doesn’t come from science. Certainly the decision to weigh the young adolescent’s individual rights more heavily than parents’ and communities’ rights–as I would do–does not come from science.

People call Secretary Sibelius’ decision “political” because it isn’t scientific and they don’t want to call it morally wrong. (Where would that come from?) I say it has moral content, it is probably the judgment that most Americans would reach, and it can be defended, but it is wrong.

One might suspect that the Secretary’s decision was “political” in a different sense: calculated to improve the Democrats’ chances in the 2012 election. If that were really her motivation, I don’t think her calculation was all that wise. The Democratic “base”–which the administration increasingly worries about–is upset about Sibelius’ decision. Conservatives would have been outraged if the morning-after pill had been legalized for teenagers, but the administration could have blamed the scientists in the FDA. Besides, those outraged conservatives wouldn’t be likely to vote for Barack Obama. You could even argue that goading them into fury is smart play right now, when they can choose an unelectably right-wing nominee.

Of course, an electoral argument could be made on the other side as well. But why do we even suspect that Secretary Sibelius was motivated by electoral considerations? That makes sense if there are only two grounds for a decision: opinion (often colored by self-interest) and science. There might be a third motive–religious faith–but the Secretary refused to cite that, perhaps because the Supreme Court has ruled against religious arguments regarding abortion. In my view, there’s also a fourth possible motive: sincere moral conviction. We choose representatives in elections because of their moral worldviews, we argue about the issues they face, and we expect them to make moral decisions. Deferring to the scientists at the FDA would itself be a moral decision, and it would only be right if it reflected the right values.

“Politics” is just a word for making value judgments together. Even deciding not to make a given decision is a decision. Human beings are political animals, and we should be proud of that.

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About Peter

Associate Dean for Research and the Lincoln Filene Professor of Citizenship and Public Affairs at Tufts University's Tisch College of Civic Life. Concerned about civic education, civic engagement, and democratic reform in the United States and elsewhere.