In most recent news, Health and Human Services Secretary Kathleen Sebelius
overruled the Food and Drug Administration’s decision that emergency contraceptive pills should be permitted to be sold freely over the counter. This decision would have allowed teenagers 16 years and older to buy and utilize emergency contraceptives, or Plan B as we know it. In realizing the potential affects that the over-the-counter transformation would have on society, we can use utilitarian ideologies to analyze whether the actions taken by Kathleen Sebelius were ethically right. Our ability to use such ideologies in evaluating Sebelius’ actions rests upon the notion that all of our actions in society, whether by politicians or citizens, are geared toward benefiting the greatest number of people. So let us begin.
Plan B One-Step is a pill that has been available without a prescription to women 17 and older, and has been available with a prescription for those 16 and younger. In 1999, Plan B was approved as a prescription-only product. When taken, the pill halves the risk of pregnancy and presents minor side effects when utilized in moderation. Teva Pharmaceuticals is the maker of Plan B and has applied to make their pill more easily accessible to the general public. Nevertheless, Secretary Sebelius’ recent decision has retained the austerity of the law, as the pill remains a prescription-only product. Today, the leniency of obtaining a prescription for Plan B has varied across state lines. In some states, pharmacists are able to write the prescription on the spot for those under the age of 17. In other states, pharmacists demand that the prescription come from one’s local doctor. Nonetheless, the restrictions enforced by Secretary Sebelius demand that the pill is dispensed solely behind the counter, which makes the pill difficult for everyone to obtain.
Secretary Sebelius has become the first health secretary to overrule a decision made by the Food and Drug Administration. In addition to Sebelius’ decision to break common practice, she has seemingly set a new precedent for future health secretaries to come. However, she has done so in controversial fashion. The issue with emergency contraceptives is an emotional issue–one that touches upon issues such as parental involvement in birth control for their children and the always-polemic topic of pro choice versus pro life. That being said, Gardiner Harris of the New York Times asserts that Sebelius’ recent decision is “likely to have powerful political reverberations in a presidential election season.”
It is obvious that establishing a market for which Plan B is easily accessible for everyone would be beneficial to young women as a whole. Dr. Margaret A. Hamburg, the commissioner of the drug administration, wrote that the agency’s scientists have “determined that the product was safe and effective in adolescent females, that females understood the product was not for routine use, and that the product would not protect them against sexually transmitted disease.” To me, the issue for whether easy accessibility to emergency contraceptives should be permitted is solely based off the knowledge of whether or not all adolescent females understand that the product is not for recreational use. I, as many others question, would the availability of Plan B have measurable effects on pregnancy and abortion rates? In the article I read recently, studies have found that when women are given free emergency contraceptives, they rarely take them after unprotected sex. A few interesting facts that I have found are that about half of all pregnancies today are unplanned, about 40 percent of children are born to unwed mothers, and 1.2 million abortions are performed every year. These facts have shocked me and made me question why the availability of Plan B is not widespread to everyone. Perhaps Plan B would be revolutionary in preventing unplanned pregnancies.
Earlier in the year, we studied the utilitarian ideologies of Jeremy Bentham and John Stuart Mill. The most notable ideology that the two advocated for was that all “actions are right to the degree that they tend to promote the greatest good for the greatest number of people.” We can view the greatest good as making the majority happier or better off. Mill believed that the “greatest good” would benefit the well being of the lives of greatest number of people.
Accordingly, I think we could use Mill and Bentham’s utilitarian ideology to analyze whether or not emergency contraceptives should be made an over-the-counter drug, making it available to everyone. I think that if Secretary Sebelius were to make Plan B an over-the-counter drug, then we would be promoting the greatest good for many reasons. Women who cannot afford the social and financial responsibilities of having a child would benefit from having the ability to easily obtain Plan B. We could also be preventing teenage pregnancies, which have seamlessly increased over the years. To me, these are the most pivotal reasons why emergency contraceptive should be an over-the-counter drug.
While I think Bentham and Mill would agree with over-the-counter Plan B, as it would in fact benefit the greater good for women as a whole, the debate is much more complex than we might perceive. In applying utilitarian ideas, we may in fact be harming society in the long run. The permission of an over-the-counter drug such as Plan B can develop into a drug abused and used ritually by the public, which would send a bad message to younger and younger generations. In addition, I think that in analyzing this dilemma, we must consider the moral principles involved with making such medications available to such a young demographic. Is it the right thing to do? The permission of Plan B over-the-counter could set a precedent for other serious medications to be considered over-the-counter drugs. Thus, there could be this sort of domino affect that would ostensibly hurt society in the long run, as serious prescription medications would be more and more widespread. The point of the matter here is that when using utilitarian ideas to analyze whether over-the-counter emergency contraceptives should be permitted, it is important that we realize the true complexity of the argument. Would it be morally right to make Plan B an over-the-counter drug, despite its potential positive affects on women?
Finally, do you think Bentham and Mill would agree the decision to make Plan B over-the-counter? Do you think Secretary Sebelius made the right or wrong decision in overruling the Food and Drug Administration? What do you think is our best course of action?