Plan B Remains Behind the Counter: Right or Wrong?


In most recent news, Health and Human Services Secretary Kathleen Sebelius

Secretary of Human Health Services

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?

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About rfieds

Student at the University of Michigan

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5 Comments on “Plan B Remains Behind the Counter: Right or Wrong?”

  1. bmazus Says:

    I am certainly no expert on plan B pills and their history, but I certainly see where this issue is coming from. On the one hand you have this pill that seems like it magically can prevent pregnancy and save thousands upon thousands of teenagers and many other women the nightmares of an unexpected pregnancy. On the other hand by letting this pill be an over the counter drug we are essentially condoning unprotected sex and being irresponsible about using protection.
    In my honest opinion I believe plan b should be sold as an over the counter drug at any drug store that wishes to. It is a product that is most of the time needed in a pinch and it should be provided to those who need it, regardless of age. What I also believe is that we need to get the word out about how plan B should not be something women and teenage girls are using on a regular basis. While there are plenty of ways in which teenagers are informed about this issue we need to keep finding better ways of getting to them. So I believe that Secretary Sebelius made the wrong decision regarding plan B, but I do believe that her intentions and reasons for making this decision are completely justified.

  2. emmaschneider11 Says:

    I feel that Secretary Sebelius made the wrong decision when she overturned the ruling for over the counter availability of the Plan B emergency contraceptive pill. I feel that the pill should be available over the counter to all ages because this is the most beneficial system. If young women need to get a prescription in order to get the pill they are less likely to do so and less able to get the pill in a timely fashion. I think if a young woman below the age of 16 is in a situation where she had unprotected sex or an accident that made her susceptible to getting pregnant she should have the right to protect herself through an emergency contraception pill without involving her parents or her doctor. If this girl has to get adult permission she may be less likely to get the pill out of fear and then more likely to get pregnant. Also, the pill works most effectively when it is taken as soon as possible. So, if a prescription is necessary there will be a longer wait time, and a decrease in the effectiveness of the pill, and once again an increased risk of pregnancy. Having the pill available over the counter allows from the easiest accessibility, and yes this may make some women feel as though they can use the pill more often than they should, but it will prevent the most unwanted pregnancies.

  3. Phil O'Donnell Says:

    The most important point which this post seems to raise is “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 would be concerned with the possible consequences of introducing almost universally accessibility of a drug similar to Plan B, as seemingly American society has a tendency to devalue morality in the favor of practicality and the often mentioned notion of ‘instant gratification’. There would be a fear that Plan B would potentially be considered to be like taking an aspirin, if not a Skittle.

    Furthermore, America already has huge problems pertaining to teenage pregnancy and I don’t believe that making Plan B more available will help to lessen this problem, as although it would in many cases help to literally prevent pregnancy (by aborting the pregnancy so to speak). In my opinion it would actually make unprotected sex more socially acceptable or lessen the stigma attached to this, I believe that this would cause a huge rise in unprotected sex which would, I predict, cause pregnancy levels to rise. Coupled to this fear of pregnancy rates rising is the fear that sexually transmitted infections would also rise due to a rise in levels of unprotected sex.

    Another interesting point which is raised is the question of whether this topic can be applied to the principle of the greatest good to the greatest number? How do you measure benefit or utility in a situation like this? Simply by the number of unplanned babies which are prevented? What about people who don’t believe in abortion and are morally offended by abortion? Are there actually more people who would be unhappy with the increased use of Plan B then those who would benefit from it. Seemingly this is a very ambiguous issue and there is seemingly little statistical or ‘hard’ evidence which can help to make conclusions. Adding to the complication is the problem that many people are simply neutral to abortion; they would ‘allow’ it, yet don’t necessarily advocate it. This is seemingly different than them actually receiving benefit from it. Hence, this there an argument that increased use of Plan B would actually bring more displeasure to society then pleasure or ‘good’? There is also the question of how you measure the intensity of ‘good’ or pleasure in this situation, as I would argue that the ‘pleasure’ (relief?) that someone feels from the ability to ‘abort’ an unwanted pregnancy would seemingly outweigh the displeasure that some people would feel about the increased use of Plan B.

  4. djavolio8 Says:

    The preceding commenter makes the best point in reference to your argument. One cannot just simply assume that adolescent females understand that Plan B is not for recreational use and is to be taken sparingly. The benefit of keeping Plan B as a prescription pill is that adolescents will not be abusing the pill thus endangering their bodies. I think when can all safely say that people are inherently stupid in medical situations and fail to take everything into account. By demanding consultation with a physician this problem is resolved.

    However, as teenage pregnancy becomes more and more common in our nation the need for access to contraceptives like Plan B is going to steadily rise. As this will remain a controversial issue I think it will end up being much easier for the federal government to let this become a state handled issue. Each state could set age and access requirements with federal aid being given to those states that promote a safe and controlled use of the substance.

  5. ajnovo Says:

    I’m not sure if selling Plan B freely over the counter would result in the greatest good for the most people since as people have mentioned earlier, it could lead to an increase in unprotected sex, and an overall acceptance of children under the age of 16 having sex.

    I feel that if a girl under the age of 16 is having sex, that is something that should be discussed with her parents. Our society should not be encouraging girls that young to have sex, and by offering Plan B I feel like our society could become hypocritical – “Don’t have sex when you’re young, but if you do just go and buy a pill that will fix your problems.” By not making Plan B available to everyone it encourages communication between parents and children about the actions they are making in their lives.

    As far as teenage pregnancies, and Plan B, how many parents do you think regret having their children? I’ll admit, having a child would change my life completely, but would it be for the worse? There are decisions that we make in our lives, and we have to live with the consequences, and by making Plan B freely available, those consequences will not be as important. I support the fact that young girls should have a prescription for Plan B

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