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Implications of Plan B availability

Charles Rice | Tuesday, October 31, 2006

The Food and Drug Administration’s approval of over-the-counter sale of the morning-after pill deserves more attention than it received.

In August, the FDA approved over-the-counter sales of Plan B, the morning-after pill, without a prescription, by pharmacists (including pharmacy departments in Wal-Mart and similar stores), to men and women who can prove that they are over 18. Some states had already allowed such sales through procedures such as “open prescriptions” given by physicians to pharmacists.

Plan B is a higher dose of the birth control pill which can be sold only by prescription. Plan B is marketed as an “emergency contraceptive,” but that is a misnomer. Like most oral “contraceptives,” Plan B operates in three ways: it prevents ovulation; it prevents fertilization, the union of the sperm and the ovum; or, if fertilization occurs, it alters the lining of the womb so as to prevent the embryo (i.e., the new human being) from implanting in the womb. Implantation, five to seven days after fertilization, is necessary for the embryo to draw nutrition and survive.

That embryo is a human being. Beyond any rational doubt, the life of each human being begins at fertilization. When Louise Brown, the world’s first “test-tube baby,” was born in 1978, the whole world knew when her life began – at the in vitro fertilization. Even with identical twins, we know there is at least one life present at fertilization.

Since the mid-1960s, “pregnancy” has been widely redefined so as to begin not at fertilization but at implantation. That made it possible to market birth control pills as contraceptives despite the fact that most of them prevent implantation and are therefore abortifacients. Plan B, in preventing the implantation of the new human being in the womb, perpetrates a homicide.

Proponents claim that easy access to Plan B will reduce unwanted pregnancies and abortions. Recent studies from Washington State and Scotland, however, draw that assumption into question. The security blanket of the “morning after pill” can reduce barriers to a girl’s consent to sexual relations. The authorization for over-the-counter sale of the morning-after pill can also facilitate sexual relations between minors and adults. A girl under 18 cannot go to a pharmacist and get the morning-after pill. But her over-18 male “partner” can get it. In 2002 the California Center for Health Statistics reported that a “slight majority” of pregnancies of girls ages 10 to 14 resulted from sex with an adult. And, of course, the morning-after pill can provide an added means to induce the consent to sexual relations of a female of any child-bearing age.

Plan B, incidentally, is not free from its own complications. The package insert notes the following possible reactions: nausea, vomiting, stomach pain, tiredness, diarrhea, dizziness, heart pain, headache and menstrual changes.

So why is the over-the-counter sale of Plan B an important cultural indicator? The over-the-counter approval of Plan B reflects the decadence of a culture in which the intentional infliction of death upon the innocent as an optional problem-solving technique. Legalized surgical abortion, of course, provides the primary example. Another is the acceptance of the killing of some kinds of patients by starvation or excessive sedation, when the family and caregivers agree that the patient would want, or perhaps ought to want, to depart. The Schiavo case moved this allowance of homicide to a new and compulsory level – Judge George Greer ordered, rather than merely authorized, Michael Schiavo to remove all “nutrition and dehydration” from his wife, Terri.

Ideas have consequences. The Columbine High School massacre in 1999 was the first of many comparable incidents. If one has a personal problem, homicide is now on the table as a culturally, if not always legally, acceptable solution.

The over-the-counter sale of Plan B brings us down to a new level. You can buy an instrument of homicide, such as a knife or a hammer, in any hardware store. But Plan B is different. To use Plan B, like a hammer, according to the manufacturer’s directions, necessarily involves a conditionally homicidal intent. The intent is to “prevent pregnancy,” including by homicide if the life of the child has already begun. The message is that innocent life is so cheap that its termination can be included in your shopping list, over-the-counter. We can predict the expansion of providers beyond pharmacies to convenience stores, gas stations, mail order, etc. And we can hardly expect that this cultural and legal verdict that innocent life is so cheap will be confined to the unborn.

As Mother Teresa said at the 1994 National Prayer Breakfast, “[I]f we accept that a mother can kill even her own child, how can we tell other people not to kill one another?” Especially if the potential mother can buy the murder weapon over-the-counter at CVS or Wal-Mart.

Professor Emeritus Charles Rice is on the law school faculty. He can be reached at (574) 633-4415 or at [email protected]

The views expressed in this article are those of the author and not necessarily those of The Observer.