ICBioethics Blog 

Changes to Emergency Contraception Rules

Written by: Leah Jeunnette, Ph.D.(c)

Emergency contraception is a controversial behind the counter drug that is taken after sexual intercourse to prevent pregnancy. The most commonly know is Plan B. The drug provides hormones to primarily prevent fertilization of an egg.

For many years, it was believed that Plan B also prevented implantation of a fertilized egg, but the International Federation of Gynecology and Obstetrics has refuted this. On April 5th of this year, a federal judge out of New York ruled that Plan B (an emergency contraception drug) should be made available over the counter to any woman no matter the age. This should not be surprising since over the past few years, the rules and restrictions regarding emergency contraception have been ever evolving.

1999: Plan B was approved by the FDA, available by prescription only

2006: Plan B was made available behind the counter to women age 18 and over

2006: Plan B was made available by prescription only for women age 17 and under

2009: Plan B was made available behind the counter to women age 17 and over

In 2013 came the biggest change to the availability of the Plan B. A Federal District judge ruled that Plan B should be made available without a prescription to any woman no matter the age. As of April 2013, the FDA is still processing the new ruling. This example, demonstrates how political, ethical, legal, and religious considerations overlap. There are those who oppose the morning after pill for ethical and religious reasons and have fought to prevent the availability for it. At the same time, others have fought for the availability of the morning after pill. Politically the government is still trying to determine how to process court rulings through the FDA. Additionally, there are pharmacists who refuse to dispense the morning after pill based upon either religious or ethical objections.

From an ethical perspective, there are various principles and concepts that come into play. The most influential one is autonomy. The debate is a little different than the traditional autonomy arguments, because the newest ruling involves minors. Minors are allowed the right to privacy regarding sexual health issues, which would include the use of emergency contraception. This means that parents or legal guardians cannot prevent the female minors from seeking any medical intervention that involves sexual health (except for abortion in some states). However, the newest ruling by this federal judge has now deemed that not even physicians can be involved in the process of obtaining Plan B. Many argue that while women under age 17 should be allowed to use Plan B, having them obtain a prescription from a physician provides an extra safety checkpoint in the process. This is to make sure that the minor knows exactly what she is taking and is safely being monitored.

Other principles and concepts to consider include informed consent, right to privacy, human dignity, sanctity of life, moral status, and rights of minors to seek medical attention.

Mitch GennusoComment