Thursday, Jul 24, 2008
As an example of how subtle and yet how ambitious the conservative Christian infiltration has been, none is more telling than the rebirth of the Food and Drug Administration's reproductive health committee. As an advisory panel it has no direct policymaking power, yet it is influential The last time the full committee met was in 1996, when it recommended the approval of RU-486. (Marketed as Mifepristone, the drug is used to terminate pregnancies during the first nine weeks.) The full panel didn't even meet to review Viagra. Since its last meeting, all the members' staggered four-year terms have expired and as a result, the panel became the first FDA advisory committee in almost 20 years whose membership lapsed.
For a year and a half, the Bush administration didn't fill any vacancies and didn't renew memberships. Enter Linda Arey Skladany, a former Capitol Hill lobbyist who heads the FDA's new Office of External Relations. A veteran of the Reagan era and the first Bush administration, Skladany has the power to name all 11 members of the reproductive health committee. And she decided to bring it back to life.
In October, just before the election, word leaked out that one of Skladany's choices for the panel was Dr. W. David Hager, who may be best known in his home state of Kentucky for organizing a revival for Billy Graham's son a little more than two years ago. A self-proclaimed pro-lifer, Hager runs a large gynecological practice in Lexington. He doesn't perform abortions, doesn't prescribe contraceptives for single patients, won't prescribe the abortion pill RU-486, won't insert IUDs, and believes headaches and premenstrual syndrome can be alleviated by reading the Scripture. He's also against the more conventional birth control pill, which more than 10 million American women use. As the editor of a book that includes the essay "Using the Birth Control Pill Is Ethically Unacceptable," Hager has said in interviews that he opposes the pill because it is a "convenient way for young people to be sexually active outside of marriage."
Hager's nomination sparked a political firestorm. Rep. Carolyn B. Maloney, D-N.Y., joined Sen. Barbara Boxer, D-Calif., as well as women's and abortion-rights groups urging the administration not to go ahead with his appointment. "The decision to appoint Dr. Hager is nothing short of irresponsible," Maloney said in a statement to Salon. "I happen to believe that the head of a women's health panel should believe in women's health.
The administration didn't back down. At the end of December the FDA approved all 11 of Skladany's nominations, including Hager. While Hager's name was bandied around as the panel's chairman, Dr. Linda Guidice, a respected reproductive endocrinologist at Stanford University, will fill that position.
Other members include Michael Green, M.D., an associate professor of obstetrics, gynecology and reproduction at Harvard Medical School who has served on the committee in the past; Vivian Lewis, M.D., who teaches reproductive endocrinology at the University of Rochester Medical Center; Valerie Montgomery Rice, M.D., director of the Reproductive Endocrinology and Infertility Division and the Women's Reproductive Center at the University of Kansas Medical Center and an expert in hormone-replacement therapy; George Macones, M.D., an assistant professor of the University of Pennsylvania's department of obstetrics and gynecology; Scott Emerson, a bio-statistician at the University of Washington; Joseph Stanford, M.D., a professor at the University of Utah's department of family and preventive medicine; Nancy Dickey, a past president of the American Medical Association; Leslie Gay Bernitsky, M.D., an urologist in Albuquerque, N.M.; and Susan A. Crockett, M.D., a clinical assistant professor at the University of Texas Health Science Center at San Antonio and the director of maternal services at Christus Santa Rosa Hospital.
"My sense is that there are clearly people on this committee who are well qualified to serve as advisors to the FDA committee on reproductive health drugs," says Amy Allison, program director for the National Women's Health Network, an FDA watchdog group in Washington. "But it's very disappointing that this administration is putting someone like Dr. Hager on a committee charged with these responsibilities. His work has focused on integrating his personal and religious beliefs into his medical practice ... His nomination shows the extreme that the Bush administration is willing to go to in an attempt to restrict women's right to reproductive health relating to abortion and family planning."
Allison says the one other panel member that she has reservations about is Stanford, a past president of the American Academy of Natural Family Planning. Stanford, a Mormon, is a proponent of natural family planning, or the rhythm method as it is known in the Catholic Church. He says he doesn't prescribe contraceptives to his patients. And he strongly believes that women should be informed that birth control pills may not prevent eggs from being fertilized. The FDA, he says, may consider changing labels on the drug to tell women of this risk. Stanford says he's done research providing evidence that fertilization can occur. "It is not absolutely proven, but it has not been disproven," he says. "It's a gray area."
In an essay excerpted on a University of Notre Dame Web site, Stanford explains his position on contraception: "A husband will sometimes begin to see his wife as an object of sexual pleasure who should always be available for gratification. This tendency is reinforced by the dominant perspective on sexuality in our society, which idealizes unlimited sexual titillation and gratification freed (at least theoretically) from any consideration of pregnancy. Sterilization and hormonal contraceptives especially feed into this prevalent and highly distorted male perspective (which is also adopted by many women)."
Stanford is also against in vitro fertilization because the procedure often creates more embryos than are used. "That's probably the No. 1 one issue: Embryos are either discarded or used for research," he told Salon. But he says that as a member of the FDA panel he won't impose his views on others. "It will be challenging and difficult," he says. "But in my professional career, I've worked with people with different views on ethic issues than I do. There's no problem if people deal with the issues in an intellectual and honest way."
At its next meeting, the panel is slated to discuss controversial hormone-replacement therapy for menopausal women. Initially scheduled for Nov. 13, the meeting was postponed until sometime early this year. However, if the committee at some point is asked to review RU-486, the so-called abortion pill, Hager must recuse himself. As a spokesperson for the Christian Medical Association, he wrote a letter last summer to the FDA criticizing its approval of RU-486 in 1996. "It would be hard to look at the petition if you had a hand in writing the petition," says Brad Stone, an FDA spokesman. "It's like being the judge and also being the one who is asking for judgment. It's an awkward situation." Salon's calls to Hager's office weren't returned.
Religious groups, adamantly opposed to the "abortion pill," are rallying around Hager. Connie Mackey, Family Research Council's vice president for government relations and a self-described feminist, says she agrees with Hager's conclusion that RU-486 is harmful to women and doesn't think his religious beliefs should disqualify him. His nomination also shows, she says, that Bush "is committed to bringing in people of faith and giving them a shot at working in conditions of influence."
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