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FDA Reproductive Panel Choices Spark Controversy

Pro-choice advocates accuse White House of injecting politics, theology into reproductive health

TUESDAY, Dec. 24, 2002 (HealthDayNews) -- The U.S. Food and Drug Administration today named 11 new members to an advisory panel on reproductive health, at least three of whom oppose abortion or birth control on religious grounds.

The holiday-eve announcement dismayed women's health advocates, who had strongly objected in October to one potential candidate, a Kentucky obstetrician opposed to abortion. Today, they found out he was selected, along with at least two others with similar views.

The advisory panel looks at contraceptives, fertility drugs like Viagra, hormones and other therapies that come before the FDA's reproductive drugs division. Its most recent controversial act was recommending that the FDA approve the abortion pill, mifepristone, which it did in 2000. Abortion foes have since been campaigning to reverse that step.

No one has objected to the appointment of Dr. Linda C. Giudice, chief of reproductive endocrinology and infertility at Stanford University Medical Center, to chair the panel.

"Under Dr. Guidice's stewardship, this panel will provide sound, science-based advice on reproductive health issues that will improve women's lives across the country," said FDA commissioner Dr. Mark McClellan, in a statement released today. McClellan, before coming to the FDA, was an associate professor of medicine at Stanford.

But there is indeed objection to three of her colleagues.

Gloria Feldt, president of the Planned Parenthood Federation of America, called the appointees "a Christmas present from President Bush," and accused the White House of "waging war" on the reproductive rights of American women.

"And they're using ideology to make that frontal assault so that reproductive rights will be a thing of the past," Feldt said.

The revelation last October of the potential candidacy of Dr. W. David Hager, a part-time professor at the University of Kentucky in Lexington, had triggered loud protest from abortion rights groups, who charged him with basing his medical beliefs not on sound science, but on Christian dogma.

An organization called The National Women's Health Network circulated a petition over the Internet to scuttle Hager's appointment, calling him "dangerous and inappropriate" and claiming he refuses to prescribe contraceptives for his single female patients. Planned Parenthood and other groups joined the chorus, urging the Bush administration to reconsider his appointment.

As proof, they refer to Hager's writings, which include a statement that women with premenstrual symptoms should turn to the Bible and prayer as well as other therapies.

"I have always said that when dealing with stress and emotional difficulties, a holistic approach" works best, Hager said in an interview with HealthDay today. "That includes prayer and meditation," as well as counseling and medication, he added.

Hager also said in the interview that he does oppose abortion "on demand" and in all cases unless a fetus "has anomalies incompatible with life."

And, he added, while he does discuss contraception with his unmarried patients, "I advise them that abstinence is the best way to avoid the consequences of non-marital pregnancy and sexually transmitted infections."

Hager acknowledged that his views "are going to affect my decision-making" on the panel. However, he said, "I objectively evaluate data to determine what is proper and improper."

Hager could find moral support from at least two other panelists who also have written about the link between Christianity and medicine.

One is Dr. Susan A. Crockett, director of maternity services at Christus Santa Rosa Hospital, in San Antonio. Crockett contributed to a book Hager co-edited, The Reproduction Revolution (Horizons in Bioethics Series): A Christian Appraisal of Sexuality, Reproductive Technologies, and the Family.

Crockett, who is listed as an "at-large" board member of the American Association of Pro Life Obstetricians and Gynecologists, was co-author of a chapter titled "Using Hormone Contraceptives Is a Decision Involving Science, Scripture, and Conscience."

Another choice, Dr. Joseph B. Stanford, of the University of Utah in Salt Lake City, advocates "natural family planning" -- essentially the rhythm method -- and opposes other forms of contraception.

In a 1999 article in First Things, a religion journal, Stanford described natural family planning as part of a larger perspective on the role of religion in health.

"I have found that medicine is permeated with attitudes toward sexuality and fertility that are incompatible with Christian values of the sanctity of life, marriage, and procreation, attitudes that both reflect and perpetuate the recreational approach to sexuality found in our secular culture," he wrote.

Earlier this year, in a pharmacology journal, Stanford also suggested that birth control pills and "morning after" contraception can trigger abortions, a view dismissed by mainstream reproductive health experts.

Efforts by HealthDay to contact Crockett and Stanford were unsuccessful.

Larry Bachorik, an FDA spokesman, denied that political considerations played a part in staffing the advisory panel. While Bachorik said he didn't know where the names of potential candidates originated, he said FDA Commissioner McClellan ultimately approved all choices.

The recommendations of FDA panels carry no force, though the agency rarely ignores their advice. But Bachorik said the committees do not set their own agendas; their priorities are handed down to them by the agency.

Tommy Thompson, secretary of the Department of Health and Human Services, which oversees the FDA, said when he was appointed that he had no plans to review the approval of the abortion pill.

Feldt, however, said even if Thompson doesn't do so, others in the government could. And she expects such a challenge in the coming year.

"But [the abortion pill] is just the tip of the iceberg here," Feldt said. "We have appointees here who even oppose the birth control pill, which has been used safely and effectively by the majority of American women at some time in their life."

Other members of the panel include Dr. Nancy Dickey, chancellor of the Texas A&M College of Medicine and past-president of the American Medical Association, and Dr. Michael Greene, director of Maternal-Fetal Medicine at Massachusetts General Hospital in Boston.

Panelist Leslie Gay Bernitsky, an Albuquerque urologist who specializes in women's health, said the topic of abortion never surfaced during her interviews for the panel. However, Bernitsky added, she was told the group would be dealing with "controversial issues."

Bertinsky declined to discuss her own views about abortion, and said they would not affect her actions on the advisory committee.

Although the panel last met in April 2000, its idle spell simply reflected a lack of items on the agenda, Bachorik said. So far, the agency hasn't chosen any topics for the committee to take up, he added.

What To Do

For more on the FDA, try the agency's web site. For more on reproductive health issues, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Gloria Feldt, president, Planned Parenthood Federation of America, New York City; Larry Bachorik, spokesman, U.S. Food and Drug Administration, Rockville, Md.; W. David Hager, M.D., professor part-time, obstetrics and gynecology, University of Kentucky College of Medicine, Lexington, Ky.; Leslie Gay Bernitsky, M.D., Albuquerque, N.M.; Dec. 24, 2002, news release, U.S. Food and Drug Administration
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