Public Comment at PCAST – Easy Means of Organized Plan B Advocacy

While the bulk of public comment sessions at U.S. federal government meetings are light on comments from regular citizens (if not just light on comments), sometimes interested, organized parties fill the gap.

As I noted during the PCAST meeting on Friday, there was some discussion in the public comment period related to scientific integrity.

Since the meeting video is now available, I caught up with what I missed on the webcast (each session has its own video file).  The discussion was framed by the Plan B decision of the Food and Drug Administration (FDA) that was overruled by the Secretary of Health and Human Services (HHS).  The Secretary complicated matters by referring to a lack of scientific studies about the drug and younger girls, and “commonly understood” cognitive and behavioral differences between the youngest girls of reproductive age and older adolescent girls.  In other words, she fought science with science.  She didn’t have to as the law allows her the ability to overrule the decision independent of a scientific justification.  But since she did, the decision is being fought on those grounds.

That fight continued in the PCAST meeting yesterday.  Five people commented, four representing various reproductive health groups, and one from the Union of Concerned Scientists.  The criticisms were what you might expect, with pretty clear counterarguments to what scientific arguments the Secretary mustered to defend her decision.  Since the decision to overturn the science was defended by also appealing to the science, the claims of violating scientific integrity or failing to ‘put science in its rightful place’ were frequent. As much as I don’t care for making this fight about science, I understand why those commenting opted to accept the frame that Secretary Sebelius placed on the decision.

Process concerns were raised, with one witness concerned that the Secretary’s science-based rationale would provide cover for other politically motivated decisions on other health products (starts around 5:40 in the video).  Having watched similar issues in the U.K., mostly around drugs policy, there is a related motivation for narrowing the debate in this manner – it allows decision-makers to avoid messy explanations that likely better reflect the truth (I’m looking in the general direction of the U.K. Home Office).

I appreciate Dr. Grifo’s efforts to use this fight to move things forward on scientific integrity matters.  She asked that the draft HHS policy be made available for public comment this month.  The president’s science adviser, Dr. John Holdren, indicated he would consider the request and forward all the concerns expressed that afternoon to the President.

He also noted – rightly – that scientific integrity does not guarantee that scientific assessments would determine the outcome of policy decisions.  It can only guarantee that the clearest and most objective assessment of the science be made available for decisions.  If we want science to dictate policy, we have to get political and understand that science often can’t determine the best option.

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One thought on “Public Comment at PCAST – Easy Means of Organized Plan B Advocacy

  1. Pingback: PCAST and Bioethics Commission Back At It With Meetings « Pasco Phronesis

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