Emergency response:

Because of a family conflict of interest (which I’m not going to discuss further, but I’ll note that there is one) I haven’t blogged much about what’s sometimes called the “War on Science.” ( I have written here, at TNR, registration required, on the general category of ‘gag rules’ of which several of the ‘war on science’ cases are a subset.)

The items in this indictment include: a scare campaign against NIH for funding studies about things that offend the sensibilities of Focus on the Family (for example, studies that try to understand sexual practices and decisions among prostitutes– something that one might think well worth studying in order to figure out how to slow or disrupt the vectors of HIV transmission); pressuring the CDC to back off of support for condoms as part of HIV-prevention; and pressuring the National Cancer Institute to give credence to the scientifically-unsupported claim of a link between abortion and cancer. This isn’t the first administration to meddle in scientific review processes for political purposes, but the current administration’s version is particuarly worrisome. It’s concentrated on public health in general and reproductive health in particular, interfering with the ability of public policy to deal honestly and competently with AIDS in particular.

Now, strict libertarian principle (or even strict Rawlsian-neutralist liberal principles) might tell us that state funding of research is a bad idea, but doesn’t give us any guidance as to how it should be structured if it exists. My view is something like this: if state funding of research is justified, it has to be because of the value of getting good science and good research. That requires that the programs, to have merit, have to be insulated as much as possible from political interference and left free to pursue good science. The basic mechanism for this is peer review. Without an open process vetted only by peer review, NIH, the CDC, and all the rest become pure pork, and arguably detrimental to the pursuit of good science. (An analogy, for my libertarian bretheren: we don’t need a state-provided currency. But given that we have one, it’s better that we have an independent Federal Reserve than if monetary policy were set by the Secretary of Treasury or by Congress.)

Now another case, maybe, and one that doesn’t involve any complicated questions about funding. The FDA has delayed a decision on whether to make an emergency contraceptive (“morning-after pill”) available over-the-counter. EC is effective only within 72 hours of intercourse (because it is not an abortifaceant). The need to get a prescription for it severely limits access. The FDA’s expert panel voted overwhelmingly for over-the-counter access in December, but social conservatives have been putting a great deal of pressure on the administration to block approval. Delays in the approval process aren’t at all unheardof. The FDA sets its own rules and its own timetables. But the safety of EC has been very, very thoroughly studied. The safe betting is that this is not a delay on the scientific merits but rather an attempt to appease the religious right (for at least a little while, and maybe until after the election), at a real cost, both in terms of freedom and in terms of an increase in unwanted pregnancies– which almost certainly means an increase in abortions, later on.

UPDATE: See more from Mark Kleiman and Eszter Hargittai.

I’ve gotten a bunch of e-mail complaining about my simply saying “EC is not an abortifaceant.” EC is ineffective after implantation, as far as we can tell; and implantation is what doctors use to mark the beginning of pregnancy, because it’s when the relevant changes to the woman’s body begin. EC therefore doesn’t terminate pregnancies, and is not medically classified as an abortifaceant. Of course, to those whose concern is with protecting the lives of newly fertilized eggs, implantation is not the relevant beginning, and they class EC (like IUDs) as an abortifaceant. Terminological dispute duly noted.

It appears, however, that EC is still more efficacious at preventing conception post-intercourse (remember, there can be quite a long gap between those two events). The sooner it’s taken, the more likely it is that it’s preventing conception rather than preventing the implantation of a zygote. I would think that this would make it seem like a matter of moral urgency to pro-lifers-who-really-believe-conception-is-the-moment that women take EC as rapidly as possible, which requires over-the-counter access rather than waiting for a prescription. But it doesn’t seem to work that way.

Other folks e-mailed to complain that the Clinton administration interfered with review processes as well, and that the EPA’s notorious meta-analysis of second-hand smoke studies was bad. Yep. Agreed. But the current administration has been undermining NIH and CDC pretty continuously. Moreover, if push comes to shove, I do think that the consequences of blocking good HIV research and HIV-prevention strategies are worse than the consequences of a too-restrictive policy on second-hand smoke, though I certainly do oppose such excessively restrictive policies.

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