RU486


After I summarized how Plan B contraception works, I’m still getting letters confusing it with RU486. RU486 induces abortions. Plan B does not. RU486 is the opposite of Plan B.

Remember that what Plan B is is an artificially high dose of progesterone (it actually uses a progesterone analog, but it’s effectively the same.) Progesterone is a hormone that maintains the uterine lining in a nice, rich, spongy, receptive state, and it also suppresses another hormone, LH, that is what triggers ovulation. Plan B keeps the uterus primed for implantation, but tells the ovary to hold its fire and not release an egg.

RU486 can’t get much different. It’s a compound, mifepristone, that antagonizes progesterone—it binds to progesterone receptors and blocks their function, so that it looks to the cells as if progesterone levels have all all dropped to zero. The cells of the uterus, whether implantation has occurred or not, are tricked into menstruating right away, shedding the uterine lining and anything growing in it.

Now I personally think RU486 is a fine idea and a perfectly reasonable and relatively safe way to induce an abortion, and I think it ought to be legal and available. However, it is nothing like Plan B. Plan B is a completely separate issue from any argument over the ethics or utility of abortion.

Comments

  1. says

    Thank you for clearing that up. So unless a person is against contraception, they can’t be against Plan B birth control.

  2. QrazyQat says

    Well, it antagonizes the hell out of rightwingers for sure. The two are also an example of why a nation needs (as Carl Sagan said) a population which is somewhat scienticifically literate, because you need a basic level of scientific literacy to understand the difference. It’s a simple, obvious difference, but understanding it seems to be far beyond much of the population, not to mention the media. There are political decisions like this to be made all the time nowadays and we’re all suffering because of that illiteracy.

    We seem to be, at present, in a position that’s the opposite of Jefferson’s time, when he noted that Europe’s intellectuals were a half dozen years ahead of America’s on science, but America’s general population held a huge lead over Europe’s on the subject.

  3. craig says

    Until I read about Plan B here the other day, I had assumed it was RU486. Why? Because they are both referred to in the media as “the morning after pill.”

    You can bet that the confusion is not accidental. Anti-“abortion” leaders are plenty happy to keep thier followers thinking the two are the same.

  4. says

    I don’t imagine that there are many visitors to this site that can understand how difficult this issue is for people who have morals and scruples.

    I mean, on the one hand it can certainly be said with confidence that the majority of those who argue loudest for the right to tear their progeny from the womb, limb from limb, and flush the results down the toilet are themselves colossal wastes of human flesh; the less they procreate the better off the rest of us will be.

    Here’s wishing the PZ household gunny sacks full of RU486 and many, many perfectly reasonable and relatively safe abortions…but no.

    Ahh, there are those damn inconvenient morals and scruples dictating that approval of such actions by the lowest common denominators amongst us cheapen the human race as a whole. So here’s wishing that the PZ family join the rest of humanity as they will.

    How much easier must be a life where one’s moral compass is as free of set direction as the wind!

  5. says

    Because they are both referred to in the media as “the morning after pill.”

    What media? By whom? If in quotes by the forced breeding lobby, then the press needs to correct that every time. If in straight reporting, then those reporters need to be fired.

    I also have to say, I’ve *never* seen that distinction blurred in the media. Both drugs may be discussed, because they touch on the same issues (do women control their bodies, or do priests?) but the distinction has been made when I’ve read about them.

  6. bmurray says

    I expect it’s handier getting your morals from an arbitrary set laid down in a book of myths and adhered to without examination and certainly without revisitation on discovery of contradicting facts.

    A life wher you actually have to think in order to assess the morality of a course of action is both more difficult (in fact beyond many it seems) and more fulfilling. Any robot can follow a program.

  7. says

    Wow, swiftee. You even got in a couple of complete sentences, with verbs and everything!

    Can you actually read?

  8. says

    I don’t imagine that there are many visitors to this site that can understand how difficult this issue is for people who have morals and scruples.

    Ah, a forced-breeding advocate who wants to force not just their wife, daughter, sister, niece to live in El Salvador, but everyone else’s as well.

  9. says

    I expect it’s handier getting your morals from an arbitrary set laid down in a book of myths and adhered to without examination and certainly without revisitation on discovery of contradicting facts.

    The interesting part is that the book in question doesn’t support the position that the forced-breeding advocates take. Nor does the history of the faith that most of them say they follow.

  10. says

    How much easier must be a life where one’s moral compass is as free of set direction as the wind!

    It has obviously escaped your notice, swiftee, that compasses are supposed to be free of set direction. If you hold the little needle still it won’t give you a useful reading.

    And I don’t think you could have provided a more useful analogy to the problems of proscriptive and unthinking morality than holding the needle in the compass. Trying to dictate where North is won’t help you navigate any more than trying to dictate how people think and feel.

  11. says

    Heh, besides why compromise my own human dignity when there are sooo many of you out there so excited to do so on my behalf! (I’ve heard that the mud is good for one’s complexion too; true?)

    BTW, (Ithika) it has evidently escaped your notice…but um, a compass (a terrestrial compass) always points to magnetic north. Of course I couldn’t guess what yours does “out there” LOL.

  12. Lya Kahlo says

    “I mean, on the one hand it can certainly be said with confidence that the majority of those who argue loudest for the right to tear their progeny from the womb, limb from limb, and flush the results down the toilet are themselves colossal wastes of human flesh; the less they procreate the better off the rest of us will be.”

    Oh, totally! I mean, it’s clearly much MORE moral to force women – all women, regardles of circumstanc – to give birth. Maybe we should take a page from El Salvador’s book. There abortion is totally outlawed for all reasons. Women need to wait until their ectopic pregnancy bursts in her fallopian tubes to get surgery. Women who have miscarriages are examined by “Forensic Vagina Specialist” to make sure it was unintentional – and if it wasn’t – 30 years in prison. And if her mom helped her out, she goes to jail too.

    What a lovely moral picture you paint, swiftee! I’m *so* signing up for the Forced Pregnancy Agenda. Clearly turning women into nameless incubators is moral superiority! I’m converted!

    (source: http://guerillawomentn.blogspot.com/ – who cites their sources)

  13. says

    swiftee,

    What really makes life easy is having a gavel of moral disdain, swinging freely without the tethers of reasoned argument. But you know that already.

  14. Pierce R. Butler says

    For the record: RU-486 (named for the French Roussel Uclaf SA corporation, which transferred its US patent rights to the non-profit Population Council) is known generically as mifepristone, and is sold in the US by Danco Laboratories as Mifeprex.

    The controversy over its use has recently been rekindled by the deaths of two California women after taking it (along with another drug, misoprostol), attributed to infection by Clostridium soredelli, a bacterium found in soil and the human intestine. It’s rare for Clostridium to attack humans, though – conveniently unmentioned in anti-choice propaganda – it’s also been implicated in deaths after liver biopsy, colon disease, bowel dysfunction, and a caesarean section.

    Apparently all of the “RU-486” deaths occurred after misoprostol – used to expel fetal tissue by inducing uterine contractions – was taken vaginally instead of orally. Planned Parenthood, among others, now requires oral administration of misoprostol: what difference this will make remains to be seen.

    New Zealand has recently banned & seized Chinese-made pills which are claimed to be abortifacients on the Chinese-language web sites selling them in NZ, as mifepristone has not been approved there and the contents of said pills may not be as advertised. If abortion is further restricted in the US, we can expect a similar underground drug business here – the new version of the back alley.

  15. craig says

    Well, paperweight, that’s because you DID read… See, the thing is, I haven’t really paid any attention to this story, so I haven’t sought any information. Because of that, all I had heard was just the typical “headline news” snippets, etc. But I suspect that that’s the most that most americans have heard.

  16. wÒÓ† says

    swiftee–

    Are you wearing clothing made of two different kinds of fabric?

    Cause if you are, Jesus says knock it off right now.

  17. darukaru says

    Well, of course outrage against Plan B has nothing to do with moral or ethical arguments against abortion. Most pro-lifers have given up on the moral and ethical arguments against abortion themselves, and satisfy themselves with heaping piles of bullshit about “accountability”. Which is a code word for “punishing women’s sexual behavior.”

  18. says

    Swiftee, you seem to have missed the whole point of this entire discussion. PZ is discussing the “morning after pill” (the real thing, not mifepristone). As he explained in easy-to-follow words in his prior post, the MAP is not an abortificant, it is a true contraceptive.

    So. No ripping limb from limb, no flushing results into the sewer system, no moral compass swinging freely or tied down, none of the above. Just no sperm-meets-egg; little Miss Eggy peers out from behind her lacy window curtains, sees swaggering studly Spermboy, shudders daintily, and decides not to go out that day.

    You should be happy, right? Right? Or do you have moral and ethical qualms about *that* as well?

    (Don’t tell me: women should be punished for having sex. Men, eh. Boys will be boys, after all.)

  19. windy says

    swiftee wrote: I don’t imagine that there are many visitors to this site that can understand how difficult this issue is for people who have morals and scruples.

    Preventing OVULATION offends your morals and scruples? Do you worship the Moon Goddess or somesuch?

  20. G. Tingey says

    I think the internet (like here) should also make the old “gypsy remedies” better-known.

    A really large intake of mint (Mentha sp.) coupled with a judicious dose of Wormwood (Atrtemesia absinthum) and Rue (Ruta graveolans) should fix any unwanted pregnancies – though the action is like RU486 – it makes the womb-lining drop out, basically.
    Ther are other herbs which have this effect, but those 3 are the most effective.

  21. CrispyShot says

    Y’know, I’ve never understood why the anti-choice crowd thinks that pro-choicers regard reproductive decisions as trivial. Being male, my experience with abortion is necessarily limited (as is Swiftee’s), but I have been with friends as they’ve pondered that. It was nothing like the cavalier, oh-I-can-get-an-abortion-before-my-lunch-date stereotype the wingnuts propagate, and I find it quite insulting when they imply otherwise.

    Hey, Swiftee – don’t like abortion? Don’t have one. Oh wait, that’s right, you don’t have to woory about that.

  22. says

    Preventing OVULATION offends your morals and scruples? Do you worship the Moon Goddess or somesuch?

    I think he worships the male prerogative. You will present your ova to him; denying him the right to fertilize is a crime against mankind.

  23. says

    My family is full of people like swiftee, folks who equate allowing women to make their own pregnancy decisions with relishing the prospect of slaughtering babies wholesale. Continuum arguments are a bitch, because there’s no way I’m going to call a tiny clump of cells a human being, but the human being doesn’t spring magically into existence at the moment of birth; it’s just that there is no other discernable line that gets crossed during gestation. Some argue that this means you have to err on the side of “life” and make women chattels of the state if they become pregnant, a wholly repugnant notion. My reaction is that the decision can only belong to the pregnant woman. Even if I regard each abortion as a kind of failure, it takes more arrogance than I can muster to place the woman’s womb under state or federal authority.

    The real answer to abortion is not legislative intervention, it’s education and effective contraception (and I don’t mean “abstinence-only” education, which would be great if only it worked, but it doesn’t). Unfortunately, many of the abstinence-only promoters recoil in horror from the very notion of contraception. This is particularly true of those with Catholic backgrounds, because the Church teaches that only Natural Family Planning (the modern version of the old “rhythm method”) is allowed. They attack morning-after pills like Plan B as abortifacients because of the slender possibility that in some cases Plan B might prevent implantation of a fertilized egg rather than preventing the initial fertilization. It’s a matter of faith with these people that the fertilized egg is a human being, which to me makes as much sense as calling an acorn an oak tree.

    They’re right to be afraid of Plan B, though. Plan B and its successors will eventually steal the abortion issue from them, moving it from surgical intervention (which anyone could regret) to flushing away microscopic ova (almost all of them unfertilized), which is not a winning platform.

  24. Ray says

    I’ve come to the conclusion that it’s impossible to have a useful secular discussion about the ethics of abortion.

    The pro-life crowd is composed primarily of fundamentalist wackos who presume to already know what’s right, while the pro-choice crowd automatically assumes that anyone wishing to discuss the issue has the nefarious motive of furthering the oppression women: they also presume to know what’s right, which makes them no better than the fundies.

    That being said, I don’t see how anyone can have a problem with Plan B, though I understand how some on the pro-life side, due to their self-imposed lack of critical thinking skills, might be confused by the issue.

  25. anon says

    Hey PZ –

    You wrote “RU486 can’t get much different.”

    I think you meant “RU486 can’t get much MORE different.”

    BTW, really good post earlier about how Plan B works. Perhaps one further update about the possible cervical mucus effect and the more remote possibility of a uterine lining effect would provide a maximally thorough discussion of the science of Plan B. Though if you want to keep the focus on the primary effect, then that makes some sense too.

    I just think we should address the uterine lining argument because it’s so weak and it’s important for people to know that it’s weak: even if this conjectured secondary effect did exist, it would only slightly alter the already-high probability of non-implantation of any random fertilized egg.

  26. Karey says

    Is it true that Plan B leaves the lining primed for implantation? Because that is the one issue on which so called pro-liifers hinge their case against Plan B on and why so many pharmacists get away with refusing to fill its prescription. Some recent studies have been calling into doubt whether it has a noticeable effect on implantation after all, but prevailing opinion on the subject has been that it does have a mechanism at work by reducing implantation somehow.

  27. rrt says

    Ray, as some others have been pointing out, there are (as I see it) two reasons some object to Plan B:

    1. For some, this isn’t about abortion at all, but the aforementioned female reproductive control and/or the general “evilness” of non-reproductive sex. With Plan B, however it functions is irrelevant…the critical fact is that it helps to remove a functional barrier to casual sex. Tying it to the potent pro-life “you’re killing babies!” argument is easy, because they can make allegations that in some cases it might not prevent fertilization but will still prevent pregnancy, and (to them) fertilization not leading to pregnancy = abortion.

    2. The rest are listening to the people from #1.

  28. Paul W. says

    Karey,

    We went over a bunch of this in the comments on the previous Plan B thread…

    Basic qualitative reasoning suggests that Plan B would more likely promote implantation than suppress it. Studies in rats and monkeys suggest that it doesn’t do either. Studies of the effects on ovulation (only) in humans seem to show that Plan B’s efficacy is entirely due to suppression of ovulation—it fails about as often (in those studies) as it fails to prevent pregnancy in practice:

    http://www.popcouncil.org/publications/popbriefs/pb11(2)_3.html

    Here’s the Wikipedia entry on Emergency Contraception, which is where I got the above link:

    http://en.wikipedia.org/wiki/Emergency_contraception#Controversy_in_relation_to_abortion

    Previous speculation that Plan B would inhibit implantation of fertilized embryos was apparently based on an alleged effect for conventional birth control pills. As I understand it, that effect was never substantiated, and the reasoning behind it wasn’t good, but it made a good marketing claim.

    The bottom line seems to be that there are pretty good reasons to think Plan B would not inhibit implantation, and recent empirical evidence that it doesn’t; if it did, it wouldn’t fail an eighth of the time.

    If you’re pro-contraception but against anti-implantation drugs like RU-486, that’s good news about Plan B.

    Otherwise, it’s good to have RU-486 available in case Plan B fails.

  29. Dianne says

    Basic qualitative reasoning suggests that Plan B would more likely promote implantation than suppress it.

    Interesting. If it works that way in humans plan B might be useful as an aid to IVF, where one of the main barriers is the rarity of successful implantation. That’d make for an interesting set of indications: both prevention AND promotion of pregnancy.

  30. rrt says

    Well, it sounds like the research was suggesting it’s neutral, but if that effect does exist, wouldn’t THAT make some anti-Plan B heads explode!

  31. says

    Swiftee,

    Have you ever actually had sex? Reading your comments, which
    are not very closely grounded in reality, one wonders.

    CrispyShot,

    I had an abortion and didn’t agonize about it–it was so very obviously the right thing to do in the situation.

    No, of course I didn’t decide, ahead of time, not to use contraception and then, if necessary, get an abortion before lunch.

    It took place before breakfast. They wanted to do it with me fasting.

    I will be 50 this year. I have a lefty blog, but I am a pillar of society.

    Do I really have to claim I agonized over my abortion in order to show that I don’t hate children, am not irresponsible about birth control, etc.?

    I am tired of hearing prochoicers say how hard abortion is for them, too, as so many do nowadays. Why get caught in right wing rhetoric?

  32. says

    My family is full of people like swiftee, folks who equate allowing women to make their own pregnancy decisions with relishing the prospect of slaughtering babies wholesale. Continuum arguments are a bitch, because there’s no way I’m going to call a tiny clump of cells a human being, but the human being doesn’t spring magically into existence at the moment of birth; it’s just that there is no other discernable line that gets crossed during gestation. Some argue that this means you have to err on the side of “life” and make women chattels of the state if they become pregnant, a wholly repugnant notion. My reaction is that the decision can only belong to the pregnant woman. Even if I regard each abortion as a kind of failure, it takes more arrogance than I can muster to place the woman’s womb under state or federal authority.

    The real answer to abortion is not legislative intervention, it’s education and effective contraception (and I don’t mean “abstinence-only” education, which would be great if only it worked, but it doesn’t). Unfortunately, many of the abstinence-only promoters recoil in horror from the very notion of contraception. This is particularly true of those with Catholic backgrounds, because the Church teaches that only Natural Family Planning (the modern version of the old “rhythm method”) is allowed. They attack morning-after pills like Plan B as abortifacients because of the slender possibility that in some cases Plan B might prevent implantation of a fertilized egg rather than preventing the initial fertilization. It’s a matter of faith with these people that the fertilized egg is a human being, which to me makes as much sense as calling an acorn an oak tree.

    They’re right to be afraid of Plan B, though. Plan B and its successors will eventually steal the abortion issue from them, moving it from surgical intervention (which anyone could regret) to flushing away microscopic ova (almost all of them unfertilized), which is not a winning platform.

  33. says

    ProfZero–No, you don’t have to claim to have agonized, but please don’t knock those of us who say how hard abortion is for us as being “caught in right wing rhetoric”. People are different, and have different responses to the same situation–which is why I argue for “choice”. It’s not up to me to say how someone else should feel about having an abortion. I have lots of friends who wouldn’t agonize a bit about it; lots of other friends who would definitely have to do a lot of thinking; a couple of friends and relatives who have had abortions of long-awaited and well-advanced pregnancies due to “incompatibilities with life”; and am acquainted with some women who gave birth and relinquished for adoption. Each of these women obviously feels/felt differently about the subject.

  34. CrispyShot says

    Prof. 0,

    My education continues. As I said, my experience is limited, and I appreciate you sharing yours.

  35. Molly, NYC says

    OT-esque, but did y’all get a look at “Pro-Life Nation” in the Sunday Times Magazine?

    The description of the sorts of expense, suffering and terror of women looking for abortions?

    Children, that’s what this country was like before Roe v. Wade. Obviously, DAs didn’t trawl OB wards looking for fresh meat like they do in El Salvador, but that scared-spitless feeling every time you were a little late, wondering where to go, what you’d have to hock, the choice between rent money and money for –what? A real doctor? A gas-station attendant posing as a doctor? Someone who sterilized his instruments and didn’t stop in the middle to rape you? And where would you find one, anyway? (And in case you were wondering: If you were a married woman, impregnated by your own husband through state-sanctified sex–no, the situation wasn’t any better.) And even when you weren’t worried yourself, every few years there’d be someone, an acquaintance, a relative, a neighbor–usually a young woman in perfect health, often a mother–suddenly dead.

    I’m just old enough to remember how scary it was, and I should hit menopause any minute now. Almost no American women of childbearing age experienced it. Which is as it should be.

    But it’s what Swiftee and his ilk want for them.

  36. amorphous says

    I don’t imagine that there are many visitors to this site that can understand how difficult this issue is for people who have morals and scruples.

    I mean, on the one hand it can certainly be said with confidence that the majority of those who argue loudest for the right to tear their progeny from the womb, limb from limb, and flush the results down the toilet are themselves colossal wastes of human flesh; the less they procreate the better off the rest of us will be.

    Well, that was certainly a refreshing demonstration of morals and scruples. And I’ll be sure to pass this along to any rape victims I know.

  37. says

    Democrats and moderates have an opportunity to change the debate on abortion and Roe v. Wade by forcing the right to specify the intended criminal consequences…including the length of prison terms they propose for both the doctor performing an “illegal” abortion and the woman receiving an “illegal” abortion.

    As long as the debate remains an abstract dialogue founded upon values and religious principles, the right will continue to garner support from voters that would, given a dose of reality, likely rethink their position on the criminalization of abortion.

    Changing the debate would also force Republicans, who have enjoyed the cover of rhetoric, to take a position they may ultimately find unacceptable and more importantly, politically damaging and dangerous.

    If nothing else, the reframing would force an honest debate about contraception and the fallacy of simply promoting abstinence only solutions. When confronted with the possibilities of an unwanted pregnancy and no viable alternatives, the moderate middle of America will likely fall on the side of better education and expanded availability of preventative methods like Plan B, as well as a reconsideration of the use of RU486…not a bad outcome from numerous perspectives. Obviously, there are people on the extreme right who will object to this approach…but they will find themselves isolated in their extremity.

    I’ve always been convinced that the party that can strike the right tone with reasonable Americans in the middle will win elections. While many politicians garner criticism from vocal members on either extreme when moving towards the center, I’m inclined to think politicians ought to court the center first…and then pick off voters from the extremes.

    The obstacles to this approach are the caucus and primary systems where participation is typically skewed to the extremes. At the same time, I think it goes a long way towards explaining the typically low voter turnout seen in this country. The middle becomes necessarily neglected until the general election and by that time they are disenchanted.

    http://www.thoughttheater.com

  38. DrYak says

    New Zealand has recently banned & seized Chinese-made pills which are claimed to be abortifacients on the Chinese-language web sites selling them in NZ, as mifepristone has not been approved there and the contents of said pills may not be as advertised. If abortion is further restricted in the US, we can expect a similar underground drug business here – the new version of the back alley.

    What are you talking about? Mifepristone + prostaglandin is the treatment of choice (before 63 days) in New Zealand and has been for a considerable amount of time!
    http://www.abortion.gen.nz/procedures/medical.html

    The chinese pills were seized because they were uncontrolled and nobody could be sure of exactly what was in them – they had not gone through any safety controls, in addition it is better to have these drugs administered in a clinical setting where the patient’s condition can be monitered. Abortion is perectely legal in NZ, albeit there are some problems with the amount of time that it can take before people can get an appointment (a disturbingly high percentage of women have to wait a couple of weeks because of to few facilities).

    I can see your point about the black market, but it behooves us to get our facts straight in this debate.

  39. Rocky says

    I read the above from “Swiftee” with interest. His point was already made in a wonderful movie call the “Handmaids Tail”. I reccomend it to all for a version of the pro-lifer reality………

  40. Samnell says

    “I don’t imagine that there are many visitors to this site that can understand how difficult this issue is for people who have morals and scruples.”

    I have morals and scruples, which is why I see the pro-life movement with a sense of profound moral horror. Were I not so encumbered, I suppose it would be easy to see women as incubators for the state.

  41. Pierce R. Butler says

    DrYak –

    Right you are – I was confusing the New Zealand situation with that in Australia, where there is an intense (and typically uninformative) debate about mifepristone underway (mostly provoked by a Bushevik-style Health Minister).

    One report [http://www.medindia.net/news/view_main_print_new.asp] has it that the confiscated medicines included “two emergency contraceptives, three abortion pills and one contraceptive pill.” Another report [http://www.stuff.co.nz/stuff/print/0,1478,3632621a10,00.html] said on Sunday that “Two Chinese students needed urgent medical treatment after taking illegal abortion pills…” – one received hers from her parents in China, and the other refused to divulge her source.

    Apparently tensions around the issue are high in NZ: a March 31 meeting of the New Zealand Abortion Providers, the first in 5 years, was held under very high security, with guards scanning IDs and no members of the public allowed.

  42. Paul W. says

    rrt writes:

    Well, it sounds like the research was suggesting it’s neutral, but if that effect does exist, wouldn’t THAT make some anti-Plan B heads explode!

    You’re right on the former count—it doesn ‘t actually appear to increase implantation, but you are right on the latter count anyway, and heads should explode.

    Plan B apparently reduces the number of abortions—natural, spontaneous abortions—by preventing ovulation and hence fertilization.

    A large fraction of fertilized embryos are spontaneously aborted. By preventing 3/4 to 7/8 of those fertilizations, the corresponding spontaneous abortions are prevented, too.

    (See Matt McIrvin’s version of Amanda Marcotte’s argument in the Plan B thread.)

    Of course, spontaneous abortions are God’s Very Own Abortions, so maybe this is interfering with God’s Perfect Plan to ensoul random embryos and abort them anyway, or maybe to notensoul them because he plans to abort them anyway… or something. And maybe that’s a very bad thing, to fail to fertilize the embryos that God means to abort anyhow… or the ones that he didn’t, or something.

    It’s hard to figure. Maybe God just can’t adapt to Plan B. Maybe he accidentally ensouls the unfertilized eggs Meant To Be Fertilized According To Plan A. Maybe he just gets all confused and fails to ensoul any embryos anywhere near Plan B, including some that are fertilized, implanted, etc. Maybe we get soulless zombies, because God just can’t keep track of his medication.

  43. Geoffrey Brent says

    I was confusing the New Zealand situation with that in Australia, where there is an intense (and typically uninformative) debate about mifepristone underway

    Not really; that debate pretty much ended back in February, with the decision to pass authority for approval back to the Therapeutic Goods Administration, where it should’ve been all along. I don’t know how the TGA’s deliberations are going, but since they’re making the decision on medical grounds it’s likely to be approved in due time.

    Long version, for those who are curious: among other things, the TGA is in charge of approving drugs for use in Australia. Their decisions are made by a panel of medical professionals, based on issues like safety and efficacy. Ordinarily, the TGA would have assessed RU-486 ten years ago.

    However, back in 1996, a conservative independent (Brian Harradine) held the balance of power in the Senate. This resulted in a lot of horse-trading, and one of the deals Harradine made was that in return for his support on a bill to privatise Telstra, the Coalition government passed a bill making RU-486 subject to ministerial approval. While the Coalition as a whole isn’t as conservative as Harradine was, it was very unlikely that any Coalition Health Minister would approve RU-486; ten years on, they’re still in power.

    However, in 2006, four senators from Australia’s three major parties and one of the minor ones co-sponsored a bill (that is very unusual in itself) to end this state of affairs and transfer the responsibility for vetting RU-486 back to the TGA. In Australia, politicians are usually expected to vote with their party, but the major parties left their individual members to vote according to individual consciences. It was very hotly debated, but in February it passed 45-28 with three abstaining; it went on to pass unaltered in the House of Representatives.

    This was generally seen as a victory for the pro-choice side, since the TGA is far more likely to approve RU-486 than the Health Minister ever was. But AFAICT, most of those who voted treated it not as a verdict on whether abortion should be legal, but on whether – given that it *is* legal – this particular method should be an exception to the usual approval process. (At least one senator who opposes abortion nevertheless supported the bill for this reason.) So AFAIK, the decision is now back with the TGA, where it should have been ten years ago.

  44. Tree says

    From New York State’s econ analysis, prior to new legislation:

    “Nationally, 49 percent of all pregnancies (excluding miscarriages) are estimated to be unintended. In New York, the proportion of unintended pregnancies (for 2000) is estimated to be much higher, nearly 58 percent. The Office of the State Comptroller (OSC) estimates that about 244,321 pregnancies in the State were unintended in that year.
    The causes of unintended pregnancy are diverse. Although today’s medical technology has given women the ability to plan their pregnancies, that technology is not infallible and women using contraception do, in fact, become pregnant. Some women become pregnant unintentionally because they do not have access to contraception, while others do not consider the possibility that a pregnancy will result from sexual activity and neglect to use contraception. In addition, some women become pregnant as the result of a sexual assault.
    In New York, two-thirds (164,630) of the unintended pregnancies in 2000 ended in abortion. The overall number of abortions per 1,000 women in New York for 2000 was 39.1. The remaining one-third (79,691) of these unintended pregnancies resulted in birth. The women experiencing these unintended pregnancies and the children born from them face a number of negative physical, emotional and financial impacts, such as depression, neglect, abuse and low birth weight, often leading to life-long challenges. Emergency contraception, if available and accessible, could play a substantial role in addressing the problem of unintended pregnancy and its consequences in New York State. In addition to the considerable impact on women and their families, unintended pregnancies – whether they result in abortion or birth – drive significant costs in both publicly and privately financed health systems. OSC estimates, based on 2000 data, the healthcare cost for the abortions, as well as the births associated with unintended pregnancies, in New York State would be $913.3 million in 2003. With this cost in mind, OSC has undertaken a preliminary analysis of the fiscal implications of making emergency contraception more readily accessible.

    System-wide savings will be even greater when potential savings in the health care sector not funded through Medicaid are considered. OSC determined that, after adjusting for inflation to June 2003, unintended non-Medicaid pregnancies in the year 2000 cost $402.5 million. A total of 33,655 births and 105,890 abortions accounted for this cost. For the purposes of this report, this category, “Other New York Healthcare Systems” consists of those who have private insurance, self-pay, are enrolled in public non-Medicaid healthcare programs or are uninsured. Reducing the number of unintended non-Medicaid pregnancies by half (to 69,772) would result in 16,828 fewer births, with a savings of $153.6 million, and 52,945 fewer abortions, with a savings of $13.4 million. 3
    A total savings of $167.0 million would be realized for unintended non-Medicaid pregnancies, which includes offsetting costs of the ECPs.

    New York State, Office of Budget and Policy Analysis, Emergency Contraception: Fewer Unintended Pregnancies and Lower Health Care Costs, pg 4-5, November 2003, (Adjusted) February 2005.

    Save taxpayer money, reduce abortions. What’s not to like about Plan B?

    Tree, proud of Paul’s expansion of the details

  45. Pierce R. Butler says

    Again, my attempt to leaven the conversation with some facts has been corrected – and again, I’m glad that Geoffrey Brent set the record straight.

    So, here’s a third try (based on a 3/28/06 story from http://www.theaustralian.news.com.au/printpage/0,5942,18639669,00.html ):

    Adding more potential confusion to the discussion, research shows that a small dose of mifepristone – about 1% of that used to induce abortion – may be an effective routine contraceptive, with advantages over today’s birth control pills.

    Two tests involving almost 200 women found the low-dose mifepristone regimen as effective as regular pills. Because no estrogen is involved, this may lower the breast cancer risk of modern oral contraceptives, and possibly even serve as a cancer preventive; because it halts women’s periods, it might also reduce PMS symptoms correspondingly.

    There are indications mifepristone may also be therapeutic for uterine fibroids, endometriosis and abnormal gynecological bleeding.

    All of which is potentially good news for women’s health, but is certain to add to popular misunderstanding, both innocent and contrived, about what is and isn’t an “abortion pill.”

    So – what have I missed or mistaken this time?

  46. Flex says

    Ray wrote, ‘The pro-life crowd is composed primarily of fundamentalist wackos who presume to already know what’s right,….’

    That is a simplification. I know a good Lutheran woman who is rational and does not believe in the literal interpetation of the bible, who also cannot be talked to about abortion because it ‘kills children’. There is no scientific explination about the nature of a fetus or a the development of a zygote which will convince her otherwise, and arguments along those lines have not only failed to sway her opinions, but have generated a distrust toward science in general. (A distrust, not a dislike. It’s a subtle distinction, but a valid one.)

    To her, the slogan ‘pro-choice’ is a horrible admission that some women may actually CHOOSE to get an abortion without having medical reasons for getting one.

    To her, the idea that the state should be getting involved in women’s reproductive decisions is not a sign of invasiveness, but a sign of how degenerate our society has become.

    However, I would not classify her as a fundamentalist.

    Humans are complex beings, that’s what makes them so fun to be around.

    Cheers,

    -Flex

  47. Pierce R. Butler says

    The Associated Press now reports [ http://www.msnbc.msn.com/id/12255365/ ] that mifepristone has been ruled out in one of the two recent deaths being investigated:

    “The one death was unrelated to either abortion or use of the pill, the Food and Drug Administration said. The second woman showed symptoms of infection. One of the women died weeks after her abortion, although it was not immediately clear which of the two. … the drug… has not been proved to be the cause in any of those [four Clostridium sordelli-positive] cases, the FDA has said. … Neither of the two women followed FDA-approved instructions for the pill, which require swallowing three tablets of one drug, followed by two of another drug two days later. Instead of swallowing the final two tablets, the second course of pills was inserted vaginally in the four women, an “off-label” use that studies have shown effective and that has been recommended by a majority of the nation’s abortion clinics. That use does not have federal approval, though studies have indicated it produces fewer side effects. … The only other U.S. death associated with RU-486 was a case of a ruptured ectopic, or tubal, pregnancy in October 2001. The drug is not to be used by women in those cases.”

  48. amorphous says

    That is a simplification. I know a good Lutheran woman who is rational and does not believe in the literal interpetation of the bible, who also cannot be talked to about abortion because it ‘kills children’. There is no scientific explination about the nature of a fetus or a the development of a zygote which will convince her otherwise, and arguments along those lines have not only failed to sway her opinions, but have generated a distrust toward science in general. (A distrust, not a dislike. It’s a subtle distinction, but a valid one.)

    So talk to her about Plan B. Say it prevents conception, as does implantable contraceptives or condoms. Show her this Plan B post. Bring up scenarios about rape or incest. Is she saying that even in these situations, there are no considerations besides “killing children”? Is she in favor of charging both the woman and doctor with premeditated murder in the case of abortions?

  49. rrt says

    I’m not sure rape and incest are really the grounds we should be arguing this on, anyway. It seems to have some traction with some pro-lifers (strangely, to me, given that with their mindset they could portray it as no different from a woman blowing a toddler’s head off with a gun because she was raped today). But it suggests we’ve conceded the original point about the nature of embryos, let alone the non-abortion-causing nature of Plan B, and if it’s fundamentally wrong to kill embryos, then claiming exceptions in rape and incest is trying to make two wrongs = right.

  50. Paul W. says

    rrt writes:

    I’m not sure rape and incest are really the grounds we should be arguing this on, anyway.

    I basically agree. I was only bringing up the rape and incest exceptions, which many moderates do accept, to illuminate what’s going on in most people’s heads now. Most people don’t really think an embryo is a person, but many do think it has some significant moral weight. That is definitely not a point I want to concede.

    Unfortunately, there aren’t a lot of good metaphors for embryos.

    One metaphor I’ve used is that an embryo is most importantly an automatically randomly-assembled blueprint, or something rather less than that; more like a provisional, partial sketch for a floorplan that will be elaborated and revised later.

    A floorplan is not a person, or anything much like a person. Or even a house.

    Some commentators in previous threads have latched onto the uniqueness of this floorplan sketch—fertilization creates a unique assemblage of information that specifies a particular person.

    To which I have two responses: (1) no, it doesn’t and (2) so what? It’s still just one of a vast number of possible floorplan sketches that are readily, randomly assemblable.

    The first point is that a given combination of chromosomes isn’t unique; we might indeed get pretty much the same basic sketch if we push the button and generate another random combination of parental chromosomes. That’s close enough to identical, given the vagaries of development anyway.

    More importantly, that particular randomly-assembled floorplan sketch isn’t morally special; it’s random. It didn’t do anything special except win a particular random lottery. It has no moral weight greater than the next combination of chromosomes we’d get if we pushed the button again, or the one after that—or zillions of possible sketches we don’t have the resources to enumerate.

    To say that it’s a person, or anything remotely like a person, is like saying that if an architect uses a random floorplan-generating program, she has a substantial obligation to build any house that the program generates—don’t push the button if you’re not promising to build the house.

    I admit that this analogy doesn’t capture something that seems important to a lot of people with qualms about abortion.

    A lot of people have a hard time thinking about possible things vs. actual things. To them an embryo is importantly an actual thing, to which you could and maybe should commit, not just another possible configuration of chromosomes, out of a vast space of possibilities. I think that’s wrongheaded, but it’s a sticking point.

    So to belabor the analogy, imagine some people planning a subdivision, where every house is probably unique. They walk around driving stakes into the ground, signifying where to build houses. And when they drive a stake into the ground, they generate a random floorplan sketch, print it out, and staple it to the stake—basically saying “build a house roughly like this about here.”

    Many of the sketches get destroyed or blown away by the weather. (Spontaneous abortions.) Sometimes somebody comes back around and puts a new floorplan sketch there; sometimes they don’t. That’s no big deal, because floorplan sketches are cheap, whereas the investment to actually elaborate the design and build the house is huge.

    Sometimes the floorplan generator malfunctions, and prints two copies of the same sketch, such that two very similar houses get built side by side. (“Identical” twins.) Sometimes two different sketches get stuck together, and one hybrid-floorplan house gets built from two distinct floorplans. (Embryonic fusion chimeras.)

    Still, it’s just randomly instantiating particular combinations and tentatively associating them with particular physical building sites. There are no houses yet, and more importantly nobody is home.

    That’s my admittedly somewhat lame metaphor. Anybody got a better one?

  51. Geoffrey Brent says

    …and just yesterday, the TGA did indeed give a Queensland doctor approval to use RU-486 for abortion purposes. It hasn’t been generally approved yet – I think that requires a drug company to make a request to the TGA, or something of that sort – but if they approved it in that case, presumably they’re willing to approve in others.

    Pierce – I didn’t mean to be heavy-handed in correcting you there, what you wrote was a reasonable description of the debate here as it was a few months ago, just that it missed more recent developments. After a lot of heat and noise, the parliamentary debate was actually quite encouraging; I was pleasantly surprised to see evidence of independent thought in people who usually toe the party line.