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weather: mainly sunny
outside: 24°C
mood: fascinated
Preamble: I'm not trying to convince anyone of anything. These are just my own notes, as if I were in a lecture, writing things down and talking to myself so that I can learn.

I came across a circulating petition about David Hager's appointment to the FDA Reproductive Health Drugs Advisory Committee (original text included here). I Googled it and Snopes'ed it. It must be an oldoldold petition from probably September 2003. It's talking about the committee not meeting for over 2 years, so they must be talking about the huge break between 2000 and 2003.

The Snopes article on W. David Hager is pretty damning. That surprised me because the forwarded message looked really histrionic.

Dr. Hager is a practicing OB/GYN who describes himself as "pro-life" and refuses to prescribe contraceptives to unmarried women.

Okay, wait. There ARE legitimate instances where ANY doctor ABSOLUTELY SHOULD be refusing a woman birth control pills. If they are prone to blood clotting, have liver problems, heart problems, etc. then they CANNOT be on "The Pill". All brands of birth control pills are DRUGS and, as such, have CONTRAINDICATIONS. Maybe she was over 35 and a heavy smoker or had suspicious lumps in her breasts... but just so happened to be not married. There is insufficient data to conclude anything from that one statement.

I also found Linda Eisele-Lockett who claims to be pro-choice, mother of two adult children, to have written directly to David Hager and has posted his responses (with his permission), as well as a response from a former patient of his.

I was actually beginning to gain a little respect for Dr. Hager. The things he said were sounding quite reasonable if you believe that he's telling the truth. Until I read this at the bottom of the RU-486 Update:

Regarding my management and writing about stress-related disorders in women, I have always offered a holistic approach to therapy. I suggest diet/exercise changes, medications as needed, counseling when required, and meditation/prayer. This is very distasteful to NOW and Planned Parenthood.

And with that kind of mean-spirited dig at two of the most well-respected organizations in the area of women's health, a large portion of his respect points went out the window. Wow, what an asshole.

Of course, why Hager doesn't seemed to have responded to anyone else except Linda is an interesting question. As is the question why Linda has no main webpage, but her entire site is under the "davidhager/" subtree. And where on earth did "Tina"'s testimonial come from?

[Update - 2221h]

Oh yeah, let's not forget that it's not just David Hager that makes up the Reproductive Health Drugs Advisory Committee. It's a group of 13 people (5 of which are women, so still a significant portion). Each of them have their CVs online in PDF form. This site (updated August 3, 2004) also says that Dr. Linda Giudice is the Chair which matches this site.

Stupid politics aside, I went looking for Mifepristone/Mifeprex/RU-486 itself. That seems to be the controversial drug in question. It could still be one of two things: either 1) the studies on it are iffy, so its Accelerated Approval was indeed the wrong thing to do or 2) Hager & Crew are being jerks about it.

I found:

Probably the most interesting is this paragraph in the Wiki reference:

The compound was discovered by researchers at Roussel Uclaf of France in 1980 while studying glucocorticoid receptor antagonists. Clinical testing began in 1982. It was first licensed in France in 1988, for use in combination with prostaglandin. Then on October 26 of that year, Roussel Uclaf stated that it would abandon distribution of the drug. It bowed to pressure from the government of France two days later to resume distribution. Mifepristone was approved in a number of other European countries in the 1990s: for example, the United Kingdom approved its use in 1991.

Oy, what happened there? I realize it could have been logistics, missing paperwork or something silly like that. The "bowed to pressure" could just be someone's personal spin on it. But it makes you go "hmmm..." =)

So.

  • 11β-[p-(Dimethylamino)phenyl]-17β-hydroxy-17-(1-propynyl)estra-4,9-dien-3-one.
  • Empirical Formula: C29H35NO2.
  • It inhibits the normal interaction of progesterone at the receptor sites... which could happen naturally.
  • There's almost 10 years of use in Europe.
  • It's always administered at a clinic under the supervision of a healthcare professional. It's never just prescribed and given to a patient to take home.
  • And presumably not without prior consultation to eliminate contraindications.
  • And if it doesn't work, they go to vacuum aspiration as a backup plan so that you don't end up giving birth to a baby with deformities and missing limbs.
  • The fatal heart-attack in France was apparently a woman who was a heavy smoker with 12 previous pregnancies. o_O And the other heart problem cases were with smokers. Gads, is everyone a bloody Chimney in Europe? But they also used mifepristone in combination with sulprostone which might be way too strong. They use misoprostal instead now which is supposed to be more gentle.

It's not as if the committee is banning abortion altogether. There's still surgery and induction (for later terms) that have been the standard for terminating pregnancy. This is just a new progesterone inhibiting drug and quite honestly, I do get the sense that it's not that well understood. There are still too many questions with it. There's money to be made with it and I really don't think Roussel Uclaf or Danco Labs are going to be giving it up, either for abortion or for Cushing's or cancer.

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Comments

( 2 comments — Leave a comment )
archangel_x
Aug. 19th, 2004 08:23 am (UTC)
Interesting.
bride
Aug. 19th, 2004 11:08 am (UTC)
It's easy to copy and paste. It takes a little more work to think. =)
( 2 comments — Leave a comment )

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