Saturday, March 14, 2009

Medical Abortion under Pressure in Ohio

Ohio's Democratic, pro-choice Attorney General, Richard Cordray, is sticking up for a state law that restricts the use of medical abortion (RU-486, aka mifepristone or the "abortion pill") to a narrower window of time than good medical practice currently requires.

According to the Columbus Dispatch, a 2004 Ohio law limits the use of RU-486 to the first seven weeks of pregnancy, while doctors commonly use it up through the ninth week. The original FDA approval covered only the first seven weeks, but subsequent experience with vastly larger numbers of women has shown it to be safe and effective for two weeks beyond that window. Doctors have been prescribing it off-label through the ninth week, in line with current medical knowledge. The Ohio law has never been implemented because Planned Parenthood sued to block it. This week, the Ohio Supreme Court heard arguments on whether the law should be allowed to take effect; the case has not yet been decided.

So what stake does the Ohio AG have in this? The Dispatch reports:
Anne Berry Straight, an attorney in Cordray's office, said she's not asking the court to set medical policy, only to recognize that lawmakers had the right to regulate the drug. ...

Straight pointed out that Ohio lawmakers already have banned the use of anabolic steroids for muscle-building and amphetamines for weight loss.

[Ohio Supreme Court] Justice Terrence O'Donnell said the court shouldn't be put in the position of playing surgeon general for Ohio.

"The court is going to micromanage the practice of medicine if we start getting into managing off-label uses like we're being asked to do (with RU-486)," O'Donnell said.
I'm not sure why either the courts or the legislature are mucking around with the fine points of medical policy! Whatever happened to the notion that doctors and public health experts should be regulating drugs? Neither the legislators nor the justices have the slightest qualifications. Heck, as a historian of medicine, I'm way more qualified than they are! Seriously!

For instance, you only need a dollop of medical knowledge to understand the difference between a medication that the FDA found to be safe and effective (RU-486) and drugs that are notorious for being abused (anabolic steroids and amphetamines). One of these things is not like the other; one of these things doesn't belong! Geez, my legislators need to watch more Sesame Street. (And no, I'm not saying that the FDA's process is perfect. It's often deeply screwed up. In this case, though, the FDA approved RU-486 in spite of intense political pressure to ignore the science.)

None of the statements from the AG's office explain why Cordray believed he had to stick up for the legislature's right to make medical policy. I understand that it's a constitutional issue as well as a matter of women's health, but I cannot fathom why the AG would have a stake in it. I do know that Cordray has publicly supported abortion rights, and I seriously fail to understand why protecting the scope of legislative power would trump his commitment to women's health.

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