New 'morning after' pill meets opposition from abortion foes

MADRID, SPAIN - SEPTEMBER 27:  In this photo i...
Image by Getty Images via @daylife

With global overpopulation among the most critical problems of the 21st century, news of a highly effective contraceptive becoming available in the U.S. would seem very good news indeed. But as health writer Rob Stein reports in the Washington Post, it may not happen:

A French drug company is seeking to offer American women something their European counterparts already have: a pill that works long after “the morning after.”

The drug, dubbed ella, would be sold as a contraceptive — one that could prevent pregnancy for as many as five days after unprotected sex. But the new drug is a close chemical relative of the abortion pill RU-486, raising the possibility that it could also induce abortion by making the womb inhospitable for an embryo.

Plan B (the last emergency contraceptive vetted by the FDA), which works for up to 72 hours after sex, was eventually approved for sale without a prescription, although a doctor’s order is required for girls younger than 17. The new drug promises to extend that period to at least 120 hours. Approved in Europe last year, ella is available as an emergency contraceptive in at least 22 countries.

“With ulipristal (ella), women will be enticed to buy a poorly tested abortion drug, unaware of its medical risks, under the guise that it’s a morning-after pill,” said Wendy Wright of Concerned Women for America, which led the battle against Plan B.

Plan B prevents a pregnancy by administering high doses of a hormone that mimics progesterone. It works primarily by inhibiting the ovaries from producing eggs. Critics argue it can also prevent a fertilized egg from implanting in the womb, which some consider equivalent to an abortion.

Ella works as a contraceptive by blocking progesterone’s activity, which delays the ovaries from producing an egg. RU-486, too, blocks the action of progesterone, which is also needed to prepare the womb to accept a fertilized egg and to nurture a developing embryo. That’s how RU-486 can prevent a fertilized egg from implanting and dislodge growing embryos. Ella’s chemical similarity raises the possibility that it might do the same thing, perhaps if taken at elevated doses. But no one knows for sure because the drug has never been tested that way. Opponents of the drug are convinced it will. “It kills embryos, just like the abortion pill,” said Donna Harrison, president of the American Association of Pro-Life Obstetricians and Gynecologists.

A federal panel will convene this week to consider endorsing the drug. Those favoring approval are worried that the ambiguous sentiments, and the power of abortion foes who seem poised to weigh in against it, will influence the outcome.

“FDA should be a ‘Just the facts ma’am’ organization,” said Susan F. Wood, an associate professor at the George Washington University School of Public Health and Health Services who resigned from the FDA to protest delays in making Plan B more accessible. “I’m hoping the FDA will take that position.”

There is an great unmet need out there for emergency contraception that is effective as this for so long,” said Erin Gainer, chief executive of HRA Pharma of Paris. Studies involving more than 4,500 women in the United States and Europe show that ella is safe, producing minor side effects including headaches, nausea and fatigue, she said.

The company has no plans to test ella as an abortion drug, but it did not appear to cause any problems for the handful of women who have become pregnant after taking the drug, she said.

“The people who are opposing this are not just opposed to abortion,” said Amy Allina, program director at the National Women’s Health Network. “They also opposed contraception and they are trying to confuse the issue.”

Back to the issue: the planet has a finite amount of space for human beings. When one human being (and often two human beings acting as one) seeks not to add an unwanted human being, would it not make sense to furnish all available safe, legal tools to assist in that humanitarian effort?

Stay tuned for the answer from the FDA.

New ‘morning-after’ pill, ella, raises debate over similarity to abortion drug.

Judge to rule on same-sex marriage

Can gay marriage be a fundamental right, when all legal protection has been denied until recently? In a state that treats domestic partners the same as spouses, “what purpose is served by differentiating – in name only – between same-sex and opposite-sex unions?”

These are two of the questions sent to opposing lawyers by U.S. District Judge Vaughn Walker, who will hear their closing arguments next Wednesday in the San Francisco case being watched for broader implications. Supporters of gay rights are seeking to overturn Proposition 8, California’s voter-approved ban on gay marriage.

The closing arguments won’t be watched by just anybody. Judge Walker ruled late this week that arguments may not be televised beyond the closed circuit of the courthouse. So you’ll have to be on site to follow the proceedings up close and personal. Media organizations had sought to have the session, which is expected to last all day, televised; proponents of Prop 8 argued against the idea.

The denial means “the public will again only hear about this case second-hand,” said Thomas Burke, the media groups’ lawyer.

Andrew Pugno, a lawyer for sponsors of the ballot measure that banned same-sex marriage, countered that “the purpose of the court is not to entertain or educate the public, but to protect the right to a fair and impartial trial.” The sponsors had opposed televising any trial proceedings.

Two same-sex couples and the city of San Francisco have sued to overturn Proposition 8, the November 2008 initiative that amended the California Constitution to define marriage as the union of a man and a woman.

Walker presided over the non-jury trial in January. He had proposed to televise the trial live to several federal courthouses around the nation and record the proceedings for a delayed Internet posting on YouTube.

The telecast, which would have been the first for a federal court in California, was blocked by the U.S. Supreme Court just before the trial started.

In a 5-4 ruling, the court said Walker hadn’t given the public enough time to comment on the proposed change in court rules. The court also cited claims by Prop. 8’s sponsors that showing the proceedings outside the courthouse might intimidate witnesses.

Media organizations asked Walker last month to approve televising the closing arguments. They said that airing a hearing that included only lawyers and the judge couldn’t affect witnesses or the fairness of the trial.

Prop 8 supporters argued, though, that cameras in the courtroom could prompt “grandstanding and avoidance of unpopular decisions or positions.” Whatever the judge’s decision, it is guaranteed to be widely unpopular.

No TV for closing arguments in Prop. 8 trial.

Abortion foes are winning, folks

WASHINGTON - JANUARY 22:  A pro-choice advocat...
Image by Getty Images via @daylife

Will women in the U.S. soon be unable to have a safe, legal abortion? That scary possibility becomes more likely every day. Does anyone really understand the pre-Roe v Wade horrors which abortion foes want to see returned? Not really. That’s because huge numbers of women who could have told the horror stories died at the hands of back-alley abortionists, and those of us who did survive are dying off fast, unheard.

This space welcomes writer John Leland’s front page article in today’s New York Times to the voices crying in the wilderness — just in case someone other than Nancy Keenan might care to listen.

At least 11 states have passed laws this year regulating or restricting abortion, giving opponents of abortion what partisans on both sides of the issue say is an unusually high number of victories. In four additional states, bills have passed at least one house of the legislature.

In a flurry of activity last week, Gov. Haley Barbour of Mississippi signed a bill barring insurers from covering abortion in the new insurance exchanges called for under the federal health care overhaul, and the Oklahoma Legislature overrode a veto by Gov. Brad Henry of a bill requiring doctors who perform abortions to answer 38 questions about each procedure, including the women’s reasons for ending their pregnancies.

It was the third abortion measure this session on which the Legislature overrode a veto by Mr. Henry.

At least 13 other states have introduced or passed similar legislation this year. The new laws range from an Arizona ban on coverage of abortion in the state employees’ health plan to a ban in Nebraska on all abortions after 20 weeks, on the grounds that the fetus at that stage can feel pain.

Fetal pain is a subject of debate in the medical community, and the United States Supreme Court has recognized the government’s right to ban abortions only after a fetus becomes viable, which is more than a month later.

“Fetal pain” is just one ploy; its determination can easily go from 20 weeks backward to ban the morning-after pill. Other ploys? Forcing a pregnant woman to look at ultrasound pictures, prohibiting a physician from discussing fetal abnormalities with his/her patient, and “in Utah, after a pregnant 17-year-old paid a man $150 to beat her in an effort to induce a miscarriage, legislators passed a law that would allow a woman in such circumstances to be charged with homicide.”

Unwanted pregnancies happen. When they do, the man involved can simply walk away, as countless millions have done and will continue to do. Why, then, should so many men purporting to have such omnipotent wisdom be empowered to eliminate a woman’s right to choose what happens to her body?

It’s going to get worse. Unless people — and that includes males of the species who still have brains and some concern for the future of womankind — start paying attention, and standing up to the fundamentalists of all stripes, the U.S. Conference of Catholic Bishops and the religious factions who claim authority over all women, it’s going to get worse than many people in today’s society can even begin to imagine.

Opponents of Abortion Advance Cause at State Level – NYTimes.com.

Child predators & citizen cops: part two

Where are the limits to the rights of self-protection? Has the internet’s ability to make instant connections also created instant-cops who can go too far?

Earlier today I posted a story about a suspected predator in my local San Francisco park who turned out to be an innocent man — but only after his photo and suspicions of his being a predator had circulated widely on the internet and local TV, thanks to a campaign started by an anxious mom. She had spotted him near the playground, unaccompanied by a child.

Several readers have weighed in off-site to say I should have more sympathy for the mom, because she was only protecting her child and others. Maybe.

Years ago, when my own children were growing up in an urban area comparable in potential lurking dangers to San Francisco today, there was a man who appeared around elementary schools over a period of months, exposing himself to little girls. He became fairly famous among teachers, parents and children as “the man in the white car”, though he always managed to elude the police.

One afternoon when my then 7-year-old daughter was walking home alone (the school was about 3 blocks distant and the times were not quite so parentally protective) a white car pulled alongside her, stopped just ahead and the passenger-side door opened. But about a half block away was my 9-year-old son, lagging an appropriate distance behind.  He sped up, taking a pencil out of his pocket and calling his sister’s name, which was enough to cause the white car to scratch off — but not before they had written down his license number. Extraordinary children, of course, as they are mine, but to be truthful every kid in town had been so thoroughly trained in what to do it was practically a reflex reaction.

The man lived about a mile away. The police paid several calls on him. Because he had not been actually caught doing anything, and it had been over six months since the last episode, involving a child who couldn’t give any description, he was not accused of anything. But the police knew where he lived (as did I, since they drove my son by the house to reconfirm it was the car) and he knew they knew, and he knew his license number was in a file of some sort that could be easily found. That was the last episode involving the man in the white car and local schools.

Could he have gone on to frighten, and possibly molest, other children? Probably. Should we have painted a red “X” on his door, or taken his picture and put it up in the post office? I don’t think so. Plenty of phone calls flew back and forth, but there were no cellphone cameras or e-mails or internet sites at the time so the net was not cast quite as wide. And nobody called the TV station.

I am still pretty sure the man in the white car was a bad guy. We now know the man in the neighborhood park was not. In either case, there’s that business of being innocent until proven guilty. Trial by internet can mess with the system, which while imperfect is still the best we’ve got.

When citizen cops turn bad

In my small, neighborhood park there is a regular assortment of runners and walkers, picnic groups, dog-walkers, grandfathers pushing strollers, homeless guys and tennis players. On any given day you can hear voices speaking Russian, Chinese, English or a lovely range of other languages. And always there are children — with moms, dads, nannies or other supervisors — stumbling around makeshift mini-baseball diamonds in the meadow or tumbling noisily around the playground. It is, in short, exactly what an ideal neighborhood park should be. Its neighborhood, within a few surrounding miles, is home to the low-ish income, middle income and affluent.

And apparently at least one over-anxious mom. Recently she spotted a man she perceived to be a potential threat. The incident was reported in a San Francisco Chronicle op ed piece by former editor and now columnist/blogger Phil Bronstein, who says he used to take his own son there. (Bronstein is not among the low-ish or middle incomes.)

A worried mom took (the man’s) photo with her phone and messaged it around with a detailed description and a warning. “He does not have children and pretends he does and is there to do pull-ups,” she wrote.

The e-mail, originally intended for a small pool of officials and families, went wide in an expanding spiral onto lots of electronic doorsteps. That’s the way it works on the Web.

“Hope someone goes Woodsman on him,” one commenter wrote.

“There were people who wanted to suspend the Constitution,” investigating police Capt. Rich Correia at the Richmond station told me about some lynch-mob sentiment. “It’s interesting how people feed off the Internet, how fast it gets around and how much people can amplify it. Folks made all sorts of assumptions about (things) they didn’t know.”

In this case, the mix of digital citizen vigilance, child safety concerns and viral networking caused a train wreck with a definite victim. And it wasn’t a kid.

San Francisco blog SFist ran the headline “Potential Child Predator” with the photo the mom took. KTVU-TV broadcast the guy’s easily identifiable portrait and kept it on the screen throughout its story. “Take a look at the picture of this man,” said the reporter. “There’s obviously concern he’s some kind of predator.”

Except he isn’t.

What he is, unfortunately, is a marked man. Tried and convicted in the courts of the internet and public communications. The cops identified him, went to his house, determined there was no danger (he was “unguarded, cooperative and surprised at being the subject of a police investigation”) and that the poor guy was doing nothing but exercises in the park. The blog and the TV people took down his photo, but you have to wonder if the original mom apologized, or if he will feel very welcome in the park now.

A somewhat different go-after-the-bad-guys story was reported today by New York Times writer Dan Frosch, this one about Justin Kurtz, a hapless Kalamazoo, Michigan college student whose properly parked car was towed from its parking lot and it cost him $118 to get it back. Anyone who’s ever had a car towed can identify with the rage that then prompted Kurtz to start a Facebook page called “Kalamazoo Residents against T&J Towing.” But after 800 people signed up in sympathetic outrage, T&J filed a defamation suit seeking $75,000 in damages. I’m rooting for Justin and his friends (having been towed under less-than-happy circumstances myself), but the whole business will likely end up costing another unnecessary load of pain and anguish — and possibly, more than $118.

The question is, how far are we ready to trust cyberspace? In the case of the Mountain Lake Park non-pervert, the hysteria continued despite fast action by the cops.

People trusted the social network far more than they did the seasoned and reputationally impressive police captain. “After 30 years on the force,” he says, “it’s hard to accept that people believe Internet chatter more than they do reaching me on the phone.”

In this case, social media was not a new and improved town crier. Instead, the hysterical tendencies that understandably surround kids’ security led to what Correia called “long e-mails of inference and innuendo like the opening act of ‘The Crucible,”’ Arthur Miller’s play about witch hunts.

As a friend of mine with kids who lives near Mountain Lake Park and got copies of the e-mail from multiple people noted, “It’s often easier to share than to deliberate. Were we deputized, or just weaponized?”

In the emerging world, you can think you’re a citizen journalist, but you’re really a citizen cop. And in the Mountain Lake Park case, people also became citizen prosecutor, judge and jury.

Viral campaigns are hard to undo, but maybe we should try. What if T&J were to return their ill-gotten $118, enabling Justin to create a new Facebook page about what a fine business they are? Their tarnished reputation could then be restored to its former glory, if towing companies have glory, for a pittance.

With the non-pervert, it’s not that simple. But maybe the over-zealous mom will take the trouble to contact him and apologize. It would be a start, although I’m not holding my breath. If I see him, however, I’m apt to be extra kind and pleasant, and then people will probably talk. As long as they don’t put us on Facebook.

‘Pervert’ in the park isn’t what he seems.

A once-a-month alcoholism shot? An anti-cigarette pill? Could happen

addiction
Image by alancleaver_2000 via Flickr

For those of us who got off addictions the old-fashioned way, reports from the recent American Psychiatric Association‘s annual meeting sound like good news, even if it’s a little late in coming. AP Medical writer Lauran Neergaard summed up the latest:

“This is the next frontier in substance abuse: Better understanding of how addiction overlaps with other brain diseases is sparking a hunt to see if a treatment for one might also help another.

We’re not talking about attempts just to temporarily block an addict’s high. Today’s goal is to change the underlying brain circuitry that leaves substance abusers prone to relapse.

It’s “a different way of looking at mental illnesses, including substance abuse disorders,” says National Institute on Drug Abuse Director Dr. Nora Volkow, who on Monday urged researchers at the American Psychiatric Association’s annual meeting to get more creative in the quest for brain-changing therapies for addiction.

Rather than a problem in a single brain region, scientists increasingly believe that psychiatric diseases are a result of dysfunctioning circuits spread over multiple regions, leaving them unable to properly communicate and work together. That disrupts, for example, the balance between impulsivity and self-control that plays a crucial role in addiction.

Addiction is a strange phenomenon, and we who know a lot about it (this writer kicked cigarettes in the 60s, alcohol in the 80s, crunching ice — you haven’t ever met an ice-crunching addict? Believe it. — five or six years ago) say it’s about time we got our own dysfunctional circuitry studies.

Think of it as if the brain were an orchestra, its circuits the violins and the piano and the brass section, all smoothly starting and stopping their parts on cue, Volkow told The Associated Press.

“That orchestration is disrupted in psychiatric illness,” she explains. “There’s not a psychiatric disease that owns one particular circuit.”

So NIDA, part of the National Institutes of Health, is calling for more research into treatments that could target circuits involved with cognitive control, better decision-making and resistance to impulses.

Addictive behavior has drawn attention from researchers and writers for years. A 1983 study done for the National Academy of Sciences by Alan R. Lang, Professor of Psychology at Florida State University reported that “some mental health experts find it useful to view addiction as including all self-destructive, compulsive behaviors”  and cited references to addictions as wide-ranging as caffeine (guilty), chocolate (definitely) and gambling (not on your life.)

Changing behaviors to conquer addictions, with a little help from therapies and therapists of all sorts, has been plugging along as a solution for decades. Takes a lot of work. Wouldn’t a magic pill be lovely?

Targeting brain circuits for addiction, relapse.

Guns, drugs & sit/lie laws: who's got the real rights?

Discussions stirred up by the comments in this space a few days ago (see below) concerning gun rights v public safety rights ranged from the specifically pro-gun and pro-open carry (“citizens use firearms for self-defense between 150,000 and 3,052,717 times a year. The lowest estimate comes to about 410 times a day, and the highest estimate is 8,363 times a day,” says willbill; “How many times has an open carry proponent shot someone? If you use statistics rather than “from the hip” anti gun rhetoric, you will find legal gun owners are not the problem. Illegal gun owners are the problem,” says airtechjr) to the pointedly anti-gun (“Besides looking really stupid, having a gun visible – even if unloaded – is scary! Do you know how fast you can jam a clip into a Glock Automatic? 3 seconds,” says Tom Medlicott.) Emeryville, CA Police Chief Ken James says it’s 1.3 seconds.

In the long run, though, the argument is not about gun rights v public safety rights, says carlfromchicago, because I have no constitutional right to feel safe in public. And this all started because I admittedly did not feel safe while attending a panel discussion on the proposed California Open Carry ban (AB #1934 now in the state legislature) and learning that I was the only unarmed citizen within three solid rows of citizens carrying (presumably legal) concealed weapons. According to Carl,

Whether people are comfortable around guns is a very interesting and relevant social discussion. But this is not a question of two rights pitted against one another. As much as we all want to feel safe, it’s simply a frame of mind. The right you have is to think what you wish, and feel what you wish … but that compels no one, or the government, to ensure what you think or what you wish becomes reality for everyone.

This brings us to San Francisco’s currently proposed sit/lie ordinance. It says (more or less) you may not sit or lie on the sidewalk. It means, please get the drug pushers and increasingly obnoxious defecators-on-front-steppers out of the ‘hood. It arose out of frustrations in San Francisco’s famously tolerant Haight Ashbury (remember the 60s?) neighborhood where things recently have gotten somewhat out of hand.

This space is a strong supporter of humane treatment and expanded rights for homeless. Countless local and national programs, some good, some better, are in place and worth everyone’s attention; I try to make regular, teeny contributions of time and resources. But should I have the right to walk along Haight Street in broad daylight without tripping on a soiled, zoned-out kid whose dog is only loosely tied next to him? That’s the question. And should we now have a law enabling law enforcement officials to wake him up (if possible), move him along or toss him in the paddy wagon to be deposited in a jail cell? That may not be the answer. Either way, it is generating great heat and not a lot of light in my beloved hometown.

San Francisco is not alone in this dilemma. City Watchdog blogger Melissa Griffin, on her Sweet Melissa blog, reports having dug up a report (“Big pdf here,” she warns) on “Homes Not Handcuffs: The Criminalization of Homelessness in U.S. Cities.”

The report surveyed laws in 235 cities (including San Francisco) and made some interesting findings:

  • 30 percent prohibit sitting or lying in certain public places.
  • 47 percent prohibit loitering in certain public places and 19 percent prohibit it citywide.
  • 47 percent prohibit begging in certain public places; 49 percent prohibit aggressive panhandling; and 23 percent have citywide prohibitions on begging.

At almost 200 pages, the report provides an exhaustive discussion of the legal landscape in 90 cities. Some have definitely used creative methods:

  • In Billings, Mont., it’s illegal to “aggressively solicit” and/or lie about being “from out of town, a veteran, disabled or homeless” while asking for money.
  • In Boerne, Texas, all panhandlers have to buy a license to solicit (like other solicitors and vendors) at a cost of $115. Durham, N.C., charges $20 for a panhandling permit.
  • Las Vegas, briefly had a law that prohibited sleeping “within 500 feet of a deposit of urine or feces.”

I am getting right back on the fence. Public safety does seem to me both an appropriate issue for discussion and an individual right. How far it can be legislated (there are over 20,000 gun laws already on the books across the country, uncertain wrote in) is debatable. I still wish guns would just go away. I don’t know what to do about obnoxious sitters/liers upon the sidewalks. Both seem obstacles to the peaceful communities some of us have in our memories and all of us have in our imaginations.

Handguns, the second amendment and the public safety

One young man with a suitcase, one with a hand...
Image by State Library and Archives of Florida via Flickr

Two sides of the gun control debate squared off in San Francisco this week, focus of a mini-battle over the fully loaded question: Does your right to walk around with a loaded gun in public override my right to feel safe when I don’t know if you might go off your rocker? This writer discovered, thanks to a show of hands at the Commonwealth Club sponsored panel, that I was the only unarmed person within a back-of-the-house three-row section. This revelation guarantees discomfort but keeps you alert.

California is among the majority of U.S. states which allow anyone to carry unloaded guns in plain sight, or licensed individuals to carry loaded guns concealed. Variations of gun laws — can you have a few in the car? how about in a restaurant? suppose your taste is for machine guns? — are complex and mind-boggling. Gun proponents fall back on the second amendment; gun-control advocates tend to cite public safety and privacy rights. Reasoned debate is pretty much out of the question.

The tempest in the California teapot arose over gun folks’ dislike of the “may issue” state business. California is a “may issue” state, meaning a permit may be issued to a law-abiding applicant; as opposed to a “shall issue” state, meaning you (law-abiding citizen) will darned well get that permit once you apply. In protest over the “may issue” situation, California gun buffs recently took to the streets — or to the local Starbucks, as the case happened — with prominently displayed weaponry. Some latte drinkers were not amused. Gun buffs were defiant. Starbucks reportedly wishes they had picked Peets. Meanwhile, CA Assemblymember Lori Saldana introduced a bill, AB 1934, to ban “Open Carry,” and the battle was joined.

At the recent panel, Emeryville CA Police Chief Ken James, University of CA Berkeley law professor Franklin Zimring and Executive Director Sam Paredes of Gun Owners of California restated most of the familiar arguments. Throughout, James was expressionless, Zimring frowned, and Paredes wore an expression that can generously be described as a not-too-friendly smile. There were assertions (thousands of lives are saved every year by people armed and defending themselves or their neighbors; police don’t need to be stopping people all over the place asking if that gun is loaded; police can’t do their crime-stoppers job without the help of law-abiding, armed citizens; it’s not easy to know when an armed citizen will misuse his arms…) that all have elements of truth and elements of fantasy.

Two details are worth noting, though. Zimring pointed out that in the 2007  Supreme Court decision (District of Columbia v Heller), Justice Antonin Scalia, writing for the 5-4 majority, took things a little farther than they had been by specifically mentioning handguns, which had not been invented when the second amendment was written. It’s handguns in public places that tend to rile up both sides. Therefore the hoopla over open carry, Zimring said, is not where the discussion should be. Eventually, the right to bear handgun v right to public safety will need to be settled. In other words, when does your right to pack a gun interfere with my right not to be around you when you do?

At the end of the discussion, moderator John Diaz, editorial page editor of the San Francisco Chronicle, asked a question about whether panelists were packing heat during this event. Off-duty Police Chief James was not, because he feels guns invite problems. Professor Zimring was not, because he said if he tried to hit a target everyone around would be in trouble. Citizen Paredes was. A concealed weapon, because you never know if another citizen might need you to leap into action. Was it loaded? Yes.

Somehow, this did not make me feel safer.