Drug Facts, Values, and the Morning-After Pill

Abstract

While the Value-Free Ideal of science has suffered compelling criticism, some advocates like Gregor Betz continue to argue that science policy advisors should avoid value judgments by hedging their hypotheses. This approach depends on a mistaken understanding of the relations between facts and values in regulatory science. My case study involves the morning-after pill Plan B and the “Drug Fact” that it “may” prevent implantation. I analyze the operative values, which I call zygote-centrism, responsible for this hedged drug label. Then, I explain my twofold account of value-ladenness, involving the constitutive role of value judgments in science and the social function of facts as political tools. Because this drug fact is ineliminably value-laden in both senses, I conclude that hedged hypotheses are not necessarily value-free.

Imposing Values and Enforcing Gender through Knowledge: Epistemic Oppression with the Morning-after Pill's Drug Label

“…Antiabortionists like Stanford believe that pregnancy and life begin at fertilization along with human personhood ; if so, fertilized eggs (zygotes) have full moral status and a “right to life” (Wilks 2000; Larimore, Stanford, and Kahlenborn 2004). Accordingly, they hold a variety of zygote-centric beliefs, which influenced their judgments about the mechanism and the scientific evidence for/against it (see ChoGlueck 2021 for more on zygote-centrism). For instance, Stanford notes how the zygote-centrist would describe a drug with this mechanism not merely as “preventing implantation” or having “a postfertilization effect,” but with more moral and teleological valance as functioning “to kill a fertilized egg” (FDA 2003, 289, my emphasis) 12…”

“…Unlike with abortion pills (for example, RU-486) that indisputably cause abortion, these refusals are premised on the value-laden empirical claim that they may also cause abortion. Antiabortionists and women's-health advocates disagree over how the morning-after pill works, and their epistemic disagreement over “the facts” of its mechanism is rooted in different ontological, ethical, and political values (see ChoGlueck 2021). How can we make sense of these epistemic and ethical stakes in the debates over emergency contraception and “conscientious refusal”?…”

The FDA ought to change Plan B's label

“…This commentary builds on my existing historical and philosophical research about the political nature of Plan B's label, including its scientific and ethical deficiencies [9,13,14]. Here, I defend three interrelated arguments for why the FDA ought to change the label of LNG EC so that it no longer mentions the possibility of a post-fertilization mechanism.…”

“…It may also prevent fertilization of a released egg (joining of sperm and egg) or attachment of a fertilized egg to the uterus (implantation)" [8, emphasis added]. At this time, there was significant uncertainty about the mechanism because of the lack of research, so this description was very hypothetical and speculative [9,10]. As committee member Alastair J.J. Wood (then editor of the New England Journal of Medicine) admonished, "I would caution, however, against studding the outside of the packet like a Christmas tree with all sorts of issues.…”

“…I'm particularly concerned about putting things on the outside of the package which are unsupported by data" (p. 341) [2]. It is exceedingly uncommon to describe a mechanism on the Drug Facts for lay users-especially with such hedged language couched in uncertainty-yet, this wording was suggested by those same anti-abortion advisers, allegedly to provide potential users with "informed consent" [9].…”