Friday, November 19, 2010

Oh, FDA ...

The FDA.  I don't know quite what to think of them sometimes.  I mean, I'm sure they do some good work.  But at the same time, it's hard to look away from the fact that a lot of their decisions come down to politics, not science.

For a Community Health class I took a few years ago, I read a book by Marcia Angell, former editor of the New England Journal of Medicine.  She discussed the controversy surrounding silicone breast implants, and the FDA ban on.  While Dr. Angell is not the most feminist woman on the planet (her book suggests that she buys into some stereotypes about feminism), her book does raise a lot of questions about whether or not the FDA ban is actually based on anything real.
The FDA banned silicone gel breast implants in 1992.  The reasons why are suspect.  No scientific study supported the claim that silicone gel breast implants caused a variety of unnamed connective tissue diseases.  After years of more studies debunking the myth, silicone is finally back on the market.  But there were countless women (cis and trans) who were unable to get silicone implants during those years, and had to get saline instead.

Why is this even important?  As a feminist, I don't see a need for breast implants beyond helping transwomen and women who have lost breasts to disease or injury (and specifically, only those women in those catagories who want implants).  But as long as we live in a patriarchy, I can't judge women for feeling pressured to have larger breasts, and since that's the case, I support a woman's right to decide what kind of implant to get.  Saline implants have downsides, especially in terms of the look and feel of an augmented breast, so there are reasons to prefer silicone gel.  And again, there was no scientific evidence to suggest that silicone gel was more dangerous than saline ...

Another example of the FDA going by politics and not science are the current age restrictions on emergency contraception.  In 2006, emergency contraception known as "Plan B" was made available over the counter for women ages 18 and older.  That was a great improvement; previously, it was prescription only.  And when you really think about it for a moment, that's really stupid.  If I have sex on Friday night and the condom tears, I would have to wait until Monday morning to call my doctor and get a prescription.  Plan B is effective when you take it up to 72 hours after failed contraception, and the earlier it's taken, the more effective it is.  Having to wait because you need your doctor to give you the go ahead can mean the difference between Plan B and Planned Parenthood.

However, 18 or older doesn't cut it.  Women under the age of 18 who are sexually active have the same issues facing them as the older women, but they also have to deal with parental disapproval; they may be less informed about sex, and they may have even more trouble getting in touch with a doctor to get a prescription.  So the FDA said, "Fine, we'll make it 17."  But the issue here is that any age restriction means that there's a population of young women who need Plan B and can't get it.

A judge has determined that the age restrictions are unnecessary, and based solely on politics and not science.  The FDA has been ordered to drop the age restrictions.

They haven't.

And now, for something slightly different: Four Loko.

Four Loko is an alcoholic beverage that apparently doesn't taste very good, but has a ton of caffeine in it.  It's been dubbed "blackout in a can" by college students, and it's landed several of them in the hospital.  Drinking it seems like a pretty bad idea.  Thanks to a ton of outcry from concerned parents and citizens, the FDA has delcared caffeine an unsafe additive to alcohol, and Four Loko will be banned.

I think the ban is politically motivated.  I don't think it's a terrible idea, but that's in the vein of me not thinking it's a terrible idea to ban cigarettes or Christianity.  That is, sure, it wouldn't affect me and I don't think it's good for people anyway, but I can't control other people's decisions, even if I think they're making the wrong one.

What's more, banning Four Loko is not going to stop people from mixing caffeine and alcohol.  From something as basic as a rum and Coke to something like Red Bull and vodka, people mix caffeine and alcohol.  Banning Four Loko will not change that.

What would have been a smarter decision?  Maybe regulating how much caffeine and alcohol can be mixed without people blacking out ridiculously quickly.  But just declaring caffeine an unsafe additive and using that to ban one class of drinks is sort of ... stupid.

Besides, have you met college students?  Do you know how many of them can black out and land in the hospital without the help of this particular drink?  They'll find a way!

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