Posting in Science
Misoprostol's use as a "morning after" pill was pioneered in Brazil, but it has other uses, like fighting ulcers, inducing labor, and dealing with the effects of a miscarriage.
(I got the picture here from an Internet pharmacy which has the drug for sale under Searle's brand name, Cytotec.)
Misoprostol's use as a "morning after" pill was pioneered in Brazil, but it has other uses as well. In the U.S., for instance, it is frequently used to induce labor. (The illustration shows its use against ulcers, frequently caused by over-use of NSAIDs like aspirin.)
You may argue over whether such "emergency contraceptives" or "medical abortions" are ethical. That is not the issue. The issue is that they are private. Some can be obtained from a clinic, others from a pharmacy.
Misoprostol may be the most important of these drugs because of its other uses, one of which is to help avoid complications from naturally-occurring miscarriages.
Plus, as Nicholas Kristof noted recently in The New York Times, misoprostol is cheap. In India it can be had for just pennies per pill, as opposed to $5 for a blister pack with mifepristone.
Enovid is about 50 years old, thus there are many editorial celebrations going on about it right now, including a PBS special. It was a revolution for people in America and the West, because it let women decide when they might have children. The sexual revolution followed.
But the pill is far from universal adoption. It must be taken daily, and many women forget. Many Americans oppose it, though the 1965 decision in Griswold vs. Connecticut -- usually cited as a privacy case, it was really about an 1879 law outlawing contraception -- means there is little they can do about it.
Misoprostol is not an American story. It's not being dispensed solely by pharmacists. It's not only useful for this purpose. And women who treat other women are being encouraged to see this as a sound way to save the lives of their patients.
In effect, it is one way that the debate over contraceptives is resolving itself.
Aug 16, 2010
At the risk of repeating myself, the importance of misoprostol is it no longer matters what you think. It also matters not at all what I think. If you can't stand that thought, I'm sorry. If you want to call that murder, I'm sorry. But your opinion is no longer determinative. What is most important is it also doesn't matter if you're a Taliban fighter in Afghanistan, or a Uganda Christian fighting "witch doctors," or a Catholic priest in Brazil. Women will do what they will do, and their opinions don't matter either. That's the change. It's not what is happening in America that is really changing, but what is going to happen elsewhere. A chemical abortion with misoprostol is indistinguishable from the millions upon millions of spontaneous miscarriages that occur every year in this world. No one would think of killing every woman who miscarried, making such women guilty unless proven innocent in some impossible way. And no one would know why the miscarriage happened, unless you want to take away a necessary drug that can cure ulcers caused by NSAIDs and aid women who naturally miscarry and help those with problems starting the childhood process have normal, healthy babies.
Dana, you make a great point. I enjoyed the article and for those that want to get into the debate over the ethical issues I ask you. What do we do with these children after they are here, you don't wish to support them, you don't wish to see them, and you don't like the consequences of their growing up in poverty. So maybe it's time for you to look deep into your own souls (if you have one) and give us a solution for what becomes of these unwanted children. If you will foster a system that helps the mothers to raise them in good environments with good schools and end hunger for them, see to it they got the same education opportunities as those with the money to buy such things. Then and only then do you have the right to tell a woman whether or not she has to have a child. What I've seen though is government programs cut, poor housing and living conditions, and little or no education due to poor schools. I'm sorry but you can't have it both ways, freedom for all or freedom for none. That's it.
Even in America... If a girl is raped and the criminal goes to prison, she only can give the unwanted baby for adoption IF the father authorizes it. No moral or ethical discourses will prevent a poor girl to be a victim twice. It's good to have solution available for those in need for it. For the majority of people, abortion is not acceptable as a birth control, for the inherent risks they pose to the girl, even when practiced in a well equipped clinic, besides the usual church/moral/ethical aspects of it. At the end, it is up to the individuals affected by the 'problem' to decide what they want to do. It's a private matter. Thanks Dana for letting us know about this.
@Dana - and don't get me wrong Dana. I understand your point. Women are not empowered when they are rape or they have an extremist for a husband or an abusive husband or the list can go on. But to now "empower" the woman to allow her to kill an innocent child? I just can't help but think that the answer to violence can not be more violence. @zackers - I notice that you didn't assert what DOES determine personhood. Re: unique DNA & chimeras. Answer: unique from the MOTHER. The poor argument that some people use is that the baby is just part of the mother until..... Again, no reasonable assertion of personhood.
"You may argue over whether such ?emergency contraceptives? or ?medical abortions? are ethical. That is not the issue. The issue is that they are private." Aaaah. So the issue isn't the taking of innocent human life. The issue is that one can murder the unborn in privacy. Well thanks for clearing that up. "It was always a question of whether mens' laws or womens' desires would rule." Wait a sec - I thought you just said it was an issue of privacy. Now you're saying it's an issue over whether "men" want to protect human life versus "women" who want to kill human life when that human life is inconvenient. "Women will no longer be forced -- by law, by custom, by war -- to bear babies they don't wish to bring to term. " I'm not sure why you're advocating one class of people (women) to be able to kill another class of people (babies). Take ANY analogy you want or ANY example in history where one group of people had the might to do wrong to a weaker group of people - and tell me that might is right.
@jwlthe4th: If unique DNA determines personhood, then how do you explain identical twins, which have the same DNA? Nobody believes identical twins are really just one person. Unique DNA cannot be the necessary and sufficient criteria for personhood -- in fact, it can't even be necessary. Also, what about chimeras? These are formed when two fertilized eggs (fraternal twins) in the same fallopian tube join to form one fetus. If personhood starts at conception, then you started out with two human beings and now have only one. Which human being died, and which human being is alive???? (Human chimeras are a scientific fact, although very rare. You can actually take samples of DNA from different parts of their bodies and determine that they have different DNA and are "related" as siblings. In fact, there is a famous case where the parenthood of a child was confused because the parent was a chimera and the sample of DNA taken from him indicated that he was the uncle, not the parent -- his original sample just happened to be taken from the wrong part of his body.)
Not really. The argument may continue. but it is being superseded by facts on the ground. Just as the pill superseded arguments over contraception 50 years ago. Again, this is not an American story. The facts on the ground will be found in Saudi Arabia, in Nigeria, in Venezuela, in India -- wherever women are found, and where women are able to treat women for common problems.
The quick answer: no. In fact, after reading the piece and a few of the comments on it, I am mystified why Dana thinks this has anything to do with ending it. Dana's conclusion is a whopper of a non sequitur.
This is off-topic, but journalism is changing. Without costs for printing or distribution, new business models are developing, and new motivations for producing journalism as well. My point was those who condemn the inclusion of opinion and conclusions into journalism are missing the point. They wind up letting themselves be manipulated by others' agendas, and they shouldn't. I was talking and writing about these coming changes in my early 20s. I believed -- and still believe -- that at the end of the day we'll have more and better journalism as a result. But that depends entirely on business models that begin at the beginning -- organizing and advocating an industry, place or lifestyle. Journalism is about organizing markets, it's not about writing at all. Journalists like to pretend otherwise, and too many journalists are running journalism companies for my taste. I will note, again, that the big journalism schools are not named for journalists, but for publishers. Publishers are not journalists -- they hire them. Thanks for writing.
I'm not assuming the drug is completely safe. You measure safety against the alternative of doing nothing. That is a calculus that occurs in the mind of the woman -- no one else. And that was my point. You're right in your conclusion. Cost, availability, and the general usefulness of this medicine mean it will be in the hands of female practitioners (including midwives) in the remotest corners of the globe. That's important.
"I just stand on the shoulders of giants." Well, perhaps you kneel at their feet. It's been a dream of mine for decades that we, as a People, could do the equivalent of the Moon Shot Program toward controlling fertility. We've left it up to the Free Market, it seems. Abortion is a big business. Not cheap, no. Not completely safe, either. Big business nonetheless. But I'm that quirky sort that still believes that an ounce of prevention is worth a pound of cure. Imagine we really, seriously, researched this. Make it the next X-Prize. The winner gets freedom from income tax the next ten years for everybody in his company. I recall reading about a species of bacteria related to the most common cause of food poisoning, that was being studied for spay/neutering pets. The result was that any ovum deposited in the uterus would be chemically affected by the bacteria. The egg became infertile. One shot was supposed to last a year, while a big overdose caused permanent sterility. Now, start with that just as a foundation. And imagine the benefits. No more teen pregnancies. No more need for abortion clinics. No more freakin' lunatics murdering abortionists. And overpopulation would stop being a looming threat.
Here is my take on the article and the ensuing discussion. 1. There are a few underlying assumptions that Dana seems to be using in his article that the basic prolifers disagree with. a. He is assuming that the drug is completely safe. That is still up for discussion. b. He is assuming that his readers know that when he refers to the controversy and wars surrounding contraception he is ONLY talking about laws and policy and is EXCLUDING any moral debate. For the prolifers, the debate starts with the moral issue. The question to us is 'does human life have value?' rather than 'should the government pay for abortion services?'. 2. Point B above was a kind of watershed moment for me and allowed myself to kind of get beyond my own mindset in order to see from Dana and the other posters' point of view. The war he was referring to was about public healthcare policy and also the power struggle between men and women. I understand the point he was making was now that there is this option with such a low price tag that governments will surely pay for those services. Science has removed all of the financial reasons to object.
stomach ulcers are causd by a bacterium that almosty all people, including children. have livig in the folds and lining of the stomach, H. pyloris
@Edouin, You are way off base. But nobody wants to read bickering between you and me, so I won't bother. @Dana, At the heart of my previous comment was, in fact, a response from me related to what seems to be happening in journalism. I'm not a journalist so I won't pretend to engage in an educated discussion about it. Without meaning to accuse you (or "slander" you as Edouin claims), I was at least partly reacting to a feeling that your article was less about informing me than convincing me of some "right" way to think about and understand an issue. To me, good journalism strives to give relevant facts from relevant perspectives, possibly asking relevant questions, but leaves it to me to decide what to make of the facts and how to answer the questions. Even now when I re-read your article after all the discussion above, I still feel it's loaded with premises and opinions that interfere with my becoming better informed. If you can point me to a good but brief publication on trends/issues in modern journalism, perhaps I could learn something useful. I think good journalism is absolutely critical to society, and I'm not sure what's happening with it today. Anyhow, I read your stuff fairly frequently even though your topics aren't exactly in my areas of greatest interest. It must be wierd or at least interesting to see how people react to what you write, and how your readers interact. It is to me.
That's OK. I'm used to it. Anyone whose work draws conclusion is going to be attacked as illegitimate by those who don't agree with the conclusions. But American journalism has always been opinionated since the days of Ben Franklin and John Peter Zenger (http://www.law.umkc.edu/faculty/projects/ftrials/zenger/zenger.ht ml). Not that I'm in their class. I just stand on the shoulders of giants. It is only in recent generations that we created a myth that journalists should pretend to ignorance and let themselves be spun by anyone who wants to spin them. My own j-school, Medill at Northwestern (http://medill.nwu.edu) practiced this way and I was not their favorite student. Nor am I their favorite alum. I don't practice that way. Never have. But I admit it's an acquired taste, and if your own prejudices run counter to my conclusions it's going to taste skunky.
By the way, Dana Blankenhorn writes on matters of interest to me so I endorse his columns on Smart Planet. He is articulate and intelligent and that is a useful pair of talents for writing. And no I am not related to or friends with him. I'm just sayin' . .
Back in the 50's when birth control was illegal and they did not sell condoms to women, a friend of mine got pregnant with her 6th child. Her husband did not raise a hand to help her with the first five (4, 3, 2, 1 year old) and spent evenings drinking with the"boys." She killed herself and he dumped the kids on the county. I am against abortion and even against these pills. However, that is because I am the master of my fate and live in a time when a woman is free to take birth control. In cases of rape or situations like the lady who lived in our neighborhood with a pig of a husband, I would want this pill to be available. Sometimes, especially in third world countries, it means the death of earlier children to have more children. Kwashiorkor means the disease that kills the first child when the second child is born. Sitting in my big house on top of my big hill with 10 nice acres of horses and grandchildren means the pill is of no use to me. But for so many women, it means the children they already have will not starve.
I don't understand why Smart Planet sees itself as the proper forum for Mr. Blankenhorn's editorials. At least half of his posts have nothing to do with technology, or more precisely how new technologies are being utilized to improve the way we do things. This article in particular is not well-written, thus somewhat confusing and unconvincing. It's also become apparent to me that he has a sense of self-superiority and thus is somewhat intolerant to those with dissenting viewpoints. I suggest that Smart Planet be more honest with its readers when it posts editorial such as this, or persuade Mr. Blankenhorn to post to a more appropriate forum, say the Huffington Post or the Daily Kos
Jeeze @kellycarter, who are you to state that Dana Blankenhorn can or cannot assign a protagonist or issue in HIS article? His editor? Like any debate (or journalistic editorial), a side must be taken, whether or not the author fully agrees or not, they have to state their intent and make their point. Going "wishy-washy" makes for poor journalism. Dana sticks to his intent, and follows up in the same vein. It is HIS article, and he has all the right in the "Free World" to define and decide which way he wants his article to flow. The whole idea of his article is to impart information "as he portrays it". If you don't agree, then respond with a counter-argument, but don't slander his article because you don't think he has the "right to decide" the intent of HIS article. Anything to do with abortion in a "Christian" country will always evoke strong responses, and even a "factual" article such as this one obviously rates a similar response. People have to get their heads out of the sand and look around at the rest of the world. Not everything revolves around the USA, and though Dana Blankenhorn understands this, it is obvious many here do not. @Dana - I may or may not agree with everything you have written, but I will defend the right for you to state your mind in public with freedom. Also, thanks for taking the "high road" in all your responses. I, indeed understand the intent of your article.
The development of the pill was a major event. It made many other changes in society not only possible, but inevitable. But that only happened here. It didn't happen everywhere. Misoprostol is going to create the same kind of changes we saw with the pill in the rest of the world. Women will no longer be forced -- by law, by custom, by war -- to bear babies they don't wish to bring to term. It's a real change in the power relationships between the sexes.
well science invented nukes which with any luck can be dropped on all the religious nutters opposed to such things and then the rest of the world can breathe a sigh of relief, when all adults who still believe in imaginary beings will finally be locked safely up in mental asylum's where they belong.
Dana, I don't mean to be hostile but please look again at your wording: 1. 'You may argue over whether such ?emergency contraceptives? or ?medical abortions? are ethical. That is not the issue. The issue is that they are private.' Why do you get to decide what the issue is? You can decide what point you're trying to make in your article, but you don't get to decide what the issue is for your audience. 2. "Misoprostol is not an American story." (in bold) Yes, there are perspectives beyond the American one(s). But that doesn't diminish any American view(s) on it. You don't get to tell our stories for us or assign ownership to "the" story. 3. "With misoprostol it doesn't matter what you think." (from your commentary after the article) It matters to your readers what they (we) think. You don't get to decide what matters to us. You are obviously very passionate about this subject. And it seems you would like the matter to just be settled. I suppose everyone wishes the matter were settled. Well, like it or not, matters of this complexity will probably never be settled. Not through science, politics, religion, law. A pill may shift the power of the decision about contraception, but it will never silence the debate. Thanks for your research, writing, and the opportunity to let readers engage you in discussion.
I am not here to argue the politics of abortion with you. I am here to tell you that misoprostol puts the question of bearing a child to term, during the first month of pregnancy at least, into the hands of the woman. Not just here, but everywhere. No law is going to be able to eliminate this drug that costs pennies per dose, as this use becomes known. I pointed out in this piece that misoprostol is not licensed by the U.S. FDA for the purposes described here, even though it apparently works in most cases. I repeat, this is not an American story. But it's just as important as the original birth control pill, because it puts the decision of when to bear children into the hands of women all around the world. It doesn't matter what I think and frankly it doesn't matter what you think, either. The "new life" never had a say. It was always a question of whether mens' laws or womens' desires would rule.
"...can and will find the cure..." Wow, I didn't know being pregnant was a disease/sickness. Dana, that's pretty cold. And why is it that everyone that is for "choice" (a.k.a. abortion) has already been born. Doesn't the new life have a say?
With misoprostol it doesn't matter what you think. You don't get to make the decision any more. You don't have a lever with which to force women to bear the product of your pregnancy against their will. Even Muslim women, in Muslim countries (which are among the most restrictive in these matters) can and will find the cure if they act quickly. That was the point of my piece. Sorry you missed it.
The obvious answer is not yet. The post above provides indication that Dana Blankenhorn has called the race way before it is finished. Of course, when anyone says science or medicine has completely solved anything by itself, that is cause for immediate disbelief and prompts one to begin the research that's required to get to the truth. Not to blame Dana Blankenhorn for stepping into it here. Conception is not just science. There are 'religious' and moral implications such that 'should I' matters as much as 'can I'. Sad commentary on commentary, I guess. These days people put up half the information and expect us to swallow it whole. There is always more to the story, but we are left to our own intellectual curiosity to follow up and get the truth.
At the moment of conception a new unique human being is formed. The DNA that results at that moment is not the mothers and not the fathers and contains all the information about this new unique human being (male, female, eye color, etc) Preventing this conception from happening is one issue and many will argue that even this is morally wrong. Destroying this newly concieved human being is quite another. Mifepristone blockade of progesterone receptors leads to the deterioration of the uterine lining in which the embryo is implanted. As this deterioration worsens, the uterus is no longer able to sustain the pregnancy and the embryo is destroyed. Misoprostol acts to expell the now dead human being, but not without risk. There are numerous record of deaths from this regiment and especially when no medical facilites are available precisly in the undeveloped counties where this is being touted as an alternative to medical abortions. This has nothing to do with science and everything to do with terminating the lives of human beings and ignoring the risks and damage that result. In rebutal to the Kristof piece- From: http://www.frcblog.com/2010/08/kristof%E2%80%99s-misguided-blithe-endorsement-of-misoprostol-abortions/ "It is interesting that Kristof mentions that this regimen is used out to nine weeks in the U.S. because it fails over a fifth of the time. That is, it leaves either an incomplete abortion or an ongoing pregnancy. Typically, women need a surgical procedure to stop bleeding or infection when this happens. In the article, however, Kristof announces that the misoprostol-only abortion is the revolutionary approach to be used in other parts of the world. He isn?t as curious as he ought to be about why the progesterone-blocking chemical is the lynchpin of Western abortions, but is not needed for poor women in poor countries. He does note that ?[r]esearchers are finding that if women take misoprostol alone, effectiveness drops to 80 to 85 percent.? As noted above, the FDA-monitored trials produced much lower rates of effective use, but let?s give Kristof his estimates. He is admitting that these women will have a failed abortion up to 20% of the time ? that is, ongoing pregnancy or incomplete abortion. They will be subject to hemorrhage and infection. The FDA informed Chairman Mark Souder that 116 cases of severe bleeding requiring transfusions had been reported to the FDA by March 31, 2006. Gary and Harrison reported that 237 of their 607 reported hemorrhage and that 42 cases were life-threatening. All of the patients who experienced ?life-threatening? bleeding would have died had they not received timely access to medical and surgical services. This is not a game, and women who do not have access to modern emergency rooms will become very ill and may die if they have chemical abortions. Chemical abortions require more oversight to be performed safely ? not less." The bottom line - abortion terminates the life of a human being no matter how "scientific" we make it sound.