Health Column: Sex, science and the Supreme Court | PostIndependent.com

Health Column: Sex, science and the Supreme Court

Phil Mohler, M.D.
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist

“Bosses belong in the Boardroom, not the Bedroom” read the signs outside the Supreme Court building after the Hobby Lobby decision earlier this summer. The Affordable Care Act (ACA) requires most employers to cover contraception in its health plans. The Green family, owners of Hobby Lobby, felt that the law infringed on their freedom to exercise their religious beliefs, specifically their belief that certain ACA required products were not contraceptives, but abortion products. The Supreme Court agreed with the Greens.

The ruling certainly limits the contraceptive choices of the 13,000 employees of the craft store. However, in spite of Judge Alito’s claim that this is a very narrow decision, the fact is that this ruling, based on very bad science and deplorable ethics, has created a very slippery slope for women’s reproductive rights.

Acccording to Judge Ruth Bader Ginsburg, “…this ruling is of startling breadth.”

The Five Old Men Judges (the majority opinion) bought Hobby Lobby’s faulty pharmaceutical fallacies.

The four methods of contraception that Hobby Lobby takes issue with are two emergency contraceptive pills, Plan B and Ella, and two IUDs, ParaGard and Mirena. These methods are contraceptives, not abortifacients. Plan B and Ella prevent pregnancy by delaying or inhibiting ovulation. There is no evidence to suggest that either Plan B or Ella interferes with fertilized eggs. They simply will not work if a woman is already pregnant. IUDs may also be used as emergency contraception after a pregnancy test has confirmed a woman is not already pregnant. IUDs do not affect ovulation, but interfere with sperm fertilizing eggs. Science is fact and apparently facts didn’t matter to this Supreme Court.

My fear is that if the progesterone in Plan B is believed to be an abortifacient (it is clearly, scientifically not), then what will keep other companies from seeking relief from buying their employees birth control pills that all contain progesterone?

The Five Old Men Judges appear to believe that the religious beliefs of the owners of the corporate structure are more important than those of their employees. This decision, Justice Ginsburg argues, disregards the beliefs and needs of employees and their dependents.

“Supporting the beliefs of one group of people behind a corporation — its owners — can harm other people,” she wrote.

My take: the Supreme Court decision was morally destitute in this decision.

Next consider, and the Five Old Men Judges (the majority opinion) obviously did not, the implications of this ruling for fertile American women.

Recall: 50 percent of all pregnancies in this country are unplanned. Only five percent of unintended pregnancies are failures of the consistent use of contraception; the other 95 percent are non-use or inconsistent use of contraception. There is additionally a growing body of evidence that it is increasingly difficult for many women to access birth control, particularly the more effective, expensive forms. Judge Ginsburg, in her dissent, lamented that an IUD insertion at approximately $900 would exhaust a minimum wage earners entire monthly pay check.

Love it or hate it, the Affordable Care Act (ACA) is bringing health care coverage to more Coloradans. In the arena of women’s reproductive care, the ACA has the potential to decrease the number of unintended pregnancies (and abortions), put women in the driver’s seat in terms of planning their families and saving the health care system money. Women who are able to time their pregnancies are more likely to complete their educations, pursue job opportunities and establish financial stability.

I believe the Green family that owns Hobby Lobby are genuine in their faith beliefs, but are scientifically naive and, more egregiously, lack consistency in their actions. A review of documents filed with the Department of Labor, dated December 2012 (three months after Hobby Lobby owners filed their contraception lawsuit), show that their 401(k) held more than $73 million in mutual funds with investments in companies that produce emergency contraception pills (Teva makes Plan B), IUDs (Teva makes ParaGard) and drugs that actually cause abortions (Pfizer makes Cytotec and Prostin E2). Hobby Lobby made large matching contributions to this company sponsored 401(k).

GJ Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for Rocky Mountain Health Plans. Email him at pjmohler@bresnan.net.


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