Contraception mandate committee faulted for abortion ties, flawed science

Sep 29, 2011 / 17:54 pm

The committee responsible for federal guidelines that could soon mandate insurance coverage of contraception is being criticized for its misuse of science and its members' ties to abortion advocacy.

“There is ample evidence that the members of the Institute of Medicine committee did not, in fact, consider the findings objectively,” wrote Human Life International America Director Arland Nichols, in a report published Sept. 28. “Indeed, we find that the members were ideologically committed to their outcome, and that Recommendation 5.5 is a skewed representation of the relevant science.”

Human Life International has also published background information on members of the Institutes of Medicine committee, showing that five of its 15 members are present or former board members of organizations promoting access to abortion. Six others have provided significant financial support for political candidates who support legal abortion.

The Department of Health and Human Services' proposed rules, formulated in response to the 2010 Affordable Care Act and the Institute of Medicine's recommendations, were announced Aug. 1 and are open to comment until Sept. 30. They require nearly all new health plans, including those of most religious groups, to cover government-approved methods of contraception and surgical sterilization.

In his report published in the Public Discourse journal, Nichols called attention to the remarks of Dr. Anthony Lo Sasso, the only committee member who disagreed with the federally-commissioned report that led to the proposed contraception mandate. Lo Sasso has said that committee members used flawed standards of evidence that “allowed the committee to bring about what they wanted.”

“The committee process for evaluation of the evidence … was largely subject to the preferences of the committee’s composition,” Lo Sasso wrote in his official dissent. “The process tended to result in a mix of objective and subjective determinations filtered through a lens of advocacy.”

Health and Human Services Secretary Kathleen Sebelius claims the guidelines were “developed after an exhaustive review of the scientific evidence. Lo Sasso, however, said the committee “failed to demonstrate” principles of “transparency and strict objectivity” in its evaluation and recommendations.

Nichols outlined several instances of alleged inaccuracy or omission in the Institute of Medicine's review process, beginning with three “open information-gathering sessions” where “nearly all of the invited speakers were known advocates of contraception and abortion on demand.”

At these sessions, he noted, “there was not one representative from the Catholic health care system, despite the fact that it constitutes the single largest provider of health care in our country.” Meanwhile, “representatives of the pro-life and pro-family organizations – who were forced to seek permission to speak – were relegated to the brief public comments portion at the end of the day.”

In his review of the Institute of Medicine's final report, Human Life International's American director found the same bias against information that could harm a pro-contraception agenda.

“In support of the report’s claim 'that greater use of contraception within the population produces lower unintended pregnancy and abortion rates nationally,' only two sources are cited—one of which is a non-peer-reviewed advocacy report,” said Nichols.

“One reason for this dearth of evidence is simple: Numerous studies show that greater access to oral contraception and emergency contraception does not, in fact, reduce unintended pregnancies or abortion.”

Findings to this effect,  he noted, have been conducted at Duke University and Johns Hopkins, and published in the Journal of Health Economics, Obstetrics and Gynecology, and the Journal of the American Medical Association.

Nichols said that conclusions are in fact “far from unanimous regarding the effect of oral contraceptives on unintended pregnancy and abortion rates.”

Meanwhile, in regard to emergency contraception in particular, “the data are homogeneous … and point to a conclusion directly opposed to that of the Institute of Medicine committee.”

“While there are many 'professional and editorial opinions' that emergency contraception should be made readily available, and 'professional projections' that it could reduce unintended pregnancies, I have been unable find a single study indicating that it is actually effective in reducing unintended pregnancies or abortions in real population groups,” Nichols stated.

He also found that a critical portion of the committee's argument, regarding the allegedly “minimal” side effects of oral contraception, relied largely on “educational” material written at an eighth-grade level.

“The public was repeatedly assured, upon Sebelius’s passage of the mandates recommended by the IOM, that the report was an 'exhaustive review of the scientific evidence,'” Nichols recalled. “Yet one of the cruxes of the committee’s argument—and one which directly impacts the health of millions of American women—is sustained by educational pamphlets” along with “one other dated study.”

“Interestingly, the pamphlets themselves state that 'the average readability level of the series … is grade 6–8.' These promotional brochures do not cite even one study.”

The Institute of Medicine committee, Nichols said, ignored “peer-reviewed studies published in the most prestigious medical journals,” indicating that oral contraceptive users experience significantly higher rates of breast cancer, while possibly quadrupling their chances of suffering a stroke.

“We do not expect completely disinterested policymaking in our democracy,” Nichols observed. “What is surprising, however, is the audacity with which the committee circumvented professional research practices in order to arrive at the conclusions they held at the outset.”

“In fact, according to information available from the public record, these committee members have donated a total of $116,500 to pro-choice organizations and candidates. Public records show that not one of the fifteen committee members has financially supported a pro-life political candidate.”

Among the committee's members were a member of the Board of Directors of the NARAL Pro-Choice America Foundation, and a former board member of Physicians for Reproductive Choice and Health.

Other members included the current chairwoman of Planned Parenthood League of Massachusetts, and the former chair and vice chair of Planned Parenthood of Nebraska and Council Bluffs. 

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“Whatever one thinks of the relevant issues, one would be hard-pressed to argue that this Institute of Medicine committee is politically nonpartisan,” said Nichols.