Accutane: The intersection of medicine and politics

Accutane is a godsend for anyone who has cystic acne, a horribly disfiguring skin problem that causes social as well as health problems for young people who suffer from it. Unfortunately, it also causes pretty awful birth defects in children whose mothers took it while pregnant. The ideal use of the drug is for 4 months at relatively high doses, but some doctors prescribe it for longer periods at lower strengths--not sure why. The drug itself is packaged interestingly--not just in a bubble pack, but a package that is almost impossible to open, and to do so, you have to break a seal that has a little picture of a pregnant belly with a big red cross through it.

A new program by the manufacturer called, iPledge, restricts prescribing for the drug to those who promise to use birth control, make doctors do pregnancy tests, and in general increase surveillance on patients using the drug so that they do not get pregnant while on it. Some men have been asked to take a pregnancy test and there are many complaints about how cumbersome the process is.

And with all this attention, and money, "Nothing has worked," according to a New York Times article Feb. 11th."The federal government has undertaken more than 40 efforts over the last 23 years to prevent women from becoming pregnant while taking Accutane." About 170,000 people take accutane, half of them women. I appreciate this admission that even when you pay attention, when the consequences are horrible, when you put the weight and money of the government and a pharmaceutical company behind your efforts, it is STILL very difficult to NOT get pregnant!!!

It is very hard, because getting pregnant is as natural for humans as it is for rabbits and cats and all of God's creatures. You have to work really hard not to get pregnant, and no one makes that easy--not the drug companies that keep even generic birth control very pricey. Not the Planned Parenthoods who cut people off their pill if they miss an appointment. Not the schools, churches, and parents who fail to tell kids how to protect themselves. Not the legislatures who don't fund sex education and family planning, but who do fund abstinence only education which not only don't teach the facts kids need to know, but actually MISLEAD kids with messages like "condoms are not effective."

The one group that I know that consistently tries to push birth control, educate women on health, and contraception, and pregnancy are ABORTION CLINICS!! And we might have some more suggestions for the makers of Accutane: Talk about abortion in your literature. Don't just say, "Don't get pregnant on this medication." which is pretty useless advice. Say: "You must use birth control while you are on this medication if you might possibly be sexually active, either voluntarily or not, during the time you are on the medication. If you become pregnant while taking Accutane, you must get an abortion due to the severe side effects associated with the drug. If that is not acceptable to you, DO NOT TAKE THIS MEDICATION." That's what we would call informed consent, and we would probably throw in a description of the problems of these deformed babies.

Unfortunately, the intersection of politics and medicine precludes such honest discussion of risk. So, what we have is expensive posturing that does no good. Bad politics and bad medicine yielding heartache for real people.
--bon

Comments

[L.]

Christine, since I want to set an example for my children that abortion is an acceptable alternative, you better believe that if I ever have one, they will know about it. But what I will be stressing is PREVENTION, and hopefully they -- and me -- will avoid "handing over hundreds of dollars, putting on a paper gown and spreading your legs for sharp instruments." It`s not something anyone does for fun.

[~Nina]

Ah, Christine can't give a straight answer or defend her position, so she whines about staying on topic.

Not that she wants to talk about Accutane, which is the original topic.

She asks me my position, I tell her, and she tells me I'm off topic because she's now been forced to show her hand. She asks me why I can defend abortion in some cases, but when I tell her, she whines that those people are "irrelevant" and tells me I'm "off-topic".

She's cool with the senseless slaughter of innocent children in an unjust war, and she thinks rape victims are "irrelevant".

Like I said....you've got some seriously fucked up shit goin' on in your head.

Basically, according to Christine, if she's cool with killing someone, it's a good thing, but if she's not, it's a bad thing.

Because Christine is the final arbitor of all things and we all just have to shut up and do as she says.

[Christine]

Nina,

Limiting evil with negative unintended consequences(in a war context) and creating evil ostentaciously and intentionally (abortion) are quite different.

Brown, white, black, or otherwise, killing a child in a war is horrific and UNINTENTIONAL. Abortion is 100% INTENTIONAL. What else do you call handing over hundreds of dollars, putting on a paper gown and spreading your legs for sharp instruments?

Find me a soldier that says they want to kill children and hunt them down and, once again, then we'll compare abortion and war. Until then, your claims are baseless.

By the way, less than 1% of abortions are rape. So defending abortions in the case of rape exclusively is irrelevant to this discussion. Weren't you throwing a fit earlier about staying on topic?

L,

As I explained above, there is no comparision between abortion and war. Protecting a country from terrorism with terrible, unintentional accidents and killing a child so "nothing else will grow inside me ever" and remarkable different. So it is black and white.

By the way, if you do abort, don't tell your born kids. That would be traumatic as hell.

[L.]

Christine, what about all the civilian casualties, the children killed by U.S. bombs or "friendly fire" in Iraq? They are innocent -- simply in the wrong place at the wrong time. Murder? Why not? Gee -- I`m guessing that your argument here won`t be so black and white, and will consider the entire complex situation over there.

I (reluctantly) consent to (heavily protected) sex, and do not consent to gestating an unwanted pregnancy -- abortion is one of the "surgical, mechanical, chemical and other ways to prevent the natural from occuring" methods of which I would avail myself.

Also, it is really hard to argue that someone who is never born "suffers." I`m not sure I will ever be able to muster any visceral pity for dead embryos.

[~Nina]

Right.

Because Iraqi children aren't really quite as human as the unborn.

Iraqi children who've been killed in the war don't count. They're brown and they're Muslim and they're not "one of us".

It's okay to have a little "colateral damage" when you're fighting for your political and economic agendas. But it's not okay to abort if you've been raped and impregnated against your will.

A woman who aborts the child of her rapist is not being selfish. She's preserving her freedom and acting in order to save herself from further assault. She's not killing her own child. She's killing the child of a violent criminal who forced the child into her body against her will.

So you believe in forcing rape victims to carry children against their will and you also support killing innocent Iraqis.

Those are some seriously fucked up priorities. Kill the brown children but force the innocent rape victims to carry a child that was forced into their body against their will.

Well, at least we know you're not really prolife and that you don't really think all killing is murder and that it's okay to kill children sometimes.

Always good to know where people really stand.

[~Nina]

Right.

Because Iraqi children aren't really quite as human as the unborn.

Iraqi children who've been killed in the war don't count. They're brown and they're Muslim and they're not "one of us".

It's okay to have a little "colateral damage" when you're fighting for your political and economic agendas. But it's not okay to abort if you've been raped and impregnated against your will.

A woman who aborts the child of her rapist is not being selfish. She's preserving her freedom and acting in order to save herself from further assault. She's not killing her own child. She's killing the child of a violent criminal who forced the child into her body against her will.

So you believe in forcing rape victims to carry children against their will and you also support killing innocent Iraqis.

Those are some seriously fucked up priorities. Kill the brown people but force the innocent rape victims to carry a child that was forced into their body against their will.

Well, at least we know you're not really prolife and that you don't really think all killing is murder and that it's okay to kill children sometimes.

Always good to know where people really stand.

[Christine]

Oh, Nina...Sweet Nina...

When an unborn baby hijacks a plane and flies it into a building, or kidnaps and beheads journalists, or otherwise threatens national security, you can equate the war in Iraq with an abortion. I wouldn't walk up to a bunch of people that put their lives on the line to protect the lives of their families at home and say anything other than, "Thank you."

There is a difference between fighting in self/national defense and killing your own child. One is selfless, the other is selfish.

L,

Consenting to sex is by it's nature RISKING a baby. They are connected. You consent to one, you risk the other. Since humans have found surgical, mechanical, chemical and other ways to prevent the natural from occuring doesn't change nature, as evidenced by the 80% of abortions performed on contraceptive users.

It's basic cause and effect, and you can't separate the two, especially when lives are at stake. Consenting to rock climbing isn't not consenting to falling and dying, but it's a risk. In your case, you want to consent to rock climbing, but if someone is going to fall and die, you think it should be your baby. How is that fair?

[~Nina]

Christine, I support abortion in the cases of rape and incest. I don't support unrestricted abortion for minors. That's it. There's your answer.

But I know your response already. I get it. Abortion ends a human life. In these cases, I feel the act is justified. I don't think all killing is murder. You do. Too bad you don't have the nerve to walk up to an army base and tell the men and women returning from Iraq your feelings.

I'm not going to argue this with you. I am not going to change my mind, ever. Nor are you. But when someone acknowledges that you are not here to "understand", but rather to pounce upon people and beat them over the head with your position (which is exactly what you have done), then you have a snitfit.

Whatever.

I believe what I believe, I vote accordingly, and I'm not going to change my mind.

Go ahead and pontificate on innocent lives and not punishing the child for the father's sin (although it's apparently fine to punish the victim in your mind) until you're blue in the face.

You obviously love the sound of your own voice - or in this case, love seeing your own words in print.

[L.]

Having an elective hysterectomy is 100% chance of major surgery. Having an elective abortion (minor sugery about which I would have no qualms) should I ever get pregnant, which is very statistically unlikely, is a chance I would rather take. For me, it is a matter of weighing risks.

But yes, if abortion were absolutely not an option for me, I might opt for the hysterectomy (though most docs would probably recommend a tubal ligation first, which aren`t always 100% effective). But for devout Catholics (I am not one -- you probably figured that out!), elective sterilization is NOT a option.

[Christina]

L., wouldn't it be better to have your uterus removed than risk creating a human being that you know in advance you'd kill? Seems like it would be less emotionally trying, and you'd not have pesky periods, and no more worry about contraception. The risk/benefit analysis sounds like it'd be a good deal. And you have the health justification -- that you need something that will, 100%, prevent pregnancy. And if there's no longer any connection between the vagina and the ovaries, BINGO!

Yeah, it's major surgery, but so is gastric banding. It could be done vaginally without opening your abdomen up. Just wondering.

[L.]

Okay, Christine, let me say it this way: I do not agree that consenting to sex is the same as consenting to a baby. I do not want another baby to grow in my uterus. Ergo, if my contraception fails, I would MURDER MY BABY. Your words, not mine, but if you insist -- be my guest to put it that way.
I am actually so terrified of another pregnancy that it is causing problems in my marriage, because my husband would like another child (so he won`t get a vasectomy) and refuses to consider adoption. The advice of a devout Catholic friend is that I am being a bad wife by refusing to honor my maritital obligations to keep my spouse satisfied, and that we need to resume normal relations, and if God sends us another baby, I need to just live with that. I imagine you would agree with her.

Not me - nothing is going to grow inside me again.

[Christine]

"there was no way she could get me out alive"

That's ridiculous. She could leave you there and you'd come out alive. Did she willfully choose to have sex to get you there, because that's where babies come from. It's not some unsuspecting stanger implanted with some alien being. I would suspect that with around 100% of abortions, the child aborted is the biological child of the woman choosing to kill them.

You refuse moral absolutes yet you create them when they don't exist to suit your point.

You're right. I do care more about the possible child you've already decided to kill over your rationalizations for killing them. I really am hoping someone will say something that would make sense, though. Every argument is so easily shot down because it only applies to unborn babies. I'm sure you'd endure another 9 months of pregnancy and a c-section to save the life of your born children, right?

What I'm getting though is that you think a woman's right to not be pregnant for 9 months supersedes a child's right to live. When one person has more rights than another, that's called oppression. Seeing how women were oppressed for so long, you'd think we'd be more careful not to oppress our own children.

You say "get to be born" but why not use "live" or "die"?

[L.]

Okay, Christine, I will honestly answer that I see nothing wrong in refusing to gestate an unwanted pregnancy, even if the tiny human doesn`t get to be born. I have never felt sorry for aborted babies, the way I feel sorry for women who have abortions -- I think, what a waste of medical resources that could be better directed, but in an ideal world, all of those pregnancies would have been prevented in the first place, so I chalk them up to, "Not meant to be."
And everyone`s definition of "bloody and complicated" is a little different, isn`t it? I choose to use contraception, and if it fails, I would either take a pill or have a minor surgical procedure. I would do this instead of choosing 9 months of illness, during which my thin uterine walls are stretched, then a surgical delivery of a baby I absolutely do not want.
You call me a "murderer," but you know what? I can live with that. It doesn`t bother me that you think I`m wrong, the way it seems to bother you. You seem to care more about the hypothetical aborted embryo in my future, than you do about why I think the way I do.

And to answer your previous question, I would indeed extend the same rules to myself. If I went to bed one night and somehow woke up in a woman`s uterus, and there was no way she could get me out alive, guess what I would expect her to do.

[Christine]

L-

You choose to make your life complicated, bloody and messy when you invent right or wrong to suit yourself. My life is quite blood-free.

I, however, don't decide what's true. What's true is true whether I like it or not. I would like it to be true that abortion is not murder, but it's not. Also, certain things are wrong whether I want to do them or not (i.e. cheat on my husband, shoot my annoying neighbor, have my child decapitated in utero.) Because I want them to be okay doesn't make them so. Sure, I could delude myself in order to do them, but that doesn't change that it's wrong. Things become wrong when another being is hurt because of it, cheating would hurt my husband, shooting my neighbor would hurt my neighbor and his family and killing my child would hurt my child. Me thinking those things are right doesn't change the damage I did to another.

It's not to late to learn right from wrong.

[Christine]

Miss Crackwhore? I must have missed that. I will answer anything, because it doesn't take semantic deception and logical gymnastics for me to do so. My beleif system if pretty straightforward and safe for all involved: Don't kill innocent people.

[Christine]

Nina-

Wow, I get that its easier to make assumptions about me than it is to argue your case, especially since there is absolutely no rhyme or reason to your thinking. To you, right and wrong what you say it is based on your own wants and desires in regards to your children living or dying. When I point out that you wouldn't those standards applied to your right to live or die, you get all pissed off and make statements about my character.

However, you are right when you say, "Christine knows exactly what is right and wrong all the time in every situation for everyone in the world." I do think killing an innocent child is wrong all the time. And I don't have to work exceptionally hard to invent a rationale for that although you have exception after exception to your rules (which negates them completely). When I say killing is wrong and it is that simple, you don't respond with "It's not because XXXXXX" but instead with "Christine thinks she's sooooooo much smarter than everyone else. And Christine is this, and Christine is that." Those arguments didn't even work in grade school, so I suggest you abandon them altogether.

I could respond in kind to your personal attacks, but I won't. For someone who lectured so many on staying on topic, I would appreciate if you would respond to the question rather than go off about what you think that I beleive about myself.

You said you favor abortion restrictions. I asked why, if abortion doesn't kill anyone. L. responded without reasoning that it's not that simple, and I responded that it either is or it isn't---then you called me a smartypants, gave me a funny face and ran off to the monkey bars.

Come on.

[~Nina]

Exactly, L.

I'm really tired of this type of tactic which assumes from the start that anyone Christine is talking to is retarded while she's just sooooo much smarter and more superior to the rest of us.

Christine knows exactly what is right and wrong all the time in every situation for everyone in the world. We're all just idiots and must listen to her.

I don't care if Christine understands me or not. The Christines of this world are why I want abortion safe and legal. Her understanding has no bearing on my views and her views are clear and unwavering, so it's obvious she's not interested in anything I have to say. She's not looking for understanding. She's merely looking to use anything I have to say as a chance to pontificate.

She sure didn't bother to respond when I pointed out that her comments about Miss Crackwhore were dead wrong, but now she demands an answer from me when it suits her - or when she's lost her audience and is desperately grasping at a chance to get it back.

[L.]

Yes, Christine, your world is simple, consistent, and neat. Mine is complicated, bloody and messy.
You say you are "just tyring to understand your thinking," but it seems to me you`re just here to lecture anyone who doesn`t share your pro-life views.

[Christine]

L.

Okay, so what's your standard? Isn't it dangerous to have such situational and subjective ethics? Basically, things can be right or wrong whenever you want them to be at any given time for whatever reasons you have or don't have. I'm sure you wouldn't want laws protecting your life to be so flimsy, with and endless list of clauses that say, "It's okay to kill L. if..." I don't think not wanting a C-section justifies killing someone, but you have to in order to go through with it. That would be a clause added to your list to justify killing your child, but you certainly wouldn't want such conditions placed on your living or dying.

Yes, I beleive that abortion is wrong 100% of the time because almost 100% of the time one or more people die from it. For me to say it's wrong at any time because someone dies from it and then to say that it's right at other times (even though one or more people are still dying from it) is completely inconsistent.

It kills a child or it doesn't. If it does, it's wrong. If it doesn't, why not? It really is that simple.

[L.]

Christine, you think abortion is absolutely wrong, 100% of the time. Some of us think it`s not quite so simple, and that depending on the circumstances, it is morally defensible SOME of the time. Very few people think it is right ALL of the time -- otherwise, you`d see lots and lots of women lining up to have their third-trimester pregnancies terminated. This is not the situation anywhere, even in places with the most liberal abortion laws.

[Christine]

Nina, you say you are concerned with "unrestricted, unfettered abortion on demand."

If there's nothing wrong with it, why not allow everyone to have access to it when they want.

If there is something wrong with it (like it kills a child), then why should anyone have access to it?

I'm just trying to understand your thinking.

[Christina]

Lyra, I don't think it's appropriate to picket or otherwise disrupt a funeral, wedding, etc. I wrote a piece back in 2001 about who the real enemy is

http://realchoice.0catch.com/library/weekly/aa022101a.htm

and the real enemy isn't the abortion worker, the prochoice activist, the judge that hands down rulings that lead to death. We play into the hands of the real Enemy when we let ourselves react in hatred toward those we're commanded to love. (That doesn't mean we're supposed to have warm, fuzzy feelings toward them but that we're to act in love. Picketing somebody's funeral to gloat that you think they're burning in Hell isn't very loving, to say the least. It's not loving toward them, nor toward their family and friends.)

And I'm glad the command to love doesn't require warm, fuzzy feelings, because when I think of Christin Gilbert gasping out her last breath, I'm not filled with warm, fuzzy feelings toward the man whose actions ended her life. It's an act of will to pray for somebody who kills a mentally disabled teenage girl, a girl whose parents were trusting him to help her, but clearly it's not impossible or I'd not be able to do it. Do I hope the secular authorities nail his hide to the wall so that he can't kill anybody else? You bet. Just as I hope anybody who's a danger is taken off the streets. But I don't want him to be mistreated. He's a human being, made in the image of God. He's no more or less valuable than any of the rest of us.

[Lyra Angelica, The Truth Serum Administrator]

Thanks, Nina. I respect your views, and I respect Christine's selflessness, too. But, like you, my trust in others has surely taken a hit during the past 10 months.

I am not a malicious person, nor do I enjoy "tormenting others", unlike the lamentable young lady referred to here. If she refrains from trying to ruin a certain courageous and commendable individual, I will not take any action. (I mean, don't get me wrong, I'll still resent the heapin' helpin' of crap she laid on me, but I can't blame her for my own gullibility - nor for the vulnerabilities in my own life.) Candidly, I have spent much of my own life longing for things (i.e., persons) I cannot have, and it's a painful part of life that most of us grimace and bear - and then move forward with our lives. But I would disgrace myself to create a turgid tapestry of bold-faced falsehoods and share 'em with others. And make no mistake - disaster nearly ensued. And you are wholly correct about another thing as well: Before believing in someone else, one should have proof - or more sold proof - of the authenticity of that person's attestations. I'm quite sure that neither Christine nor you could stomach the picketing of someone's funeral, even if you disagreed with their views on a certain topic. Moreover, I appreciate not being called a "baybee-killyur" - that's always appreciated. Teri, do us all a favor - before you start casting myriad stones - take a good, long, protracted look in the mirror. That's what Jesus commanded - or have you forgotten this? The world doesn't revolve around you or any other person who harbors a highly inflated sense of their own self-importance. Nina and Christine - best wishes to both of you.

[~Nina]

*sigh* I'm not sure if you meant your comments for both of us or just Christina...

Look, I'm not a rabid prolifer. I am not out to criminalize abortion, nor do I classify it as "murder".

I am concerned about unrestricted, unfettered abortion on demand. I don't like the notion of an abortion "industry", but I don't believe we should criminalize abortion, either.

I don't think using words like murderer and homicide are appropriate in abortion discussions. They're only meant to inflame.

So I don't think you're a murderer at all. Just so you know.

As for the celibacy thing, I'm hardly celibate, although I agree that it's really sort of tasteless to discuss such things in this type of forum. Besides, I'm awfully skeptical about women who feel the need to tell you a hundred thousand times that they're "chaste". If you are, I'll know. If you have to tell me five times every minute, I'm only going to think the opposite.

[Lyra Angelica]

Oh dear.....

I have this to say, and it shall be my final word on this website: Christina and Nina: I respect both of your respective evocations here. But, Christina, you do not deserve to be a dupe (as I was). It is clear - it is abundantly clear - that you have a wonderful heart, a giving spirit, and a gentle soul that more than one individual has abused.

However, you also believe abortion is murder. That would make me a murderer by your definition. I truly do not wish to debate the morality of this issue, it makes my head throb. Further, I do not believe that either one of us should trot out our celibacy and claim it as moral superiority over others who are engaged in healthy (sexual) relationships - where a (gasp!) pregnancy might occur. That being said, I wish you the best - because you deserve it.

Teri is currently in cahoots with a virulent anti-abortion cabal (based in Wichita) known as Operation Rescue West. This Gang of Four(teen) is fond of picketing funerals, harassing abortion clinic employees at their place of employment, homes and restaurants of choice. (If you don't believe me, go to Google, type in "One Man's God Squad" - and read the horrors therein.) She is attempting to publicly humiliate and harm a certain individual. If she does so, I will be cooperating with the proper individuals by speaking the truth - the truth about the web of lies she told me - every evening - over a two-month period from April-June 2005. I have an E-Mail she sent me in which she claimed to have "lost the baby" during the first week of June 2005. Now, that sort of discredits her attestations about her current reproductive activities, doesn't it?

But it wasn't only the miasma of untruths she wove (like a Black Widow spider who kills and eats everything she copulates with) that turned my heart to stone: Her abject and repulsive disrespect for men (by her OWN admission); her self-admitted sexual addiction, history of manipulative and abusive behavior toward others, and refusal to take responsibility for her actions. Why, just get a load of this gem: "But HE'S the one who's married - isn't he? If I slept with him, I didn't commit any sin, did I?" Holy sheet music - it's a good thing she ain't Catholic - she'd have been thrown (forcibly) out of the Confessional for that pearl of wisdom. Let me reiterate: If Teri does not harm anyone, I will not take action. If she does so, I will not be complacent (or uncaring). I will work to defend an individual who does not deserve the fallacies this woeful young lady has shat his way.