Evangelical doctor's "Plan B" memo disclosed

WASHINGTON — Soon after the Food and Drug Administration overruled its advisory panel last year and rejected an application to make emergency contraception more-easily available, critics of the agency said it had ignored scientific evidence and yielded to pressure from social conservatives.

The agency denied the charge, but an outspoken evangelical-conservative doctor on the panel subsequently acknowledged in a previously unreported public sermon that he was asked to write a memorandum to the FDA commissioner soon after the panel voted 23-4 in favor of over-the-counter sales. He said he believes his memo played a central role in the rejection of that recommendation.

The new information comes from a videotaped sermon given in October by Dr. W. David Hager. On the tape, Hager said he was asked to write a "minority report" that would outline why over-the-counter sales should be rejected.

Speaking at the Asbury College chapel in Wilmore, Ky., Hager said: "I was asked to write a minority opinion that was sent to the commissioner of the FDA. For only the second time in five decades, the FDA did not abide by its advisory-committee opinion, and the measure was rejected."

Hager told the group he had not written his report from an "evangelical Christian perspective" but from a scientific one, arguing that the panel had too little information on how easier availability would affect girls under 16. The FDA later cited that lack of information as the reason it rejected the application.

"I argued from a scientific perspective, and God took that information, and he used it through this minority report to influence the decision," Hager said. "Once again, what Satan meant for evil, God turned into good."

The videotape of Hager's sermon was first obtained by the magazine The Nation, which is publishing a story about the doctor today.

In an e-mail to The Washington Post, Hager said the request for the "minority report" came from "outside the agency," but he had previously told two other journalists that the request came from an FDA staff member.

An FDA spokeswoman said yesterday that the agency had not asked Hager to write a report and that Hager had sent what she called a "private citizen letter" to Commissioner Mark McClellan.

Hager has been a highly controversial figure because of his strong views against abortion and emergency contraception and in favor of abstinence education.

Hager was appointed by the FDA to the Reproductive Health Drugs advisory panel in 2002 and reappointed last year. A prominent Kentucky obstetrician and gynecologist, he has written numerous books on women's health, generally from an evangelical Christian perspective.

During his October sermon, Hager said White House officials asked him in June 2001 to serve in some capacity, initially as a candidate for surgeon general and later as a member of two advisory boards. After one month, Hager said, he was called by the White House and asked to resign from those committees and join the FDA's reproductive-drugs panel instead because "there are some issues coming up we feel are very critical, and we want you to be on that advisory board."

While the FDA sometimes rejects the recommendations of its expert panels, the Plan B case was highly unusual in that the vote was so lopsided in favor of over-the-counter sales and its own science staff had also strongly favored approval.

Plan B has been available with a prescription since 1999. Its manufacturer, Barr Laboratories, applied for permission to sell it without a prescription in 2003, arguing that it could cut the number of abortions from unintended pregnancies. Emergency contraception generally works if it is used within 72 hours of unprotected sex.

Social conservatives in Congress, and many others opposed to abortion, have spoken out against the Plan B application, saying it would encourage unsafe sexual behavior.