The back corner of Livermore's Memory Gardens, where Holly Patterson was interred in September just a few weeks past her eighteenth birthday, is strewn with tributes to those who died before their time. Mourners have decorated grave sites with toy cars and motorcycles, sports pennants, plastic medallions bearing the Corona beer logo, and animal-shaped Mylar balloons that wave in the breeze. While headstones in the rest of the cemetery tend towards the religious or the floral, these are engraved with electric guitars, Jet Skis, and horses, or inset with photos of boys in Little League uniforms or smiling high-school girls on Picture Day. The photos are recent, their colors still fresh. And most of those pictured are very, very young.
Holly's grave doesn't have a headstone, and the grass hasn't yet healed with the surrounding turf. She lies, almost unnoticed, at the very edge of the lot, where the cemetery fades away into lawn, her grave site temporarily marked with a small black placard, some flowers, and a few trinkets. But Holly's passing has received more attention than all of these other young people combined. Her name and the circumstances of her death have become rallying cries in a battle now being duked out in Congress and the halls of the US Food and Drug Administration.
Holly died of septic shock, the result of an infection produced by incompletely expelled fetal tissue following a medically induced abortion. The Alameda County Coroner's report was careful to note that her death was of natural causes -- the abortion caused an inflammation, which caused an infection, which led to her death. The report didn't even list the brand name of the drug she took.
Nevertheless, her death has renewed a fierce political battle over Mifeprex, the only drug in the United States approved for ending unwanted pregnancies. Also known by the generic name mifepristone, or its original lab name, RU-486, Mifeprex is legal but highly controlled. It is available only from doctors who have ordered it direct from the drug's sole manufacturer, Danco Laboratories, and have promised to abide by a long list of regulations. More than 200,000 American women have taken Mifeprex since the FDA approved it in 2000, and it has been widely lauded by abortion providers and pro-choice advocates as a safe and effective alternative to surgical abortion. Indeed, they argue that any abortion procedure carries a risk of death twenty times lower than does carrying a pregnancy to term.
But abortion opponents -- who fought the drug's introduction to the United States and have been agitating for further regulation, if not a total suspension, of Mifeprex ever since it was approved -- say it's a dangerous chemical that is poorly managed both by the FDA and the clinics that dispense it. Over the last three years, they point out, Danco has reported at least four hundred adverse events to the FDA, including severe bleeding and bacterial infections. Mifepristone also has been linked with the death of one other American woman, although she had preexisting medical conditions that should have made her ineligible to take it. Holly's death is arguably the first in which a healthy American woman died after using the pill as intended.
Those seeking a poster girl for their efforts to ban RU-486 seem to have found her in Holly Patterson. Last month, with the blessing of Holly's father Monty Patterson and his new wife, Helen Patterson, South Carolina Congressman Jim DeMint introduced a bill dubbed "Holly's Law," which alleges that the FDA rushed the approval of the drug in order to satisfy the Clinton White House. Introduced the same day that President George W. Bush signed a legislative ban on late-term abortion, DeMint's bill asks the government to pull RU-486 off the market for six months while the General Accounting Office reviews the process by which it was approved. Seventy-six members of the House, including Majority Leader Tom DeLay, have signed on as cosponsors. If the FDA is found to have violated its own rules, RU-486 could be kept off the market indefinitely.
Holly's death also gave new life to a bill that has languished in Congress for years, the so-called RU-486 Patient Health and Safety Act, which would place further restrictions on how Mifeprex is dispensed. The bill was originally proposed in 2000, then reintroduced in 2001, and again early this year by Louisiana Republican David Vitter, but has been hung up in the House Subcommittee on Health. With Holly's death, foes of RU-486 hope Vitter's bill will have the juice to earn a floor vote.
Although Holly Patterson was legally an adult when she took Mifeprex, her father and his wife are supporting the Tell-a-Parent initiative proposed for next fall's state ballot. The measure, sponsored by an Oakland group calling itself Life on the Ballot, would require parental notification 48 hours before a minor has an abortion. Currently, California doesn't require parental consent or notification.
Supporters of these measures insist their efforts are not simply attempts to gain political traction from a girl's untimely death, but rather are much-needed safety checks on medical abortions. John Hart, spokesman for Congressman DeMint, puts it this way: "If this was an accident involving an airplane, you would ground the fleet and review safety procedures."
Pro-choice advocates, meanwhile, are bracing for this onslaught of legislation, calling it part of the right wing's ceaseless antiabortion crusade. "Antichoice forces never wanted this medication to be available," says Vicki Saporta, president of the National Abortion Federation. "They just don't want abortion to be available in the US by any method."
The current clash over Mifeprex is really just another standoff in an epic battle. Holly's death has reignited a complex medical and ethical debate between ideologically fierce opponents who squared off long before she was even born. It's the sort of argument in which the two sides can look at identical statistics and draw opposite conclusions. Is one death out of 200,000 American users a very low adverse-event rate for a prescription drug, as the pill's supporters maintain? Or is one death for the sake of what opponents deride as a "lifestyle drug" one death too many?
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