A few days ago Michelle Malkin had a post noting what a horribly horribly dangerous drug RU-486 is. Bill Ardolino called her on that one and pointed out that the actually numbers imply that Michelle is pushing crap statistics for ideological reasons.

So, let’s get this straight: assuming accurate data (admittedly a big assumption), a total of ten women (reported) have died, presumably related to a fatal interaction with the drug, in 16 years of international use. Of those ten, five occurred in the United States, where 460,000 women have taken the drug safely since its approval, five years ago.

That equals a mortality rate of 0.0000108, meaning that 1 out of every 92,000 people that took the drug have died.

Bill compared it among other things to penicillin,

Yeah, so can penicillin, at a greater mortality rate than RU-486:

The risk of penicillin fatal allergy is about 1 in 75,000.

Now Michelle has responded…with complete nonsense.

Bill implies that RU-486 is safe because only a small number of deaths have been linked to it. He notes (correctly) that plenty of other drugs are on the market despite being linked to far more than four deaths.

This is a good point, and I should have noted it in my post.

Even so, I’m not quite ready to start pumping RU-486 into the water supply.

Errr…excuse me, but who said anything about pumping it into the water supply? Whiskey Tango Foxtrot on that one? This is just a completely doltish thing to write. Nobody is advocating putting it in the water supply like it is floride…nobody.

Michelle continues,

Just last month, the FDA expanded its warning about possible side effects. The drug already carried a black box warning (the most extreme warning possible).

According to the Los Angeles Times, the FDA is continuing to investigate the drug’s safety. Is the FDA “shoehorning science and medicine in order to fit an ideological agenda?” What about the Centers for Disease Control and Prevention, the California Department of Health Services, and the Los Angeles County Department of Health Services–all of which have launched their own investigations? Are they right-wing whackos too?

The Times says the crux of these inquiries is how and why the women who died after taking RU-486 got infections and “whether more women might have been harmed.”

Clearly these agencies are worried that these four women are just the tip of the iceberg. So am I.

That is fine and good, but right now there is zero evidence to suspect that this drug is any less safe than amoxicillin that Michelle Malkin has been giving to her children.¹ Yet, I don’t see Michelle writing nonsense about pumping Amoxicillin into the water supply. Should there be ongoing research into RU-486? Sure, just as there is ongoing research into people who have allergic reactions to penicillin.

Bill Ardolino sums up very nicely,

And of course I don’t expect a blogger to conduct statistical analysis worthy of a professional epidemiologist for every post on a health issue (my own general analysis was flawed, superficial and exposed to various avenues of criticism), but I would caution Michelle, and anyone else that writes about science or medicine in the context of politics, to use a bit of perspective when working backwards from an ideological presumption. We’re all prone to making these mistakes, especially in the context of a political issue that commands our passion.

This is exactly right. We all have our preconceived notions, biases and beliefs. Ideally we don’t want these things to get in the way of scientific research or even our evaluation of information such as with RU-486, but that is probably asking too much. Still, a reasonable thing to do is look at other similar instances to see if things measure up well. In this case, checking the risks RU-486 poses with other items that are on the market is the obvious thing to do. Further we can’t justify the position that RU-486 is dangerous because it could be shown that there are more women who died from taking the drug. If this line of reasoning were valid we could apply it other things that Michelle supports such as the Iraq war, immigration reform/control, etc.

Update: Over at Imago Dei there is a post trying to defend Malkin’s position. The problem with this post is that it presents no new data on which to conclude that RU-486 is more of a risk than other drugs that are approved. It does provide some additional information on the problems that can arise from RU-486, but again most of this information is theoretical and/or something that while real may not be a wide spread problem.

The bottom line: RU 486 is a medication used for an elective procedure pushed through using an accelerated FDA protocol that has resulted in the deaths of at least five women. The dangers have been pointed out by concerned pro-life groups and have been essentially ignored as ideological propaganda while Danco and the FDA continue to change the labaling and warn physicians of potential adverse effects. Regardless of where you stand on the issue of abortion, this is very concerning.

And I wonder if the anti-choice (aka pro-life) groups are using this issue legitimately or if they are using in place of their real agenda which is to make abortions illegal. Further, even if the criticism that is leveled against Bill Ardolino and others who have taken his side is accurate the very same criticism applies to Michelle Malkin’s “analysis” as well. Of course, you wont get that from the Imago Dei post.

Update II: The post at Hyscience is what I’d like to see more of from the pro-life side of the debate.

In the way of a summation I’d like to make a couple of points. First of all, idealogically, I believe that abortion by any means is the murder of an unborn child, and that it is wrong, immoral and should be unlawful. Having gotten that matter out in the way of a disclaimer, if you are one of ten percent of women that have Clostridium sordellii in your vaginal flora, I believe that with what little we know now about the possible mechanisms involved in possible fatal side effects, using RU-486 is a risk. If you are one of the ninety percent of women who don’t have Clostridium sordellii in your vaginal flora, taking RU-486 is less a risk. On the other hand, if one or both of the proposed mechanisms are not involved in fatal side effects resulting from the use of RU-486, a possibility, then both camps may be equally at risk. Does it look like the just the “tip of the iceberg?” From what we know as we speak, we don’t know! Do I think it’s the tip of the iceberg? From what I’ve read about the pharmacology and what I know about the immunoendocrinology, I don’t believe that anyone at this time believes it to be the tip of the iceberg. And as Bill offers in his post, the regulatory agencies are fulfilling their mandate to look out for public safety, but the jury is still out on their conclusions.

This is how Michelle Malkin’s post should have ended, IMO. Arguing that one is opposed to abortion and hence RU-486 on moral/ethical grounds, and then taking a cold hard look at the numbers and resisting the temptation to give into one’s biases is exactly what this kind of discussion needs…from both sides.

Update III: Over at Wizbang Paul makes the same desperate attempt other have with regards to this issue. Namely to shift the focus form the safety of RU-486 for the women taking–i.e. the context of Michelle Malkin’s original post, to abortion. The probelm should be obvious. Michelle Malkin’s post dealt with the risk to women of taking RU-486. She focused specifically on that and then strongly implied the drug should be yanked from the market based on this safety/risk issue. Paul can’t seem to see this. He writes,

You can do the same cost vs benifit for the automobile or any other product. You want to do a cost vs benifit by only looking at that fact that (by your metric) the cost is cheap. That’s silly.

A band new Ping Zing for $1 is not a deal for me… I don’t golf.

I’m not shifting the focus to abortion. The pill is used to create abortions. It is imposible to consider the cost vs benift without mentioning abortion… be realistic Steve.

In other words to Paul there is no way to look at the two issues seperately. It is like saying I can’t look at the statistics on drunk driving without looking at the morality of driving while drunk. I trust that most people can see that one can focus solely on the statistics of drunk driving without becoming entangled in the morality aspect of said act.

Here’s the crux of it Steve: Can you genuinely compare the benefit to society of antibiotics to the benefit of RU-486?

If you can’t, then your comparing the cost is the red-herring.

I wasn’t even trying to make some sort of statement with regards to the benefit of society. To do such a thing would require to bring in a great deal of other issues such as abortion, possibly crime, the impact on families, etc. What Bill at INDC and later myself are focusing on, like Michelle Malkin, was the safety of the drug in question.
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¹Amoxicillin is a penicillin related anti-bacterial that is often prescribed ear infections and other maladies in children and as noted is actually more “risky” than RU-486 in terms of the statistics.