Broadening the scope of our understanding of mechanisms: lessons from the history of the morning-after pill

Abstract

Philosophers of science and medicine now aspire to provide useful, socially relevant accounts of mechanism. Existing accounts have forged the path by attending to mechanisms in historical context, scientific practice, the special sciences, and policy. Yet, their primary focus has been on more proximate issues related to therapeutic effectiveness. To take the next step toward social relevance, we must investigate the challenges facing researchers, clinicians, and policy makers involving values and social context. Accordingly, we learn valuable lessons about the connections between mechanistic processes and more fundamental reasons for (or against) medical interventions, particularly moral, ethical, religious, and political concerns about health, agency, and power. This paper uses debates over the controversial morning-after pill (emergency contraception) to gain insight into the deeper reasons for the production and use of mechanistic knowledge throughout biomedical research, clinical practice, and governmental regulation. To practice socially relevant philosophy of science, I argue that we need to account for mechanistic knowledge beyond immediate effectiveness, such as how it can also provide moral guidance, aid ethical categorization in the clinic, and function as a political instrument. Such insights have implications for medical epistemology, including the value-laden dimensions of mechanistic reasoning and the “epistemic friction” of values. Furthermore, there are broader impacts for teaching research ethics and understanding the role of science advisors as political advocates.

This is a preview of subscription content, log in to check access.

Notes

  1. 1.

    I thank an anonymous reviewer for suggesting that socially relevant philosophy is the next step in the philosophy of mechanisms after the turns to history, practice, and the special sciences.

  2. 2.

    Overlooking some of the differences between their accounts, the specifics range from organized entities and activities that operate regularly and cyclically (Machamer et al. 2000) and complex systems whose parts interact directly and invariantly to make a difference between variables (Glennan 2002) to a structure performing a function by virtue of its organized parts (Bechtel and Abrahamsen 2005). However, for my purpose of understanding the production and use of mechanistic knowledge, these nuanced distinctions are immaterial.

  3. 3.

    There has been extensive philosophical debate over the sharpness of these context-based distinctions and their epistemic import (see Schickore and Steinle 2006). Nevertheless, if understood as loosely overlapping phases operating throughout inquiry, they provide a useful structure for framing my analysis.

  4. 4.

    Since I aim to expand and then reframe the discussion, I will not evaluate these existing arguments, although I will note criticisms (see footnotes 5, 7, 8, and 9).

  5. 5.

    In contrast, Jeremey Howick (2011) argues that mechanistic reasoning is not a reliable heuristic because of its high cost-to-benefit ratio.

  6. 6.

    Unlike the developers themselves, some of their collaborators and patrons were feminists committed to women’s liberation, such as Margret Sanger and Katharine Dexter McCormick. Nevertheless, they were all motivated to some degree by eugenics and the need for population control (see Marks 2001; Marsh and Ronner 2008).

  7. 7.

    However, one should note that it not a hierarchy of evidence per se but of methodologies (Bluhm 2005). For a review of critiques of Evidence-Based Medicine, and an analysis of its proper place in medical epistemology, see Solomon (2011, 2015).

  8. 8.

    This evidential function in the strong form advocated by Russo and Williams is more contested than the heuristic one. Medical researchers (e.g., Guyatt et al. 2015) and institutions (e.g., the Cochrane Collaboration) oppose it implicitly by omission from their hierarchies of evidence. Several philosophers argue against the evidential function of mechanism explicitly (Andersen 2012; Bluhm 2013; Broadbent 2011; Dragulinescu 2012; Solomon 2015), while others argue that the possible evidential import of mechanistic evidence can be outweighed by commercial forces (Holman 2017).

  9. 9.

    Nonetheless, some philosophers have condemned such attempts to generalize or extrapolate from mechanistic knowledge as dubious because of the instability of mechanisms across populations (Howick 2011; see also La Caze 2011).

  10. 10.

    While beyond the scope of this paper, I think that such standards are empirically unsatisfiable and thus deceptive.

  11. 11.

    I thank David Teira and Ashley Graham Kennedy for suggesting this objection and possible responses.

  12. 12.

    I thank Robyn Bluhm, David Teira, and an anonymous reviewer for pressing me to expound on these epistemic implications of value-ladenness.

References

  1. Andersen, H. (2012). Mechanisms: What are they evidence for in Evidence-Based Medicine. Journal of Evaluation in Clinical Practice, 18(5), 992–999.

    Article  Google Scholar 

  2. Au, Y. C. (2016, April 28). Synthesising heterogeneity: Trends of visuality in biological sciences circa 1970s2000s. Doctoral dissertation. University College London. http://discovery.ucl.ac.uk/1478180/. Accessed 31 August 2018.

  3. Austriaco, N. P. G. (2007). Is plan B an abortifacient? The National Catholic Bioethics Quarterly, 7(4), 703–707.

    Article  Google Scholar 

  4. Bechtel, W., & Abrahamsen, A. (2005). Explanation: A mechanist alternative. Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences, 36(2), 421–441.

    Article  Google Scholar 

  5. Bluhm, R. (2005). From hierarchy to network: A richer view of evidence for evidence-based medicine. Perspectives in Biology and Medicine, 48(4), 535–547.

    Article  Google Scholar 

  6. Bluhm, R. (2013). Physiological mechanisms and epidemiological research. Journal of Evaluation in Clinical Practice, 19(3), 422–426.

    Article  Google Scholar 

  7. Broadbent, A. (2011). Conceptual and methodological issues in epidemiology: An overview. Preventive Medicine, 53(4–5), 215–216.

    Article  Google Scholar 

  8. Bucar, E. (1999). Caution: Catholic health restrictions may be hazardous to your health. Washington, DC: Catholics for a Free Choice.

    Google Scholar 

  9. Burns, G. (2005). The moral veto: Framing contraception, abortion, and cultural pluralism in the United States. Cambridge: Cambridge University Press.

    Google Scholar 

  10. Cartwright, N., & Hardie, J. (2012). Evidence-based policy: A practical guide to doing it better. Oxford: Oxford University Press.

    Google Scholar 

  11. Cartwright, N., & Stegenga, J. (2011). A theory of evidence for evidence-based policy. In W. Twining, P. Dawid, & D. Vasilaki (Eds.), Evidence, inference, and enquiry (pp. 291–322). Oxford: Oxford University Press.

    Google Scholar 

  12. CDD (Chicago Daily Defender). (1967, May 16). Lawyers mull legality of a new pill. Chicago daily defender (daily edition), p. 17. Chicago, IL.

  13. Chang, M. C. (1959). Degeneration of ova in the rat and rabbit following oral administration of 1-(p-2-diethylaminoethoxyphenyl)-1-phenyl-2-p-anisylethanol. Endocrinology, 65(2), 339–342.

    Article  Google Scholar 

  14. Chang, M. C. (1964). Effects of certain antifertility agents on the development of rabbit ova. Fertility and Sterility, 15, 97–106.

    Article  Google Scholar 

  15. Chang, M. C. (1967). Physiological mechanisms responsible for the effectiveness of oral contraception. In R. K. B. Hankinson, R. L. Kleinman, & P. Eckstein (Eds.), Proceedings of the eighth international conference of the International Planned Parenthood Federation, Santiago, Chile, 915 April 1967 (pp. 386–392). London: International Planned Parenthood Federation.

  16. Chang, M. C. (1968). Mammalian sperm, eggs, and control of fertility. Perspectives in Biology and Medicine, 11(3), 376.

    Article  Google Scholar 

  17. Chang, H. (2011). Beyond case-studies: History as philosophy. In S. Mauskopf & T. Schmaltz (Eds.), Integrating history and philosophy of science (pp. 109–124). Dordrecht: Springer.

    Google Scholar 

  18. Chang, M. C., & Harper, M. J. K. (1966). Effects of ethinyl estradiol on egg transport and development in the rabbit. Endocrinology, 78(4), 860–872.

    Article  Google Scholar 

  19. Chang, M. C., & Yanagimachi, R. (1965). Effect of estrogens and other compounds as oral antifertility agents on the development of rabbit ova and hamster embryos. Fertility and Sterility, 16(3), 281–291.

    Article  Google Scholar 

  20. ChoGlueck, C. (2018). The error is in the gap: Synthesizing accounts for societal values in science. Philosophy of Science, 85(4), 704–725.

    Article  Google Scholar 

  21. Clarke, B., Gillies, D., Illari, P., Russo, F., & Williamson, J. (2014). Mechanisms and the evidence hierarchy. Topoi, 33(2), 1–22.

    Article  Google Scholar 

  22. Coleman, M. P. (2013). War on cancer and the influence of the medical-industrial complex. Journal of Cancer Policy, 1(3), e31–e34.

    Article  Google Scholar 

  23. Craver, C., & Darden, L. (2013). In search of mechanisms: Discoveries across the life sciences. Chicago, IL: University of Chicago Press.

    Google Scholar 

  24. Craver, C., & Tabery, J. (2017). Mechanisms in science. In E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy. Metaphysics Research Lab, Stanford University. https://plato.stanford.edu/archives/spr2017/entries/science-mechanisms/. Accessed 31 August 2018.

  25. Croxatto, H. B. (2005). Nuestra historia: El Instituto Chileno de Medicina Reproductiva (ICMER). http://www.icmer.org/documentos/historia_icmer/nuestra_historia_hbc_02-05-2011.pdf. Accessed 31 August 2018.

  26. Croxatto, H. B., Brache, V., Pavez, M., Cochon, L., Forcelledo, M. L., Alvarez, F., et al. (2004). Pituitary–ovarian function following the standard levonorgestrel emergency contraceptive dose or a single 0.75-mg dose given on the days preceding ovulation. Contraception, 70(6), 442–450.

    Article  Google Scholar 

  27. Croxatto, H. B., Devoto, L., Durand, M., Ezcurra, E., Larrea, F., Nagle, C., et al. (2001). Mechanism of action of hormonal preparations used for emergency contraception: A review of the literature. Contraception, 63(3), 111–121.

    Article  Google Scholar 

  28. Daniels, K., Jones, J., & Abma, J. C. (2013a). Use of emergency contraception among women aged 1544, United States, 20062010. NCHS data brief, no 112. Hyattsville, MD: National Center for Health Statistics. https://www.cdc.gov/nchs/data/databriefs/db112.pdf. Accessed 31 August 2018.

  29. Daniels, K., Mosher, W. D., & Jones, J. (2013b). Contraceptive methods women have ever used: United States, 19822010. National health statistics reports, no 62. Hyattsville, MD: National Center for Health Statistics.

  30. Darden, L. (2006). Reasoning in biological discoveries: Essays on mechanisms, interfield relations, and anomaly resolution. Cambridge: Cambridge University Press.

    Google Scholar 

  31. Davis, D. L. (2007). The secret history of the war on cancer. New York: Basic Books.

    Google Scholar 

  32. Díaz, S., Hardy, E., Alvarado, G., & Ezcurra, E. (2003a). Acceptability of emergency contraception in Brazil, Chile, and Mexico: 1-Perceptions of emergency oral contraceptives. Cadernos de Saúde Pública, 19(5), 1507–1517.

    Article  Google Scholar 

  33. Díaz, S., Hardy, E., Alvarado, G., & Ezcurra, E. (2003b). Acceptability of emergency contraception in Brazil, Chile, and Mexico. 2-Facilitating factors versus obstacles. Cadernos de Saúde Pública, 19(6), 1729–1737.

    Article  Google Scholar 

  34. Douglas, H. (2009). Science, policy, and the value-free ideal. Pittsburgh, PA: University of Pittsburgh Press.

    Google Scholar 

  35. Douglas, H. (2014). The moral terrain of science. Erkenntnis, 79(S5), 961–979. https://doi.org/10.1007/s10670-013-9538-0.

    Article  Google Scholar 

  36. Dragulinescu, S. (2012). On ‘stabilising’ medical mechanisms, truth-makers and epistemic causality: A critique to Williamson and Russo’s approach. Synthese, 187(2), 785–800.

    Article  Google Scholar 

  37. Dragulinescu, S. (2017). Mechanisms and difference-making. Acta Analytica, 32(1), 29–54.

    Article  Google Scholar 

  38. Durand, M., del Carmen Cravioto, M., Raymond, E. G., Durán-Sánchez, O., De la Luz Cruz-Hinojosa, M., Castell-Rodríguez, A., et al. (2001). On the mechanisms of action of short-term levonorgestrel administration in emergency. Contraception, 64(4), 227–234.

    Article  Google Scholar 

  39. Ellertson, C., Trussell, J., Stewart, F. H., & Winikoff, B. (1998). Should emergency contraceptive pills be available without prescription? Journal of the American Medical Women’s Association, 53(5 Suppl 2), 226–229.

    Google Scholar 

  40. Elliott, K. (2011). Is a little pollution good for you? Incorporating societal values in environmental research. New York: Oxford University Press.

    Google Scholar 

  41. FDA (Food and Drug Administration). (2003). Nonprescription Drugs Advisory Committee (NDAC) in joint session with the Advisory Committee for Reproductive Health Drugs (ACRHD). Meeting transcript. No. 202/797-2525. Washington, DC: U.S. Food and Drug Administration.

  42. FDA (Food and Drug Administration). (2006). Label, insert, and CARE program proposal for Plan B. Drugs@FDA database. http://www.accessdata.fda.gov/drugsatfda_docs/label/2006/021045s011lbl.pdf. Accessed 21 August 2018.

  43. FDA (Food and Drug Administration). (2013). Birth control: Medicines to help you. Case documents for the Supreme Court of the United States. https://www.supremecourt.gov/opinions/URLs_Cited/OT2013/13-354/13-354-2.pdf. Accessed 29 April 2016

  44. Fehr, C., & Plaisance, K. S. (2010). Socially relevant philosophy of science: An introduction. Synthese, 177(3), 301–316.

    Article  Google Scholar 

  45. FIGO & ICEC (International Federation of Gynecology and Obstetrics & International Consortium for Emergency Contraception). (2011). Mechanism of action: How do levonorgestrel-only emergency contraceptive pills (LNG ECPs) prevent pregnancy? New York, NY: Family Care International. http://www.figo.org/sites/default/files/uploads/MOA_FINAL_2011_ENG.pdf. Accessed 31 August 2018.

  46. Foster, A. M., & Wynn, L. L. (2012). Emergency contraception: The story of a global reproductive health technology. New York: Palgrave Macmillan.

    Google Scholar 

  47. Fridman, E. P. (2002). Medical primatology: History, biological foundations and applications. (R. D. Nadler, Ed.). London; New York: CRC Press.

  48. Garmendia, F., Kesserü, E., Urdanivia, E., & Valencia, M. (1976). Luteinizing hormone and progesterone in women under postcoital contraception with D norgestrel. Fertility and Sterility, 27(11), 1250–1255.

    Article  Google Scholar 

  49. Glasier, A., Thong, K. J., Dewar, M., Mackie, M., & Baird, D. T. (1992). Mifepristone (RU 486) compared with high-dose estrogen and progestogen for emergency postcoital contraception. New England Journal of Medicine, 327(15), 1041–1044.

    Article  Google Scholar 

  50. Glennan, S. (2002). Rethinking mechanistic explanation. Philosophy of Science, 69(S3), S342–S353.

    Article  Google Scholar 

  51. Glennan, S. (2016). Mechanisms and mechanical philosophy. In P. Humphreys (Ed.), The oxford handbook of philosophy of science. Oxford: Oxford University Press.

    Google Scholar 

  52. GRADE Working Group. (2004). Grading quality of evidence and strength of recommendations. BMJ, 328(7454), 1490.

    Article  Google Scholar 

  53. Greep, R. O. (1995). Min Chueh Chang, 19081991. Biographical Memoir. National Academy of Sciences. http://www.nasonline.org/publications/biographical-memoirs/memoir-pdfs/chang-m-c.pdf. Accessed 31 August 2018.

  54. Gross, S. E., Lavi, S., & Boas, H. (2018). Medicine, technology, and religion reconsidered: The case of brain death definition in Israel. Science, Technology and Human Values. https://doi.org/10.1177/0162243918783477.

    Article  Google Scholar 

  55. Grou, F., & Rodrigues, I. (1994). The morning-after pill—How long after? American Journal of Obstetrics and Gynecology, 171(6), 1529–1534.

    Article  Google Scholar 

  56. Guttmacher Institute. (2018). Targeted regulation of abortion providers. Fact sheet. Guttmacher Institute. https://www.guttmacher.org/state-policy/explore/targeted-regulation-abortion-providers. Accessed 31 August 2018.

  57. Guyatt, G., Rennie, D., Meade, M., & Cook, D. (2015). Users’ guides to the medical literature: A manual for evidence-based clinical practice. New York: McGraw-Hill Education Medical.

    Google Scholar 

  58. Hapangama, D., Glasier, A. F., & Baird, D. T. (2001). The effects of peri-ovulatory administration of levonorgestrel on the menstrual cycle. Contraception, 63(3), 123–129.

    Article  Google Scholar 

  59. HAS (Haute Autorite de Sante). (2015). NORLEVO 1,5 mg, comprimé, renouvellement de l’inscription. Renewal of registration. French National Authority of Health. https://www.has-sante.fr/portail/upload/docs/evamed/CT-13654_NORLEVO_PIS_RI_Avis1_CT13654.pdf. Accessed 31 August 2018.

  60. Hatcher, R. A., & Conrad, C. C. (1971). Adenocarcinoma of the vagina and stilbestrol as a “morning-after” pill. New England Journal of Medicine, 285(22), 1264–1265.

    Google Scholar 

  61. Holman, B. (2017). Philosophers on drugs. Synthese. https://doi.org/10.1007/s11229-017-1642-2.

    Article  Google Scholar 

  62. Holman, B., & Bruner, J. (2017). Experimentation by industrial selection. Philosophy of Science, 84(5), 1008–1019.

    Article  Google Scholar 

  63. Hoshino, K. (1993). Legal status of brain death in Japan: Why many Japanese do not accept “brain death” as a definition of death. Bioethics, 7(2–3), 234–238.

    Article  Google Scholar 

  64. Howick, J. (2011). The philosophy of evidence-based medicine. West Sussex, UK: Wiley-Blackwell, BMJ Books.

    Google Scholar 

  65. Hughes, E. C. (1972). Obstetric-gynecologic terminology: With section on neonatology and glossary of congenital anomalies. Philadelphia: Davis.

    Google Scholar 

  66. Hurlbut, J. B. (2017). Experiments in democracy: Human embryo research and the politics of bioethics. New York: Columbia University Press.

    Google Scholar 

  67. Illari, P. (2011). Mechanistic evidence: Disambiguating the Russo-Williamson thesis. International Studies in the Philosophy of Science, 25(2), 139–157.

    Article  Google Scholar 

  68. Illari, P. (2017). Mechanisms in medicine. In M. Solomon, J. R. Simon, & H. Kincaid (Eds.), The Routledge companion to philosophy of medicine (pp. 48–57). Abingdon: Routledge.

    Google Scholar 

  69. Illari, P., & Williamson, J. (2012). What is a mechanism? Thinking about mechanisms across the sciences. European Journal for Philosophy of Science, 2(1), 119–135.

    Article  Google Scholar 

  70. Jackson, M. (1967). Recent developments in the biological control of fertility: Report from the medical session. In R. K. B. Hankinson, R. L. Kleinman, & P. Eckstein (Eds.), Proceedings of the eighth international conference of the International Planned Parenthood Federation, Santiago, Chile, 9-15 April 1967 (pp. 484–486). London: International Planned Parenthood Federation.

  71. Jasanoff, S. (1990). The fifth branch: Science advisers as policymakers. Cambridge, MA: Harvard University Press.

    Google Scholar 

  72. Kahlenborn, C., Peck, R., & Severs, W. B. (2015). Mechanism of action of levonorgestrel emergency contraception. The Linacre Quarterly, 82(1), 18–33.

    Article  Google Scholar 

  73. Kahlenborn, C., Stanford, J. B., & Larimore, W. L. (2002). Postfertilization effect of hormonal emergency contraception. Annals of Pharmacotherapy, 36(3), 465–470.

    Article  Google Scholar 

  74. Kennedy, A. (2018). Solving antibiotic resistance with the power of evolution. The Prindle Post. https://www.prindlepost.org/2018/06/solving-antibiotic-resistance-with-the-power-of-evolution/. Accessed 31 August 2018.

  75. Kesserü, E., Camacho-Ortega, P., Laudahn, G., & Schopflin, G. (1975). In vitro action of progestogens on sperm migration in human cervical mucus. Fertility and Sterility, 26(1), 57–61.

    Article  Google Scholar 

  76. Kesserü, E., Garmendia, F., Westphal, N., & Parada, J. (1974). The hormonal and peripheral effects of d-norgestrel in postcoital contraception. Contraception, 10(4), 411–424.

    Article  Google Scholar 

  77. Kitcher, P. (2011). Science in a democratic society. Amherst, NY: Prometheus Books.

    Google Scholar 

  78. Kohorn, E. I. (2009). John McLean Morris: A career in surgery, gynecology and reproductive physiology. Connecticut Medicine, 73(4), 223–227.

    Google Scholar 

  79. La Caze, A. (2011). The role of basic science in evidence-based medicine. Biology and Philosophy, 26(1), 81–98.

    Article  Google Scholar 

  80. Lader, L. (1966, April 10). Three men who made a revolution. New York Times, p. 181. New York, NY.

  81. Lalitkumar, P. G. L., Lalitkumar, S., Meng, C. X., Stavreus-Evers, A., Hambiliki, F., Bentin-Ley, U., et al. (2007). Mifepristone, but not levonorgestrel, inhibits human blastocyst attachment to an in vitro endometrial three-dimensional cell culture model. Human Reproduction, 22(11), 3031–3037.

    Article  Google Scholar 

  82. Landgren, B.-M., Aedo, A.-R., Johannisson, E., Kumar, A., & Yong-en, S. (1989). The effect of levonorgestrel administered in large doses at different stages of the cycle on ovarian function and endometrial morphology. Contraception, 39(3), 275–289.

    Article  Google Scholar 

  83. Langston, N. (2010). Toxic bodies: Hormone disruptors and the legacy of DES. New Haven, CT: Yale University Press.

    Google Scholar 

  84. Larimore, W. L., & Stanford, J. B. (2000). Postfertilization effects of oral contraceptives and their relationship to informed consent. Archives of Family Medicine, 9(2), 126–133.

    Article  Google Scholar 

  85. Larimore, W. L., Stanford, J. B., & Kahlenborn, C. (2004). Does pregnancy begin at fertilization? Family Medicine, 36(10), 690–691.

    Google Scholar 

  86. Longino, H. E. (1990). Science as social knowledge. Princeton, NJ: Princeton University Press.

    Google Scholar 

  87. Luker, K. (1984). Abortion and the politics of motherhood. Berkeley: University of California Press.

    Google Scholar 

  88. Lynch, W. A. (1977). Comments on “Medication to prevent pregnancy after rape”. Linacre Quarterly, 44(3), 223–228.

    Google Scholar 

  89. Machamer, P., Darden, L., & Craver, C. F. (2000). Thinking about mechanisms. Philosophy of Science, 67(1), 1–25.

    Article  Google Scholar 

  90. Marchionni, C., & Reijula, S. (2019). What is mechanistic evidence, and why do we need it for evidence-based policy? Studies in History and Philosophy of Science Part A, 73, 54–63.

    Article  Google Scholar 

  91. Marions, L., Hultenby, K., Lindell, I., Sun, X., Ståbi, B., & Danielsson, K. G. (2002). Emergency contraception with mifepristone and levonorgestrel: Mechanism of action. Obstetrics and Gynecology, 100(1), 65–71.

    Google Scholar 

  92. Marks, L. V. (2001). Sexual chemistry: A history of the contraceptive pill. New Haven, CT: Yale University Press.

    Google Scholar 

  93. Marsh, M. S., & Ronner, W. (2008). The fertility doctor: John Rock and the reproductive revolution. Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  94. McCarthy, D. (1977). Medication to prevent pregnancy after rape. Linacre Quarterly, 44(3), 210–222.

    Google Scholar 

  95. McCarthy, D. (1978). Pregnancy after rape. Linacre Quarterly, 45(1), 8.

    Google Scholar 

  96. Miller, P. (2015). Good Catholics: The battle over abortion in the Catholic Church. Berkeley: University of California Press.

    Google Scholar 

  97. Moggia, A., Beauquis, A., Ferrari, F., Torrado, M. L., Alonso, J. L., Koremblit, E., et al. (1974). The use of progestogens as postcoital oral contraceptives. The Journal of Reproductive Medicine, 13(2), 58–61.

    Google Scholar 

  98. Morris, J. M., & Van Wagenen, G. (1966). Compounds interfering with ovum implantation and development: III. The role of estrogens. American Journal of Obstetrics and Gynecology, 96(6), 804–815.

    Article  Google Scholar 

  99. Morris, J. M., & Van Wagenen, G. (1973). Interception: The use of postovulatory estrogens to prevent implantation. American Journal of Obstetrics and Gynecology, 115(1), 101–106.

    Article  Google Scholar 

  100. Morris, J. M., Van Wagenen, G., Hurteau, G. D., Johnston, D. W., & Carlsen, R. A. (1967a). Compounds interfering with ovum implantation and development. I. Alkaloids and antimetabolites. Fertility and Sterility, 18(1), 7–17.

    Article  Google Scholar 

  101. Morris, J. M., Van Wagenen, G., McCann, T., & Jacob, D. (1967b). Compounds interfering with ovum implantation and development. II. Synthetic estrogens and antiestrogens. Fertility and Sterility, 18(1), 18–34.

    Article  Google Scholar 

  102. Müller, A. L., Llados, C. M., & Croxatto, H. B. (2003). Postcoital treatment with levonorgestrel does not disrupt postfertilization events in the rat. Contraception, 67(5), 415–419.

    Article  Google Scholar 

  103. Naqvi, R. H., & Warren, J. C. (1971). Interceptives: Drugs interrupting pregnancy after implantation. Steroids, 18(6), 731–739. https://doi.org/10.1016/0039-128X(71)90032-8.

    Article  Google Scholar 

  104. NCCB (National [United States] Conference of Catholic Bishops). (1971). Ethical and religious directives for catholic health facilities. Second edition. Washington, DC: United States Catholic Conference Office of Publishing and Promotion.

  105. NCCB (National [United States] Conference of Catholic Bishops). (1995). Ethical and religious directives for catholic health care services. Third edition. Washington, DC: United States Catholic Conference Office of Publishing and Promotion.

  106. Nudeshima, J. (1991). Obstacles to brain death and organ transplantation in Japan. The Lancet, 338(8774), 1063–1064.

    Article  Google Scholar 

  107. Ortiz, M. E., Ortiz, R. E., Fuentes, M. A., Parraguez, V. H., & Croxatto, H. B. (2004). Post-coital administration of levonorgestrel does not interfere with post-fertilization events in the new-world monkey Cebus apella. Human Reproduction, 19(6), 1352–1356.

    Article  Google Scholar 

  108. Parkes, A. S. (1967). Future trends. In R. K. B. Hankinson, R. L. Kleinman, & P. Eckstein (Eds.), Proceedings of the eighth international conference of the International Planned Parenthood Federation, Santiago, Chile, 915 April 1967 (pp. 501–506). London: International Planned Parenthood Federation.

  109. Population Council. (2005). Emergency contraception’s mode of action clarified. Population Briefs, 11(2), 3.

    Google Scholar 

  110. Prescott, H. M. (2011). The morning after: A history of emergency contraception in the United States. New Brunswick, NJ: Rutgers University Press.

    Google Scholar 

  111. Robinson, M. D. (2018). Financializing epistemic norms in contemporary biomedical innovation. Synthese. https://doi.org/10.1007/s11229-018-1704-0.

    Article  Google Scholar 

  112. Rock, J. (1963). The time has come: A Catholic doctor’s proposals to end the battle over birth control. New York: Knopf.

    Google Scholar 

  113. Rock, J. (1965). Let’s be honest about the Pill! Journal of the American Medical Association, 192(5), 401–402.

    Article  Google Scholar 

  114. Rolin, K. (2017). Scientific community: A moral dimension. Social Epistemology, 31(5), 468–483.

    Article  Google Scholar 

  115. Rossiter, M. W. (1982). Women scientists in America: Struggles and strategies to 1940. Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  116. Rothman, D. J. (2003). Strangers at the bedside: A history of how law and bioethics transformed medical decision making. Second edition. New York: Aldine de Gruyter.

    Google Scholar 

  117. Russo, F. (2012). Public health policy, evidence, and causation: Lessons from the studies on obesity. Medicine, Health Care and Philosophy, 15(2), 141–151.

    Article  Google Scholar 

  118. Russo, F., & Williamson, J. (2007). Interpreting causality in the health sciences. International Studies in the Philosophy of Science, 21(2), 157–170.

    Article  Google Scholar 

  119. Russo, F., & Williamson, J. (2011). Epistemic causality and evidence-based medicine. History and Philosophy of the Life Sciences, 33(4), 563–582.

    Google Scholar 

  120. Russo, F., & Williamson, J. (2012). EnviroGenomarkers: The interplay between mechanisms and difference making in establishing causal claims. Medicine Studies, 3(4), 249–262.

    Article  Google Scholar 

  121. Schiappacasse, V., & Díaz, S. (2012). Chile: One step forward, one step back. In A. M. Foster & L. L. Wynn (Eds.), Emergency contraception: The story of a global reproductive health technology (pp. 107–122). New York: Palgrave Macmillan.

    Google Scholar 

  122. Schickore, J., & Steinle, F. (2006). Revisiting discovery and justification: Historical and philosophical perspectives on the context distinction. Dordrecht: Springer.

    Google Scholar 

  123. Scientific American (1966, June). Retroactive birth control. Scientific American, 214(6), 56.

  124. Shirley, B., Bundren, J. C., & McKinney, S. (1995). Levonorgestrel as a postcoital contraceptive. Contraception, 52(5), 277–281.

    Article  Google Scholar 

  125. Sjövall, T. (1967). Summary of the conference. In R. K. B. Hankinson, R. L. Kleinman, & P. Eckstein (Eds.), Proceedings of the eighth international conference of the International Planned Parenthood Federation, Santiago, Chile, 915 April 1967 (pp. 507–513). London: International Planned Parenthood Federation.

  126. Smugar, S. S., Spina, B. J., & Merz, J. F. (2000). Informed consent for emergency contraception: variability in hospital care of rape victims. American Journal of Public Health, 90(9), 1372–1376.

    Article  Google Scholar 

  127. Solomon, M. (2011). Just a paradigm: Evidence-based medicine in epistemological context. European Journal for Philosophy of Science, 1(3), 451–466.

    Article  Google Scholar 

  128. Solomon, M. (2015). Making medical knowledge. Oxford, UK: Oxford University Press.

    Google Scholar 

  129. Spona, J., Matt, K., & Schneider, W. H. F. (1975). Study on the action of D-norgestrel as a postcoital contraceptive agent. Contraception, 11(1), 31–43.

    Article  Google Scholar 

  130. Stanford, J. B. (2011). Testimonies: Joseph B. Stanford. Mormon Scholars Testify. http://mormonscholarstestify.org/2691/joseph-b-stanford. Accessed 31 August 2018.

  131. Stanford, J. B., Hager, W. D., & Crockett, S. A. (2004). The FDA, politics, and Plan B: To the editor. New England Journal of Medicine, 350(23), 2413–2414.

    Article  Google Scholar 

  132. Steele, K. (2012). The scientist qua policy advisor makes value judgments. Philosophy of Science, 79(5), 893–904.

    Article  Google Scholar 

  133. Supreme Court of the United States. (2013). Brief for respondents, on petition for a writ of certiorari to the United States Court of Appeals for the Tenth Circuit, no 13–354. http://sblog.s3.amazonaws.com/wp-content/uploads/2013/10/No-13-354-Brief-for-Respondents.pdf. Accessed 31 August 2018.

  134. Supreme Court of the United States. (2014). Syllabus: Burwell v. Hobby Lobby Stores, no 13–354 and 13–356. https://www.supremecourt.gov/opinions/13pdf/13-354_olp1.pdf. Accessed 31 August 2018.

  135. Thagard, P. (1999). How scientists explain disease. Princeton, NJ: Princeton University Press.

    Google Scholar 

  136. Thagard, P. (2011). Patterns of medical discovery. In F. Gifford (Ed.), Philosophy of medicine (pp. 187–202). Amsterdam: Elsevier North-Holland.

    Google Scholar 

  137. Time. (1966, May 6). The morning-after pill. Time, 87(18), 74.

  138. Tone, A. (2001). Devices and desires: A history of contraceptives in America. New York: Hill and Wang.

    Google Scholar 

  139. Ugocsai, G., Resch, B., Traub, A., & Sas, M. (1984). Biological, microscopic and scanning electron microscopic investigations of the effects of postinor d-norgestrel in rabbits. Contraception, 30(2), 153–159.

    Article  Google Scholar 

  140. Watkins, E. S. (1998). On the Pill: A social history of oral contraceptives, 1950–1970. Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  141. Weaver, S. (2017). The harms of ignoring the social nature of science. Synthese. https://doi.org/10.1007/s11229-017-1479-8.

    Article  Google Scholar 

  142. WHO (World Health Organization). (2017). WHO model list of essential medicines. 20th list. http://www.who.int/medicines/publications/essentialmedicines/20th_EML2017_FINAL_amendedAug2017.pdf. Accessed 31 August 2018.

  143. Wilks, J. (2000). The impact of the Pill on implantation factors: New research findings. Ethics and Medicine, 16(1), 15–22.

    Google Scholar 

  144. Williams, D. K. (2016). Defenders of the unborn: The pro-life movement before Roe (Vol. Wade). New York, NY: Oxford University Press.

    Google Scholar 

  145. Wynn, L. L., & Trussell, J. (2006). The social life of emergency contraception in the United States: Disciplining pharmaceutical use, disciplining sexuality, and constructing zygotic bodies. Medical Anthropology Quarterly, 20(3), 297–320.

    Article  Google Scholar 

Download references

Acknowledgements

I gave an earlier version of this paper at the 2017 International Society for History, Philosophy and Social Studies of Biology in Sao Paulo, Brazil, and received many helpful comments from the audience. Special thanks to Elisabeth Lloyd and Jutta Schickore for advice and support. Additional thanks to Robyn Bluhm, Sandy Gliboff, Kate Grauvogel, Nora Hangel, Bennett Holman, Ashley Graham Kennedy, Naomi Oreskes, Emanuele Ratti, David Teira, and two anonymous reviewers for helpful comments and engaging conversations.

Funding

This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1342962. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Christopher ChoGlueck.

Ethics declarations

Conflict of interest

The author declares that he has no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

ChoGlueck, C. Broadening the scope of our understanding of mechanisms: lessons from the history of the morning-after pill. Synthese (2019). https://doi.org/10.1007/s11229-019-02201-0

Download citation

Keywords

  • Mechanism
  • Pharmacology
  • Medical epistemology
  • Therapeutic effectiveness
  • Science and values
  • Socially relevant philosophy of science