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From: B. Harris)
Subject: Re: Doctor-bashing
Date: 12 Mar 1999 23:04:40 GMT

In <> Terri <> writes:

>Quite the contrary. Women do indeed discuss these things with each other.
>Contrary to Dr. Chung's post it is not the insurance companies who are
>demanding investigation of unnecessary hysterectomies. Rather it is the
>women who have been injured by the surgery they later learn was
>unnecessary who are leading this fight. Just as it was women who demanded
>that drugs intended to be used for them be tested on them.

   Yes, they did.  Alas, they forgot to offer to give up all right to
sue for damages in cases of becoming pregant and delivering a baby with
a birth defect (which happens in some fraction of births, drugs or
not).  Pharmaceutical companies really would rather not deal with the
extra liability of dealing with women of childbearing age who cannot be
trusted to use two forms of contraception.  Nor do they want to be sued
by elderly, frail, and chronically ill patients who react badly to a
drug which works fine in people who are younger and have fewer
problems.  Understandably, they'd rather have the doctor who uses the
drug bear primary responsiblity for using it in somebody who is already
on many other drugs and who doesn't have much physiological reserve.
If somebody's gunna be sued for being dumb, it should be the guy on the
spot who has the information.  If you look at package inserts, they
generally say things which translate out to: don't use this stuff in
very old or debilitated people, or woman who can become preganant, or
in babies or small children, unless you really don't have much choice.
If such groups want access to information about what drugs do to them,
they are going to have to sign some kind of social contract to bear the
risk when the drugs are being tested.  And that's a VERY different
situation than is the case in many trials, especially phase I trials,
where drugs are being given sometimes to people who are not expected to
benefit directly from them, and who run the risk of being harmed in
exchange for money.  How are you going to do that in babies, pregant
women, and folks in the ICU?

>So long as your practice is devoid of young and middle-aged women, you
>aren't likely to run across too many negative hysterectomy stories.

   And why not?  Really, I'm interested in what you think happens to
women when they age.  I assume you think they all not only give up sex,
but forget they ever had it.  And when asked about their medical
histories, a surgery which wiped out a major source of pleasure in
their lives will be forgotten also, or mentioned with a yawn.  Perhaps
you think all of my patients are demented?

                                     Steve Harris, M.D.

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