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Ralph Nader > In the Public Interest > Women and Medical Malpractice

What incompetent physicians do to their women patients in this country amounts to a nationwide mayhem and carnage, regularly observed by their competent colleagues, who know of this chronic malpractice, yet remain silent.

For over a generation, physicians have conducted unnecessary hysterectomies which now total in the millions. Despite numerous authoritative studies condemning the abuse of this surgical procedure, the destruction continues at a rate far higher than that which prevails in many European countries. Fee-for-service medicine does have its perverse incentives sometimes.

A recent comparison of careful and careless hospitals by our Washington-based Health Research Group showed rates from about 12 percent to over 30 percent of births delivered by cesearean section. The lower figure is the level accepted by the medical community as appropriate, while the higher rate occurs largely due to the doctor’s own convenience and receipt of higher fees.

It is also long known that doctors are, on the whole, more likely to prescribe more drugs, especially mood drugs, to women than to men because they are perceived as having an “emotional” basis for their asserted malady. The valium data support this observation.

Now comes more evidence of physician recklessness promoted by the drug companies under the de-regulatory indifference of Reagan’s Food and Drug Administration (FDA).

From internal Dow Corning and FDA documents, there is information which clearly demonstrates that silicone gel, presently being implanted in 130,000 women a year mostly for breast augmentation (cosmetic) purposes, causes highly malignant cancers in over 23% of the laboratory animals tested. Dr. Sidney Wolfe, head of the Health Research Group, has written to FDA Commissioner, Frank Young, demanding that there be a halt to the use of silicone gel materials for human implantation.

Dr. Wolfe noted that concerned FDA scientists urged Dr. Young to issue a medical alert to warn the public and to require mandatory leaflet information regarding adverse reactions and risks.

Dow Corning is the major producer of silicone gel. Its own records showed silicone gel to be cancerous in animals. These materials were not promptly sent to FDA, but were obtained by the agency during an inspection in December 1987.

The FDA took six and one-half years, beginning in January 1982, before it completed its proposal to require Dow and other manufacturers to submit safety data because in the FDA’s cautious words, it “presents a potential unreasonable risk of injury.” Dow Corning denies the risk and the supine FDA so far is letting Dow’s cash register ring unabated.

In another petition to the FDA, Dr. Wolfe cited the FDA’s own Fertility and Maternal Health Drugs Advisory Committee which twice voted to’ remove the agency’s permission for certain estrogen-containing compounds, including the widely used drugs TACE and Deladumone, to be used to suppress lactation among mothers who elect not to breastfeed their infants.

These drugs, together with Parlodel and methyltestosterone, are given to between 500,000 and 1,000,000 women annually for this purpose. Yet such prescriptions have little or no advantage over nature’s course, while all these drugs present risks for serious side effects, including blood clots, hypertension, psychoses, nausea, dizziness and virilization. Parlodel has been reported to have other adverse reactions including strokes, seizures and heart attacks though a causal relation has neither been confirmed nor ruled out as of yet.

Most recently, the story of Dr. James C. Burt of Dayton, Ohio is being reported in the press. The Ohio State Medical Board formally charged him this month with “gross immorality” and “grossly unprofessional conduct” in conducting his “love surgery” on thousands of women who often suffered permanent physical damage. Once again many local physicians were repulsed by his useless and bloody operations and his flamboyant writings on his sexual surgery. But for twenty years, they remained silent.

The hospital where he performs such brutality requires him to obtain his patients’ signature on an “informed consent” form apparently to reduce the hospital’s legal exposure. The form includes statements such as “an unproven, non-standard practice, and not a generally accepted procedure.”

The next time you hear doctors’ complaining about malpractice insurance rates, ask them what they are doing individually and as a group against the injurious and fatal kinds of malpractice that their licensed, colleagues are getting away with so daily.