The Unfortunate Experiment


Book Description

In 1984 the medical journal Obstetrics and Gynecology published a paper that would initiate an investigation into one of the greatest medical scandals of the late twentieth century. Titled "The Invasive Potential of Carcinoma in Situ of the Cervix", it discussed the results of an experiment that had been run at the National Women’s Hospital in Auckland, New Zealand, since 1955. The experiment looked at the natural history of cervical carcinoma in situ (CIS) – in other words, what happens if no treatment is initiated in a condition suspected (when the experiment began) to lead to cervical cancer. The paper divided participants into two groups, one that had negative results after biopsy or treatment, and one smaller group that continued to test positive. This second group had a significant rate of cervical cancer; some of these women were followed for twenty-five years without treatment, and in only 5% did the disease spontaneously resolve. For the other 95%, outcomes ranged from positive but localised results to metastatic disease and death. The authors said these results were in contrast with other, earlier papers about the experiment. After much research, Sandra Coney, one-time editor of a NZ feminist magazine, and Phyllida Bunkle, a women’s studies lecturer, wrote an article about the experiment, exposing the unauthorised research performed by one prominent gynaecologist in support of his belief that CIS was not associated with cervical cancer. Professor Herbert Green, a physician of considerable influence and power throughout New Zealand, persisted in his belief despite increasingly convincing proof of a progressive connection between the two conditions, never sought permission from his patients, or even told them what he was doing.




Doctors in Denial


Book Description

A first-hand account by one of the doctors who exposed the truth at National Women's Hospital. Jones sets the record straight with his personal story: a story of the unnecessary suffering of countless women, a story of professional arrogance and misplaced loyalties, and a story of doctors in denial of the truth.




A History of the 'Unfortunate Experiment' at National Women's Hospital


Book Description

In the late 1980s, a national outcry followed the publication of Sandra Coney and Phillida Bunkle's 'Unfortunate Experiment' article in Metro magazine about the treatment of carcinoma in situ at National Women's Hospital. The article prompted a commission of inquiry led by Judge Silvia Cartwright which indicted the practices of doctors at the hospital and led to lawsuits, censure, a national screening programme and a revolution in doctor-patient relations in New Zealand. In this carefully researched book, medical historian Dr Linda Bryder provides a detailed analysis of the treatment of carcinoma in situ at National Women's since the 1950s, an assessment of international medical practice and a history of the women's health movement. She tackles a number of key questions. Was treatment at National Women's an 'unfortunate experiment'? Was it out of line with international norms? Did Herb Green and his colleagues care more for science than for their patients? Did women die as a result? And what were the sources of the scandal that erupted?




The Rise and Fall of National Women's Hospital


Book Description

In this major history, Linda Bryder traces the annals of National Women's Hospital over half a century in order to tell a wider story of reproductive health. She uses the varying perspectives of doctors, nurses, midwives, consumer groups, and patients to show how together their dialog shaped the nature of motherhood and women's health in 20th-century New Zealand. Natural childbirth and rooming in, artificial insemination and in vitro fertilization, sterilization and abortion: women's health and reproduction went through a revolution in the 20th century as scientific advances confronted ethical and political dilemmas. In New Zealand, the major site for this revolution was National Women's Hospital. Established in Auckland in 1946, with a purpose-built building that opened in 1964, National Women's was the home of medical breakthroughs scandals. This chronicle covers them all.




The Cartwright Papers


Book Description

The Cervical Cancer Inquiry and its report (known as the Cartwright Report) were momentous events in the recent history of New Zealand. Critical issues were at stake: matters of life and death; the life's work of leaders within the medical profession; professional reputations; public trust in the profession, and its own sense of self-worth. After seven months of considering evidence, Judge Silvia Cartwright, assisted by expert medical and legal teams and drawing on specialist opinion from all over the world, concluded that Associate Professor Herbert Green had been conducting unethical research at National Women's Hospital, and that many women had been affected. This book of essays recounts some of this history. Several of the contributors were participants: Clare Matheson writes as one of the patients; Professor Charlotte Paul was a medical adviser to the Inquiry; Sandra Coney (with Phillida Bunkle) wrote the article leading to the Inquiry; Dr Ron Jones was one of the three authors of the 1984 article, using data from Green's own patients, that demonstrated that carcinoma of the cervix had a significant invasive potential. Other authors are specialists in other fields: Professor Alastair Campbell and Associate Professor Joanna Manning comment from the perspective of medical ethics and medical law respectively; Ron Paterson is the Health and Disability Commissioner; Jan Crosthwaite is a philosopher with expertise in medical ethics. These essays not only review the history but also document how the Cartwright Report changed the whole landscape of medical practice and biomedical research in this country, leading to far better protections for both patients and research participants. Yet despite all the regulatory changes, the most significant change to which the Cartwright Report contributed was attitudinal - a rejection of medical paternalism and a new expectation that patients would be treated as partners in their care. The findings of the Report remain controversial and continue to be debated to this day. This book provides a perspective on the current debates and helps place them in context. As Clare Matheson (one of Green's patients) said: 'We must never forget lest it happen again'. Contributors include: Alastair Campbell, Silvia Cartwright, Sandra Coney, Jan Crosthwaite, Ron Jones, Joanna Manning, Clare Matheson, Ron Paterson, Charlotte Paul.




Medical Apartheid


Book Description

NATIONAL BOOK CRITICS CIRCLE AWARD WINNER • The first full history of Black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment. No one concerned with issues of public health and racial justice can afford not to read this masterful book. "[Washington] has unearthed a shocking amount of information and shaped it into a riveting, carefully documented book." —New York Times From the era of slavery to the present day, starting with the earliest encounters between Black Americans and Western medical researchers and the racist pseudoscience that resulted, Medical Apartheid details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how Blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of Blacks. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions. The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused Black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust.




Pioneer Work in Opening the Medical Profession to Women


Book Description

Elizabeth Blackwell, though born in England, was reared in the United States and was the first woman to receive a medical degree here, obtaining it from the Geneva Medical College, Geneva, New York, in 1849. A pioneer in opening the medical profession to women, she founded hospitals and medical schools for women in both the United States and England. She was a lecturer and writer as well as an able physician and organizer. -- H.W. Orr.




Screening


Book Description

Screening programmes involve the systematic offer of testing for populations or groups of apparently healthy people to identify individuals who may be at future risk of a particular medical condition or disease, with the aim of offering intervention to reduce their risk. For many years, screening was practised without debate, and without evidence, but in the 1960s serious challenges were raised about many of the screening procedures then being practised. Benefits and harms of screening must be measured in high quality trials, and the benefits of screening must be weighed alongside the negative side-effects. Concerns were raised about potential and actual harm arising when people without a health problem received dangerous and unnecessary investigations and treatments as a result of routine screening tests. Controversy raged, and it took some 50 years to achieve widespread recognition that evidence-based and quality assured programme delivery was essential, coupled with provision of balanced informed to enable informed choice for potential participants. Commercially motivated provision of poor quality and non-evidence based screening tests is increasing and screening remains a highly contested topic that has relevance in all health systems including for the general public and media. This book serves as a practical and comprehensive guide to all aspects of screening. Following the international success of the first edition, this second edition brings extensive updates and new case study material. The first section deals with concepts, methods, and evidence, charts the story of screening back to 1861, and covers all aspects of a screening programme and how to research the full consequences. The second section is a practical guide to sound policy-making and to high quality delivery of best value screening. The controversies, paradoxes, uncertainties, and ethical dilemmas of screening are explained, and each chapter is packed with examples, real-life case histories, helpful summary points, and self-test questions. Reference is made to the NHS, a leader in screening, but the primary focus is on universal principles, making the book highly relevant across the globe.




Strengthening Forensic Science in the United States


Book Description

Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.




Globalisation and the Wealth of Nations


Book Description

Neither an argument for nor against globalization, this book is a careful and thorough analysis of the issues of globalization and an imaginative, wide-ranging picture of the globalizing world. It aims to both inform and enable readers to improve their own decisions about how to harness globalization, the economic theory behind it, the political and social consequences, and the various options for nations in a globalized world. Case studies aid in the exploration of this largely unstoppable but governable force in the world today.