The Pill and the Public's Right to Know

Mintz, Morton

The Pill and the Public's Right to Know by MORTON MINTZ Touring the recent hearings on The Pill, spokesmen for population control organizations charged that vast numbers of women were being scared...

...Perhaps Alan F. Gutt-macher, president of Planned Parenthood-World Federation...
...Southam did not say if she was troubled by the accurate reporting of the uneasiness about widespread use of The Pill acknowledged by Dr...
...Once evidence of hazards began to develop and be reported, the population control people were put in a dilemma...
...This mean little episode would not be worth recounting were it not for a couple of facts...
...This was a way of saying that they disapprove of those reporters who disclosed, among other things, that the safety of The Pill had not been demonstrated before massive use began...
...He kept saying that it hasn't been proved, or that it is "conjecture," that The Pill may cause cancer, heart disease, diabetes, or other diseases...
...Guttmacher cited a Gallup Poll in the February 9 issue of Newsweek...
...It is useful to see The Pill first of all as a piece of technology, much as DDT, say, is a piece of technology, albeit in a vastly different area...
...His Republican colleague from Kansas, Senator Robert J. Dole, who can be counted upon by the drug industry for support at climactic moments, came through again...
...Dr...
...It can be stated flatly that the pills do not interfere with a woman's ability to bear children when she stops taking them," he said in a signed article in the February, 1966 issue of Good Housekeeping...
...It is "verbiage which is difficult to define," he testified...
...When asked about the disclosure by Senator Nelson, Guttmacher said, "No, I do not remember that...
...It was even suggested that large numbers of women, because of the hearings, already had become pregnant and were seeking abortions...
...Harold Schulman of Albert Einstein College of Medicine...
...One highly revealing disclosure in the article was that two-thirds of the women quitting The Piil said their doctors had failed to apprise them of the risks—some of which, especially blood-clotting diseases, have been demonstrated...
...Is this the kind of decision that we have a right to make, to withhold knowledge developed by the [Government itself], or should these matters be made a matter of public knowledge, counting, as it seems we always have to do, upon the ultimate good judgment of the public to come to a reasonable conclusion...
...Physicians have prescribed The Pill for millions of American women—far more than the 8.5 million estimated to be taking it currently...
...During an exchange with Guttmacher, Nelson asked, "Do we have a right not to have public hearings and not to make the information available on the ground that all the press may not carry it the way some people think they ought to carry it...
...It is not easy to forgive a con game in which women who do not need The Pill, because they have acceptable alternatives, are induced to use it in order to provide reassurance to women who do need it...
...We have not even undertaken the studies which would tell us of possible effects on the offspring of some of those human beings...
...The Pill and the Public's Right to Know by MORTON MINTZ Touring the recent hearings on The Pill, spokesmen for population control organizations charged that vast numbers of women were being scared off the drugs, would become pregnant, and would bear children who, being unwanted, would be beaten by their parents...
...That is true, but he failed to say that the testing which would establish whether The Pill does or does not cause these and other dread maladies has not been done...
...That statement was made by Dr...
...It was with poor grace that the population-control leaders laid down a barrage of attacks on Nelson for holding hearings, the entire purpose of which was to determine if women were being adequately informed about known and possible hazards of The Pill...
...Anna L. Southam, of Columbia College of Physicians & Surgeons, told the Subcommittee, "I beg the press to report accurately or not at all...
...indeed, he conceded—under questioning—that "perhaps the American physician has been remiss in not trying to educate himself about the intricacies of The Pill...
...Neither is population^ control the issue (not only because Senator Nelson is for it, but also because the effectiveness of The Pill in controlling world population has been drastically oversold...
...Schulman...
...Southam's view, such reporters do "a disservice to the consumer who should depend on her doctor for advice...
...How could they not be privately terrified by the prospect of Senate hearings intended to elicit literally vital facts, rather than "verbiage" which creates "complacency" in the user...
...Guttmacher, put the blame on Nelson for the entire eighteen per cent...
...No tissue or organ system is free from a biological, functional and/or morphological effect...
...John Rock, in the January, 1968 issue of Family Circle, that The Pill "is perfectly safe...
...While denying that he was urging "a type of censorship," he said, "If hearings such as this are going to be held, I believe the committee must carefully plan and screen all individuals who are invited to testify as to the content of their testimony...
...Phyllis Piotrow, former executive director of the Population Crisis Committee, went so far as to suggest that there will be a crop of "Nelson babies," in dubious honor of Senator Gaylord A. Nelson, the Wisconsin Democrat who is chairman of the Senate Monopoly Subcommittee...
...In the February 9 Newsweek article, it was noted that eighteen per cent of the women polled recently had stopped using The Pill, and that only one-third of them, or six per cent, had given as their reason doubts generated by the Nelson hearings...
...It can be stated flatly that this statement, challengeable even before he made it, is in error: Some women do become infertile...
...Guttmacher himself has produced verbiage which tranquilized women so they could be hormonized...
...there has been a rather great con game played on the American public/" "Very frequently, in a free country, people do not come to reasonable conclusions," Nelson went on...
...How could they help but be nervous about fair reporting...
...Consider Dr...
...For example, millions of women have given up The Pill over the years because they didn't like the synthetic hormones, or because of other reasons unrelated to criticism of the drugs...
...Or that it is too complicated for the public to understand...
...Last September the FDA's consultants on The Pill produced a report of almost unrelieved grimness...
...Many of the changes appear to be reversible after short periods of treatment, but it is impossible to form judgments on the reversibility of some of the changes resulting from prolonged administration...
...Which doctor...
...Guttmacher agreed, as he had to do, that such statements were far out of line...
...But at least it is verbiage which does create a certain sense of complacency in the user...
...Southam also was upset by "nonmedical science writers" (possibly including the generalist writing this article), as was Dr...
...Elizabeth B. Connell of Columbia, and the next day Dr...
...In an exchange with the Senator, Guttmacher did say that the hearings had "served a useful purpose in making the doctor more careful," and General William H. Draper, Jr., honorary chairman of the Population Crisis Committee, predicted that "the long-range effect . . . will be constructive and in the interest of the American people...
...Connell engaged...
...MORTON MINTZ, a seasoned student of the drug industry, is the author of "The Pill: An Alarming Report," just published by Beacon Press in hardcover and Fawcett in paperback...
...The issue is not whether sales of The Pill should be halted (among other things, this would create a bootleg market...
...Southam or Corf man...
...How could attention be called to the risks without peril to their cause...
...The "Nelson babies" phrase, he said, "is all right with me...
...The ABM, Vietnam, Laos—subjects such as these may be the subject of Congressional hearings but not, he was suggesting, something as sensitive as The Pill...
...This is one of the risks, it seems to me, of having a free society in which there are many risks...
...Hilton A. Sal-hanik of Harvard and two other scientists who, in behalf of the National Institutes of Health, ran a workshop on the metabolic effects of The Pill...
...To escape it they came up with a legalistic gimmick...
...The issue, rather, is the rational and humane use of technology...
...Schulman or Salhanik...
...Nelson brought up one of the numerous drug company pamphlets that made blatantly misleading, and sometimes downright false, euphoric statements about safety...
...A second fact is that a troubling impression emerges from a reading of the hearing transcript: that the slur on Nelson was symptomatic of the attitudes of certain population control advocates...
...The answer is in significant part that The Pill drove a wedge between "woman" and "women"-—between the individual and social engineering, between safety for one person and efficacy among millions...
...If it really is all right, which it really isn't, then it also is all right, presumably, to personalize any diseases caused by The Pill—say, "Piotrow strokes" or "Dole thromboembolisms...
...In Dr...
...Saying that the law does not define safety, they drew the conclusion that The Pill earns "the designation safe within the intent of the legislation...
...But he had not, and other population-control advocates had not, protested the pamphlets when protest might have done some good—during the decade of the 1960s when doctors were handing them out by the millions...
...Connell's testimony was figured to have been completed and mailed off to the Subcommittee on February 19...
...It was with poor grace that the population-control leaders laid down a barrage of attacks on Nelson . . ." The Nelson hearings began on January 14...
...With the eighteen per cent as a base, they made extrapolations about the ultimate number of resulting pregnancies (with scant regard for those women who switched to methods other than The Pill) and child batterings (without acknowledging the lack of an established correlation between children who were unwanted at the time of conception and children who are beaten...
...One is that the "Nelson babies" phrase attracted substantial attention in news media...
...We did not know what we were doing when we bought The Pill, just as we did not know what we were doing when we bought DDT...
...How could they call attention to dishonesty in pamphlets published by manufacturers and distributed by doctors without simultaneously faulting, say, an assertion such as one made by Dr...
...That statement happens to have been made by Dr...
...Guttmacher approved of that conclusion...
...At one point in the hearings Nelson said in exasperation, "I think there has been a rather great con game played on the American public...
...Nelson cited a Chicago study showing that within two months of inception of use, forty per cent of a group of women stopped using The Pill...
...So far as is known, no one has complained of inaccuracy in the reporting of another authoritative statement: that until recently the effects of The Pill were "inadequately investigated or ignored...
...But she created a strong impression that, deep down, she would prefer no reporting at all to accurate reporting of, say, a statement that The Pill "should be monitored and restricted to women who cannot use other methods effectively...
...They were angry not only at Nelson, who happens to be one of the most ardent and articulate supporters of family planning on Capitol Hill, but also at much of the press and even, far-fetched as it may sound, at the application of democratic process to their particular cause, worthy and important as it is...
...This suggestion was knocked down by the calendar...
...His case may be the most interesting of the lot...
...The protests came from the FDA and the "nonmedical science writers" disdained by the Southams and the Schulmans...
...Philip A. Corfman, director of the Center for Population Research at the National Institute for Child Health and Human Development...
...Louis M. Hellman, former chairman of the Food and Drug Administration's outside consultants on contraception...
...But on February 24, Dr...
...But why would such a thing be done...
...That is no reason for substituting an arbitrary system...
...For such hope as it may offer, his claim was that the medical profession is "educable...
...But on the whole Guttmacher's performance was badly flawed...
...Guttmacher did not assert that doctors had educated themselves about The Pill before massively prescribing it...
...That was five or six days short of the time needed for a number of women to be frightened by the hearings, stop using The Pill, become fertile, conceive, and be reliably tested for pregnancy...
...The testing of The Pill having been ludicrously inadequate, and massive unscientific and sometimes dishonest promotion of The Pill having proceeded apace despite the inadequacy of testing, we are today, and will remain for a long time, ignorant of the full range of its potentials for pollution of the bodies of millions of human beings...
...Some other points got buried in the rather fast shuffle in which witnesses such as Dr...
...In his prepared statement, Dr...
...He went through the tired and meaningless routine of comparing the fatality rates of women on The Pill and women in auto accidents...
...Until studies demonstrated a cause-effect relation between The Pill and clotting, he was saying it hadn't been proved that there was such a connection...

Vol. 34 • May 1970 • No. 5


 
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