Fw: CPR in Sunday's NYTimes !

[Guest guest]

----- Original Message ----- From: Zuckerman

friends@...

Sent: Sunday, October 19, 2003 7:35 AM

Subject: CPR in Sunday's NYTimes !

Dear Friends,

I don't really agree with this article -- I think the emotion over implants is because the women feel betrayed by doctors they had trusted, and the doctors don't like being portrayed as not protecting their patients. But I'm glad we're a reasonable voice in the debate.

A Sexual Subtext to the Debate Over Breast ImplantsOctober 19, 2003 By GINA KOLATA Even before Dr. J. , a plastic surgeon,arrived at a Food and Drug Administration meeting last weekon breast implants, he was expecting a highly chargedencounter. Which he got. Dr. , a professor at the M.D. Cancer Centerin Houston, was part of an advisory panel charged withdeciding whether to recommend that silicone breast implantsbe allowed back on the market, after an 11-year hiatus.Over two days in Gaithersburg, Md., a crowd of interestedobservers, including more than 100 speakers, pleaded withthe panel to vote their way. "I went to the meeting very anxious about the level ofcontentiousness I expected to face and worried aboutalienating one side or the other," Dr. said. "I satthere wondering, why, why, why is this such a polarizingtopic?" The answer, he decided, was that while debate was cast asone of safety - are the implants, made by a company calledInamed, safe enough to be sold? - the underlying questionwas whether it was acceptable for a woman to enlarge orenhance her breasts. "This goes far beyond medicalconsiderations," Dr. said. "It involves society andwomanhood. All of that is hidden in the question aboutsafety." Some speakers at the F.D.A. meeting said the benefits couldnot outweigh their risks. For example, ph ,president of Dads and Daughters, a national nonprofit groupthat says it "galvanizes fathers and others to transformthe pervasive cultural messages that devalue girls andwomen," told the panel he was worried that the availabilityof implants would encourage healthy teenage girls tobelieve they should enlarge their breasts. "We are hammering our children with the notion that howthey look is more important than who they are and what theycan do," he said, "and that is just wrong." Mr. said that even if the devices were provedabsolutely risk-free, he would not want them on the market.And because safety, as noted, is defined in terms ofa ratio of benefit to risk, "if there is zero benefit, thenit can never be safe." Dr. Zuckerman, president of the National Center forPolicy Research for Women and Families, asked, "What is therisk and what is the benefit, and who decides?" Dr. Zuckerman said she still has questions about the safetyof implants, but would support their sale if thosequestions were answered. Nonetheless, she said, "I thinkthat Joe 's comments touched a chord for a lot ofpeople." Other forms of cosmetic surgery do not seem to elicit thesame emotional reaction, said Dr. H. McGrath, a panelmember who is a professor of plastic surgery at theUniversity of California in San Francisco. "In our society, orthodontia is really a surgicalenhancement," she said. "It is not without risk, but it iscommonplace and widely accepted." So, too, she said, is surgery to repair children'sprotruding ears and breast reduction surgery for boys withgynecomastia, or abnormally large breasts. The condition isnot uncommon among adolescent boys and eventuallydisappears in most cases. "I never heard any comment that this is an inappropriatecosmetic enhancement," Dr. McGrath said, referring to thebreast reduction surgery, although it does carry risks ofanesthesia, bleeding, infection or nipple numbness. "Norhave I heard anyone say a physician is doing this out ofself-interest. But those same two issues come up with youngwomen who are trying to make their breasts larger." The issue does not arise, at least for most people, whenreconstructive breast surgery is called for, said Dr. L. Spear, a professor of plastic surgery at townUniversity and the medical monitor for Inamed's clinicaltrials. "Obviously, even in breast reconstruction for cancer, thebenefit is primarily for appearance," Dr. Spear said. "Butalmost everyone would agree that if your breast is removed,replacing it is not just cosmetic." But, he added: "Suppose you have a more or less normalbreast. How important is it that you enhance it? I thinkthere is an argument that the benefit is not as great, andthen you get down to the issue of whose right it is todecide how valuable it is." In the end, Dr. decided to avoid that issue, atleast in his capacity as a member of the F.D.A. advisorypanel, and to focus instead on what the scientific datasaid about the safety of implants. "I was trying to define the risks and let individualsdecide the benefits for themselves," he said. The risks included rupture and a hard and painfulcontraction of scar tissue over the implant. Most of thepanel's scientists agreed that implants have not beenlinked to a risk of systemic diseases, like cancer, lupusor chronic fatigue, or neurological problems. Ultimately, Dr. voted with the majority of the panelin its 9-to-6 vote last Wednesday to recommend thatimplants should once again be allowed back on the market inthe United States. Now the decision is up to the F. D. A.,which usually, although not always, does as its experts'committees advise. http://www.nytimes.com/2003/10/19/weekinreview/19KOLA.html?ex=1067573253 & ei=1 & en=6ce133a71c369a57---------------------------------Get Home Delivery of The New York Times Newspaper. Imaginereading The New York Times any time & anywhere you like!Leisurely catch up on events & expand your horizons. Enjoynow for 50% off Home Delivery! Click here:http://www.nytimes.com/ads/nytcirc/index.htmlHOW TO ADVERTISE---------------------------------For information on advertising in e-mail newsletters or other creative advertising opportunities with The New York Times on the Web, please contactonlinesales@... or visit our online media kit at http://www.nytimes.com/adinfoFor general information about NYTimes.com, write to help@.... Copyright 2003 The New York Times Company