* science held hostage to PCness
22 May 1994
Today's "This Week with David Brinkley" discussed how women have not
been treated with as much concern by the medical establishment as men
have (and I am not claiming this to be entirely false, but:)
There was an introductory piece which asserted that women's health was
not being given the reserach attention that men's was because studies
almost always use men, i.e. heart attacks and treatments are studied in
men and the results assumed to apply to women. Donna Shalala, after
agreeing with this, was asked by George Will what would get less
funding when women's issues got more. Her answer was that ultimately
nothing would because studying breast cancer would have as much benefit
for men as current research!?!
First, there is the hypocrisy of it. Researching heart attacks on men
does not help women but researching breast cancer does help men,
according to Shalala.
Second, Shalala is using the "shuttle fallacy". It is: just look at all
the good research that could not be done without the shuttle. Well,
yes, but just look at the greater amount of good research which has
gone undone because we squandered money on an innefficient research
tool, the shuttle. So it is with medicine. While there may very well
be spin-off results from studying breast cancer we achieve those
results only at the cost of not studying the interesting problems
directly (I'm not saying breast cancer should not be studied, only that
the spin-off justification is bogus).
Third, the main argument is that since women react differently to
medicines, they need to be tested too to determine safety and efficacy.
This is true but it changes the meaning of 'testing' in the middle of
the argument. When drugs are originally tested, they are tested to see
if they work, not to see how extraneous conditions impair their
function. The usual reason given is that hormonal changes of women's
menstrual cycles interfere with measuring the effect of the drug.
That's a perfectly valid objection. We may like to know how well
ibuprofen works on cancer victims, but we don't test it there in the
first place to see if it works.
Fourth, Shalala asserted we are spending "too little" on breast cancer
research. I had to laugh at this. This is from the same people who
tell us we are spending "too much" on health care. The answer is
obvious: if we are spending too little on breast cancer, then invest in
companies researching cures and reap the profit later. That's not what
what she means of course. What she means is that the 'aristocracy of
pull' has found other diseases to be more politically profitable, any
concern for real needs, or cost, or trade-offs is long ago lost.
The implicit argument seems to go like this: funding for women's health
concerns shoulds get as much as men's (even defining this is hopeless).
If it doesn't, it proves science is sexist. This line of reasoning
just completely leaves reality behind in several ways:
1) Using men for testing is cheaper (young men will more readily
2) Diseases are not equal, the bang for the buck may be much larger
in one gender specific disease than another.
3) Funding != truth, no matter how hard we try. Research cannot
proceed 'equally' on all fronts.
On another tack, most women's groups would scream at the thought of any
sort of a contract promising not to be or to become pregnant. Lack of
research is the harvest they reap for that policy since drug companies
are scared of being sued into oblivion for birth defects of a baby born
to a mother who was undergoing testing. Such contracts are generally
illegal, of course. I'm not sure what hoops one would have to jump
through to make it enforceable in this case.