Do doctors see all women as pre-pregnant?
Jennifer over at ParentDish has a really interesting post about how women are perceived by their health care providers. It stemmed from a discussion over at the NYT's Well Blog, about all women of childbearing age being viewed as "pre-pregnant" or as "walking uteruses" when being treated for medical conditions. Do doctors assume that all women are pregnant until proved otherwise? And does it have an impact on their ability to treat us as whole patients?This trend, say experts, started in the 1960s when doctors realized that drugs -- thalidomide was the drug in question -- taken by the mother could harm the fetus. Since the, when treating conditions or precribing medication, doctors have to consider the theorhetical fetus any time they treat a woman. At Well Blog, they're asking the question: Is this appropriate?
I'm used to being asked "Are you/could you be pregnant?" But for the most part, my doctors believe me when I assure them that no, I'm not. They respect that I'm in charge of my body and my fertility. Then again, on one very important occasion, I was wrong, adamantly wrong until proved otherwise through a pregnancy test. So it's easy for me to see both sides of this issue.
What do you think? Do doctors worry too much about a woman's reproductive status when making medical decision? Or is it appropriate to assume that any woman of child-bearing age could be pregnant?










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Reader Comments (Page 1 of 1)
8-30-2008 @ 8:51PM
Ivo Cerckel said...
1.
“Since [thalidomide], when treating conditions or prescribing medication, doctors have to consider the theoretical fetus any time they treat a woman. At Well Blog, they're asking the question: Is this appropriate?”
2.
We are always being told by that thalidomide had not been tested,
or at least that it has not been tested on humans,
AND THAT
if it had been tested on humans,
then BLAHBLAHBLAH …
But thalidomide has been tested in REAL LIFE by inter alia Dr Kelsey in 1938 and some neurologists at the congress of neurologists held on 30 April - 1st May 1960 in Duesseldorf.
Kelsey and these neurologists assembled in Duesseldorf found out that thalidomide led to serious birth defects in the babies.
Gruenenthal, the manufacturer of thalidomide, knew that. Guv’mint also.
But that did prevent the Gruenental from (continuing to) marketing it until 27 November 1961
It does however prevent doctors from treating women (I am a male thalidomide monster) like they should be treated
because thanks to Gruenenthal’s and guv’mint’s actions,
doctors have to consider the theoretical fetus any time they treat a woman
How could this possibly be appropriate?
3.
Thalidomide was definitely known in the year 1938 and [its] defects were noted in Phoenix, AZ (USA) in a medical journal that year. It was known as a cure for Hanson’s Disease and made by [Richardson]-Merrill Co. in [Cincinnati], OH (USA). I don’t know what action was taken, but a young female doctor named Frances Oldham Kersey (or Kelsey) recognized its dangers.
Theodore, Princeton, WV/USA
(reaction under From The Times April 4, 2008 Thalidomide: 50 years on victims unite to seek more compensation Nigel Hawkes, Health Editor
www DOT timesonline DOT co DOT uk /tol/news/uk/health/article3671815.ece
Kelsey was the lady who in 1960 only joined the US of A Food and Drugs Administration (FDA).
Once there, she further delayed thalidomide’s approval (thalidomide was marketed since 1957)
and was given a Presidential award by US of A president Kennedy for that delay.
Wikipedia says
that Kelsey is credited SINCE NINETEEN THIRTY-EIGHT with her interest in teratogens - that is, drugs that cause congenital malformations,
that 1938 was the date of the creation of the FDA,
and that Kelsey managed to be appointed there in 1960
en DOT wikipedia DOT org /wiki/Frances_Oldham_Kelsey
Thalidomide was marketed since 1957.
Kelsey was only appointed in the FDA in 1960.
How can she get (all) the credit for having ‘saved’ the US of A from it?
4.
The whistle on the thalidomide drug was blown at a congress of neurologists on 30 April - 1st May 1960 in Duesseldorf. (1)
Gruenenthal, the manufacturer in nearby Aachen, cannot possibly argue it didn’t know that.
Gruenenthal only withdrew thalidomide from Europe on 27 November 1961.
In September 1961,
that’s more than sixteen months after the Duesseldorf congress of neurologists,
Richardson-Merrill made an application in US of A to allow thalidomide there.
This application was only withdrawn in 1962. (2)
And then Gruenenthal comes arguing that outside Ireland and a few other countries where it sold the drug directly, it can refuse compensation because this would be the responsibility of the licence holders. (3)
Should Gruenenthal not have informed its licence holders about the harmful effects of the drug?
5.
TO REPEAT
Thalidomide has been tested in REAL LIFE by inter alia Dr Kelsey in 1938 and some neurologists at the congress of neurologists held on 30 April - 1st May 1960 in Duesseldorf.
Kelsey and these neurologists assembled in Duesseldorf found out that thalidomide led to serious birth defects in the babies.
Gruenenthal, the manufacturer of thalidomide, knew that. Guv’mint and father, quack (surgeon?) Henri Cerckel, also,
But that did prevent the Gruenental from (continuing to) marketing it.
It does however prevent doctors from treating women (I am a male thalidomide monster) like they should be treated
because thanks to Gruenenthal’s and guv’mint’s actions,
doctors have to consider the theoretical fetus any time they treat a woman
How could this possibly be appropriate?
Ivo Cerckel
ivocerckel AT siquijor DOT ws
NOTES
(1)
Chronik des Conterganfalls
Tragödie - Katastrophe - Skandal?
www DOT wdr DOT de/ themen/gesundheit/pharmazie/contergan/chronik.jhtml?rubrikenstyle=contergan
30. April/1. Mai 1960:
Auf einem Neurologen-Kongress in Düsseldorf berichtet der Neurologe Ralf Voss über die Nervenschädigungen, die seinen
Beobachtungen zufolge durch Thalidomid verursacht werden. Die Forschungsabteilung von Grünenthal versucht daraufhin, die Nervenschädigungen an Ratten zu reproduzieren - ohne Erfolg. Grünenthal-Forschungsleiter Mückter schließt daraus, dass es sich um besondere Situationen handelt, für die Contergan nur selten als Ursache infrage kommt.
+
27. November 1961:
Die Firma Grünenthal kündigt in einem Telegramm an das Düsseldorfer Innenministerium an, ihre Thalidomid-Präparate im In- und Ausland sofort aus dem Handel zu nehmen.
+
30. November 1961:
Eine Sachverständigen-Kommission, die das NRW-Innenministerium eingerufen hat, kommt zusammen. Die Experten erklären es für wahrscheinlich, dass Thalidomid Missbildungen hervorruft.Das amerikanische Arzneimittelunternehmen informiert Richardson-Merrill die US-Gesundheitsbehörde über die Ereignisse in Deutschland und zieht vier Monate später seinen Antrag auf Zulassung von Thalidomid zurück
(2)
Wie Amerika vor der Contergan-Katastrophe bewahrt wurde
Von Martina Lenzen-Schulte
www DOT faz DOT net/ s/Rub7F74ED2FDF2B439794CC2D664921E7FF/Doc~EAF 04FB1B60CD4F83A586AA2D7BB84170~ATpl~Ecommon~Scontent.html
(3)
“Outside Ireland and a few other countries where Grunenthal sold the drug directly it has refused compensation, arguing it is the responsibility of the licence holders.”
( Thalidomide victims in new compensation call
By Andrew Jack in London
Financial Times April 3 2008 03:00 | Last updated: April 3 2008 03:00
www DOT ft DOT com/cms/s/0/6c825e5c-0117-11dd-a0c5-000077b07658.html
If the German links don’t work,
try entering the title in
www DOT google DOT de
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