Christian Feminists an oxymoron
Feminism Is Bad For Women's Health Care
http://interactive.wsj.com/articles/SB984012316295048875.htm
The Wall Street Journal
March 8, 2001
Commentary
Feminism Is Bad For Women's Health Care
By Sally Satel. Dr. Satel, a fellow at the American Enterprise
Institute, is the author of "PC, M.D. -- How Political Correctness is
Corrupting Medicine" (Basic Books, 2001).
That women are second-class citizens of the medical research
establishment is a claim much trumpeted. Hillary Rodham Clinton once
remarked on the "appalling degree to which women were routinely excluded
from major clinical trials of most illnesses." A recent report of the
Commission on Civil Rights claimed that "women have been excluded from
clinical trials for decades." Last June the Harvard Women's Health Watch
proclaimed that "nearly all drug testing has been done on men."
But what we know is wrong. Last week the National Institutes of Health,
which had stated in 1997 that "women were routinely excluded" from its
research, issued a retraction of this claim. The Institutes' recognition
of this error (made in two letters to a Rockville, Md.-based advocacy
group called Men's Health America) is most welcome.
But don't expect the women's health lobby -- the network of public
"offices of women's health" that exist on the state and federal levels,
and the university-based "women's health centers" -- to admit it any
time soon. For these groups must make women appear embattled and
shortchanged if they are to gain government support, raise funds and
justify themselves in the eyes of the public.
The NIH retraction comes a few months after the publication of a study
by Curt Meinert and colleagues at Johns Hopkins University. Writing in
the journal Controlled Clinical Trials, Mr. Meinert debunks an enduring
feminist myth: that there is gender bias in medical research. His review
of major medical journals in 1985, 1990 and 1995 found that female
subjects outnumbered males at a rate of 13 to 1 across all cancer
trials, with the vast bulk of the women participating in trials
specifically for breast cancer. Yet the myth found its way into Al
Gore's campaign platform: "Throughout my career I have fought for more
research funds for those diseases so recently considered less important
because they befell only women, such as breast cancer. . . . I pledge to
you: women's health will always be at the top of my agenda."
It's hard to know what more any president could do, especially regarding
breast cancer. Breast cancer research has received more money than any
other cancer since 1985, the year the National Cancer Institute began
keeping good records of disease-specific funding. Using the yardstick of
"years of healthy life lost," breast cancer is one of the five most
generously funded illnesses, according to a 1999 article in the New
England Journal of Medicine. The other four are heart disease, dementia,
AIDS and diabetes.
And breast cancer is not an exception. Women were routinely included in
all trials for years. Back in 1979, 268 of the 293 NIH-funded clinical
trials contained female subjects. Food and Drug Administration surveys
in 1983 and 1988 found that "both sexes had substantial representation
in clinical trials."
Why is it important to topple the myth that women are shortchanged by
medical research? Because the notion that women have been denied their
fair share of breakthroughs has been used to lobby for policies and
resources that waste money and, worse, unwittingly harm women.
Recall the great mammography debate in the U.S. Senate. In 1997 an NIH
consensus group declared that women in their 40s need not undergo yearly
mammograms. The group reasoned that the relatively high rates of false
diagnosis in 40-50 year-old women -- and the needless surgery that may
accompany such a diagnosis -- did not outweigh the small reduction in
mortality that the mammograms would yield.
Women under 50, then, were advised to make a decision with their doctor.
Reasonable enough, but the lack of firm guidance incensed a cadre of
women senators and Health and Human Services Secretary Donna Shalala.
Sen. Olympia Snowe (R., Maine) led the crusade to pressure the NIH to
change its recommendation to one of annual mammograms for all. During
the debate, Ms. Snowe boasted to the Washington Post that "it was my
female colleagues and I who led the charge to put an end to clinical
trials entirely on men -- even for breast cancer."
Breast cancer is a serious matter, but women's health suffers when the
emphasis on breast cancer overshadows the five-fold larger risk of death
from heart disease. This is where responsible women's health advocates
come in, to educate women about relative health risks and the importance
of timely screening for blood pressure, diabetes, and cervical and
breast cancer.
Finally, the notion that women need to be compensated for being left out
has led to the expenditure of millions of federal and state dollars to
create "offices of women's health" within health agencies to oversee
various expenditures and create new programs for women's health. Instead
of building bureaucracies, the money would be better spent on research
or direct delivery of care.
An exception, in my view, is the NIH's Office of Research on Women's
Health. Ably run for about a decade, that office has been collecting the
data that show how widely women's health has indeed been studied. Thanks
to its efforts, we know that the composition of subjects in all clinical
trials funded in 1998 -- the last year for which there are data -- was
68% women. In fact, despite its self-defeating rhetoric about exclusion,
the NIH was the very font of decades of outstanding research in which
women were routinely included.
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The NIH's official declaration that women have not been shortchanged
by no means denies that progress still needs to be made in the health of
women. But it is wrongheaded to confuse the need to know more -- an
imperative that will always be with us -- with the myth that women are
given short shrift by medical research.
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Copyright © 2001 Dow Jones & Company, Inc. All Rights Reserved.
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