TO DO NO HARM: DES and the Dilemmas of Modern Medicine by

TO DO NO HARM: DES and the Dilemmas of Modern Medicine

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A psychiatric study of the damage done to individuals and to the medical-care system by the DES tragedy--not a history of the tragedy itself (viz. Cynthia Orenberg's DES: The Complete Story). Psychiatrists Apfel (Harvard) and Fisher (U. of Chicago) raise two concerns. Now that the turmoil and publicity have died down, they fear that the public will be lulled into thinking the problem has been handled adequately: ""individual vigilance might cease under premature reassurance from professional experts."" Ongoing investigation and monitoring, they argue convincingly, is a must. Questions of physical care aside, the authors are concerned with the tragedy's setting and the traumas it caused: between mothers and daughters, between patients and doctors, and within the physician's professional world. In Apfel and Fisher's analysis, there were no villains: the DES tragedy happened because patients and doctors interact in a certain way in our medical system, and because physicians are trained and operate in a certain way within that system. The resulting problems have been handled within the same frameworks, with the additional factor of mother-daughter relations. The way to prevent such tragedies, then, is not to draw up additional rules and regulations; rather, we should better understand how our system allows them to occur. Laudable in exposing evasive stratagems, then and now--doctors still don't like to admit what they don't know about the drug's effects--but a work chiefly pitched to the theoretically-minded.

Pub Date: Nov. 14th, 1984
Publisher: Yale Univ. Press