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In 1984 the medical journal Obstetrics and Gynecology published a paper that would initiate an investigation into one of the greatest medical scandals of the late twentieth century. Titled "The Invasive Potential of Carcinoma in Situ of the Cervix", it discussed the results of an experiment that had been run at the National Women’s Hospital in Auckland, New Zealand, since 1955. The experiment looked at the natural history of cervical carcinoma in situ (CIS) – in other words, what happens if no treatment is initiated in a condition suspected (when the experiment began) to lead to cervical cancer. The paper divided participants into two groups, one that had negative results after biopsy or treatment, and one smaller group that continued to test positive. This second group had a significant rate of cervical cancer; some of these women were followed for twenty-five years without treatment, and in only 5% did the disease spontaneously resolve. For the other 95%, outcomes ranged from positive but localised results to metastatic disease and death. The authors said these results were in contrast with other, earlier papers about the experiment. After much research, Sandra Coney, one-time editor of a NZ feminist magazine, and Phyllida Bunkle, a women’s studies lecturer, wrote an article about the experiment, exposing the unauthorised research performed by one prominent gynaecologist in support of his belief that CIS was not associated with cervical cancer. Professor Herbert Green, a physician of considerable influence and power throughout New Zealand, persisted in his belief despite increasingly convincing proof of a progressive connection between the two conditions, never sought permission from his patients, or even told them what he was doing.
In the late 1980s, a national outcry followed the publication of Sandra Coney and Phillida Bunkle's 'Unfortunate Experiment' article in Metro magazine about the treatment of carcinoma in situ at National Women's Hospital. The article prompted a commission of inquiry led by Judge Silvia Cartwright which indicted the practices of doctors at the hospital and led to lawsuits, censure, a national screening programme and a revolution in doctor-patient relations in New Zealand. In this carefully researched book, medical historian Dr Linda Bryder provides a detailed analysis of the treatment of carcinoma in situ at National Women's since the 1950s, an assessment of international medical practice and a history of the women's health movement. She tackles a number of key questions. Was treatment at National Women's an 'unfortunate experiment'? Was it out of line with international norms? Did Herb Green and his colleagues care more for science than for their patients? Did women die as a result? And what were the sources of the scandal that erupted?
In this major history, Linda Bryder traces the annals of National Women's Hospital over half a century in order to tell a wider story of reproductive health. She uses the varying perspectives of doctors, nurses, midwives, consumer groups, and patients to show how together their dialog shaped the nature of motherhood and women's health in 20th-century New Zealand. Natural childbirth and rooming in, artificial insemination and in vitro fertilization, sterilization and abortion: women's health and reproduction went through a revolution in the 20th century as scientific advances confronted ethical and political dilemmas. In New Zealand, the major site for this revolution was National Women's Hospital. Established in Auckland in 1946, with a purpose-built building that opened in 1964, National Women's was the home of medical breakthroughs scandals. This chronicle covers them all.
A first-hand account by one of the doctors who exposed the truth at National Women's Hospital. Jones sets the record straight with his personal story: a story of the unnecessary suffering of countless women, a story of professional arrogance and misplaced loyalties, and a story of doctors in denial of the truth.
NATIONAL BOOK CRITICS CIRCLE AWARD WINNER • The first full history of Black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment. No one concerned with issues of public health and racial justice can afford not to read this masterful book. "[Washington] has unearthed a shocking amount of information and shaped it into a riveting, carefully documented book." —New York Times From the era of slavery to the present day, starting with the earliest encounters between Black Americans and Western medical researchers and the racist pseudoscience that resulted, Medical Apartheid details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how Blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of Blacks. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions. The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused Black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust.
The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
In this major history, Linda Bryder traces the annals of National Women’s Hospital over half a century in order to tell a wider story of reproductive health. She uses the varying perspectives of doctors, nurses, midwives, consumer groups, and patients to show how together their dialog shaped the nature of motherhood and women’s health in 20th-century New Zealand. Natural childbirth and rooming in, artificial insemination and in vitro fertilization, sterilization and abortion: women’s health and reproduction went through a revolution in the 20th century as scientific advances confronted ethical and political dilemmas. In New Zealand, the major site for this revolution was National Women’s Hospital. Established in Auckland in 1946, with a purpose-built building that opened in 1964, National Women’s was the home of medical breakthroughs scandals. This chronicle covers them all.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
#1 NEW YORK TIMES BESTSELLER • “The story of modern medicine and bioethics—and, indeed, race relations—is refracted beautifully, and movingly.”—Entertainment Weekly NOW A MAJOR MOTION PICTURE FROM HBO® STARRING OPRAH WINFREY AND ROSE BYRNE • ONE OF THE “MOST INFLUENTIAL” (CNN), “DEFINING” (LITHUB), AND “BEST” (THE PHILADELPHIA INQUIRER) BOOKS OF THE DECADE • ONE OF ESSENCE’S 50 MOST IMPACTFUL BLACK BOOKS OF THE PAST 50 YEARS • WINNER OF THE CHICAGO TRIBUNE HEARTLAND PRIZE FOR NONFICTION NAMED ONE OF THE BEST BOOKS OF THE YEAR BY The New York Times Book Review • Entertainment Weekly • O: The Oprah Magazine • NPR • Financial Times • New York • Independent (U.K.) • Times (U.K.) • Publishers Weekly • Library Journal • Kirkus Reviews • Booklist • Globe and Mail Her name was Henrietta Lacks, but scientists know her as HeLa. She was a poor Southern tobacco farmer who worked the same land as her slave ancestors, yet her cells—taken without her knowledge—became one of the most important tools in medicine: The first “immortal” human cells grown in culture, which are still alive today, though she has been dead for more than sixty years. HeLa cells were vital for developing the polio vaccine; uncovered secrets of cancer, viruses, and the atom bomb’s effects; helped lead to important advances like in vitro fertilization, cloning, and gene mapping; and have been bought and sold by the billions. Yet Henrietta Lacks remains virtually unknown, buried in an unmarked grave. Henrietta’s family did not learn of her “immortality” until more than twenty years after her death, when scientists investigating HeLa began using her husband and children in research without informed consent. And though the cells had launched a multimillion-dollar industry that sells human biological materials, her family never saw any of the profits. As Rebecca Skloot so brilliantly shows, the story of the Lacks family—past and present—is inextricably connected to the dark history of experimentation on African Americans, the birth of bioethics, and the legal battles over whether we control the stuff we are made of. Over the decade it took to uncover this story, Rebecca became enmeshed in the lives of the Lacks family—especially Henrietta’s daughter Deborah. Deborah was consumed with questions: Had scientists cloned her mother? Had they killed her to harvest her cells? And if her mother was so important to medicine, why couldn’t her children afford health insurance? Intimate in feeling, astonishing in scope, and impossible to put down, The Immortal Life of Henrietta Lacks captures the beauty and drama of scientific discovery, as well as its human consequences.
NEW YORK TIMES BESTSELLER • The award-winning book that inspired an Apple Original series from Apple TV+ • A landmark investigation of patient deaths at a New Orleans hospital ravaged by Hurricane Katrina—and the suspenseful portrayal of the quest for truth and justice—from a Pulitzer Prize–winning physician and reporter “An amazing tale, as inexorable as a Greek tragedy and as gripping as a whodunit.”—Dallas Morning News After Hurricane Katrina struck and power failed, amid rising floodwaters and heat, exhausted staff at Memorial Medical Center designated certain patients last for rescue. Months later, a doctor and two nurses were arrested and accused of injecting some of those patients with life-ending drugs. Five Days at Memorial, the culmination of six years of reporting by Pulitzer Prize winner Sheri Fink, unspools the mystery, bringing us inside a hospital fighting for its life and into the most charged questions in health care: which patients should be prioritized, and can health care professionals ever be excused for hastening death? Transforming our understanding of human nature in crisis, Five Days at Memorial exposes the hidden dilemmas of end-of-life care and reveals how ill-prepared we are for large-scale disasters—and how we can do better. ONE OF THE TEN BEST BOOKS OF THE YEAR: The New York Times Book Review • ONE OF THE BEST BOOKS OF THE YEAR: Chicago Tribune, Seattle Times, Entertainment Weekly, Christian Science Monitor, Kansas City Star WINNER: National Book Critics Circle Award, J. Anthony Lukas Book Prize, PEN/John Kenneth Galbraith Award, Los Angeles Times Book Prize, Ridenhour Book Prize, American Medical Writers Association Medical Book Award, National Association of Science Writers Science in Society Award