This book examines four medical innovations that epitomize the pitfalls of progress: DES, a synthetic estrogen prescribed to millions of women to prevent miscarriages, which produced devastating side effects; the artificial heart; the 1976 swine flu immunization program; and genetic engineering. Dutton and the contributors trace the human choices that govern medical and scientific innovation and explore the political, economic, and social factors that influence those choices. In the process, they reveal a deep gulf between the priorities of medical innovation and the concerns of the general public. They then propose concrete policy changes to help bridge that gulf.
Preface; Acknowledgments; List of abbreviations; Part I. Overview: 1. Introduction; 2. Where are we and how did we get there? Part II. Four Case Studies: 3. DES and the elusive goal of drug safety; 4. The artificial heart Thomas A. Preston; 5. The swine flu immunization programme; 6. Genetic engineering: science and social responsibility Diana B. Dutton and Nancy E. Pfund; Part III. Lessons, Questions and Challenges: 7. Risks and rights; 8. Compensating the injuries of medical innovation; 9. What is fair? Medical innovation and justice; 10. The role of the public; 11. What is possible? Toward medical progress in the public interest; Notes; Index.
'In this book Diana Dutton successfully delineates the hazards of policy-making when professional groups dominate or usurp decision making in the delicate relationship between the scientific constituency and the whole of society. In a skillful and detailed analysis, she portrays the resulting disastrous ill effects of lack of appropriate linkage-science policy-making without public participation … should be read and taken to heart by the scientific community as well as the public to which it is addressed.' The Pharos (Journal of the Alpha Omega Alpha Honor Medical Society)