From breast implants to mobile phones, the media loves a good scare. And why
not? Scares sell newspapers and boost ratings. But what happens when the line
between scares and genuine scandals become so blurred nobody can tell the
difference? And what happens when our views of a technology become dominated by
groups of people claiming to be its victims and their media-savvy lawyers?
What happens, of course, is that we all lose out. The victim group phenomenon
began in the US but is now spreading鈥攁nd hard-headed evidence counts for
little in the face of the emotions it unleashes.
Take the case of Norplant. Almost from the moment the Pill popped out of
labs, family planning experts were dreaming of the next revolution. Women could
easily forget to take the Pill. What was needed was a 鈥渇it and forget鈥�
contraceptive. Enter Norplant, with its six matchstick-sized capsules that sit
under the skin of the inside arm. It鈥檚 benefited millions of women worldwide and
is now available in nearly 60 other countries. But if you want to get this
implant in Britain, be quick, for in October it will vanish from clinics.
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When Norplant was launched in Britain six years ago, it had been under
clinical assessment since the 1960s, its pros and cons detailed in some 400
papers. In the first year, some 34 000 British women switched to it. The only
complaints came from women who couldn鈥檛 get the implant because their health
authorities were too stingy to provide it.
But the honeymoon was shortlived. Across the Atlantic, a lengthy damages case
against the makers of silicone breast implants had just netted the litigants a
small fortune, and lawyers were on the lookout for similar lucrative causes.
Norplant was an obvious target. 鈥淲ill the lawyers kill off Norplant?鈥� wondered
the headline writers of the New York Times in May 1995, after reports
that hundreds of American women had joined a lawsuit against Wyeth-Ayerst,
Norplant鈥檚 manufacturer. Their chief claim was that the procedure for removing
Norplant capsules was painful and could cause scarring, even nerve damage. Some
women also claimed to have experienced irregular bleeding.
A week later, a legal firm in Nottingham began the hunt for British 鈥渧ictims鈥�
after one dissatisfied user took her story to the press. Like those of some of
the American women, Caroline Forster鈥檚 story was pretty awful. She spoke about
side effects such as heavy, continuous bleeding and shambolic attempts to remove
Norplant from her arm. Soon Forster, her lawyers and other women who claimed to
have suffered from the implant launched a Norplant Action Group.
The legal action had no chance of success and never reached the courts. Yes,
some of the women had suffered, and badly. But fact is that the Pill can also
cause problems. Since the implant works by releasing a progestogen hormone found
in many oral contraceptives, it was never going to be free from the risk of side
effects鈥攁s the distributors explained in the literature that a ccompanied
their product. And yes, not all doctors were competent at explaining those
risks, or at inserting and removing the capsules. But these were failings of the
healthcare system, not the technology.
In the US, adverse publicity scared women off using Norplant, but the implant
survived鈥攋ust. In Britain, it was doomed because of the literally hundreds
of damning articles published in the media. Some had headlines that were just
about plausible (鈥淗igh-tech birth control has ruined our sex lives鈥�), others
were beyond parody (鈥淣ew birth control made me a monster鈥�). And throughout, key
scientific reports backing the implant were consistently ignored or pushed to
the background.
Lurid headlines
In 1998, for instance, the WHO, the American College of Obstetricians and
Gynaecologists, and Britain鈥檚 Family Planning Association issued a statement
recommending the implant as 鈥渟afe and effective鈥�.
The contraceptive faced other problems. Doctors were as bothered by a dispute
with health officials over the fees they would be paid to provide it as they
were about the fear of a litigious patient. But without the lurid headlines,
demand for the implant would have remained high.
So what鈥檚 to be learnt? From top professionals to the layest of lay people,
we all need better ways of getting independent information about technologies we
have to live with. But in a climate where governments and their watchdog
agencies are no more trusted than industry, it鈥檚 not obvious where that
information is going to come from.
As for the drugs companies and healthcare system, both sides could benefit
from making doubly sure that the medics know how everything works properly. In
the present climate of fear over new technologies, nobody can leave anything to
chance.
The victim-is-always-right mentality of the media is unlikely to change. But
maybe it will come to recognise that trashing a technology can also create
victims.
In this case, those victims are vulnerable teenagers in need of 鈥渇it and
forget 鈥� contraception who have been scared off implants for good.