Hard News: A Real Alternative
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Thanks Mark, great responses. The thread here actually starts right at the bottom of page 2 with Cecilia's exclamation (10th August) at the Listener story.
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It's great that a number of academics are publically debating the issue - we so need more quality, informed public debate. It's been very worthwhile to read, listen and follow links to relevant information.
It's also fascinating that a 20 year old medical enquiry should still provoke such intense reponses. Still some slow-burning feelings there.
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Kerry, shows that academics should never underestimate 'lived experience'. And why oral history and personal interviews are valuable research methods. I can't understand why Linda Bryder didn't interview at least a few key informants.
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Hilary -I tautoko your comment to Kerry: that paticular baby grew up to be a nurse & midwife & academic with a dedication to *listening* to all her patients and 'subjects' -especially the women.
I cant understand why historians who are dealing with a fraught
area dont go beyond the historical record -given that many people who were part of Green's studies, *and* a lot of the prime informants are still very much alive.
Guess I'll just have to wait to read her book (which I will borrow from a library...:) ) -
My Broadsheet collection has just gone to the Downtown Community Ministry book fair (TSB arena, Wgtn, 5-6 Sept). I'm grieving, but moving on.
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JoJo,
A book of essays on the Cartwright Report, stemming from the conference held in 2008 to mark the 20th anniversary, is being published later this year. I believe none of the contributors to that book were asked to comment on the article in the Listener before publication.
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I didn't know Paul Henry was a doctor!
All we need is for Paul Henry to run for The Listener editorship and we'll be sweet. He would have been even more sympathetic to a backlash against feminism and radical stuff than Joanne Black.
I note with interest that Black was careful to qualify Bunkle's statements . She didn't do this with the article on Bryder. (Or rather the sub-editor didn't.) The headline of one was Finally the truth - no ifs, no buts. The headline this week is in speech marks: "Never a doubt".
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Next week's Listener (29 Aug) has another 2+ pages of letters, including a fine professorial stoush - Emeritus Professor Colin Mantell (FRCOG) regrets that National Women's Hospital has disappeared, while Professor Ronald Jones writes as Professor of Obstetrics and Gynaecology, National Women's Hospital. Professor Linda Bryder responds substantively to Professor Jones (ie more than "read the book"). And three others.
Overall I think you could say 5-1 in favour of the Bryder view of what happened. But couched in such terms that I would anticipate the story continuing to run.
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Thanks Cecilia - that was interesting. I particularly appreciated seeing the quote from Green himself (not in someone else's minutes of a meeting but his words in a considered academic paper) -
He had clearly stated his aim in a 1970 paper: ‘to follow adequately diagnosed but untreated lesions indefinitely … to settle the question as to what happens to carcinoma in situ’.
as I've been trying to get hold of what I guess is his same 1970 paper, so far unsuccessfully, to see the full context.
There seems to be a school of thought that since Green's study (even as planned let alone as implemented) did not meet all the criteria to be a good reliable experiment by the standards of the 1980s or today, therefore it was not an experiment. This school of thought is clearly misguided. But on the other hand, his study being an experiment does not equate to he being a Nazi monster and National Women's of his day as Auschwitz.
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This school of thought is clearly misguided.
i totally agree with you Chris.
i cannot see how people can argue that his actions over many years were ethical. -
Professor Bryder, a well-known medical historian, was by her own admission surprised by her findings. She found there was no evidence that Dr Green had performed a clinical trial on patients with cancer of the cervix and that treatment at the hospital between 1955 and 1976 was based on contemporary evidence and was consistent with world best practice.
Colin Mantell
Professor Emeritus
(Wanaka)Her theme that Green was simply following overseas trends is not true. Carcinoma in-situ (CIS) – now called cervical intraepithelial neoplasia 3 (CIN 3) – has always been treated and in 1958 the less radical cone biopsy replaced hysterectomy as the preferred management of CIS at National Women’s.
Ronald W Jones
Professor of Obstetrics and Gynaecology, National Women’s HospitalLetters to this week's Listener. Who speaketh the truth?
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clinical trail=RCT (which has been covered enough I think). There is also a difference between saying that treatment at the hospital (in aggregate) was based on evidence and best practice, and potentially what Green did.
While Mantell worked in O&G, cervical cancer was not his research area. It is Jones' research area, but to be clear, he was a co-author on the Lancet Oncology paper with Charlotte Paul upthread. I do find it interesting in light of Bryder's argument that Green was saving women from hysterectomy that Jones puts a date on the switch from hysterectomy to cone biopsy.
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Thanks, James. That clarifies it to some extent.I wonder if reading the book would be edifying. Without the medical background I doubt if readers could tease out all the issues.
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Yes, this week's Listener's letters – online version only - is extended with this substantial article by two of the specialist advisers to the Cartwright inquiry, Professors Linda Holloway and Charlotte Paul of Dunedin School of Medicine. It looks thorough in comprehensively demolishing Linda Bryder’s analysis of what Green was doing in researching/managing ‘carcinoma-in-situ’.
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ODT review of the book -- Confused offering adds little insight
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http://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466&objectid=10597266&pnum=0
And here's a Herald Article: today
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That article by David Skegg (a lead expert adviser at the inquiry) explains the value of cervical screening including projected numbers saved, after this denunciation of Bryder's bias:
A social historian can hardly be blamed for misunderstanding scientific evidence, but her book's factual errors and selective quotations make it seem more like an exercise in polemic than academic scholarship.
Dr Herbert Green was a strident opponent of cervical screening, even after it had been shown to be beneficial. Given Professor Bryder's eagerness to defend all of Green's positions, it was unsurprising that Kim Hill (on Radio NZ) kept asking her a question about our national cervical screening programme: "Is there any evidence that it is actually saving lives?"
In case anyone's still concerned about credibility, the Herald's "about the author" para notes:
Sir David Skegg is the Vice-Chancellor of the University of Otago. He is an adviser to the World Health Organisation on reproductive health and research.
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Thanks for the follow-up links James, Cecelia & Sacha. It's been a fascinating case and a great example of how this community makes it easy to get meaningfully informed.
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I really appreciate how our crowdsourcing of good knowledge works here too. Betterer than Google.
For the keen, Women's Health Action are advertising a "Cartwright Comes of Age" seminar on 6 November in Auckland - links from their main page, or direct to the PDF flyer and registration form. May see you there.
I just had to edit that. Cos.
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The Herald will be doing a feature article this weekend with reaction from various people to the book. There's going to be some slamming of it going on.
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Thanks Kyle. I'm looking forward to reading the Herald on Saturday. I've just read the bulk of the original Metro article from Sacha's link. I think it sounds very reasoned - very well researched. I can't remember if I read it at the time - I must have!
Reading the Metro article reminds me of how far the treatment of women has come since then. I had a gyne cancer in 1996 and was sent every pathology report and every letter sent to my GP. Because of being informed, I was able to ask for a second opinion and request treatment which I would otherwise not have received. As a result (I guess it could just be luck) I recovered from a stage 3c cancer.
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I'm looking forward to reading the Herald on Saturday
Zounds! Is this the first time a PA villager has declared such a thing?? Better wear gloves. Thanks for letting us know, Kyle.
Cecelia, glad to hear you won that battle. This debate will have extra meaning for you and every other woman who has faced the battle and survived. The level of dissent in the medical community has unnerved me somewhat, though, I thought they'd come to grips with it years ago. Still, Skegg's words capped it rather well.
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A big fat paper on a Saturday with pictures and a magazine and this week an opposite line to The Listener on a fascinating topic ...
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