Tag Archives: breast cancer

Catholics, contraceptives and John Locke

Catholics, contraceptives and John Locke

By Michael Gerson

It is extraordinary how far some will go to knit the random scraps and patches of events into the quilt of a narrative. So the Susan B. Komen controversy, resistance to the administration’s contraceptive mandate, a stag-party joke by Foster Friess and a cruel epithet from Rush Limbaugh somehow add up to a Republican war on women, sure to provoke the political backlash of an entire gender.

American women haven’t behaved as predicted or demanded. President Obama’s job approval has risen or, more recently, fallen independently of the chromosomal status of voters. Men and women, it turns out, resent dipping into their retirement savings to drive to work.

Recent opinion surveys on the contraceptive mandate, in particular, have shown women to be an independent-minded lot. In coverage of its own recent poll, the New York Times conceded that the views of women on this topic are “split.” By a plurality of 46 percent to 44 percent, women believe that employers should be able to “opt out” of providing birth-control coverage for religious reasons. But opinion is not really “split” on the question of whether “religiously affiliated employers, such as a hospital and university” should be able to opt out of offering coverage. Women support this proposition by 53 percent to 38 percent.

How is this possible? Americans overwhelmingly endorse contraception and regularly practice what they preach. Most believe — myself included — that child spacing and preventing the spread of sexually transmitted diseases are public goods. Why not impose this social consensus on all private institutions?

The answer depends on your view, not of contraception, but of pluralism and religious freedom.

One tradition of religious liberty contends that freedom of conscience is protected and advanced by the autonomy of religious groups. In this view, government should honor an institutional pluralism — the ability of people to associate, live and act in accordance with their religious beliefs, limited only by the clear requirements of public order. So Roger Williams welcomed Catholics and Quakers to the Rhode Island colony, arguing that a “Church or company of worshippers (whether true or false) .?.?. may dissent, divide, breake into Schismes and Factions, sue and implead each other at the Law, yea wholly breake up and dissolve into pieces and nothing, and yet the peace of the Citie not be in the least measure impaired or disturbed.”

There is another form of modern liberalism that defines freedom of conscience in purely personal terms. Only the individual and the state are real, at least when it comes to the law. And the state must often intervene to protect the individual from the oppression of illiberal social institutions, particularly religious ones.

This is the guiding philosophy of the American Civil Liberties Union. But as Yuval Levin, editor of National Affairs, pointed out to me, this approach has roots in the Anglo American tradition of political philosophy. John Locke’s “Letter Concerning Toleration” urges legal respect for individual conscience because “everyone is orthodox to himself.” But Locke offered no tolerance for the institution of the Catholic Church: “That Church can have no right to be tolerated by the magistrate which is constituted upon such a bottom that all those who enter into it do thereby ipso facto deliver themselves up to the protection and service of another prince.” In Locke’s view, Catholics can worship as they wish as individuals, but their institution is a danger to the liberal order.

In American history, the treatment of the Catholic Church has often been the measure of institutional religious tolerance. It is amazing how Lockean (unconsciously, one assumes) recent actions by the Obama administration have been. Catholics individuals are free to worship. Catholic institutions must be forced to reflect liberal ideals and values.

On a variety of issues, balancing individual and institutional rights isn’t easy. But the contraceptive mandate is a particularly revealing test case. One side of the controversy argues that the autonomy of religious institutions is essential to the expression of individual conscience and important to the common good. The other side believes that the moral and health choices of individuals need to be protected by government against oppressive religious groups such as the Catholic bishops. So it is not enough for contraceptives to be legal and generally available; they must be provided (directly or indirectly) by Catholic institutions to their employees.

This is the real debate on the contraceptive mandate — and the administration has not won it.

Revealed: true scale of breast implant scandal

Revealed: true scale of breast implant scandal

By Laura Donnelly, Robert Mendick, Harriet Alexander and Josie Ensor

The evidence was supplied privately to the Department of Health (DoH) on Friday by Transform, Britain’s biggest cosmetic surgery chain, The Sunday Telegraph can disclose.

It prompted the Government to question the official figures supplied to the regulator by private cosmetic surgery companies.

Mr Lansley was “very concerned” and “unhappy” that firms had not given the regulator full information about the failure rate.

The review could lead to the Government advising women to have the implants removed at an estimated cost of as much as £150?million. The implants were manufactured by Poly Implants Protheses (PIP), a French company, from industrial-grade silicone rather than medical-grade.

Mr Lansley said yesterday that evidence from around the world did not suggest a need for women to worry, but promised that the Government would act swiftly as information emerges.

The rupture rate of seven per cent – if replicated across the industry – is seven times higher than the one per cent official figure the British regulator was sticking to last week in its attempt to reassure tens of thousands of women.

Health officials will want to know urgently if Transform’s rupture rate is a one-off or symptomatic of the whole industry.

Women with the implants, including those recovering from breast cancer, fear future ruptures causing pain and inflammation and the leakage of industrial silicone into their bodies. There is no long-term data that assesses the risks, including the incidence of cancer, caused by the cheap silicone.

A source at Transform said: “One of our surgeons is helping the DoH. He has taken our data with him and we believe – and it needs rechecking – that the rupture rate is actually higher at about seven per cent.”

The source said the figures had been supplied to the Medicines and Healthcare Products Regulatory Agency (MHRA) since 2006 and questioned why the regulator had not picked up on them sooner. Last month the MHRA declared there was “no evidence of any disproportionate rupture rates other than in France”.

In France, the official rupture rate is five per cent, and women who have the implants are being offered free removal.

Other cosmetic surgery providers in the UK have now been ordered to comb through their data.

Mr Lansley has asked Prof Sir Bruce Keogh, the NHS Medical Director, to review all data relating to PIP breast implants and any possible danger they pose.

The Health Secretary said last night: “We have received data from an organisation yesterday that was not previously acknowledged or communicated to the MHRA. The validity of this data still requires full assessment and evaluation, so I have asked [Prof Keogh] to lead an urgent investigation so that we can establish exactly what has happened and whether we need to improve the regulatory regime.” Mr Lansley is “very concerned about the content and quality of the data that cosmetic surgery providers are sharing with the regulator”, his spokesman said. The review is expected to report its initial findings this week, with a decision on how to proceed – including whether to give women free breast implant removal operations – likely to be made at a later date.

The regulatory system will also come under scrutiny. Dr Susanne Ludgate, the MHRA clinical director, said yesterday: “It’s clear there is conflicting data coming from the cosmetic surgery sector. It raises doubts about the surveillance and reporting of incidents by these companies. We will urgently work to identify where problems may be.”

British surgeons warned about the PIP implants five years ago.

Brook Berry, who led an NHS plastic surgery unit in the north-east of England, was so alarmed by the damage a PIP implant caused to a woman recovering from breast cancer that he wrote to the British Journal of Plastic Surgery in 2007 that “the reliability of PIP implants must be questioned and, for myself, I intend to discontinue their use in favour of implants from other manufacturers”.

Mark Harvey, a lawyer who is planning to bring a case against up to 20 clinics on behalf of at least 350 women later this month, said yesterday: “There has been significant under-reporting of problems with these implants. There does not appear to be any follow-up regime to check on whether cosmetic surgery companies have been reporting incidents fully.”

His clients are seeking damages of between £15,000 and £20,000.

Donna Breeden, 31, a hairdresser from Southampton, who is planning legal action, said: “It is a ticking time-bomb. Every day, I am worried sick.”

She paid Harley Medical Group £4,250 for a breast augmentation operation in February 2010, just a month before the PIP implants were withdrawn.

She said the firm has refused to listen to her demands for the implants to be removed and replaced at no extra charge.

Catherine Kydd, 39, a mother of two from Dartford in Kent, suffered a rupture in 2009. “It was absolute hell,” she said. “I now have industrial silicone in my body and I have no idea what the long-term effects are. I have to now live with this for the rest of my life.”

Andrew Hay, managing director of Cloverleaf Products Ltd, the British supplier of the implants, told The Sunday Telegraph that his firm had supplied between 6,000 and 7,000 implants to the NHS, which were mainly used for women recovering from cancer surgery.

While some women will have had two implants, others may have had only one – meaning that the number of women receiving the PIP implants on the NHS is likely to be greater than 3,000.

Mr Hay expressed his shock that the PIP implants had turned out to be made from industrial silicone.

On Friday, the DoH said it had no current plans to contact NHS patients.

Nigel Robertson, Transform’s chief executive, said his company would begin this week to contact women who have PIP implants.

His company used PIP as its main supplier up until 2005 when it switched to another firm, based in the US, for “commercial reasons”.

Mr Robertson said the cosmetic industry could not afford to pay for the replacement of faulty implants. He estimated that the cost of such an operation is in the region of £3,000. This means the total cost to the industry would be £120?million, putting many clinics out of business.

Mr Robertson said greater regulation of the industry was needed.

The PIP implants were taken off the market in March 2010. Jean-Claude Mas, the company’s founder, is facing fraud charges and a manslaughter charge brought by the family of a woman who died of cancer in France. Studies so far have found no link between the implants and cancer.

Mr Lansley said yesterday that evidence from around the world did not suggest a need for women to worry, but promised that the Government would act swiftly as information emerged.


Cancer: 7.5 Million Strong………….and growing.

World cancer toll is on the rise, says research

Custom Search

Sarah Boseley
The Guardian

At least 12.6 million people are diagnosed with cancer around the world every year, and more than 7.5 million die of the disease – a toll that is steadily rising in every country as the population expands and people live longer, according to research by the World Health Organisation.

Cancer was the cause of 14% of all deaths around the world in 2008, the year for which there are the most recent comprehensive figures, but the rates varied enormously from one region to another, from 5% in Africa to 21% in the western Pacific. More than a quarter of all deaths in the UK – 27% – were from cancer.

Cancer Research UK (Cruk) and the International Agency for Research on Cancer (IARC), an arm of the World Health Organisation, are releasing their report as the first United Nations summit opens in New York on tackling the killer diseases that every nation is now having to confront: heart and lung diseases, diabetes and cancer.

These so-called “non-communicable diseases”, which have all taken off as sedentary lifestyles, junk food, smoking and drinking have spread around the planet, are already a massive burden on rich countries and are steadily becoming one in poorer countries, too.

Cruk has high hopes of the summit, which is intended to focus the attention of government leaders on ways of preventing as well as treating the new scourge. “While it is clear that tackling cancer worldwide will remain one of the major challenges in the 21st century, this high-level meeting will finally put cancer on the global agenda, providing the biggest and best opportunity to drive forward major changes in this area,” says its report.

Worldwide, men are more likely to get cancer than women – 204 out of every 100,000 men and 165 per 100,000 women got cancer in 2008, according to age-standardised data. The incidence rate is rising fast in the developing world but is still markedly lower in Africa, where 88 per 100,000 people got cancer, than in North America and western Europe, where 334 and 335 people respectively per 100,000 were diagnosed.

Data is not well collected or kept in most developing countries, but the younger age of the population and different diets and lifestyles play a big part. The highest incidence among men in the world was in France and Australia, which had 361 cases per 100,000. Among women, it was Denmark, with 325 per 100,000. The UK rate was 33rd highest among men and 12th for women.

Four common cancers are responsible for 45% of the death toll, says the report – lung cancer, which is the biggest killer among men, liver, stomach and colorectum. In the UK, the biggest killers are lung, colorectum, breast and prostate.

For several decades, lung cancer has been the most common cancer in the world. In 2008, there were 1.6m diagnoses and the largest proportion – 55% – is now in the developing world, where public smoking bans and advertising restrictions generally do not apply.

The declaration to be signed at the end of the UN meeting will call on governments to take action against tobacco marketing. About a quarter of all adults in the world – more than 1 billion people – are thought to smoke. In Europe, male smoking has peaked, but the habit is still on the increase among young women and girls. The UK has the seventh highest lung cancer rate in women among 184 countries with reliable statistics in the world.

Breast cancer is by far the most common cancer among women, with 1.38mdiagnoses in 2008, which is a quarter of the total for women. It affects a larger proportion of women in wealthy countries, although the developing countries have high numbers and it is a growing problem there.

Reproductive behaviour – having fewer children and postponing childbearing, and breastfeeding less – as well as weight, lack of exercise and drinking are all thought to be factors in the rise in cases. Breast cancer is the most common cause of death among women worldwide.

Cervical cancer hits developing countries hardest as screening, vaccination and treatment bring the numbers down in the richer world. More than eight out of 10 cases (86%) are now in the developing world, and 88% of the 275,000 deaths. The UK death rate is low, ranked 157th out of 184 countries on mortality rates.