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The Pill | Article

The Pill and the Doctor/Patient Relationship

Library of Congress

Senate hearings on the Pill held in 1970 led not only to an investigation of the birth control pill's safety, but also to an examination of the relationship between doctors and patients. The issue gained national attention when the feminists protesting at the hearings expressed their anger with the medical establishment and with what they perceived was a lack of control over their own bodies.

"White-Coated Gods"
At a press conference convened by an organization called D.C. Women's Liberation during the hearings, Alice Wolfson told the assembled reporters, "We will no longer tolerate intimidation by white-coated gods, antiseptically directing our lives." Making it clear that the group was by no means opposed in principle to the Pill, she instead attacked a medical profession that allowed "unsafe contraceptives" to be "foisted on uninformed women."

Doctors Not Fully Informed
Alice Wolfson had come of age in an era when doctors "knew best." Women did not participate in medical decisions, and the standard for a "good patient" was one who didn't ask questions. Doctors had all the answers.

Yet doctors were not fully informed when it came to birth control. Doctors commonly received their information about drugs directly from pharmaceutical companies -- which, critics charged, had a vested interest in downplaying the health risks. Although medical journals published reports of health hazards, they were often specialized journals that the average general practitioner, gynecologist or obstetrician did not read.

Reluctance to Inform Patients
The problem was compounded by that fact that some doctors who were aware of the risks did not always consider it necessary to inform female patients about the potential for strokes, heart attacks or blood clots while on the Pill. According to a 1970 Gallup poll, two-thirds of the women surveyed said that their doctors had never warned them about risks of the Pill when they prescribed the drug.

Among medical professionals, it was a commonly held belief that women, being very "emotional," might overreact. Not wanting to unduly alarm women, doctors took the decision out of their patients' hands. It was also a commonly held belief that women were "suggestible," and if you told them about potential side effects, female patients were likely to develop them.

Since the incidence of serious complications arising from the Pill was relatively small, many doctors determined that the benefit was worth the risk for their female patients. This was precisely the paternalist behavior doctors had been taught in medical school, and they saw no reason to act any differently with regard to birth control.

Deciding for Themselves
But the Pill was different. Feminists like Alice Wolfson were furious that doctors were making what could be a life or death decision without involving women in the decision. If risks were involved, women should be given all the information and make an informed decision for themselves. They also began questioning validity of the "benefit vs. risk" model, since the Pill was being given to healthy women, and safer alternatives for birth control were available.

In the aftermath of the Pill hearings, women's relationships with their doctors would be transformed. Many women refused to remain passive in their own health care. Motivated by the Pill hearings, the feminist health care movement moved into high gear and challenged the traditional model of paternalistic doctor/patient relationships.

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