Last, to the authors and the people quoted in the article, a plea for understanding: please recognize what we are and call us what we are proud to be called family physicians. Rick W. Swanson, MD, CCFP Professor and head Department of Family Medicine University of Calgary Calgary, Alta.
Reference 1. Rice DI: Foreword. In Shires DB, Hennen BK, Rice DI (eds): Family Medicine: a Guidebook for Practitioners of the Art, 2nd ed, McGraw, New York, 1987: xii
Getting the facts straight pregnant woman recently A\ called the Motherisk Program at the Hospital for Sick Children, Toronto, very concerned about information she had read in a pamphlet in a Shoppers Drug Mart store. This pamphlet (Having a Healthy Baby, Shoppers Drug Mart/Pharmaprix, Willowdale, Ont., 1987) purports to help women who are planning to become or are pregnant to decrease their. reproductive risks. However, there are major errors in the information, of which we give some examples. Commonly known as the Pill, estrogens and progesterones together help prevent pregnancy. . . But it is important to remember that estrogens and progesterones can cause birth defects if taken during pregnancy. Continued use of this medication may also increase the risk of vaginal cancer in your daughter when she reaches childbearing age.
Oral contraceptives are not believed today to be teratogenic in humans, but most crucially they do not cause vaginal cancer in 988
CAN MED ASSOC J 1992; 147 (7)
offspring. This may be caused by Assoc J 1992; 146: 1697, 1700) is diethyistilbestrol,' which is not a trifle too disingenuous. used as an oral contraceptive. Samuels informs us that it is not unusual for plaintiffs' attorBirth defects may occur even if you neys to contribute to scientific conferences and that the 1990 are no longer taking the Pill. New York Collegium Ramazzini meeting on asbestos was a model Again, an updated review by of scientific impartiality. Then Motherisk has failed to find any why were all the attendees who evidence for this. had been named as expert witThe pamphlet contains many nesses in impending litigation similar "facts," which leads us to banned by Judge J.M. Kelly from wonder how a professional group appearing in court? Perhaps the of pharmacists, who honestly in- learned judge had the impression tended to do good by providing that the symposium was not enthe public with valuable informa- tirely objective! Why, despite the tion, can publish such erroneous request of three invited attendees, data. was Dr. Corbett MacDonald not In our experience many invited to the meeting? The delibwomen tend to terminate other- erate omission of a scientist with a wise wanted pregnancies because reputation that far outshines any of unfounded fears of teratogeni- of those attending speaks for itcity.2 Information of this quality self. Since two of those who rehelps to perpetuate such fears. quested the invitation were former trainees of his I wonder why Gideon Koren, MD, FRCPC the monkeys were asked when the Chrisoula Eliopoulos, BSc organ-grinder was available. Motherisk Program The information concerning Division of Clinical Pharmacology and Toxicology donations from the plaintiffs' lawHospital for Sick Children yers was passed on to me by a Toronto, Ont. medical colleague and not by a defendant's lawyer. References Samuels also castigates the 1. Herbst AL, Uffelder H, Bosbanzer DC: Canadian government for the Adenocarcinoma of the vagina: associa- steps it has taken to promote the tion of maternal stilbestrol therapy with use of asbestos, a mineral that (if tumor appearance in young girls. N used with care) is still useful; Engl J Med 1971; 284: 878-881 2. Koren G: Maternal-Fetal Toxicology: a strangely, he does not mention Clinician's Guide, Dekker, New York, that the US government sells large 1990: 373-382 amounts of subsidized tobacco to Indonesia and other Southeast [Shoppers Drug Mart has declined Asian countries. to respond publicly. Apparently this pamphlet and others are un- Keith Morgan, MD,F,CPC dergoing revision and in the mean- Chest Diseases Unit time will be removed from phar- University Hospital London, Ont. macy shelves. - Ed.]
[The author responds.]
Asbestos: the turbulent interface letween science and policy
If Dr. Morgan would step out of his role of spokesman for the asbestos cartel and apply the methods of science in which presumI' hesitate to prolong this corre- ably he was trained, he would not spondence, but Mr. Sheldon depend on gossip. He would read ,LW. Samuels' letter (Can Med the court records and find that the LE jer OCTOBRE 1992
Reference 1. Rice DI: Foreword. In Shires DB, Hennen BK, Rice DI (eds): Family Medicine: a Guidebook for Practitioners of the Art, 2nd ed, McGraw, New York, 1987: xii
Getting the facts straight pregnant woman recently A\ called the Motherisk Program at the Hospital for Sick Children, Toronto, very concerned about information she had read in a pamphlet in a Shoppers Drug Mart store. This pamphlet (Having a Healthy Baby, Shoppers Drug Mart/Pharmaprix, Willowdale, Ont., 1987) purports to help women who are planning to become or are pregnant to decrease their. reproductive risks. However, there are major errors in the information, of which we give some examples. Commonly known as the Pill, estrogens and progesterones together help prevent pregnancy. . . But it is important to remember that estrogens and progesterones can cause birth defects if taken during pregnancy. Continued use of this medication may also increase the risk of vaginal cancer in your daughter when she reaches childbearing age.
Oral contraceptives are not believed today to be teratogenic in humans, but most crucially they do not cause vaginal cancer in 988
CAN MED ASSOC J 1992; 147 (7)
offspring. This may be caused by Assoc J 1992; 146: 1697, 1700) is diethyistilbestrol,' which is not a trifle too disingenuous. used as an oral contraceptive. Samuels informs us that it is not unusual for plaintiffs' attorBirth defects may occur even if you neys to contribute to scientific conferences and that the 1990 are no longer taking the Pill. New York Collegium Ramazzini meeting on asbestos was a model Again, an updated review by of scientific impartiality. Then Motherisk has failed to find any why were all the attendees who evidence for this. had been named as expert witThe pamphlet contains many nesses in impending litigation similar "facts," which leads us to banned by Judge J.M. Kelly from wonder how a professional group appearing in court? Perhaps the of pharmacists, who honestly in- learned judge had the impression tended to do good by providing that the symposium was not enthe public with valuable informa- tirely objective! Why, despite the tion, can publish such erroneous request of three invited attendees, data. was Dr. Corbett MacDonald not In our experience many invited to the meeting? The delibwomen tend to terminate other- erate omission of a scientist with a wise wanted pregnancies because reputation that far outshines any of unfounded fears of teratogeni- of those attending speaks for itcity.2 Information of this quality self. Since two of those who rehelps to perpetuate such fears. quested the invitation were former trainees of his I wonder why Gideon Koren, MD, FRCPC the monkeys were asked when the Chrisoula Eliopoulos, BSc organ-grinder was available. Motherisk Program The information concerning Division of Clinical Pharmacology and Toxicology donations from the plaintiffs' lawHospital for Sick Children yers was passed on to me by a Toronto, Ont. medical colleague and not by a defendant's lawyer. References Samuels also castigates the 1. Herbst AL, Uffelder H, Bosbanzer DC: Canadian government for the Adenocarcinoma of the vagina: associa- steps it has taken to promote the tion of maternal stilbestrol therapy with use of asbestos, a mineral that (if tumor appearance in young girls. N used with care) is still useful; Engl J Med 1971; 284: 878-881 2. Koren G: Maternal-Fetal Toxicology: a strangely, he does not mention Clinician's Guide, Dekker, New York, that the US government sells large 1990: 373-382 amounts of subsidized tobacco to Indonesia and other Southeast [Shoppers Drug Mart has declined Asian countries. to respond publicly. Apparently this pamphlet and others are un- Keith Morgan, MD,F,CPC dergoing revision and in the mean- Chest Diseases Unit time will be removed from phar- University Hospital London, Ont. macy shelves. - Ed.]
[The author responds.]
Asbestos: the turbulent interface letween science and policy
If Dr. Morgan would step out of his role of spokesman for the asbestos cartel and apply the methods of science in which presumI' hesitate to prolong this corre- ably he was trained, he would not spondence, but Mr. Sheldon depend on gossip. He would read ,LW. Samuels' letter (Can Med the court records and find that the LE jer OCTOBRE 1992
