First, they Came for the Smokers...

[steepholm]

The continuing story of the sub-standard French breast implants, and whether or not they’re more likely to rupture than other ones, and whether (if they do rupture) they’re more likely to cause serious harm, has been playing out for some time. It’s a question that combines medicine and statistics in a way that I don’t feel I can (or particularly want to) comment on.

But I've been getting very uncomfortable about the way this has become yet another platform for those who wish to ration NHS care on moral (or, as they would no doubt say, "lifestyle") grounds. This kind of debate has come and gone many times over the years. Should smokers be treated on the NHS? Or people who choose to drink over 30 units of alcohol per week? What about people who have an accident when driving without a seatbelt? Or skateboarding? Or flipping pancakes while on the phone? Now there's a new group of people about whom to feel smugly judgemental: the women who have breast implants for - gasp! - cosmetic reasons. I've seen this line taken in several places, most recently this morning on Broadcasting House (forty minutes in).

I do think there's an element of misogyny here. The speakers seem so fixated on the motives for which the women got the implants in the first place that they seem unable to accept that the reasons they may need them removed are medical, not aesthetic. Someone in that radio clip mentions the analogy of tattoos, but the NHS won't remove your tattoo for you because you no longer like dolphins. On the other hand, if your tattoo becomes infected, you'll get treated for that. Is this a difficult distinction to grasp?

There's more to it than misogyny, though. Let's try this thought experiment. Imagine it turned out that a well known brand of lipstick was highly carcinogenic, and that it had given thousands of women cancer of the mouth. Would there be voices in the media loudly arguing that the women be refused treatment, on the grounds that they had only used the lipstick for cosmetic reasons? I doubt it.

I think at least two other factors are in play. First, fewer people get breast implants than use lipstick, and they cost a lot more. The sense that it is an unjustifiable extravagance - and that neither we nor any of our close friends would do it - will have put it above many people's prudery threshold. Second, the women involved have in almost all cases suffered no harm, so far. The removal would be because of the increased risk of rupture, rather than to treat the consequences of rupture. And there's a stubborn feeling in this country that preventative medicine isn't real medicine at all.

Comments

[karinmollberg.livejournal.com]

Too true for comfort.

[shewhomust.livejournal.com]

This is all true.

But it's only part of the argumenr, because the question of whether the NHS should remove the dodgy implants leaves out the role of the private cosmetic surgery industry, which has made good money out of selling the implants, and now seems to be incapable of supplying solid information about whether their removal will do more or less harm than leaving them in.

I say 'selling' because - well, you don't need to hear the arguments about how profitable it is to make women dissatisfied with their bodies. They are meeting a 'need' which only exists because they (and their allies) have created it. But if this were legally treated as a sale of goods, they'd be liable for selling something which was not fit for its purpose.

So I'd like to see them forced to help pick up the pieces...

[lamentables.livejournal.com]

There was a discussion in the week - must have been on the World Service as I can't take R4 any longer - in which the speaker was so virulently against the NHS dealing with this issue that she came awfully close to saying that the women involved deserved whatever harm befell them.

[cmcmck.livejournal.com]

And not every woman has implants for what they term 'cosmetic reasons'. They've agreed to remove those used in reconstructive surgery, for example.

People in my position too- I was lucky enough that mine, like Topsy, 'just growed', but not everyone is that fortunate.

[sartorias.livejournal.com]

I do wish that some of that energy would be aimed at the cosmetic industry, which makes a huge cash flow out of these things. They may as well put some of that cash into R&D to make their products safe.

As for why women get them, there are all kinds of reasons, but few are frivolous. Yet that's all you hear about on the media.

[calimac.livejournal.com]

"Is this a difficult distinction to grasp?"

It probably is. It's a fine and subtle point that, judging from past experience with fine and subtle points, is probably beyond many people's capacity.

"Clearly they were at fault for using non-medical grade silicon - and if they still exist should be first in the firing line."

The company should be imprisoned for criminal neglect. (We have a saying in this country: "I'll believe a corporation is a person when Texas executes one.") Seriously, a company didn't do this: people did, and those people are probably still around.

[a-d-medievalist.livejournal.com]

I have to admit I have mixed feelings on this, because I am really opposed to most non-reconstructive cosmetic surgery. I absolutely think the NHS should replace any implants they supplied -- better that they should sue/try to recover costs than that individuals should -- but I don't think they should pay for replacement/removal surgery for people who went to private clinics for cosmetic (non-reconstructive) purposes. BUT I think that those clinics should do the replacements, and that their insurance companies should then try to recover the costs. I don't think any patient should have to pay for removal/replacement.

[gillo]

That tattoo bloke on BH also said that the reconstruction implants were about "self-esteem based on appearance" - IOW, vanity, because there's no medical need to have anything restored after a mastectomy.

Hmmm. Do not like where that one was going either.

I tend to agree that the surgeons who implanted cut-rate prostheses probably do have a moral duty to do something about it. But in the end the NHS is there to deal with rupture, infection and serious risk. End of.