The Right to Choose and the Right to Know: Women's Health and Integrity Depend on Both

By Cynthia Pearson, Executive Director

NWHN supports women’s right to choose what’s best for them when they’re dealing with their health. We also support everyone’s right to make fully informed decisions about their health care. Aren’t these two the same? Well, not always.

Two articles in this issue address whether women who “choose” certain treatments are really able to make fully informed decisions. Kristen Suthers’ article describes how many menopausal women suffering from bothersome hot flashes are offered antidepressants as an alternative to hormone replacement therapy (HRT) — without being told they may experience withdrawal syndrome if they stop taking the pills, especially if they stop quickly instead of tapering off slowly. Similarly, Kiesha McCurtis’s article on oocyte cryopreservation makes it clear that gynecologists and others who promote egg freezing as a way to extend a woman’s fertility aren’t giving the full picture. They’re marketing the process as a virtual guarantee for women who want to improve their odds of childbearing in the future — without fully disclosing either of the low likelihood of success or the real dangers of experiencing serious side effects.

And yet, both of these medical treatments are defended not just by the purveyors (who are likely influenced by the fact that they make money from these activities) but also by women who use the treatments…women who often say “It’s my right to choose.” Sometimes the media reports on these controversies make it seem that women who raise safety questions are against other women’s right to make their own choices about their health. Remember the fight over silicone gel-filled breast implants? In 1992, the Food and Drug Administration (FDA) issued a moratorium on the devices, which had never been officially approved but were freely available through regulatory loophole. Some women were delighted, because they hoped FDA action would lead to better studies and, ultimately, safer implants. Other women were furious and spoke out at public hearings, insisting the FDA shouldn’t hamper their right to make their own decision about choosing implants. Another example over the struggle between the right to choose and the right to know is happening right now with bio-identical hormones (See “Natural Hormones are Powerful Chemicals,” in the May WHA). Compounding pharmacies have been promoting something that doesn’t exist – “natural HRT” — to women in the menopausal transition. When the FDA finally cracked down on pharmacies’ false claims about “natural HRT”, many women were angry and told the FDA to keep its hands off their hormones and stop interfering with their use of bio-identicals.

NWHN believes that women have the right to choose whether or not to use menopause hormone therapy, breast implants, or any of the other products discussed in this issue. We also believe that everyone has the right to full information about their health choices and that informed decisions can’t be made without it. Sometimes that means individual doctors need to do a better job of sharing information. Sometimes that means drug companies need to clean up their act and stop running exaggerated ads. Sometimes it means the FDA has put the brakes on widespread use of products that haven’t been thoroughly tested for safety and effectiveness. The bottom line is, we won’t tell you what to do, but we will make sure you have a reliable, feminist source for trust-worthy information that can help you make the best decision for yourself.