Double Dose: Illinois Court Rules on Sterilization; Choosy Mothers Choose ... Well, Not This C-Section Story; Fundamentalism Comes Under Public Health Scrutiny; Botox, Body Image and Aging; Coming of Age on Antidepressants; and More

By Christine Cupaiuolo — April 27, 2008

Court Denies Bid to Sterilize Mentally Disabled Woman: “Disability rights advocates and medical ethicists praised a precedent-setting ruling Friday by the Illinois Appellate Court denying a bid to sterilize a mentally disabled woman against her will,” reports the Chicago Tribune.

The woman’s guardian had sought a tubal ligation, but a three-judge panel ruled unanimously that the guardian did not prove sterilization was in the woman’s best interest. There are “less intrusive and less psychologically harmful [birth-control] alternatives,” read the opinion.

“It’s extraordinarily significant” because it guarantees the disabled a court hearing, said Katie Watson, a Northwestern University professor who wrote a friend-of-the-court brief in the case on behalf of about two dozen medical ethicists.

“In the past, this was a decision that could be made between a guardian and a doctor,” she said. “The decision must be moved into the light.”

Choosy Mothers Choose … Well, Not This C-Section Story: Time magazine’s “Choosy Mothers Choose Caesareans” is problematic on multiple levels — but mainly for overplaying the role of women requesting elective c-sections as the reason being the skyrocketing caesarean rate, and downplaying the risks involved. Lucinda Marshall rocks with a great response.

Fundamentalism Comes Under Public Health Scrutiny: From Women’s eNews: “Amid the growing influence of fundamentalism around the world, Asian researchers say women in almost any affected religion — Christian, Muslim or Hindu — pay the price in eroded health and safety.” Read the story by Swapna Majumdar, a journalist based in New Delhi.

Take Two on Time Off: “This year marks the 15th anniversary of the landmark Family and Medical Leave Act, which made it possible for many workers to take unpaid job-protected time off to care for their newborn children or sick relatives,” writes Nancy Trejos at the Washington Post. “But instead of celebrating, workers’ rights advocates and the Bush administration are battling over what would be the most sweeping revisions ever to the law.”

Trejos notes that a “fierce debate” has been sparked by some proposed changes, which have yielded more than 4,000 public comments:

Under proposals being considered by the Labor Department, workers would have to tell their bosses in advance when they take nonemergency leave, instead of being able to wait until two days after they left. They would have to undergo “fitness-for-duty” evaluations if they took intermittent leave for medical reasons and wanted to return to physically demanding jobs. To prove that they had a “serious health condition,” they would have to visit a health-care provider at least twice within a month of falling ill. What’s more, employers would have the right to contact health-care providers who authorized leave.

Botox and Disrespect of Aging: “The 2,775,176 Botox treatments in 2007, at a cost of more than $1 billion dollars neatly expresses the desperation some people feel about physical signs of aging,” writes Ronni Bennett, before going on to discuss recent studies on the potential dangers of Botox and the FDA’s make-your-own-personal-judgment advice to consumers.

Coming of Age on Antidepressants: Writing in The New York Times, Richard A. Friedman, MD, reflects on the remarks of a 31-year-old patient who has been treated for depression since she was a teen: “I’ve grown up on medication,” she said. “I don’t have a sense of who I really am without it.”

The patient credited the medication with saving her life, “but now she was raising an equally fundamental question: how the drugs might have affected her psychological development and core identity.” Friedman continues:

Her experience is far from unique. Since their emergence in the late 1980s, serotonin reuptake inhibitors like Prozac and Zoloft have become some of the most widely prescribed drugs in the world, for depressed teenagers as well as adults. Because depression is often a chronic, recurring illness, there are certain to be many young people, like Julie, who are coming of age on these newer antidepressants.

We know a lot about the course of untreated depression, probably more than we do about very long-term antidepressant use in this population.

Plus: Friedman and Norman Rosenthal, MD, were both guests on NPR’s “Talk of the Nation” on Thursday, discussing the physical and psychological effects of taking antidepressants long-term.

Ireland Releases Study on Menopause: Ireland’s Minister for Health, Mary Harney, published “Menopause and Me,” hailed as the largest ever study in Ireland on awareness, attitudes and experiences of menopause, according to The Irish Times. Ireland’s Women’s Health Council carried out the study, which is available online here.

Performance Artist Killed on Peace Trip: An Italian performance artist, Pippa Bacca, 33, was raped and killed by a driver who offered her a ride just three weeks into a hitchhiking trip from Italy to the Balkans to the Middle East. Bacca and her friend, Silvia Moro, 37, both wore wedding dresses as part of their “Brides on Tour” project, created to send a message of peace and “marriage between different peoples and nations.” Elisabetta Povoledo writes in The New York Times:

The performance piece, a trip through nearly a dozen countries in the Balkans and the Middle East, many of them ravaged by war recently, was meant to underscore that “by overcoming differences and lowering the level of conflict,” individuals and cultures could come together, Ms. Moro said in a telephone interview. “Meeting people was the key.”

Accepting rides with strangers was crucial to the art performance’s success, Ms. Moro said. The artists’ statement at their Web site,, says, “Hitchhiking is choosing to have faith in other human beings, and man, like a small god, rewards those who have faith in him.”

Ms. Moro explained: “It’s a poor way of traveling, and we wanted to underscore that you can’t foster love between people if you’re holed up in business class. You can’t go to, say, Mauritius, and eat pasta. You won’t understand people until you break bread with them, because it’s in the small diversities that you find similarities.”

3 responses to “Double Dose: Illinois Court Rules on Sterilization; Choosy Mothers Choose … Well, Not This C-Section Story; Fundamentalism Comes Under Public Health Scrutiny; Botox, Body Image and Aging; Coming of Age on Antidepressants; and More”

  1. An ob/gyn wrote a scathing response to the “Choosy Mothers Choose…” story. Hopefully Time will print it, but if not, here’s what he said:

    Dear Editors:

    Your writer glamorizes a major surgical procedure that,if performed unnecessarily, can have serious outcomes for the mother and baby. This is not a face-lift,it is major abdominal surgery that has three times the maternal death rate as vaginal birth. Are the women who elect this [usually when prodded by their doctors] made aware of that? Are they also aware that their baby may be born too soon or too small and have long-term educational problems because their brains are not fully developed? Do they understand that,after the first cesarean, the next pregnancy has twice the stillbirth rate and can have life-threatening problems with the placenta because of the uterine scar? Do they know that there is no epidemiologic evidence that cesarean prevents future urinary incontinence and in fact can make future abdominal surgery more difficult due to abdominal adhesions?

    My point is that most women with normal pregnancies who agree to elective induction of labor or scheduled cesarean haven’t a clue about some of the very negative consequences of the surgery. Cesarean section is a very important and life-saving intervention in some high risk situations. However there is plenty of evidence that vaginal birth has a toning and protective effect on the baby’s brain and results in babies with less asthma,chronic lung disease, and learning disabilities.

    In my opinion,if this unfortunate trend continues, our society may find out in the near future that “It’s not nice to fool Mother Nature.”

    Charles Mahan, MD, FACOG
    Professor,USF Chiles Center for Healthy Mothers and Babies

  2. I really liked the information put out in the Irish menopause study and it’s format on the web– balanced, included lots of personal anecdotes, and just seemed so woman-friendly. Very accessible. I have found in the U.S. the site to be pretty helpful and user-friendly for menopause related articles, but when it comes to the NIH or other govt agencies, not so much. Am I missing something?

    Oh and Anita, I agree about botox. Botox and breast implants make me think I’m living on another planet.

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