A WOMAN'S RIGHT TO CHOOSE by Peter Huber Forbes, February 17, 1992 at Pg. 138 Copyright 1992 by Peter Huber. Electronic copies of this document may be distributed freely, provided that this notice accompanies all copies. ------- The remarkable thing about the silicone breast implant flap is not who's screaming, but who isn't. Whose voice is missing from this latest junk-science fracas? Look at it this way. A woman is seated in the privacy of her doctor's office. She's discussing a matter of intensely personal interest. It affects both her mental and her physical well-being. Some women even believe it affects their chance to snare mates and bear children. Pretty personal stuff, I'd say. And the Food & Drug Administration want to horn in. So where are the pro-choicers to protest the FDA's intrusion? Where's the American Civil Liberties Union? Where are the ACT-UPers, who've been denouncing the FDA logjam on AIDS drugs? There's a principle at stake here, but the people with the greatest need to affirm it aren't saying anything. The smartest thing the right-to-life forces could do right now would be to seize on the pro-choice groups' silence. Find an appropriate front, challenge the FDA's ban on silicone breast implants all the way to the Supreme Court -- and aim to lose every step of the way. Forget privacy -- a ban on implants is in the public interest. And incidentally, if the state can regulate whether or not a woman can put a bag of silicone into her chest, it obviously can also regulate whether she can put an aspirator into her uterus or a contraceptive pill into her mouth. But as sometimes happens when Big Brother decides to protect little sister, without the aspirator you may get the coat hanger. There are 170,000 new cases of breast cancer every year. The possibility of breast reconstruction helps some women screw up their courage to get regular screenings and, if they feel it is necessary, undergo reconstructive surgery. The available alternatives -- saline implants or a woman's own tissue -- are either much more expensive or unsuitable for some women or some types of repair. Some 30,000 women a year are seeking some kind of reconstruction after surgery. Now, thanks to Washington's fringe-science vigilantes, many women believe that the only safe end of breast cancer is irreparable mutilation. Do you suppose that 1 in 100 breast cancer victims will find that prospect too dismal to bear, and so wait an extra six months before having that lump checked out? Or might it be 1 in 10 -- 17,000 women a year, perhaps? I don't know; no one does. But it's a pretty safe bet that some real women are going to die because of the choice they just lost to hand-wringing at the FDA. A whole lot more women, in fact, than are ever likely to be killed by silicone itself. The FDA knows this. Norplant, the new contraceptive that the FDA recently approved with much fanfare, is delivered from a silicone implant. Silicone is used to lubricate syringes: A diabetic can inject a breast's worth of silicone during her lifetime. Silicone is used in intravenous tubing and in shunts for delivering chemotherapy. Some 30,000 American men have silicone-based testicular implants. Science can never prove negative propositions absolutely. But if silicone presents any serious chemical hazards to the human body, they should already be apparent. The fact is, they aren't. We are dealing here not with science but with Washington's policy pundits and publicists, who prosper by making mountains out of molehills. All of this should be largely beside the point, of course. Even if silicone presents real dangers, it obviously also offers some real benefits, unless we are to believe that every woman who ever sought a breast implant was a fool or a dupe. That's pretty much what we're being told, however. The entire debate has revolved around a vision of vain, foolish, helpless women -- women at the mercy of manipulative doctors and conspiring chemical companies, women more like children than adults, women incapable of making intelligent, individual choices for themselves. Given all the recent publicity, no one can even plausibly claim that a woman who now opts in favor of a silicone implant has not been fully informed of the risks. If anything, she has been overinformed. The choice should now be hers. Feminists have been making a lot of bad tactical calls recently, but the position they have taken on breast implants is their worst yet. When it came down to defending the individual woman's right to choose, or denouncing adolescent male conceptions of female beauty, many feminists preferred to denounce. With or without silicone on the market, some men will always be adolescents, and some women will always cater to their tastes. But when you compromise on the principle of personal autonomy -- of freedom of individual choice -- you are soon left with all compromise and no principle. If the pro-choicers can't win this one -- don't even care to win it, in fact -- they can't win anything. A breast implant, safe or dangerous, intact or ruptured, in the first, second or third trimester after insertion, is still just a bag of plastic. When a woman stands in her doctor's office discussing a breast implant, there's only one body and one life involved: her own. And who gets to say how that body and life should be managed? David Kessler of the FDA, that's who.
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