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From savvy consumers to informed risk managers: Shifting images of medical self-care

Abstract : In February 1889, a 26 year-old Brooklyn woman, Ida Hunt, was told by a well-known surgeon, Mary Dixon Jones, that she suffered from an internal tumor that may burst and put her life in danger. Upon Dixon Jones’s advice Hunt underwent an abdominal surgery, developed a peritonitis and died. The Brooklyn newspaper, The Eagle, used Hunt’s death to mount a campaign against Dixon Jones, accusing her of being a knife happy, sadistic and corrupted practitioner, who persuaded naive women to undergo unnecessary and risky operations. In fact, Hunt was a savvy consumer of medical services, who consulted numerous doctors for her severe gynecological complaints, carefully evaluated her options, and in all probability elected Dixon Jones precisely because she advocated radical surgical solutions. In 2008, the company 23andMe included mutations in BRCA genes which predispose for breast and ovarian cancer in their “health package”. The company’s experts gathered testimonies from grateful clients who found out unexpectedly that they were BRCA mutation carriers and decided to undergo prophylactic surgeries (ablation of ovaries, and, for some, mastectomy). 23andMe lost in 2013 the right to propose health information in the US, but in the same year the American College of Medical Genetics and Genomics (ACMG) recommended to include BRCA mutations among incidental findings that should be reported to patients. This recommendation, and the 2014 proposal to generalize the testing for BRCA mutations, were made in spite of lack of firm data on efficacy of preventive measures to reduce cancer deaths in mutation carriers, especially those without a family history of breast and ovarian malignancies. People, advocates of BRCA testing argue, have the right to know about their health risks in order to be able to make informed decisions about their management. This article takes these two cases as a starting point of reflections on continuity and change in self-care practices, with an accent on their gendering.
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https://hal-cnrs.archives-ouvertes.fr/hal-03479806
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Submitted on : Tuesday, December 14, 2021 - 3:01:24 PM
Last modification on : Wednesday, December 15, 2021 - 3:57:26 AM

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  • HAL Id : hal-03479806, version 1

Citation

Ilana Löwy. From savvy consumers to informed risk managers: Shifting images of medical self-care. EA journal, NAEA, 2016, 7 (2). ⟨hal-03479806⟩

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