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Since the late nineteenth century, medicine has sought to foster
the birth of healthy children by attending to the bodies of
pregnant women, through what we have come to call prenatal care.
Women, and not their unborn children, were the initial focus of
that medical attention, but prenatal diagnosis in its present form,
which couples scrutiny of the fetus with the option to terminate
pregnancy, came into being in the early 1970s. Tangled Diagnoses
examines the multiple consequences of the widespread diffusion of
this medical innovation. Prenatal testing, Ilana Löwy argues, has
become mainly a risk-management technology—the goal of which is
to prevent inborn impairments, ideally through the development of
efficient therapies but in practice mainly through the prevention
of the birth of children with such impairments. Using scholarship,
interviews, and direct observation in France and Brazil of two
groups of professionals who play an especially important role in
the production of knowledge about fetal
development—fetopathologists and clinical geneticists—to expose
the real-life dilemmas prenatal testing creates, this book will be
of interest to anyone concerned with the sociopolitical conditions
of biomedical innovation, the politics of women’s bodies,
disability, and the ethics of modern medicine.
Cervical cancer is an emotive disease with multiple connotations.
It has stood for the horror of cancer, the curse of femininity, the
hope of cutting-edge medical technologies and the promise of
screening for malignant tumours. For a long time, this disease was
identified with the most dreaded aspects of malignancies: prolonged
invalidity and chronic pain, but also physical degradation, shame
and social isolation. Cervical cancer displayed in parallel the
dangers of being a woman.
In the 20th century, innovations initially developed to control
cervical cancer - radiotherapy and radium therapy, exfoliate
cytology (Pap smear), homogenisation of the 'staging' of tumours,
mass campaigns for an early detection of precancerous lesions of
the cervix - set standards for diagnosis, treatment and prevention
of other malignancies. In the late 20th century, cervical cancer
underwent another important change. With the display of the role of
selected strands of HPV (Human Papilloma Virus) in the genesis of
this malignancy, it was transformed into a sexually transmitted
disease. This new understanding of cervical cancer linked it more
firmly with lifestyle choices, and thus increased the danger of
stigmatisation of patients; on the other hand it opened the
possibility for efficient prevention of this malignancy through
vaccination.
Ilana Lowy follows the disease from antiquity to the 21st century,
focussing on the period since the mid-19th century, during which
cervical cancer was dissociated from other gynaecological disorders
and became a distinct entity. Following the ways in which new
developments in science, medicine, and society have affected
beliefs about medical progress and an individual's responsibility,
gender roles, reproduction, and sex, Lowy demonstrates our
understanding of what cervical cancer is, and how it can be
prevented and cured.
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