This book examines four medical innovations that epitomize the pitfalls of progress: DES, a synthetic estrogen prescribed to millions of women to prevent miscarriages, which produced devastating side effects; the artificial heart; the 1976 swine flu immunization program; and genetic engineering. Dutton and the contributors trace the human choices that govern medical and scientific innovation and explore the political, economic, and social factors that influence those choices. In the process, they reveal a deep gulf between the priorities of medical innovation and the concerns of the general public. They then propose concrete policy changes to help bridge that gulf.

"In this book Diana Dutton successfully delineates the hazards of policy-making when professional groups dominate or usurp decision making in the delicate relationship between the scientific constituency and the whole of society. In a skillful and detailed analysis, she portrays the resulting disastrous ill effects of lack of appropriate linkage--science policy-making without public participation....should be read and taken to heart by the scientific community as well as the public to which it is addressed." The Pharos (Journal of the Alpha Omega Alpha Honor Medical Society)"Dutton's synthetic analysis of these episodes will be enlightening even for readers who well remember all four controversies and have read other commentaries on each episode...Dutton's book gives an unusually lucid account of how we got where we are and what the issues and options are. It is admirably suited to use in courses on science, technology, and society; but I also recommend it highly to anyone who is interested in understanding the origins of the unwieldy problems facing the biomedical community." ISIS"...a probing and constructive book that can be unhesitatingly recommended to interested readers and teachers, who can use individual chapters in the classroom." Transactions &Studies of the College of Physicians of Philadelphia"It is a well-written, stimulating, and carefully referenced work...Dutton makes a compelling case for the general public's active participation in solving the problems engendered by technological innovations...the book appeals in particular to those concerned with the threat of technologies to individual and societal life, and to world's ecological balance." Zane Robinson Wolf, Nursing History Review"Important and extraordinary, this book is beautifully written and makes the subject matter fascinating and understandable to any interested and intelligent reader." John Farley, Journal of Interdisciplinary History"...a superb exposé of modern medicine--a priceless glimpse of how it became lost in the forest....I thoroughly enjoyed reading this book....This is one of the landmark books in health and medicine and should be required reading for all health professionals, especially physicians....This book is an eye-opener--a take-home lesson--for those who think modern medicine has made significant advances in human health and well-being." Brian Leibovitz, Journal of Optimal Nutrition

The distance between medical and public priorities is exposed in four case studies that reveal the human choices governing scientific innnovation and explore the political, economic and social factors influencing those choices.

Preface; Acknowledgments; List of abbreviations; Part I. Overview: 1. Introduction; 2. Where are we and how did we get there? Part II. Four Case Studies: 3. DES and the elusive goal of drug safety; 4. The artificial heart Thomas A. Preston; 5. The swine flu immunization programme; 6. Genetic engineering: science and social responsibility Diana B. Dutton and Nancy E. Pfund; Part III. Lessons, Questions and Challenges: 7. Risks and rights; 8. Compensating the injuries of medical innovation; 9. What is fair? Medical innovation and justice; 10. The role of the public; 11. What is possible? Toward medical progress in the public interest; Notes; Index.