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April 12, 1985

To Do No Harm: DES and the Dilemmas of Modern Medicine

Author Affiliations

Tufts-Tufts—nter Boston

JAMA. 1985;253(14):2136-2137. doi:10.1001/jama.1985.03350380156043

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The authors of this book describe a modern medical tragedy, one that began with the same excitement that we experience in many medical discoveries. Diethylstilbestrol (DES) was prescribed between 1940 and 1970 to several million women to help them carry their pregnancies to term. The consequences of the use of this synthetic estrogen were not well known, and it was only later that they became clear. Drs Apfel and Fisher raise important questions about the explosion of modern medical technology. They vividly delineate the factors contributing to experimentation with new techniques and drugs and how the pressures experienced by physicians, coupled with their fantasies of heroism, meld with pressures from their patients to tempt them toake risks prematurely and totold to tto excitement of discovery and the promise of success.

Diethylstilbestrol was first producedngland in 1938 and was originally recommended for toxemia in pregnant women. It was used to prevent