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April 15, 1998

Dalkon ShieldUnshielded: The Human Cost of the Dalkon Shield

Author Affiliations

Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998American Medical Association

JAMA. 1998;279(15):1224-1225. doi:10.1001/jama.279.15.1224-JBK0415-6-1

Mary F. Hawkins' Unshielded: The Human Cost of the Dalkon Shield purports to focus on the human costs of the Dalkon Shield intrauterine contraceptive device (IUD) during and following the prolonged litigation process. Although there are some accounts from women who suffered adverse health consequences with use of this IUD, the book focuses more on the history of the device, from its development through the litigation process.

The author is a communications consultant and teacher, which may explain why the technical medical details relating to the epidemiology of IUD risks are not particularly well handled. She also tends to selectively cite articles supporting the view that all IUDs, not just the Dalkon Shield, cause pelvic inflammatory disease, even though there is substantial evidence to suggest that is not the case. Similarly, she states that other implants, eg, Norplant, breast implants, are "questionable medical devices," which may cause a variety of medical problems, but fails to quote the significant and growing medical literature that suggests otherwise. The author also tends to convey uncritically the opinions of other authors on the subject as those of lawyers or jurists actively involved in the litigation process, even though their opinions have not undergone the same peer review scrutiny as those of researchers in the field.

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