The book Women’s Bodies and Medical Science: An Inquiry into Cervical Cancer, tells the story of a well-known ‘medical scandal’: the presumably unethical experimentation on women with abnormal cervical smears in the National Women’s Hospital, Auckland, New Zealand. A 1987 newspaper article drew attention to unorthodox treatment of cervical cancer and precancerous lesions at the Women’s Hospital that, the article claimed, resulted in the unnecessary deaths of several women. This publication led, in 1988 to the creation of an official investigation commission, the Cartwright Inquiry, which condemned physicians of the National Women’s Hospital, in particular the gynaecologist Herbert Green. The book, Women’s Bodies and Medical Science: An Inquiry into Cervical Cancer, is a fascinating unpacking of the complexities of this supposedly straightforward case. The book follows intersections between medical practices, politics the press and the law, studies the effects of the women’s health movement on the delivery of healthcare, and is a stimulating reflection on the management of therapeutic uncertainty and closure of medical controversies. Green advocated a conservative treatment of cervical carcinoma in situ (CIS) and, in many cases, proposed a ‘wait and see’ attitude. The Cartwright Inquiry stated that Dr Green and his colleagues failed to conform to the accepted standards of treatment of CIS and conducted an unacceptable ‘experimentation’ on women. However, as Bryder’s careful research shows, in the 1950s and 1960s, treatment of CIS treatment was controversial. The majority of the experts proposed a more aggressive approach to the therapy of this lesion than Green did, but others advocated a conservative therapy. Both approaches were risky. An insufficiently aggressive treatment sometimes failed to prevent a malignancy, and an aggressive one carried a significant danger of unnecessary morbidity. In the absence of reliable, quantitative data on outcomes, doctors were only able to make educated guesses. Moreover, Bryder argues that the accusation that Green conducted an unauthorised experiment on women was groundless. The supposed ‘experiment’ never existed. Green did not aim to compare therapies, but merely attempted to provide his patients with the best standard of treatment as he understood it. Women’s Bodies and Medical Science, makes visible the difficulties of dealing with prognostic and therapeutic uncertainty. It also shows the potentially negative consequences of militant activity grounded in a generalised and non-reflexive mistrust of the medical establishment. In New Zealand, an ad hoc alliance between muckraking journalists, a group of feminist activists, and politicians who aspired to demonstrate their interest in women’s problems, created a feverish and unhealthy climate that favoured exaggerated accusations. Journal articles described women treated at the National Women’s Hospital as being ‘like lambs to slaughter’ and compared the treatment of CIS by Greene to medical experiments in Auschwitz. Bryder’s book provides an interesting and stimulating analysis of an exemplary case. It might have been further enriched by providing a broader context of feminist involvement in healthcare in the 1970s, 1980s and 1990s. Clearly annoyed by the way some segments of New Zealand women’s movement transformed the complexities of Green’s case into a simplistic accusation that male gynaecologists had an ‘anti-women’ attitude, her book may convey the impression (although, in all probability, this was not the author’s intention) that all consumers/activists’ interventions in medical controversies are dangerous, and that journalists’ critique of doctors’ activities may produce incalculable harm. The history of the Women’s Health Movement points to a different direction. Militant interventions may indeed produce dangerous simplifications and demagogical excess, but they may also help to put an end to harmful and unethical practices. Activists in the US drawing attention to the harm caused by the intrauterine device Dakon Shield and by DES therapy to prevent premature childbirth, helped to limit excessive medical intervention in childbirth, promoted better governmental control of pharmaceuticals, and opened the way to more equal relationships between patients and physicians. Bryder’s study provides a wealth of evidence to prove that Green’s treatment of cervical cancer, called an ‘unfortunate experiment’ by the New Zealand Press, was neither unfortunate, nor an experiment, and, in this specific case, critique of medical practices may have got out of hand. This does not mean, however, that such a critique is unnecessary or is bound to be flawed. Bryder’s own careful display of the complexities of the management of uncertainty in treatment of cervical malignancies points out possible directions of a constructive, responsible and well-informed critique of the medical establishment by healthcare users.
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Dec 1, 2023
Laurie Ouellette 
Open Access