|ChemCases lets you learn chemistry and enjoy doing it by applying the same chemical principles that the inventors used develop the products you use. And you can join with other learners to debate the fundamental issues that confront these scientists as they make responsible decisions about what they do.|
Heat and Chemical Resistant Silicone Rubber
On July 14, 1998, the Wall Street Journal reported that cosmetic breast implants in the United States in 1998 would reach the record number of about 130,000 that were done in 1990. This article followed by a week the announcements that bankrupt Dow Corning had reached a settlement in a long-standing class action suit against the company. And then on December 2, 1998, a court-appointed scientific panel said it saw no proven links between breast implants and disease.
In 1993, almost 9,000 individuals filed law suits against Dow Corning claiming medical injury from their implants. By May 1995, the company faced more than 20,000 individual suits. In addition, since early 1992, Dow Corning had faced a class action law suit brought by more than 100,000 claimants that hoped to compensate those injured by the implants more quickly. Dow Corning saw the number of claimants in this suit rise above 400,000. Dow Corning filed for Chapter 11 bankruptcy. This means the company saw its assets could not cover the liabilities it expected from the suit. The bankruptcy proceedings halted the litigation; it did not stop Dow Corning from continuing its other business activities.
The litigation was painfully slow. The women who claimed injury had to wait until mid 1998 to learn that Dow Corning and their negotiators had agreed on a settlement that would have Dow Corning pay more than $3.2 billion as monetary compensation for ruptured implants and claimed autoimmune disease symptoms. Claimants could expect to begin receiving compensation for their injuries by 1999 if they voted to approve the terms of the settlement. The settlement did not take away the rights of individuals to sue Dow Corning, but it did specify amounts that claimants who settled within the suit would receive.
The Wall Street Journal reported on July 14, 1998 that a tide of women were seeking the saline cosmetic breast implants now in standard use. The number of procedures in 1998 might exceed the 120,000 completed in 1990, the highest year to date. There was a "pent-up demand" for the procedure, which had dropped off to about 20,000 per year after the silicone implant procedure was stopped in 1992 because of concerns the implant was the source of autoimmune disease conditions.
The paper noted the bankrupt Dow Corning Corporation had agreed to the $3.2 billion settlement of the class action suit. Dow Corning denied culpability for the medical conditions claimed by the class represented in the suit. The paper added that controlled studies recently appearing in the medical literature indicated the silicone implants were not responsible for the immune diseases as claimed by the class action.
It is not simple to decide the impact of the silicone implant. That is why ChemCases is here: to examine the evidence and show how science and chemistry relate to real-world situations and decisions. And the evidence contains science. The FDA and the Independent Review Group of the UK have reviewed the scientific work. Understanding their positions demands that we have the knowledge and clear thinking to interpret what may be complex and contradictory. Three facts seem clear:
- Implants rupture on occasion and leak silicone fluid into the body.
- Some silicone fluid leaks through the walls of an intact implant.toimmune disease occurs in women with implants.
Other scientific issues remain unresolved without further study.
- Is the frequency of autoimmune disease in women with implants any higher than that in women without implants?
- Is rupture of the implants significant?
- What is the physical response to silicone fluid in the body?
Who is Responsible?
Dow Corning will settle with claimants. But who was responsible for the disease and injury claimed by the individuals with implants?
There is only one way for individuals to decide these questions. We must examine the detailed evidence for ourselves. We cannot be led only by the histories of individual pain and suffering. Most of those histories are real, but the evidence of disease itself does not make a link to implants as the cause. Perhaps a large number of women without implants would suffer the same level of discomfort and disease. Let us as scientists, putting aside the emotions of the women with painful experiences with implants, examine the evidence. Perhaps we must seek truth in a larger context, the context in which science and decision making interact:
- Is science, which has the potential to improve our lives and alleviate suffering, absolved from the responsibility for negative unintended effects that may come with the advances?
- Is our culture itself responsible here? Our society idealizes appearance and puts great pressure on girls and women to live up to this "ideal." Does societal pressure unduly influence women to seek implants, thus indicting our society itself for the damage done?
- Can scientists be trusted to answer the questions? Some studies that might enlighten us are funded by parties with interests in the outcome. Can scientific authors separate their intellectual product from the source of their support? Can we find comfort in the court-appointed experts' report that silicone implants and breast disease are not related.