PROFITABLE PROMISES - Essays on Women, Science and Health, by Ruth Hubbard. Common Courage Press, Monroe, Maine, 1995, 237 pages, $11.95 paper.

Review by Del Meyer, MD

Dr. Hubbard, the first woman to be given a tenured biology professorship at Harvard, has treated us to a number of timely essays on issues in health and biology from a woman's point of view. Every man should read them. This volume, sent unsolicited by the publisher for review, is the first in a new series on the politics of science.

Hubbard, with the help of the series editors Bates and Shooter, has brought together sixteen articles and talks spanning several years in a three section book. Part I is a series of essays concerned with the extent to which our lives are being medicalized and geneticized. She states, "Even while we are in good health, and from before we are born until after we die, medical experts and laboratories are eager to sample us so as to try to foretell what diseases or disabilities we or our descendants may be heir to. Though this foreknowledge is advertised as enriching our lives, the real profits go to the scientific and technical entrepreneurs who pioneer and market the tests to which we are encouraged to submit."

She illustrates this by recounting a June 1993 BBC broadcast wherein a medical expert "warned that, unless everyone takes a particular new genetic test, some of us who show no signs of the condition whose presence this test supposedly detects might never know that we, in fact, have it." Hubbard continues, "Though I hope the irony of this physician's statement does not escape you, she was being entirely serious. However, the television program also revealed that her research into this condition (called fragile X syndrome) was being supported, in part, by the very biotechnology company that markets the test kits used to detect the condition and that analyzes the test samples she collects. Such not so subtle conflicts of interest are becoming all too common."

Hubbard further continues, "As a result of the current genomania, our world is being increasingly peopled by what are coming to be called the healthy, or asymptomatic, ill... While we gaze in fascination into some women's bellies, hoping to foresee the health of their future children, we close our eyes to the lack of the basic preconditions for health and the public health needs of infants, children, and adults living in our midst... By shifting attention away from these needs, the current genomania actually threatens health."

In Part II on Women, Science, and Power, Hubbard puts some new wrinkles on some old issues. She states that when we talk about women's health, we conjure images of procreation rather than the conditions that plague primarily women such as lupus, rheumatoid arthritis, and scleroderma. She tackles the politics of fetal/maternal conflict: court mandated caesarian sections; fetal protection and the work place; fetus as patient and plaintiff; and how health care reform impacts on these issues.

In Part III, toward a political understanding of science, Hubbard strikes some hallowed ground stating that technology, once initiated, will grind on; that its course cannot be changed and certainly cannot be stopped. She feels we need to keep informed so that we can say "no" whenever and wherever we want to and not become overwhelmed by the quantity of specialized knowledge. She states the motivation is responsible citizenship, not technological nihilism.

Hubbard does not feel that the "gay genes" represents a step forward in the civil rights of gays. She argues against the search for a genetic basis for crime. The recurring theme is, "When technology is harnessed to yield profits for the few rather than to improve the lives of most people, science and its technological products undermine rather than enhance our lives."

These sixteen essays are reasonably short and, can be sampled individually. So the next time insomnia strikes and you're not in the mood for Chaucer, you might pick up Hubbard for ten or fifteen minutes to give the brain something to work on while you sleep. We need her perspective.