"What do women want?" psychiatry's founding father Sigmund Freud famously asked.  Well apparently even some women don't know even though they think they do. Or maybe the question is just inherently unanswerable.  Yeah, that's it.
 
Thinking women absolutely needed a new breast after a mastectomy to heal mentally, emotionally and socially  feminists, some doctors and other concerned types pushed forth a law requiring medical insurance for the surgery also cover reconstruction.  And now researchers have discovered

The number of women choosing breast reconstruction after a mastectomy has not risen much, despite a law mandating medical insurance coverage for the procedure, researchers report.

Granted there are regional, ethnic and age differences regarding the choices women make but the study indicates that this was another unnecessary law: finding a problem that didn't exist and passing a law to solve the non existent problem.  In the process this may have had the unpleasant effect of increasing insurance rates for women or putting those women who have had a mastectomy under undue pressure to endure reconstruction.

"I was surprised," said lead researcher Dr. Amy Alderman, an assistant professor of surgery at the Ann Arbor VA Health Care System and the University of Michigan at Ann Arbor. She and other experts expected reconstruction rates would rise significantly after the federal Women's Health and Cancer Rights Act (WHCRA) went into effect in 1999. 

But if the research doesn't prove a deeply held pre—conceived notion, why more research is needed, probably taxpayer funded. And the justification will be women as victims, women too intimidated to care for themselves, especially those deemed minority.

"The law was passed thinking the rate was too low," Alderman said. "Either this [study] means the law wasn't needed, or the law didn't address the problems that exist."

The study results raise more questions, Alderman said. Her team will next look at the database to determine who got immediate reconstruction, who delayed it, who declined it, and why.

"We want to look to see what factors influenced the decision—making process," she said. That might include patients' socioeconomic status, the feelings of their partner and other family members about reconstruction, and how much information they get from their doctor.

Alderman suspects that some minority women may decline the operation due to general wariness about the health—care system.

Perhaps there should be a study on why doctors want to force their non—medical beliefs onto patients and why doctors don't respect the decisions of patients in non—medical matters.
 
Ethel C. Fenig   2 06 06