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Message in a Bottle: The Making of Fetal Alcohol Syndrome [Hardcover]

Janet Golden
4.0 out of 5 stars  See all reviews (1 customer review)


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Book Description

January 30, 2005 0674014855 978-0674014855 1

A generation has passed since a physician first noticed that women who drank heavily while pregnant gave birth to underweight infants with disturbing tell-tale characteristics. Women whose own mothers enjoyed martinis while pregnant now lost sleep over a bowl of rum raisin ice cream. In Message in a Bottle, Janet Golden charts the course of Fetal Alcohol Syndrome (FAS) through the courts, media, medical establishment, and public imagination.

Long considered harmless during pregnancy (doctors even administered it intravenously during labor), alcohol, when consumed by pregnant women, increasingly appeared to be a potent teratogen and a pressing public health concern. Some clinicians recommended that women simply moderate alcohol consumption; others, however, claimed that there was no demonstrably safe level for a developing fetus, and called for complete abstinence. Even as the diagnosis gained acceptance and labels appeared on alcoholic beverages warning pregnant women of the danger, FAS began to be de-medicalized in some settings. More and more, FAS emerged in court cases as a viable defense for people charged with serious, even capital, crimes and their claims were rejected.

Golden argues that the reaction to FAS was shaped by the struggle over women's relatively new abortion rights and the escalating media frenzy over "crack" babies. It was increasingly used as evidence of the moral decay found within marginalized communities--from inner-city neighborhoods to Indian reservations. With each reframing, FAS became a currency traded by politicians and political commentators, lawyers, public health professionals, and advocates for underrepresented minorities, each pursuing separate aims.


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Editorial Reviews

From The New England Journal of Medicine

The author, a history professor, reviews the responses of medical, political, and legal institutions to the fetal alcohol syndrome. Leaving the biomedical discussion to standard medical textbooks, she focuses in this book on a social context beyond the consulting room. Golden recounts the reluctance of physicians and society to accept alcohol as a teratogen, in spite of warnings dating back centuries. For example, Josef Warkany's monumental 1971 work on congenital malformations did not indict alcohol nor even include it in the index (the complete syndrome includes malformations of the face, viscera, and brain). The concept of a fetal alcohol syndrome emerged in the 1960s and 1970s, during a revolutionary expansion of knowledge about teratogenesis. It was the era of the realization that "the face predicts the brain," when physicians recognized many face-brain malformation syndromes and correlated them with abnormal karyotypes or exogenous teratogens. Golden points out that wide publicity about thalidomide-induced phocomelia had primed the profession to expect the identification of other teratogens in humans. She reviews the polarized debates among religionists, feminists, and legislators as to whether to consider maternal alcoholism, with its potential for harming the fetus, as a moral failure or a disease that requires compassionate treatment. Should the law punish an alcoholic mother? Is the harmed child justified in suing her? Is brain impairment due to the fetal alcohol syndrome a justifiable defense for a criminal or, as attorney Alan Dershowitz contends, an "abuse excuse" that replaces personal responsibility with a diagnostic label? In the debate over "medicalizing" deviancies such as alcoholism and compulsive gambling as sicknesses, I would hope that physicians would prefer medicalization to punishment. Because each new discovery opens a Pandora's box of reactions, physicians need to find effective means of public education that will elicit productive responses from society. In this area, Golden highlights the shortcomings of the news media, government agencies, and the courts and points to the resistance of manufacturers to publicizing warnings that raise liability concerns or that may result in controversial legislation. Golden writes clearly, though occasionally repetitiously, and provides abundant references. She avoids personal polemics and evangelizing. Her modus operandi is to quote opposing viewpoints in their historical context and then underline contradictions. At times the reader may almost wish for recommendations, but Golden eschews easy answers. Most physicians and health workers will find the book interesting and provocative and will come away with a much fuller appreciation of the complex responses that medical discoveries trigger in society. These are excellent outcomes for a book. William DeMyer, M.D.
Copyright © 2005 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

Janet Golden's Message in a Bottle explores the fascinating history of the discovery of alcohol's damaging effects on fetuses. [Golden] does a solid job of delivering the science that backed the diagnosis, as well as the social context that shaped America's view of the condition...In the first chapter, Golden promises to provide a comprehensive look at the discovery of fetal alcohol syndrome, as well as the scientific, historical and social context that framed the debate over the condition. She delivers on all counts. Most interestingly, the book explains how laypeople and doctors alike were hesitant to accept that alcohol might be dangerous...The book details the chronology of changing medical knowledge and delivers its information remarkably well. (January W. Payne Washington Post Book World 20050515)

Golden's is a model study of the wide-ranging sociocultural consequences that can follow the clinical identification and description of a new syndrome. (Robin Room The Lancet 20050611)

Message in a Bottle by Janet Golden is the most comprehensive and easily read text on the history, politics, public health debate, legislation, psychosocial and family dynamics, and media discussion concerning fetal alcohol syndrome. This is a must-read for any professional involved in the study of alcohol abuse and neurodevelopmental outcomes of children, fetal medicine, pediatrics, social work, psychiatry, and other areas of mental health. (Denis Viljoen Journal of Clinical Investigation )

This book is an almost essential read for students of developmental disabilities and diagnostic clinicians. For other readers it offers an engaging and informative insight into the effects of the discovery of new diagnoses on wider society. (Raja A. S. Mukherjee British Medical Journal 20051008)

Janet Golden's versatile cultural and medical history of Fetal Alcohol Syndrome (FAS) in America is an enlightening addition to the literature on the social history of medicine, alcohol and drug problems, and women's health...This book would work well as a text in an undergraduate class on society and medicine or gender and health. At the same time, Golden's well-researched and documented study will enhance the knowledge of professionals in many fields, including history, gender studies, medicine, communications, and sociology. (Pamela E. Pennock American Historical Review 20070401)

Product Details

  • Hardcover: 240 pages
  • Publisher: Harvard University Press; 1 edition (January 30, 2005)
  • Language: English
  • ISBN-10: 0674014855
  • ISBN-13: 978-0674014855
  • Product Dimensions: 9.3 x 6.5 x 0.9 inches
  • Shipping Weight: 1.1 pounds
  • Average Customer Review: 4.0 out of 5 stars  See all reviews (1 customer review)
  • Amazon Best Sellers Rank: #2,531,899 in Books (See Top 100 in Books)

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4.0 out of 5 stars Message in a bottle: the making of fetal alcohol syndrome December 27, 2012
Format:Kindle Edition|Amazon Verified Purchase
Clear and informative sociomedical history of the development of the FAS concept. A wider perspective than what you get from the medical press. A balanced account.
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