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Hoffman-ISSUeS continued'frompg. 2In response to these consumerdemands, physicians are practicingmore and more defensive medicinemoreand more Cesareans, morestress testing, more sonography—creating newer and more complicatedtoys, driving the costs ofhealth care higher and higher, lesseningaccessibility—all resulting in akind of "Uterine Star Wars."Physicians are pressured tobecome even more and more Godlike—andGod help them if theydon't deliver! In New York, the malpracticerates for obstetrics havebeen driven so high by enormous settlementsthat many obstetriciansentertain the idea and even makethe decision to give up deliveringbabies. In an environment whereeveryone is concentrating on offensiveweaponry—rather than preventativeapproaches—there are losseson all sides—especially for women.It is a fact that a significantamount of the massive health caredollars spent in this country arespent for treatment of individuals inthe last months of life. In a contextof $400 billion dollars, this is a startlingfigure, especially when juxtaposedwith others like: In 1990, theblack infant mortality rate will be 14per 1,000. Only 79 percent of womenwill receive adequate prenatal careinstead of the 90 percent that hadbeen projected by the Public HealthService. According to 1985 Journalof Pediatrics statistics, the gapbetween black and white infant mortalityseems to be widening in thelast three years. While Administrationofficials claim there is no relationshipbetween relevant Federalprograms which have been cut andchanges in infant mortality, a NewYork Times editorial points out thatthe figures strongly suggest a link.Michigan, for example, has lost 25percent of its funding for maternaland child-health programs and theblack infant mortality rate hasstalled at 23.1. In parts of Detroit, ithas been as high as 33 per 1,000.Ironically, every dollar spent onprenatal care for women at risk ofbearing low-birth weight babies willsave more than $3 in specialized carelater. It has been stated and demonstratedtime and time again thatadequate pre-natal care will drasticallyreduce the amount of low-birthweight and problem deliveries. It hasalso been adequately demonstratedthat it is the poor women, the22minorities, that suffer most fromthe lack of ongoing pre-natal medicalattention. In the area of contraceptiveservices, a recent study byMargaret Terry Orr et. al. (FamilyPlanning Perspectives, Vol. 17, #2)reveals that only half of all privatephysicians will provide contraceptiveservices to Medicaid-eligible women,fewer than one third will provideobstetric care. Our society whichuses women and sex to sell all of itsproducts offensively, expends minimalfinancial resources on defense.And let's take a hard look atwhat is happening to Americanteenagers.A recent study by the AlanGuttmacher Institute revealed thefascinating comparative data thatteenage pregnancy rates in thiscountry are more than twice as highas they are in Canada, England andFrance; three times higher than theyare in Sweden and seven timeshigher than they are in the Netherlands.An analysis of the differencesin the systems revealed that it wasthe availability of confidential andfree or low-cost contraceptive servicescombined with realistic sex educationprograms in the schools alongwith concurrent liberalized abortionlaws that resulted in greater contraceptiveuse among teenagers. A salientpoint by Kajsa Sundstrom-Feigenburg,a Swedish gynecologist..."We didnot think it was a good thing forSwedish teenagers to begin theirsexual lives by having an abortion."Many of our country's teenagers,and we see quite a few at CHOICES,begin their sexual lives just this way.The results of female sexuality aresurgical invasions. Would we rather"teach them a lesson" than teachthem prevention?It is not uncommon for amother to call to make an appointmentfor her 12-year-old daughter'sabortion and demand that it be doneunder "local anesthesia" so that shecan "learn" from the pain of theexperience. This concept of adversarial,invasive conditioning—abortionto teach responsibility—does notexist only in the vacuum of maternalweaponry.It is a reflection of the largersociety (America as mother if youwill, as ultimate reinforcer) and themessages and the reinforcementsare crystal clear. The only real valuesare technology and consumerism —as defined and deified by the malepower establishment. Women's livesand health have become mere extensionsof this—they do not have valuein and of themselves, but as consumeritems. This concept of beinga perfect product operates not onlyfor ourselves but for our childrenas well.It thrusts us to diets, to exercise,to cosmetics and ultimately, totechnology, to achieve that elusivestate of consciousness and existenceknown as being "10," being perfect.In this sense, the women'smovement has not only been coopted,it has become part of maledominatedmainstream thinking. Akind of thinking that results in moreand more consumerism, more andmore technology, and less and lesstrue (female defined) liberation.It is time for women tochange the climate of the debate. Itis time for us to re-define and reorderour national priorities.Is it right that the majority ofour health care dollars go to dyingpatients in the last months of theirlives when children in their mother'swombs or in the first months oftheir lives are being neglected? Isn'tthe price for the medical boys playingwith their toys too high? Yes,DeVries is brilliant. Yes, a perfectartificial heart down the roadsometime, somewhere may be ofmajor benefit to the few (and theyinclude the research and medicalcommunities).The New York Times reportedon Friday, May 24, that the artificialheart had received a sweepingendorsement from a committee ofexperts appointed to study its potentialimpact on society. The reportcalled for greatly expanded Federalresearch to develop a fully implantablepermanent artificial heart. Toquote the study, "Such devices couldprovide a significant increase in lifespanwith an acceptable quality oflife for 17,000 to 35,000 patientsbelow age 70 annually."What does this say about ournational ethics and priorities?The benefit to the many mustbe weighed against the benefit tothe few. John Stuart Mill's doctrineof Utilitarianism demands that youtake an individual case and multiplyit for all the world and if it works foreveryone, it is an assumptive good.Virtue is based on utility and conductshould be directed towards promotingthe greatest happiness for the