"Beyond birth control:" the Yaz/Yasmin controversy and the risk evaluation of hormonal contraceptives
Notice bibliographique
Résumé
Concerns about the safety of the pill have come to the fore recently, due in large part to the public outcry over deaths allegedly caused by popular contraceptives Yaz and Yasmin. Media reports link the drugs to at least 23 deaths in Canada and over 100 in the U.S. as well as thousands of injuries worldwide, as a result of a purported increased incidence of blood clots. The question of what should be considered an acceptable risk threshold for approved contraceptive pills has been contested by many groups, including regulatory bodies, medical professionals, epidemiologists, and consumers. This thesis provides an in-depth sociological examination of the Yaz/Yasmin controversy through qualitative analysis of stakeholder interviews and content analysis of key medical, regulatory, and legal documents. I examine the most recent safety debates in order to analyze the central phenomena that play a role in the regulation and risk/benefit assessment of oral contraceptives: managing data uncertainty, calculating reproductive risks against ancillary benefits, and the precariousness of informed consent. After an introductory chapter in which I situate the thesis within the larger scholarly conversations on contraceptive assessment specifically and technological risk more generally, the findings are presented in three article-length manuscripts. In the first article, I investigate strategies that regulatory bodies and professional associations use to assure the public of the safety of Yaz and Yasmin. I found that a discourse of pregnancy risks is employed in official risk communication. I argue that this has gendered implications for the development of contraceptives and their risk assessment. In the second article, I explore how pill users who have experienced side effects understand the risks of hormonal contraception and advocate for changes in risk communication and drug regulation. I found that women highlighted the inadequacy of risk information received from both doctors and pharmaceutical companies. In addition, affected users rejected the use of reproductive risk as the primary comparative risk when assessing pill safety. In the third paper, I look at processes through which individual stakeholders measure and debate contraceptive risk. Here, I highlight how contraceptive risk assessment is characterized by systemic uncertainty and doubt. Furthermore, the paper stresses the tough choices that users have to make in a climate of indecision coupled with pharmaceutical companies' involvement in research and marketing. While we know that the history of the pill has been fraught with many debates about its safety, less attention has been paid to the current changing context and how different social actors still contest the measurement and meaning of contraceptive risk. I found that many questions about risks are unresolved or dealt with in ways that create divergence between professionals and affected users. In the concluding chapter, I discuss the sociological implications of my findings, the limitations of this study and potential directions for future research on the evaluation of contraceptive risk. The Yaz/Yasmin controversy has amplified contemporary critiques of the pill. In documenting and analyzing the dynamics of this risk debate, this thesis contributes to a deeper understanding of how the risks and benefits of contraception are currently assessed in the North American context.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,013 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,003 | 0,002 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».