Denial and delay. If the approach sounds familiar, it is because, sadly, it happens frequently in medicine. Individuals don’t want to admit to health problems, denying and delaying until it is much more difficult to make a difference
It is a tragedy, because everyone knows that prevention is better than the best health care. Of course, when a patient or a medical professional take this catastrophic approach, the results impact only the circle around that person. But when an entire industry adopts “deny and delay” as its strategy, it can sicken thousands and even millions of people over decades.
Individuals may avoid facing the facts because they are afraid, don’t have health insurance or just don’t want to feel vulnerable. Industry almost always takes this approach to avoid oversight and maximize profits.
Since 1964, when the U.S. Surgeon General declared cigarettes to be harmful to people's health, the tobacco industry has engaged in manipulative tactics to deny the facts and delay action. It has denied the deadly health effects of tobacco, despite overwhelming scientific evidence that links smoking to nearly uncountable medical problems — lung cancer, heart disease and low birth weights in newborns, to name just a few. And it has delayed the passage and implementation of public health protections that could have saved countless lives and billions of dollars.
Industry-funded denial and delay wear many different masks. Denial can be achieved by funding phony scientific studies, hiring scientists to support the industry position, and bringing in third-party “experts” to start smear campaigns against legitimate research and researchers.
Delay includes pouring millions into lobbyists, gifts and hospitality to influence legislative and agency decision-makers. And it can mean tying progress up in knots with endless studies, committees, lawyers and lawsuits.
Maine physicians saw these tactics used aggressively right here every time proposals were brought forward to limit smoking, even when children’s health was on the line. Despite overwhelming scientific evidence of harm, what should have taken just a few years took several decades to accomplish. Denial and delay has worked very well for the tobacco industry for almost 50 years.
Unfortunately, here in Maine this cynical approach is front and center again. Only this time it is the chemical industry trying to block common sense efforts to limit children’s exposure to toxic chemicals in the products they use every day. The current battleground is bisphenol-A, or BPA.
BPA has been implicated as a hormone disrupting chemical at low doses. It interferes with normal hormonal balance, especially in developing fetuses and infants, who are so vulnerable to the effects of both natural and synthetic hormones. The effects of BPA are pervasive and include affecting the receptors involved in metabolism, obesity and brain signaling.
Maine’s Board of Environmental Protection is currently considering a proposal to phase out the use of toxic BPA in baby and toddler food packaging. The board already concluded that BPA is harmful when it named BPA as Maine’s first priority chemical under the Kid-Safe Products Act. The Board also found BPA to be intentionally added to food and beverage packaging, and that infants and toddlers are exposed to BPA by eating certain packaged foods. Studies show that BPA exposure could be reduced by two thirds if food packaging were BPA-free.
The conditions for the board to get BPA out of baby and toddler food packaging have already been met: we know BPA harms children, we know children are exposed to BPA in their food, and we know safer alternatives to BPA are available and affordable. The chemical industry knows it, too, and recognizes there is overwhelming support and momentum among Maine people and policymakers for protecting children from BPA. So, just like the tobacco industry, they are resorting to “deny and delay.”
Normally thoughtful people can be led astray by these industry tactics as millions of dollars are put into misrepresenting the facts. That’s why Maine physicians and physician organizations, including the Maine Medical Association and the Maine Chapter of the American Academy of Pediatrics support getting BPA out of baby and toddler food packaging.
In a famous quote from the internal documents of Brown and Williamson Tobacco Company, in 1969 a company representative said: “Doubt is our product, since it is the best means of competing with the 'body of fact' that exists in the minds of the general public.”
Denial and delay. It is the same tactic again, with the same deadly results. This time let’s not let the perpetrators get away with it for so long.
Dr. Lani Graham and Dr. Daniel Oppenheim are co-chairs of the Maine Medical Association’s Public Health Committee. Graham is a former director of the Maine Centers for Disease Control and current director of the Medical Professionals Health Program. Oppenheim is an endocrinologist practicing in Scarborough and president of the Maine Chapter of Physicians for Social Responsibility.