Just the Facts?

Does Dianne Mandernach really believe in a link between abortion and breast cancer?
Courtesy of the Minnesota Department of Health

When Republican legislators passed a 24-hour waiting period for abortions last April by tacking the measure sub rosa onto a bill dealing with circus regulation, opponents complained that public-health policy was in danger of being hijacked by right-wing partisans. They were right to worry.

As the Star Tribune reported in early December, the abortion bill--called the Woman's Right to Know Act--has stirred considerable controversy within Minnesota's Department of Health. At particular issue is a department informational pamphlet called "If You Are Pregnant," which the new law requires doctors to show women 24 hours before they have an abortion. In addition to pictures of developing fetuses and graphic descriptions of abortion procedures, the pamphlet includes a passage suggesting a link between abortion and breast cancer. "Findings from some studies suggest there is an increased risk of breast cancer among women who had an abortion," it reads, "while findings from other studies suggest there is no increased risk. This issue may need further study."

The only problem: According to the best and most recent scientific evidence, no such link exists. Indeed, an earlier draft of the pamphlet mentioned a February 2003 National Cancer Institute symposium during which researchers concluded that having an abortion does not increase the risk of breast cancer. The pamphlet's language was altered, the Star Tribune reported, after health department commissioner Dianne Mandernach consulted with the office of Governor Tim Pawlenty. By linking cancer and abortion, critics charge, the health department is manipulating science in order to frighten women away from abortion clinics.

And, abortion-rights advocates say, Minnesota's case is only part of a deliberate, national disinformation campaign orchestrated by abortion foes.

"Basically, everybody knows politicians are elected to advance an agenda," says Tim Stanley, executive director of NARAL Pro-Choice Minnesota. "That's a given. But there've always been certain departments that are off-limits to ideology. The [National Institutes of Health] and Health and Human Services stuck to science and what was right. What you have now is the administration co-opting science, distorting science to further its goals. And the primary victims of ideology trumping science are the women of Minnesota."

The criticism is hardly limited to pro-choice activists. Dr. Steve Miles, a bioethicist at the University of Minnesota, calls the pamphlet "a disgrace." "What's so disappointing here," he says, "is that health departments, like the courts, are supposed to be apolitical mediators of controversy. In the case of the courts, they mediate laws. Health departments mediate scientific knowledge."

(Mandernach's office referred questions to a health department spokesperson, who did not return calls requesting comment. But the Strib quoted Mandernach's response to the controversy: "We are not taking an inaccurate scientific position.")

There's reason to believe the pamphlet's dissembling language is actually part of a calculated national strategy. Twenty-eight states have some version of the 24-hour waiting period on the books (although a number of those laws are still being adjudicated in state courts). While they vary subtly from state to state, the laws are all based on Pennsylvania's waiting-period statute, the first of its kind to be deemed constitutional by the U.S. Supreme Court in 1992. On its website, the national antiabortion group Americans United for Life (AUL) even offers a boilerplate model for such legislation. And in fact, a chief Senate backer of Minnesota's antiabortion legislation, Paynesville Republican Michelle Fischbach, happens to be married to the executive director of Minnesota Citizens Concerned for Life (MCCL), the state's largest antiabortion group.

Minnesota's Woman's Right to Know Act is broadly similar to statutes in most other states. However, Minnesota is among only a handful of states--including Texas, Louisiana, Mississippi, and Kansas--that assert a link between abortion and breast cancer in their legislation. But the dubious cancer-abortion link isn't just being made in the legislatures of backwater states. In 2002, a group of conservative federal lawmakers, reportedly with the support of the Bush administration, pressured the National Cancer Institute to alter a fact-sheet on breast cancer so that it suggested a link with abortion. That apparent promotion of bunk science for ideological ends prompted an outcry from the scientific community: The February NCI symposium was, in fact, intended largely to put the manufactured medical controversy to rest.

The contentious Minnesota pamphlet is based on similar handbooks from Kansas and Louisiana, both of which contain the controversial passage about breast cancer. The Louisiana pamphlet was developed in part by Dorrinda Bordlee, a lawyer for the AUL, who on the organization's website boasts that "her efforts led to the nation's first regulatory warning on the abortion-breast cancer link." And Mandernach has acknowledged that the MCCL was consulted during the drafting of the pamphlet. Abortion-rights groups and abortion providers, she claimed, were not consulted because they did not offer their expertise--an assertion that, according to a number of abortion-rights groups, is simply untrue.

Indeed, in the wake of the blowup, some outside critics, and Democratic legislators, are now questioning Mandernach's fitness to head the state's health department. Says the University of Minnesota's Miles, "The question needs to be asked, given her mishandling of this, whether she has sufficient credibility to speak on controversial matters of public health facing the state. To a large degree, the credibility of the health department is its biggest asset. And in large part, [Mandernach] is just a temporary steward of that. It's not hers to abuse. It's ours. The people of Minnesota need to be able to trust their health department."

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