One of the challenges when it comes to determining damages in injury lawsuits is putting a monetary value on intangible losses, such as pain and suffering, emotional distress, and anxiety. These are considered to be “non-economic damages,” and fall under the category of “mental anguish.” Putting a dollar figure on emotional pain is difficult, but it is nonetheless a factor that can diminish the quality of life as surely as a crippling injury.
There are some who believe that breast cancer survivors who suffered irreversible alopecia (hair loss) as a result of undergoing treatment with Taxotere should simply be grateful they're alive and move on. Hair may indeed mean little to some people. However, for most of us, our hair is intimately entwined with our sense of self (to which the booming hair styling and hair care products industries can attest).
It is also very much a cultural thing. Some may recall the Old Testament story of Samson, who was undone when Delilah cut off his “seven locks” of hair. In some Native American tribes, men would never cut their hair. A few societies required women to bind up their hair when they married, and hunter-gatherer tribes would braid their hair in a certain manner. There are dozens of examples from around the world throughout history.
Contemporary Western society is no different. In the broader context of culture, history, and anthropology, it is easier to see how the unexpected loss of one's hair can have devastating emotional and psychological effects. Furthermore, recent scientific assessments bear this out.
In April 2001, the Journal of the European Academy of Dermatology and Venereology published a study from the U.K. in which members of an alopecia support group were asked to complete a survey designed to measure long-term emotional state. The researchers found that people who lost their hair to an illness or other cause beyond their control were more likely to experience “loss of self-confidence, low self-esteem and heightened self-consciousness.”
In 2008, Psychooncology published a review of the literature on how alopecia affects cancer patients in terms of quality of life. The researchers found that “Hair loss consistently, ranked amongst the most troublesome side effects, was described as distressing,” particularly among breast cancer survivors. In 2011, a study appearing in the Journal of the American Academy of Dermatology recommended that “dermatologists should address these psychosocial and quality of life issues when treating patients with alopecia.”
The bottom line is, chemotherapy-related alopecia can and does have severe effects on the psyche – and in the case of Taxotere victims, those effects can last a lifetime.
Women who are plaintiffs in current Taxotere litigation say that if they had known there was a risk of permanent alopecia, they might have chosen a different medication. In fact, they should have known, because drugmaker Sanofi-Aventis certainly did in 2005. That year, the company began including a warning about irreversible alopecia on labels of the product sold in Europe and Canada – but issued no such warning in the U.S. until 2015. Why?
The answer is far from clear, but the difference is that the U.S. health care system, unlike those in the rest of the world, is run for the benefit and profit of large, private corporations. Add to that the fact that the F.D.A. has increasingly become beholden to those private interests and you can draw your own conclusions.