History of Breast Cancer’s Cultural Reception and the Birth of Komen
The largest breast cancer organization in the United States emerged as part of a national phenomenon of health activism in the United States in the 1980s (Klawiter). Prior to the 1980s, public discourse about the disease was accompanied by notions of shame and disfigurement. One patient who underwent treatment in 1979 noted, “In 1979 people just wanted you to have surgery and they didn’t want to talk about it…you were in and out of the hospital and that was that! There was no social workers, no support groups…” (Klawiter 858). The emergence of health activism changed the identities of those affected from victims to survivors, “…The health activist groups that emerged in the 1980s and 1990s, while diverse in their agendas, shared a sense of the importance of disease identity categories that suggested live, active, and empowered individuals, “(King 106). Civil rights activist Audre Lorde, referencing her struggle with breast cancer, wrote, “For silence has never brought us anything of worth,” (King 103). Initially, breast cancer activists campaigned the government for access to information about treatment options. In this early period, breast cancer activists used particular cultural gender ideals to frame their cause,“…these breast cancer activists strategically drew upon conservative norms of heterofemininity in their media presentations and public testimonies. As part of their script, they positioned themselves as the victims of callous surgeons and in the need of state protections…” (Potts 65). Other activists purposely framed their work in a manner that combatted traditional conceptions of femininity (Potts 66). The utilization of “survivor” terminology challenges feminine passivism by framing women as active fighters. It is important to note that many founders of the breast cancer movement were importance political and economic leaders who had the resources to bring the disease into the public discourse. Eventually, these insiders played a role in the emergence of corporate activism that further pushed breast cancer into the media.
Susan Goodman Komen was thirty-three when she was diagnosed with breast cancer and died only three years later. In 1982, Nancy Goodman Brinker, Susan’s younger sister, formed Susan G. Komen for the Cure with the sense that if Susan had known more about prevention and treatment options, she may have survived. According to the website, Komen’s mission is, “to find a cure and eradicate breast cancer,” (Komen.org). In 1984, Nancy Brinker was also diagnosed with breast cancer. In part, Brinker attributes her survival to the early screening processes that identified the disease. Her first hand experience has contributed to Komen’s emphasis on preventative measures, which have been controversial (Epstein).
Susan G. Komen for the Cure emerged at a time when volunteerism and giving habits were changing in the United States. While the American lifestyle has promoted excessive consumerism since the 1950s, a new period of conscious consumerism emerged towards the end of the 19th century (Bailey). Firms in the private sector began to recognize the importance of making a positive social, environmental, and economic impact. Samantha King, author of Pink Ribbons, Inc., cites September 11th 2001 as a turning point in American consumerism and volunteerism:
“The period since September 11, 2001, has seen an intensification of the normalizing discourses that tie philanthropic activities to proper citizenship. While the Bush administration has enacted a far-reaching and brutal military response, ‘ordinary’ Americans have been told that they can best help the nation recover from this tragedy by consuming and volunteering, and any activity that falls outside these narrow confines of acceptable citizenship, or which seeks to question its parameters, is deemed suspicious, if not outright dangerous. It seems particularly crucial, then, at this point in history, to find ways to make visible the relations of inequality, obligation, and exploitation that structure well-intentioned charitable practices,” (King 124).
Komen, with the help of fundraising guru Dan Pollotta, created the Susan G. Komen 3- day in an effort to capitalize on the public desire to volunteer and contribute (Pallotta 3). Organized walks have been an optimal form of activism for numerous women’s issues, beginning with crusading for the right to vote (Schultz 1133). The 3-day, 60-mile walks take place in major cities in the United States. In order to participate, walkers must raise $2,300 for Susan G. Komen for the Cure. Komen was also instrumental in the creation of October as Breast Cancer Awareness Month. Public activism and positive narratives contributed to the de-stigmatization of breast cancer, “Breast cancer is rarely viewed now as a shameful or self- induced disease and is, as we have seen, most often portrayed as an enriching and affirming experience during which women with breast cancer are rarely categorized as ‘victims’ or ‘patients,’” (King 102). These events resulted in a strong national community grounded in emotional support, the celebration of women’s strength, and public volunteerism.
By the mid 2000s, Komen was the largest breast cancer organization in the United States. The company’s strategy of intense publicity and corporate partners and sponsorships resulted in the organization’s signature pink on products. Today, the non-profit boasts hundreds of partnerships with organizations such as American Airlines, the Dallas Cowboys, Ford, and General Mills. Charity Navigator, an online guide to informed giving, rates Komen in the four star category- the highest any organization can receive.
Under the Lens of Feminist Ethics of Care
Feminism is defined as, “…involving both a recognition that women are oppressed by sexism and a commitment to end that sort of oppression,” therefore feminist ethics critiques many normative theories (Sherwin 2). Neglected experiences of women and the criticism of traditionally feminine characteristics from traditional schools of ethical thought led to the rise of feminist ethics. All ethical theories suggest strategies to make decisions by. Classical ethical theories use human reason and rationality to weigh options in decision making, “This ideal of rational control implies that the properly human self is not dependent on others…” (Groenhout 25). Mainstream ethical decision making theories rely on individual reasoning, in turn neglecting human capacity for emotion and interpersonal relationships, “ Further, reason has often been defined in terms that exclude the emotions or affections. If reason is the distinguishing feature of the human, then the emotional relationships humans experience are seen as opposed to reason,” (Groenhout 25). Feminist critiques of mainstream ethical theories lead to the development of care theory.
Mainstream ethics focuses on the individual, but care theorists stress the significance of social interactions that are central to the human experience. According to care theorist Virginia Held, care is the most basic moral value (Held 71). Care is also located in the feminine realm. Women are more likely than men to provide unpaid (and undervalued) labor in the form of care. It is important to note that the dominant ethical philosophers had the status as men and as academics to delegate care to others, which could explain the lack of incorporation of care into ethical theories in the past (Groenhout 25). There are three basic beliefs of care theorists. First, all individuals are interdependent for achieving their needs and interests. Second, those particularly vulnerable to our choices and their outcomes deserve extra consideration to be measured according to. This calls for all people to be aware of how vulnerable others are to our decisions, and the level of their potential affectedness. Third, contextual details of a situation are important. Paying attention to detail will enable the actors to safeguard or promote specific interests of all involved. Incorporating these beliefs into decision making will enable those who are vulnerable to benefit more from the world we live in, “The care given aims, in the ideal case, at the full intellectual, emotional, spiritual, and physical well-being for others cared for, and it occurs in the context of social structures that encourage the development of the capacities to give and receive care in all,” (Groenhout 24). According to Joan Tronto, there are four ethical elements of care theory: attentiveness, responsibility, competence, and responsiveness. Through employing these decision-making variables, an organization can make changes to benefit more people to a greater degree.
Care theory, a subset of feminist theory, is especially relevant for the analysis of organizations that specifically consider the interests of women. Komen, as a breast cancer organization, aims to address the needs of a vulnerable population. According to Susan Sherwin, “A politicized feminist stance urges those with cancer not to settle for passive dependence on medical authority and not to accept the isolating interpretation of the disease as an individual phenomenon but to identify themselves as part of a social group in search of collective change and action,”(Sherwin 1). Susan G. Komen for the Cure, while it highlights women’s collective action and values the historically overlooked experiences of women, acts unethically based on the tenets of feminist ethics of care.
Komen’s Exclusivity: Survivor Terminology and Campaigns for Women
The experience of having breast cancer has changed as a result of the social activism of the last three decades. Through labeling a person in remission a “survivor,” the individual is portrayed as an active resister who has played a role in the disappearance of his or her disease. This vocabulary replaced “victim” and “patient” labels in the 1980s. Through using this terminology, Komen portrays breast cancer as a transformative experience that leads to a happy ending,“ While it is quite common for illness to function as a transformative experience on an individual basis, often in positive ways, the dominant discourse of breast cancer survivorship, as I argue through this book, leaves little room for alternative, less positive, understandings of the disease experience and its long term effects, or, relatedly, of the political-economic context in which the fight against the disease is being waged,” (King 102). Komen’s survivor-based campaign is an example of this dominant positive discourse. The organization is neglecting people who experience breast cancer in less positive ways. Komen is not solely responsible for this cultural ideal, “It is sufficient to understand the deep historical roots of certain culturally accepted attitudes and to recognize that these conventional habits of thought about female victims of violence have the effect of privatizing the experience and hiding its social dimensions,” (Sherwin 3). Because negative breast cancer experiences do not align with the cultural ideal of the positive survivor model, vulnerable people’s experiences are hidden from the public discourse.
Komen’s employment of “survivor” terminology chiefly dishonors those who will eventually die as a result of the disease. In the film, Pink Ribbons Inc., women with stage IV breast cancer are interviewed about their experiences with the disease. Sandy Kugleman noted that the first time she was diagnosed with the disease, she “did all the right things” to fight it (Pink Ribbons Inc., 17:05). Five years later, she was diagnosed with stage IV breast cancer. At this stage, she expressed her frustration with the perception of those who will not “beat” the disease. According to feminist scholar Susan Sherwin, “We are told that we can avoid cancer by improving our lifestyles, monitoring our bodies for the most minimal of changes and, in still too many cases, maintaining an appropriate attitude of calm and cheerfulness,” (Sherwin 3). The survivorship message communicates the idea that people can overcome the disease if they try all their options and stay strong. The opposite message applies to those to whom the disease will be fatal. While the negative portrayal of those who will die of breast cancer is not an intended result of employing survivor terminology, it harms those who are most vulnerable. Ethics of care dictates that those who are most vulnerable should be afforded extra consideration when decisions are being made.
Breast cancer can develop in both men and women, but it is about 120 times more likely to be found in women (Komen.org). While it is rational for Komen to focus the majority of its efforts on women, many people aren’t even aware that men can get breast cancer. Komen perpetuates this ignorance through its pink, woman centered campaigns. Men are less than women likely to seek medical help (Marsiglio). For this reason, men would benefit from knowing the symptoms of the disease in order to identify that this is a problem that can directly affect them as well.
Breast cancer may appear to be an “equal opportunity” illness that has the potential to form in all women (and sometimes men) equally, but specific groups are more likely to develop the disease (Sherwin 2). While breast cancer awareness campaigns highlight the role of individual behavior in cancer risk factors, one’s setting is an powerful determinant, “The cancer research agenda largely ignores the environmental factors widely implicated in the spread of various cancers: toxic chemicals, exposure to radiation, synthetic hormones fed to livestock, ozone depletion, and iatrogenic (medically induced) effects of radiation treatment, drugs or medical devices; its preventive focus concentrates overwhelmingly on individual lifestyle issues” (Sherwin 6). Even some individual behaviors are connected to larger social and political trends; for example, smoking is more common among oppressed groups than privileged members of society (Sherwin 6). The Komen 3-day walkers are typically white; white women are most likely to have leisure time and disposable income to spend on the event. White women are most likely to be diagnosed with breast cancer, while African American women are most likely to die from the disease. Through a care theory analysis, it is clear that Komen should prioritize the needs of at risk populations because cancer does not affect everyone equally, and not all people have the same access to care, “Once we understand that cancer is inextricably tied to large-scale economic and political priorities, it becomes clear that its occurrence is a political issue.” (Sherwin 7).
Komen’s Partnerships: Causing or Curing Breast Cancer?
Susan G. Komen for the Cure actively looks for corporate partnerships and sponsorships; to date, they have hundreds. Corporations recognize consumer’s desire to make a positive impact through spending. Breast cancer organizations an ideal partnership for corporations. Health is something that the vast majority of consumers agree is important. In addition, women are the ideal recipients of aid, “In this period (1990s), the public focus was more oriented to thinking about breast cancer in relation to the broader neglect of women’s health and the rights and needs of women as a group,” (King 113). Business, historically considered a masculine sphere, may also be pulled towards supporting a women- focused cause, economically coming to the rescue of the “damsels in distress.” Organizations like the NFL, Worldwide Wrestling Entertainment, and machinery retailers employ exaggerated notions of traditional masculinitiy that correspond with protecting women. A number of other industries have jumped at the opportunity to partner with Komen, “The mainstream movement (Susan G. Komen) was so successful in transforming the public discourse of breast cancer that leading names in corporate America, especially the beauty, ﬁtness and fashion industries, adopted breast cancer as their cause celebre,” (Klawiter 847). Pink-washing, or the production of pink colored products that support breast cancer organizations, gives the consumer that ability to make symbolic gestures in support of a cause and the corporation to better its reputation.
Susan G. Komen for the Cure has partnered with a number of corporations that contribute to rising rates of breast cancer or negatively affect the wellbeing of women and men. Kentucky Fried Chicken and Komen partnered to create the “Buckets for the Cure” campaign. KFC promotes unhealthy consumption, a contributing factor to obesity, which in turn, is a risk factor for breast cancer. Ford’s “Warriors in Pink” special edition mustang not only contributes to air pollution, which increases risk for breast cancer, but the soluble metal working fluids used in the process of manufacturing the pink-washed cars has been proven to cause breast cancer (Pink Ribbons, Inc., 1:10). Sally Beauty, another partner, manufactures cosmetics that contain endocrine disruptors and cancer causing chemical compounds. Even fracking has been pink-washed. Koch Industries subsidiary, Georgia-Pacific, is a producer of natural gas. The process of hydraulic fracturing has been linked to breast cancer, “In the six counties in Texas which have seen the most concentrated gas drilling, breast cancer rates have risen significantly, while over the same period the rates for this kind of cancer have declined elsewhere in the state,” (Fox). Each of these companies has directly supported Komen’s commitment to ending breast cancer, yet has been accused (and in some cases, guilty) of causing the disease. It is likely that corporate pink-washing will increase sales, enabling the business to continue to expand the risk of breast cancer.
Many of Komen’s partnerships are in direct opposition to Komen’s goal of ending breast cancer; therefore Komen’s commitment to the partnerships is unethical, “Care theory also requires analysis of the ways that the structure of human social existence either does, or does not support ethical relationships,” (Groenhout 36). Komen is supporting organizations that have been linked to causing cancer. Those who may get cancer as a result of working in a car factory or consuming KFC are likely to occupy a vulnerable space without much spending power. These partnerships may also affect what research Komen can support, “Komen refuses to prioritize research on the environmental causes of breast cancer and on primary prevention — an unsurprising stance given their dependence on pink-washing sponsors,” (Horn 3). There is available information to Komen allows them to respond in a way that protects the wellbeing of women, but they fail to do so, “The problem, of course, is that breast cancer culture as currently configured does not encourage these kinds of critical responses- Komen Foundation founder Nancy Brinker told the Philadelphia Inquirer in 2004 that she has no time for activists’ ‘whining and kvetching’- and is in fact structured to close, rather than open, the context in which participants understand the problem of breast cancer to exist,” (King 115). In order to distribute resources to cure breast cancer in he most effective way, Komen must take these concerns seriously.
Sick and Sexualized: Interpreting Women with Breast Cancer in Komen’s Media
Since breast cancer activism began, the public image of the breast cancer survivor shifted from the disfigured, undesirable woman to one whose femininity and sexuality is intact and even emphasized. There is nothing sexy about the disease, yet many of Komen’s ads and its partner’s ads use sexuality to draw attention to the cause. Discourse about breasts is the center of breast cancer campaign marketing, “Cultural anxieties about breast cancer are determined by the intersection of popular discourses of femininity and illness at the icon of the breast, and complicated by its status as diseased,” (Potts 37). The focus on breasts reinforces the outdated ideal that women are sexual objects, “Women are attributed value via bodies which are sexualized and commodified for the male gaze and masculine consumption; or through bodies which are conceptualized in terms of reproductive potential,” (Potts 39). Pornhub.com, an organization with no history of philanthropic donating, gave one penny for every thirty views of its particular “breast- themed” videos during the month of October last year. Lingerie retailers have capitalized on partnerships with Komen. Even Playboy developed a sponsorship agreement with Komen called “Bunnies for the Cure.” The breast puns and imagery in the media identify the disease as a threat to sexuality, instead of life. This phenomenon expresses the sentiment that a woman’s value comes from her physical appeal, and in some cases, that women should protect their sexuality for the benefit of men. The advertising rarely expresses the variety of ways in which women experience their bodies and femininity, which differs with age, class, and race, “…the kinds of images which accompany breast cancer reporting and consistently present readers with images of young and healthy breasts- either full and voluptuous, or young and pert,” (Potts 41). Men are rarely included in breast cancer advertising; but when they are, they are occasionally sexualized. The focus on women’s breasts when depicting breast cancer undermines more important aspects of their experience with cancer.
Mastectomies are rarely discussed in the media, and when they are, revealing imagery rarely is rarely present. In her study Laura Potts discovered that when reviewing mastectomies, only 2 of 800 articles or advertisements displayed a photo of a woman who had a breast (or breasts) removed (Potts 43). Societal ideas of disease are associated with mastectomy much more than they are with generic breast cancer depictions, “Like other forms of amputation, perceptions of mastectomies and lumpectomy are governed by ideas about disfigurement, damage, and mutilation. Its associations are with disease and not recovery,” (Potts 43). The negative, somber depiction of mastectomies overlooks the diverse emotional states of women and men. Male mastectomies are very rarely present in the mainstream media.
The employees at Komen have the ability to choose corporate partnerships and what campaigns the organization’s name is attached to. Komen should actively promote the depiction of a range of women, and their many complex experiences with cancer. The consequences of the sexualization of women in the media include increased feelings of shame about one’s body, higher rates of eating disorders, self- objectification that can to unhealthy sexual relationships, and more. Applying the ethics of care would change the manner in which the organization depicts women, “A caring society would attend to the health of the social relations between its members, rather than primarily promote the nearly boundless pursuit of individual self interest…” (Held 136). Komen should be stricter with its advertising and media requirements in order to promote wellbeing for all women and men.
Conclusion: Komen and Care Theory
There’s no doubt that Susan G. Komen has played an instrumental role in bringing people together to support those affected by breast cancer. Through survivorship narratives, counterproductive partnerships, and sexualized media, Komen plays a role in harming vulnerable populations who are also affected by breast cancer. Care is directly tied into Komen’s goals, “Care, the emotion involved in tending to the physical needs of other, dependent humans, holds a central place in ethical theory because of its indispensability for human life,” (Groenhout 24). Komen claims that it wants to end breast cancer; if the organization wishes to take this mission seriously, it should employ an ethic of care in every aspect of the business.
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