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This article analyzes the way the Porto-based journal Jornal do Médico reported on the thalidomide disaster. The pages of the publication are researched from the beginning of 1960 to the end of 1962 with the aim of identifying and discussing two interconnected questions: the delay in publishing news on the harmful effects of the drug, which was sold in the country under the brand name Softenon®, and the discursive construction of a lack of accountability on the part of physicians for the phenomenon of medication iatrogenesis.

Background: Thalidomide was introduced as a non-toxic sleeping pill in 1957 and was prescribed in more than 20 countries. In 1961 the link between congenital limb defects and thalidomide use in pregnancy was proven, resulting in withdrawal of the drug., Material and Methods: On the basis of literature searches and personal experience we review the effects and use of thalidomide today., Results: In vitro, thalidomide has immunoregulatory properties. This has lead to the administration of thalidomide in many immunological diseases. In 1964 it was discovered that thalidomide was effective against erythema nodosum leprosum. Thalidomide also has effect on aphthous stomatitis and Behçet's disease. The effect is more uncertain in graft-versus-host-disease, rheumatoid arthritis and Crohn's disease. Thalidomide reduces angiogenesis in experimental animals, and this has led to several studies of thalidomide as a possible anticancer drug. Advanced or resistant multiple myeloma may be a new target for thalidomide; at least 30% of these patients obtain response during treatment. Results indicate that patients with breast cancer and glioma do not benefit from treatment with thalidomide., Interpretation: Thalidomide has proven to be effective in the treatment of erythema nodosum leprosum and aphthous stomatitis. It is also effective in advanced multiple myeloma, but not in other cancers.

In this paper we examine how a standardized drug distribution system contributed to a therapeutic and symbolic make-over of thalidomide. In the 1960s, thalidomide was seen as a horror drug that caused severe birth defects among over 10,000 babies who were exposed to it in utero. Currently, thalidomide is viewed as a potentially life-saving drug which is being distributed in the USA. We discuss this transformation from a social worlds perspective, showing how the standardized drug distribution system normalized the risk of foetal birth defects, while preserving the autonomy of health care professionals. The distribution system accomplished this transformation by focusing on the risk associated with female reproductive behavior, and by providing close reproductive surveillance of female patients. This standardized system solidified social inequalities and professional power relationships, revealing assumptions about trust, responsibility and risk.