By Glenn Ellis
Research Bioethics Fellow at Harvard Medical School
Glenn Ellis is a Research Bioethics Fellow at Harvard Medical School, and a health columnist and radio commentator who lectures, nationally and internationally on health-related topics
Women, especially women of color and poor women, tend to suffer disproportionately in our healthcare system. The problem is growing worse now that there’s a group of trial lawyers eager to exploit female victims, under the guise of offering help.
Take for instance that roughly one-quarter of U.S. women suffer from pelvic floor disorders, and according to the Washington Post, about 3-4 million of them have been treated with transvaginal mesh. The vast majority of these women receive repairs using transvaginal mesh without complications, but a significant minority experienced serious problems.
After the publicity surrounding this issue hit the fan, the lawyers pounced. It has come to light that a collaboration involving some law firms, doctors, and finance companies are pressuring women into unnecessary surgeries to remove the mesh. Giving new meaning to the term “insult to injury,” this phenomenon, according to the New York Times, is leading unsuspecting women to the operating table – even in cases when the removal could worsen the symptoms.
If that’s not enough, some unscrupulous hedge funds are financing companies connected with law firms specializing in suing manufacturers of the mesh. These law firms often use overseas telemarketing callers in countries such as India and the Philippines to contact women, known to have had the mesh surgery, with offers to join in lawsuits to sue the mesh manufacturers.
The New York Times highlighted a growing problem that tends to target women: the industry grown out of medical device settlements. For example, a court-ordered, charitable fund, the Common Benefit Trust, established out of the Dow Corning breast implant settlement fund, which also resulted from a faulty medical device. The Common Benefit Trust appears to have used some of this money to fund policy centers, advocacy groups, and a conference on litigation.
Pelvic organ prolapse, a medical issue sought to be treated by the transvaginal mesh, is one of the most common reasons for women to have surgery. It is ranked among the top three reasons that women have hysterectomies.
Then there are racial disparities. Compared with African-American women, Latina and White women had four to five times higher risk of symptomatic prolapse, thought to be in large part due to the lower rates of African-American women reporting the condition as a problem to doctors. Researchers see this pattern as part of a culture where African-American and/or poor women will not typically see the condition as a problem requiring them to consider surgery.
Issues like the transvaginal mesh that has revealed disparate treatment of women are not new. All patients–but especially women patients and minority patients that have traditionally been marginalized–deserve better than to be exploited in some of their most vulnerable times.
Those vulnerable times include childbirth and other areas of maternal health. Dr. Niva Lubin-Johnson, president of the National Medical Association, which represents more than 50,000 African-American physicians on issues of health disparities and justice, says, “There is a crisis for African-American women that is related to maternal mortalities –and that’s across any economic level and educational level for African-American women. We are losing in that area,” she says.
As for the transvaginal mesh, Lubin-Johnson says women must take extreme precaution when contacted by anyone about removals of that or any other device. “No, you go talk to your own physician about that and not to someone who is doing a cold call because of some possibility of joining a law suit…Talk to your own physician first; even if they were not the one who put the mesh in.”
Since The New York Times began shining a light on these bad behaviors, federal prosecutors from the Eastern District of New York have begun investigating the allegations of unnecessary and unneeded vaginal mesh removal surgeries. According to reports, doctors, lawyers, financiers and others who may have been involved in the sham have been subpoenaed.
So, if you’re considering medical treatment, be an informed consumer. Be sure to have your health care provider explain all of your options, as well as their possible risks and benefits. Though if these risks are not avoided, by all means, beware of financial lures to have surgeries that you do not need and that could leave you in a condition far worse than before.