First, do no harm. This advice for those aspiring to become doctors has stood the test of thousands of years for a reason.
Patients must have confidence that when they go to see a doctor they are in safe hands.
And so the grim revelation reported by The Scotsman that a surgical mesh implant had, for the first time, been formally recorded as an underlying cause of a death – that of 75-year-old Eileen Baxter from Loanhead – prompted questions at the highest level yesterday, with calls for First Minister Nicola Sturgeon to set up an urgent review.
More than 100,000 of women across the UK have been given the implants over the past two decades, but complaints have been growing from patients who have found themselves in permanent pain – sometimes so bad that they are unable to work or even walk.
Use of the implants, designed to treat pelvic organ prolapse and incontinence, is currently suspended by NHS Scotland, although they can still be used in some cases.
Sturgeon told Holyrood that in the six months to March the procedure had been carried out 33 times, compared to more than 11,000 times in the same period of 2013/14. She also pledged to give calls for a review “careful consideration”.
The UK’s Medicines and Healthcare Products Regulatory Agency is responsible for deciding which medical devices can be used by the NHS, so it may be the appropriate body to re-examine the safety of the implants.
But if the Scottish Government does not hold its own review, it needs to press the MHRA to do so for the sake of future patients and the thousands who already have mesh implants, who will understandably be extremely worried.
There are experts who have argued against a complete ban on mesh implants – such as Scotland’s Chief Medical Office, Dr Catherine Calderwood – on the grounds that there is little or no alternative for some patients.
And such views need to be taken seriously. It may be that a problem can occur in specific cases for reasons that are not well enough understood.
If the implants can be used safely to help patients, then they should be.
But, given someone has died and there have been numerous accounts of serious, life-changing problems, the medical world needs to establish the facts – and quickly.