In recent months many members of AUGS have been frustrated by misinformation related to surgical technologies and materials that creates fear and anxiety in our patients. Media reports are often superficial and polarizing. For example, coverage of FDA decisions often fails to distinguish between transvaginal mesh for prolapse, and other forms of pelvic mesh (such as slings or sacrocolpopexy mesh). Even more alarming are those who employ misinformation and fear to seek personal profit. This is exemplified by the recent coverage of charges against a physician in our space and a “surgical funding facilitator” who were part of an alleged scheme to defraud women with mesh implants to undergo unnecessary surgery.
This episode offers an opportunity to reflect on the critically important role that any member of AUGS may be asked to play in presenting the science and state of the art of our subspecialty to the public. This not only pertains to the media, but also in a court of law before juries of our peers. AUGS members should not shy away from providing opinion and testimony, in courts of law or of public opinion. Who is better positioned to provide guidance in the complex and nuanced realities of caring for women with pelvic floor disorders and the outcomes of their treatments? At the same time, there are critically important responsibilities of an Expert Witness that must be upheld.
Recognizing the importance of this issue, your previous President, Charley Rardin, convened a task force to look at the ethics of offering Expert Testimony. The task force included individuals with experience on behalf of both plaintiff and defense, as well as those with expertise in Ethics. Together, they developed the AUGS Code of Conduct for Expert Witnesses. You can review the code here.
This code has two components:
- A policy statement clarifying what the organization expects of members who decide to provide Expert testimony or services.
- An affidavit noting that AUGS considers activities as an expert to fall within the scope of your medical practice and is subject to peer review in the same way that your clinical practice is. All AUGS members involved in these services are expected to sign this affidavit and send in to AUGS where it will be kept on file.
We must fiercely preserve and protect the integrity and credibility of the science that we present to the outside world. And we must work hard to resist the forces that would convince women with successful surgeries that their “defective” and “recalled” devices must be urgently removed, at significant risk, and cost, and by surgeons they may not know. We should not stand by while our patients, who have no adverse events, fall victim to profiteers. At times, testimony before a court of law is an invaluable way to protect patients, but this endeavor must meet the same level of ethical responsibility to our patients that we expect in clinical care. We need to resist losing control of our own story.
This message was adapted in part from the 2018 State of the Society Address.