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HEALTH

French breast implant scare: women told ‘don’t panic’

European authorities sought to head off panic Wednesday over hundreds of thousands of French-made breast implants at the centre of a health scare, saying there was no proof of a link to cancer.

French authorities are to issue an expert report on Friday saying whether the implants, produced by the now-bankrupt Poly Implant Prothese (PIP) company, should be removed after several suspicious cancer cases.

Documents obtained by AFP on Wednesday showed that tens of thousands of women in more than 65 countries, mainly in South America and western Europe, received implants produced by the company.

According to PIP’s 2010 bankruptcy filing in the French city of Toulon, it exported 84 percent of its annual production of 100,000 implants.

Between 2007 and 2009, 50 to 58 percent of its exports went to South American countries including Venezuela, Brazil, Colombia and Argentina, the filing showed.

In the same period, 27 to 28 percent of exports went to western European nations including Britain, Spain, Italy and Germany. 

French health officials have already said the government plans to recommend to the 30,000 French women with PIP implants that they be removed, after eight cases of cancer, mainly breast cancer, were reported.

France’s health ministry however has said there was no “urgent health risk” from the implants and no “causal link” with cancer has yet been proved.

PIP was shut down and its product banned last year after it was revealed to have been using non-authorised silicone gel that caused abnormally high rupture rates of its implants.

Facing financial difficulties, the company, once the world’s third-largest producer of silicone implants, replaced the medical-grade silicone in its implants with industrial-strength material.

The Medicines and Healthcare products Regulatory Agency (MHRA) in Britain, where up to 50,000 women have been given PIP implants, urged patients not to panic, although it said they may want to consult their surgeons.

“We did extensive genotoxic and chemical tests and we could find no evidence of any safety aspect associated with this filler,” MHRA medical director Suzanne Ludgate told BBC radio.

“We have been working very closely with the professional bodies to look at the incidence of cancer associated with these breast implants and we’ve worked with the cancer registry and we can find no evidence for any association.”

In Germany, authorities said it was not known how many German women had received the implants and that no recall was planned for the moment.

“We are waiting for the decision from French authorities, with whom we are in close contact,” a health ministry spokesman told AFP.

German authorities “had already in April warned women and doctors who used these products,” he said.

In Spain the health ministry said it was not recommending the implants be removed but was urging women who had received the implants to have them checked for ruptures.

It also could not say how many Spanish women had received the implants.

The commercial filing also showed eastern European countries including Bulgaria, Russia and Poland accounted for 10 percent of PIP’s exports in 2009.

Middle Eastern and Asian countries accounted for only about eight percent of its exports that year.

Prosecutors in Marseille, near the firm’s home base of Seyne-sur-Mer, have received more than 2,000 complaints from French women who received the implants and have opened a criminal investigation into the firm.

A lawyer for PIP founder Jean-Claude Mas, 72, told AFP his client was prepared to face prosecution and denied the implants could be linked with health problems.

“For the moment there is no evidence that the product can cause illness,” the lawyer, Yves Haddad, said.

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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