Abstract
The major trend in medicine in the past two decades has been toward the transformation of the physician’s primary goal from treating patients in the best way they know how to the goal of treating patients in a way that minimizes their potential exposure to a medical malpractice suit. This risk-aversive movement is characterized by use of “defensive medicine” (tests and procedures ordered not to help the patient but to protect the physician in the event of a lawsuit), almost constant complaining about the price of liability insurance and the “medical malpractice crisis,” and the rise of “risk management” as a health care industry specialty. Many physicians feel that the medical profession has lost control over its own destiny, and that regulators, lawyers, and insurance companies have stripped them of their professional autonomy. Physicians have a point: Public policy over the past decade has been driven by the desire to contain and reduce costs rather than the desire to increase access to medical care or to improve its quality. This emphasis has tended to limit physician income and hurt physician morale. There is no magic solution to the “medical malpractice insurance problem.” This chapter describes the current system, outlines some of its costs and benefits, and suggests that patients and their physicians can work together to establish a partnership that will help physicians (in cooperation with their patients) regain professional autonomy and will simultaneously decrease the likelihood of lawsuits being filed for unanticipated negative results of treatment.
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Notes
Bums, Malpractice Suits in American Medicine before the Civil War, 43 Bull. Hist. Med. 41, 52 (1969). But see Bennet, “Pluses of Malpractice Suits,” New York Times Magazine, July 24, 1988, at 31.
D. Konoid, A History of American Medical Ethics: 1847–1912 (1962), at 50–51. For contemporary perspectives see Health Care Improvement and Medical Liability (Proceedings of an HHS Research Conference) (Washington, D.C.: HHS, 1988) and A. Holder, Medical Malpractice Law, 2d ed. (New York: John Wiley & Sons, 1978).
In extremely rare cases, where the entire medical profession or speciality has failed to keep up with medical advances, the courts themselves will define “reasonable prudence.” See, e.g., Helling v. Carey, 519 P.2d 981 (Wash. 1974) (failure to do routine glaucoma test is negligent as a matter of law).
Kg., Lab v. Hall 200 So. 2d 556 (Dist. Ct. App. Ha. 1967).
Kg., Hill v. Boughton, 146 Ha. 505, 1 So. 2d 610 (1942).
Noel v. Proud, 189 Kan. 6, 367 P.2d 61 (Kan. 1961).
E.g., Williams v. Chamberlain, 316 S.W.2d 505 (Mo. 1958).
Michael v. Roberts, 91 NH 499, a3 A.2d 361 (1941).
Kg., Brune v. Belinkoff, 354 Mass. 10 a, 235 N.E.2d 793 (1968); Murphy v. little, 112 Ga. App. 517, 145 S.E.2d 760 (1965); Douglas v. Bussabarger, 73 Wash. 2d 476, 438 P.2d 829 (1968); Blair v. Eblen, ad 370 (Ky. 1970). See also Tallbull v. Whitney, 172 Mont. 6, 564 P. 2d 167 (1977).
E.g., Francisco v. Parchment Med. Clinic, 407 Mich. 325, 285 N.W.2d 39 (1979) Robbins v. Footer, 553 F.2d I a3 (D.C. Cir. 1977).
E.g., Barnes v. Bovenmyer, 255 Iowa 220, a N.W.2d 312 (1963); Lewis v. Read, 80 NJ Super. 148, 193 A.2d 255 (1963); Belk v. Schweizer, 286 N.C. 50, 149 S.E.2d 565 (1966); Siirila v. Barrios, Mich. App. 72, 2a8 N.W.2d 801(1975), aff d, 398 Mich. 576, 248 N.W.2d 171 (1976).
Sims v. Helms, 345 So. 2d 7 al (Ha. 1977); see also Buckroyd v. Bunten, 237 N.W.2d 808 (Iowa 1976); Marsha Tomaselli, 118 R. I. 190, 372 A.2k 1280 (1977).
Radman v. Harold, 279 Md. 167, 367 A.2d 472 (1977). But see Callahan v. William Beaumont Hosp., 400 Mich. 177, 254 N.W. 2d 31 (1977).
Siirila v. Barrios, 398 Mich. 576, 248 N.W.2d 171 (Mich. 1976).
E.g., Mondot v. Vallejo Gen. Hosp., 15 App. 2d 588, 313 P.2d 78 (1957); Irick v. Andrew, 545 S.W.2d 557 (Tex. Ct. Civil App. 1976).
E.g., Seneris v. Haas, 45 Cal.2d 811, 291 P.2d 915 (1955).
Young v. Caspers, 311 Minn. 391, 249 N.W.2d 713 (1977).
Robinson v. Weaver, 550 d 18 (l’ex. 1977).
Proewig v. Zaino, 394 NYS.2d 446, 57 A.D. 892 (1977).
Simmons v. Riverside Methodist Hosp., 44 Ohio App. 2d 146, 336 N.E.2d 460 (1975).
Sanchez v. South Hoover Hosp., 132 Cal. Rptr. 657, 553 P.2d 1129 (1976); Moran v. Napolitano, 71 N.J. 133, 363 A.2d 346 (1976).
Graham v. Sisco, 248 Ark. 6, 449 ad 949 (1970); Chaffin v. NiCosia, 621 Ind. 698, 310 N.E.2d 867 (1974).
Miller v. Dickert, 190 S.E.2d 459 (S.C. 1972).
Swope v. Printz, 259 S.C. 1, 468 ad 34 (1971).
Nardone v. Reynolds, 538 F.2d 1131 (Sth Cir. 1976).
Annas, Katz & Trakimas, Medical Malpractice Litigation under National Health Insurance:Essential or Expendable?, 1975 Duke L. J. 1335, 1344; and see Dietz, Baird & Beru, The Medical Malpractice Legal System, in US Dept. of Health, Education, and Welfare, Report of the Secretary’s Commission on Medical Malpractice, App., at 87, 119 (1973).
The best book on the crisis of the mid-1970s is S. Law & S. Polan, Pain and Profit: The Politics of Malpractice (New York: Harper & Row, 1978). On the 1980s, see Danzon, The Effects of Tort Reforms on the Frequency and Severity of Medical Malpractice Claims, Ohio St. L. J. 413 (1987); Note, The Constitutionality of Medical Malpractice Legislative Reform: A National Survey, 18 Loy. U. Chi. L. J. 1053 (1987); and Note, 1986 Tort Reform Legislation: A Systematic Evaluation, 73 Cornell L. Rev. 628 (1988).
“Insurance Crisis Is Over—At Least for Now,” Hospitals, Apr. 20, 1988, at 46. See also Harrington & Litan, Cause of the Liability lnsurance Crisis, 239 Science 737 (1988); and Blum, “Malpractice Claims Down, Costs Are Up,” National Law Journal, Jan. 23, 1989, at 1.
New York Times, Apr. 13, 1986, III, at 3.
P. Danzon, Medical Malpractice (Cambridge, Mass.: Harvard U. Press, 1985)
See, e.g., D. K. Roberts, J. A. Shane & M. L. Roberts, eds., Confronting the Malpractice Crisis: Guidelines for the Obstetrician-Gynecologist (Kansas City, Mo.: Eagle Press, 1985); and K. S. Fineberg et al., Obstetrics/Gynecology and the Law (Ann Arbor, Mich.: Health Administration Press, 1984).
D. Delillo, White Noise, (New York: Penguin, 1986), at 285.
See also Note, The 1985 Medical Malpractice Reform Act: The New York State Legislature Responds to the Medical Malpractice Crisis, 52 Brooklyn L. Rev. 135 (1986).
A complete list of the names, addresses, and phone numbers of these agencies appears in C. B. Inlander, L. S. Levin & E. Weiner, Medicine on Trial (New York: Prentice-Hall, 1988), at 239-53. Under the Health Care Quality Improvement Act of 1986, and the Medicare and Medicaid Patient and Program Protection Act of 1987, the federal government will operate a national data bank to keep track of physicians who have been disciplined and move from one state to another. Patients will not have access to this data, although they should. See Gianelli, “Data Bank to Chronicle Licensing, Malpractice Actions,”American Medical News, Jan. 13, 1989, at 11.
For an excellent discussion of medical malpractice litigation in Great Britian, see Miller, Medical Malpractice Litigation: Do the British have a Better Remedy? 11 Am. J. Law & Med. 433 (1986). See also Annas et al., a6; and Abraham, Medical Liability Reform: A Conceptual Framework, 260 JAMA 68 (1988).
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© 1992 George J. Annas and the American Civil Liberties Union
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Annas, G.J. (1992). Medical Malpractice. In: The Rights of Patients. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-4612-0397-1_14
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