The shame of medical malpractice

Journal of Legal Medicine

Volumn 27, Issue 1, 2006, Pages 17-32

  Mehlman, Maxwell J ^a,b,c  

^a Department of Law ^*  (United States)

^b CASE WESTERN RESERVE UNIVERSITY   (United States)

^c CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COST; HEALTH CARE; HEALTH CARE PERSONNEL; HEALTH CARE POLICY; HUMAN; INSURANCE; LAW; LAW SUIT; LEGAL ASPECT; MALPRACTICE; MEDICAL ERROR; NEGLIGENCE; PHYSICIAN; REVIEW;

COMPENSATION AND REDRESS; HUMANS; LIABILITY, LEGAL; MALPRACTICE; PHYSICIANS; UNITED STATES;

EID: 33644745134     PISSN: 01947648     EISSN: 1521057X     Source Type: Journal    
DOI: 10.1080/01947640500533218     Document Type: Review

References (71)

1. See MAXWELL J. MEHLMAN, RESOLVING THE MEDICAL MALPRACTICE CRISIS: FAIRNESS CONSIDERATIONS 11-81 (2003).
2. COMM. ON QUALITY HEALTH CARE IN AM., INST OF MED., TO ERR IS HUMAN 26 (Linda T. Kohn et al. eds., 2000)
3. (citing Eric J. Thomas et al., Costs of Medical Injuries in Utah and Colorado, 36 INQUIRY 255, 255-64 (1999)).
4. AM. ASS'N OF FAMILY PRACTITIONERS, 2005 FACTS ABOUT FAMILY MEDICINE tbl. 93 (2005), available at http://www.aafp.org/x530.xml#x733.
5. Mike Norbut, Primary Care Physicians Are Caught in Productivity Squeeze, AMEDNEWS.COM, Sept. 20, 2004, at http://www.ama-assn.org/amednews/site/free/ bil10920.htm.
6. MERRITT, HAWKINS & ASSOCS., SUMMARY REPORT: 2004 REVIEW OF PHYSICIAN RECRUITMENT INCENTIVES 3-4, available at http://www.merritthawkins.com/pdf/ mha2004incentivesurv.pdf (last visited Aug. 14, 2005).
7. John Edwards, Juries: "Democracy in Action," NEWSWEEK, Dec. 15, 2003, at 53, available at http://msnbc.msn.com/id/3660763/;
8. Charles Hurt, Edwards' Malpractice Suits Leave Bitter Taste, WASH. TIMES, Aug. 16, 2004, at A1, available at http://www.washingtontimes.com/national/ 20040816-011234-1949r.htm.
9. FED. R. CIV. P. 11(c)(2).
10. MODEL CODE OF PROF'L RESPONSIBILITY EC 7-4 (1980).
11. 29 Fed. R. Serv. 3d 914 (E.D. Pa. 1994).
12. Id.
13. 261 F.3d 1075 (11th Cir. 2001).
14. News Release, Coy Knobel, Enzi Seeks Justice for Patients and Healthcare Providers (July 31, 2003), available at http://enzi.senate.gov/jus4pat.htm.
15. See John Wennberg & Allen Gittelsohn, Small Area Variation in Health Care Delivery: A Population-Based Health Information System Can Guide Planning and Regulatory Decision-Making, 182 SCIENCE 1102 (1973).
16. See Evidence-Based Med. Working Group, Evidence-Based Medicine; A New Approach to Teaching the Practice of Medicine, 268 J.A.M.A. 2420 (1992) (discussion of how examining evidence from clinical research is the "way of the future" and a "paradigm shift").
17. David M. Studdert & Troyen A. Brennan, Toward a Workable Model of "No-Fault" Compensation for Medical Injury in the United States, 27 AM. J.L. & MED. 225, 228 (2001).
18. See Randall R. Bovbjerg & Frank A. Sloan, No-Fault for Medical Injury: Theory and Evidence, 67 U. CIN. L. REV. 53, 72-73 (1998) (stating "no-fault by design normally omits large tort benefit, namely for non-pecuniary loss," and "may also provide for lower attorneys' fees than are customary in tort"). The overhead cost of delivering no-fault compensation is very low, especially for attorneys' fees on both sides. Id. at 121.
19. See Catherine T. Struve, Improving the Medical Malpractice Litigation Process, 23 HEALTH AFF. 33, 37 (2004) (discussing proposals for the formation of medical courts to hear medical liability claims).
20. See generally Russell M. Pelton, Medical Societies' Self-Policing of Unprofessional Expert Testimony, 13 ANNALS HEALTH L. 549, 550 (2004) (discussing "physicians who take the stand as expert witnesses and knowingly mistate or misrepresent their expertise, or knowingly misstate the standard of care").
21. Maxwell J. Mehlman, Quackery, AM. J.L. & MED. (forthcoming).
22. See, e.g., Scott E. Maizel, Time for a Change, BALT. SUN, Jan. 21, 2004, at 17A (stating the "current medical malpractice system treats health care as a potential lottery for dissatisfied patients").
23. See, e.g., Neil K. Komesar, Injuries and Institutions: Tort Reform, Tort Theory, and Beyond, 65 N.Y.U. L. REV. 23, 58-59 (1990) (advocating compensation for nonpecuniary losses as an effective means of injury prevention, but acknowledging the inclusion of nonpecuniary losses in tort awards may allow "too much insurance").
24. WhiteHouse.gov, Medical Liability: A Framework for Addressing the Medical Liability Crisis, at http://www.whitehouse.gov/infocus/medicalliability (last visited Aug. 12, 2005).
25. See, e.g., Gary T. Schwartz, A National Health Care Program: What Its Effect Would Be on American Tort Law and Malpractice Law, 79 CORNELL L. REV. 1339, 1341-42 (1994).
26. See Michelle M. Mello & Troyen A. Brennan, Deterrence of Medical Errors: Theory and Evidence for Malpractice Reform, 80 TEX. L. REV. 1595, 1603-06 (2002).
27. See Barry R. Furrow, The Problem of Medical Misadventures: A Review of E. Haavi Morreim's Holding Health Care Accountable, 29 J.L. MED. & ETHICS 381, 384-86 (2001).
28. See Donald J. Palmisano, Why Your Doctor Might Quit, SATURDAY EVENING POST, Nov. 1, 2004, at 50, 86 (stating "the AMA sees a clear need to stop the shame-and-blame mentality");
29. see also News Release, Mass. Med. Soc'y, Massachusetts Medical Society President Cites Professional Liability, Medicare Reform as Biggest Issues Facing Massachusetts Physicians (Nov. 7, 2003), avilable at http://www.massmed.org/AM/ Template.cfm?Section=Home&CONTENTID=10099&TEMPLATE=/CM/ContentDisplay. cfm (quoting Thomas E. Sullivan, M.D., president of the Massachusetts Medical Society, stating the tort system "needs to move away from the 'shame and blame system' of today");
30. Press Release, Am. Health Lawyers Ass'n, Report Examines Medical Errors Debate (Nov. 17, 2003), available at http://www.healthlawyers.org/Template.cfm? Section=Press_Releases1&CONTENTID=2884&TEMPLATE=/ContentManagement/ ContentDisplay.cfm (stating in Attachment A that a 24-member colloquium panel agreed "there is a need for a change away from the current culture of 'shame and blame' in reporting adverse medical events");
31. James H. Herndon, Advancing Patient Safety: Changing the Culture in Orthopaedics, AAOS BULL., June 2003, at 37, 37, available at http://www.aaos.org/wordhtml/bulletin/jun03/acdnws1.htm (citing need to change the culture of medical practice from "'shame and blame' atmosphere");
32. Press Release, Bill Frist, U.S. Senator (R. Tenn.), Introduction of the Patient Safety and Quality Improvement Act (June 3, 2002), available at http://frist.senate.gov/index.cfm?FuseAction=PressReleases.Detail& PressRelease_id=1191&Month=6&Year=2002 (calling on Congress to change "the health care culture from 'name, shame, and blame' to a culture of safety and continuous quality improvement").
33. See James Q. Whitman, What Is Wrong with Inflicting Shame Sanctions?, 107 YALE L.J. 1055, 1055 (1998);
34. Toni M. Massaro, The Meaning of Shame: Implications for Legal Reform, 3 PSYCHOL. PUB. POL'Y & L. 645, 678-82 (1997).
35. Massaro, supra note 27, at 689-92;
36. Whitman, supra note 27, at 1060-61.
37. For a review of the debate, see David A. Skeel, Jr., Symposium - Norms & Corporate Law: Shaming in Corporate Law, 149 U. PA. L. REV. 1811, 1815-21 (2001).
38. Alex Geisinger, A Group Identity Theory of Social Norms and Its Implications, 78 TUL. L. REV. 605, 649 (2004).
39. All professionals are likely to perceive that they are being accused of incompetence rather than just of making a mistake when a malpractice claim is asserted against them. The sense that this is overkill may explain, in part, why judges are reluctant to sanction attorneys for filing frivolous lawsuits. Physicians and other health care professionals are unique, however, in that their malpractice victims typically suffer significant physical injury.
40. Gail Garfinkel Weiss, You've Been Sued. There's Help, MED. ECON., Feb. 7, 2003, at 56, 59, available at http://www.medicaleconomics.com/memag/article/ articleDetail.jsp?id=111267.
41. Id. at 56.
42. LOUISE ANDREW & JOHN-HENRY PFIFFERLING, MANAGING MEDICAL MALPRACTICE STRESS 1 (2003), available at http://www.magmutual.com/risk/malpractice-stress1. html.
43. Id.
44. Striving for Perfection and Predictability, ADA COMMUNITY BRIEF (Am. Dental Ass'n, Chicago, Ill.), Nov. 2004, at 4, available at http://www.ada.org/ prof/resources/pubs/epubs/brief/brief_0411.pdf.
45. Chantal M.L.R. Brazeau, Coping with the Stress of Being Sued, 8 FAM. PRAC. MGMT. 41, 41-44 (2001), available at http://www.aafp.org/fpm/20010500/ 41copi.pdf.
46. ANDREW & PFIFFERLING, supra note 34.
47. Mark Crane, The Godfather of Patient Safety Sees Progress, MED. ECON., Aug. 8, 2003, at 29, 33, available at http://www.medicaleconomics.com/memag/ article/articleDetail.jsp?id=112473.
48. Weiss, supra note 32.
49. See Cheryl Clark, Doctors Focus on Curbing Mistakes, SAN DIEGO UNION-TRIB., Mar. 19, 2005, at B2, available at http://www.signonsandiego.com/ uniontrib/20050319/news_7m19errors.html (quoting Dr. Lucien Leape, calling for creation of "blame-free network to report medical errors");
50. see also VIRGINIA A. SHARPE, HASTINGS CTR., PROMOTING PATIENT SAFETY: AN ETHICAL BASIS FOR POLICY DELIBERATION (2003), which states: If as safety experts both within and outside medicine maintain, it is flaws in the system, rather than in individual character and performance, that produce the vast majority of preventable errors - a premise this essay accepts - then the dominant strategy of blaming individuals will continue to be ineffectual and counterproductive in improving safety.
51. Id. at S6;
52. Frist, supra note 26;
53. Bryan A. Liang, The Adverse Event of Unaddressed Medical Error: Identifying and Filling the Hole in the Health-Care and Legal Systems, 29 J.L. MED. & ETHICS 346, 347 (2001) ("the fundamental systems-based nature of error and its successful reduction clearly indicate that individually criented shame-and-blame mechanisms are antithetical to and ineffective in reducing error").
54. COMM. ON RAPID ADVANCE DEMONSTRATION PROJECTS: HEALTH CARE FIN. & DELIVERY SYS., INST. OF MED., FOSTERING RAPID ADVANCES IN HEALTH CARE: LEARNING FROM SYSTEM DEMONSTRATIONS 81-90 (2002).
55. See Donald M. Berwick, Continuous Quality Improvement as an Ideal in Health Care, 320 NEW ENG. J. MED. 53, 53-56 (1989) (advocating use of the Theory of Continuous Improvement in health care).
56. See WASH. REV. CODE ANN. § 5.66.010(1) (West Supp. 2005). Other states include: Arizona (S.B. 1036, 47th Leg., 1st Sess. (AZ. 2005)); California (CAL. EVID. CODE § 1160 (West Supp. 2005)); Colorado (COLO. REV. STAT. ANN. § 13-25-135(1) (West 2005)); Florida (FLA. STAT. ANN. § 90.4026(2) (West Supp. 2005), Georgia (GA. CODE ANN. § 24-3-37.1(c) (Supp. 2005)); Illinois (S.B. 475, 94th Gen. Assem. Reg. Sess. (Ill. 2005)); Maryland (H.R. 114, 2005 Gen. Assem., 419th Reg. Sess. (Md. 2005)), Massachusetts (MASS. GEN. LAWS ANN. ch. 233, § 23D (West 2000); Missouri (H.R. 393, 93d Gen. Assem., 1st Reg. Sess. (Mo. 2005)); Ohio (OHIO REV. CODE ANN. § 2317.43(A) (West Supp. 2005)); Oklahoma (OKLA. STAT. ANN. tit. 63, § 1-1708.1H(A) (West, Westlaw through 2005 Reg. Sess.)); Texas (TEX. CIV. PRAC. & REM. CODE ANN. § 18.061(c) (Vernon, Westlaw through 2005 Reg. Sess. 79th Leg.)); Virginia (VA. CODE ANN. § 8.01-581.20:1 (West Supp. 2005)); West Virginia (W. VA. CODE ANN. § 55-7-11a(b)(1) (LexisNexis Supp. 2005)); and Wyoming (WYO. STAT. ANN. § 1-1-130(a) (West, Westlaw through 2004 Sp. Sess. 57th Leg.)).
57. Jeffrey O'Connell, Offers that Can't Be Refused: Foreclosure of Personal Injury Claims by Defendants' Prompt Tender of Claimants' Net Economic Losses, 77 NW. U. L. REV. 589, 601-04 (1982).
58. See James F. Blumstein et al., Beyond Tort Reform: Developing Better Tools for Assessing Damages for Personal Injury, 8 YALE J. ON REG. 171, 177-88 (1991);
59. Randall R. Bovbjerg et al., Valuing Life and Limb in Tort: Scheduling "Pain and Suffering," 83 NW. U. L. REV. 908 (1989).
60. See Studdert & Brennan, supra note 20, at 228;
61. see generally William G. Johnson et al., The Economic Consequences of Medical Injuries: Implications for a No-Fault Insurance Plan, 267 J.A.M.A. 2487 (1992) (discussing the costs of implementing a no-fault insurance plan, including its characteristic "compensation for nonnegligent as well as negligent injuries that are due to medical care in hospitals").
62. Another example might be physicians who make, and seek to cover up, patterns of errors that denote true incompetence.
63. Wickline v. State, 192 Cal. App. 3d 1630 (Cal. Ct. App. 1986).
64. See Wilson v. Blue Cross of S. Cal., 271 Cal. Rptr. 876 (Cal. Ct. App. 1990) (holding under similar circumstances, the third-party payer also could be found liable).
65. Wickline, 239 Cal. Rptr. at 815.
66. Mello & Brennan, supra note 24, at 1635-36.
67. This could obviate the need for controversial punitive damages.
68. See, e.g., Richard C. Henke, Workers' Compensation in New Jersey: Toward a Removal of Workers from the Sacrificial Altar of Production Quotas, 56 RUTGERS L. REV. 789, 792-96 (2004).
69. 530 U.S. 211 (2000).
70. Id. at 235.
71. 739 N.E.2d 496 (Ill. 2000).