Tuesday, June 15, 2010

Medical Tort Reform and Repentence -- D&C 58: 43

"By this ye may know if a man repenteth of his sins—behold, he will confess them and forsake them."(D&C 58: 43)

Usually, when we talk about repentance, we're referring to individual sins (as in the scripture above). Sometimes, we might even forget that those aren't the only kind of sins: the Doctrine and Covenants, for example, frequently warns listeners to leave the sins of their generation. If a whole generation can sin, can't a company, a government, or even an entire profession?

Let's consider medical malpractice. Our mortal bodies are sacred, and it's probably safe to say that it's in some small way, least, sinful for a doctor or nurse to be careless in treating them. Sinful especially in the sense of being something no good doctor really wants to do, although habits, time constraints, etc. mean that doctors, like all people, don't always live up to the standard of conduct they want. There's a good case to be made that most malpractice, in fact, doesn't come from "bad" doctors, but from normal doctors failing to perform as well as they'd like under normal conditions.

Currently, the legal remedy for a doctor who makes a mistake with serious consequences is to take that doctor to civil court, preferably for a jury trial. If the effect of the mistake has been particularly tragic, the jury tends to award large amounts of money to the patient. This, it is assumed, will teach the doctor a lesson, and he/she will pay better attention next time. In essence, our legal system for medical malpractice is effective if and only if stiffer punishments invariably lead to better repentance.

I don't think that's the case. I have an easier time imagining that stiffer punishments encourage hiding one's sins or refusing to accept accountability for one's sins. What if, instead of focusing so exclusively on compensation for the families who are harmed, we put some sort of upper limit on medical malpractice awards, and focused more energy instead on changing habits and conditions for doctors' next patients? Doctors already meet regularly in most hospitals to talk about recent events and how to improve practice. What if malpractice trials devoted attention to what could be done in the future to decrease the overall incidence of a given accident?

That would certainly make it easier for doctors to quickly and fully confess their "sins," instead of having strong financial motivation to hide them. It might also make it easier for doctors, collectively, to forsake a given pattern of error by having freer access to the relevant data.

Would capping damages in medical malpractice cases actually serve to promote collective repentance?

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