Personal Injury Lessons: Acountability

January 27, 2011

The recent shooting tragedy in Tucson, Arizona has sparked a national dialogue on how political discourse is conducted in the United States. Some thought that the murder of a federal judge and attempted assassination of a moderate Democratic congresswoman might be linked to some right-wing anti-government sentiment. Others pointed out that we should not jump to conclusions without really knowing anything of the motivations of the alleged shooter. Mr. Loughner, it now seems, was simply insane. He was anti-government to be sure, but his bizarre, disconnected ideas cannot be fairly attributed to, say, Sarah Palin's infamous cross-hairs.

Nevertheless, many agreed with the comments made by Sheriff Dupnik, when he said that extremism and intolerance had gotten out of hand. People remembered when Ms. Palin called Mr. Obama an associate of terrorists who hated America, prompting some in her audiences to shout back, “kill him!” Then, there were those spooky men who have started showing up at political events with firearms and signs stating how the ground of liberty needs to be watered, occasionally, with the blood of tyrants. (They were not referring to King George.) Finally, everyone remembers when the healthcare debate was stultified by hysterical claims of “death panels” to euthanize the elderly.

So, even though the alleged shooter, Mr. Loughner, may have just been a troubled man, and nothing more, Sheriff Dupnik's point still stands because, first, even if the Tucson shooter was not acting pursuant to some politically manufactured hysteria, that doesn't mean that there aren't troubled individuals who might so act in the future, and, second, the threat of potential violence aside, irresponsible, inflammatory rhetoric is undoubtedly making it difficult for us to rationally debate important policies.

Take, for example, the healthcare debate. Many Republicans, and some Democrats, believe that some sort of protection for doctors from medical malpractice suits is necessary to keep medical costs down. Huge amounts of money, it is contended, have been awarded to people claiming they have been harmed by medical negligence. This not only poses a direct cost to the healthcare system , but also has a significant indirect cost because it forces doctors to practice “defensive” medicine whereby doctors order expensive, unnecessary diagnostic tests and other procedures to protect themselves against lawsuits.

Democrats have opposed “tort-reform” proposals that limit or completely protect doctors and hospitals from malpractice litigation. Medical negligence, including things like minsdiagnosises, botched surgeries, medication errors, and emergency room malpractice is, they argue, widespread, and the threat of litigation is an important deterrent to the provision of substandard care, or to the credoentialling of incompetent doctors by hospitals. Moreover, there is a basic fairness, Democrats argue, to requiring that doctors bear the costs imposed on individuals and society by treatment which falls below the professions standard of care. Would it be better to place the financial burden on the innocent patients, or the taxpayers, who might get stuck holding the bill? And, as for the issue of “defensive” medicine, how many doctors would really admit that they order useless and unnecessary tests for their patients?

But there was no meaningful discussion of these issues during the healthcare debate because there were no meaningful discussion between the parties at all.

These are all important questions which must be analyzed, if not dispassionately, then, at least with some reason. And how is that possible if people are too frightened of “socialism,” and “death panels” to to even consider things like, well, you know, facts and figures. People really ought to think about that because, at some point in time, they will find themselves trusting their life, or the life of someone dear to them, to the care of doctors.
Can the medical profession be trusted to just police itself? If the court system is allowed to place only some limited value on the pain, disfigurement, disability, or even death, of those harmed by negligent treatment, will the medical profession then use this limited value when making decisions over our lives and deaths?

Maybe we should take this opportunity to reflect upon the importance of things like civility, rationality, fairness, and respect in our political discussions, because the future victims of our inability to talk to each other could be . . . us.