Understanding the anatomy of a malpractice suit. In the United States this is a doctor’s best defence

In the United States, the majority of physicians have been sued and those who have not, will be. Defendants share the notion that the lawsuit is totally fallacious. To be fallacious, the outcome of a medical intervention must be an unpreventable random maloccurrence. This is the only alternative to a medical error. The conflict over outcomes that are random and outcomes that are medical errors results in 46,000 malpractice suits every year in the USA. The burden of proof is a preponderance of evidence, but this is insufficient to do more than just infer, not prove, a relationship between the medical intervention and the outcome. Plaintiffs, generally, prove a malpractice case using inductive reasoning. Inductive reasoning leaves much to intuition. They use inductive reasoning because, by definition, preponderance of evidence, also, leaves much to intuition. Deductive reasoning is objective and there is no place for intuition. With deductive reasoning, the burden of proof is now sufficient to distinguish whether or not the cause relates to the effect with 95% confidence. A model for deductive reasoning in malpractice which is completely consistent with the scientific method is presented. This should and would derail frivolous lawsuits.

Practicing Defensive Medicine Benefits No one

Background: More doctors are practising defensive medicine, which may have an impact on patient care. This paper explores the consequences and reasons, for the widespread trend, and recommendations for patient-focused clinical care. Objective: A malpractice suit is the most scarring ordeal that a physician can undergo emotionally and financially. Excessive investigations may be counterproductive. Avoiding certain procedures or patients, for the fear of adverse outcome can be hazardous. There is a need for a better, discerning and judicious system, to minimise the trauma to the largely conscientious and dedicated medical professionals. Discussion How and when the term defensive medicine started, is difficult to trace. However, over the past few decades, it seems to be a well-known practice in industrialised countries. It may have been due to increasing complaints against doctors heralding potential litigation and malpractice suit. Most doctors do not take the privilege of the trust of their patients lightly and respond to it with utmost sincerity.

Sovereign immunity and its implications for neurosurgery

The proportion of neurosurgeons facing a malpractice suit each year is highest among all medical and surgical specialties. It is critical for neurosurgeons to understand local malpractice laws because they vary among states. Sovereign immunity, as described in the 11th constitutional amendment, provides absolute immunity to states from being sued by their residents and by other states. A state may waive its sovereign immunity, however, and substitute itself as the defendant in place of a state-employed physician in the court of law. This means that a physician working for a state-funded hospital may not be liable to a malpractice suit. Further provisions of the law allow the state not to pay indemnity beyond a certain limit, which discourages plaintiff attorneys from pursuing indemnity charges against physicians working for state-funded institutions. In this review, the authors describe the concept of sovereign immunity and its implications for the practice of neurosurgery.