A law to encourage reporting mistakes; organs are for donating, not for sale; a malpractice defendant's best revenge
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Consultant and neurologist Michael S. Smith has drawn some intriguing parallels between the causes of medical mistakes and pilot error. In his article "Medical errors: Lessons from aviation" [June 18], he proposes a medical safety reporting system similar to the one the Federal Aviation Administration has established to report adverse aviation incidents.
Your readers should be aware that legislation for such a systemthe Patient Safety and Quality Improvement Actpassed in the House of Representatives more than a year ago, by a lopsided 418 to 6 vote. Its purpose is to create a conduit for sharing information or concerns about medical errors confidentially and without fear of litigation. Unfortunately, lobbying efforts of trial attorneys have held up this bill in the Senate. We need physicians and their professional societies to contact their senators to support passage of the Senate version of this billS. 720before the end of this year's term.
I read with horror Pius Kamau's letter to the editor, "Legalizing the sale of human organs" [June 18]. Particularly disturbing was his argument that more organs would be available for transplant "if we could get over our queasy sentiments about organ procurement and make organ sale legal." I am glad our consciences make us queasy!
If selling organs for cash were legal, it could easily coerce the most vulnerable members of society to do so. Envision these scenarios:
A loan officer calls a creditor for an overdue payment and suggests, "Why don't you sell a kidney to pay off your loan?" Or even worse, "I don't see any other option for you but to sell an organ."
An uninsured hospital patient needs to work out a payment schedule for his bill. The finance officer presents a "responsible and viable" means to reduce or satisfy the outstanding bill: participation in the hospital's organ transplant program.
By proposing that conscience be overridden for the good of the organ procurement program, Kamau raises the age-old question: Is conscience directed by the mindless process of evolution and subject to change according to the needs of society? Or is it directed by the Creator to find each human being unique and special, not to be sold as parts?
What sort of organ transplant program do we wantone that pressures the financially vulnerable with cash incentives, or one that encourages the show of kindness through a loving, voluntary gift of organ donation?
I understand how upset ob/gyn Patricia I. Carney was when her character, integrity, and reputation were attacked in a malpractice lawsuit ["Malpractice: Our system lives on personal attacks," May 7].
In 39 years of practice, I have been the defendant in two malpractice cases in which I was similarly mistreated, and I suffered like Carney. However, in both trials, the juries found unanimously in my favor.
If you find yourself in this situation, here's something that may help you on the stand to stiffen your back and put up with the abuse: Remember that most plaintiffs' attorneys take their cases on a contingency basis. That means that when they loseafter months of time, effort, and expense on their partthey end up with nothing. Keep in mind that if only we can beat them, they go home and have to pay the bill themselves. That's probably the best revenge we can get in the current court system.
Stanley E. Rosenberg, MD
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Letters to the Editors.
Sep. 3, 2004;81:9.