Our Hands Are Tied: Legal Tensions and Medical Ethics

By Marshall B. Kapp | Go to book overview

6
"A Dispirited Lot": Malpractice and What Else?

In an unprecedented move that paved the way for the consideration of similar policies in other states, the Massachusetts legislature in the summer of 1996 enacted legislation to give consumers easy access to data on every Massachusetts physician's malpractice awards, disciplinary actions by hospitals or medical boards, lawsuit settlements, and convictions for felonies or serious misdemeanors. To the majority of physicians there, publicizing their mistakes is just one more insult on top of what they perceive as managed care red tape, increasingly onerous insurance company and insurance purchaser scrutiny, and constant second-guessing from all sides. In a reaction typical of the state's medical profession, an internist in private practice for thirty-five years who is also a clinical professor of medicine complained, "We're a dispirited lot" ( Carton, 1996).

Many American physicians in the twilight of the twentieth century are professionally dissatisfied. Although physician comments about, or emanating from, this unhappiness frequently center on attorneys and the awful negative impact of the medical malpractice system on the quality of American medicine for both patients and practitioners, the psychological malaise that runs throughout much of the medical profession today springs from a considerably more complicated combination of sources. The health care system and the role of the physician in it, having undergone a massive but orderly evolution over most of our history ( Cassedy, 1991; Starr, 1982), has been swept up in a virtual revolution over the past decade and a half. This sea change in health care financing and delivery has created a whole slew of perceived ills.

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Our Hands Are Tied: Legal Tensions and Medical Ethics
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Preface ix
  • References xiv
  • Acknowledgments xv
  • 1 - Losing at the Lottery: Physician Perceptions of the Legal Environment 1
  • Notes 22
  • Notes 23
  • 2 - The Lawyer Made Me Do It: from Legal Perception to Medical Practice 27
  • Note 46
  • References 46
  • 3 - Risk Managers and Legal Counsel: Ethical Enablers or Paid Paranoids? 53
  • References 64
  • 4 - Doing Everything: Treating Legal Fears near the End of Life 65
  • Note 87
  • References 88
  • 5 - Who Is Responsible for This? Everyday Patient Intrusions to Protect the Provider 97
  • Note 118
  • References 118
  • 6 - A Dispirited Lot: Malpractice and What Else? 123
  • 7 - Reconciling Risk Management and Medical Ethics: Opportunities and Obstacles 141
  • References 164
  • Index 171
  • Bout the Author 177
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