In case you haven’t heard, The Unnecesarean recently ran a series of guest posts on the topic of Defensive Medicine. It is well worth a trip over to check out the posts. Start here at the beginning with Jill’s post Defending Ourselves Against Defensive Medicine and work your way through.
However, if you have time to read only one article of the series, might I suggest reading the brilliant Barbara Katz Rothman’s Who is defending whom from what? Katz Rothman links defensive medicine to socioeconomic class and access (or lack thereof) to money and healthcare. All of this, of course, is tied up together with our current medical culture that privileges some decisions and outcomes and medical heroism and others as, well, sue-able offenses. Add to that the complicated lens of risk, and we’re in a fine pickle now.
Just a taste:
In the United States especially —where each child is born into great and unending poverty unless lucky enough to be born to a parent willing and able to pull it out, where basic needs go unmet, where medical care for children with disabilities can wipe a family out financially, where medical bills are the leading cause of bankruptcy — a needy child inevitably necessitates a search for deep pockets. If I had a child who used a wheelchair, I’d want the best possible chair, and probably a sports-use chair besides; the best household adaptations money could buy; every imaginable object and service that would make that kid’s life better. And if I had to sue my mother to get it, why sue I would.
In a better kind of insurance system, people would be insured for need – if you have a very expensive kid, one who needs wheelchairs and ramps, expensive surgeries, long-term nursing care, or all of those, then those needs would be met. That is how universal health care coverage works in most of the world. But we have not got that kind of system, so instead, individuals have to sue. Private companies insure practitioners, and patients with unmet needs can sue practitioners who in some way failed them.