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by repolfx 2559 days ago
Not a malpractice lawyer here, but surely the answers to your question are somewhat obvious? Many countries don't have the same culture of suing doctors as the USA.

Having read this I honestly was left wondering whether malpractice should exist as a concept at all. Clearly several people screwed up with bad consequences here. But it seems like this isn't something the courts can fix.

For one, isn't it true that many (most?) doctors in the USA have malpractice insurance? Any lawsuit win against them doesn't make much personal financial difference, just increases medical costs for everyone else as the payment to the 'victim' (not the actual direct victim in this case) is just socialised and dispersed. Moreover the fact that insurance is sold at all suggests that malpractice claims are seen as being in some sense random and unavoidable risk events, not something that can actually be avoided by just being sensible.

For another, presumably the underlying logic of malpractice suits is to punish the underlying error in order to incentivise ... something ... that would prevent a recurrence. Is there any plausible, actionable outcome here which would prevent this type of repeated human error in future? One that that isn't counterbalanced by costs that would yield worse outcomes in other cases? If so, why are we so sure the courts are best placed to locate and enforce this vs the medical profession itself, which I believe already aims to save as many lives as possible?

In the software industry there are no malpractice suits. I can't believe it would benefit anything if there were: imagine if people could directly take devops staff at major web services to court anytime there was an outage because they made a thinko in a config file? Would this magically eliminate outages because everyone is now being super careful? Certainly not. People are already well incentivised to avoid mistakes. You'd just get malpractice insurance in the software industry too, and those costs would be passed on to employers in one form or another, so all that'd occur is random payouts to random people who happened to sweet-talk the court into perceiving "malpractice" vs ordinary mistakes and a whole lot of time spent on lawyers. I can't believe it'd actually impact software reliability in any meaningful way, and if it somehow did it'd probably only be by eliminating business models that were striking a reasonable risk/stability balance already (e.g. Twitter and Facebook in the early days prioritised moving fast and breaking things over absolute stability despite millions of people using their services).

5 comments

If you are a paying customer and you signed an SLA with a service provider, you absolutely could take them to court for not meeting their end of the uptime agreement. A business providing internet services to other businesses with SLAs would probably have some sort of insurance to cover that kind of situation.

The facility where the doctor works typically pays for the malpractice insurance. The facility is the one that also hires and fires doctors. Screw up too much and jack up the insurance premium, the facility might decide that you need your own coverage or they might just fire you. The hospital might try to increase prices to cover the increased premiums but that only works to an extent. Medical insurance companies make agreements with healthcare facilities as to what services and goods cost what. They aren't going to start to pay out more just because the doctors there are screw-ups.

I don't think I would feel comfortable in a country where I would have no legal recourse against a doctor that harmed me due to incompetence.

Would you host your app with a datacenter that says they will try their best not to have outages? Or would you rather use a datacenter that guarantees 99.671% uptime?

> For one, isn't it true that many (most?) doctors in the USA have malpractice insurance? Any lawsuit win against them doesn't make much personal financial difference, just increases medical costs for everyone else as the payment to the 'victim' (not the actual direct victim in this case) is just socialised and dispersed.

Let's say a doctor screws up and you end up having to do an extremely expensive procedure to fix that. Wouldn't winning a malpractice lawsuit allow you to cover those expenses? That's just one of the ways medical malpractice lawsuits make sense.

> For another, presumably the underlying logic of malpractice suits is to punish the underlying error in order to incentivise ... something ... that would prevent a recurrence. Is there any plausible, actionable outcome here which would prevent this type of repeated human error in future? One that that isn't counterbalanced by costs that would yield worse outcomes in other cases?

Honest question: what do you think is grounds for a medical malpractice lawsuit these days? As far as I've been able to figure out, it seems that there has to be some kind of relatively serious, provable negligence involved.

> If so, why are we so sure the courts are best placed to locate and enforce this vs the medical profession itself, which I believe already aims to save as many lives as possible?

I'm having a hard time addressing that idea, because your way of thinking is foreign to me. Look, we are talking about things that seriously screw up people's lives or even end them. To me, your idea of self-regulated medical profession sounds like proposing that, instead of suing the truck driver who ran over your kid, you should let his employer deal with him.

> In the software industry there are no malpractice suits.

Medicine and software industry are not the same thing.

> random people who happened to sweet-talk the court into perceiving "malpractice" vs ordinary mistakes

Well, there it is. You seem to believe that there is no such thing as malpractice, it's all just "ordinary mistakes" that just might end up killing people or screwing up their health permanently.

> Any lawsuit win against them doesn't make much personal financial difference, ...

Just ~like vehicle insurance, the rate goes up with more paid claims.

Malpractice is a form of tort law pertinent to 'professionals' https://en.wikipedia.org/wiki/Malpractice IIRC the acm would like to make programming a 'profession' along the lines of the professions open to malpractice suits and if that happened programmers could also be sued for malpractice.
Have you noticed very few doctors run private practices anymore? The excess litigation and cost of malpractice insurance is so high they can't afford it.

That's why they are all grouping, and usually even just under a hospital. It takes a huge group to be able to be able to get the leverage on insurance.