I totally disagree, DK. I used to do medical malpractice cases (representing the doctors). As Dr. Bill says, most of the people who pursue these are fueled by emotions and other issues than strictly medical acts. If the doctor did not communicate with them, in their opinion, if the doctor had no "bedside manner" and was abrupt, or they simply did not like being told that their options were limited (often due to problems of their own making - drug abuse, alcoholism, overweight, etc.), these were the cases most likely to have complaints filed.
What this will end up doing is to make it so that doctors simply will refuse to take patients who are "risky," and those patients will end up dying or becoming very ill. Let me give you a real example of how bad this can be. One doctor specialized in emergency room operations using transfusions consisting of the "fake blood" that was the only thing that certain religious groups would consider, and even then, they did not want a transfusion usually.
You get a parent who has a 5 year old hit and severely injured in an automobile accident. The child has nearly bled out before he reaches the hospital, and the only way on earth his life can be saved is through an operation to repair internal organs that are lacerated and bleeding out. He's got approximately 45 minutes to live. But before the oepration can be done, the child asolutely, positively MUST have a transfusion, or he will die for certain on the operating table, and there will be NO chance of him surviving with or without the operation.
The parents fret and pace and debate religious issues of the transfusion. They call their local religious leader. They eat up the time as their child is bleeding to death. They are struggling to overcome very deeply held religious beliefs that go to the core of everything they believe and have always practiced. But they know that if they do not overcome these issues, and go for the transfusion, they are guaranteeing their child's death.
So in the last 5 or 10 minutes of the 45 minute window of opportunity, they reluctantly sign the paperwork for the procedures to be done to give the transfusion (of fake blood, not even the real blood) and operate on the child.
Although the medical crew is standing by, and they rush the child in the very second the signatures are complete, the child is too far gone at that point due to the delays, and he either dies, or he lives, but has some other substantial problem from the deprivation of blood. Maybe he has stroked and their is now brain damage. None of this would likely have occurred had the parents given immediate consent when they were first asked to. But now they end up suing the doctor, the hospital, and everyone involved.
Although this is an example, this is a real issue that came up repeatedly with certain doctors who were the only ones willing to risk their malpractice insurance, to take those last-second surgery candidates. The doctor in the case I'm talking about was an outstanding surgeon in all other respects, and did a consistently great job when he was not handicapped by a refusal of others to allow him the tools necessary to do his job. But in a goodly percentage of these absolute last-second approvals for transfusions and blood, the patients were too far gone by the time the decision was made, and they did not pull through, despite heroic measures by the doctor and hospital staff.
Would you have doctors refuse to take on patients who are risky, for fear they will lose their license? Whom does that benefit? Certainly not the patients whose lives he did save. And it was no fault of his that the decisions in the other cases were made so very late in the time alloted for survival.
Yet, emotions run high in the death of a child or famly member. And in these cases, there is the added issue of how the family feels regret over having broken religious prohibitions in their final effort to save the child. People are cruel and unthinking sometimes, and the advice often given in these cases, by laypersons, is that the child's life or death is in God's hands, and the parents//family should just let that be. Would you? Could you if it was your child? And what right does anyone have to criticize a parent who does their utmost to save the child? But that is exactly what happened, and that fueled a lot of the decisions to sue.
There are procedures already in place to remove a truly bad doctor. Records are available to check on the performace of doctors. This is seemingly the recipe for a disaster in the making, penalizing any doctor who takes on more than the best candidates for surgery. I don't know about you, but I don't want myself or my loved one to be on the table in emergency, and have all the doctors back away from a needed operation due to their own financial considerations.
If we apply the same rules here, would this extend to MASH units? Think of Vietnam or any area of heavy combat and injuries/casualties. Do we remove any doctor who loses three patients, or who has a complaint against them, or do we go with the choice of saving lives wherever and as best we can?