Compensation for injury?

Abstract

In Seymour Ochsner’s American Roentgen Ray Society address [1], he makes one point which I consider fallacious. Because it comes from one of the giants of American radiology and appears in a widely circulated and highly reputable professional journal. it could even be considered dangerous. I feel compelled to take issue with him publicly to avoid having his remark construed as being in harmony with the mainstream of contemporary medical thought. Ochsner stated, “Some mishaps will inevitably occur in the practice of radiology. There seems to be an irreducible minimum even when the radiologist is well educated, the department well equipped, and the procedure well conducted. If the patient is damaged. it is logical that a reasonable award be made in settIement ’ The implication is clear. In the event of injury incurred in the course of medical treatment, whatever the cause, with or without malpractice, the patient has a right to compensation. I fail to see the logic. Who is to pay the “reasonable award” in the event of injury? The state (i.e., the people)? Why? They have done no wrong. The physician? Why? In the absence of malpractice, the physician had done no wrong. The insurance company? Why? It is contracted to cover malpractice risk. not to indemnify every patient who suffers injury. (Can you imagine the premium schedule of the insurance company providing such coverage?) The desire to compensate the injured is prompted by a sense of compassion and to that extent is commendable, but an award for damage implies guilt. If the physician is guilty of nothing, why should he pay? In the final analysis, even compassion must be leavened with justice. Otherwise the magistrate who decides that the patient be indemnified takes upon himself the role of a Robin Hood. His ultimate concern becomes the arbitrary redistribution of wealth rather than the dispensation of justice. Let us take a moment to analyze a parallel situation. You and I live in adjacent homes. Between our houses but on my property there stands a huge and stately oak tree. By chance a windstorm arises severe enough to topple the oak which falls toward your house, crushing the bedroom wing, a crib, and your newborn child. Who is guilty? No one. Who pays? No one. Is the story tragic? Indeed it is. Does it arouse compassion? If not. it should! Tragedy and injury are sometimes acts of God. As such they cannot be tied to the payment of a “reasonable award ’