Yesterday, Dr. Conrad Murray, who administered the drug that led to pop icon Michael Jackson’s death, was found guilty of involuntary manslaughter and sentenced to four years in prison. Superior Court Judge Michael Pastor said Jackson died “because of the actions of and the failures to perform legal duties.” Deputy District Attorney David Walgren described Murray’s negligence as a key reason for Jackson’s death, including describing Murray’s administration of the anesthetic propofol to Jackson within his home setting as “reckless and inexcusable” because he lacked proper equipment in the event that Jackson stopped breathing (a common side effect of the drug), which is, in fact, exactly what happened.
This case is significant because it connects the moral problem of “negligence” within the medical profession to the legal description of “involuntary manslaughter.” Medical error is defined as “a preventable adverse event caused by the failure of an action to be completed or use of the wrong action that results in injury or death of a patient.” Identifying a mistake in medicine is not always easy, but often times it is evident, such as in worsened health or death. The complexity arises when we consider the skills of the doctor. Do medical errors occur because the doctor makes a careless mistake or the doctor lacks enough information to act and does so anyway? Perhaps the doctor was inadequately prepared yet was still licensed as a physician and thus acted with the best of his or her abilities and still faulted. Furthermore, a medical error implies that the mistake is “preventable,” implying that at least most other doctors in that position would have behaved differently.
Let’s take this discussion one step further from defining medical error and apply it to the legal field: is there a difference between purposeful and malicious mistakes in the eyes of the law? Should there be a difference? Is a mistake a mistake, one that takes a human life in particular, and therefore should be punished?
The Hastings Center estimates that medical errors take the lives of as many as 98,000 patients each year in the US alone. These preventable medical errors cost the nation $17 billion to $29 billion in health care, lost income, and other expenses. Today, however, patients and families seeking compensation for injuries due to medical errors are tending to shift away from law suits and tort recourse to other means of malpractice litigation. For example, one of the models that the Hastings Center purports is one developed by the University of Michigan, aptly named the “University of Michigan model”: “developed by the risk managers of the university’s health care system… [this model] has greatly reduced lawsuits and cut legal costs” by focusing on disclosure, apology and sympathy, and fair compensation before the patient even has the chance to take the issue to court.
On the other hand, there is also an increasing trend of doctors ordering unnecessary procedures and prescribing nonessential drugs out of fear of malpractice suits. This abuse of medical resources can also be seen as a medical error: prescribing an x-ray for a patient who does not need one in order to be safe increases the exposure of radiation to the patient. Furthermore, the time it takes for an unessential x-ray on that patient is time taken away from another patient who does need it; this could be justified as a medical error.
Medicine, and therefore the health and welfare of society, is benefited by a clearer understanding of medical error and a system that safeguards the ability of both patients and doctors to act to the best of their abilities.
By: Naomi Scheinerman
(Photo courtesy of WorkingNurse)