Medicine, wherever it is practiced, involves heavy things that are not for the faint of heart. Outcomes sometimes involve death, and errors are not always (or often) easy to spot. Poor outcomes can haunt doctors and nurses both professionally and personally – almost as much as they can haunt the families of patients. Nonetheless, in the United States, no comprehensive system exists to monitor medical errors. As Ofri details in this well-written and timely book, this situation neither provides justice to the needs of patients and their families nor allows the medical system to learn from its mistakes.
This book probes two medical cases that were particularly error-filled. One involved a patient with leukemia, a form of cancer, and the other involved a patient whose case was clearly mismanaged at several points. Errors accumulated in each case, and each was met with silence and obfuscation by the medical establishment. At the outset, positive outcomes were not guaranteed, but compounding errors guaranteed horrific outcomes involving death. Families of both patients sought corrective measures for the causative systemic problems, but despite noble intentions and proper efforts, neither family were successful.
Ofri holds the Danish medical system as an example. In this small country, parliament passed a Patient Safety Act of 2005 to set up a system that judges and potentially compensates patients for negative outcomes. Gone were the excesses of legal case and drama of the courtroom; also gone were the huge settlements for hyperbolic cases. In its place was something more equitable and more enlightened. Instead of requiring excessive, provable harm like death or permanent disability, the Danish system just required preponderance of the evidence for more mundane claims.
The author rightly questions whether such a system could ever succeed in the United States. For one, we are more brashly capitalistic and individualistic than Denmark. Further, our country is much larger and more diverse. We also have a long and deep suspicion of centralized medical data collection. But the Danish system simply seems fairer and more just to both parties. In it, the doctor-patient relationship never transforms into an adversarial duel filled with legal tactics. Medicine at its best aims to be humane; doesn’t this system better fit that ethos?
This work can find an obvious home among American healthcare workers, whether doctors, hospital administrators, or nurses. Particularly those with patient contact should attend to Ofri’s clear message. Policymakers and administrators of public health might also want to give this one a read because of obvious import into government. Ofri’s call may yet be a bit early for legislation to be passed, but my experiences concur that it needs to be heard. It deserves to be on the radar for public health advocates once the challenges of COVID dissipate. I’m glad that I found and read this book.
When We Do Harm: A Doctor Confronts Medical Error
By Danielle Ofri
Copyright (c) 2020
Beacon Press
ISBN13 9780807037881
Page Count: 298
Genre: Medicine
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