Errors, Medicine and the Law

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Untoward injuries are unacceptably common in medical treatment, at times with tragic consequences for patients. The phrases ‘an epidemic of error’ and ‘the medical toll’ have been coined to describe this problem of ‘iatrogenic harm’, which it has been suggested may have contributed to 98,000 deaths per year in the US. Some of these incidents are the result of negligence on the part of doctors, but more usually they are no more than inevitable concomitants of the complexity of modern healthcare. This book is fundamentally about distinguishing the former from the latter. Although medicine is used as the book’s primary example, the points made apply equally to aviation, industrial activities, and many other fields of human endeavour. The book advocates a more informed alternative to the blaming culture which has increasingly come to dominate our response to accidents, whether in the medical field or elsewhere.
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Editorial Reviews

From The Critics
British Medical Journal
[A] superb book … Merry and McCall Smith are not simply out to protect doctors: their central thesis is that many ‘negligent’ incidents should not attract blame, but they also support reporting systems because ‘there are too many medical accidents’ … I do know some people who should be forced to read Errors, Medicine and the Law.
Jane Wright
Errors, Medicine and the Law is a most timely contribution to the enduring debate about how society should respond to accidents in general, and medical accidents in particular ... This is a highly readable, accessible text that should be read by all those who are interested in the compensation debate, and the field of tort law in particular.
Web Journal of Current Legal Issues
British Journal of Surgery
It is written in exemplary English by a cardiac anaesthetist (A. Merry) and a professor of medical law (A. McCall Smith), and must surely be of interest to anyone practising at the ‘sharp end’ of medicine.
Journal of the Medical Protection Society
This is a book that will interest those who have concerns that errors occurring in medicine are too often equated with negligence … The major goal of the book is to seek a fundamental re-evaluation of the way in which we think about accidents and blame, and for this it must be applauded.
Medical Law Review
Errors, Medicine and the Law is the latest contribution to eschew the individual blame mentality in favour of a systems analysis approach. Reflecting the interdisciplinary nature of the topic under review, the authors, a cardiac anesthetist and a professor of medical law, draw from a wide range of literatures. As they remark, ‘error events’ are a global problem occurring in a number of different settings. The result is a book that will interest, amongst others, lawyers, medics, psychologists, and sociologists.
From The Critics
Merry (a cardiac anesthetist) and Smith (medical law, U. of Edinburgh) study medical "mishaps": how they occur, and how people are blamed for them. They argue that injury during health care frequently reflects institutional failures or unavoidable human error rather than individual moral culpability. Blaming physicians, they write, "may simply leave the scene set for a recurrence of the same tragedy. ... This book is as much about understanding when blame is appropriate as about knowing when it is not. It has at its center concern for the patients who are injured, but (also) makes the point that some doctors, by unwittingly contributing to such injury, become victims themselves"—and so does the health care system, as lawsuits run rampant. Annotation c. Book News, Inc., Portland, OR (
From the Publisher
"A comprehensive exploration of the science of errors applied to healthcare..." Journal of Perinatal & Neonatal Nursing
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Product Details

  • ISBN-13: 9780521000888
  • Publisher: Cambridge University Press
  • Publication date: 6/28/2008
  • Edition description: New Edition
  • Pages: 264
  • Sales rank: 1,445,664
  • Product dimensions: 5.98 (w) x 8.98 (h) x 0.59 (d)

Meet the Author

Alan Merry is a practising cardiac anaesthetist, whose research focuses on safety, and in particular, on reducing error, in anaesthesia. He was the co-founder and co-chair of the New Zealand Medical Law Reform Group, which contributed to the passing of the Crimes Amendment Act 1997 which redefined the threshold for criminal prosecution arising from negligently caused harm in New Zealand. He is author of a number of papers in medical and legal journals. He has developed a computer-based systems approach to reducing drug administration in anaesthesia (the IDAS) which applies many of the principles discussed in this book, and which is in use in several Auckland hospitals.

Alexander McCall Smith has been involved in medico-legal issues for more than twenty years. He has lectured on the subject at universities throughout the world. He is the Vice-Chairman of the Human Genetics Commission of the United Kingdom, a member of the International Bioethics Committee of UNESCO, and the Chairman of the Ethics Committee of the British Medical Journal. He is the author of a number of books in the areas of medical law and criminal law, including Law and Medical Ethics (with J. K. Mason), which is now in its fifth edition.

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Table of Contents

Introduction 1
1 Accidents 6
2 The human factor 41
3 Errors 72
4 Violations 98
5 Negligence, recklessness and blame 127
6 The standard of care 152
7 Assessing the standard - the role of the expert witness 176
8 Beyond blame: responding to the needs of the injured 204
Conclusion 241
Index 249
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