Her letters never offer any factual data and almost always suggest that doctors are the worst thing that ever happened to health care….I’ve long suspected that she works closely with ATLA or one of the fake “consumer” groups, as her letters most often appear at critical legislative times and often parrot whatever the ATLA propaganda of the day is at the time…

When do you want to be held responsible?

Absolutely do not agree with criminalization idea, but in regards to the above comment…it was my understanding that doctors can, in fact, end or refuse relationships with patients for no reason at all EXCEPT in emergent care. If such is the case, then no “rules” are needed…you already have the law’s permission to turn away anyone you wish.

In order for a “Crininal” standard to be applied in a ‘Japanese – like’ system we would have to have the legislature [ of each state ] define all of the elements of any particular crime associated with the potential 10,000 types of malpractice that could conceiveably arise.

Your comments, although well intended, about differences in criminal and civil standards, call forth a reminder.

That reminder is – that even with events that are now prosecuted criminally [ such as potential opioid overprescribing ] the government tries to employ civil standards to gain criminal convictions – and they often get away with it !!!

The “Criminal standard” for a doctor would be:
1- Direct testimony from a patient that the doctor knowingly gave the prescription in the bona fide absence of a painful condition.
2- Proving that the doctor didn’t examine the patient before issuing the prescription.
3- Proving that the doctor believed his patient was drug dependent [ an addict. ]

Some doctors have been successfully prosecuted because they were INTENTIONALLY prescribing to dependent patients without legitimate pain conditions.

However; there have been successful prosecutions [ and persecutions ] where the government got away with convincing a jury that the doctor was ‘guilty’ without having established a case base on criminal standards. { Bill Hurwitz case . ]

What makes anyone think that there will be less prosecutorial arbitrariness if we establish the ‘Japanese’ system?

Unfettered prosecutorial discretion based on political exigencies will continue to plague ANY system.

That’s just the way it is – and always has been – ever since we played COPS and ROBBERS, back in the day when we were kids.

Some of us just never grew up.

This idea is just an abortion. It is beyond terrible, and would have absolutely disastrous consequences if implemented.

The problem is that of recategorizing malpractice as a “crime” and using the state prosecution apparatus to prosecute them in criminal court. It says nothing about reducing the incidence of civil litigation, only encouraging more criminal prosecution.

The problem is one of definitions. “Malpractice” requires a relatively low standard for a jury finding of liability, “more likely than not”, or some similar threshhold. Using that standard–and there really are no others unless you want to use simple assault or manslaughter as a criminal equivalent–tries to slide a civil definition of a tort under the criminal bar, not raising the burden of finding for of civil malpractice so much as lowering the burden of criminal proof. Requirements of mens rea or not will not necessarily protect a defendant against unjust criminal convictions at the hands of an overzealous district attorney looking for publicity. There has been enough abuse in other cases from those kinds of prosecutors. Let the prosecutors sue the state boards of medicine if they think those authorities have not been diligent enough in disciplining bad doctors.

This idea seems not at all a search for justice, but a boondoggle for both district attorneys and even more so for criminal defense counsel. It is just a terrible idea, for which there no respectable parallel in any similarly-run legal systems.