Abstract

Summary and ConclusionMinutes before the jury would have returned a decision in Kaufman's favor, assessing damages of almost a half-million dollars against the physicians who treated her, she settled out of court for approximately half that sum. I would argue that responsibility in medicine, that liability for malpractice, should be restricted to cases of negligence in which there is no question concerning the proximate causality of the physician's proven negligence to the harm which resulted. It is clear that “negligence” covers a wide range of actions. The solution to this problem lies in the definition of the physician's duties—not in the use of malpractice settlements for the compensation of tragic but accidental consequences whose risks were realistically inevitable or else willfully assumed by the patient as well as the physician. In medicine, there is a strict prima facie duty to know as much as possible. In practice, this approaches an ideal duty. The distinction between an ideal duty and a realistic duty emphasizes the importance of having the patient assume as full responsibility for the risks attendant to inevitable and unforeseeable consequences as the physician. In assessing fault for such consequences, it is essential to recollect that an agent cannot be said to have caused every happenstance which occurs while he acts; moreover, he certainly cannot be held strictly responsible for the cause of every event which succeeds his act. Thus, the primary problem in medical ethics is epistemological rather than normative