Dealing with Medical Malpractice

List of Tables ix

List of Figures xi

Acknowledgments xii

Foreword / Rudolf Klein xv

Introduction 1

Background: the American medical malpractice dilemma 7

Part I. The sociological issue 33

1. Professional autonomy 35

Part II. Britain's approach: professional dominance, internal divisions, and public discontent 55

2. Introduction to the General Medical Council: a disciplinary committee session in July, 1983 57

3. Evolution of the GMC: disciplinary procedures and regulations 65

4. Interviews: insiders view the General Medical Council's work—dissension within the ranks 71

5. The general context of complaints and efforts at reform 89

6. The medical protection societies and the courts 107

7. Patterns of Professional Conduct Committee decision-making 113

8. Thinking about the medical malpractice system in Britain 125

Part III. Sweden's approach: public control and the hidden structure of medical authority 131

9. Introduction to the Swedish Medical Responsibility Board: a session in May, 1983 133

10. Procedures and influences in the decision-making process 138

11. Interviews: listening to the decision-makers 150

12. Outside views of the MRB: the Swedish Medical Association, local boards, and other comments 164

13. Swedish patient no-fault insurance: a rational patient compensation system 174

14. Preventing medical injury 184

15. Patterns of Medical Responsibility Board decision-making 187

16. Thinking about the medical malpractice system in Sweden 200

Part IV. Overview

17. Comparing Britain and Sweden 209

18. The sociological issue revisited: professional autonomy, power, and authority 236

19. Lessons to be learned 245

Endnotes: updates, 1986 253

References 258

Index 264