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Individual malpractice insurance decisions revisited.

Nurses' professional obligations to their patients include financial accountability. Whether nurses best provide this through self-insurance, coverage by an employer's insurance policy, or by purchase of an individual policy remains a personal decision. Changes in law and the health care market, however, should prompt a revisiting of this decision because the relative costs and benefits of each option may have changed. The pace of these changes, the unexpected consequences of some of the legal changes, and the individual differences in each nurse's situation may require seeking legal counsel to identify and evaluate the risk/benefits in that situation. The cost of that counsel may well exceed the cost of the policy premium.

Decision Making↗

Teaching malpractice litigation in a mock trial setting: a center for perinatal medicine and law.

OBJECTIVE: To describe a novel center for perinatal medicine and law in a school of medicine and assess its inaugural presentation of the role of expert witnesses in a mock trial setting. METHODS: The center's first program was an obstetrics and gynecology Grand Rounds that staged an abbreviated mock trial. The case summary was read. An attorney then conducted the direct examination of the plaintiff's obstetrics and gynecology and neonatal expert witnesses. The audience acted as the jury and anonymously voted electronically after the direct examination. The plaintiff's attorney then conducted the cross-examination of the defense experts on issues pertaining to possible bias and expert compensation with only a limited inquiry into substantive medical issues. A second vote was taken. A posttrial panel discussion and questionnaire evaluated the importance of this program to medical education. RESULTS: The first vote indicated 86% of the jury decided that negligent obstetric management contributed substantially to the infant's injury, and 82% of the attendees felt that negligent neonatal care was a substantial factor in the infant's injury. After the cross-examination, 63% of the jurors now felt that negligent obstetric management contributed to the brain damage; whereas only 39% of the participants concluded that negligent newborn care was responsible for the injury. During posttrial discussion, the audience suggested that cross-examination of defense experts on issues of bias rather than medical care negatively affected their perception of the examining attorney's case. CONCLUSION: Analysis of the questionnaire showed that the attendees strongly appreciated experiencing this abbreviated mock trial and indicated that the center was a welcome addition to medical education.

Adult↗