Friday, February 24, 2006

Accidents Happen

Last night I went to a friend’s house to attend a meeting of Citizens Against Lawsuit Abuse (CALA). At the meeting, a doctor and an activist spoke about the need for tort reform and the aggregate cost of frivolous lawsuits.

The activists showed a short video clip from a local news program where a lawyer had been going after local small businesses one by one and suing them for failing to comply with standards for disabled access. The guy used a form letter that claimed the business had violated all manner of arcane building codes and had a fictitious example of a disabled person who had suffered upon visiting that business. The expectation was that the business owner would settle out of court for a few thousand bucks.

Send a letter and get $8,000. Brilliant! Evil, but brilliant.

As I sat there, I tried to figure out what the general problem was. I came up with this:

Essentially, the problem is that the public is ignorant of the Normal Probability Distribution. Accidents will happen. For a doctor or dentist, if they happen at the first or second standard deviation, then something is terribly wrong. You can’t have a doctor screwing up 25% of the time. If they happen at the fifth or sixth standard deviation, then that’s probably just fate.

These lawsuits and the cases of egregious mistakes the press publish do not attempt to determine where on the probability curve the event occurred. Nor do they determine the cost of pushing these events one more standard deviation down the curve.

We all drive cars. We accept that there is some nonzero probability of getting killed in an accident every time we get in the car. From personal experience, we have some concept of just how unusual this is. We understand the cost-benefit trade off of driving. We could eliminate all traffic accidents if we just walked. What we don’t understand is just how unusual a tragically bad reaction to a drug is. Nor do we understand the cost-benefit trade-off of removing said drug from the market.

The real problem that CALA faces, the one we all face together as a society, is how to educate ourselves on this trade-off so we can make informed decisions in our laws and lives. My favorite talk show host, Hugh Hewitt, makes a good living crusading against the poor job done by the press, but at present, it is the press that will have to do the bulk of the education.

It seems to me that if the editors at the newspapers understood basic probability and statistics and basic business economics, they could read the articles written by their staff with an eye towards educating the public about the real cost-benefit trade-offs.

That job falls on those of us who care.

What do you think? Did I screw up somewhere along the line? Comments are most welcome.

The Blogosphere Strikes!
Following a comment by a reader, I removed a portion that claimed that a single malpractice lawsuit would end a doctor or dentist's career. I had thought this was a little on the hysterical side and a bit of research said it was indeed over the top. However, I stand by the rest of the post.

1 comment:

Evan said...

What we don’t understand is just how unusual a tragically bad reaction to a drug is. Nor do we understand the cost-benefit trade-off of removing said drug from the market.


I wonder if defendants are allowed at any stage to introduce evidence (including personal testimony) about people who benefited tremendously from the drug. Benefits have to be assessed along with costs.

That said, it is pretty well established law (strict liability) that manufacturers are often expected to be liable for most mishaps resulting from prescribed use of the medicine.