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High Hopes and Malpractice

Arch Surg. 1976;111(9):1042. doi:10.1001/archsurg.1976.01360270114026.
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It is myopic and misleading to consider the malpractice phenomenon apart from the society in which it occurs. Yet, this context has received too little attention.

Most litigation arises when the medical outcome falls short of the patient's expectations. Accountability is soon the issue, and the physician, the hospital, personnel—each or all—become the culprits, sometimes justifiably, often not.

The purpose of this communication is not to absolve the incompetent and negligent, but to examine some factors that engender the malpractice sequence.

An apparent paradox in our culture is the mixture of myth and science, of rationality and irrationality. Technological prowess has led us to expect that "all is possible." We are primed to expect more than we are likely to receive. It is hard not to become a victim of false hopes in a land where cigarette smokers are depicted as winning a pliant beauty, not a fatal cancer; where


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