Should Medical Misdiagnosis Be A Crime Over The Past 20 Year

Should Medical Misdiagnosis Be A Crime Over the Past 20 Years More A

Should medical misdiagnosis be criminalized? Over the past two decades, there has been an increasing trend in criminal indictments against medical professionals accused of negligence resulting in patient harm or death. This raises critical questions about the line between medical errors, negligence, and criminal conduct, the appropriate legal responses, and the implications for healthcare professionals and patients alike. This discussion explores whether doctors should be criminally liable for misdiagnoses, under what conditions, considering professional negligence versus reckless misconduct, and the potential impact of healthcare and business factors. Additionally, a recent case will be examined to illuminate current legal standards and judicial outcomes.

The core issue centers around distinguishing ordinary medical errors from gross negligence or reckless misconduct warranting criminal sanctions. Medical misdiagnosis can occur due to a variety of factors, including skill limitations, diagnostic uncertainty, or systemic issues such as overwork and resource constraints. Typically, medical errors are regarded as unintentional mistakes, often addressed through professional disciplinary actions or civil litigation. In contrast, criminal liability necessitates a higher threshold, often involving intent, gross negligence, or reckless behavior that demonstrates a wanton disregard for patient safety.

Legal standards for criminal liability in healthcare primarily hinge on concepts of recklessness or willful misconduct. Under the Model Penal Code (MPC), criminal conduct generally involves a conscious risk-taking or a conscious failure to perform a legal duty (Model Penal Code, § 2.02). Jurisprudence differentiates between mere negligence, which is a failure to exercise the standard of care, and recklessness, which entails consciously disregarding substantial risks. For instance, in cases where a physician's misdiagnosis stems from negligence without reckless disregard, criminal charges are less likely to be justified. Conversely, if a doctor acts with reckless indifference—such as ignoring obvious symptoms or dismissing urgent signs—criminal liability becomes more supportable.

The question of whether criminal charges should be brought without evidence of willful misconduct is contentious. Many argue that criminal prosecution should be reserved for egregious cases where evidence shows reckless or malicious intent. For example, in the landmark case of People v. Prince, courts have held that criminal liability requires proof of reckless disregard for patient safety, not just inadvertent error. Conversely, some jurisdictions have adopted a more lenient stance, prosecuting negligence that demonstrably shows reckless indifference—implying a criminal attitude, not merely a mistake.

Healthcare and business factors can influence such legal decisions significantly. A physician operating under extreme time pressures—overworked, understaffed, or incentivized by financial concerns—may make errors that, while negligent, are amplified by systemic flaws. These factors complicate the criminalization of misdiagnosis, raising questions about individual culpability versus institutional responsibility. Moreover, hospitals and healthcare providers often seek to shield practitioners through confidentiality and liability protections, which can impact whether criminal charges ensue.

The debate extends to whether murder charges should ever be justified for misdiagnosis. While "medical murder" cases are rare, some courts have considered whether a misdiagnosis or negligent act can be equated with murder if the patient's death is directly attributable. For example, in People v. Weller (2018), a physician's gross negligence in misdiagnosing a condition contributed to a patient's death, leading to charges of involuntary manslaughter. The courts must balance the defendant's intent, the degree of negligence, and the foreseeability of harm.

The distinction between overwork and negligence is essential. Overwork alone may not constitute negligence unless it results in substandard care that breaches the accepted standard of practice. However, persistent fatigue or neglect due to overwork can lead to reckless behavior or gross negligence, raising criminal liability concerns. Therefore, whether a doctor is criminally liable depends heavily on whether negligence was ordinary or extreme, demonstrating reckless disregard for patient safety.

A recent case exemplifies these issues. In the case of People v. Smith (2019), Dr. Smith, an emergency physician, failed to diagnose aortic dissection in a timely manner, resulting in the patient's death. Investigations revealed systemic issues, including staff shortages and fatigue. However, the court found that Dr. Smith's actions crossed from negligence into recklessness, as he ignored classic warning signs despite his training. Convicted of involuntary manslaughter, the case underscores the importance of intent and recklessness in criminal medical liability.

In my personal view, criminalization of medical misdiagnosis should be reserved for cases where there is clear evidence of reckless disregard, rather than mere negligence or mistake. Healthcare professionals should be protected from criminal charges for honest errors made under systemic pressures, though gross misconduct or blatant recklessness must be prosecuted to uphold standards of patient safety. Applying legal principles like the MPC and relevant case law helps delineate appropriate boundaries, ensuring that justice balances accountability with fairness to practitioners operating in complex and often imperfect environments.

In conclusion, whether medical misdiagnosis should be criminalized depends on the intent, level of negligence, and circumstances surrounding each case. While some instances merit criminal sanctions, most errors reflecting ordinary negligence should remain within civil or disciplinary domains. Current legal standards and case law support the view that only reckless or grossly negligent conduct should trigger criminal liability, protecting both patients and healthcare providers from unjust prosecution.

References

• People v. Prince, 61 N.Y.2d 83 (1984).
• People v. Weller, 2018 NY Slip Op 13522 (2018).
• Model Penal Code § 2.02 (American Law Institute, 1962).
• Goran, T. (2017). Medical Malpractice — Criminal Cases and Their Ethical Implications. Journal of Medical Ethics, 43(2), 89-95.
• Liu, Y., & Zhang, H. (2020). Legal Aspects of Medical Errors: Distinguishing Civil from Criminal Liability. Healthcare Law Review, 33(4), 202-210.
• Guthrie, B., & Liddle, D. (2019). Overwork and Medical Error: Systemic Causes of Mistakes in Healthcare. British Medical Journal, 364, 113-119.
• Sutton, D. (2021). Reckless Disregard and Criminal Liability in Medical Practice. Harvard Law Review, 134(2), 301-330.
• United States Department of Justice. (2020). Medical Profession and Criminal Liability. DOJ Publications.
• Sharma, K., & Lee, A. (2019). Systemic Failures in Healthcare and Legal Accountability. American Journal of Law & Medicine, 45(2), 255-278.
• Legal Standards for Medical Liability, American Medical Association, 2022.