The document discusses the reasons patients sue doctors, primarily due to perceived negligence and a lack of communication and dignity during medical treatment. Research indicates that patients often seek not only financial compensation, but also accountability, explanations, and systemic changes following their experiences. The document contrasts fault-based and no-fault compensation schemes, highlighting issues in the legal processes and the emotional impact on both claimants and researchers involved in this sensitive area.

1. “They wouldn’t listen….”
Why do patients sue doctors?
Angela Melville – angela.l.melville@iisj.es
Scientific Director’s Talk
Date: 15th December 2011

2. International Institute
for Sociology of Law
• Each director stays for two years only
• Angela Melville (Flinders University, Australia) is
the new director
– In 2010 we had 32 visiting scholars
– In 2011 we had 198 workshop participants
– In 2011 we had 220 conference participants
– We currently have 13 Masters students from 11
different countries

3. Clinical negligence
• A clinical negligence claim involves an
injured patient suing their doctor
• The patient believes the doctor was
negligent
• Patients may have suffered serious
injuries or have lost a family member

4. Our research
University of Manchester, School of Law
(with Frank Stephen, Anne-Maree Farrell, Sarah Devaney)
1) Funded by Nuffield Foundation
– Based in northern England
– Talked to 30 claimants
2) Funded by Scottish Government
– Based across Scotland
– Talked to 40 claimants

5. Previous research
• Usually researchers talk to medical
professionals
– Doctors believe patients sue because they
want money
– Law reform reflects only one set of views
• 6 previous studies involving claimants
– 5 in the US; 1 in the UK
– All used questionnaires

6. Questionnaires
• Can provide reliable, generalisable results
which are relatively easy to analyse
• However:
– Responses are pre-determined
– Limited aims (motivations)
– Insensitive

7. In-depth interviews
• Allowed claimants to raise topics important
to them
• Looked at the entire experience of
claiming
• Allowed claimants to feel listened to

8. Ethical issues
• Wrote to claimants asking consent to interview
– Some claimants were not contacted
– Consent was voluntary
– What topics are to be discussed, length of interview,
order of topics
– Did not re-contact
• Many claimants rang up first
• Counsellor on stand-by
• List of contacts

9. Sensitive interviewing
• Recovery can be long and slow, and each
interviewee may be at a different stage in
this process
• Researcher cannot know fully what
someone has gone through
• Gap between academic knowledge and
personal knowledge
• Researcher needs to be comfortable

10. Impact on researchers
• Interviewing can be emotional work
• Can leave researcher feeling emotionally
overloaded, isolated, desensitived,
uncomfortable with level of disclosure
• Feel as if you need to give something
back
• Impact can be on: interviewers but also
transcribers, other research assistants

11. Dealing with emotional interviews
• Set clear boundaries about what the
research can do
• Practice the interview beforehand
• Do background reading
• Regularly debrief
• Have a mentor
• Work in a team
• Keep a diary

12. …then he just sat up and he looked like, you know The Scream,
Edvard Munch’s picture? And just this massive, massive spurt of
blood came out, and he was just like this… and then he died.
And they still wouldn’t let me in the ambulance, they left me on the
road, then they let me in the ambulance, and he’d died. And I said I
think you ought to close his eyes, he’s passed away. And they
started giving him CPR, and there wasn’t anything of him, it would
have broken all his ribs, they were just being so rough... They
wouldn’t close his eyes, they wouldn’t, they wouldn’t stop doing that
on his chest, and they did that all the way to the hospital. And I
begged them not to, just to leave him in peace and then they
wouldn’t even cover his face when he went through A and E and all
these people were just looking at him, and he’d died. And I thought it
was just so cruel, I just thought that was so cruel and undignified.

13. What went wrong?
• Patient had been injured
• But also:
– Medical treatment had been delayed
– Lack of dignity
– Medical staff had been rude
– Poor communication
– Knew there was a problem, but no-one would
listen

14. Making a complaint
• Hospital would not accept responsibility
• Denied that there had been a problem
• Doctors had been arrogant
• Hospital tried to blame a junior doctor or
nurse
• Did not feel listened to

15. Unsuccessful claims
• 1st need to gather all the medical reports
• 2nd independent expert looks at the
reports
• Claimants felt that the expert was:
– Biased
– Had missed the most important points
– Refused to listen
• Majority of claims fail

16. Successful claims
• Only outcome was often money
• But claimants also wanted:
– Explanations
– Apology
– Changes so that mistakes would not happen
to someone else
– Opportunity to talk to the doctor
– Receive compensation, but still felt as if no-
one would listen

17. Fault based schemes
• Claimant must prove that the doctor was
at fault
• Benefits
– Deterrance (doctors are more careful)
– Doctors learn from their mistakes
– Only claims with merit receive compensation
– Claimants get the full value of their claim

18. Problems
• Defensive medicine
• Doctors do not admit errors
• Patients with low value claims cannot find
legal representation
• High proportion of settlement is paid to the
lawyer rather than the claimant
• Only provide financial compensation

19. No fault schemes
• Eg New Zealand
• Claimant does not have to prove liability
• Benefits
– More low value claims receive compensation
– Can provide alternative outcomes
– Less need for legal representation, therefore lower
costs
– Doctors more likely to admit errors
– Also need to have compulsory disclosure of errors