When is the practice of pathology malpractice?: Figure 1

Abstract

Because of its complex nature, surgical pathology diagnosis has an appreciable degree of fallibility and is increasingly subject to legal scrutiny. In litigation, the first practical step is to explain why and how this adversity could happen, and the second is the question of apportionment of responsibility and its legal consequences. As pathologists, we have to provide a methodology of investigation allowing a clear distinction between reasonable and unacceptable pathology practice without the twist of hindsight. For that we need to examine the different steps from test ordering to the final report. The most critical aspect of the enquiry is the act of diagnosis itself. What can reasonably be expected and what precautions have normally to be taken? Experts are often requested to re-examine the slides. For that we need a well-devised protocol enabling blinded review. Tort law has two important interconnected goals: compensation for damages and prevention of the same slip ever being made again. We can only properly learn from our mistakes if we carry out an unbiased investigation. Poor normative judgement of diagnostic failures will backfire on the profession.

Hindsight Bias and Law

“…For example:How might HB affect public perceptions of police performance during investigations (see Ask & Granhag, 2010; Wasieleski, Whatley, & Murphy, 2009)?How might negative outcome knowledge make individuals overestimate the likelihood of a defendant’s guilt (Winters & Jeglic, 2016)?How might knowledge of the case outcome (e.g., child abuse is confirmed) make individuals misremember schema-consistent (abuse-related) details (Lindholm, Sjöberg, & Memon, 2014)?Continue to examine ways to reduce HB in experts. Proposed solutions include:using blind review procedures (i.e., reviewer only receives information critical to making a judgment), such as those suggested by Giard (2010) and Robertson (2010) in medical malpractice cases and Kassin, Dror, and Kukucka (2013) and Servick (2015) in forensic investigations. For example, a promising avenue for forensic investigations is Linear Sequential Unmasking, which involves blinding forensic examiners to potentially biasing information.…”

“…Continue to examine ways to reduce HB in experts. Proposed solutions include: o using blind review procedures (i.e., reviewer only receives information critical to making a judgment), such as those suggested by Giard (2010) and Robertson (2010) in medical malpractice cases and Kassin, Dror, and Kukucka (2013) and Servick (2015) in forensic investigations. For example, a promising avenue for forensic investigations is Linear Sequential Unmasking, which involves blinding forensic examiners to potentially biasing information.…”

Collaborative and Statutory Pathology Practice

“…DOI: 10.15406/icpjl.2018.06.00144 assessments should be incorporated in a legal ability in medicine and healthcare. 1 Tort law has two appended missions, rectification of adversity and restraint from misjudgement. When a pathologist is held accountable, it admonishes the compatriots to counteract a reoccurrence of the disaster.…”