Intended for healthcare professionals

Rapid response to:


Bush signs act that restricts class action suits in state courts

BMJ 2005; 330 doi: (Published 03 March 2005) Cite this as: BMJ 2005;330:499

Rapid Response:

Disingenuous Remarks from the AMA on Tort Reform

Front and Center on the March 5th, 2005 homepage of the American
Medical Association is a link to the AMA’s sponsored Medical Liability
Reform initiatives. One of those initiatives is the “Fund for American’s
Liability Reform.” That “strategic advocacy”, as the AMA describes it,
will help to “mobilize grassroots activists, galvanize public support and
target media activity” in what the AMA site says will “directly (the word
‘directly’ was emphasized by the AMA) affect the passage of medical
liability reform at the federal level.” (1)

Likewise, the most prominent US physician, Senate Majority Leader
William Frist (R-TN), has been an outspoken proponent of tort reform,
including passage of the bill that Ms. Lenzer accurately described (one
that limits certain class action suits from state courts and moves them,
instead, to Federal jurisdictions.)(2) Dr. Frist said in his Shattuck
Lecture published in the January 20th, 2005 of the New England Journal of
Medicine that the United States must “stop the litigation lottery” and “we
must pass medical litigation reform.” (3) He commented that the cost of
medical malpractice, including “frivolous lawsuits” and “defensive
medicine“ (the label that describes the alleged behavior of ordering
excessive tests and procedures attributed to physicians’ fearful responses
to the threat of medical liability) accounts for more than $100 billion a
year in additional US health care costs. (3)

With the information from the AMA website (including the AMA’s
specific support for President Bush’s tort reform that I did not include
above) and Dr. Frist’s lecture, I was surprised to read Dr. Nelson’s
comment in his rapid response, suggesting that the AMA did not take a
position on the bill. (4) On the one hand, it is entirely possible that
the AMA did not specifically--- and in writing---endorse the restriction
of class action lawsuits from state courts. On the other hand, the AMA’s
support for tort reform is long-standing. It would be almost disingenuous
to suggest that the AMA, while asking its members for financial
contributions to assist nationwide efforts to support President Bush and
the Majority Senator’s liability reform initiatives, would not be
supportive of this particular piece of legislation.

This issue of tort reform is, perhaps, larger than medical liability
or any real desire to protect the interest of American physicians. The
benefits, if any, of this legislation may temporarily dampen medical
malpractice rates. If that relief occurs in any meaningful way, it is
welcome. Any such benefits are, however, offset by the increasing
inability of Americans to access what has been a constitutionally-
protected freedom: To seek redress for injuries, including those due
directly to corporate healthcare and business negligence. Without a
Federal Patient Bill of Rights and with increasingly restrictive access to
the state courts, Americans will be further hampered in their ability to
seriously question their healthcare products, decisions and management.

1. American Medical Association website. Fund for America’s Liability
Reform. March 5th, 2005.

2. Lenzer. J. Bush signs act that restricts class action suits in
state courts
BMJ 2005;330:499 (5 March)

3. Frist. WH. Health Care in the 21st Century. N Engl J Med 2005;

4. Nelson, JC. Response to: Bush signs act that restricts class
action suits in the state courts.” BMJ: 2005; 330: 499-c March 5, 2005

Competing interests:
None declared

Competing interests: No competing interests

06 March 2005
Stefan P. Kruszewski
Harrisburg, Pennsylvania USA 17112