Saturday, 27 August 2011


I’ve always been intrigued with Science Fiction. It allows people to take a look at their own world from a slightly different perspective and subtly challenge both individual and societal belief systems. Perhaps at times its fanciful and unrealistic, but it is also one of the most effective ways to stimulate analytical thought and confront our ideas of the status quo.

An interesting example of this is a Star Trek (Next Generation) episode on the concept of marriage. In this episode of the popular science fiction TV series – a society exists where the default option for married couples is mandatory divorce after a five year period. Instead of staying together – the couples are asked to prove to a marriage tribunal after the five year period has elapsed that they want to remain married. It’s a simple concept in reverse and yet the implications on our culture today are fascinating. A far fetched scenario perhaps but one that focuses change at a system level instead of an individual.

Leaving the science fiction world, I read an article in an Australian national news publication that made me ponder how we institute change on a system level when so much is at stake for an individual.

The newspaper article in question revealed that an individual had suffered a significant adverse health outcome despite presenting to a Victorian emergency department upon feeling unwell. The article went on to discuss the involvement of legal representation and the potential allocation of compensation for the individual who has been left with medical complications and ongoing care needs for the rest of their life.  In this age of accountability and transparency – the article intimated that an individual or individuals at the health service might have to answer to claims of medical mismanagement or negligence.

In the health service industry, the system for compensation is structured in a way that one party must prove the other was at fault. The only possible option for the individual at the heart of this issue to receive compensation is to commence legal proceedings, thereby attempting to blame another individual or group for the adverse outcome.

Now lets employ some science fiction to this scenario for a moment. Imagine this individual had not sought the help of their local health service. Yet the same outcome ensued. The individual was left severely impaired for the rest of their lives but had not asked anyone for help after feeling unwell. Does this mean they are not entitled to compensation? The cost of their healthcare needs will not change. The impact on their life and those around them will not change. But who is responsible for their adverse health outcome?  The simple answer is that any person who experiences an adverse outcome should be compensated (mandatory compensation). It is our obsession with accountability and allocation of blame in the health system that needs to change.

 If we continue with the concept of mandatory compensation – the individual has limited scope to commence legal proceedings. In fact, the process of litigation may be completely bypassed altogether if all individuals were entitled to seek compensation in some form. Government or tax-payer money could be allocated to individuals on a case-by-case basis so that everyone who suffers an adverse outcome receives a level of compensation on an equitable basis. Instead of allocating tax payer dollars to private legal firms who ‘win’ cases, our taxes could then be spent elsewhere. As tax-payers do we really need to be lining the pockets of private legal firms?

The money saved from expensive legal fees and court time could be allocated to the system at fault - the health service. Years of successive government funding levels have meant that Australian health services are overworked and under resourced – yet still perform relatively well on the world stage.  Unfortunately, despite the allocation of resources, adverse outcomes will undoubtedly occur and individuals will continue to be affected. Also, there is some scope for exploitation to occur in the context of mandatory compensation.  Perhaps this is where the role of private law firms can be reversed – and expend their energy in preventing such exploitation from occurring.

The process of finding someone to blame for a bad outcome is not the answer, both in the context of a marriage breakdown or an adverse health outcome. However, changes to the status quo need to occur by examining a situation from many different perspectives – not just science ficiton. Compensate those individuals affected as the default option and let humanity underpin our relentless quest for accountability.


  1. I like the idea, Arron. Great blog. i love the concept. It definitely spares the individual who has suffered an outcome the frustration of navigating through the legal process to seek compensation as a way of funding his or her expenses, in the process, making them scenical, jaded and angry.

    For me, it allows medical and nursing professional to stay focused on caring for patients rather than seeing patients as just 'jobs' that need to be performed so as to avoid being criticised of negligence, aka being sued. Caring for patients requires doing more than just what is enough to avoid being sued. It involves going above and beyond the call of duty of care. The quality of care is different. It is the difference between saying 'my mother cares for me' and 'my mother has a duty to care for me'. It is the difference of being healed and being fixed, and as we know, most conditions of which are not fixable can be healed.

    Our obsession with accountability is served i think from the peer review processes which are quite thorough as are root cause analyses that are performed. In a less litigatious but more supportive environment, I would hope that training doctors would more likely cultivate a motivation not based on fear of doing the wrong thing but by doing what is best for the patient.

    I like your analogy of star trek as well. I don't recall the episode. Was it Star trek with Captain PIcard, Captain Kirk or Captain Janeway?

  2. Awesome...such an astute observation and concept :) And love the response from Kev.

    I think the other issue here is apologies and forgiveness. The individual in this case of course deserves some kind of compensation. It is our responsibility to look after one another.

    But sometimes, a simple acknowledgement of another person's bad luck or grief can go a long way. It is unfortunate that this litigious environment has bred a fear of making apologies because people now feel it means we are admitting fault. On the international and national political stage, apologies are a rarity. And this seems to be leaking to the household level, where saying you are "sorry" for someone's loss, pain or frustration is met with questions about the genuineness of the verbal offering. Do we now not have a right to say "sorry" unless we take responsibility for the situation?

    It is funny that we go around ranting and raving about people's mistakes and questioning them as human beings, judging them as good or bad people because of their mistakes, when by our very nature we are imperfect.

    It is even more unfortunate when we judge so harshly, those who are trying their best to save our lives.

    When do we get to put hospitality staff on the stand for getting our orders wrong?

    If a doctor cannot make a mistake, we are effectively saying they are not human. Why is it we feel we have the right to punish doctors so harshly, when their crime is only that they take up a profession which involves such high risk.

  3. Thanks Kevin - just to clarify... the reference was actually a combination of 'ferengi' marriage law and 'tavnian' wedding ritual... Ferengi appeared in both 'next generation' and 'DS9.' The 'tavnian' reference was to 'DS9' episode 'the muse.' cheers :)