Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, July 23, 1995                   TAG: 9507210087
SECTION: HORIZON                    PAGE: G-1   EDITION: METRO 
SOURCE: GALE SCOTT/NEWSDAY
DATELINE: NEW YORK                                LENGTH: Medium

WHEN GOOD DOCTORS MAKE BAD MISTAKES

``Physicians acquire their knowledge from our dangers, making experiments at the cost of our lives. Only a physician can commit homicide with complete impunity,'' wrote Pliny the Elder, the Roman scholar from the first century A.D.

Doctors, ethicists and patient advocates interviewed offered only slightly different versions of the view that society should not punish doctors.

At the Hastings Institute, a medical-ethics think tank, lawyer Ellen Moskowitz said there is a three-part system for dealing with such errors. Punishment should come through the tort system, in the form of a malpractice case. The state licensing board can restrict a doctor from practicing. The hospital can take a more ``educative'' approach, learning how the error happened and how to prevent it.

``Should an error ruin a person? It shouldn't,'' Moskowitz said. ``Doctors, like everyone else, are subject to human error ... if it seems to be a single tragic error, I would be surprised if the state removed the license.

``A doctor has to be held accountable ... traditionally we have relied on malpractice [suits]. It's a crude way of doing it, but dollars are the best way we have.''

Dr. Arthur Cooper of the Columbia University College of Physicians and Surgeons said even the most eminent surgeons make inexcusable errors. But that does not mean they should be punished, he said.

While he was in training, Cooper recalled, he was present at a case review session where a much admired surgeon conceded a patient bled to death because of his error. ``He was a very honorable and decent man, and he blamed himself,'' Cooper said.

``The mark of a great surgeon is that he or she recognizes immediately when the error had been made, owns up and does whatever is necessary. ... Every single surgeon has been close to making major mistakes and somehow hauled back from the brink,'' he said. ``Any of us could make an error.''