Don't forget that nurses can now legally be thrown under the bus with criminal charges for malpractice while hospitals walk away scotch-free [1]. This is huge in the nursing community right now.
This kind of thing is going to further disassociate nurses from interacting like a human with their patients. If you risk criminal prosecution and prison time from making a mistake, everyone starts walking on eggshells and become afraid of doing anything beyond box ticking. They'll start turning a blind eye to things they know are wrong, because the system doesn't see them. All work will align towards pure compliance with the law and the hospital system at the expense of intimate connection with patients.
And of course, a lot of nurses are in the job for the human connection, and will consequently be burned out at an increasing rate.
To some degree this might actually be good long term, because it will be that much harder for hospitals to manipulate nurses into working around the limitations of the system to provide real care, which allows the administration to turn a blind eye to their own flaws. There's going to be a surge of malicious compliance that ends up shining a bright spotlight on just how abusive and dysfunctional hospital systems really are.
And patients will ultimately be the ones who suffer.
> Don't forget that nurses can now legally be thrown under the bus with criminal charges for malpractice while hospitals walk away scotch-free
The nurse in that case was prosecuted for criminal reckless homicide (not malpractice, which is civil negligence.) The characterization of the hospitals direct responsibility is negligence not arising to criminal (gross) negligence (as the principal of respondeat superior doesn't apply in criminal law, the employees recklessness would not be imputed to the employer the way it would in a civil case.)
As for civil liability if the hospital, that was settled out of court with the victims family, the hospital did not get off scot free.
This... isn't a new thing that deserves the “now” label like it is a change. Criminal wrongdoing by employees (including in healthcare) very often does not rise to a level of criminality for the employer, and that's been true for a long time.
You aren't wrong but you also aren't giving my comment the benefit of the doubt. I'm not a lawyer. When I say "malpractice" I'm not referring to the legal definition of the word, but the layman's term, defined as, "improper, illegal, or negligent professional activity or treatment, especially by a medical practitioner", which fits here well.
>This... isn't a new thing that deserves the “now” label like it is a change. Criminal wrongdoing by employees (including in healthcare) very often does not rise to a level of criminality for the employer, and that's been true for a long time.
Of course criminal charges for a patient death cannot be administered on an entity like an entire hospital, I didn't mean to insinuate that. But those who share responsibility for her actions: the administrators, doctors, morticians, everyone involved in designing the processes which led to this disaster and being involved in covering it up (i.e. the "hospital"), all seem at least partially liable if we are looking at this mistake through a criminal lens. Would you agree?
Some studies say that medical error is the third leading cause of death in the US [1] - yet how often do we see "criminal reckless homicide" brought against nurses? There was an incredibly disingenuous serious of mistakes that had to happen for this nurse to mess up so badly, don't get me wrong. But when nurses are working 50-70 hours a week doing 14 hour shifts under extremely high pressure from management, these insane strings of mistakes are simply going to be an occurrence, and we shouldn't be using our tax dollars to pay for shitty lawyers to go after them for these mistakes. It's a waste of everybody's time, energy, and money, is detrimental to patients, and is a contributor to the fact that 90% of nurses are considering leaving the profession.
The solution isn't that Radonda Vought, who killed a patient through a string of crassly negligent actions should walk free - one would like to see the whole chain of command be given serious prison time. It's clear that patient safety at Vanderbilt isn't a priority - training and safety culture reflects that.
Strange to see that HN, which is generally suspicious of copaganda, falls for very transparent nursepaganda.
> one would like to see the whole chain of command be given serious prison time
Absolutely. To each according to their authority.
RaDonda Vaught made a mistake, and admitted it, repeatedly, in multiple interviews.
But that mistake was only partly because of her free will. Vanderbilt University Medical Center incentivized her to make that choice, for their own profit, and with control over her employment.
RaDonda Vaught goes to prison.
VUMC pays a fine and nobody goes to prison.
I think HN takes a dim view of a company holding someone's contract in their hands, saying "Do something illegal or I tear this up," and then blaming the employee when everything explodes.
They're playing chicken with patients' lives, and passing off the charges to their employees when they lose.
The strong libertarian vibe of npr saying she's being scapegoated?
When you have millions of drugs being issued, there will be some legitimate mistakes happening -- some will even cause death. If you want people to actual work in healthcare, they shouldn't be fearing for their lives for being less than perfect.
please cite where an npr report gives the impression she's been scapegoated in such a way that she doesn't deserve the consequences she's been given. I'd love to read it honestly.
From what I've seen there's been a lot of reporting on her case, and how Vandy rightfully deserves a lot of pain, and a lot on how a subset of nurses feel she's been railroaded, but I've not seen what you claim and would like to know where I missed it.
I'll also re note that pharmacists have carried this burden for over a hundred years, and their removal from the process is part of how this chain of mistakes happened to begin with.
"she doesn't deserve the consequences" is different than scapegoating. Scapegoating means she's the sole person being blamed for the failures of a larger group.
From the article:
"pursued penalties and criminal charges only against the nurse and not the hospital itself...Vanderbilt received no punishment for the fatal drug error...appears to support defense arguments that Vaught's fatal error was made possible by systemic failures at Vanderbilt."
That certainly seems to lay claim that there are more issues than the single nurse. Holding others accountable doesn't negate her culpability but it would prevent her from becoming a scapegoat.
But the electorate continues to reward "tough on crime" prosecutors. Their incentives are all towards maxing out the savagery towards defendants, systemic repercussions be damned.
From the article:
> Janie Harvey Garner, the founder of Show Me Your Stethoscope, a nursing group on Facebook with more than 600,000 members, worries the conviction will have a chilling effect on nurses disclosing their own errors or near errors, which could have a detrimental effect on the quality of patient care.
> "Health care just changed forever," she said after the verdict. "You can no longer trust people to tell the truth because they will be incriminating themselves."
That's the exact opposite of how the NTSB operates. It satisfies the infantile urge to blame and shame a supposed evildoer, to the great detriment of everybody in the long run.
> That's the exact opposite of how the NTSB operates.
Bingo! I have a friend in the UK who organizes "post-mortem" (no pun intended) workshops and process training for hospital staff, precisely to do the NTSB-like thing after medical procedure errors occur. Rather than trying to point fingers and identify scapegoats, the central question is: "what went wrong here, and how do we reduce the chances of that happening again?"
Of course, occasionally the answer might be "We hired the wrong person, and we should fire them", but that seems to be only very rarely true.
this is fairly common in the medical field, the usual name for it is "morbidity and mortality" [0]
> The objectives of a well-run M&M conference are to identify adverse outcomes associated with medical error, to modify behavior and judgment based on previous experiences, and to prevent repetition of errors leading to complications. Conferences are non-punitive and focus on the goal of improved patient care.
I don't think "tough on crime" voters strongly differentiate, based on the behaviors of the prosecutors themselves. The biggest resume priority seems to be maintaining a ludicrously high conviction percentage, which is awful for different reasons (innocent defendants forced into plea bargains).
Only a small subset of prosecutors elected in the most liberal districts are rewarded by their constituencies for exercising prosecutorial discretion. I say that without making any judgment as to whether they're using that discretion well — I'm just observing that very few prosecutors work that way.
> I don't think "tough on crime" voters strongly differentiate, based on the behaviors of the prosecutors themselves. The biggest resume priority seems to be maintaining a ludicrously high conviction percentage, which is awful for different reasons (innocent defendants forced into plea bargains).
Well, I think your position is probably one of ignorance. Plenty of people I talk to are for tough prosecution on things like violent crime and against tough prosecution for simple drug possession.
> Only a small subset of prosecutors elected in the most liberal districts are rewarded by their constituencies for exercising prosecutorial discretion. I say that without making any judgment as to whether they're using that discretion well — I'm just observing that very few prosecutors work that way.
Yes, that does seem to be a trend. Prosecutorial discretion is actually important, but it doesn't mean you let crime run rampant, either.
> The biggest resume priority seems to be maintaining a ludicrously high conviction percentage, which is awful for different reasons (innocent defendants forced into plea bargains).
I don't live in a jurisdiction that elect prosecutors, but is this actually a thing? Do candidates/incumbents run campaign ads on their conviction rate? Are voters researching/talking about the conviction rate of the candidates like it's a pissing contest?
> If the conviction rate had been measured by actual cases pursued, rather than all cases referred by police, Hallinan said, his office would have had a conviction rate that was relatively similar to Los Angeles and other major cities.
> And Hallinan was getting results. Overall, crime rates were plummeting. Violent crime had gone down close to 60 percent in San Francisco since Hallinan took office.
> Still, the low conviction rate resulted in headline after headline about San Francisco’s permissive attitude toward crime, a media environment harnessed by the Harris campaign.
Do we really want to live in a society where people are not prosecuted because the family of the victim forgave them? So if two people commit the same offence, Person A is not prosecuted because the victim's family forgave him but Person B is because the victims family did not? Was offender B just unlucky on victim selection? The rule and application of law should not be based on the feelings of the victims family. Did the dead person forgive them?
We certainly don't want to ignore them, given they have the most immediate understanding of the situation and entitlement to guilt.
We don't allow plaintiffs to sue without standing. Why do we allow DAs to prosecute without a victim?
The state has a justification to pursue crime, but it seems like that should be limited when there's (no victim) or (victim who disagrees with prosecution).
Is the dead person not a victim? If someone is murdered and their family is like good I hated them anyway does that nullify the existence of a crime? Are we basing prosecution now on the character of the victim? That's a pretty quick path to deciding that certain victims have no value in society.
The dead person is a victim, and in a perfect society we'd just execute the killer. 1:1.
In reality, the justice system is imperfect, inequal access to defense, imperfect identification of killers, etc.
All murder is bad.
But I'd certainly say murdering a good person is worse than murdering a bad one. And if a family, who on average has more incentive to think well of the victim than anyone, doesn't... should that be ignored?
I hear what you are saying but honestly yes it should be ignored. For reasons of both fairness but more importantly I want justice to be blind. I don't want the police or prosecutors to be able to decide that person A was a dick or was a republican or a democrat or white / black so his murder is not as important. It could also lead to situations where the murder of a rich person is prosecuted more harshly than that of a poor one as the rich person donated so much to charity. The law has to be blind and based on clearly defined parameters.
But I feel like discretionary prosecution is already breaking blindness.
And furthermore, perversely-incentivized blindness. Get a high conviction rate, by throwing the book at people charged with "PR bad" crimes, regardless of the individual, and as long as they aren't politically connected and potentially useful in your future political career.
Compared to that motivation of your average DA / USA, "How surviving family feels" doesn't seem worse.
I agree with you in regards to how the current system is not blind and discretionary prosecution is a negative. I am all for pretty much anything that removes a prosecutors ability to give a pass to a preferred class of offender. By that I generally mean police officers. Giving them an additional power to decide the value of a victim based on their family or their biased opinion of goodness is not a net positive and just further greys the area. I hear what you are saying and actually sympathize with it but I think the solution should be to focus on removing as much discretion as possible as it just gives prosecutors and law enforcement decision making power they should not have.
If the entire chain of command is responsible, but only one person responsible for the poor result pays a real price, then is it really justice at all?
I'm not saying the rest of them should not be prosecuted if there was fault further up the chain as well. I agree they should be. In this case the nurse clearly breached many protocols and delivered the killing action so she bears responsibility. If there is a systematic failure then they should pursue that too. Justice is not a decision that well we could not get them all so no point prosecuting anyone.
Consider this: someone drives without paying proper attention and kills someone. It's time for victim impact statements, and relative after relative asks the court for lenience on the driver because the victim was a drunk and a wifebeater, the world is better off without him.
Not sure that that is a good idea, justice is about more than just those immediately affected by a crime
Is it though? Should a cop be prosecuted for accidentally killing an innocent civilian in the course of duty during a non violent traffic stop? I would argue that they should be. How many chances should a nurse get to accidentally kill someone? Do they only get prosecuted the second time? Third?
If you are responsible for the death of another person due to your own negligence then you should be prosecuted for a crime and be removed from any scenario where you are able to repeat that mistake.
A cop killing an innocent civilian at a nonviolent traffic stop can pretty much happen only because of malice or negligence. We use the word "accident", but it's never really an accident. If a nurse accidentally kills someone, it may really be an accident.
Furthermore, the nurse is in a profession where people die all the time due to reasons beyond the nurse's control, and surviving relatives are not always rational in who they blame. So nurses will be falsely accused much more often than police.
> A cop killing an innocent civilian at a nonviolent traffic stop can pretty much happen only because of malice or negligence.
This was found to be by recklessness, which is beyond negligence but short of malice.
> We use the word "accident", but it's never really an accident.
Acts due to negligence, and even recklessness, really are accidents.
> Furthermore, the nurse is in a profession where people die all the time due to reasons beyond the nurse's control, and surviving relatives are not always rational in who they blame.
Surviving relatives don't make prosecutorial decisions, nor are they triers of fact in criminal cases.
> So nurses will be falsely accused much more often than police.
That...doesn't follow from what you’ve described, even taking everything preceding it as true.
> A cop killing an innocent civilian at a nonviolent traffic stop can pretty much happen only because of malice or negligence.
I'm not sure this is true, specifically because the difference between a nonviolent traffic stop and a lethal (to the officer) traffic stop can be a split second.
If my keyboard had a 0.01% chance of lethally shocking me... I'm pretty sure that would alter my typing behavior.
"can pretty much happen only because of malice or negligence"
Negligence means "failure to take proper care in doing something", which is often just called an accident.
That is exactly what the nurse did, she failed to take proper care and someone died. The nice thing about the law is that what the relatives feel should not matter at all, that's why we are supposed to have impartial prosecutors that review the facts and determine if charges are warranted.
Bottom line, no matter the profession if you fail to take proper care and someone dies as a result, you should be prosecuted and prevented from getting the opportunity to do it again.
>Negligence means "failure to take proper care in doing something", which is often just called an accident.
This is not true, because you're equivocating on the word "proper". An accident is failure to take proper care, where proper care means "care that follows the rules". Negligence is failure to take proper care, where "proper" means "can reasonably be expected". They are not the same thing.
Not really sure where you are getting those definitions from. Proper means proper. The nurse did not follow the rules. The nurse did not provide any of the care that could have been reasonably expected. Fail to see a difference, she failed both of your definitions.
[1]https://www.npr.org/sections/health-shots/2022/03/24/1088397...