Friday, January 27, 2017

Medical Indemnity: Protection or Compensation?

One of the (many) puzzling elements of the NMC anti-midwifery fiasco is the NMC's insistence that, by shutting down midwives whom they judge to have "insufficient" indemnity cover, they are thereby "mak[ing] sure that all women and their babies are provided with a sufficient level of protection should anything go wrong," and that they "had to act quickly in the interests of public safety."

This rhetoric strikes me as deeply misleading.  Indemnity cover is not a public safety issue.  Not only does it do nothing to prevent bad medical outcomes from occurring in the first place, it cannot even ensure in general that financial support is available when needed for increased caring costs associated with (e.g.) disability.  All that indemnity cover does for patients is ensure that greater compensation can be paid in a malpractice lawsuit -- a very rare and specific set of circumstances.

Indemnity cannot be relied upon to "protect" families "should anything go wrong" because it does not cover anything going wrong, but only things going wrong due to malpractice on the part of the medical practitioner.  If a baby suffers brain damage due to unavoidable complications, for example, indemnity will not help. For that, we need disability support as part of the general social safety net.

Tuesday, January 17, 2017

UK Shuts Down Independent Midwives

A new low for harmful over-regulation: The UK has just regulated independent midwives out of business (at least for the time being).  The Nursing and Midwifery Council decided that they did not consider the indemnity cover of Independent Midwives UK (which has worked fine since indemnity cover was legally mandated in 2014) to be "adequate" after all.  So, as of 11 January last week, independent midwives have been legally barred from attending the births of their clients, severely disrupting the birth plans of these expectant parents (threatening their right to a home birth, disrupting their continuity of care, and generally undermining patient autonomy and the values that led these expectant parents to invest in an independent midwife in the first place).

Saturday, January 07, 2017

2016 in review

(Past annual reviews: 20152014, 2013, 2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005, and 2004.)

Applied Ethics

* The Instrumental value of one vote -- can be much higher than many philosophers seem to assume.

* Pets and Slavery -- explains why domesticated animals are not inherently wronged by their guardians, or morally akin to "slaves".

* Philanthropic focus vs abandonment -- diagnoses some bad reasoning from the CEO of Oxfam, who mistakenly thinks there are reasons of fairness to help people inefficiently.