1.

Medical Malpractice
Medical malpractice is defined as any act or omission by a physician during treatment of a
patient that deviates from accepted norms of practice in the medical community and causes an
injury to the patient. Medical malpractice is a specific subset of tort law that deals with
professional negligence. “Tort” is the Norman word for “wrong,” and tort law is a body of law
that creates and provides remedies for civil wrongs that are distinct from contractual duties or
criminal wrongs. “Negligence” is generally defined as conduct that falls short of a standard; the
most commonly used standard in tort law is that of a so-called “reasonable person.” The
reasonable person standard is a legal fiction, created so the law can have a reference standard of
reasoned conduct that a person in similar circumstances would do, or not do, in order to protect
another person from a foreseeable risk of harm.
Lawsuits alleging medical malpractice are generally filed in a state trial court. Such trial courts
are said to have jurisdiction over medical malpractice cases, which is the legal authority to hear
and decide the case. Legal rules guide venue and jurisdiction in each state. Some towns may be
located in two judicial districts, thereby giving the aggrieved patient an option to file suit in more
than one trial court. If the malpractice claim involves the federal government acting through a
federally funded clinic or a Veteran’s Administration facility, then the action is filed in a federal
district court. Each state has at least one such federal district court. Federal courts may also be
appropriate for filing malpractice claims where a complete diversity of state citizenship exists,
i.e., if the parties to the litigation are from different states, or if a federal question is invoked,
such as violation of a fundamental constitutional right during the allegedly negligent conduct.
Under limited circumstances, a medical malpractice case may be filed or moved to a federal
court. This can occur if the underlying case invokes a federal question or federal constitutional
issue or if the parties live in different states. The federal equivalent of state trial courts consists of
a system of 94 United States district courts; at least one is located in each state. Like state courts,
U.S. district courts have a judge and a jury panel that hear the case. While the rules that apply to
legal procedures in U.S. district courts are uniquely federal, they are similar to state rules of legal
procedure. The substantive law applied by federal courts to resolve legal disputes, ie, statutory
law or legal precedent, is derived from the state in which the district court is located. Thus, if a
medical malpractice case is tried in federal court, state malpractice law still applies, with federal
procedural rules of jurisprudence. Procedural rules have to do with legal housekeeping functions
that guide the litigation process.
In the United States, the patient alleging medical malpractice must generally prove four elements
or legal requirements to make out a successful claim of medical malpractice. These elements
include: (1) the existence of a legal duty on the part of the doctor to provide care or treatment to
the patient; (2) a breach of this duty by a failure of the treating doctor to adhere to the standards
of the profession; (3) a causal relationship between such breach of duty and injury to the patient;
and (4) the existence of damages that flow from the injury such that the legal system can provide
redress.
Increasing medical malpractice litigation relates to increased medical expenditures, because of
increased resource utilization from defensive practices to avoid claims. The concern has been
raised that physician may settle cases to avoid the nuisance, harassment, and financial risk
inherent in jury trials. Monetary payments, even if through pretrial settlement, are usually
reported to a national practitioner databank and to state medical licensing boards and medical
societies. While the goals of such reporting are related to ensuring quality of care, the advantages
of these mechanisms remain unclear. The role of lawsuits and pretrial settlement in contributing
to the large costs of the U.S. healthcare system are a subject of an intense national debate.

For many physicians, the deposition under oath is the most vivid encounter with the legal system
during a medical malpractice suit. In law, a deposition is a witness testimony that is given under
oath, and recorded for use in court at a later date. In the United States, a deposition is part of the
discovery process by which litigants gather information in preparation for trial. Federal Rules of
Civil Procedure and their corresponding state counterparts govern the taking of testimony by
deposition. Typically, the patient’s attorney will file notice with the attorney defending the
doctor that a deposition is needed. All parties agree upon a convenient time and place. In many
cases, the place is the doctor’s office, preferred by the defense lawyers since physicians are
comfortable in their offices, and have books and other reference materials available, in case they
are needed. A deposition begins with a court reporter administering the same oath or affirmation
that the party being deposed would take if the testimony were to be in court, before a judge and
jury. Then a verbatim stenographic record of all that is said during the deposition is taken, just
like a recording in court. A written record of the testimony, or a video record, is then available to
all parties in the litigation.

Medical malpractice occurs when a health care professional or provider neglects to provide
appropriate treatment, omits to take an appropriate action, or gives substandard treatment that
causes harm, injury, or death to a patient. A malpractice suit can have a devastating impact on a
practitioner's professional and personal life. The physician's reaction to this event is profound,
affecting his own life-style and that of family, colleagues, and patients.
 2. LABORATORY ERRORS THAT LEAD TO LAWSUIT
All providers know medical errors create a serious public health problem that poses a
substantial threat to patient safety.  Yet, one of the most challenging unanswered questions is
"What constitutes a medical error?" The answer to this basic question has not been clearly
established. Due to unclear definitions, “medical errors” are difficult to scientifically measure. A
lack of standardized nomenclature and overlapping definitions of medical errors has hindered
data analysis, synthesis, and evaluation.
laboratories have a major impact on patient safety as 80–90 % of all the diagnosis are made on
the basis of laboratory tests. Laboratory errors have a reported frequency of 0.012–0.6 % of all
test results. Patient safety is a managerial issue which can be enhanced by implementing active
system to identify and monitor quality failures. This can be facilitated by reactive method which
includes incident reporting followed by root cause analysis. This leads to identification and
correction of weaknesses in policies and procedures in the system. Another way is proactive
method like Failure Mode and Effect Analysis. In this focus is on entire examination process,
anticipating major adverse events and pre-emptively prevent them from occurring. It is used for
prospective risk analysis of high-risk processes to reduce the chance of errors in the laboratory
and other patient care areas.
Health care professionals experience profound psychological effects such as anger, guilt,
inadequacy, depression, and suicide due to real or perceived errors. The threat of impending
legal action may compound these feelings. This can also lead to a loss of clinical confidence.
Clinicians equate errors with failure, with a breach of public trust, and with harming patients
despite their mandate to “first do no harm.”
Fear of punishment makes healthcare professionals reluctant to report errors. While they fear for
patients’ safety, they also dread disciplinary action, including the fear of losing their jobs if they
report an incident. Unfortunately, failing to report contributes to the likelihood of serious patient
harm. Many healthcare institutions have rigid policies in place that also create an adversarial
environment.  This can cause staff to hesitate to report an error, minimize the problem, or even
fail to document the issue. These actions or lack thereof can contribute to an evolving cycle of
medical errors.  When these errors come to light, they can tarnish the reputation of the healthcare
institution and the workers. 
Some experts hold that the term “error” is excessively negative, antagonistic and perpetuates a
culture of blame. A professional whose confidence and morale has been damaged as a result of
an error may work less effectively and may abandon a career in medicine. Many experts suggest
the term “error” should not be used at all. Due to the negative connotation, it is prudent to limit
the use of the term “error” when documenting in the public medical record. However, adverse
patient outcomes may occur because of errors; to delete the term obscures the goal of preventing
and managing its causes and effects. 
Errors, no matter the nomenclature, typically occur from the convergence of multiple
contributing factors. Public and legislative intolerance for medical errors typically illustrates a
lack of understanding that some errors may not, in fact, be preventable with current technology
or the resources available to the practitioner. Human factors are always a problem, and
identifying errors permits improvement strategies to be undertaken. In particular, blaming or
punishing individuals for errors due to systemic causes does not address the causes nor prevent a
repetition of the error. The trend is for patient safety experts to focus on improving the safety of
health care systems to reduce the probability of errors and mitigate their effects rather than focus
on an individual’s actions. Errors represent an opportunity for constructive changes and
improved education in health care delivery.
Governmental, legal, and medical institutions must work collaboratively to remove the culture of
blame while retaining accountability. When this challenge is met, health care institutions will not
be constrained from measuring targets for process improvement, including all errors, even with
adverse outcomes.
Healthcare providers want to improve outcomes while reducing the risk of patient harm. Despite
provider best efforts, medical error rates remain high with significant disability and death.
Preventable medical errors contribute substantially to healthcare costs, including higher health
insurance costs per person expenses. Only by health professionals working together will the cost
and injury associated with medical errors be mitigated.
Medical laboratories play a pivotal role in the diagnosis and management of patient. With
approximately 60–70 % of medical decisions related to diagnosis and treatment involve
laboratories; quality failures in laboratory medicine have potential to jeopardize patient safety.
Hence, laboratories have been at the forefront to enhance patient safety. With increased
automation in manual processes occurring in laboratories, reduction has been observed in quality
failure rate in last 10 years. However, it mainly focused on the analytical phase. Hence, in
addition to advancement in technology, there is requirement for vigilance among laboratory
personnel regarding prompt reporting of possible quality failures followed by investigations.
Such systemic approach seeking identification of weakness in total testing process followed by
correction in policies and procedures require openness among laboratory staff, rather than to
apportion blame to individual staff members. Hence, it is important for all laboratories to identify
quality failures, classify it by cause (i.e. pre-analytical, analytical, post-analytical) followed by
grading the seriousness of quality failure. Classifying the quality failure directs the attention to
the step in total testing process requiring scrutiny and is useful for monitoring the quality
performance and grading helps in prioritizing the corrective action.
3.ABORTION: A PHILOSOPHICAL DEBATE

Philosophical debate about the ethics of abortion has reached stalemate on two key issues. First,
the claim that fetuses have moral standing that entitles them to protections for their lives has
been neither convincingly established nor refuted. Second, the question of a pregnant woman's
obligation to allow the gestating fetus the use of her body has not been resolved. Both issues are
deadlocked because philosophers addressing them invariably rely on intuitions and analogies,
and such arguments have weaknesses that make them unfit for resolving the abortion issue.
Analogical arguments work by building a kind of consensus, and such a consensus is virtually
unimaginable because (1) intuitions are revisable, and in the abortion debate there is great motive
to revise them, (2) one's position on abortion influences judgments about other issues, making it
difficult to leverage intuitions about other ethical questions into changing peoples' minds about
abortion, and (3) the extent of shared values in the abortion debate is overstated. Arguments by
analogy rely on an assumption of the commensurability of moral worldviews. But the abortion
debate is currently unfolding in a context of genuinely incommensurable moral worldviews. The
article ends by arguing that the default position must be to permit abortion as a consequence of
the freedom of conscience protected in liberal societies.
Abortion is a philosophically interesting issue because both sides seem so certain of their conclusions,
yet the issue is at the same time clearly a derivative one. It is also highly political, and needs to be seen
within the context of the growth of the women's movement. A philosophical overview of the issue in
section 1 construes the central claims of the pro-choice and anti-abortion positions as moral and
conceptual constructions, which extend everyday moral thinking into the area of abortion. It notes the
interesting relation between such constructions and other arguments about abortion, and how this is
responsible for their social and historical specificity. Section 2 defends the pro-choice position as a
victory of moral sensitivity over linguistic guile. Section 3 situates the argument within the politics of
feminism, and recognizes the limited contribution which philosophy is able to make.
Abortion is the termination of a pregnancy. The kind of abortion that is controversial is induced
abortion, in which the embryo or fetus is prematurely removed or caused to be expelled. Induced
abortions are commonly voluntary (elective). Induced, elective abortion is in contrast to
spontaneous abortion, or miscarriage, in which the embryo or fetus is involuntarily expelled
because of accidental trauma or disease.
The two chief positions on the morality of abortion can be called the “pro-life” position and the
“pro-choice” position. The basic pro-life position holds that induced abortions are morally
impermissible (morally wrong, morally prohibited). The basic pro-choice position holds that
induced abortions are morally permissible (morally allowable, not morally wrong).
All humans develop from a zygote which is formed when a human sperm fertilizes a human
ovum. The zygote undergoes a process of cellular multiplication as it slowly moves through the
fallopian tube to be implanted in the uterine wall. The zygote is called a conceptus during the
process of fertilization. This process takes place between seven (7) to nine (9) days. The
embryonic stage begins on the third week after fertilization and continues until the eighth week
of pregnancy. By the end of the eighth week, the embryo is called a fetus because it has
sufficiently developed and begins to look human. At this stage, brain waves can be monitored.
Quickening which occurs by about the eighteenth week is another milestone in the developing
pregnancy.

When a fetus starts living can’t be determined but according to facts, the heart beats after 16-25
days and the brain works after 40 days. Some people think that after conception you become a
person whereas others think otherwise. But suppose you have 50 pills on a table and one is
poisonous. Would you randomly swallow a pill not caring if it’s is a normal pill or poison? No,
you value your life so why not a fetus? The fetus could be alive and abortion could be murder.
Because abortion is legal, whether or not the fetus lives to be born depends on people and
whether the unborn are protected by rights.
Pro-Choice believes women have the freedom to choose abortion. This group believes abortion
is a personally protected choice. They think if abortion is illegal, it will increase in “back alley”
abortions, or self-abortions or worse, the mother may kill the baby, as some young mothers
have. They believe the fetus is a “mass of tissue” (Wilke, 1) instead of human. Pro-choice
believes personhood begins after birth. They think kids should be wanted and reducing
unwanted children will lower child abuse. They also believe the world is way overpopulated. But
since when does a person’s life depend on the amount of people in the world.

Reason’s women give for why they seek abortion are often far more
complex than simply not intending to become pregnant; the decision to
have an abortion is usually motivated by more than one factor. While
improved contraceptive use can help reduce unintended pregnancy and
abortion, some abortions will remain difficult to prevent, because of
limits to women's ability to determine and control all circumstances of
their lives.
ASSISTED SUICIDE: HARRIET SCOTT’S STORY

Harriet Robinson Scott could not have known that her legal fight for
freedom, first started when she was about thirty in 1846, would
eventually contribute to civil war and the end of slavery in America. Her
decision to file a suit for freedom and to stay with it until its final
conclusion were acts of high courage and determination. These traits
would give strength to the long and difficult struggle for civil rights that
Harriet Robinson Scott’s descendants would endure for the next
hundred years.