Decision Analysis and Medical Malpractice

Normative decision theory has been applied to the problem of evaluating alternative diagnosis-treatment strategies. The courts rely on a different set of doctrines in performing the same sort of evaluation. This paper investigates the differences. It is suggested that the alleged “malpractice crisis” results largely from the application of a set of ambiguous and mutually inconsistent medico-legal principles such as “reasonable medical certainty,” “standards of good medical practice in the community,” and “proximate cause.” The expected utility criterion of decision analysis is proposed as an alternative to this melange, both for the purposes of establishing the existence of negligence and for determining the proper amount of compensation.