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Alternative Law Journal |
Simone Brookes
Simone Brookes is a Monash University law
student.
Why should a surgeon who loses a case because their lawyer has
failed to read a brief not have as much right to be compensated as the lawyer
when the surgeon leaves a swab inside
him?[1]
It is a matter of some
annoyance to members of the medical profession that lawyers (as represented by
judges) uphold an immunity from suit for negligence, which affects their own
profession. Meanwhile, medical practitioners remain liable for negligence and
have no choice but to give lawyers the final say on matters of medical practice,
as it is for the court to determine the standard of care required of a
professional in each individual
case.[2] This article examines the
line of argument ‘if it’s good enough for one, it’s good
enough for the other’ and shows how that proposition adds further fuel to
the case for the abolition of the advocate’s immunity from
suit.
Under the common law, Australian barristers and solicitors are
immune from claims for negligence in the course of advocacy and in relation to
pre-trial work intimately connected with the presentation of a case in
court.[3] They are not subject to a
duty of care in respect of any act or omission in the conduct of a
client’s case in court, or in the making of preliminary decisions
affecting the way in which the case will be conducted when it comes to a
hearing.[4] This position is
reinforced by statute.[5]
No
member of the medical profession is immune from being sued for professional
negligence. Medical practitioners may be found negligent if a plaintiff can
successfully prove on the balance of probabilities that they were owed a duty of
care, that the required standard of care was not met, and that the breach of the
duty of care caused loss or damage to them which was reasonably
foreseeable.[6] Medical practitioners
may be sued for failing to meet reasonable standards of work, for example, in
relation to the examination, diagnosis, and treatment of a
patient.[7]
Apart from this
special area of immunity, lawyers are liable for professional negligence in the
same way as members of the medical profession. One may ask why, if ‘high
risk’ legal advocates are immune from negligence, the same does not apply
to ‘high risk’ medical practitioners, such as surgeons.
The primary basis for justifying an immunity from negligence within the legal
profession is to maintain the advocates’ duty to the court over and above
their duty to the client. Duties relating to the court include efforts by an
advocate not to prolong cases, to prune irrelevancies, not to mislead the court
and to cite relevant precedents even if they are against their clients’
interests.[8] Justice in the interests
of the general public is considered to be of greater importance than justice to
the individual, so that duty to the court takes precedence. A lawyer must
attempt to advance the interests of their client within the wider sphere of
their loyalty to the legal
system.[9]
Further, rules of
the bar associations make clear the advocate’s duty to endeavour to
control client conduct. The rules require the advocate, in effect, to pressure
the client not to mislead the court. This is over and above the lawyer
personally misleading the court.
There is a concern that the
advocate’s overriding duty to the court will be compromised if the
immunity from negligence actions is removed. Lawyers could become so concerned
for the rights of their clients, or afraid of being sued by them, that they
might fail to observe their duty to the court. Exposure to liability could
increase the incidence of lawyers adopting ‘client-advocate’
roles.[10] Lawyers might be tempted
to pursue the goals of a client by whatever legal means available, thereby
overriding their duty to the court. For example, they could prolong litigation
through such means as creating delay and expense in order to hinder the
enforcement of legal claims against their client.
In high pressure
situations, the independent judgment of a lawyer could be compromised. This
could lead to the adoption of over-cautious tactics such as the excessive
calling of witnesses and the protraction of cross-examinations. The backlog of
litigation would continue to rise.
Are these concerns justified? Those
who argue for the removal of the lawyer’s immunity from suit for
negligence suggest that the advocate’s duty need not be compromised by the
threat of negligence proceedings. In the event of such actions, judges would
appropriately direct juries whether an advocate had failed to use the standard
of care which a reasonably competent practitioner should be expected to use, or
had merely made a non-negligent error of judgment. Advocates could be exempted
from liability for making errors in high pressure situations, as judges would
take into account the conditions under which they were
working.[11] Inefficient practices
could be controlled by judges who had the authority to limit the asking of
unnecessary questions and the calling of unnecessary
witnesses.[12] Further, if the
advocate erred on the side of observing their ethical duty to the court and lost
their case as a result, the judge in a subsequent damages action alleging a
lawyer’s negligence could take a ‘protective’ approach which
would recognise the difficulties created by conflicts of interest and,
notionally, at least, would set the standard of care at a lower level.
The current lack of immunity within the medical profession suggests that a
greater emphasis is placed on the health of individual patients, than on the
wellbeing of society.[13] However,
there are some exceptions to this proposition. For example, it has been held
that the importance of confidential communications between a patient and health
care provider may be outweighed by the public interest in the protection of
third parties from serious harm.[14]
Further, the illegality of mercy killing in all Australian jurisdictions tends
to indicate that medical practitioners owe the community a duty to abide by the
law, even if that means they are unable to pursue the interests of an individual
patient.
In the context of medical litigation, the distinction between
negligence and a mere error of judgment is well
established.[15] An error of
clinical judgment may not be negligent where reasonable professional skill and
care was exercised in forming the clinical
judgment.[16]
If an immunity
is justified for advocates, considerations suggest it should be equally
applicable to surgeons. Surgeons remain liable for negligence, even though the
extra pressures under which they work could potentially have more disastrous
‘life or death’ consequences than could arise for advocates under
similar high pressure conditions. Further, they could be deterred from using
their best judgment to take a risk to save life or limb as a result of a fear
that if they were to make a mistake, it would result in an action by a patient
or the patient’s family.
It is clear that a lack of immunity within
the legal and medical systems would be equally likely to result in overcautious
practices. The fact that surgeons in the theatre remain liable for professional
negligence whilst lawyers in court do not, may indicate that there is a greater
public interest in the efficient administration of justice than in health
care.[17]
In particular,
‘defensive medicine’ is a tactic that has been adopted by medical
practitioners in order to avoid liability in negligence. It may involve
undertaking additional procedures such as taking more time to explain risks,
arranging for more frequent consultations and organising unnecessary diagnostic
tests. This approach aims to make a patient aware of all the risks of
treatment, as there is no cause of action in negligence if a patient accepts
treatment knowing what might occur. However, there is a danger that excessive
and unnecessary medical procedures will lead to the wasting of resources.
It may be argued that an immunity could be justified with respect to
medical practices aimed at improving the overall health of the general
community. Such a proposal has been suggested in relation to pathology screening
services.[18] Proposals in favour of
a statutory immunity for screening services suggest that liability for
negligence within the medical profession should not exist in certain instances
where:
| • | screening programs are carried out with a demonstrable and appropriate level of quality on the grounds that any adverse outcome is due to a recognised error rate; |
| • | resource limitations prevent the addition of technology or expertise that is available but beyond the financial means of an agency to provide; and |
| • | negligence is limited to a failure to comply with certain standards of practice, as measured against legislative standards (which would need to be implemented), so that litigation could only occur as a result of a failure to comply with such standards.[19] |
Conversely,
it may be argued that if quality assurance programs and benchmark standards
could be properly managed, there would be no need for a statutory immunity for
screening services. Negligent conduct should not necessarily be excused simply
because a procedure has a recognised error
rate.[20] Such views emphasise that
the right of an individual to sue for negligence is central to our legal system.
There is a concern that public confidence in the judicial system would falter
if the legal immunity were
abolished.[21] The strong public
interest in finalising litigation must be balanced against the notion that a
person who has been wronged as a result of a negligent action should be able to
seek redress.
Lawyers fear that a flood of litigation would result.
However, in reality, it is unlikely that most people would have the will,
finance, or time, to go through the court process a second time. Only those
involved in cases where a seriously unjust result was obtained would be keen to
maintain an action in negligence, as worthless and insubstantial claims usually
fail.
The public confidence concern is equally, if not more, applicable
to the medical profession. First, the health of individuals might be jeopardised
if they were to be deterred from seeking medical help as a result of negative
publicity within the medical profession. However, it may be argued that this
consideration is not relevant to those cases where medical care is not optional.
Second, there is a real risk that if surgeons were found liable for negligent
operations, it might deter other practitioners from undertaking such procedures.
Medical fields where high levels of legal action were reported might result in
practitioners avoiding high risk areas of medicine.
The fear that medical
practitioners have of litigation is compounded by the knowledge that there is an
adverse effect on the practices of doctors who are sued. Even if a plaintiff is
unsuccessful, the mere fact that a doctor has been involved in court may have
psychological, social and economic impacts on their life.
The ‘cab-rank’ principle requires advocates to accept a client
who desires their services within their field of practice and can pay their fee.
Today the application of this principle is limited. In practice, it will only
apply in order to prevent a barrister from refusing a solicitor’s
instructions in a field of law within which he practises because ‘he does
not like the solicitor or the solicitor’s client, or the nature of a
lawful claim or ground of defence of which that client wishes to avail
himself’.[22] Therefore,
advocates have a fair degree of freedom to select their clients.
In most
medical negligence cases, a duty of care is owed by the person treating the
patient and by the incorporated health facility where treatment is given. The
need for an immunity from negligence within the medical system may be
strengthened where a medical practitioner has no choice but to provide medical
assistance. They may come under a duty to treat a person who is not already
their patient and is in need of emergency
care.[23] If the practitioner does
not have reasonable cause for refusing treatment, a cause of action will arise
if it was within their capacity to provide such treatment and the requisite
proximity criteria are
satisfied.[24] Further, there is
some statutory support which suggests that a medical practitioner will be liable
for ‘unsatisfactory professional conduct’ if they refuse or fail to
attend to a person for the purpose of rendering medical assistance where they
have reason to believe that that person is in need of urgent
attention.[25]
It is not fair that an injured member of the public should be denied
compensation from their lawyer when they can recover compensation from their
doctor. While lawyers and doctors are not in direct competition with each other,
professional people are paid on the basis that they will provide a quality
service, and if they are negligent in providing that service they should be
liable to pay compensation.
The legal immunity granted to advocates
should be abolished. Present public policy considerations are not of sufficient
weight to justify a legal immunity from suit for professional negligence. If the
immunity were abolished, various procedures could be implemented to maintain a
just and efficient legal system. Judges would need to ensure that advocates
respected their duty to the court and, where that duty conflicted with duty to
the client, that the former duty took precedence, thereby protecting the
advocate from suit in appropriate cases. Additionally, it would be necessary for
judges to take a more active role in advising juries whether a defendant had
been negligent or had merely made a non-negligent error. This distinction has
been established in the medical system and obviates the need for a legal
immunity to be extended to medical practitioners.
References
[1] Masel, Geoffrey, Professional
Negligence of Lawyers, Accountants, Bankers and Brokers, CCH Australia Ltd,
1989, 2nd edn, p.192.
[2] Rogers
v Whitaker (1992) 175 CLR
479.
[3] Giannarelli v Wraith
(1988) 165 CLR 543.
[4]
Giannarelli v Wraith above, at
579.
[5] See s.442(1) of the
Legal Practice Act 1996
(Vic).
[6] Victoria, Parliament,
Law Reform Committee, The Legal Liability of Health Service Providers: Final
Report, Melbourne, 1997,
p.10.
[7] Australian Professional
Liability — Medical, CCH Australia Ltd,
p.26,753.
[8] Luntz, Harold and
Hambly, David, Cases and Commentary, Butterworths, 1995, 4th edn,
p.178.
[9] Ramsay, Ian,
‘Ethical Perspectives on the Practice of Business Law’, Law
Society Journal, p.60.
[10]
Ramsay, Ian, above, p.61.
[11]
Victoria, Law Reform Commission, ‘Accountability Through Legal Action:
Liability for ‘In-court’ Action’ in Accountability,
Discussion Paper 24, July 1991,
p.19.
[12] Victoria, Law Reform
Commission, above, pp.18-20.
[13]
Victoria, Parliament, above, ref. 6,
p.30.
[14] Tarasoff v Regents
of the University of California (1976) 551 P2d 334. In that case it was held
that the therapist had a positive duty to exercise reasonable care to protect
the foreseeable victim.
[15]
Heerey, P.C., ‘Looking Over the Advocate’s Shoulder: An Australian
View of Rondel v Worsley’ (1968) 42 ALJ 3 at
7.
[16] Maynard v West Midlands
Regional Health Authority [1984] 1 WLR 634 (HL), Darley v Shale (1993) 4 Med LR
161.
[17] Victoria, Law Reform
Commission, above, ref. 11,
p.20.
[18] Victoria, Parliament,
above, ref. 6, pp.30-2.
[19]
Victoria, Parliament, above, ref. 6,
pp.30-2.
[20] Victoria,
Parliament, above, ref. 6,
pp.30-2.
[21] This discussion
draws on the considerations expressed in Giannarelli v Wraith (1988) 165
CLR 543.
[22] Ross, S. and
MacFarlane, P., Lawyers Responsibility and Accountability: Cases,
Problems and Commentary, Butterworths, 1997,
p.330.
[23] Woods v Lowns
(1995) 36 NSWLR 344.
[24]
Woods v Lowns above.
[25] Section
37, Medical Practice Act 1992 (NSW).