Type I and II Equilibria and Racism

June 23, 2020

To my boys:

 

Are there too many malpractice lawsuits or not enough of them? 

 

Most physician organizations would say there are too many, and that they cause an overabundance of unnecessary tests and procedures under the heading of "defensive medicine".

 

Most trial lawyers and some patient advocates would say there are not enough, that physicians are tribal and will protect their own to the detriment of patients who were harmed under their care.

 

The fact that the truth is somewhere in between was not a surprise for me when I studied the concept in graduate school. What did change my thinking on that topic was when my professor asked us all whether mistakes on both sides (I.e. frivolous suits and missed malpractice) mattered if the overall perceived risk of a malpractice lawsuit  was such that the main societal purpose of tort law (deterring bad medicine) was achieved? For it is possible that the balance of (in statistical parlance) type I errors where false claims occurred and type II errors where malpractice was not detected could be such that the overall outcome is achieved.

 

While the above is an open question, the concept is something I've thought about in the case of the killings of black Americans by the police and one of the key critiques of the reform/defund/etc. movements. Critics will cite that the use of deadly force, when controlling for a number of other factors, is not statistically more significant against black Americans.

 

The problem, in my opinion, is that the defenders of the police departments are not focusing on the type II error cases, where episodes of inappropriate use of force are not seen and counted, yet impact members of affected/targeted communities anyway. Cases like the Floyd case can then serve as to help compensate by being heavily focused on, thus bringing the total amount of public attention more in line with the actual size of the issue.

 

 

 

 

 

 

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