In the article, "Public Reporting, Patient Safety, and Quality Improvement: The Need for Legal Protections,"1 the author, Ms Hofler, states that the healthcare safety crisis can be "fixed" by legislative protection in potential malpractice cases. However, her argument is flawed on many bases.

First, most states legally protect such things as incident reports and any information provided to any type of patient safety committee from being admitted into evidence in a court of law. In addition, medical malpractice lawsuits are the RESULT of a flawed healthcare system, not the CAUSE of a flawed healthcare system.

Ms Hofler claims that when patients see data about healthcare errors, they assume that the "[healthcare] system[horizontal ellipsis]is failing its customers." The healthcare system IS failing its customers!! According to Starfield,2 healthcare is the third leading cause of death in this country. Ms Hofler believes that this is partially due to litigious patients and their attorneys. However, damages awarded in medical malpractice lawsuits, even excessive damages, are not responsible for this high death rate. Furthermore, the "medical malpractice insurance crisis" can be explained. Medical malpractice insurance companies, just like any other capitalistic business, are in business for one thing-to make money, period.

Ms Hofler has the honorable position of being a registered nurse. All nurses are always patient advocates in any given situation. According to the American Nurses Association's Code of Ethics, Provision 3, "a nurse promotes, advocates for, and strives to protect the health, safety, and RIGHTS of the patient."3^(p12) The American Nurses Association's code continues with "[horizontal ellipsis]under no circumstances should the nurse participate in, or condone through silence [horizontal ellipsis]an attempt to hide an error [horizontal ellipsis][instead of] correct[ing] the conditions that led to the error." 3^(p14)

However, Ms Hofler does exactly this in her article and asks that additional "harm" be brought about to an already harmed patient in the form of limiting a patient's access to information. This limitation will not make injured patients more satisfied with the poor healthcare that they have received. It does not make sense to blame poor injured patients for their injuries caused by the healthcare system, which is just what Ms Hofler does. We need to fix the healthcare system with real healthcare solutions, not legal solutions.

Stephanie Warnock, JD, RN

Nursing Instructor, Covenant School of Nursing, Nurse Attorney, (Independent Contractor), Lubbock, Tex ([email protected])

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