On April 12,1974 Dr. Kenneth Edelin was indicted for manslaughter in connection with a legal abortion he performed at Boston City Hospital. Specifically he was charged with causing the death of the baby boy who, the prosecution charged, was born as the result of a hysterotomy. After a lengthy trial that consisted almost exclusively of complex medical testimony Dr. Edelin was found guilty of the charge. On December 17, 1976 the Massachusetts Supreme Judicial Court reversed the verdict and ordered that a judgment of acquittal be entered.

All six judges who heard the case voted to reverse the conviction with five Justices deciding that a judgment of acquittal should be entered. These five Justices found that there was insufficient evidence lo go to a jury on the issue of whether Or. Edelin was guilty of wanton or reckless conduct, and that motions for a directed verdict of acquittal should have been granted by the trial judge. Three of the live Justices would have reached the same result on both the grounds that there was insufficient evidence of live birth. and that there was a prejudicial divergence between the accusation and the instructions to the jury.

The malpractice Insurance crisis of 1975 saw many insurance companies which had provided medical malpractice coverage leave the field. Those that stayed increased their premium rates astronomically. One of the results has been a flood of legislation, a torrent unparalleled , , , in the history of medical law In this country. We may expect soon to be deluged again, this time with court decisions reviewing and interpreting the constitutionality of these laws. This brief article reviews the first trickle of such cases.

The bulk of the issues litigated to date have centered around the use of screening panels. A number of states have set up such panels. in all of the cases so far litigated. the panels contained a judge who usually sat with a physician and a lawyer. Before a lawsuit is filed, the plaintiff is required to bring the case before Me panel, which makes a determination of liability and damages. Either party may there after bring the case to trial.

Growing dissatisfaction with traditional bar association grievance mechanisms as a deterrent against the institution of “frivolous” medical malpractice suits has promoted physicians to explore other methods of legal redress against “unscrupulous” lawyers. One avenue of recourse now being popularized among physicians is a countersuit by defendant physician against plaintiff patients and attorneys. The reasoning behind this approach has been bluntly expressed by a recent successful countersuitor, Dr. Leonard Berlin, “The school bully who harasses innocent children in the playground isn't stopped by reporting to his parents—he's stopped only by a punch in the face. Lawyers who abuse the court systems similarly can only be stopped through the same court system.”

Attractive as the countersuit attack may appear on the surface, the effectiveness of such a retaliatory measure in stemming medical malpractice litigation is questionable and doubtful.

A great deal of discussion and debate has centered around the right of a terminally ill patient to refuse life-sustaining treatment. The statement of policy found in Idaho's recent Natural Death Act summarizes many of these issues:

The legislature finds that adult persons have a fundamental right to control decisions relating to the rendering of their medical care, including the decisions to have life sustaining procedures withheld or withdrawn in instances of a terminal condition.

The legislature further finds that modern medical technology has made possible the artificial prolongation of human life beyond natural limits.

The legislature further finds that patients suffering from terminal conditions are sometimes unable to express their desire to withhold or withdraw such artificial life prolongation procedures because of the progress of the disease process which renders the patient comatose or unable to communicate with the physician.