|
There was a time when I had access to firsthand accounts of medical catastrophes. It was extremely frustrating because my sources would never go public. Doctors scandalise one another but never break ranks. Knowing that a colleague’s career is on the line is a great inhibitor. Nobody is infallible and it is easy for any doctor to put himself or herself in the shoes of a friend or colleague whose years of studies appear to be going up in smoke because of some momentary lapse.
It is all too easy to choose to save the doctor who can continue to serve the community while sacrificing the patient’s or the patient’s family’s rights to redress. Professional omert-à is also a form of insurance: if the worst happens to me, my colleagues will keep their mouths shut too. If I squeal I become fair game. Medical services may be cheaper in Malta because of the infrequency of malpractice suits. Elsewhere they have become an occupational hazard for the medical profession, part of everyday reality.
It is not only when the matter becomes public that the system fails: inquiries are often less than transparent and very often unsatisfactory in their findings. In most cases where patients or their families persist. it appears that an out of court settlement is arrived at. However it remains impossible to gather data about the cases that never become public. Sometimes only the doctors know that something was botched. There were instances when the patients or their families thanked the medical staff not knowing that a major failure had taken place.
I do not have it in for doctors. I have no reason to believe that they are better or worse than doctors elsewhere. Here they inhabit a small pond where everybody knows everybody else. It is no different with lawyers. It is extremely hard to find one to sue another. Here too professional loyalty is founded on the experience of vulnerability. In matters where secrecy and trust form a lethal cocktail with the esoteric and artificial reality of the law, lawyers tend to make allowances for one another when hearing complaints from the uninitiated public. The line must be crossed at high speed before a colleague will listen carefully to allegations of malpractice.
I have no doubt that it is the same with architects, dentists, pharmacists and engineers, all the “old” professions. In the case of lawyers, at least, it is a violation of the code of ethics to express an opinion on the professional competence of a colleague.
Since there are “old” professions, there are also “new” ones, some so new that they may not be regarded to be such by their own practitioners. In every case it would help to have a clear code of ethics, to stick to it and to appreciate the vulnerability of the public in our very small pond.
The matter came home to me in considering the public joust between two friends of mine: the editor of this newspaper, Saviour Balzan and Louis Cassar, a consultant on the ecology, with regard to the EIA on the proposed development of Ta’ Cenc. Some serious allegations were made, which I will not repeat because they were vociferously denied and some matters raised which I would like to explore.
One is the matter of professional ethics in journalism. Our journalism is significantly hampered by libel laws which make a truly free press impossible. Libel suits are a damn good gamble for those making them while journalists can only lose, if nothing else, the time it takes to have the matter sorted out in court. Judicial precedent has unwittingly imposed self-censorship on some newspapers that engage lawyers to ensure that they are not embroiled in unfruitful visits to the courts: if in doubt leave it out. Once more the general public is the loser. Newspapers that are willing to take risks in the legal minefield should be treasured.
On the other hand it makes sense that journalists should have some rules to go by. Since it is inescapably true that mud sticks, every effort should be made to give the target of one’s enquiry a chance to defend himself or herself. This is particularly true with regard to persons who are not normally public persons.
The incestuous landscape came to mind when considering Louis Cassar’s predicament. He has acted according the rules, when the rules are unsatisfactory. He is a member of the MEPA Board and an independent consultant on development applications. It is perfectly legitimate by the existing rules for these two hats to cover one head in Malta. He has done no wrong.
It is the system that is wrong. The absurdity of architects stepping out of the room while their colleagues on the DCC decide a case in which they act for a client is palpable. In Louis Cassar’s case he acts as one of several consultants in preparing part of an Environmental Impact Assessement for a development application to be decided by the MEPA Board on which he is a member. His detachment from any case in which he has been professionally commissioned to prepare a report, his absence from any meeting of the Board in which it is discussed, may not be enough, even if it is no problem for those who appointed him to the Board. He is in the position of an architect stepping out of the room or shifting his seat and changing his role at a DCC sitting. Even if justice is done it does seem a little iffy. Louis may be convinced and fully justified in his belief in his own correctness. That is not the point: there should be no doubt on the matter in the minds of the uninitiated.
In any trifling lawsuit, none of us would be happy learn that the judge is occasionally paid (indirectly by the other party in our suit) to give advice to some other court (from which he stands down) perhaps not on the matter in hand but all the same……. The MEPA Board is a quasi judicial body deciding matters of the utmost importance not only for private individuals but for the community as a whole and for all future generations. It may lack the pomp and ceremony of a courtroom but it certainly should have the same dignity and care to be and to appear to be beyond reproach.
The reason given for engaging practicing architects and experts to sit on MEPA bodies is that there are too few to go around. It is not done this way abroad where you must have two heads to wear two hats. The rationalisation among architects is that it is useful to have the persons deciding on development applications fully familiar with the construction scene. It is about as logical as having mechanics to judge car collisions cases or doctors in malpractice suits.
The essential quality of persons entrusted to decide on anything in the name of the community is that they are impartial, and competent to interpret the rules correctly and consistently. It is vital that they are seen to be so. Architects are not necessarily planners and ecologists and not necessarily economists or sociologists. Expertise in all these fields is equally essential in reaching a planning decision. It is nonsense to expect all the necessary skills to be available on the MEPA Board except through reference to experts.
Because our pond is very, very small is no good reason to allow it to become a swamp of ethical contradictions. In fact it is a very good reason for being more, not less, on our guard in safeguarding the impartiality and the perceived impartiality of a court in all but name and one that regularly decides on the future health, wealth and strength of the country.
The same applies in every other field: the client, the patient, the customer and the citizen should be king. We should be clearly aware of the ease with which we are denied redress in the event of misfortune. None of us are doctors, lawyers and Indian chiefs all rolled into one, we are all clients and citizens. We have a right to redress from judicial and quasi-judicial bodies beyond reproach. In the case of the MEPA Board we need to know that it is in a position to safeguard the commons effectively and not prone to any professional distortion nor exposed to the merest suspicion of bias because of personal interest or professional penchant.
hcvassallo@kemmunet.net.mt
|
