SATURDAY MAILBOX

THE BALTIMORE SUN

Faulting lawyers won't improve malpractice mess

The Sun's editorial on the recent rise in malpractice insurance rates wisely recognized that we must improve the way we compensate victims and deter medical malpractice ("Defensive medicine," Aug. 17). However, I disagree with its emphasis on the harm supposedly caused by plaintiff lawyers.

For example, the editorial devoted three paragraphs to the plight of a single doctor who claims he will no longer deliver babies because his premiums are too high. But it didn't devote any space to describe any of the large numbers of victims of hospital and physician negligence who receive no compensation.

The editorial spoke of juries giving away lavish amounts. But it didn't cite any actual cases where victims have received exorbitant amounts. It took a swipe at plaintiff's attorney's fees. But it didn't mention the time and costs of prying information out of stonewalling doctors, hospitals and insurance companies or what defense lawyers are paid.

I heartily agree that the problem of medical negligence is serious and we must find better ways to deal with it.

But that requires that we stop focusing on anecdotes about bedraggled doctors and evil lawyers (or evil doctors and bedraggled lawyers), gather real facts, critically examine the claims of all sides and discuss real options for improvement.

Charles Shafer

Baltimore

The writer teaches torts at the University of Baltimore School of Law.

Making state juries render fair awards

No matter what the result of the current malpractice reform debate may be, blaming the plaintiffs' bar, health care providers or malpractice insurers hasn't done much to address the fundamental problem The Sun identified: Finding a predictable dispute resolution mechanism that fairly compensates victims of malpractice but just as fairly exonerates health care providers when they have done nothing wrong ("Defensive medicine," editorial, Aug. 17).

Unlike some of my colleagues, I believe that the jury system can provide such a mechanism. But for it to start reaching its potential, that system needs to dust off some of the tools it already has in place.

First, Maryland's evidentiary rules on expert testimony need to be actively asserted (by lawyers) and enforced (by judges) to guard against dubious "experts" rendering opinions with no scientific basis. Allowing an expert to rely on "because I said so" instead of the scientific method makes such testimony unreliable as a foundation for a decision.

Second, regardless of caps on damage awards for pain and suffering, the larger financial exposure for Dr. Robert L. Brenner and Maryland's other obstetricians stems from the "cost of care" expenses that go along with birth injury cases and often reach six figures yearly.

Currently, each side hires a "life care planner" and "life expectancy expert" who often provide vastly different estimates. A better system would be for judges to appoint special masters or experts (as is provided for in the Maryland Rules) to present evidence on the true cost of care and life expectancy.

Third, where a jury has clearly ignored the scientific evidence, judges should override the verdict or, alternatively, provide for a new trial. The Maryland Rules give judges that power, but such actions continue to be rare.

J. Mark Coulson

Baltimore

The writer is a defense attorney who works on malpractice and product liability matters for Miles & Stockbridge, P.C.

Let mercy supersede desire for vengeance

I'm glad The Sun is keeping the moral issue of capital punishment before us ("Death sentence in Md. would go against trend," Aug. 14). And those of us who are Christians need to follow the example of Christ in deciding where we stand on it. The Gospels give us clear indication that mercy must supersede vengeance.

There is in us a human urge for revenge, an urge we should resist. Standing in God's shoes, we want to make things right as we see right.

Such feelings come from a sense of self-righteousness. We place ourselves in God's place, declaring that one death deserves another death, a death administered by our hands.

Yet we are generally far removed from the actual execution. We read about it in the paper and say with too-easy self-assurance, "He got what he deserved." We stand back self-satisfied that justice was done.

We have decided for God a life-and-death issue. We have judged our peer to be deserving of death.

But would we want those hurt by our offenses to judge us, or prefer to leave such judgment to our merciful God?

George S. Brown

Glen Arm

Corruption as usual for state Democrats

It's business as usual for Maryland's Democratic politicians.

Maryland prosecutors and the FBI announced investigations into alleged illegal campaign finance transactions on the part of high-powered Democratic state Senate President Thomas V. Mike Miller.

However, Maryland's Democratic-controlled General Assembly has decided that any possible illegal actions by this fellow Democrat deserve little more than a wink and a nod, and have quietly closed its investigation into Mr. Miller's alleged wrongdoings ("Panel seen ready to end ethics inquiry of Miller," Aug. 13)

Maryland's Democrat leaders can't seem to find the time to look into the accusations. After all, Mr. Miller is such a powerful Democrat that the new Senate annex in Annapolis is named after him, and no Democrat has the courage to challenge his actions. Thus, another Democrat gets a free pass.

And now that Maryland's Democrats have failed in their attempt to place blame for the state's budget deficit on Gov. Robert L. Ehrlich Jr., they are scrambling to find ways to bring more money to Maryland's coffers.

By voting in Governor Ehrlich, Marylanders voted for slots, for trimming state government and against tax increases. But House Speaker Michael E. Busch and a small circle of Democrats knew better for Marylanders. And now that Marylanders are not buying the "blame the governor" game, Mr. Busch is doing a full 180-degree turn.

Now it seems Mr. Busch is ignoring his previous backers -- churches, civic groups, anti-gambling interests -- and backing slots legislation.

How can a seemingly intelligent man make such a massive shift in his opposition to slots in a few months? How can one state's legislature ignore the fact that one of its own is under the FBI's microscope?

Do they believe that by burying their heads in the sand the entire investigation will fade away? Or that state voters are stupid and won't recall how one man forced cuts in services and education to further his own political career?

Or do these examples show that Maryland's Democrats are completely out of touch with reality and consider voters nothing but obstacles to their own enrichment?

Tony Ondrusek

Hunt Valley

Holding the budget hostage to gambling

We have a concern about a state government that holds the well-being of its citizenry for ransom.

Gov. Robert L. Ehrlich Jr. is, in essence, saying that if we want him to implement the recommendations of the Thornton Commission, we need to support slots. We would suggest that it is the responsibility of government to find funding for its programs in ways that don't adversely affect citizens.

A recent trip to Reno, Nev., for a family reunion brought home to us the conditions a community will face with the introduction of gambling.

One block over from the glitzy casino faM-gades, we saw the seedier reality of gambling: six pawnshops, four of them huge, in a four-block stretch.

We would suggest that the questions posed by some legislators about who should operate the slots or the amount that should be given to the communities in which they are located miss the point.

The question needs to be: "Should we have slots at all?"

To us, the answer is obvious.

Don C. Macaulay Elaine M. Yamada Baltimore

Opportunity to boost alternative energy

Thank you for the excellent editorial "Mr. Philbrick's opportunity" (Aug. 11), which outlines both the challenges and the opportunities before the state on the environment.

As a citizen who is especially concerned about air quality, I certainly would be heartened if the Ehrlich administration, as well as the Maryland congressional delegation, were to step away from President Bush's poorly named Clear Skies initiative and join other states in expressing support for the Kyoto treaty on greenhouse gases.

The Clear Skies initiative does not act to address carbon dioxide emissions from power plants (which are a primary cause of global warming).

Another key environmental opportunity for the acting secretary of the environment, Kendl P. Philbrick, and the Ehrlich administration is to lead Maryland in passing a renewable energy bill that would gradually phase in the development of clean, renewable sources of energy. More than 15 other states have passed such laws.

Energy derived from the wind, the sun and agriculture not only is increasingly viable, but also has exciting economic potential for state businesses.

Krista McKim

Baltimore

The writer is a volunteer for the Chesapeake Climate Action Network.

Red-light cameras cut rate of crashes

As director of Baltimore's Department of Transportation, I am concerned that the attention given to a citation mistakenly generated by the city's red-light camera program will overshadow the program's tremendous public safety benefits ("City's red-light citation has couple seeing double," Aug. 6).

The article detailed an incident in which a driver received two red-light camera citations for the same infraction containing identical photos but with differing data. The first citation was issued correctly -- the vehicle did run a red light. The second citation was mishandled and sent to the vehicle owner.

But this isolated incident should not make us lose sight of what is most important. The red-light camera program has provided significant safety benefits to citizens and visitors.

Red-light running in Baltimore and across the nation is a frequent cause of collisions that often result in injury or death.

In Baltimore, the number of accidents at protected sites has fallen by 64 percent for side impacts and 54 percent for rear-end collisions. Injuries resulting from red-light running have fallen 73 percent at intersections with cameras.

Like Baltimore, cities across the country are finding that red-light camera programs change driving habits for the better, greatly reduce costly accidents and -- most importantly -- save lives.

Alfred H. Foxx

Baltimore

Court didn't alter critical areas law

The editorial "More burden on the bay" (Aug. 10) unfairly portrayed property owner (and my client) Edwin H. Lewis and his project. It also misstated the substance and effect of the Court of Appeals' decision that Wicomico County's Board of Zoning Appeals committed numerous errors in denying his application for a critical area variance to build a private hunting camp.

The editorial implies that Mr. Lewis engaged in "overdevelopment near sensitive shorelines" without noting that only 4.5 percent of the 5.3 acres of the buildable upland in his marsh is not in the critical area buffer (and most of that was required to be reserved for a septic system).

Realistically, Mr. Lewis had nowhere other than the buffer to locate the camp, and he asked to develop only 1.5 percent of the buffer (or 0.1 percent of the property).

And The Sun's suggestion that the cumulative impact of "such development" would kill all the crabs and leave nothing to hunt and fish is totally unwarranted and not supported by any evidence. Indeed, if all development in the Chesapeake region were of the same nature as this camp, we would not need a critical areas law.

Environmental consultants who studied and conducted on-site tests of the project testified that the hunting camp would have no adverse effect on water quality or habitat. They also pointed out that the out-of-the-buffer location for the cabins suggested by the state would be, environmentally speaking, the "absolute worst place" to place the camp because it would have required cutting down the oldest and largest oak and pine trees on the site and would have opened up the forest canopy.

The state's principal expert witness had performed no study or on-site testing and only speculated that the camp would be environmentally harmful. The court applied the long-established rule that an expert's opinion is worthless unless it is based upon established facts.

Because there was no evidence that the hunting camp cabins would cause any harm to the environment, the Court of Appeals' decision does not either "shift the burden of proof' to the state or "gut" the critical areas law, as the editorial incorrectly suggests.

If a property owner submits credible evidence that his or her project meets the criteria for a variance, he or she has met the burden of proof, unless the state offers credible evidence to the contrary. In this case, the state could not and did not.

Misinformed and misled by the state's Chesapeake Bay Critical Areas Commission, the county board erroneously denied the hunting camp variance. The court did what it should have done -- tell the board it was wrong.

Raymond S. Smethurst Jr.

Salisbury

The writer is the attorney for Edwin H. Lewis.

Offer working people a chance to do better

I live in Severna Park on a peaceful tree-lined street and have a wonderful job working for the nearby government agency. My four children go to great schools and have never had to wonder where their next meal was coming from.

A few days ago, I had to find a way to get to Glen Burnie to pick up one of my cars, which had just been repaired. Most of the neighbors were on vacation so I and my 9-year-old twins headed to the closest bus stop. In less than an hour we were on the No. 14 bus that runs between Annapolis and northern Anne Arundel County.

I had not been on a municipal bus in quite some time. What I saw was both depressing and instructive.

There were, for sure, signs of despair. A few elderly women got on near the hospital. My twins wanted to know why they had their belongings in black plastic trash bags. But most of the people on the bus were not street people, but individuals who worked in the service industries that line Ritchie Highway.

Most of them looked exhausted. The air-conditioning in the bus didn't work (surprise!), so their ride home did not provide any relief from the heat of the day.

It was a diverse crowd, and an array of languages could be heard. Observing this microcosm of the American working class, I thought about the many political pundits who claim President Bush is a shoo-in to win re-election. I wondered how many of the hard-working people on that bus would agree that he is looking out for their interests. I also wondered how many of them would agree with his philosophy that it is a good thing to hand billions of dollars to people who are already rich instead of investing in education and health care programs that help all Americans.

What I saw that day only reinforced the uncomfortable truth that rather than cutting taxes we should be raising them across the board. We should raise them to improve our schools, repair our roads and bridges and provide our military and civil authorities the resources they need to fight the grim specter of terror.

As we got off the bus at the dealership, I had the final thought that the world did not owe any of the hard-workingmen and women on that bus a living. What our nation does owe them, however, is a chance to improve their lives.

Patrick D. Weadon

Severna Park

An artist who gave life to Smith Island

A part of Smith Island has been lost with the death of artist Reuben Becker Jr. ("Reuben Becker Jr., 66, artist of bay, Smith Island," Aug. 15).

Although he was not a native of Smith Island, Mr. Becker was a very important member of the community. When I arrived on the island in 1974, I met Mr. Becker in the third-floor studio that looked out onto the bay and chronicled the seasons and island life through his paintings.

Mr. Becker was a mentor to me and to other young islanders. He often suggested literature to read and movies to watch, and engaged in long philosophical discussions with us over his famous linguine with clam sauce accompanied by any number of bottles of wine.

Mr. Becker always seemed to know who needed a little extra guidance and time. He opened his home to anyone who may have needed a place to stay or just a person to talk to. He was never too busy to stop and spend some time with you.

I have since moved from Smith Island to work in the Baltimore County schools. But I look around the walls of my house and I see Mr. Becker in every room. His paintings remind me of the natural beauty of the island and transport me back to the days when the Chesapeake Bay was my home.

Mr. Becker has given me a view of the world that I hope I can pass on to my sons. My life and my experience on Smith Island were made more full through our friendship.

Barbara Tyler

Lutherville

Treatment is the solution

I read with great consternation the article about community opposition to methadone clinics in the suburbs ("Following addicts, methadone debate migrates to suburbs," Aug. 18).

The facts mentioned in the article are as follows: First, studies prove the effectiveness of methadone treatment. Second, the need for treatment in the suburbs greatly outpaces its availability. Third, methadone treatment allows former heroin addicts to live ordinary lives, including being employed and providing a home for their children. And fourth, well-run programs can be great assets to the community, not just in providing treatment for those in the community with addictions, but in providing other support services as well.

Finally, two recovering heroin addicts gave testimonials about the success of methadone treatment.

What I did not read was one good reason a community would oppose an addiction treatment program in its area. A treatment program is not a part of the problem; it's part of the solution.

Drug and alcohol addiction exists in every community. Most of us know a family member or friend who has had or is dealing with a substance abuse problem. And many of us know people in the suburbs who have such a problems.

Communities need to learn more about treatment programs and methadone particularly. Programs need to be cognizant of community concerns.

But what we don't need is blind opposition everywhere a clinic wants to open because of fear that is based on not understanding the treatment.

Paula Minsk

Baltimore

The writer is executive director of the Maryland chapter of the National Council on Alcoholism and Drug Dependence.

While I can sympathize with those who do not want methadone clinics in their neighborhoods, I do not understand how they can then complain about drugs, crime, etc. in their communities.

Drug addiction has to be treated. With treatment comes hope of stopping the crimes and drug sales that come with addiction. People complain every day about criminal activity; they want something done. Well, methadone clinics are a way to help fight back.

We cannot put the clinics out in the middle of nowhere.

The clinics have to be accessible to the addicts and, unfortunately, there are addicts all around us, in every neighborhood and every community.

Kathy Riley

Baltimore

As a public health researcher who has studied drug users for more than 15 years, I feel compelled to reply to the suggestion by some community members and politicians that methadone clinics are "bad for business" and should be blocked in certain areas. Nothing could be further than the truth.

Studies conducted by my research group and others over the last three decades have repeatedly shown the benefit of methadone programs in curbing dependence on heroin and other opiates. In fact, every dollar spent on drug treatment saves $10 in future health care costs.

Yet a disturbingly high number of community residents suffer from "NIMBYism" (Not In My Backyard), a condition in which people approve of drug treatment "anywhere but here."

A promising solution to this problem is to offer mobile methadone clinics, which bypass the NIMBY problem and offer clients anonymity in treating their opiate addiction, taking treatment to people where they live.

Our research group evaluated a mobile methadone clinic in the city and found that it had excellent success rates and prompted no community concerns. Still, this program and others like it suffer from funding shortfalls, even though every indication suggests they should be expanded.

Methadone treatment is a necessary and vital medical intervention that is urgently needed; to deny addicts such treatment is to inadvertently perpetuate the problem.

Once drug users experience recovery, so will our area.

Steffanie Strathdee

Baltimore

The writer is a professor of epidemiology at the Johns Hopkins University's Bloomberg School of Public Health.

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