nobody expects to find themselves in court

But doctors should expect to find themselves in court! Indeed, wasn’t the point of this seminar to mold your expectations?

Every 12 years. Neurologists are average. Psychiatrists only every 30 years. Well, actually, those are claims, not ones that make it to court, but court costs and rules are what determine this. I thought most claims were tuned to produce a settlement without going to court. If that’s true and only 20% pay out, most must be called bluffs, a detail I’ve never heard.

Also, insurance companies expect to find themselves in court. But if price on a cost plus basis, maybe they don’t have an incentive to keep costs down.

Trivia: neurology and ophthalmology are the only specialties where the mean payout is close to the median.

Report comment

– Does he or she flatly contradict the other doctors I’ve consulted for the same problem? (ALWAYS consult at least 2 doctors for major problems. ALWAYS ALWAYS.)

– Does he deny that I have the symptoms I claim to have?

– Can I discover critical, non-controversial facts relevant to my treatment that he is unaware of by spending one hour on google? Ask him to list the treatment possibilities, then name the options he didn’t list and ask why he didn’t mention them.

– Is there a mechanism in place for me to send a message to the doctor and get a response within a few days?

When you find doctors who pass all these tests, stick with them.

Report comment

I wonder if, in the same way nobody expects to find themselves in prison, nobody expects to find themselves in court. Or at least, the probability of finding yourself in court is sufficiently low that no one has the energy to solve the collective action problem of getting a thousand people with a tiny chance of ending up in court to petition to make the courts fairer. So lawyers and witnesses and plaintiffs can do whatever the heck they want, because everyone assures themselves they’ll never be a defendant and so they have no reason to care.

That’s a straw man. A better starting point is: Given the odds of finding yourself in court or in prison, would it be rational to do anything about the problems with them? And also: Can someone who’s never been in court or prison know enough about them to do anything about them?

Report comment

So, the number I remember but haven’t looked up, is a 93% guilty plea rate in magistrates’ court – 96 still sounds troublingly high, but I would expect it to be close to that high anyway.

Report comment

It’s true that justice systems differ widely, as do populations, making it difficult to draw simple comparisons (in Germany, the prosecutor conducts the investigation, which does grant a certain latitude, but does not have the same power at sentencing). But I believe the United States is alone in granting its prosecutors the amount of discretion which they enjoy here.

Consider: the prosecutor decides whether to indict you or not (grand juries are rather vestigial, not much of a check anymore). The prosecutor decides with which crime to charge you, which has a huge influence on the amount of time you could be facing. Within that crime, the prosecutor can ask for (and almost always receives) greater or lesser leniency. Turn it around: the prosecutor can threaten to add more charges or time should you prove uncooperative, and of course can then do so. The prosecutor can often freeze the assets with which you would have hired a competent, focused attorney. The prosecutor can threaten to charge your spouse if you refuse to plead. The prosecutor holds all the police evidence, and while the prosecutor has the duty to turn over exculpatory evidence to the defense, this does not always happen (Brady violations differ in frequency by DA’s office; some not at all, while I think the New Orleans office went twice to the Supreme Court in four years). The prosecutor may (and does) review the case with who may be the principal witnesses against you, the police, with predictable results at solidifying the case (remember that the evidence can consist of police testimony only, and often does). The prosecutor can also offer to drop the charges if you drop a civil rights lawsuit. Prosecutors are highly motivated to win, in my observation; they are litigators to the core (and would be proud to say so). I am not saying they are unethical, but I do think they have multiple motivations, several of which push them to see guilt and fight to prove it beyond what may be warranted. The defense has only one card to play: if every case goes to trial, the system will break, because there isn’t time for everyone to have a trial. It is literally a Prisoner’s Dilemma.

Perhaps the above examples do not strike you the way they do me. I found them surprising and distressing (several are Supreme Court cases). Many legal scholars argue this system of plea bargaining invests far too much power in the prosecutor, essentially removing the adversarial aspect of our system, turning it into an inquisitorial system, negating defense counsel’s input, and leading to the temptation of overcharging. It is possible to have an inquisitorial system – France – but our system of review is predicated on the notion that the trial level uses an adversarial system.

If a defendant does get beyond plea bargaining and go to trial (relatively rare), the trial itself has its own flaws. Trial is theater, which is inevitable, but usually the impresario is again the prosecutor. The police receive an excellent buildup, basically as expert witnesses, and often receive more credibility from the jury. The defendant cannot afford an O.J. Simpson attorney. And I think (and I’ve heard others say the same) that juries don’t really use the “beyond a reasonable doubt” standard. They don’t know how, even when they try. It’s hard (I mean, even I find it difficult). They often use “preponderance of the evidence” instead.

So while I continue to believe that a 96% success rate in this context is prima facie implausible, there are other reasons why our conviction rate might be higher than it ought to be.

Report comment

Report comment

http://www.amazon.com/The-New-Crow-Incarceration-Colorblindness/dp/1595586431

This book discusses (among other subjects) how it’s often applied in practice; in some cases, the accused aren’t even properly aware of what the consequences of accepting the plea bargain will be until they’ve already done so.

Report comment

Report comment

screw over a group I’m in

This ought not to be controversial because it is not about a trade-off between existing groups. It’s not standard triage between two patients in front of the doctor, but all about the doctor not knowing what group the patient is in. When the doctor faces this choice, he has a patient in front of him and is trying to save that very patient, and has to make a decision under uncertainty. Ex post, you know what group you are in and it is very scary. But that’s like being disappointed in Newcomb’s problem.

roughly 3-hour window

I’m pretty skeptical of this claim. A window sounds too convenient for avoiding the triage problem. If I were to do this calculation, I’d assume that the cost to ischemics of the relevant 1 hour delay is 1/3 of the claimed claimed cost of delaying 3 hours. That factor of 3 almost certainly decides things in favor of the hemorrhagic victims and not administering heparin immediately.

Report comment

There are at least a dozen reasons why the conviction rate might be higher in one state than in another, only a few of which imply fascism. Give the issue some more thought.

Note that 96% is considered a really terrible success rate in much of the business world. You may have heard the buzzword “six sigma”? That means failure is six standard deviations outside the norm, for a 99.9999998% success rate. We are far from having a factory-efficient system for convicting the accused.

Report comment