A lawyer who specialized in representing plaintiffs in medical liability cases recently was a serious candidate for president of the United States. This career background is not unprecedented among national leaders. In fact, such a lawyer was elected president. His name was Abraham Lincoln.
Several factors, which may sound familiar, contributed to the rise in medical liability claims in the mid-1800s. Standards for bringing lawsuits were relaxed by the courts. Americans became less likely to accept illness and suffering as divinely ordained. Medical advertising became widespread. And in 1849 the American Medical Association (founded just two years earlier) published standards for medical education and ethics and established a board whose mission was to expose medical quackery. Defining standards of practice also helped to define malpractice more clearly. As a result of these developments, between 1840 and 1860 there was an 850 percent increase in medical liability cases in the United States. The rate of population growth was far less in this period, about 85 percent.
This was the time when Abraham Lincoln was pursuing his career as a lawyer. He was self-taught, as he could not afford law school, and he read for the bar on his own. To quote from letters he wrote to aspiring apprentices: “If you wish to be a lawyer, attach no consequence to the place you are in, or the person you are with…Work, work, work, is the main thing.”
Honest Abe had a general practice, including a substantial amount of medical liability litigation, both for plaintiffs as well as physicians. For instance, he vigorously defended two physicians who treated a carpenter’s closed bilateral femur fractures. The patient, who refused the recommended closed manipulation, ended up with one leg shorter than the other and sued for $10,000 (about $210,000 in 2004). Lincoln won several postponements and a change of venue. He even employed courtroom exhibits, such as one that illustrated the difference between a young (flexible) chicken bone and an older (brittle) bone. The jury was deadlocked, but the plaintiff’s lawyers obtained an out-of-court settlement in the end.
So, yes, medical liability lawyers have run for president. And one of them has a monument in our nation’s capital.
Michael Schulder, MD, is associate professor in the Department of Neurological Surgery and director of Image-Guided Neurosurgery at UMDNJ-New Jersey Medical School.