January 31, 2004

We really should scrutinize John Edwards’ great success as a trial lawyer in medical malpractice cases, while the decision whether he will be the nominee is being made. As Adam Liptak and Michael Moss describe in today's NYT, Edwards was especially successful suing obstetricians; he faulted them for failing to perform Caesareans when the fetal heart monitor showed signs of distress. His lawsuits, and the lawsuits they inspired, have led doctors to respond to signs of distress more quickly, and there is a debate now about whether this change is good, whether lawyers like Edwards rely on “questionable science,” and whether there should be new laws to make it harder for plaintiffs’ lawyers to win these cases.

Based on this article, it appears that Edwards will do quite well standing up to criticisms about his past. First, he attributes his high level of success to his skill and effort selecting the cases that deserved to win:
"I took very seriously our responsibility to determine if our cases were merited," Mr. Edwards said. "Before I ever accepted a brain-injured child case, we would spend months investigating it."
This is the negative side of the same point:
"He took only those cases that were catastrophic, that would really capture a jury's imagination," Mr. Wells, a defense lawyer, said. "He paints himself as a person who was serving the interests of the downtrodden, the widows and the little children. Actually, he was after the cases with the highest verdict potential. John would probably admit that on cross-examination." ….

"For the one or two who got a substantial jury verdict," said George W. Miller Jr., a former state representative in North Carolina who practices law in Durham, "there were 99 that did not get anything, either because they were not able to finance litigation or their claim was questionable."
Second, he easily makes the charge of unnecessary Caesareans seem weak:
"The question is, would you rather have cases where that happens instead of having cases where you don't intervene and a child either becomes disabled for life or dies in utero?"
What odds would you accept for your child before you would decline the Caesarean? Would you have the Caesarean if there was one chance in 100 that the baby would be brain damaged without it? There are people on the other side of the debate:
Dr. Karin B. Nelson, a child neurologist with the National Institutes of Health, says the notion that paying greater heed to electronic monitoring will prevent brain injuries remains just that, a notion. "Evidence of high medical quality contradicts the assumption that the use of electronic fetal monitoring during labor can prevent brain damage," Dr. Nelson said.
The medical debate ought to take place, but I can’t see how doubts about Caesareans will play well served up as an attack on Edwards in the political arena:
Mr. Edwards's colleagues in the plaintiffs' bar do not accept that analysis. "You find me a low C-section rate," said Daniel B. Cullan, a doctor, lawyer and co-chairman of the trial lawyer association's birth trauma group, "and I'll show you children in wheelchairs."
What does seem to have some power as a political weapon is the charge that “[h]is campaign is disproportionately financed by lawyers and people associated with them.” This article about Edwards runs on the front page of today’s NYT, right under an article headlined “Democrats Assail, and Tap, ‘Special Interests.’” (That sounds like an Onion headline!) Here’s the key paragraph about Edwards in that article (written by Glenn Justice and John Tierney):
Mr. Edwards tells audiences, "I've never taken a dime from a Washington lobbyist and I never will." That might be literally true — not many lobbyists give dimes these days — but Mr. Edwards has accepted at least a few contributions from current and former lobbyists, and his campaign manager was a registered Washington lobbyist in 2002. Mr. Edwards has also accepted millions of dollars from lawyers, including members of the Association of Trial Lawyers of America, a trade group that wields enormous influence on tort reform. An ex-president of the group, Fred Baron, is a financial co-chairman for Mr. Edwards's campaign. The new president of the group and all four executive officers, have each given $2,000.
So look for generalized carping about personal injury lawyers. But I think Edwards will brilliantly and elegantly come back with vivid details about real cases that will make him look good and his critics uncaring.

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