Pain And Suffering

BOSTON -- Dr. Paul Bilder may never become a famous name in the history of end-of-life care at the end of the millennium.Dr. Bilder is no Jack Kevorkian, the pathologist who brazenly defied the law and forced the country to deal with assisted suicide. Nor is he Timothy Quill, the internist whose published admission that he helped a terminal patient to die encouraged other doctors out of the closet.But Dr. Bilder represents a landmark nevertheless. This month, the Oregon pulmonary specialist became the first doctor in the country to be disciplined by a state board of medical examiners for under-treating pain in his patients.

Maryland business groups lined up solidly yesterday against a bill that would lift a cap on damages for pain and suffering in hundreds of cases brought by victims of asbestos-related cancer.Some of the state's leading industry lobbyists took their turns denouncing the legislation, whose chief beneficiary would be the law firm of Peter G. Angelos, at a hearing of the Senate Judicial Proceedings Committee."This is the kind of legislation that sends shivers down the spines of a lot of business people," said J. William Pitcher, representing pharmaceutical manufacturers.

The House of Delegates gave its approval last night to a bill that would let some asbestos victims collect higher damages for pain and suffering -- a measure whose largest single beneficiary would be Peter G. Angelos.The legislation, which passed on an 84-52 vote, faces long odds in the Senate, where a powerful committee chairman has prevented action on the bill.Proponents say the bill would remove a cap on damages that unfairly penalizes some victims of asbestos-related diseases and their families because of the long time it takes their illnesses to develop.

WASHINGTON -- In a year when big-ticket topics such as tobacco lawsuits and highway spending are expected to dominate Congress, a low-profile proposal to revamp auto insurance could become the issue that really pulls at people's purse strings.The auto legislation would cut insurance premiums an average of 32 percent, according to a study last year by Congress' Joint Economic Committee. That would mean savings of $243 a year for the average driver -- or nearly $45 billion a year nationwide.

IT'S NOT RIGHT. Some 200,000 Maryland drivers break the law by not buying car insurance, but when they are in an accident, some of them sue and collect big awards for noneconomic "pain and suffering" damages.They are gaming the system.Not only are these uninsured drivers -- between 5 and 9 percent of Maryland motorists -- taking unfair advantage of state law, they are forcing up the price of car insurance for other motorists.A bill in the state Senate -- it sailed through the House on a 104-20 vote -- would let uninsured motorists collect medical and out-of-pocket losses from an accident, but not pain and suffering awards if they knowingly avoid buying car insurance.

In a major setback for shipyard, steel and construction workers suffering from asbestos-induced illnesses, a state appeals court ruled yesterday that the thousands of suits they and their families have filed are subject to a state limit on pain and suffering.The Court of Special Appeals slashed from $3.5 million to $500,000 the judgment that a Baltimore jury awarded in 1995 to two widows of asbestos victims. The court ruled that the legislature's limit on noneconomic "pain and suffering" damages applies to any suit filed on behalf of a victim who died after the limit took effect Oct. 1, 1994.

WHILE TAKING part in Jewish religious services I have often wondered why we devote so much effort to praising God. Doubtless Christians and Muslims do the same -- Muslims' declaration that ''Allah is great'' immediately comes to mind, as do the Christian adorations of Jesus Christ. But I am particularly aware of it in the prayers of my fellow Jews.On a typical Sabbath, our prayers practically gush in praise of God. It seems that we cannot find enough exemplary things to say about God, not enough adjectives to describe the praiseworthiness of God, the glories of God, the grandeur of God. Even the basic prayer of mourning, the Kaddish, begins with ''Magnified and sanctified be the name of God . . .'' and includes ''Exalted and honored be the name of the Holy One.''Does God really need our singing His (or Her)

A Baltimore County jury has found two companies negligent in the 1992 death of Martin Wirtz, a mechanic who climbed inside a tank truck to save a friend and died inhaling fumes from chemical waste.After nearly two hours of deliberation Thursday, the jury ordered the companies -- Farmington Freight Inc. and Cargill Inc. -- to pay Wirtz's estate $146,249 for medical and funeral bills and for pain and suffering and mental anguish.The suit was filed by Wirtz's sister, Linda Wirtz of Florida, on behalf of his estate.

An article in Thursday's editions of The Sun about a Baltimor Circuit Court jury's awarding $10.2 million to a Baltimore woman and her son incorrectly stated that part of the award was for punitive damages. Those damages were for pain and suffering.The Sun regrets the errors.Pub Date: 11/01/97

WASHINGTON -- The Clinton administration warned the Supreme Court yesterday that a ruling to let doctors aid in suicide would lead to needless deaths across America, ending the lives of many vulnerable people.Predicting that assisted suicide could not be controlled once allowed, the administration advocated power for states to outlaw the practice -- preferably by a total ban, with no exceptions.Any exception, the administration contended, "will lead to the deaths of many persons who are not competent, who are not terminally ill, and who do not make truly voluntary requests for assistance" in suicide.

Police identify man, 19, who drowned in Dundalk creek 3 Baltimore County police identified Tuesday a man who drowned while attempting to swim across a creek a day earlier as a 19-year-old Dundalk resident. Cpl. Michael Hill, a police spokesman, said authorities suspect that Cedric Hart of the 500 block of Main St. had a seizure while swimming across Chink Creek near Bear Creek in Dundalk about 3:15 p.m. Monday. Hart was taken to Johns Hopkins Bayview Medical Center in cardiac arrest and pronounced dead at the hospital, according to Hill.

WASHINGTON -- The Senate yesterday blocked legislation that would have limited jury awards in medical malpractice cases, shunting aside one of President Bush's policy objectives. In procedural votes on two bills, proponents failed in bids to cut off debate. The defeat means that the effort to restrain malpractice awards is unlikely to move forward unless Republicans increase their numbers on Capitol Hill in November's election. The bills would have limited damages for pain and suffering to $250,000 in most instances, with an upper limit of $750,000 for cases involving multiple medical facilities.

HOW DO YOU suppose the president of the United States arrived at the $250,000 price tag on pain and suffering? Do you think he would be satisfied with $250,000 for pain and suffering if, say, a member of his family sustained abdominal trauma from a fall from a tree swing and bled to death because emergency room physicians didn't make a timely and precise diagnosis? (True story, Baltimore County, 1992. You can look it up.) Or maybe pain and suffering - or "noneconomic damages" - should max out at $650,000.

Some Maryland doctors say they welcome as a good start the hastily negotiated legislation passed by the General Assembly last week to rein in malpractice premiums, but they warned that more far-reaching legal reforms would be required to solve an insurance crisis that threatens some physicians' practices. The bill would slash doctors' malpractice premiums, which are scheduled to increase 33 percent this year, and impose a tax on HMOs to subsidize premiums. Even though Democrats promise to override an expected veto by Gov. Robert L. Ehrlich Jr., who opposes the tax, some doctors say they will continue to press for more measures to limit lawyers' fees and lower limits on awards for pain and suffering.

The family of a Pasadena teenager filed lawsuits yesterday against two Anne Arundel County homeowners for $1.75 million, seeking compensation for the Northeast High School student's death after a fight outside a party at the couple's house. The claims, filed in lawsuits on behalf of Noah Jamahl Jones' mother, Robin Jones, and his aunt, Phyllis Jones, with whom he had been living, say that Steve and Evelyn Steinbach of the 700 block of 205th St. in Pasadena failed to "exercise control and supervision of the social gathering taking place on their property."

The family of a Pasadena teenager filed lawsuits yesterday against two Anne Arundel County homeowners for $1.75 million, seeking compensation for the Northeast High School student's death after a fight outside a party at the couple's house. The claims, filed in lawsuits on behalf of Noah Jamahl Jones' mother, Robin Jones, and his aunt, Phyllis Jones, with whom he had been living, say that Steve and Evelyn Steinbach of the 700 block of 205th St. in Pasadena failed to "exercise control and supervision of the social gathering taking place on their property."

A state Senate committee showed some sentiment for malpractice reform yesterday, and Gov. Robert L. Ehrlich Jr. and House leaders said they would push forward to pass legislation this year that would curb the rapid escalation of malpractice premiums. A day of legislative maneuvering, however, ended with no official action and unclear prospects about what type of bill could be enacted this year. "We now are at the beginning stages of a health care access crisis. I want to stop it before it degenerates dramatically," the governor said.

Physicians will rally in Annapolis today to protest skyrocketing malpractice insurance costs, which this year have increased 28 percent for many doctors in Maryland and more for specialists. The doctors want limits on pain and suffering awards rolled back to $350,000 from the current $635,000, along with curbs on lawyers' fees, a system that allows awards of future damages paid over time, and a change in the way lost wages and other economic damages are calculated. The demands are angering many people who believe they should be able to sue doctors for malpractice and win large sums of money.

AFTER 28 years of delivering babies, Pikesville physician Robert L. Brenner had a sentimental ambition: He wanted to deliver the babies of the babies he had ushered into the world. But that dream evaporated recently, three weeks before the first of the next generation was due, because Dr. Brenner couldn't afford malpractice insurance. Last month he scaled back his practice to gynecology alone in order to save $42,000 a year on malpractice coverage. Insuring combined obstetric and gynecologic services was consuming nearly 50 cents of every dollar he and a partner are paid at $1,600 per delivery -- and a hefty premium increase is coming next year.

A POPULARITY CONTEST between doctors and lawyers wouldn't even be close. Some human quality almost compels a view that doctors are honorable, compassionate and, we hope, all-knowing. How else could we trust them with our health, our bodies, our lives? Lawyers? Well, it's hard to feel warm and fuzzy about a profession of trained talkers who will argue day is night or night is day if it suits the interests of their clients. But there are no paragons in the titanic clash of special interests that masquerades as an effort by Congress to restore order to the process of protecting patients from medical malpractice.