Nurses say no to I-330, I-336

Registered nurses are first and foremost patient advocates. That's why the Washington State Nurses Association and numerous other nursing organizations are opposing both medical-malpractice initiatives on the ballot this November.

This fall, nurses decided we could not stand by silently and allow patients' interests to come second while doctors and lawyers fulfill their own agendas. This is the reason we are joining many others, including AARP, Washington Senior Lobby, Gov. Christine Gregoire and Insurance Commissioner Mike Kreidler, in urging voters to reject I-330 and I-336.

There can be a better solution. In 2004, nursing groups outlined several basic principles that are central to a medical-malpractice compromise that would offer a balanced approach for providers and patients. Washington nurses believe that any medical-liability-reform package must address five points:

• Access to care for patients;

• Access to affordable malpractice insurance for providers;

• Access to the civil-justice system for patients injured by medical negligence;

• A fair and reasonable cap on non-economic damages of $1 million, adjusted annually for inflation;

• And patient safety measures that focus on the prevention of injuries.

Neither medical-malpractice initiative does this.

I-330, supported by the Washington State Medical Association, goes too far — taking away fundamental patient rights and placing a very low cap on non-economic damages.

I-330 would allow physicians and hospitals, as well as nursing homes and other care facilities, to require patients to sign a waiver, agreeing to mandatory binding arbitration in medical-malpractice cases, before receiving treatment. The waiver states that you are "giving up your right to a jury or court trial." Nurses believe patients must retain the right to go to court when other means of resolving disputes have failed.

I-330 would also place a very low cap of $350,000 on non-economic damages in medical-malpractice cases. This cap is too low to properly compensate all patients across the board, and it discriminates against those patients who may not incur wage loss because they are stay-at-home moms, seniors or children.

I-330 does not address the very issue its proponents aim to improve: liability insurance. I-330 does not even mention insurance rates, or include any sort of public disclosure of insurance industry business practices. Nor does I-330 contain any measures that would to make health care safer for patients.

On the other hand, I-336, supported by the Washington State Trial Lawyers Association, does not do enough. It contains no cap on non-economic damages, refusing to acknowledge that there are some excessive non-economic awards and that reasonable limits are needed.

I-336 takes a punitive approach to patient safety — focusing on punishing doctors who have committed malpractice, rather than working toward safer systems to prevent negligence in the first place.

Neither I-330 nor I-336 is the answer. The WSNA is ready to go back to the Legislature to work with all interested parties for a comprehensive, meaningful solution. Not everyone will get what they want, but Washington patients and providers will win.