Opinion ID: 1802251
Heading Depth: 3
Heading Rank: 2

Heading: Dr. Longmire, Dr. Weatherall, & Emergency Room Group, Ltd.

Text: In the past, this Court has held that physicians engaged in public service are qualifiedly immune from suit for medical treatment decisions made during the course of that service. Marshall v. Chawla, 520 So.2d 1374 (Miss. 1988); and Hudson v. Rausa, 462 So.2d 689 (Miss. 1984). Hudson is the genesis of this rule. In Hudson, the widow of a deceased factory worker brought suit against a physician, who had prescribed medication for the deceased to treat his case of infectious tuberculosis. She charged that the prescribed medication had caused her husband's death. The physician was employed by the State Board of Health to formulate and carry out policies to stop the spread of certain communicable diseases. The widow also joined a nurse, who worked in conjunction with the doctor, and who was also employed by the State Board of Health. The Court upheld grants of summary judgment to the physician and the nurse. We held that the physician and the nurse were immunized from suit for their discretionary decisions made either in instituting their program or administering treatment pursuant to their program. 462 So.2d at 695-696. Hudson was followed in Marshall. There, the husband of the plaintiff was admitted into the emergency room of a state eleemosynary hospital late one night complaining of a severe headache and vomiting. Defendant, a physician on the staff of that hospital, was on duty at the time. Defendant did not report to the emergency room, but told the staff to administer dramamine to the patient. The man was taken home, where he suffered a stroke and died approximately ten hours later. The deceased's widow brought a wrongful death action against the doctor. This Court affirmed a lower court dismissal of the case, holding that the treatment decisions of the doctor were given qualified immunity. 520 So.2d at 1377. The instant case gives us an opportunity to revisit those decisions, and today we find those decisions to have been erroneous to the extent they extended medical personnel in public service qualified immunity for treatment decisions. Thus, we overrule Hudson and Marshall to that extent. The discretion exercised by medical personnel in making treatment decisions is not the sort sought to be protected by the common law qualified immunity bestowed upon public officials. Common law qualified immunity has traditionally sought to protect the discretion of public officials so that those officials would not be deterred by the threat of suit from making decisions and formulating policies that are in the public good. State of Mississippi for the Use and Benefit of Brazeale v. Lewis, 498 So.2d 321, 322 (Miss. 1986); Pruett v. City of Rosedale, 421 So.2d 1046, 1052 (Miss. 1982); and Hudson, 462 So.2d 689, 695 (citing Gregoire v. Biddle, 177 F.2d 579, 581 (2nd Cir.1949) (Learned Hand, J.)); See also, generally, Wyatt v. Cole, 504 U.S. ___, ___, 112 S.Ct. 1827, 1832-1833, 118 L.Ed.2d 504, 514-515 (1992) (contains thorough discussion of the history of and rationales underlying common law public official immunity). In Lewis, this Court noted that qualified immunity for the discretionary acts of public officials has evolved [i]n order to allow our lawmakers and government officials to participate freely and without fear of retroactive liability in risk-taking situations requiring the exercise of sound judgment. 498 So.2d at 322. In Gregoire v. Biddle , Justice Learned Hand said of qualified immunity: The justification for doing so is that it is impossible to know whether the claim is well-founded until the case has been tried, and that to submit all officials, the innocent as well as the guilty, to the burden of a trial and to the inevitable danger of its outcome, would dampen the ardor of all but the most resolute, or the irresponsible, in the unflinching discharge of their duties. Again and again the public interest calls for action which may turn out to be founded on a mistake, in the face of which an official may later find himself hard put to it to satisfy a jury of his good faith. There must indeed be means of punishing public officers who have been truant to their duties; but that is quite another matter from exposing such as have been honestly mistaken to suit by anyone who has suffered from their errors. As is so often the case, the answer must be found in a balance between the evils inevitable in either alternative. In this instance it has been thought in the end better to leave unredressed the wrongs done by dishonest officers than to subject those who try to do their duty to the constant dread of retaliation. 177 F.2d 579, 581 (quoted in Hudson, 462 So.2d at 695). We noted a further rationale for removing such policy decisions from the purview of the Courts in Pruett v. City of Rosedale , where we said Judicial review of basic policy-making decisions continues to be regarded by many as inappropriate because courts have no standards by which to judge such decisions. Judges and jurors are in no better position to evaluate the reasonableness of policy determinations than are those officials who are charged with making them. The reasonable man standard of tort law is not an appropriate measure for the political, social or economic desirability of government programs and the methods selected for pursuing them. State tort standards cannot adequately control those government decisions in which, to be effective, the decision maker must look to considerations of public policy and not merely to established professional standards or to standards of general reasonableness. 421 So.2d at 1051-52. None of these considerations undergirding common law qualified immunity are applicable to medical treatment decisions. First of all, there is nothing inherently governmental about decisions regarding individual medical treatment. They do not involve the formulation of public policy in any respect. Therefore, the notion of promoting governmental decisions that are in the public good is completely inapplicable. Second, the fact that a physician or other medical provider is employed by the State does not expose that physician to any greater threat of suit than he would otherwise face in private practice. He therefore will be no more discouraged by the threat of suit from taking actions he thinks are prudent, than he ordinarily would be as a private physician. Furthermore, the threat of suit will not discourage physicians from seeking and accepting government employment, because they will face the exact same potential exposure to liability that they would as private physicians. Finally, the judicial system is perfectly capable of adjudicating the reasonableness of medical treatment decisions. Our courts do it every day in medical malpractice actions heard across this state. The medical treatment decisions made by medical personnel at state health institutions are no different from the private medical care decisions that are currently being judged. This view is one that has been taken by a majority of the courts which have ruled on whether common law qualified immunity extends to cover medical treatment decisions. See Kiersch v. Ogena, 230 Ill. App.3d 57, 172 Ill.Dec. 335, 595 N.E.2d 696 (1992); Gould v. O'Bannon, 770 S.W.2d 220 (Ky. 1989); Protic v. Castle Co., 132 Wis.2d 364, 392 N.W.2d 119 (1986); Cooper v. Bowers, 706 S.W.2d 542 (Mo. App. 1986); James v. Jane, 221 Va. 43, 282 S.E.2d 864 (1980); Comley v. Emanuel Lutheran Charity Bd., 35 Or. App. 465, 582 P.2d 443 (Or. App. 1978); and Henderson v. Bluemink, 511 F.2d 399 (D.C. Cir.1974). But see de Sanchez v. Genoves-Andrews, 161 Mich. App. 245, 410 N.W.2d 803 (1987). Henderson is one of the leading cases in this tradition. In that case, an army doctor argued that his status as an army officer insulated him from liability for alleged acts of negligence in treating and diagnosing a patient's illness. The United States Court of Appeals for the District of Columbia Circuit held that common law qualified immunity did not extend to protect decisions by the doctor which were strictly medical in nature. 511 F.2d at 401-403. In doing so, it noted several of the same considerations which influence this Court to hold that medical treatment decisions are not protected by common law qualified immunity. The Court of Appeals said: The chief policy underlying the creation of immunity for lower governmental officials is mainly that which stems from the desire to discourage the fearless, vigorous, and effective administration of policies of government. However, that policy is not applicable to the exercise of normal medical discretion since doctors making such judgments would face the same liability outside of government as they would face if the complaint below is upheld. [Therefore], the threat of liability for negligence would not deter the fearless exercise of medical discretion within government service any more than the same threat deters the exercise of medical discretion outside of government. Holding government medical personnel to the same standards of care which they would face outside of government service in no way burdens their public responsibility or deters entry into government service or the vigorous exercise of public responsibility once having entered that service. Id. at 402-403. This Court noted these considerations in Marshall v. Chawla but chose, nevertheless, to follow its decision in Hudson v. Rausa . It did so based on the following rationale: ... It is obviously true that not all forms of discretion are alike and in some other spheres of government the rule laid down in Hudson might have to be modified to account for that fact. But in the case of medical doctors in public service, special circumstances are present which make a broader grant of immunity sound policy. In saying that the threat of liability would not deter the fearless exercise of medical discretion within government service any more than the same threat [would do so] outside the government, the Henderson court overlooked the objection that such vulnerability might very well deter doctors from entering government service in the first place. The protection of qualified immunity no doubt serves as a powerful incentive to many doctors to serve in state eleemosynary institutions and this in turn, makes medical care available to many who [would] not be able to afford medical care in private facilities. 520 So.2d at 1377. On further reflection we find this reasoning faulty. It reflects fact finding which is legislative in nature and of dubious validity. Moreover, it promotes a goal beyond the pale of the traditional justification for qualified immunity. Today, we hold that common law qualified public official immunity will be restricted to its designed purpose. Accordingly, it will not be extended to decisions that involve only individual medical treatment. Those decisions will be judged on the same standards as if made by private providers. Decisions made by medical personnel engaged in public service will continue to be protected to the extent that they involve the formulation and implementation of public policy. The actions of Dr. Longmire and Dr. Weatherall that are at issue in this case deal only with the treatment of Helen Womble in the SRH Emergency Room on the nights of March 29 and 30, 1986. They did not involve formulating or implementing public policy. Therefore, they are not afforded protection in any respect by the common law qualified immunity.