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Brian Leveille
Professor Megan Lancaster
ENGL 134-41
6 December 2014
Proposition 46: The Solution to Medical Malpractice
Preventable medical errors kill up to 440,000 people each year, making medical
negligence the third leading cause of death in this country behind only heart disease and cancer
(California 32). Despite multiple viewpoints on the issue of medical malpractice, there is one
thing everyone can agree on; looking at the number of deaths that occur each year as a result of
negligence of doctors is sickening, and this preventable number must be reduced effectively.
When looking at this statistic, one way this astonishing number of deaths could have been
reduced would be through Proposition 46, which was voted on by citizens of California on
Tuesday, November 4th, 2014. The proposition itself had three main parts, all of which dealt with
important medical issues including medical malpractice. If Proposition 46 had passed, it would
have increased the cap for noneconomic damages in medical malpractice lawsuits from $250,000
to $1.1 million. It also would have required doctors to be subject to random drug and alcohol
tests. Lastly, the Proposition would have required health care providers to check a statewide
database before prescribing certain, dangerous drugs to patients. According to facts provided by
In Depth on Measure Proposition 46: Drug and Alcohol Testing of Doctors. Medical
Negligence Lawsuits, supporters of Proposition 46 argued that the proposition would have
saved lives by both cracking down on prescription drug abuse by doctors, and protecting patients
from impaired doctors. Supporters also argued that increasing the cap on compensation for pain
and suffering would more fairly value lives lost due to medical malpractice. Furthermore,

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supporters still argued that if Proposition 46 had passed, the use of an online database would
have reduced over-prescription of dangerous drugs. Nonetheless, opponents of Proposition 46
argued that the proposition used drug testing of doctors to disguise its real intent, which they
believed was to increase the limit on the amount that could be rewarded from medical
malpractice lawsuits. Opponents also argued that increasing the cap on noneconomic lawsuits
would result in many doctors moving to states with lower malpractice insurance rates. Lastly,
opponents argued that the use of an online database of personal prescription drug history would
allow for the invasion of an individuals privacy as well (In Depth of Measure Proposition 46).
Although Proposition 46 did not pass, with nearly two thirds of voters in opposition, the
proposition should have passed due to the fact that it would have improved patient safety and
saved lives; moreover, Proposition 46 would have held doctors accountable for their medical
negligence, which is an easily preventable error that accounts for a tremendous amount of deaths
each year.
Considering one of the three main parts of Proposition 46 was to have doctors randomly
tested for drugs and alcohol, those who voted against Proposition 46 believed this would have
been a waste of time and money. Opponents realized that Proposition 46 was written and
funded by trial lawyers. [And,] Its only real purpose [was] to enrich trial lawyers by making it
easier for trial lawyers to sue doctors (In Depth on Measure Proposition 46). Nonetheless,
voters also realized that the proposition would [Quadruple] the limit on medical malpractice
awards in California, which [would] cost taxpayers hundreds of millions of dollars every year,
and cause many doctors and other medical care professionals to quit their practice or move to
places with lower medical malpractice insurance premiums (California 33). Those in opposition
to Proposition 46 realized that if the cap were raised to $1.1 million, this would in turn lead to

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increased taxes and fees, and/or cuts in government services (In Depth on Measure Proposition
46). With that being said, people who voted no on Proposition 46 believed the current $250,000
cap on damages keeps costs limited, which allows access to affordable health care at a low cost.
Additionally, those in opposition believed that Proposition 46 was also a poor idea
considering it would jeopardize individual privacy of personal prescription drug history. Zachary
David Skaggs, a medical student at the Keck School of Medicine of the University of Southern
California, argued against Proposition 46, stating that When a tech giant like Apple cant
reliably guard its customers private photos, trusting an underfunded state program to keep its
newly minted database securecould result in unforeseen privacy issues (Skaggs). Like
Skaggs, others who voted no on Proposition 46 agreed that the state medical board does not have
the resources to administer the program. In turn, this could lead to the loss of privacy of many
individuals who trust the health care system. Overall, seeing that Proposition 46 was not only
written by trial lawyers, but quadrupling the cap on noneconomic damages would lead to an
increase of taxes and result in doctors leaving the state, these reasons persuaded many people to
vote no on Proposition 46. In addition, the idea that the use of an online database could
potentially lead to privacy loss was a third reason so many citizens voted no on Proposition 46.
The reasons which influenced many people to vote no on Proposition 46 are not entirely
valid; moreover, when looking at the real truth behind Proposition 46, it can be seen that
opponents made a wrong decision by voting no. Considering those in opposition believed that
Proposition 46 used drug testing of doctors to disguise its true intent of making it easier for trial
lawyers to sue doctors and profit from those lawsuits, this is not the truth. The real reason
Proposition 46 proposed to drug test doctors was to keep patients safe. According to In Depth
on Measure Proposition 46: Drug and Alcohol Testing of Doctors. Medical Negligence

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Lawsuit, Nearly 20% of health professionals suffer from substance abuse at some point during
their careers. Drug testing of doctors would identify impaired doctors and deter drug and alcohol
abuse in others (In Depth on Measure Proposition 46). Considering drug testing is already
required for pilots, police officers, firefighters, train operators, and other safety workers who deal
with the public, drug testing doctors, who also work with the public, would be a smart idea that
could prevent many medical errors and save lives. Secondly, although raising the cap on
noneconomic damages may raise taxes, doing so is necessary to keep up with inflation. Seeing
that the $250,000 cap on noneconomic damages in medical malpractice cases was established in
1975, one must understand this cap was created nearly 40 years ago. By raising the cap of
$250,000 to $1.1 million, this increase would only mirror the increase of inflation that has
occurred since the cap was established. Although many people in opposition believed that raising
the cap would cause doctors to leave the state due to an increase in medical malpractice
insurance, this is not necessarily true either. According to In Depth on Measure Proposition 46:
Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits, Although most states
have limits on noneconomic damages in medical negligence cases, Californias cap of $250,000
is the lowest of any state in the nation (In Depth on Measure Proposition 46). Understanding
this statistic, although raising the cap in California from $250,000 to $1.1 million may seem
unreasonable, when looking at other states, this would not be unreasonable at all. Besides, not
only would raising the cap on noneconomic damages for medical malpractice stay current with
inflation, but doing so would also more fairly value the lives lost due to malpractice.
Lastly, while those in opposition of Proposition 46 believed that individual privacy would
have been jeopardized if shared on a database, this too is not entirely true. According to In
Depth on Measure Proposition 46: Drug and Alcohol Testing of Doctors. Medical Negligence

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Lawsuits, under current law, the controlled drug database already exists, where it is securely
managed by the Department of Justice. With that being said, requiring doctors to check the
database before prescribing dangerous medications would only prevent over-prescription and
drug abuse, saving lives and hundreds of millions of dollars (In Depth on Measure Proposition
46). In fact, the Center for Disease Control (CDC) reports that overdoses tied to common
prescription painkillers such as Vicodin and OxyContin killed more than 16,500 people in 2010.
Requiring doctors to check a database before being allowed to prescribe certain, dangerous
medications would allow them to see if their patients are drug abusers. Consequently, this would
allow doctors to potentially save both the drug abusers lives, as well as many others
(Prescription Drug Overdose in the United States: Fact Sheet). After analyzing both sides of
Proposition 46, it is clear that voters made the wrong decision. Not only would drug testing
doctors prevent deaths caused by negligence, but raising the cap for noneconomic damages
would more fairly reimburse those who have suffered through medical negligence by keeping up
with inflation. Furthermore, requiring doctors to check a database before prescribing certain
medications would prevent drug abuse and would also lead to fewer deaths. Looking at these
facts, it seems obvious that Proposition 46 should have passed, and that the pros of the
proposition clearly outweigh the cons.
In the end, after taking a deep look into Proposition 46, it is not about the money that
could or could not have been saved, but rather about the lives that could have been saved.
Considering between 44,000 and 98,000 people die in US hospitals annually as a result of
medical errors (Leape), if Proposition 46 had passed, this number would have been reduced.
Unfortunately, Proposition 46 did not pass, and the large amount of preventable deaths caused by
medical negligence is still going to be an issue. Bob Pack, one of the authors of Proposition 46,

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believed Proposition 46 would have been a great way to save lives. Bob Pack believed so
strongly in Proposition 46 because of a specific incident that occurred in his life. Both of Bobs
two young children were killed by a hit-and-run driver under the influence of prescription
painkillers and alcohol. The driver was an addict who had obtained prescriptions from multiple
doctors and was able to get thousands of pills. The driver was ultimately convicted of seconddegree murder, but there were no apparent consequences to the doctors who had furnished the
prescriptions for those thousands of prescription painkillers (In Depth on Measure Proposition
46). Although many may disagree on whether or not Proposition 46 should or should not have
passed, it is clear that if it had passed, more lives would be saved. For example, if doctors were
required to check a database of personal drug history before prescribing certain drugs, then
perhaps both of Bobs two children would still be alive today. Sadly, events like these will
continue to occur, and, considering medical malpractice is a leading cause of death in the United
States, this sad fact will also continue to be true unless action is taken.
In conclusion, seeing the amount of deaths that occur each year due to medical
malpractice is astonishing, especially after realizing these deaths could be prevented. Some may
feel that these deaths are inevitable, as medical negligence is unpreventable, however these
people are wrong. By testing doctors for drugs and alcohol, and requiring them to observe a
personal prescription drug database before prescribing certain, dangerous medications to
potential drug abusers, there is no doubt that more lives could be saved. Moreover, raising the
cap for noneconomic damages due to medical malpractice from $250,000 to $1.1 million would
not only reflect the increase in inflation, but doing so would also more fairly value the lives lost
to medical negligence. Overall, there is no doubt that Proposition 46 should have passed, and
hopefully we will see it again on the next ballot.

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Works Cited
California. California General Election Official Voter Information Guide. Sacramento:
California Secretary of State Elections Division, 2014. Print.
In Depth on Measure Proposition 46: Drug and Alcohol Testing of Doctors. Medical
Negligence Lawsuits. League of Women Voters of California. League of Women Voters,
California, November 2014. Web. 4 November 2014.
Leabanon, N., and N. Hanover. How Many Deaths Are Due to Medical Error? Getting the
Number Right. Eff Clin Pract. 6 (2000): 277-283. Web. 11 November 2014.
<http://ecp.acponline.org/novdec00/sox.pdf>.
Leape, Lucian L., and John A. Fromson. Problem Doctors: Is There a System-Level Solution?
Annals of Internal Medicine. 144.2 (2006): 107-115. Web. 11 November 2014.
<http://annals.org/article.aspx?articleid=719485>.
Leape, Lucian L. Institute of Medicine Medical Error Figures Are Not Exaggerated. Jama.
284.1 (2000): 95-97. Web. 11 November 2014.
Pack, Bob. Yes on Prop. 46. Danville, California. 5 November 2014. Address.
Prescription Drug Overdose in the United States: Fact Sheet. Centers for Disease Control and
Prevention. 17 October 2014. Web. 11 November 2014.
Skaggs, Zachary D., How California Could Lose a Generation of Doctors. Real Clear Policy.
27 October 2014. Web. 4 November 2014.