It was with concern and not a little outrage that I read the editorial authored by Dr Richardson in the April 2012 issue of the Journal.
Apart from assuming that every defendant is an “obviously guilty scumbag,” Dr Richardson blames accident victims with chronic pain for the delays in the criminal justice system. I will defer to my legal colleagues to explain the problems with the provincial court system that contribute to this, noting that civil litigants only go through the Supreme Court.
In my clinical experience over the last 14 years of treating more than 1000 victims of trauma, claimants litigate because the insurer denies the injuries or takes advantage of the patient’s naivety by offering very low settlements. I continue to see these patients after settlement and have never yet seen a miraculous recovery. Dr Richardson’s views are as insulting to these patients as they should be repugnant to caring physicians.
Dr Richardson wears his prejudice on his sleeve and echoes those inherently skeptical of patients with chronic pain, apparently subscribing to the notion that if the doctor cannot find a cause, there is no cause to find. Many of these patients will develop a pain disorder—a psychiatric illness with a poor prognosis—as a result of the accident and became disabled as a result. For these patients, this injury is far from trivial. Fractures and chest and abdominal injuries typically have a better outcome.
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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
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