Dr Michael Bassett

Dr Michael Bassett

Newspaper Columns

The Blame Culture

DOM/PRESS The Blame Culture, 17 August 2004

Most of us are familiar with the "we want answers" cry from those who have suffered misfortune. These days, trying to hold someone else accountable for things that go wrong is a common phenomenon everywhere in the world, as a recent article in the International Herald Tribune showed. A British spokesman for Norwich Union Insurance is reported as saying "there is something going on in society which is really eating away at personal responsibility. If anything happens to you in life, someone else has to take the blame". The Blame Culture also flourishes in Europe and the US. It's not just over medical misadventure, where the British National Health Service currently faces claims totalling NZ$15 billion whereas 30 years ago they amounted to NZ$2.8 million. Some people manufacture claims. Britain is awash with frivolous lawsuits. David Beckham on a salary from Real Madrid of 5.5 million Euros per annum recently blamed the club for not training him well enough before the European Cup soccer tournament. A student at the University of Kent who was caught plagiarising admitted he'd done it for years and blamed his teacher for not catching him sooner. That was a genuinely creative piece of blame transference.

We are seeing more and more of it in New Zealand. The notion that misfortune is someone else's fault got a lift with the "no fault" principle for accidents underpinning ACC. For the first few years after its introduction in 1974 everything from genuine accidents to minor illnesses was categorised as an "accident". The "accident" rate increased by 40% per annum as people sought to avail themselves of ACC benefits. Costs soon threatened to bankrupt the institution. Much tougher policies were introduced, but public expectations of ACC still far exceed what is possible.

It's when lawyers, judges and politicians get involved and are required to exercise historical judgement that the thicket becomes dense. Not enough history is taught in our schools. The professions undervalue it. Few understand the way in which conventional wisdom and standards of conduct, as well as expectations, change over time. Instead, people want to judge the past by today's standards that are the only ones they know. Good historians call it "presentism". Thus the woman who was recently on TV "wanting answers" because many years back a relative in a psychiatric hospital was given shock treatment and later injected with Paraldehyde. Actually, patients' rights were relatively undefined until after the Cartwright inquiry in 1988, meaning that the doctor was "God" and not as accountable as he/she is today. More importantly, shock treatment, Paraldehyde and Haloperidol were commonly used in psychiatric care into the early 1980s. It took the 1983 Oakley Hospital inquiry to change things. Knowledge and drugs have gradually improved. So has psychiatric care. Should we hold accountable the then medicos because of the standard of world knowledge in their time? Unfair, surely?

A bandage left inside a patient is a straight forward issue. But not some of the "cures" used in earlier times on tuberculosis victims. Some were placed in tents so that they could get fresh air - a treatment that sometimes hastened death. We could certainly demand answers for that. But all we could learn is how far modern medicine has progressed since then.

It's the same with many issues before the Waitangi Tribunal. I listened to someone at a hearing blame the Crown for not building enough hospitals in Maori areas in the 19th century. When it was explained that the prevailing wisdom until the mid 20th century was that hospitals rarely cured people - Maori or Pakeha - and were regarded as places most people went to die, the claimant looked astonished.

Accepting the reality that medical knowledge at any one time is imperfect, that accidents will always happen, and that often no one is to blame but oneself, is something many can't understand. Today's urge to hold others accountable for their own stupidity or for a lack of omniscience has grown to ridiculous proportions. What drives the Blame Culture? Is it the politicians who are too ready to pay out on complaints? Lawyers touting for work on a no win, no fee basis? Or a minute of celebrity status on TV for so-called victims who are really digging for gold? Whatever, a correction will eventually take place. In the end, those who aren't prepared to accept the realities of life or responsibility for the choices they exercise, will always be hobbled by grievance and unhappiness.