Defensive Healthcare Practice: An Environment for Corruption

This chapter highlights how ‘defensive medicine’—a departure from standard medical practice—has the potential to lead to or is in reaction to neglect, malpractice and acts of corruption. Patients that complain about poor healthcare are dismissed and/or blocked by powerful individuals, and/or medical councils with an investigation (if at all) often conducted behind closed-doors. However, medical practitioners that raise issues regarding practice and/or complain are also subject to abuse and vilification. One technique used in the healthcare sector is that of Non-Disclosure Agreements (NDAs) (known as ‘gagging orders) to prevent poor and/or incorrect treatment of patients, unethical and harmful practices reaching the public. This potential for unethical and/or corrupt acts is compounded in jurisdictions with limited regulatory oversight and/or those that suffer state capture. Furthermore, I highlight how the medical profession can also precipitate and participate in healthcare corruption since it has the power to define an ‘issue’ as a medical one, in need of a course of treatment, based on status and medical knowledge and allows medical practitioners to engage in and/or thwart, block and obfuscate investigation into medical practice/treatment and corrupt behaviour.