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Nietzsche’s morality: a genealogy of medical malpractice
  1. T J Papadimos
  1. Correspondence to:
 T J Papadimos
 Departments of Anesthesiology, Medicine, and Medical Microbiology and Immunology, Medical University of Ohio, 3000 Arlington Avenue, Toledo, Ohio 43614, USA; tpapadimos{at}


Medical malpractice is of increasing concern and 60 billion dollars are added annually to healthcare costs. The practice of defensive medicine, decreased availability of doctors, and increased health insurance premiums are all results of medical malpractice. An argument is made from the perspective of Friedrich Nietzsche’s On the Genealogy of Morals that a primal cause of the litigiousness of the public against doctors results from resentment or “ressentiment”. The relationship of promises, responsibility, and guilt between doctors and patients is explored, as well as what may be necessary to reduce the public’s ressentiment. Modern malpractice in the US is covered by Nietzsche’s line of reasoning in On the Genealogy of Morals, although his reasoning is condemned by most Western philosophers. Doctors may be able to better manage their interactions with patients and limit their exposure to litigation by understanding and exploring alternative philosophical and historical origins—or aetiologies—of patient/doctor conflict.

  • delivery of health care
  • ethical theory
  • jurisprudence
  • malpractice
  • morals
  • philosophy

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