PT - JOURNAL ARTICLE AU - T J Papadimos TI - Nietzsche’s morality: a genealogy of medical malpractice AID - 10.1136/jmh.2005.000223 DP - 2006 Dec 01 TA - Medical Humanities PG - 107--110 VI - 32 IP - 2 4099 - http://mh.bmj.com/content/32/2/107.short 4100 - http://mh.bmj.com/content/32/2/107.full SO - J Med Humanit2006 Dec 01; 32 AB - 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.