The extent and existence of "defensive medicine" -- excessive medical care to defend a physician against malpractice claims -- is a perennial subject of both policy and academic debate.  For example, malpractice liability and associated defensive medicine are among the most-cited reasons for escalating health-care spending in the United States.

In this colloquium, Dr. Brian Chen will present results from his research investigating the extent of defensive medicine in Taiwan. He studies the impact of a series of court rulings in Taiwan that increased physicians’ liability risks, and a subsequent amendment to the law that reversed the courts’ rulings, on physicians’ test-ordering behavior and propensity to perform Caesarean sections.  He finds that physicians faced with higher malpractice pressure increased laboratory tests as expected, but unexpectedly reduced Caesarean sections.  (The reduction in Caesarean deliveries may be due to the fact that liability risks were more closely aligned with physicians’ standard of care after the court rulings.) After the law was amended to negate the court decisions, physicians reversed their previous behavior by reducing laboratory tests and increasing Caesarean deliveries.

This pattern of behavior is highly suggestive of the existence of defensive medicine among physicians in Taiwan. In other words, by studying physicians' response to legal changes in Taiwan, we find that greater malpractice liability may, under certain circumstances, prompt physicians to perform more services without necessarily improving patient health.

Dr. Brian Chen recently completed his Ph.D. in Business Administration in the Business and Public Policy Group at the Haas School of Business, University of California at Berkeley. He received a Juris Doctor from Stanford Law School in 1997, and graduated summa cum laude from Harvard College in 1992.

On May 10-11, 2010 the Program on Good Governance and Political Reform in the Arab World at CDDRL held its international inaugural conference. In line with the Arab Reform Program's vision, the conference featured internationally renowned scholars, activists, and practitioners from the Arab world, Europe and the United States. Over the two days, conference participants engaged in multidisciplinary debates addressing hard politics as well as soft politics, and analyzing political reform from different angles, with panels on the economy, state systems, the media, civil society, political opposition, youth politics, and the role of international actors. Problems facing political reform in the Arab world today were discussed and scrutinized, as were possible paths forward. The conference debates unearthed the need for a deep understanding of the problems facing political reform in the region that is driven by an analysis of long-term and often ignored issues that are at the core of political developments. The debates also highlighted that problems and prospects for reform are different in each Arab country because each country has its own unique set of issues and because within each country different ethnic groups, classes, and locales have different takes on and stakes in political developments. The conference closed with a speech by Dr. Saad Eddin Ibrahim.