July 5, 2001

Robert Weitzel, M.D.

Email: raw1md@qwest.net

Dear Dr. Weitzel:

It is clear to me that great advantage is being taken of humanity's need to blame someone or something for a loved one’s death. Blame is an interesting phenomenon because it often takes the place of understanding. I often counsel medical students to have brief discussions with themselves concerning the fact that they are not to blame for a patient’s illness when the patient fails therapy or there is lack of understanding of what causes an illness. The physician is not to blame for the occurrence of cancer, old age, and other disorders that occur naturally during the course of life. Singling out an individual as at fault for all that happens is a prosecutorial posture often assumed by lawyers. An empathetic and humanitarian physician often struggles with the feeling that somehow he is to blame for the patient’s misfortune. If we carry this concept to its end-point, physicians will leave medical practice in droves because the issue of blame will become foremost in all discussions of terminal management.

In the great majority of cases involved in your litigation, there were multiple factors responsible for the patient’s death, which are related either to the natural history of disease or the result of illnesses for which there is no treatment and an associated lack of understanding. To blame the physician for all of these characteristics of the illness is a penchant of the prosecutor.

The idea of blame is rampant among patients with poorly understood illnesses. Let us blame the environment, a key person, or society in general for our illness. The idea of blame ignores the fact that age does impose limitations on function, that we do not understand many illnesses that disable us through life, and finally, that all things must come to an end even the Universe itself. As our population ages, the impact of neurologic disease on the elderly is expected to increase. I refer you to a Supplement to Neurology, Vol 54, #11, supplement 5, 2000, entitled The Frequency and Impact of Neurologic Diseases in the Elderly of Europe, by Lenore J. Loaner, Ph.D., and Albert Hoffman, M.D., editors.

Yours truly,

Jack H. Petajan, M.D., Ph.D.

Professor of Neurology

JHP:lh

CC: Miguel A. Faria, Jr., M.D., HaciendaPub.com

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