Punishing Harm-Creators
Everyone grieves for the three killed and many injured in the 2013 Marathon Bombing. Most watched the manhunt closely and cheered with the residents of Watertown when the second suspect was captured after extra-ordinary efforts by multiple law enforcement agencies.

On Wednesday of the same week a massive explosion at a Texas fertilizer plant killed at least 14 and injured many more. But this story was pushed off the front page by a story about a lesser harm in Boston. There was no televised manhunt for the corporate CEO or Texas state government official who opposed efforts to regulate who might be responsible.

According to the Bureau of Labor Statistics (a very conservative figure) 4,609 Americans died as a result of workplace injuries in 2011. But no manhunt and no celebration of heroic law enforcement efforts to hold those responsible accountable for the harm they caused.

After explaining that regulatory efforts and market (internalizing externalities) approaches are needed but insufficient, the author (1989, Economic& Political Weekly) argues that we need to reframe the conversation and redefine the corporate negligence that causes serious harm to people, families and communities as a criminal act.

“The primary cause of most industrial mass disasters can be shown to be in the negligent acts of specific individuals within the corporation. It is argued that such negligence is not to be understood merely as a lapse on the part of those particular individuals, but is in fact a manifestation of the normal attitude required of corporate functionaries; that this peculiarly modern form of ‘institutional irresponsibility’ is precisely the problem we are up against, and that criminal sanctions offer the most appropriate and the only effective means of ensuring a high sense of responsibility on the part of corporate functionaries whose decisions have the power to jeopardize people’s lives (711).”

Data from an article in the Journal of the American Medical Association by Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health uses the best available data (oddly, the CDC list of leading causes of deaths does not include this) to estimate there are 225,000 iatrogenic (meaning patient deaths caused by a doctor) deaths per year in the US.

Disclaimer: I love our family doctor as much as the next person and I am thankful for the care she provides in our times of need. I am also thankful for the prosperity made possible through private sector innovation, including much innovation that takes place within large corporations. Further, I believe that most, or even nearly all, of our doctors and corporate leaders love their children and strive to be good parents, partners, and community members. None of this, however, erases the harms and our responibility to do our best to prevent them...including doing as much to prevent these, or punish those responsible when we fail to prevent these, as we do against other harm-creators like the marathon bombers, street thugs, and minor drug users.

An article in Medical News Today cites a study by HealthGrades, a healthcare firm, concluding that an average of 195,000 preventable patient deaths in the US (2000-2002) were caused by in-hospital medical errors, with an associated cost of $6 billion.

But, instead of manhunts for corporate leaders and doctors responsible for causing much larger, and routine, harms we hear politicians in Texas proudly call for less regulation of corporate health and safety practices and politicians all over the country calling for ‘tort reform’ to reduce the capacity of the average citizen to hold these elites accountable for the harms they routinely cause.