A welcome step was taken last week in giving the public appropriate access to medical malpractice settlements when a Lackawanna County judge ruled that details of a medical malpractice settlement would not be sealed, as has been the standard practice for two decades.

The ruling by Common Pleas Judge Terrance Nealon to reject lawyers' requests to seal the records of the case could be a historic first step toward providing the public with full access to details of malpractice suits against doctors.

In any discussion about medical malpractice, it is important to remember that just because a malpractice lawsuit has been filed - even if it is won or settled - it does not necessarily mean the physician involved is a bad doctor. Everyone makes mistakes, even doctors. Beyond that reality, there is the issue that some doctors, especially specialists taking on the most difficult and dire cases, are bound to have some bad outcomes, because the people coming to them tend to be more seriously ill.

It is also important to understand that insurance companies sometimes settle a case that the doctor might have won if it had been fought in court. The insurance company weighs the cost of settling against the cost of litigating, and sometimes opts to settle because it is cheaper. This unfortunate circumstance should be a factor when evaluating a doctor who has had a malpractice case settled.

But those common-sense cautions against judging a doctor solely on lawsuits filed or settled still doesn't justify the sealing of all malpractice cases from the public view.

When or if this information is made public, care should be taken so that all aspects of the case are presented clearly and fairly. But the public's right to know should be given preference over a doctor's desire to keep these matters hidden. The right to know should also trump the plaintiff's desire to keep details of the case - especially monetary settlement figures - private.

The medical community will continue to resist and fund legal challenges to opening medical malpractice cases to public review. But Nealon's decision might represent a sea change that will eventually open all such cases in Pennsylvania to public review. That would be a welcome and overdue change.

Judge Nealon based his ruling on the fact that taxpayer money from the state's Mcare fund was used to pay a portion of the final settlement. He argued that since the Mcare fund is sustained by tax dollars, the public has a right to know how that money is being spent. Many would argue that the outcomes of malpractice cases should be public even if tax dollars are not involved.

Doctors should not be judged solely on medical malpractice suits filed, settled or won. But as imperfect a yardstick as malpractice suits might be, doctors' malpractice histories should not be hidden from public view.

The medical community will likely continue to fight to block public access to malpractice cases, thereby restricting the public's right to know a doctor's history. But eventually the public's right to know will prevail, and Nealon ruling last week will be seen as a significant step in that direction.

- J.L.W.III