Under the aegis of Ministry of Health Holdings, mediation between doctors, medical institutions and patients has been going on for some time.

It is timely that Chief Justice Sundaresh Menon has brought it to the fore ("CJ seeks to ease doctors' fears of malpractice suits"; Tuesday).

In the current form, where a trained mediator (normally well versed in law) - assisted by an appointed, neutral, medical third party - conducts the mediation, accused doctors and aggrieved patients may feel that there is insufficient gravitas during the mediation process.

The appointment and training of judges as mediators may resolve this.

Doctors accused of any form of medical negligence suffer a great emotional trial before any physical trial in court.

It is enough lesson for them to practise the most defensive and expensive form of medicine thenceforth; a case of once bitten, twice shy, be it litigation or mediation.

I doubt very much that just because mediation is less costly, disputatious and protracted than litigation, doctors will try to get away by doing less for patients.

"I tried to save you money" will never be an acceptable reason, or even excuse, before any arbiter of right and wrong.

Simply because mediation is swifter, cheaper and less confrontational than litigation through a court process, increasingly frivolous mentions before mediators will surface.

It is already a problem now, but will soon be a big headache when mediation becomes prevalent and avails itself to any opportunistic patient who simply wants to try his luck for any amount of compensation even when only pettily aggrieved.

Still, mediation is the way forward. While it is a private process not under the glare and scrutiny of the public, and does not affect any subsequent due proceedings in court, doctors know that they need to be far more circumspect of patients and their rights.

It makes for a better practice of medicine, just not a cheaper one.

Be it mediation or litigation, costs for purveyors and consumers of medical care will inexorably increase, albeit at a slower pace.

Yik Keng Yeong (Dr)