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An Israeli who gets sick - that is, every one of us at some point in our lives - is responsible for his or her own fate. That is the lesson learned from the charges the State Comptroller levels in his report on medical malpractice.

Cases of negligence, incompetence, failure and conflicts of interest occur a lot but are often not investigated, investigated improperly or covered up, the comptroller reported.

For the medical establishment, it means that no lessons are learned from past mistakes and failures keep recurring.

The report found that fear of malpractice suits, as well as the conflicting interests of the Health Ministry, hospital supervisory authorities and other medical bodies, all have a hand in the whitewashing of failure.

It starts in the medical schools, which don't adequately teach about patient safety. It continues in the risk-management offices of the hospitals, whose critical role is not subject to any rules and whose operations depend on the goodwill of hospital management.

The doctors themselves, the comptroller said, try to minimize their errors in front of patients out of fear it will harm their reputations or lead to lawsuits. When investigations are conducted, they become evidence-gathering exercises that could end up being used in court against the doctors.

The threat of legal entanglements such procedures carry has serious consequences, as the people involved try to avoid producing written documentation and, in many cases, destroy evidence.

The hospitals themselves often make systematic efforts to hide evidence, according to the comptroller.