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| The legal concept of the
"paper-thin" skull relates to the premise that a slight injury
directed to a highly vulnerable body structure can have usually
devastating consequences for the individual. The classic example
given is that of the "paper-thin" skull where a modest blow
could produce severe and permanent brain damage. This is clearly a
valid concept. Indeed, "all men are not created biologically
equal." It is also the reason why entities such as worker's
compensation, which assume all work injury, or insult, is being
directed to a "normal" body structure is inherently irrational. With the advent of genomic testing it is now becoming possible to determine, at birth, various genetically determined lifespan liabilities. These involve all of the bodies organ systems. From the medical-legal standpoint this concept seems to be played out most often in the area of spine-related tribulations. What then is the result of minor, long-term, insult being applied to a congenitally abnormal structure such as a spine. What if the spine owner is born with a genomic entity such as juvenile discogenic disease? What if the individual is a trucker where back problems represent an additional occupational hazard and disease entity? What if the individual is a cigarette smoker and doesn't know the additional risk factors from this? The legal entity of a "Gillette Injury" means that through repetition a "normal" body part can legitimately sustain a "injury" in the worker's compensations sense. How do genomics, smoking, etc. all effect a Gillette injury? What if the person has been directed by their physician to stop smoking, improve nutrition and exercise and start a self-administered health maintenance program and does not do this? Whose responsibility does it then become? Is the employer or insurer at fault? All the more reason to promote independent health maintenance programs such as individual owned medical savings accounts. |
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