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19 August 2003 | Volume 139 Issue 4 | Pages 267-273
The system of tort liability for medical malpractice is frequently criticized for poorly performing its theoretical functions of compensating injured patients, deterring negligence, and dispensing corrective justice. Working from an actual malpractice case involving serious injury but no apparent negligence, the authors explore these criticisms from the perspectives of both the plaintiff–patient and the defendant–physician. They then examine the tort system through the lens of patient safety and conclude that the tensions between the system and patient safety initiatives suggest a need to reexamine our attachment to adversarial dispute resolution in health care. They propose targeted reforms that could improve the functioning of the system and create incentives to improve safety and quality.
For a list of questions and answers from the Quality Grand Rounds conference, see the Appendix.
Author and Article Information
From the Harvard School of Public Health, Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts.
*This paper was prepared by Troyen A. Brennan, MD, JD, MPH, and Michelle M. Mello, JD, PhD, MPhil, for the Quality Grand Rounds series. Robert M. Wachter, MD, prepared the case for presentation. The case and discussion were presented at the University of California, San Francisco, on 4 December 2002.
Grant Support: Funding for the Quality Grand Rounds series is supported by the California Health Care Foundation as part of its Quality Initiative. The authors are supported by general institutional funds.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Troyen A. Brennan, MD, JD, MPH, Brigham and Women's Hospital, 75 Francis Street, PBB4, Boston, MA 02115.
Current Author Addresses: Dr. Brennan: Brigham and Women's Hospital, 75 Francis Street, PBB4, Boston, MA 02115.
Dr. Mello: Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115. IMPROVING PATIENT CARE
QUALITY GRAND ROUNDS
Series Editors: Robert M. Wachter, MD; Kaveh G. Shojania, MD; Sanjay Saint, MD, MPH; Amy J. Markowitz, JD; and Mark Smith, MD, MBA
Improving Patient Care is a special section within Annals supported in part by the U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ). The opinions expressed in this article are those of the authors and do not represent the position or endorsement of AHRQ or HHS.
Funding for the Quality Grand Rounds series is supported by the California Health Care Foundation as part of its Quality Initiative. The authors are supported by general institutional funds.
Patient Safety and Medical Malpractice: A Case Study
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