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PSNet: Patient Safety Network
Journal Article
Review

Narrative review: do state laws make it easier to say "I'm sorry"?

McDonnell WM, Guenther E. Annals of internal medicine. 2008;149:811-6.

Multiple studies have demonstrated that patients clearly want errors to be fully disclosed, and desire that clinicians apologize for the errors. However, clinicians frequently cite fear of malpractice lawsuits as a reason to avoid apologizing for an error. This study reviewed statutes from all 50 states to determine the current legal climate regarding physician apologies. Thirty-six states have enacted apology laws. Of these, 28 states prohibit "expressions of sympathy" from being used as evidence in a malpractice suit, but "admissions of fault" (i.e., full disclosure of an error) are protected in only 8 states. Most of these laws were enacted within the past 3 years, and thus the authors were unable to determine their effect on patient–physician communication of errors. A prior study used economic modeling to forecast that full disclosure of errors, with or without legal protection, would likely lead to an overall increase in malpractice lawsuits.