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

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.