DOES MALPRACTICE LIABILITY PROMOTE PATIENT SAFETY? A METHODOLOGICAL EXCURSION

• Published in: Jurimetrics (Chicago, Ill.) Vol. 62; no. 4; pp. 397 - 419
• Main Authors: Saks, Michael J, Landsman, Stephan
• Format: Journal Article
• Language: English
• Published: Chicago American Bar Association 22.06.2022
• Subjects: Care and treatment; Costs; Laws, regulations and rules; Liability; Malpractice; Management; Medical innovations; Medical malpractice; Medical personnel; Patient safety; Patient satisfaction; Patients; Prevention; Research methodology; Torts
• ISSN: 0897-1277; 2154-4344

A persistent question concerns the safety-promoting effects of malpractice liability. The goal of the present Article is to contribute to improved future research on the effects of liability risk on safety. The main focus is on the methodological challenges of conducting research capable of finding such effects when they exist and not finding them when they do not exist. A recent review of the empirical literature suggests that most of that research finds little indication of patient safety effects. The examination of the methodological challenges presented by the research question illuminates a series of hurdles that make detection of a safety effect, if one exists, unusually difficult. The most daunting of those potential obstacles is the possibility that all levels of liability risk above some threshold elicit much the same response. Consequently, studies that look at varied risk levels, all of which are above the threshold, are methodologically destined to find "no effect." We recommend a number of improvements that could be adopted in future empirical studies to strengthen their validity and enhance their ability to find safety effects that might exist. Or, if safety effects do not exist, to reach null results that are more convincing.