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Book Chapter

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The health care system in the United States is in turmoil. Patients are being harmed by too many, often fatal, mistakes. At the same time, physicians and hospitals are trying to cope with a costly medical malpractice crisis. These two crises create a vicious cycle. When something goes wrong in patient care, physicians and hospitals withhold apologies and offer as little information as possible for fear that anything they say may be used against them should patients or family members sue. Family members, in many cases, sue not only to receive compensation for injuries, but also in search of answers and explanations and because no one has said, “I'm sorry.” Each new suit reinforces providers' fears and inhibits the sort of conversation and exchange of information with patients and colleagues that might restore trust and prevent errors being repeated, thereby decreasing lawsuits. This chapter explores ideas developed as part of the Pew Demonstration Mediation and ADR Project (“ADR Project”) to help break the cycle.

Between 2002 and 2004, the ADR Project conducted a participant observer study that examined how mediation and conflict resolution skills might be helpful in disclosing adverse medical events and, when appropriate, reaching fair resolution of resulting claims for compensation. We focused on how those skills could be used to repair ruptured relationships between patients and physicians, to turn conversations about what went wrong into opportunities for learning about ways to improve patient safety, to include patients and their families in discussions about safety, and, when appropriate, to provide patients fair and timely compensation for their injuries.


Law | Medical Jurisprudence | Medicine and Health


This material has been published in "Medical Malpractice and the U.S. Health Care System", William M. Sage and Rogan Kersh. This version is free to view and download for private research and study only. Not for re-distribution or re-use.