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Medical liability system, Medical errors, Public health, Patient safety, Systems thinking


Health Law and Policy | Medical Jurisprudence | Torts


"Patient safety" has come of age. With the publication of several empirical studies of medical injuries and the recent Institute of Medicine Report, To Err is Human: Building a Safe Health System, scholars from a variety of disciplines are advocating "systems thinking" as a way of preventing medical accidents. These scholars have been influenced by efforts to reduce accidents in other high risk industries such as aviation and scholarship in law proposing "no fault systems" for compensating medical accident victims. This article proposes that in order to incorporate "systems thinking" about medical error reduction, legal scholarship on the health care system must move beyond its preoccupation with the medical liability system. To develop a new framework for the role of law in enhancing patient safety, this article proposes that law's interaction with the public health system is the appropriate starting point for framing the legal analysis of patient safety. This framing of the issues acknowledges that the liability system may have a role to play in error reduction in medicine, but determining what this role is requires more empirical study of legal institutions as part of the emerging system of patient safety. To discover the appropriate role of law in the prevention of medical errors, this article encourages legal scholars to learn to pose empirical questions about how various institutions interact with the health care system.

Publication Citation

Larry I. Palmer, "Patient Safety, Risk Reduction, and the Law" 36 Houston Law Review 1609 (1999)