Skip to main content
    • Aa
    • Aa

Minimising medical litigation: a review of key tort and legal reforms

  • Harold Tan (a1)

The traditional tort system in medical malpractice is increasingly perceived as being incapable of addressing the mismatch between claims and negligent injuries. Tort reforms have been introduced in various developed countries in an attempt to bring about greater fairness and economic sustainability in the compensation of medical injuries and to reduce the overall rate of medical litigation. This paper reviews the key tort reforms that have been used in various countries, notably the US and the UK, and discusses the arguments that had been put forth by advocates and opponents of such reforms. The impact of these tort reforms, where studied and available, is also reviewed and discussed in the paper.

Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

M. I. H. Aas (1991) ‘Malpractice’, Quality Assurance in Health Care, 3(1): 21–39.

O. Bar-gill (2005) ‘The Evolution and Persistence of Optimism in Litigation’, Journal of Law Economics and Organisation 22(2): 490507.

C. Becker (2006) ‘Medical Malpractice Liability Reform – No Easy Task’, Association of Perioperative Registered Nurses Journal 83(2): 489–95.

H. B. Beckman , K. M. Markakis , A. L. Suchman and R. M. Frankel (1994) ‘The Doctor-Patient Relationship and Malpractice. Lessons from Plaintiff Depositions’, Archives of Internal Medicine 154(12): 1365–70.

C. F. Beckner and A. Katz (1995) ‘The Incentive Effects of Litigation Fee Shifting When Legal Standards are Uncertain’, International Review of Law and Economics 15(2): 205–24.

R. P. Bergen (1972) ‘Mediation of Liability Claims’, Journal of the American Medical Association 222(2): 241–42.

M. Bismark and R. Paterson (2006) ‘No-fault Compensation in New Zealand: Harmonizing Injury Compensation, Provider Accountability, and Patient Safety’, Health Affairs 25(1): 278–83.

R. R. Bovbjerg (2007) ‘Commentary: Malpractice Reform in Policy Perspective’, The Milbank Quarterly 85(2): 297305.

R. R. Bovbjerg , F. A. Sloan and P. J. Rankin (1997) ‘Administrative Performance of “No-fault” Compensation for Medical Injury’, Law and Contemporary Problems 60(2): 71115.

T. A. Brennan , C. M. Sox and H. R. Burstin (1996) ‘Relation Between Negligent Adverse Events and the Outcomes of Medical Malpractice Litigation’, New England Journal of Medicine 335(26): 1963–67.

C. Brown (1985) ‘Deterrence in Tort and No Fault: The New Zealand Experience’, California Law Review 73(3): 9761002.

M. J. Browne and R. Puelz (1999) ‘The Effect of Legal Rules on the Value of Economic and Non-economic Damages and the Decision to File’, Journal of Risk and Uncertainty 18(2): 189213.

C. M. Currie (1998) ‘Mediation and Medical Disputes’, Mediation Quarterly 15(3): 215–26.

S. Daniels and J. Martin (1999) ‘“It’s Darwinism – Survival of the Fittest”: How Markets and Reputations Shape the Ways in which Plaintiffs’ Lawyers Obtain Clients’, Law & Policy 21(4): 377–99.

P. M. Danzon (1984) ‘The Frequency and Severity of Malpractice Claims’, Journal of Law and Economics 27(1): 115–48.

P. M. Danzon (1984) ‘Tort Reform and the Role of Government in Private Insurance Markets’, The Journal of Legal Studies 13(3): 517–49.

P. M. Danzon (1985) Medical Malpractice Theory, Evidence and Public Policy. Cambridge MA: Harvard University Press.

P. M. Danzon (1994) ‘Tort Reform: The Case of Medical Malpractice’, Oxford Review of Economic Policy 10(1): 8498

E. A. Dauer and L. J Marcus . (1997) ‘Adapting Mediation to Link Resolution of Medical Malpractice Disputes with Health Care Quality Improvement’, Law & Contemporary Problems 60(1): 185–218.

R. Dingwall and P. Fenn (1994) ‘Is NHS Indemnity Working and is There a Better Way?’, British Journal of Anaesthesia 73: 6977.

C. W. Duclos , M. Eichler and L Taylor . (2005) ‘Patient Perspectives of Patient–Provider Communication After Adverse Events’, International Journal for Quality in Health Care 17(6): 479–86.

A. Ehrensweig (1964) ‘Compulsory “Hospital Accident” Insurance: A Needed First Step Toward the Displacement of Liability for “Medical Malpractice”’, University of Chicago Law Review 31: 279–91.

W. Emons (2007) ‘Conditional Versus Contingent Fee’, Oxford Economic Papers 59: 89101.

W. Emons and N. Garoupa (2006) ‘US-style Contingent Fees and UK-style Conditional Fees: Agency Problems and the Supply of Legal Services’, Managerial and Decision Economics 27: 379–85.

H. S. Farber and M. J. White (1994) ‘A Comparison of Formal and Informal Dispute Resolution in Medical Malpractice’, Journal of Legal Studies 23(2): 777806.

P. Fenn , A. Gray and N Rickman . (2004) ‘The Economics of Clinical Negligence Reform in England’, The Economic Journal 114: F272–92.

P. Fenn and A. Mcguire (1994) ‘The Assessment: The Economics of Legal Reform’, Oxford Review of Economic Policy 10(1):117.

Jr, J. J. Fraser (2001) American Academy of Paediatrics: Technical Report: Alternative Dispute Resolution in Medical Malpractice. Pediatrics 107(3): 602607.

R. M. Friedenberg (2004) ‘Malpractice Reform’, Radiology 231: 3–6.

L. M. Froeb and B. H Kobayashi . (1996) ‘Naive, Biased, Yet Bayesian: Can Juries Interpret Selectively Produced Evidence?’, Journal of Law Economics and Organisation 12(1): 257–76.

W. J. Gaine (2003) ‘No-fault Compensation Systems: Experience Elsewhere Suggests it is Time for the UK to Introduce a Pilot Scheme’, British Medical Journal 326; 997–98.

H. Gravelle and M. Waterson (1993) ‘No Win, No Fee: Some Economics of Contingent Legal Fees’, Economic Journal 103(420): 1205–20.

J. Guirguis-blake , G. E. Fryer , Jr, R. L. Phillips et al. (2006) ‘The US Medical Liability System: Evidence for Legislative Reform’, Annals of Family Medicine 4(3): 240–46.

M. J. Hatlie and S. E Sheridan . (2003) ‘The Medical Liability Crisis of 2003: Must We Squander the Chance to Put Patients First?’, Health Affairs 22(4): 3740.

C. C. Havighurst (1984) ‘Reforming Malpractice Law Through Consumer Choice’, Health Affairs 3(4): 6370.

E. Helland and A. Tabarrok (2000) ‘Runaway Judges? Selection Effects and the Jury. Journal of Law Economics and Organisation 16(2): 306–33.

E. Helland and A. Tabarrok (2003) ‘Contingency Fees, Settlement Delay and Low Quality Litigation: Empirical Evidence from Two Datasets’, Journal of Law Economics and Organisation 19(2): 517–42.

G. B. Hickson , C. F. Federspiel , J. W. Pichert et al. (2005) ‘Patient Complaints and Malpractice Risk’, Journal of the American Medical Association 287(22): 2951–57.

J. S. Horner (2000) ‘Autonomy in the Medical Profession in the United Kingdom – A Historical Perspective’, Theoretical Medicine 21(5): 409–23.

J. Horwitz and T. A Brennan . (1995) ‘No-fault Compensation for Medical Injury: A Case Study’, Health Affairs 14(4): 164–79.

G. A. Huber (2003) ‘Creating a Safe Environment’, Health Affairs 22(4): 41–3.

J. W. Hughes and E. A. Snyder (1995) ‘Litigation and Settlement Under the English and American Rules: Theory and Evidence’, Journal of Law & Economics 38: 225–50.

L. I. Huycke and M. M Huycke . (1994) ‘Characteristics of Potential Plaintiffs in Malpractice Litigation’, Annals of Internal Medicine 120(9): 792–98.

C. E. Hyde (2006) ‘Conditional versus Contingent Fees: Litigation Expenditure Incentives’, International Review of Law and Economics 26: 180–94.

E. Inselbuch (2001) ‘Contingent Fees and Tort Reform: A Reassessment and Reality Check’, Law &Contemporary Problems 64(2/3): 175–95.

D. Isaacs (2004) ‘Should Australia Introduce a Vaccine Injury Compensation Scheme?’, Journal of Paediatric Child Health 40: 247–49.

R. James (1998) ‘The Limitation Period in Medical Negligence Claims’, Medical Law Review 6: 6298.

A. Kachalia , N. K. Choudhry and D. M. Studdert (2005) ‘Physician Responses to the Malpractice Crisis: From Defense to Offense’, Journal of Law, Medicine and Ethics 33(3): 416–30.

A. Klement and Z. Neeman (2005) ‘Against Compromise: A Mechanism Design Approach’, Journal of Law, Economics and Organisation 21(2): 285314.

L. A. Kornhauser and R. L Revesz . (1994) ‘Multidefendant Settlements Under Joint and Several Liability: The Problem of Insolvency’, Journal of Legal Studies 23(1–2): 517–42.

H-R. Krause , A. Bremerich and J Rustemeyer . (2001) ‘Reasons for Patients’ Discontent and Litigation’, Journal of Cranio-Maxillofacial Surgery 29: 181–83.

C. E. Lavenant , C. L. Hayward and P. Jesilow (2002) ‘Tort Reform and Physician Sanctioning’, Law and Policy 24(1): 115.

H. D. Lee , M. J. Browne and J. T. Schmit (1994) ‘How Does Joint and Several Tort Reforms Affect the Rate of Tort Filings? Evidence from State Courts’, Journal of Risk and Insurance 61(2): 295316.

R. Lewis (1993) ‘The Merits of a Structured Settlement: The Plaintiff’s Perspective’, Oxford Journal of Legal Studies 13(4): 530–47.

R. Lewis (1998) ‘Deducting Collateral Benefits from Damages: Principle and PolicyLegal Studies 18(1): 1540.

R. Lewis (2005) ‘Insurance and the Tort System’, Legal Studies 25(1): 85116.

R. Lewis (2006) ‘The Politics and Economics of Tort Law: Judicially Imposed Periodical Payments of Damages’, Medical Law Review 69(3): 418–42.

Y. P. Liao and M. J White . (2002) ‘No-fault for Motor Vehicles: An Economic Analysis’, American Law and Economics Review 4(2): 258–94.

C. B. Liebman and C. S. Hyman (2004) ‘A Mediation Skills Model to Manage Disclosure of Errors and Adverse Events to Patients’, Health Affairs 23(4): 2232.

A. R. Localio , A. G. Lawthers , T. A. Brennan et al. (1991) ‘Relation Between Malpractice Claims and Adverse Events Due to Negligence. Results of the Harvard Medical Practice Study III’, New England Journal of Medicine 325(4): 245–51.

D. P. Mason (1993) ‘The Statute of Limitations’, Current Obstetrics &Gynaecology 3: 176–77.

M. L. May and D. B Stengel . (1990) ‘Who Sues Their Doctors? How Patients Handle Medical Grievances’, Law & Society Review 24(1): 105–20.

M. M. Mello , D. M. Studdert and C. M. Desroches (2004) ‘Caring for Patients in a Malpractice Crisis: Physician Satisfaction and Quality of Care’, Health Affairs 23(4): 4253.

M. M. Mello , D. M. Studdert , A. B. Kachalia et al. (2006) ‘“Health Courts” and Accountability for Patient Safety’, The Milbank Quarterly 84(3): 459–92.

C. S. Meschievitz (1991) ‘Mediation and Medical Malpractice: Problems with Definition and Implementation’, Law and Contemporary Problems 54(11): 195215.

T. B. Metzloff , R. A. Peeples and C. T. Harris (1997) ‘Empirical Perspectives on Mediation and Malpractice’, Law and Contemporary Problems 60(1): 107–52.

T. J. Miceli (2000) ‘Deterrence, Litigation Costs and the Statute of Limitation for Tort Suits’, International Review of Law &Economics 20: 383–94.

A. Morris (2007) ‘Spiralling or Stabilising? The Compensation Culture and Our Propensity to Claim Damages for Personal Injury’, Modern Law Review 70(3): 349–78.

J. Mosher (1994) ‘Challenging Limitation Periods: Civil Claims by Adult Survivors of Incest’, University of Toronto Law Journal 44(2): 169222.

L. J. Nelson , M. A. Morrisey and M. Kilgore (2007) ‘Damages Caps in Medical Malpractice Cases’, The Milbank Quarterly 85(2): 259–86.

K. Oliphant (1996) ‘Defining “Medical Misadventure”. Lessons from New Zealand’, Medical Law Review 4: 1–31.

R. Peeples , C. T. Harris and T. B. Metzloff (2000) ‘Settlement Has Many Faces: Physicians, Attorneys and Medical Malpractice’, Journal of Health and Social Behavior 41(3):333–46.

D. L. Rubinfeld (1984) ‘On Determining the Optimal Magnitude and Length of Liability in Torts’, Journal of Legal Studies 13(3): 551–63.

D. Rubinfeld and S. Scotchmer (1993) ‘Contingent Fees for Attorneys: An Economic Analysis’, RAND Journal of Economics 24(3): 343–56.

M. J. Saks , L. A. Hollinger , R. L. Wissler et al. (1997) ‘Reducing Variability in Civil Jury Awards’, Law and Human Behavior 21(3): 243–56.

J. T. Schmit , M. J. Browne and H. D. Lee (1997) ‘The Effect of State Tort Reforms on Claims Filings’, Risk Management and Insurance Review 1(1): 117.

P. Shah and A. W Shuren . (2005) ‘The Current Medical Malpractice Environment: An Analysis of Causes and Solutions’, Journal of Paediatric Health Care 19: 112–16.

S. Shmanske and T. Stevens (1986) ‘The Performance of Medical Malpractice Review Panels’, Journal of Health Politics, Policy and Law 11(3): 525–35.

F. A. Sloan (1985) ‘State Responses to the Malpractice Insurance “Crisis” of the 1970s: An Empirical Assessment’, Journal of Health Politics, Policy and Law 9(4): 629–46.

F. A. Sloan and C. R Hsieh . (1990) ‘Variability in Medical Malpractice Payments: Is the Compensation Fair?’, Law and Society Review 24(4): 601–50.

F. A. Sloan , P. M. Mergenhagen and R. R. Bovbjerg (1989) ‘Effects of Tort Reforms on the Value of Closed Medical Malpractice Claims: A Microanalysis’, Journal of Health Politics, Policy and Law 14(4): 663–89.

M. L. Smith (2005) ‘Deterrence and Origin of Legal System: Evidence from 1950–1999’, American Law and Economics Review 7(2): 350–78.

C. T. Struve (2003) ‘Improving the Medical Malpractice Litigation Process’, Health Affairs 23(4): 3341.

D. M. Studdert (1997) ‘Can the United States Afford a “No-fault” System of Compensation for Medical Injury?’, Law and Contemporary Problems 60(2): 134.

D. M. Studdert , M. M. Mello and T. A. Brennan (2004) ‘Medical Malpractice’, New England Journal of Medicine 350(3): 283–92.

D. M. Studdert , M. M. Mello and A. A. Gawande (2006) ‘Claims, Errors and Compensation Payments in Medical Malpractice Litigation’, New England Journal of Medicine 354(19): 2024–33.

D. M. Studdert , M. M. Mello , W. M. Sage et al. (2005) ‘Defensive Medicine Among High-risk Specialist Physicians in a Volatile Malpractice Environment’, Journal of the American Medical Association 293(21): 2609–17.

D. M. Studdert , E. J. Thomas , H. R. Burstin et al. (2000) ‘Negligent Care and Malpractice Claiming Behaviour in Utah and Colorado’, Med Care 38: 250–60.

D. M. Studdert , Y. T. Yang and M. M. Mello (2004) ‘Are Damages Caps Regressive? A Study of Malpractice Jury Verdicts in CaliforniaHealth Affairs 23(4): 5467.

T. Swanson (1991) ‘The Importance of Contingency Fee Arrangements’, Oxford Journal of Legal Studies 11(2): 193226.

C. Tena-tamayo and J. Sotelo (2005) ‘Malpractice in Mexico: Arbitration not Litigation’, British Medical Journal 331: 448–51.

T. Thomason (1991) ‘Are Attorneys Paid What They’re Worth? Contingent Fees and the Settlement Process’, Journal of Legal Studies 20(1): 187223.

C. Vincent , A. Phillips and M Young . (1994) ‘Why Do People Sue Doctors? A Study of Patients and Relatives Taking Legal Action’, The Lancet 343(8913): 1609–13.

W. K. Viscusi (1988) ‘Pain and Suffering in Product Liability Cases: Systematic Compensation or Capricious Awards?’, International Review of Law and Economics 8(2): 203–20.

W. K. Viscusi (2004) ‘Tort Reform and Insurance Markets’, Risk Management and Insurance Review 7(1): 924.

W. K. Viscusi and P. H Born . (2005) ‘Damages Caps, Insurability, and the Performance of Medical Malpractice Insurance’, Journal of Risk and Insurance 72(1): 2343.

W. K. Viscusi , R. J. Zeckhauser , P. Born et al. (1993) ‘The Effect of 1980s Tort Reform Legislation on General Liability and Medical Malpractice Insurance’, Journal of Risk and Uncertainty 6: 165–86.

W. Wadlington (1991) ‘Medical Injury Compensation, a Time For Testing New Approaches’, JAMA 265: 2861.

J. A. Wall , J. B. Stark and R. L. Standifer (2001) ‘Mediation: A Current Review and Theory Development’, Journal of Conflict Resolution 45(3): 370–91.

A. Yoon (2001) ‘Damage Caps and Civil Litigation: An Empirical Study of Medical Malpractice Litigation in the South’, American Law and Economics Review 3(2): 199227.

A. Yoon (2004) ‘Mandatory Arbitration and Civil Litigation: An Empirical Study of Medical Malpractice Litigation in the West’, American Law and Economics Review 6(1): 95134.

M. Zander (2002) ‘Where Are We Now On Conditional Fees? – Or Why This Emperor is Wearing Few, If Any, Clothes’, Modern Law Review 65(6): 919–30.

D. Wittman (2003) ‘Lay Juries, Professional Arbitrators, and the Arbitrator Selection Hypothesis’, American Law and Economics Review 5(1): 6193.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Journal of Law in Context
  • ISSN: 1744-5523
  • EISSN: 1744-5531
  • URL: /core/journals/international-journal-of-law-in-context
Please enter your name
Please enter a valid email address
Who would you like to send this to? *