Medical Malpractice

MM first came to the attention of policy makers primarily in the USA where, from the 1970s, healthcare providers denounced problems in getting insurance for medical liability, pointing out to a crisis in the MM insurance market (Sage WM (2003) Understanding the first malpractice crisis of the 21th century. In: Gosfield AG, (ed) Health law handbook. West Group, St. Paul, pp 549–608). The crisis was allegedly grounded in an explosion of requests of compensations based on suffering iatrogenic injuries. Since then, MM problems have been identified with scarce availability of insurance coverage and/or its affordability, the withdrawal from the MM insurance of commercial insurers, the growth of MM public insurance or self-insurance solutions, the choice of no-fault rather than negligence liability, the adoption of enterprise liability for hospitals, the concerns for defensive medicine, and the implementation of tort reforms so to decrease MM pressure (i.e., frequency of claims and the levels of their compensation) on healthcare practitioners. While the initial contributions to the topic are mainly based on the US healthcare and legal system experience, a growing attention to these problems has raised in the last decades also among European countries (Hospitals of the European Union (HOPE) (2004) Insurance and malpractice, final report. Brussels, www.hope.be; OECD (2006) Medical malpractice, insurance and coverage options, policy issues in insurance n.11; EC (European Commission, D.G. Sanco) (2006) Special eurobarometer medical errors).