The medical literature and lay press have increasingly

Narrative Review: Do State Laws Make It Easier to Say “I’m Sorry?” William M. McDonnell, MD, JD, and Elisabeth Guenther, MD, MPH Initiatives intended to reduce the frequency and impact of medical errors generally rely on recognition and disclosure of medical errors. However, fear of malpractice liability is a barrier to physician dis- closure. Some U.S. state legislatures have attempted to encourage physicians to disclose medical errors by enacting “apology laws.” The authors reviewed the codified statutes of each of

the 50 states and the District of Columbia to determine the prevalence and characteristics of such apology laws. They found that many states have recently adopted apology laws and that there is variability in these laws. The authors review some of the important differences in these laws and explore the potential impact of apology laws. Ann Intern Med. 2008;149:811-815. www.annals.org For author affiliations, see end of text. T he medical literature and lay press have increasingly reported on the incidence and impact of medical error. Among the most influential is the Institute of Medicine report “To Err Is Human: Building a Safer Health System” (1). The report estimated that more than one half of the adverse medical events occurring each year are due to pre- ventable medical errors. These medical events cause 44 000 to 98 000 deaths annually in the United States (1). The annual costs associated with these errors in lost income, disability, and health care expenditures may be as much as $29 billion (1). The potential for severe consequences from medical error, including disability or death, underscores the need for aggressive action. THE CASE FOR DISCLOSURE AND APOLOGY The errors in any system must be identified before...

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