Closing Death’s Door

After heart disease and cancer, the third leading cause of death in the United States is iatrogenic harm (avoidable injury or infection caused by a healer). Research suggests that avoidable errors claim several hundred thousand lives every year. The principal economic counterforce to such errors, malpractice litigation, has never been a particularly effective deterrent for a host of reasons, with fewer than 3% of negligently injured patients (or their families) receiving any compensation from a doctor or hospital's insurer. Closing Death's Door brings the psychology of decision-making together with the law to explore ways to improve patient safety and reduce iatrogenic injury, when neither the healthcare industry itself nor the legal system has made a substantial dent in the problem. The authors describe the scope of the problem, as well as unsuccessful efforts by the healthcare industry, as well as law, to effectively address the problem. The authors offer a set of ideas intended to start a conversation that will lead to new legal policies that lower the risk of harm to patients.