BUSI 302 Week 7 Research Paper Example

Professional Malpractice in Healthcare: Legal, Social, Ethical and Biblical Aspects

Introduction

Professional malpractice is negligence by a professional, a failure to meet the standard of care expected of a reasonable practitioner that causes harm to a patient (Judson & Harrison, 2016). Malpractice is usually discussed as a legal problem of claims, verdicts and insurance, but it is also a social problem that shapes how medicine is practiced, an ethical problem about honesty after harm and, for Christians, a question of accountability and grace. This paper examines all four aspects and argues that healthcare organizations should respond to errors with prompt disclosure, apology and fair resolution, an approach that is ethically required, consistent with Scripture and, the evidence suggests, legally sound.

The Legal Aspect

Judson and Harrison (2016) explain that a malpractice plaintiff must prove four elements: that the professional owed a duty to the patient, breached that duty by failing to meet the standard of care, the patient suffered harm and the breach caused that harm. Defendants may argue that the standard of care was met, that the patient's own conduct contributed to the injury or that the suit came too late under the state's time limit for filing. Because most cases turn on the standard of care, expert testimony usually decides them.

The law has also tried to change how clinicians respond after errors. Most states have passed apology laws to make apologies inadmissible as evidence of liability. Ross and Newman (2021) found that these laws have not reduced malpractice rates, largely because most protect only expressions of sympathy and not admissions of fault. A clinician who says an expression of sympathy is usually shielded, but one who says "we made a mistake" may not be. Sim et al. (2025), comparing jurisdictions, argue that only full apology protection removes the legal barrier to candor. The legal framework therefore still discourages exactly the honest disclosure that ethics requires.

The Social Aspect

Malpractice claims arise from social relationships as much as from injuries. Sim et al. (2025) observe that many injured patients file suit less for money than because no one apologized or told them plainly what went wrong. When a clinician goes silent after an error, the patient may conclude that the only way to learn the truth is through a lawsuit.

In primary care, where I work, claims follow predictable patterns, which is good news for administrators because predictable risks can be managed. Wallace et al. (2013) reviewed 34 studies and found that failure or delay in diagnosis caused 26% to 63% of primary care claims, with medication errors second at 5.6% to 20%. Naseralallah et al. (2023) found medication errors in 23% to 92% of prescriptions in outpatient settings, mostly prescribing and dosing errors arising from system weaknesses. These figures point to processes, such as test result follow-up and prescribing safeguards, that administrators can improve. In my own practice, a critical lab result once sat unreviewed for three weeks because results were filed by staff before a physician saw them; the fix was a daily report of unreviewed critical values, a small system change that addresses the most common kind of primary care claim.

The fear of malpractice also shapes practice in ways that cost society. Williams et al. (2021) note that more than half of physicians in some surveys admit to defensive medicine, ordering tests and procedures chiefly for self-protection. Defensive medicine raises costs and exposes patients to unnecessary interventions without reliably preventing claims. It also changes the relationship between clinician and patient, turning each visit into a possible future lawsuit rather than a shared effort to solve a problem, which is the opposite of the trust that reduces claims in the first place.

The Ethical Aspect

Ethically, disclosure of errors is a duty. Heller and Souter (2024) describe it as part of a clinician's obligation to the patient, essential to informed decision-making and to learning from errors through root cause analysis. The principles of respect for autonomy and veracity require that patients know what happened to them, and justice requires that harmed patients be compensated fairly. Heller and Souter identify fear of litigation, fear of damaging the relationship and lack of training as the main reasons clinicians do not disclose, and they recommend training and institutional support.

The fear of litigation, though understandable, is not well supported by evidence. Kachalia et al. (2018) tracked malpractice claims and costs at four Massachusetts hospitals as each launched a communication-and-resolution program, an approach in which the hospital tells patients about adverse events, investigates them, apologizes and, where warranted, offers compensation. None saw worsening liability trends, and some saw fewer claims and lower defense costs. A newer federal rapid review judged the evidence low in strength but favorable, with the best-designed programs lowering claim rates and defense spending, while effects on patients themselves are still largely unstudied (Sokol-Hessner et al., 2026). What ethics requires, the evidence suggests, institutions can afford. The remaining barrier is often culture: clinicians who have never seen a disclosure handled well assume it will go badly, and only experience with a supported process changes that assumption.

The Biblical Aspect

Scripture speaks directly to the response after wrongdoing. Proverbs warns that hiding one's wrongs leads to failure, while confessing and turning from them leads to mercy (English Standard Version Bible, 2001/2016, Proverbs 28:13). James urges believers to confess their sins to one another so that they may be healed (English Standard Version Bible, 2001/2016, James 5:16). Mason (2021) applies this tradition to medicine, proposing a model of disclosure based on confession and arguing that even errors for which a physician is not morally culpable should be acknowledged, because acknowledgment restores the relationship with the patient and offers the physician a path out of isolation and shame.

A biblical view also sets a high standard of care. For Pellegrino (1999), the pattern for Christian clinicians is Christ's own ministry of healing, in which skill, compassion and service belong together. In that light, negligence is not only a legal breach but a failure of the service a Christian clinician owes the patient, and careful practice is a form of stewardship over the lives entrusted to clinicians. The golden rule, to do to others what we would have them do to us (English Standard Version Bible, 2001/2016, Matthew 7:12), offers a simple test for disclosure: every clinician would want to be told the truth if they were the patient. At the same time, the gospel offers grace to those who err, which allows organizations to hold clinicians accountable without treating them as beyond restoration. Honesty after harm is where the law's minimum, ethics' duty and Scripture's call to confession finally meet.

Implications for Healthcare Administrators

For administrators, these findings support three actions. First, adopt a written disclosure and resolution program, with risk management involved, so that every harmful error is disclosed promptly and handled consistently. Second, train clinicians and staff in disclosure conversations, since lack of training is a leading barrier. Third, invest in the processes where primary care claims arise, especially tracking of test results and referrals and prescribing safeguards, so that fewer errors occur in the first place. Each of these steps can be measured, by disclosure rates, training completion and the number of overdue results each month, which lets leaders see whether the program is working.

Conclusion

Professional malpractice is defined by law, but it is shaped by social forces, judged by ethics and, for Christians, understood in light of Scripture. The legal system still discourages full candor, patients often sue because they were not told the truth, ethics requires disclosure and Scripture calls for confession, accountability and grace. The evidence that disclosure programs do not raise liability costs removes the main practical objection. Healthcare organizations that respond to errors with honesty serve their patients, their clinicians and their own long-term interests.

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Heller, K. O., & Souter, K. J. (2024). Disclosure of adverse events and medical errors: A framework for anesthesiologists. Anesthesiology Clinics, 42(3), 529-538. https://doi.org/10.1016/j.anclin.2023.12.003

Judson, K., & Harrison, C. (2016). Law and ethics for the health professions (7th ed.). McGraw-Hill Education.

Kachalia, A., Sands, K., Van Niel, M., Dodson, S., Roche, S., Novack, V., Yitshak-Sade, M., Folcarelli, P., Benjamin, E. M., Woodward, A. C., & Mello, M. M. (2018). Effects of a communication-and-resolution program on hospitals' malpractice claims and costs. Health Affairs, 37(11), 1836-1844. https://doi.org/10.1377/hlthaff.2018.0720

Mason, J. (2021). Confessional approach to disclosure of medical error. Christian Bioethics, 27(2), 203-222. https://doi.org/10.1093/cb/cbab006

Naseralallah, L., Stewart, D., Price, M., & Paudyal, V. (2023). Prevalence, contributing factors, and interventions to reduce medication errors in outpatient and ambulatory settings: A systematic review. International Journal of Clinical Pharmacy, 45(6), 1359-1377. https://doi.org/10.1007/s11096-023-01626-5

Pellegrino, E. D. (1999). Christ, physician and patient, the model for Christian healing. The Linacre Quarterly, 66(3), 70-78. https://doi.org/10.1080/20508549.1999.11877550

Ross, N. E., & Newman, W. J. (2021). The role of apology laws in medical malpractice. Journal of the American Academy of Psychiatry and the Law, 49(3), 406-414.

Sim, S. W., Krishna, L. K. R., & Porter, G. (2025). Saying 'I'm sorry' at the bedside: When and why should apologies following medical mishaps be protected from legal liability? Medical Law Review, 33(1), fwaf011. https://doi.org/10.1093/medlaw/fwaf011

Sokol-Hessner, L., Stewart, C. M., Sharma, R., Zhang, A., Gallagher, T. H., Kachalia, A., Bass, E. B., & Clifton, M. (2026). Programs for responding after patients are harmed by their healthcare: A Making Healthcare Safer IV rapid review. Journal of Patient Safety and Risk Management, 31(3), 128-138. https://doi.org/10.1177/25160435261422384

Wallace, E., Lowry, J., Smith, S. M., & Fahey, T. (2013). The epidemiology of malpractice claims in primary care: A systematic review. BMJ Open, 3(7), e002929. https://doi.org/10.1136/bmjopen-2013-002929

Williams, P. L., Williams, J. P., & Williams, B. R. (2021). The fine line of defensive medicine. Journal of Forensic and Legal Medicine, 80, 102170. https://doi.org/10.1016/j.jflm.2021.102170