FEAR OF legal liability weighs heavily on the minds of many physicians.1,2 This fear all too often distorts the practice of medicine3 and undermines a sense of professional integrity. Anyone who has participated in ethics committee case consultations or who has rounded with medical teams in intensive care units or on the wards will know how easily the discussion can devolve into a single-minded focus on legality. The fear of liability, and the consequent practice of "defensive medicine" to avoid lawsuits, leads to a paradox. When physicians are overly concerned with the threat of law, do not understand the reasons people sue, and fail to understand the medical malpractice system, they engage in behaviors that, ironically, make themselves more vulnerable to lawsuits. The predominant focus of physicians should instead be on demonstrating the knowledge, skills, and attitudes that result in a patient's or family's maintaining respect for a physician even in the face of a bad outcome. Keeping this focus can be the most effective legal protection.
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