Shift and escalation of professional liability

Doctors are at risk of having to take blame even if they have acted according to good medical practice. One reason for this is to be found in two mechanisms, shift of liability and escalation of liability--irrational mechanisms by which doctors are affected after a medical mishap. A mishap is difficult to accept and those who suffer because of it want to place responsibility somewhere. A shift of liability occurs when responsibility is displaced from the patient or the system to the doctor. Escalation takes place when a mishap is considered much worse after the fact than in the risk evaluation ex ante. The author points at the problems these mechanisms cause for patients, doctors, and society and provides some suggestions as to how doctors may handle such situations in a fruitful manner.