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Malpractice is defined as professional negligence that results in injury or harm to an individual. Although the term malpractice can be applied to other professions, the most common reference is in the area of medicine or healthcare. The Joint Commission defines malpractice as “improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position.” Malpractice arises from the branch of law called tort law or civil law, where a remedy can be provided for the action. This is different from criminal law or penal law, where causes of action lead to prosecution. When malpractice occurs in healthcare delivery, it is referred to as medical malpractice, although it can involve any healthcare provider or facility.

This entry focuses first on the elements necessary to establish a claim of medical malpractice. Then, it discusses the incidence of malpractice. Last, this entry addresses the limitations that may occur as a result of medical malpractice claims.

Elements of Malpractice

To make a claim that medical malpractice has occurred, a claimant must establish four elements: (1) duty, (2) breach of duty, (3) causation, and (4) damages. All four of these elements must exist and must be proven for a medical malpractice claim to be satisfied. Unlike criminal actions, where the standard is “beyond a reasonable doubt,” in civil actions such as malpractice, the standard of proof is “the preponderance of evidence, which means more likely than not,” or 51 on a scale of 100.

Duty

The duty of care is a legal obligation that requires that an individual adhere to a reasonable standard of care when performing acts that could cause harm to another. Although the law does not necessarily define the duty of care, its meaning may develop through common law or local customs. For example, physicians generally are said to have a duty of care by virtue of the physician-patient relationship. This relationship may be established when a patient first makes an appointment to receive care and treatment, or it may be established when a physician is consulted to render emergency care and treatment. Hospital or other healthcare facility personnel are said to have a duty of care because they are either employees or contractors for an agent that agrees to deliver services to a patient. Pharmacists also have a duty of care when they can reasonably foresee that their actions or inactions could reasonably cause harm to clients. Although all healthcare employees generally are expected to honor the duty of care for patients under their care, there have been cases where employees have successfully argued that they did not have a duty of care because provision of care would have violated their own ethical principles.

In healthcare, the duty a professional owes to an individual under his or her care is based on standards of care. Standards of care address the reasonableness of care and hold a professional accountable to deliver care as would a reasonable person with similar training and skills in similar circumstances. This is known as the reasonable-person standard.

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