Patient safety and the law in Canada
Patient safety initiatives are increasingly at the forefront in health policy and health care, sparked initially by the 1999 release of the Institute of Medicine’s infl uential report, To Err Is Human , in the United States. 1 That report highlighted not only the frequency and gravity of preventable patient injury, but also the need to address the role played by systemic factors in order to improve the safety and quality of health care. Its insights into the genesis of error soon prevailed in policy discourse in other countries as well, reframing the debate about how to make care safer. However, the extent to which this approach can be incorporated into legal reasoning and how best to do so are still unclear. Lawsuits remain the primary means to resolve claims for harm caused by defi cient care, and in negligence law, liability and entitlement to recover damages are premised on a fi nding of fault. The disjunction between law and patient safety is signifi cant, because law plays a large part in shaping the environment for the provision of health care, assessment of risks, and responses to adverse events by all concerned.