First, do no harm, second, say sorry? Investigating the impact of a new tort reform

Abstract We investigate the effect of so-called “apology laws” on physician procedure choice and birth outcomes. Advocates believe they may reduce litigation since a harmed person who receives an apology or explanation may be less likely to sue, all else equal. In the medical context, this could translate into a reduction in defensive medicine practiced. To investigate this possibility, we examine the impact of these laws on the use of C-sections, a common measure for gauging the practice of defensive medicine by OB/GYN physicians. We find consistent evidence that “partial” versions actually increase the use of C-sections, contrary to the intention of these laws. More specifically, we find it is older, presumably more established physicians who respond the most. Moreover, we also find some evidence that these particular laws also reduced the rate of preventable pregnancy complications, which suggests that the extra C-sections induced may not just represent defensive medicine (JEL I10, I18, K13).