How different countries respond to adverse events whilst patients’ rights are protected

Eva Gil-Hernández, Irene Carrillo, Mary Elizabeth Tumelty, Einav Srulovici, Kris Vanhaecht, Katharine Ann Wallis, Priscila Giraldo, María Pilar Astier-Peña, Massimiliano Panella, Sofia Guerra-Paiva, Sandra Buttigieg, Deborah Seys, Reinhard Strametz, Asier Urruela Mora, José Joaquín Mira

Research output: Contribution to journalArticlepeer-review


Patient safety is high on the policy agenda internationally. Learning from safety incidents is a core component in achieving the important goal of increasing patient safety. This study explores the legal frameworks in the countries to promote reporting, disclosure, and supporting healthcare professionals (HCPs) involved in safety incidents. A cross-sectional online survey was conducted to ascertain an overview of the legal frameworks at national level, as well as relevant policies. ERNST (The European Researchers’ Network Working on Second Victims) group peer-reviewed data collected from countries was performed to validate information. Information from 27 countries was collected and analyzed, giving a response rate of 60%. A reporting system for patient safety incidents was in place in 85.2% (N = 23) of countries surveyed, though few (37%, N = 10) were focused on systems-learning. In about half of the countries (48.1%, N = 13) open disclosure depends on the initiative of HCPs. The tort liability system was common in most countries. No-fault compensation schemes and alternative forms of redress were less common. Support for HCPs involved in patient safety incidents was extremely limited, with just 11.1% (N = 3) of participating countries reporting that supports were available in all healthcare institutions. Despite progress in the patient safety movement worldwide, the findings suggest that there are considerable differences in the approach to the reporting and disclosure of patient safety incidents. Additionally, models of compensation vary limiting patients’ access to redress. Finally, the results highlight the need for comprehensive support for HCPs involved in safety incidents.

Original languageEnglish
JournalMedicine, Science and the Law
StateAccepted/In press - 2023

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the European Cooperation in Science and Technology, (grant number CA19113).

Publisher Copyright:
© The Author(s) 2023.


  • compensation
  • disclosure
  • healthcare professionals
  • legal frameworks
  • patient safety
  • Quality of care
  • second victims

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health Policy
  • Law


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