Malpractice reform advocates suggest that medical care consistent with established practice guidelines may serve as a “safe harbor” to protect physicians from medical malpractice litigation. Last year, the state of Oregon completed work on a federally funded study exploring potential improvements to both patient safety and the medical liability system through implementation of medical practice guidelines. The study evaluated whether adoption of guidelines may provide greater clarity of the standard of care expected of practitioners while affording liability protection (safe harbor) when followed.

The concept of safe harbor legislation is not new. In 1990, Maine adopted legislation applying practice guidelines to four high-liability-risk specialties (anesthesiology, emergency medicine, OB/GYN and radiology). Under the state’s plan, compliance with guidelines could be pleaded by providers alone (“one sided” use) as a defense against a malpractice claim. Since enactment, only one...

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