I agree that it is incomplete and, indeed, untrue, to suggest that none of Canada's incidents and errors is reported or analyzed because of fear of litigation. However, the fact remains that medical error is underreported in Canada.1 The question is why. There are myriad reasons: the lack of a supportive environment is one, fear of legal reprisal is another. The Canadian Medical Protective Association has stated that people reveal medical errors at their legal peril because “there is no privilege [exemption from legal action] following disclosure.”2 Evidence acts come under provincial and territorial jurisdiction and therefore differ substantially. Changing this legislation would be an easier — and less expensive — approach to alleviating this problem, at least when compared with instituting supportive environments. Let's hope it's only the first of many steps.
Barbara Sibbald Associate News Editor CMAJ