Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 14, 2025
Date Accepted: Sep 19, 2025
On the influence of apologies on the likelihood of lawsuits in cases of perceived medical negligence: Analysis of archival and experimental data
ABSTRACT
Background:
Disappointing Medical Care (DMC) encompasses cases of medical failures, malpractice, or errors. Literature suggests that individuals' perceptions of harm resulting from medical procedures influence their likelihood of seeking legal recourse and that apologies may mitigate the inclination for legal action.
Objective:
Here, we aim to scrutinize and potentially challenge this prevailing notion.
Methods:
We conducted four studies utilizing a dataset of 3815 social media posts detailing possible DMCs incidents to which we link a proxy for legal action. Two preregistered crowdsourcing studies were conducted to assess the impact of different apology types on intention-to-sue. Additionally, two studies investigated the ability to predict legal action from either the language of posts (and reactions to them) or from attributes of the posts.
Results:
Results show that apologies are rarely mentioned in descriptions of DMCs and that the descriptions of DMCs predict the proxy of legal action (Area Under Curve: 0.82). Crowdsourcing studies reinforce these findings and demonstrate that physical and emotional damage are independently the strongest predictors of intention to sue.
Conclusions:
Apologies appear to exert little influence on individuals' intent to pursue legal action in DMC cases. This suggests that medical providers aiming to mitigate legal risks must explore alternative interventions beyond apologies. Clinical Trial: AsPredicted #114542 & #148676
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