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Book cover for Closing Death's Door with xray of chest that shows scissors inside
January 2021
Oxford University Press

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Closing Death’s Door

Legal Innovations to End the Epidemic of Healthcare Harm
Michael J. Saks
Stephan Landsman

After heart disease and cancer, the third leading cause of death in the United States is iatrogenic harm (avoidable injury or infection caused by a healer). Research suggests that avoidable errors claim several hundred thousand lives every year. The principal economic counterforce to such errors, malpractice litigation, has never been a particularly effective deterrent for a host of reasons, with fewer than 3% of negligently injured patients (or their families) receiving any compensation from a doctor or hospital's insurer. Closing Death's Door brings the psychology of decision-making together with the law to explore ways to improve patient safety and reduce iatrogenic injury, when neither the healthcare industry itself nor the legal system has made a substantial dent in the problem. The authors describe the scope of the problem, as well as unsuccessful efforts by the healthcare industry, as well as law, to effectively address the problem. The authors offer a set of ideas intended to start a conversation that will lead to new legal policies that lower the risk of harm to patients.


Michael J. Saks is a Regents Professor in the Sandra Day O'Connor College of Law and Department of Psychology at ASU. Saks’ research interests focus on empirical studies of law and the legal system, especially decision-making in the legal process, evidence law, the law's use of science, the behavior of the litigation system and legal policy affecting medical patient safety.