Doctors should admit their mistakes.

"Doctors are frightened of malpractice" a comment recently made on his colleagues by a former director of the United States National Cancer Institute [1]. In Britain a remorseless increase in the number of actions against doctors by patients and their relatives and the cost of such actions has led to the government taking over responsibility for compensation for medical negligence [2]. In North America doctors in high risk specialties such as obstetrics and gynaecology are restricting the range of disorders they will treat in order to keep down malpractice insurance premiums. Around the world lawyers are encouraging the belief that any patient who perceives the results of medical treatment as less than 100% successful should go to court to demand damages. Is this ever increasing confrontation between doctors and patients a trend that will continue throughout the 1990s? Will even more doctors practise defensive medicine? Or is there some way of restoring confidence on both sides of the consultation desk so that malpractice litigation reverts to what it should be a rarity that indicates that something has gone very seriously wrong? The malpractice epidemic has its origins in a series of related but independent changes in attitudes that have developed in the last two decades. Firstly, in most western countries the general public has become aware that going to law may be financially rewarding. Victims of road traffic accidents have expected recompense since the 19th century, but these expectations have now extended to individuals who believe themselves harmed by defective foods, drinks, or other products, who lose their jobs, or find themselves discriminated against.