American Law Institute Sets New Standards for Medical Malpractice, Less Focused on Customary Practices

New malpractice standards shift focus of proper medical care to a more patient-centric approach.

An independent legal group recommends that U.S. courts should evaluate medical malpractice claims by scrutinizing the specific care provided to each patient, rather than relying on the general practices of healthcare providers.

Medical malpractice occurs when a healthcare provider fails to meet established standards of care, leading to patient harm. These standards are professional norms that dictate the level and type of care that reasonably competent practitioners would provide under similar circumstances. Essentially, they serve as a benchmark for evaluating whether healthcare professionals have performed their duties with the necessary level of skill and care. 

Deviations from these standards can range from errors in diagnosis, treatment, aftercare, or health management, each potentially resulting in adverse patient outcomes. Medical malpractice claims hinge on proving such deviations, demonstrating that they directly caused harm, which could have been avoided had the proper standards been followed.

In May 2024, the American Law Institute (ALI), an independent organization committed to modernizing and clarifying the law, implemented new guidelines for medical malpractice. These new guidelines from ALI seek to address the complexities involved in evaluating individual patient treatments rather than broadly applied medical standards.

However, a recent study published in the Journal of the American Medical Association (JAMA) on February 26, highlights that doctors frequently resort to “defensive medicine,” practicing overly cautious medical care primarily to avert malpractice lawsuits. The study suggests that ALI’s new guidelines could significantly alter this trend by providing physicians with greater autonomy and enhancing patient safety.

The research team, led by Daniel J. Aaron of the University of Utah, noted that traditional medical malpractice evaluations heavily relied on “customary practices” to determine whether a physician had provided reasonable care. However, Aaron’s team highlights that the new guidelines shift this focus, now emphasizing the skill and knowledge of competent clinicians in comparable situations to establish the standard of care.

In addition, the ALI’s guidelines say that juries can override the traditional definition of “customary practices” in a given setting, if those practices are not up to contemporary standards.

The researchers determined that this might lead to a shift away from reliance on medical customs to a greater reliance on evidence-based medicine when determining whether malpractice has occurred, which could allow for greater physician autonomy when treating patients.

However, Aaron’s team points out that different states will adopt ALI’s recommendations at different times and to varying degrees. For this reason, the team indicates that courts will most likely rely on the old standards of “customary practices” for some time.

Medical Malpractice Lawsuits

One of the leading causes of medical malpractice lawsuits in the U.S. is misdiagnosis, with studies indicating that diagnostic errors can be linked to 800,000 U.S. deaths and disabilities each year.

Prior studies have also highlighted medical misdiagnosis lawsuits as being among the leading causes of malpractice payouts in the U.S., accounting for 35% of insurance claims.

These kinds of lawsuits often allege doctors have mistakenly diagnosed serious disease symptoms as less severe conditions, which can result in delayed treatment of the actual problem. To reduce the risk of a medical misdiagnosis, health experts recommend several important actions patients can take, including:

• Keeping thorough records of their personal medical history,
• Staying informed about diagnostic tools, medical research and treatment options, and
• Following up with providers about treatment plans and next steps for any chronic or recently diagnosed health conditions.