New York state lawmakers are confronted with critical decisions in the legislative session that relate to patient safety, stability of liability insurance rates, and a proposal urging a radical change for brain injured newborns because they have the most serious injuries. The American College of Obstetricians and Gynecologists (ACOG) is the national professional organization for obstetricians. ACOG's proposed bill submitted to our Legislature seeks legal immunity (no fault).

ACOG has maintained that large payments in cases claiming oxygen deprivation at birth as a cause of neurologic impairment are meritless. ACOG's premise is that oxygen deprivation (a potentially avoidable event) rarely causes disabling brain damage and thus payment on meritless cases proves that the civil justice system does not work for their members who, therefore, should have liability immunity through a no-fault system.

The obligation to pay acts as a warning that the law demands the exercise of due care (accountability). That accountability has created financial and other incentives that have promoted patient safety.

The American Society of Anesthesiologists (ASA), the national professional society for anesthesiologists, is an example of one organization that recognized this concept. In the 1980s, the ASA used information learned from liability cases to adopt mandatory safety standards. As a result, they made the administration of anesthesia safer. For example, they dramatically cut their anesthetic related mortality rates from about one for every 5,000 to 10,000 procedures to one per every 200,000 procedures⁴ and also, their liability insurance premiums dropped dramatically. Anesthesia is an intrinsically hazardous undertaking yet the specialty has been cited as a model for reducing patient errors.