Clinical risk management has been defined elsewhere as: “a particular approach to improving the quality of care, which places special emphasis on occasions on which patients are harmed or disturbed by their treatment.” Litigation undoubtedly provides the impetus for risk management on both sides of the Atlantic, but its main focus should be the prevention of harm to patients. The stated aims of this book are different: it begins by asking what are the factors that lead to medical malpractice lawsuits? This, then, is a textbook about how to avoid litigation. It is not about the avoidance of harm to patients.

To concentrate only on those episodes of patient care that result in litigation is to …