My lede:

When you hurt someone, saying “sorry” may seem like the least you can do. But when the hurt occurs in the medical arena, offering an apology is not so easy.

Thirty-five states have laws offering some kind of legal protection for physicians who express regret or empathy to patients who experience an adverse event. But laws vary in what they protect from admissibility in court. Most insurers discourage doctors from apologizing for fear it could hurt them in court, and lawyers often advise against it.

Hospitals are required to tell patients about serious mistakes. But it is unclear to what extent disclosure policies are followed, and these disclosures may not be accompanied by apologies.

More than a decade since studies first showed that openness and apology might work, “I’m sorry” is still rarely uttered in medicine.

The whole shebang.