Dr. Tony Holohan:

I would like to be able to tell the Chairman that there are multiple systematic reviews published that address these questions, but there is a lot of literature. The literature points to a situation whereby when disclosure happens in the way that I am describing where trust and confidence is maintained, it reduces the likelihood of litigation. There are examples in jurisdictions where mandatory notification has been introduced where they have been able to demonstrate that there has been a reduction in the activity in terms of litigation.

Certainly, one of the fears is that individuals may feel that by making a disclosure they are contributing in some way to their own legal risk, etc., and that is part of the reason for the protection here. It may almost be counterintuitive that a full implementation of an open disclosure with the balance between what we have struck here - mandatory in some cases but voluntary protections in the majority - is all aimed at ensuring that it is not optional and that it happens in every circumstance, and if it happens in every circumstance that it might contribute to a reduction in the likelihood of medical legal cases.