Virtual reality evidence on the impact of physicians' open versus defensive communication on patients.

Using virtual reality (VR) in an experimental setting, we analyse how communicating more openly about a medical incident influences patients' feelings and behavioural intentions. Using VR headsets, participants were immersed in an actual hospital room where they were told by a physician that a medical incident had occurred. In a given scenario, half of the participants were confronted by a physician who communicated openly about the medical incident, while the other half were confronted with the exact same scenario except that the physician employed a very defensive communication strategy. The employed technology allowed us to keep everything else in the environment constant. Participants exposed to open disclosure were significantly more likely to take further steps (such as contacting a lawyer to discuss options and filing a complaint against the hospital) and express more feelings of blame against the physician. At the same time, these participants rated the physician's communication skills and general impression more highly than those who were confronted with a defensive physician. Nevertheless, communicating openly about the medical incident does not affect trust in the physician and his competence, perceived incident severity and likelihood of changing physician and filing suit.

Sanctions for Intimate Partner Sexual Violence: Is the Law on the Books the Law in Action?

Intimate partner sexual violence (IPSV) is common, yet in many jurisdictions the law still does not adequately recognize it. In those jurisdictions that have formally criminalized IPSV, little is known about the extent to which IPSV-related law on the books is implemented in practice. Especially scarce is systematic quantitative evidence on the processing of IPSV cases by the justice system. We investigate unique case-level court data on the processing and sanctioning of violent sex crime cases in Belgium, a jurisdiction where the law adequately criminalizes IPSV, but where criminal judges are afforded broad sentencing discretion. Our data allow us to observe both the conviction and the sentencing decision. Consequently, we are able to address the endogenous sample selection concerns that arise in the assessment of IPSV-related sentencing disparities by estimating a full-fledged sample selection model. Upon inclusion of a broad range of defendant, victim, and other case controls, we show that defendants who are the victims' spouses or partners receive statistically significantly shorter prison sentences than defendants who are unrelated to the victims, in the sense that they are neither the victims' current or former spouses nor family. The documented extralegal disparity is quantitatively noteworthy and survives a series of robustness checks as well as alternative model specifications. Our analysis thus lends empirical credibility to the perspective that while national legislatures have often been slow to address IPSV, the justice systems may be even slower at internalizing the corresponding law. Our evidence-based insight into de facto legal responses to IPSV is of direct relevance to many jurisdictions globally.

The resolution process and the timing of settlement of medical malpractice claims.

We draw on uniquely detailed micro-level data from a Belgian professional medical liability insurer to examine how different procedural and legal events that take place during the unfolding of a medical malpractice claim influence the timing of its settlement. Utilizing the competing risks regression framework, we find that settlement hazard is all else equal statistically significantly positively associated with the completion of those procedural and legal events that most effectively reveal factual information about the underlying medical malpractice case. Consistent with theory, settlement hazard is either unassociated or even negatively associated with the completion of other procedural and legal events. Our analysis, therefore, provides policy insights into which aspects of the resolution process could be emphasized, and which de-emphasized, in order to reduce the often excessive duration of medical malpractice claims and its adverse effects on the healthcare system.

Investigating medical malpractice victim compensation: micro-level evidence from a professional liability insurer's files.

We examine micro-level data on medical incidents recorded by a major Belgian professional liability insurer to identify the predictors of medical malpractice victim compensation. The data allow us to track each instance of suspect medical malpractice from the moment of insurer's knowledge about the incident to file closure. We are, therefore, able to investigate the determinants of both the incidence and amount of indemnity payment while addressing the associated sample selection concerns. Conditional on some indemnity having been paid, provider specialty risk predicts the indemnity payment amount, but only via the effect of sustained injury type. We find little evidence of vertical or horizontal inequities in indemnity payment. Our results highlight previously overlooked features of the incident resolution process as quantitatively important predictors of victim compensation.