Institutionalizing Medical Malpractice Mediation: Can Hospital-Based Alternative Dispute Resolution Replace Judicial Litigation for Low-to-Mid Tier Medical Negligence Claims
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Abstract
The protracted nature, escalating costs, and adversarial structure of judicial litigation for low-to-mid tier medical negligence claims often deepen the trauma experienced by patients and strain the professional well-being of clinicians. This paper investigates the viability of institutionalizing hospital-based alternative dispute resolution (ADR), specifically structured mediation, as a compassionate and systematic replacement for conventional tort litigation in lower-stakes clinical disputes. By analyzing existing models of early disclosure and offer programs, comparative institutional economics, and legal barriers regarding confidentiality and patient power asymmetry, this study evaluates whether hospital-sponsored mediation can foster equitable settlements, preserve the therapeutic relationship, and reduce systemic transaction costs without compromising patient rights. The findings suggest that while internal mediation models drastically reduce resolution timelines and legal overhead, their long-term efficacy depends heavily on establishing institutional neutrality, mandatory binding disclosure protections, and independent ombudsman oversight to prevent power imbalances. Ultimately, this research posits that integrating institutionalized ADR into hospital risk-management frameworks can transform medical malpractice from an alienating, zero-sum legal contest into a proactive, patient-centered feedback loop that honors both accountability and healing
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