The Journal of Legal Medicine, 27:55–70 Copyright C  2006 Taylor & Francis Group, LLC 0194-7648/06 $12.00 + .00 DOI: 10.1080/01947640500533317 MOTIVATIONS FOR MEDICO-LEGAL ACTION LESSONS FROM NEW ZEALAND Marie Bismark, MBChB, LL.B., MBHL * Edward A. Dauer, LL.B., M.P.H. † INTRODUCTION A tangle of motives lies behind a patient or family’s decision to take legal action following medical injury, and money is only one of them. 1 These mo- tives, which all can be considered to represent a demand for some form of “ac- countability,” generally fit into four themes: 2 restoration, including financial compensation or some other intervention to “make the patient whole again”; correction, such as a system change or competence review to protect future patients; communication, which may include an explanation, expression of responsibility, or apology; and sanction, including professional discipline or some other form of punitive action. Previous studies exploring patients’ reasons for filing a malpractice suit have identified a similar spectrum of needs. In the United States, factors that have prompted claims among families of children with severe perinatal injuries have been studied. 3 Even though these families presumably faced significant * Marie Bismark was a 2004-2005 Harkness Fellow in Healthcare Policy at the Department of Health Policy and Management, Harvard School of Public Health. This Harkness Fellowship research was funded by the Commonwealth Fund, a private New York-based foundation that supports independent research on health and social issues. The views expressed in this article are those of the authors. Please address correspondence to Dr. Marie Bismark at mariebismark@gmail.com. † Edward Dauer is Dean Emeritus and Professor of Law at the University of Denver Sturm College of Law, and Visiting Scholar in the Division of Public Health Practice, Harvard School of Public Health. The authors thank David Studdert, Ron Paterson, and Barry Dorn for their contributions to this article. 1 Edward A. Dauer, The Four Dimensions of the Accountability Motive: Sanction, Correction, Restoration, and Communication, XXIXth International Congress on Law and Mental Health (July 4, 2005); Gerald B. Hickson et al., Factors that Prompted Families to File Medical Malpractice Claims Following Perinatal Injuries, 267 J.A.M.A. 1359, 1362 (1992); Charles Vincent et al., Why Do People Sue Doctors? A Study of Patients and Relatives Taking Legal Action, 343 LANCET 1609, 1612 (1994). 2 Edward A. Dauer, The Role of Accountability in Legal and Ethical Responses to Medical Error (forth- coming 2006). 3 Hickson et al., supra note 1, at 1359; FRANK A. SLOAN ET AL., SUING FOR MEDICAL MALPRACTICE 65-68 (1993). 55