Written by: Lexi Sipos
Introduction
Healthcare workers in America are arguably the backbone of our society, so why aren’t they protected accordingly? According to the American Medical Association Code of Ethics, which outlines professional responsibility expectations, “When a patient suffers significant medical complications that may have resulted from the physician’s mistake or judgment, the physician is ethically required to disclose to the patient all the facts necessary to ensure understanding of what has occurred.”[1] While this rule serves to protect the public by promoting transparency, it neglects to safeguard the doctors, nurses, and other healthcare professionals. Healthcare professionals put themselves at the risk of liability daily for the purpose of helping aid the general public, which is a forgotten thought in the eyes of the law. To combat this concern, thirty-nine states have implemented “I’m Sorry Laws.”[2]
The Foundations
Terminology
I’m sorry laws, also known as apology laws, are laws that shield healthcare workers who make statements of sympathy following a disruptive incident from having those same statements used against them in court.[3] For example, Virginia has enforced their own version of these laws:
“In any wrongful death action brought pursuant to § 8.01-50 against a health care provider, or in any arbitration or medical malpractice review panel proceeding related to such wrongful death action, the portion of statements, writings, affirmations, benevolent conduct, or benevolent gestures expressing sympathy, commiseration, condolence, compassion, or a general sense of benevolence, together with apologies that are made by a health care provider or an agent of a health care provider to a relative of the patient, or a representative of the patient about the death of the patient as a result of the unanticipated outcome of health care, shall be inadmissible as evidence of an admission of liability or as evidence of an admission against interest.”[4]
While Virginia has enforced all-inclusive apology statutes such as the above, several states do not offer such protections to their health care providers. The fourteen states that do not have apology laws on the books are: Alabama, Arkansas, California, Florida, Illinois, Kansas, Kentucky, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, New York, and Rhode Island.[5]
Analyzing the current landscape
Certain states have actually opened health care providers up to additional liability. Rather than offering protections to these providers, Florida, Nevada, New Jersey, Pennsylvania and Vermont have added mandatory notification requirements of an adverse healthcare event.[6] New Jersey’s law helps visualize these broad public safety protections but lacks representation for health care professionals.
“A health care facility shall report to the Department or, in the case of a State psychiatric hospital, to the Department of Human Services, every serious preventable adverse event that occurs in the facility.”[7]
The specific language indicating a “serious preventable adverse event” is consequential. New Jersey defines an “adverse event” as “an event that is a negative consequence of care that results in unintended injury or illness, which may or may not have been preventable.”[8] The addition of “may not have been preventable” has broadened the scope for healthcare professionals to be liable for the unexpected.
The repercussions can be vast. What if a healthcare worker does not say “I’m sorry,” while explaining that there was a medical emergency resulting in someone’s death? You might predict that the humane approach would be to show empathy and offer apologies for someone’s loss by expressing an “I’m sorry.” However, the system does not afford doctors, nurses, and other healthcare workers such freedom. How can the law promote honesty, a humane value, but discourage empathy?
Emotional Analysis
Empathy is the backbone of the healthcare profession. The provision of health care is service-oriented work that encompasses care for patients of all ages, beliefs, and values.[9] It is difficult to imagine that the law is trying to strip the profession of the very characteristic that fuels it.
In the past, and is still the case today, healthcare providers were advised to deny and defend every single allegation of medical negligence even when the healthcare provider knew something went wrong.[10] This creates a conflict with the healthcare worker’s instinct to offer help, which includes easing sadness. Denial of negligence in such cases can cause animosity towards healthcare workers and the system[11] According to Micheal Smith, author of “I’m Sorry Laws: What’s a Respiratory Therapist’s Apology Worth?”, “Angry people are more likely to file lawsuits, and angry people are less likely to settle their lawsuits early.”[12] Empathy is not being embedded into the foundation of the law. Rather, it is further angering plaintiffs.
More importantly, “an upfront apology or expression of sympathy can relieve anger and frustration and reduce the level of emotion, paving the way for a quick settlement rather than lengthy and costly litigation.”[13] At the end of the day, patients are humans looking for a human connection to offer answers, but it must be remembered that healthcare professionals share this same sentiment. Admittedly, the healthcare professional’s discussion with the patient’s family can be reduced down to a simple recollection of what happened. However, the benefit of an expression of empathy in that conversation cannot be overlooked.
Societal Implications
Healthcare professionals are held to a higher standard than the general public. A concrete example of this is manifested in the Federal Rules of Evidence, Rule 409, Offers to Pay Medical or Similar Expenses in civil cases.[14] The rule explicitly states:
“Evidence of furnishing, promising to pay, or offering to pay medical, hospital, or similar expenses resulting from an injury is not admissible to prove liability for the injury.”[15] This rule’s purpose is to protect human instincts and “humanitarian motives.”[16] The importance behind this is in part because when an individual breaks public laws, they are offered a safeguard to the human impulse to apologize. Meanwhile, healthcare workers are not afforded the same opportunity to console their patients and loved ones.
Conclusion
Ultimately, while over half of the states have successfully passed I’m sorry laws, healthcare workers in many states remain unprotected. California is the third largest state in the county with no safeguard for their healthcare professionals to offer empathy in the wake of a tragedy.[17] As a result, while the human conscience naturally wants to show empathy, these laws serve as a reminder and stop sign that all healthcare workers need to protect themselves from fear of suit. The law takes away the agency for healthcare workers to decide: how to console the patient? The harsh reality is that they must prioritize transparency over humanity, and it can be detrimental to American society.
[1] Flauren Fagadau Bender, AMA Journal of Ethics, “I’m Sorry” Laws and Medical Liability, https://journalofethics.ama-assn.org/article/im-sorry-laws-and-medical-liability/2007-04.
[2] Heather Morton, National Conference of State Legislatures, Medical Professional Apologies Statutes, (Aug. 2, 2021), https://www.ncsl.org/financial-services/medical-professional-apologies-statutes.
[3] See Flauren Fagadau Bender, AMA Journal of Ethics, “I’m Sorry” Laws and Medical Liability, https://journalofethics.ama-assn.org/article/im-sorry-laws-and-medical-liability/2007-04 (explaining that patients or their loved ones can sue health care workers for an error made); See also Michael L. Smith, I’m Sorry Laws: What is a Respiratory Therapist’s Apology Worth, The Health Law Firm, https://www.thehealthlawfirm.com/resources-and-documents/im-sorry-laws/.
[4] Va. Code Ann. § 8.01-52.1 (2025).
[5] Heather Morton, National Conference of State Legislatures, Medical Professional Apologies Statutes, (Aug. 2, 2021), https://www.ncsl.org/financial-services/medical-professional-apologies-statutes.
[6] Flauren Fagadau Bender, AMA Journal of Ethics, “I’m Sorry” Laws and Medical Liability, https://journalofethics.ama-assn.org/article/im-sorry-laws-and-medical-liability/2007-04.
[7] N.J. Admin. Code § 8:43E-10.6 (2026).
[8] N.J. Stat. Ann. § 26:2H-12.25 (2025).
[9] 10 Must-Have Characteristics for Health Care Professionals, University of Minnesota Twin Cities, (Sept. 20, 2023) https://ccaps.umn.edu/story/10-must-have-characteristics-health-care-professionals.
[10] Michael L. Smith, I’m Sorry Laws: What is a Respiratory Therapist’s Apology Worth, The Health Law Firm, https://www.thehealthlawfirm.com/resources-and-documents/im-sorry-laws/.
[11] Id.
[12] Id.
[13] Flauren Fagadau Bender, AMA Journal of Ethics, “I’m Sorry” Laws and Medical Liability, https://journalofethics.ama-assn.org/article/im-sorry-laws-and-medical-liability/2007-04.
[14] Fed. R. Evid. 409
[15] Id.
[16] Id.
[17] Amy Tikkanen, What is the Largest U.S. State by area, Britannica, (Feb. 16, 2026), https://www.britannica.com/topic/largest-U-S-state-by-area.