The Judge, the Legislator and … the Mediator. The Long Journey of Medical Malpractice in Italy

This contribution intends to describe the main features and the evolution of the system to compensate patients for damages caused by healthcare in Italy. In the first part, it outlines the main traits of the regulation developed by the courts on the basis of the general principles established by the civil code, highlighting the gradual shift in favour of patients. Then, it concentrates on the significant legislative measures passed in the last few years in order to tackle the crisis of medical malpractice litigation and reduce the overall costs of the system. The second part focuses on the development of alternative methods of dispute resolution in the field of medical malpractice. The two main ADR processes on which the Italian legislator relies as tools to reduce the number of cases dealt with by the courts are compulsory mediation, established in 2010, and the “pre-action expert report” (accertamento tecnico preventivo—ATP), that, according to the recent Gelli Bianco law is now the main ADR process for all medical malpractice cases.