Defensive medicine takes place when hospital staff performs unnecessary treatments, or avoids high-risk procedures to reduce its exposure to malpractice litigation. Doctors in particular prescribe tests, procedures or specialist visits (positive defensive medicine), or, alternatively, avoid high-risk patients or procedures (negative defensive medicine). Defensive medicine is a damaging effect of medical litigation. It increases the cost of the healthcare system and exposes patients to unnecessary risks. The number of negligence claims against doctors is continuously increasing (by +4,1% between 2006 and 2007 in Italy; ANIA, 2009). A large number of legal initiatives taken by patients have induced many doctors to adopt a defensive “strategy” to avoid jeopardizing their careers. The threat of medical malpractice litigation constitutes a serious obstacle to improving the reliability of healthcare organizations and patient safety.