We estimate the extent of defensive medicine by physicians during labor and delivery, drawing on a novel and significant source of variation in liability pressure. In particular, we embrace the no‐liability counterfactual made possible by the structure of liability rules in the Military Heath System. Active‐duty patients seeking treatment from military facilities cannot sue for harms resulting from negligent care, while protections are provided to dependents treated at military facilities and to all patients—active‐duty or not—who receive care from civilian facilities. Drawing on this variation and addressing endogeneity in the choice of treatment location by estimating mother fixed effects specifications and by exploiting exogenous shocks to care location choices stemming from base‐hospital closures, we find suggestive evidence that liability immunity increases cesarean utilization and treatment intensity during childbirth, with no measurable negative effect on patient outcomes.

中文翻译：

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防御医学和产科实践：军事卫生系统的证据

我们利用责任压力变化的新颖而重要的来源来估计医生在分娩和生产过程中的防御医学程度。特别是，我们接受了军事卫生系统中责任规则结构所带来的无责任反事实。从军事设施寻求治疗的现役患者不能起诉因疏忽照顾而造成的伤害，而向在军事设施接受治疗的受抚养人和所有从民用设施接受治疗的患者（无论是否现役）提供保护。通过估计母体固定效应指标并利用外源性电击来护理因基础医院关闭而产生的护理部位选择，利用这种差异并解决治疗部位选择中的内生性，