A unanimous jury decision recently awarded $20 million to the family of a Minnesota woman who died after giving birth. Plaintiff attorneys are calling the judgment the largest wrongful death malpractice verdict in the state’s history. The case is raising longstanding questions about the fairness and cost of malpractice lawsuits.

Limiting malpractice damages long has been on the agenda of those who argue that awards – especially in jury trials – often are based on emotion more than facts. They also claim that the threat of high awards results in “defensive medicine” in which doctors and health providers order tests and treatments that may not be medically necessary, but demonstrate thorough care should anything go wrong.

Proponents of the current system counter that malpractice suits have reduced medical errors and make care providers more accountable and transparent.

Reforms have advanced in some states over the past decade or so. Texas implemented some of the most comprehensive changes in 2003, limiting damages for pain and suffering in most malpractice cases to $250,000. While awards have come down, other promised benefits of the law have been mixed. For example, the law has not brought an influx of doctors to Texas or reduced medical costs as advocates predicted it would.

New York is considering a change in its laws that might be felt in Minnesota. A bill on its way to

Gov. Andrew Cuomo would expand the window during which a lawsuit can be filed. Rather than starting the clock at the time the action occurred, it now would begin at the time of discovery. That is the standard in 44 states, with Minnesota being one of the six outliers.

Defensive medicine does add to the cost of care. Most experts, though, put it in the 2-to-3 percent range, agreeing with the findings of a 2014 study published in the Journal of the American Medical Association. That analysis put the cost of defensive medicine at 2.9 percent of total medical spending. In a health system as expensive as the United States, that’s not an insignificant amount of money, but at best it is a small part of the answer to controlling medical costs.

More creative solutions are needed, especially those that encourage continued efforts by health providers to reduce medical errors while protecting the rights of those patients who have been harmed. One proposal offered in the journal Health Affairs suggests policy trade-offs (an abstract of the article is here; the full article is available by subscription). The authors suggest that federal limits on malpractice reforms be tied to reforms that would make the cost and quality of medical services more transparent and expand practice privileges for health professionals like physician assistants, among other changes.

There is no financial award that will fully compensate the Minnesota family for the loss of a mother and wife. But smart reforms can protect those who truly are harmed while improving the medical care system for everyone.