Confidence in a country's health care system, its viability, its smooth functioning and patient safety require indemnification and deterrence systems that: Adequately cover liability, both that of the medical practitioner and the health care establishment; Provide fair compensation of injury; and Deter medical malpractices. Over the last years, in many OECD countries, these systems have experienced difficulties resulting in high-risk specialty physicians and surgeons leaving the practice and the development of expensive and useless-if not risky-defensive medicine.This publication surveys and assesses various types of mechanisms and reforms implemented and refined in OECD countries that best limit and indemnify medical accidents. Reasons for difficulties faced by some compensation and prevention regimes, given the specificities of national circumstances and in particular of health care systems, are examined.The study offers a series of unique and focused policy options and suggestions of interest for private and public parties in countries in the process of establishing a more efficient indemnification and deterrence system to cope with medical accidents.